Pennsylvania Pharmacist May/June 2013

The official publication of the Pennsylvania Pharmacists Association

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO 533

May/June 2013 z Volume 94 z Issue 3

Pharmacists Making It Fair for Local Care www.papharmacists.com

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PPA Board of Directors PPA Officers: President: Robert B. Frankil, RPh President Elect: J. Scott Miskovsky, RPh First Vice President: Eric R. Esterbrook, RPh Second Vice President: Donna Hazel, RPh Immediate Past President: Adam C. Welch, PharmD, MBA, BCACP Regional Directors: Central: Janet Getzey Hart, RPh Northeast: Jonathan D. Ference, PharmD, BCPS Northwest: Mary E. Grisnik, PharmD Southeast: David B. Cunningham, RPh Southwest: Lauren Simko, PharmD Academy Directors: Academy of Alternative Pharmacy Practice: Jamie McConaha, PharmD Academy of Pharmacy Technicians: Jennifer L. Simpson, CPhT Academy of Chain Pharmacists: Stephanie Harriman McGrath, PharmD Academy of Community Pharmacists: Martin J. Kendra, RPh Academy of Health System Pharmacists: Paul T. Kocis, PharmD, FASCP Academy of Long Term Care and Consultant Pharmacists: Brant Gahr, RPh Academy of Pharmacy Industry Association: Al Emmans Academy of Student Pharmacists: Tamiko Yamatani PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Ext. 3 Communications Coordinator: Erika Butts ebutts@papharmacists.com Ext. 2 Membership Coordinator: Corey Wenger cwenger@papharmacists.com Ext. 1 Program Coordinator: Sara Powers spowers@papharmacists.com Ext. 4 Government Relations Manager: Donald L. Smith, III Ext. 6 dsmith@papharmacists.com Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com ppa@papharmacists.com www.facebook.com/PAPharmacy www.twitter.com/papharmacists Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA. Editorial Board: Tara L. Pummer, PharmD, Chairman Hershey S. Bell, M.D., M.S., FAAFP Stephanie Smith Cooney, PharmD Bernard Graham, PhD Brian S. Plager, RPh, MBA Associate Editor: Erika Butts Editor/Manager: Pat Epple Published by: Graphtech Sarah DiCello, Publications Manager (717) 238-5751 sarah@thinkgraphtech.com For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 alexis@thinkgraphtech.com Designed by: Graphtech State Board of Pharmacy Members: Edward J. Bechtel, R.Ph. – Independent Community Gayle A. Cotchen, PharmD., MBA – Institutional Philip McCarthy – AG/Consumer Pauline Montgomery, R.Ph. – Independent Community Theresa M. Talbott, R.Ph. – Chain Community Mark J. Zilner, R.Ph. – Chain Community 2013 Board of Pharmacy Meeting Dates: January 15, February 19, March 19, April 16, May 14, June 18, July 16, August 20, September 17, October 15, November 19, December 10

Our Vision

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers.

Our Mission

The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

Pennsylvania

Departments

MAGAZINE

Message from the President . . . . . . . . . . . . . . . . . . . . . . . . 5 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Member News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 New Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Features Community Pharmacy Spotlight — McElroy’s Pharmacy . . . . . . . . . . 13 PPA Member Profile: Shelley Otsuka, PharmD . . . . . . . . . . . . . . . 15 Profiles in Pharmacy Innovation: Adam Wood, PharmD . . . . . . . . . . 16 Breaking New Ground in Chronic Pain Management . . . . . . . . . . . . 17 Financial Forum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Rx and the Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Association News Pennsylvania Student Pharmacists Attend PPA’s Annual Government Relations Advocacy for Student Pharmacists (GRASP) Program . . . . . . . . . 25 Pennsylvania Pharmacy Legislative Day “Making It Fair for Local Care” . 28 PPA Election Information & Ballot . . . . . . . . . . . . . . . . . . . . . . 30 Passion for Your Professional Association: My Rotation at PPA . . . . . . 31 Pharmacy Technician Corner . . . . . . . . . . . . . . . . . . . . . . . . 33 Welcome New Staff Member! . . . . . . . . . . . . . . . . . . . . . . . . 34 Member Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Industry News Pharmacy in World War II . . . . . . . . . . . . . . . . . . . . . . . . . . 39 The NCPA Adherence Challenge . . . . . . . . . . . . . . . . . . . . . 41

Pennsylvania Pharmacist I May/June 2013 I 3

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Departments

Robert Frankil, RPh PPA President 2012-2013

Article Head Message fromGoes the President Here Get (Others) Involved!

P

PA and pharmacy in Pennsylvania have a lot going for them right now. Over the last few years, membership has grown steadily for PPA, PharmPAC contributions have increased each year, pharmacist immunizations have become commonplace, and we got SB201 (now Act 207) passed into law for Equal Access to Community Pharmacy. It comes as no coincidence that applications for new pharmacies are also on the rise with the PA State Board of Pharmacy.

I can say with some confidence, that five years ago, not too many pharmacists in PA would have predicted that all these things could have been accomplished.

What it says to me is that with more pharmacists becoming active in PPA and other pharmacy associations, good things happen.

But by no means are we in a position to sit back and rest on our laurels.

Even with record membership, we can do better. PPA has about 2,000 members, and only about 1,000 are community pharmacists.

I believe there are more than 6,000

practicing community pharmacists in PA, and close to 20,000 pharmacists in all practice settings.

It is our job to ask (demand) our fellow pharmacists who are not members to join their state professional association. Other professions (dentists, physicians, real estate brokers, nurses, etc.) have a much higher penetration of members in their association.

Just think if PA had only 20% of pharmacists as PPA members, we would more than double membership.

While PharmPAC reached record numbers last year, we can do better. Our goal this year is $75,000. While this seems high, we only need $75 per year from each community pharmacist member to reach this goal. Less than $1.50 a week is a small price to pay for a strong voice on Capitol Hill.

Legislative victories depend on PAC money. It is no coincidence that SB201 was passed last session: Pharmacy was on the radar of legislators because we used PAC money to get face time with them and deliver our message.

But remember, our opponents will ramp up their efforts to try to defeat us next time and they

(insurance lobbies, PBMs) have deeper pockets than us. We need your contributions more than ever....give a gift to PharmPAC today.

Continue to expand your immunization practice. This is a stream of revenue that did not exist for us a few years ago.

Administering immunizations also increases our professional exposure to the public. Bills have been introduced in both the senate and house to lower the age for pharmacists to administer. After what happened last year with the flu, there is no reason why pharmacists should not be able to administer to those younger than 18. And remember, our license permits us to administer injectables, not just immunizations.

Think outside the box and look into administering other meds to expand your practice and bottom line.

Act 207 now requires most plans to offer a level playing field, so our patients will pay the same copay at all community pharmacies and mail order. This will affect plans as they expire and renew, so we Continued on page 11

Pennsylvania Pharmacist I May/June 2013 I 5

Departments Thank You to Our Corporate Partners These companies support PPA activities throughout the year.

PLATINUM LEVEL

GOLD LEVEL

SILVER LEVEL

BRONZE LEVEL

Calendar of Events May

21

29

CE Webinar: Trains, Planes, and Vaccines: A Journey into the World of Travel Medicine New Practitioner Lunch & Learn CE Webinar: Cure for the Summertime Blues: Review of Treating Lyme’s Disease and Sunburn

June

1-5

4

ASHP Summer Meeting, Minneapolis, MN Health System Pharmacist Lunch & Learn CE Webinar: Preceptor Development: Laying the Groundwork July

12 ACPA President’s Dinner 13-17 AACP Annual Meeting, Chicago, IL 26-27 PPA Board of Directors and Student Board Meeting and Leadership Retreat August 10-13 NACDS Total Store Expo, Las Vegas, NV 21-23 ASHP Residency Preceptors Conference, Washington D.C. September 22-24 ACCP Annual Meeting, Bethesda, MD 26-29 PPA Annual Conference, Gettysburg, PA

26 PPA Board of Directors October 12-14 NASPA Fall Meeting 12-16 NCPA Annual Convention, Orlando, FL 16-18 AMCP Educational Conference, San Antonio, TX November 19-22 ASCP Annual Meeting & Exhibition, Seattle, WA

21 PPA Board of Directors

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For additional events and PPA committee meetings be sure to see our Calendar of Events on the PPA website!

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6 I Pennsylvania Pharmacist I May/June 2013

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Departments Department

Member News LECOM Receives Awards From Safe Communities Erie

L

ECOM administrators walked away with the top Awards presented at the Safe Communities Erie Annual Meeting on February 13, 2013.

School of Pharmacy Dean Hershey S. Bell, MD received the Safe Communities Award of Achievement.

Dr. Bell spearheaded a project for LECOM using the White House Drug Policy for a prescription drug abuse project over the past two years.

The committee also recognized pharmacy school faculty member Kimberly Burns, RPh, JD, with the Distinguished Leadership Service Award. She has had a significant role in her partnership with the Erie County Department of Health – as Chairman for the Prescription Drug Abuse Task Force, state committee work with the Injury Prevention Planning Group, and national member of the Safe States Alliance.

LECOM School of Pharmacy at the PA Pharmacty Reception at APhA

Pennsylvania Pharmacy Reception at APhA Convention

P

PA, along with the seven schools of pharmacy in the Commonwealth, recently hosted a Pennsylvania Pharmacy Reception during the American Pharmacists Association (APhA) 2013 Annual Meeting.

This year marked the sixth year for the event which draws school alumni, current students and faculty from all seven schools along with PPA members and other Pennsylvania pharmacists.

Philadelphia College of Pharmacy at the PA Pharmacy Reception at APhA

University of Pittsburgh School of Pharmacy at the PA Pharmacy Reception at APhA

Duquesne University-Mylan School of Pharmacy at the PA Pharmacy Reception at APhA

8 I Pennsylvania Pharmacist I May/June 2013

Departments

Temple University School of Pharmacy at the PA Pharmacy Reception at APhA

Z Jennifer Malinowski, PharmD, Associate Professor of Pharmacy Practice at Wilkes University, was part of a panel of authors on a continuing education article, Treatment Options for Gout, which appeared in NCPA’s America’s Pharmacist, March 2013.

Z An article, “Taking a look at the WHOLE, Pharmacy owners discuss what’s most important in their relationships with their wholesaler partners,” by Bruce Kneeland, a national account manager with Epicor Software Solutions, appeared in NCPA’s America’s Pharmacist, April 2013.

PPA CEO Visits Pittsburgh Area PPA CEO Pat Epple recently visited student groups at both Duquesne University – Mylan School of Pharmacy and the University of Pittsburgh School of Pharmacy. She also attended an ACPA general meeting and presented a CPE program.

Thomas Jefferson University School of Pharmacy at the PA Pharmacy Reception at APhA

PPA CEO Pat Epple visits Duquesne University-Mylan School of Pharmacy students.

Wilkes University School of Pharmacy at the PA Pharmacy Reception at APhA

An article, “Patient-Centered Medical Home, Including pharmacists makes a difference in managing patient care” by Jamie L. McConaha, PharmD, GCP, BCACP, Assistant Professor of Pharmacy Practice at Duquesne University appeared in NCPA’s America’s Pharmacist, March 2013.

PPA CEO Pat Epple visits University of Pittsburgh School of Pharmacy students.

Continued on page 10

Pennsylvania Pharmacist I May/June 2013 I 9

Departments Member News

Continued from page 9

NACDS Rx Impact Day

runner-up. Ellen Feeney from Wilkes University and Meghan Mitchell from Temple University, were also top ten finalists. Congratulations to all three students!

Z Allegheny County Pharmacists Association (ACPA) recognized their 2012-2013 Scholarship winners at their meeting on March 18, 2013. Michael Basista, PharmD candidate, was awarded the scholarship for a Duquesne University-Mylan School of Pharmacy student and Deanna Rowe, PharmD candidate, was awarded the scholarship for a University of Pittsburgh School of Pharmacy student.

Pharmacists Caroline Athanis and Hemanshu Parikh from Rite Aid, Rick Gribik from Klingensmith’s Drug Store, Inc., and Don Smith, PPA’s Government Relations Manager, met with Congressman Tom Marino (PA) during the NACDS Rx Impact Day in Washington, DC.

Michael Basista is presented the ACPA scholarship by ACPA’s current President, Jamie L. McConaha, PharmD, GCP, BCACP, and President-Elect, Summer Bruchwalski, PharmD.

Pharmacists Caroline Athanis and Hemanshu Parikh from Rite Aid, David Cippel and Rick Gribik from Klingensmith’s Drug Store, Inc., and Don Smith, PPA’s Government Relations Manager, met with Congressman Glenn Thompson (PA) during the NACDS Rx Impact Day in Washington, DC. Z Three students from Pennsylvania schools of pharmacy were top ten finalists at the 2013 APhA-ASP National Patient Counseling Competition, held at the 2013 APhA Annual Meeting & Convention. Pamela Lyons from the University of Pittsburgh was first

10 I Pennsylvania Pharmacist I May/June 2013

Deanna Rowe is presented the ACPA scholarship by ACPA’s current President, Jamie L. McConaha, PharmD, GCP, BCACP, and President-Elect, Summer Bruchwalski, PharmD.

Departments Berks County Pharmacists Association officers from left, Edward Yakabosky, Darryle Tillman Jr., and Eric Esterbrook.

The Berks County Pharmacists Association held a dinner meeting and CE Program on March 26, 2013.

PPA CEO Pat Epple presented the newest version of her PA Pharmacy Update program at the St. Joseph Medical Center in Reading. z

President’s Message

Continued from page 5

may not see any changes right away. If we see differential copays and mandatory mail order still in effect, find out the details as to the employer and the PBM, and report it to PPA. Or better yet, make a phone call yourself and speak to the employer about it. You might be surprised how much respect a community pharmacist gets.

PPA is about to launch our PPCN (Pennsylvania Pharmaceutical Care Network). We have hired PJ Ortmann to market this network to payers for MTM services and more.

This is a cutting-edge initiative that few states have undertaken. When up and running, this will provide a platform for pharmacies to provide other services and gain more revenue. This is a very exciting project that has taken a few years to get going and we are almost there.

During my term as President of PPA, I have seen many pharmacists and students stand out and lead our profession. Wonderful things have been done by talented professionals. Only some of the results are listed in this message, and we can do so much more. Get others involved, and become more involved yourself. The sky is the limit for Pharmacy in Pennsylvania.

PPA has been putting more Phun into Pharmacy....Phlash Mobs, golf outings at top golf venues, and our affiliated county associations have been having lots of programs for nights out with colleagues. So make it a point to come out to at least one meeting or conference this year....you will be back for more.

The PPA staff has undergone changes in personnel under Pat’s dedicated and watchful eyes.

Skilled staffers Sara, Erika, Corey

and Don have given the support to PPA that the membership needs.

Without these people, many of the accomplishments over the last year could not have been done. Thanks to all of you.

It has been my pleasure and honor to serve as PPA’s President for the past year. I think we have had a good deal of success and wins, and I think we have many more challenges ahead of us. But we can accomplish all of them if we have the dedication and support of the full membership, with a growing and engaged membership going forward.

Please contact me with any question or concern at all.

Thanks, Rob z Robert Frankil, RPh Bobbygolf@comcast.net Twitter @bobbygolf cell phone 267-304-4449

Pennsylvania Pharmacist I May/June 2013 I 11

Departments

New Members

P

PA welcomes the following New Members who joined the association February 5, 2013 – April 2, 2013. Please make these new members feel welcome and part of Pennsylvania pharmacy!

Active Pharmacist Roberta M. Farrah University of Pittsburgh School of Pharmacy Pittsburgh John M Kremer Beward Pharmacy Mifflintown Angelo John Greco Duquesne University – Mylan School of Pharmacy Pittsburgh Elliott Cook Provider Resources, Inc. Erie Fadeke H. Salako Rite Aid Reading Dusanka Trifunovic Sellersville Pharmacy Chalfont Bonnie Ann Falcione University of Pittsburgh School of Pharmacy Pittsburgh

Technician

Shannon Monac

Carol A. Pfundt Rite Aid Monroeville

Jenna Murray Michael Perry

Marcell Vasquez Almonte

Patricia A. Nixon Total Home Health Care, Inc. Marshalls Creek

Mary Riedy

Chelsea Wampole

Brian Rupp

Wilkes University Nesbitt College of Pharmacy

Brooke Norton

Resident

Lanette Sipple Rachel Trichtinger Arin Whitman

Student

LECOM School of Pharmacy

Duquesne University Mylan School of Pharmacy Kristi Albright Stephanie Arntz Christina Benton Jessica Bieniecki Katlyn Bonner

Suzanne Marie DivelySmith Williamsport

Brian Michael

Maria Demetriou Nicole DeNardis Burke Donahoe Shane Donnelly Brian Gutierrez Chelsea Harrison Jessica Heintz Daniel Jenniches Rima Khalil Erica Liska Kelsey Miksic Daril Miller

12 I Pennsylvania Pharmacist I May/June 2013

We sincerely thank everyone who has helped recruit a member and for helping make PPA stronger!

Ae-Ree Choi Kishan Patel

Alyssa Wise Cara Wise

Tricia Coulter

Kristin Ball Motley Claymont

Nicholas Lee Signorella

Laura Jane Muchesko University of Pittsburgh School of Pharmacy Johnstown

Carla Herling Wegmans Food Markets Warrington

Stacie Ann Kramer Norland Avenue Pharmacy, LLC Chambersburg

Rose Niklewicz

Thomas Jefferson University School of Pharmacy

Maggie Wolfe Danielle Workoff

Lisa Marie DePietro Alicia Shontz Paulina Trzcinka Mark Wible Philadelphia College of Pharmacy at USP James Appio Marcin Cebula Amanda M. Fidler Tuynh Nguyen Rob Nietupski Robert Rossi University of Pittsbugh School of Pharmacy Austin Hammaker Allison Lazar Heather Lezanic Glenna Shutzberg

2012-2013 Member-GetA-Member Campaign!

You can win one of two $250 prizes for recruiting a pharmacist member during the 2012-2013 Member-Get-A-Member Campaign!

It’s simple: Have the new pharmacist you recruit place your name in the recruited by box on the application form either printed or online. For every application that has your name on it, you will be entered for a chance to win. Recruit one member and receive one chance, recruit ten members and receive ten chances. A winner will be drawn at random and announced at PPA’s Annual Conference in September.

It’s no secret that a bigger PPA is a stronger PPA! And a stronger PPA is better for pharmacy in Pennsylvania!

Pharmacy needs your help!

Members join because someone asks them to join. Start recruiting today!

Features

Community Pharmacy Spotlight

McElroy’s Pharmacy By: Andrew Santeusanio, PharmD Candidate 2013 University of Pittsburgh School of Pharmacy

D

elivering personalized pharmaceutical care within a community environment have always been the ideals that have helped to establish and maintain McElroy’s Pharmacy, located on Main Street in Litiz. In fact, Jeff Eshelman, the current owner of the pharmacy, first got his inspiration to attend pharmacy school through a friend who was working for Mr. McElroy at the time. His friend never actually ended up going through with pharmacy school, but fortunately enough Jeff did.

Born and raised in Litiz, Jeff initially went to the University of Pittsburgh branch campus located at Johnston for one semester to help ease his transition to city life before transferring to Pittsburgh’s main campus for the remainder of his education. During his years as an intern, Jeff worked in the pharmacy at Lancaster General Hospital, however, he eventually decided that hospital pharmacy was too impersonal, and Jeff could not resist the urge to return home to the Litiz community. So upon graduation, John married

his high school sweetheart and reverted to the original source of his pharmaceutical inspiration, McElroy’s Pharmacy, and he has been there ever since.

Like Jeff himself, McElroy’s Pharmacy has deep roots within the Litiz community. At the turn of the twentieth century it was known as Fry’s Pharmacy before Mr. McElroy purchased the business in 1940. Unfortunately, Mr. McElroy passed away in the 1980s and the pharmacy passed through another owner before Jeff finally bought it in 2010. Over his time

working there, Jeff says that he has witnessed a number of changes within the pharmacy. When he first purchased the business two years ago Jeff began by renovating the building with new lighting and fixtures as well as revamping the drab interior to create a lighter, more vibrant atmosphere. He also banned the sale of cigarettes and all tobacco products in the interest of the health of his patients.

However, despite these superficial changes, McElroy’s Pharmacy still remains a corner drugstore located Continued on page 14

Pennsylvania Pharmacist I May/June 2013 I 13

Features Community Pharmacy Spotlight

Continued from page 13

on the same street within the heart of the Litiz community.

Today McElroy’s remains a community based service providing pharmaceutical care to the citizens of Litiz and the surrounding area. In addition to refilling prescriptions, McElroy’s also provides immunizations, blood pressure screenings, diabetic counseling, and help with smoking cessation. For patients who cannot physically make it to the pharmacy itself, McElroy’s also offers delivery services for a number of customers.

Additionally, McElroy’s Pharmacy has maintained Medicare Part B certification and remains the only Freedom Blue certified pharmacy within Lancaster County. But to local residents, McElroy’s functions not only as a pharmacy but as a community center as well. Jeff admits that people will even call McElroy’s to find out things like what time the annual Halloween Parade will be starting or how to apply for various local events. It is services like these that continue to make McElroy’s an indispensable staple of the Litiz community.

When asked how he plans to compete with the rapid growth of chain pharmacies in the future, Jeff had a three-part recipe for success. First, stay involved within the community and participate in a number of outreach events.

Second, get to know your patients on a personal level. Finally and above all, follow the golden rule of pharmacy, “treat patients as you would want to be treated yourself.”

14 I Pennsylvania Pharmacist I May/June 2013

Jeff and his staff have adopted the policy of treating and counseling patients as if they were a part of the family, which has in turn helped to build strong customer relationships and a loyal clientele.

In the current economic climate of bigger is better, McElroy’s Pharmacy continues to prove that

Tony Hayslip, ABR/AREP 713-829-7570 Tony@RxBrokerage.com

there is still value in customer service and personalized care.

With the passage of Senate Bill 201, allowing universal access to community pharmacy services, hopefully small-town independent pharmacies like McElroy’s will continue to flourish and give back to their communities. z

Ernie Zost, RPH 727-415-3659 Ernie@RxBrokerage.com

Features

PPA Member Profile Shelley Otsuka, PharmD Title: Assistant Professor of Clinical Pharmacy at Philadelphia College of Pharmacy Education: Pre-pharmacy: University of Illinois- Champaign-Urbana Pharmacy: Southern Illinois University-Edwardsville Post Graduate: PGY1 Residency at The Ohio State University What made you choose pharmacy as a profession?

When choosing her career path, Dr. Otsuka noticed that the profession of pharmacy was advancing and wanted to be part of a profession that would allow her to “make a difference and help people better their lives.”

What do you like most about being a pharmacist?

Having dual roles in pharmacy, Dr. Otsuka has two favorite activities - teaching students and providing direct patient care.

What is your role at Penn Presbyterian Medical Center?

Not only does Dr. Otsuka help expand the minds of student pharmacists from PCP but, she also serves as a consultant for more than 100 University of Pennsylvania resident physicians at an outpatient internal medicine clinic. Dr. Otsuka’s responsibilities include

responding to drug information questions, educating physicians on medications and medical devices, assisting in appropriate drug selection and dosing, and managing patients with chronic disease states such as hypertension, diabetes, dyslipidemia, and smoking cessation. She also assists in the newly developed multi-disciplinary transitions of care clinic.

What was the most memorable experience of your career?

During her residency, Dr. Otsuka had an opportunity to participate in many dinners, receptions, and discussions with then APhA president, Marialice Bennett. Dr. Otsuka felt these experiences left an impression of the importance of pharmacy associations in the advancement of the profession and in her ability to network with other pharmacists.

continuity of care due to the advent of the affordable care act and hospital reimbursement being tied to readmissions. In reaction to this change in healthcare, Dr. Otsuka plays a key role in the transitions of care clinic at the University of Pennsylvania internal medicine clinic to ensure continuation of care for her patients and reduce hospital readmissions. The clinic provides her with the opportunity to practice in an innovative pharmacy setting.

What made you decide to join PPA? “Every state that I have lived in, I have been a part of their state pharmacy association. It’s another great way to network and learn about state issues that arise What is the most significant which may potentially affect the advancement in pharmacy practice in patients we see as well as our your career? careers.” Because Dr. Otsuka is Dr. Otsuka feels the “up and not from Pennsylvania, becoming coming” transitions of care concept involved in the public relations will have an enormous impact committee has helped her on the role of pharmacists in network, collaborate with other healthcare. Pharmacists are now pharmacists, and become involved becoming a key component of in her professional the healthcare team “It is important to be community. Dr. when patients are Otsuka recommends transitioned from part of your state being involved the hospital to representation and in PPA, “It is outpatient setting. Dr. have a voice in the Otsuka recognized agent of change.” the importance of Continued on page 24

Pennsylvania Pharmacist I May/June 2013 I 15

Features

Profiles in Pharmacy Innovation: Brought to you by the PPA Educational Foundation. Pharmacists…Advancing patient care!

The Foundation regularly showcases profiles of pharmacists who are involved in innovative patient care or pharmacy practice.

Name of Pharmacist: Adam Wood, PharmD

Compounding Pharmacy also provides a full consultative service, smoking cessation resources, OTC testing options through a laboratory license, neurotransmitter testing through neuroscientists and nutritional consultations.

Site Description: Adam is the primary compounding pharmacist at Catasauqua Compounding Pharmacy in Catasauqua, PA. Adam describes the pharmacy as “a small town compounding pharmacy with a big city heart and technology.” The pharmacy tries to help local patients find medications for their specific disease states that they would not be able to find otherwise.

Why Adam Chose to Advance His Practice: When asked why he chose to advance his practice in veterinary pharmacy Adam said, “Veterinary medicine is one of the largely overlooked areas of medicine.

People usually think if they have a question about a pet’s medication they call the veterinarian, they don’t think to call the pharmacist.”

Non-humans are not a focus during training for pharmacists, but because of Adam’s passion for animals he chose to advance his practice in that area. As a child, he grew up in a family that always had pets and his affinity for animals started at a young age.

Innovative and Other Services Provided: The pharmacy provides hormone, pain and general wellness consultations. The primary two focus areas are hormone and pain consultations because they see those patients most commonly on a daily basis. Adam estimates that between 50-60% of their patients in some way are on hormone replacement, while another 35% of their business is veterinary pharmacy. Catasauqua

Animals are referred to as patients in their pharmacy and they refer to pet owners as clients. Adam said that many of the veterinary patients have become members of their clients’ families. Statistically since there are so many cats and dogs in the United States, a lot of people are touched by sick animals.

Adam said he enjoys veterinary pharmacy because it is, “Going out and helping those patients that can’t speak for themselves, which has to include educating owners

Graduate of: Wilkes University School of Pharmacy

16 I Pennsylvania Pharmacist I May/June 2013

of animals on how to properly medicate.” He also stressed that pet owners need to not only provide routine care and visits to their veterinarians to discuss the health of their pets, they also need to make sure they have a good understanding of the medications their pets are taking and how the medications may affect their overall health. Adam said that veterinarians are like physicians, seeing more and more patients on a daily basis.

As a pharmacist if he can answer questions about medications for pet owners that frees up the time for a veterinarian to have a few extra minutes in the day to maybe provide a higher level of care to another animal.

Advice for others: Adam has a few suggestions for other pharmacists looking to expand their practice in veterinary pharmacy. He said that the ACVP is great at providing regular Pet Talk hand-outs which cover all species.

He also recommends finding a veterinarian in the field, especially someone in academia that you can develop a relationship with and share resources with while working together. Adam also recommends for pharmacists “To get to know the vets in your area, get into their offices and talk to them and find out what they need and how you can help them.” z Contact Information: Phone: (610) 264-7340 Email: compounding@hartzells.com

Features

Breaking New Ground in Chronic Pain Management Geisinger develops pharmacist based outpatient pain therapy program Thomas Franko, PharmD Brooke Dougherty, PharmD

Chronic pain is an often overlooked and socially stigmatized disorder. Research shows that more people in America have chronic pain than diabetes, coronary Thomas Franko, PharmD with Dr. John Han, artery disease and cancer put Director of Interventional Pain. together. The average cost of pain therapy per year equals about Under collaborative practice $2,000 per citizen. There has been agreements, pharmacists are a national cry to ensure better adjusting medication regimens care for those with chronic pain, to better control these patients and the leadership at Geisinger and results are showing. With Medical Center has heard this call. over 18,000 When deciding patients in their how to better “The clinical pharmacy care, the MTM treat ambulatory program was patients with pain, department is headed well equipped Geisinger turned by very talented, to its medication knowledgeable and caring to face the challenge of pain therapy leaders. With a wellmanagement. management established service model A network (MTM) pharmacy already in place, the proper of pharmacy team to lead the allocation of resources will and system charge. leadership, For the past 17 permit the patient to see years, Geisinger the pharmacist in their area coupled with primary care and has empowered of expertise,” interventional pharmacists to –Dr. John Han” pain physicians take charge of formulated a several disease plan to bring this states including clinic into light. After months of anticoagulation, diabetes, planning, they were ready to roll hyperlipidemia and hypertension.

Thomas Franko, PharmD with Rebecca Betz, PT, MPT, OCS, Senior Physical Therapist at the aqua therapy center.

out the first outpatient pharmacist managed chronic pain program on the east coast. The only other existing programs are hospital/ transitional care based in California, Washington, Iowa and Minnesota.

“The clinical pharmacy department is headed by very talented, knowledgeable and caring leaders. With a well-established service model already in place, the proper allocation of resources will permit the patient to see the pharmacist in their area of expertise,” says Dr. John Han, Director of Interventional Pain.

Two pharmacists were chosen and provided training in pain therapy, opioid conversion, anticoagulation and nerve pain.

Both pharmacists were afforded the opportunity to study addiction in a “hands on” environment by spending two weeks at Marworth Continued on page 23

Pennsylvania Pharmacist I May/June 2013 I 17

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0:13 AM

Features PHARMACY MARKETING GROUP, INC.

Financial Forum This series, Financial Forum, is presented

by Pro Advantage Services, Inc., a subsidiary of Pharmacists Mutual Insurance Company, and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Parents, Alzheimer’s & Money Easing into a Difficult Conversation

E

very eighth American aged 65 and older has Alzheimer’s disease, and 43% of Americans aged 85 and older have it, according to the Alzheimer’s Association. Consider those percentages in light of the Social Security Administration’s estimate that about 25% of today’s 65-yearolds will live past age 90. These shocking statistics have serious implications for family wealth.1,2 Your choices. What are your options when it comes to helping a parent out with money management? Informally, you can “lend a helping hand” and check in with mom and dad to make sure that bills and premiums are paid, and deadlines are met. But if you elect to formally take the financial reins, you are looking at a twophase process: * You can get a power of attorney and assume some of the financial responsibilities.

A power of attorney is a detailed

and strictly constructed legal document that gives you explicitly stated measures of financial authority.

If you try to handle financial matters for your parent(s) without a valid power of attorney, the financial institution involved may reject your efforts.3 A durable power of attorney lets you handle the financial matters of another person immediately. The alternative - a springing power of attorney - only takes effect when a medical diagnosis confirms that person’s mental incompetence.

Copies of the power of attorney should be sent to any financial institution at which your parents have accounts or policies. It may be wise to get a durable power of attorney before your parent is unable to make financial decisions; many investment firms require the original account owner to sign a form to allow another party access to an account owner’s invested assets.4 You are going to have to hunt for information, such as...

• Where mom or dad’s income comes from (SSI, pensions, investments, etc.)

• Where the wills, deeds and trust documents are located.

• Who the designated beneficiaries are on insurance policies, IRAs, etc.

• Who the members of mom or

dad’s financial team or circle are.

You need to talk with them; they need to talk with you.

• The crucial numbers: checking and savings accounts, investment accounts, insurance policies, PIN numbers and of course Social Security numbers.

• It will also help to learn about their medical history and prescriptions.

If the disease progresses to the point where your mom or dad can’t make competent financial decisions, then you are looking at a conservatorship. In that case... *You can act to become your mom or dad’s conservator. This means going to probate court.

You or your parent can initiate a request for conservatorship with a family law attorney; if the need is more immediate, you or your family’s attorney may petition the court. In either case, you will need to show documentation that your parent is no longer financially Continued on page 22

Pennsylvania Pharmacist I May/June 2013 I 19

Features PHARMACY MARKETING GROUP, INC.

and the Law

By Don. R. McGuire Jr., R.Ph., J.D. This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Discovery 101

A

sk anyone who works in the claims department at an insurance company and they will tell you that the Discovery phase of litigation is the most timeconsuming and expensive part of the process. But if you don’t work in the claims department or a law firm, could you readily explain what Discovery is and why it is so costly?

Discovery is defined by Rules 26 to 37 of the Federal Rules of Civil Procedure.1 Discovery is a process where opposing sides in the litigation share information about the case with each other.

This process is mandatory, although compliance with the rules is generally self-enforced by the parties. This sharing of information takes many forms and helps each side to evaluate the strengths and weaknesses of their case prior to trial. These forms include; 1.

Depositions by Oral Examination, 2. Depositions by Written Questions, 3. Interrogatories to

20 I Pennsylvania Pharmacist I May/June 2013

Parties, 4. Producing Documents, Electronically Stored Information, and Tangible Things, or Entering onto Land, for Inspection and Other Purposes, 5. Physical and Mental Examinations, and 6.

Requests for Admissions.

Depositions, whether written or oral, are one of the largest cost drivers in the Discovery process.

Little use of Depositions by Written Questions is seen in most cases, so I will concentrate on Deposition by Oral Examination. The main reason that this exchange consumes so much time and money is that virtually anyone connected with the case can be deposed.

The parties, employees of the parties, fact witnesses, and expert witnesses can all be deposed.

Depending on the complexity of the case, the deposition can be a half day, whole day or potentially even multiple days. Coordinating witnesses’, parties’, and attorneys’ schedules can be a nightmare.

This is multiplied in multiple defendant cases or class action cases. Depositions are important

because they give a preview of what a witness is going to say on the stand at trial. Witness testimony is crucial to evaluating a case.

Preparation for a deposition, taking the deposition and analysis of the answers is time consuming for your attorney. If the number of Depositions is large, Discovery is well on its way to being the most expensive part of litigation.

Interrogatories are written questions that can only be submitted to the opposing party.

They cannot be used to gain information from witnesses or other non-parties. There is a limit to the number of Interrogatories that can be served on the opposition. Many times Interrogatories are used to gather background facts such as date of birth, address, work history, arrest records, etc. As with Deposition questions, it is permissible to object to questions, but the objecting party must have a good faith basis to object beyond just not wanting to answer.

Producing Documents, Electronically Stored Information, and Tangible Things, or Entering onto Land, for Inspection and Other Purposes is comprised of 2 parts. The inspection of land and/or buildings occurs when

Features relevant, but the bigger issue here is documents. In the not too distant past, this rule dealt almost exclusively with documents. Not so today. This rule encompasses not only paper documents, but e-documents, e-mail, spreadsheets, photos, drawings, and almost anything else that you can imagine.

Recent changes to the rule require that electronic documents be produced electronically to preserve the metadata. Metadata and its implications are a topic of their own, but be aware that metadata can have a dramatic impact on the evidentiary value of the documents themselves. When the case involves a complex issue and/ or a long running issue, it doesn’t take too long these requests for production to take on a life (and an expense) of their own.

Parties may also request that the opposing party undergo a physical or mental examination.

This is not automatic. The request must be approved by the court.

The examination must be relevant to some issue in the case, so this cannot be requested without reason. This is usually used in situations where the party wants an independent opinion on, or verification of, the opposing party’s condition.

The last form of Discovery is the Request for Admission. This is a written request to the opposing party asking them to admit the truth of some facts, application of the law to the facts, or the genuineness of documents. As you might have guessed by now, the item in question must be

relevant to the case at hand. The responding party must admit as requested, deny or object to the request. Making an admission under this rule renders the issue decided and the issue is not debated at trial. This rule has the potential to actually shorten a trial.

Discovery is self-governed by the parties and the rules provide deadlines for responding to the various forms of requests. Also, the parties cooperate to establish an overall schedule for Discovery to take place so that depositions, etc. are completed during a reasonable timeframe. Disputes about discovery make their way in front of a judge. The judge can order the parties to participate in Discovery and can impose further sanctions, up to and including dismissal of the case, for failure to do so.

Discovery is a very important part of the litigation process, but it can be very timeconsuming and expensive to comply with. This is especially true for the pharmacist defendant who has to take time away to be deposed or spend valuable time searching for and organizing records.

Your attorney does realize the impact that Discovery has on your life,

but your attorney also knows the potential downside for failure to comply. © Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company. z 1 – I will use the Federal rules for this article because they are consistent nationwide. Many states mimic them for their own rules, but you should make sure which approach your state takes.

This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice.

Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.

Pennsylvania Pharmacist I May/June 2013 I 21

Features Financial Forum

control over many aspects of a protected person’s life. A conservatorship limits control to the management of the protected person’s assets and financial affairs.5 What if I don’t want to assume this kind of responsibility? Some wealth management firms offer daily money management as an option in a “family office” suite of services.

The firms make home visits to help with bill paying, filing medical claims and other recurring tasks; carefully scrutinize anyone offering this service. (Visit aadmm.com for the American Association of Daily Money Managers.)6 The other choice is to give

Continued from page 19

competent. You must provide medical documentation of his or her dementia to the court as well.

The court will interview the involved parties, look at the documentation and perform a background check on the proposed conservator. This is all pursuant to a hearing at which the court presents its decision. If conservatorship is granted, the conservator assumes control of some or all of the protected party’s income and assets.5 How do conservatorships differ from guardianships? A guardianship gives a guardian

a relative, a financial services professional, or a family lawyer durable or springing power of attorney or limited or full conservatorship. Such a decision must not be made lightly.

Keep your parents away from unprincipled people. These steps may prove essential, yet they will not shield your family from scam artists. Be on the lookout for new friends and acquaintances. If your instincts tell you something is wrong, investigate. z

Citations.

1 – www.alz.org/downloads/ facts_figures_2011.pdf [2011] Continued on page 24

Avoid diminishing the value of your pharmacy.

Don’t leave money on the table when you transition the ownership of your business.

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3. DO NOT engage in conversations, information sharing or negotiations with ANY buyer without professional representation, particularly if contemplating a sale to a chain. Thirteen years of experience selling pharmacies has shown us time after time that direct engagement rarely—if ever—gets the independent owner the best price or the best deal.

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22 I Pennsylvania Pharmacist I May/June 2013

Features Breaking New Ground

Continued from page 17

Rehab Facility in Waverly, PA. The program was debuted at Geisinger’s Interventional Pain Center in Danville, PA in September 2012. A second clinic was implemented in October 2012 at the South Wilkes-Barre campus.

The goal of the program was multifaceted. First was to ensure the safe and effective treatment of chronic pain in ambulatory patients. Second was to try and decrease the amount of opioid medications patients were taking and substitute more non-opioid or adjunctive medications. Third was to provide physicians with more time to conduct pain procedures, such as epidural injections, with more time and care. The program quickly gained support from physicians, mid-level practitioners and nursing.

“The MTM pharmacist has helped our clinic manage difficult medication patients. The pharmacist has been able through the use of adjuvant medications and education to decrease their opioid medication doses. This has allowed the pain interventionists to do what they do best,” says Marlair Graham, operations manager for the interventional pain clinic.

The clinics are quickly evolving and recognizing the need for more patient and provider education.

Members of the clinic, along with pharmacy leadership, have hit the road to educate and promote the clinic to various primary care sites

throughout the Geisinger network.

Additionally, the pharmacists have presented at the yearly Geisinger Chronic Pain Symposium in October 2012 and spoke at the Ambulatory Care Pharmacy CE Day in March 2013. Patient education has increased as well. Along with individual teaching sessions during visits, an introductory course entitled “Empowering You to Manage Your Pain” was developed for all new patients. This course will focus on several issues that may be unknown to patients such as adjunctive medication use, opioid induced hyperalgesia and appropriate use of Tylenol and anti-inflammatory products. Lastly, pharmacists are speaking at pain support groups to better inform and educate patients on a more informal level.

One area that has truly benefited from this program is patients with intrathecal pain pumps. The pain pump program is overseen

by Dawn Snyder, Clinical Nurse Specialist. According to Snyder “having an MTM pharmacist in our pain clinic has been invaluable in weaning our patients from intrathecal pain pump medications.

When this therapy is no longer effective due to tolerance or hyperalgesia, the MTM pharmacist has been able to convert the patients to oral medications resulting in improved pain relief.”

This is truly a multi-disciplinary clinic as the pharmacists are working closely with not only physicians and mid-levels, but

physical/occupational therapy and pain psychology. “There is a team approach which allows the pharmacist and the physician to work together to develop treatment plans for complex patients,” says Graham. All departments are seeing the value of the clinic and are happy to provide support in the care of patients.

“Overall, patients appear satisfied and have an additional/ alternative choice for medication management and care. The patient’s ability to speak directly to the pharmacist during business hours has increased workflow and productivity. The medication evaluation, consultation and patient/staff education have translated to positive functional, social and emotional outcomes for our patients,” says Dee Hollenbach, Nurse Coordinator. “In general patients are appreciative of having the time to talk to someone and express issues of importance without being rushed,” echoed Han. This model of care is still in its infancy, but the future looks bright.

“The staff is more comfortable and acceptable in sharing responsibility to take care of patients with the pharmacist. So far there is a positive trend and correlation with teaming up with pharmacy in patient care,” says Han. The culture of chronic pain management is changing, and pharmacists are showing that they can help lead the charge. z

Pennsylvania Pharmacist I May/June 2013 I 23

Features Financial Forum

PPA Member Profile

Continued from page 22

Continued from page 15

2 – money.usnews.com/ money/blogs/planning-toretire/2010/07/22/predicting-yourown-life-expectancy [7/22/12] 3 – www.law-business.com/ powers-of-attorney [4/27/12] 4 – http://www.kiplinger.com/ magazine/archives/managing-yourparents-money.html [4/27/12] 5 – dhs.sd.gov/gdn/ guardianshipfaqs.aspx [6/2/12] 6 – www.smartmoney.com/ retirement/planning/talking-tomom-about-alzheimers-and-hermoney-1335192298522/ [5/7/12] Provided by courtesy of Pat Reding, CFP of Pro Advantage

Services Inc., in Algona, Iowa. For more information, please call Pat Reding at 1-800-288-6669.

important to be part of your state representation and have a voice in the agent of change.”

Registered representative of and securities offered through Berthel Fisher & Company Financial Services, Inc. Member NASD & SIPC

If you could give yourself one piece of advice when you were a student, what would it be?

Be involved in as many professional organizations as you can. They can provide you with networking and new experiences.

Being involved keeps you aware of legal issues that may affect both your profession and your patients.

Attend meetings, “It’s a real eye opener when you get to be around that many pharmacists in a certain setting.” z

Pro Advantage Services, Inc./Pharmacists Mutual is independent of Berthel Fisher & Company Financial Services Inc. Berthel Fisher & Company Financial Services, Inc. does not provide legal or tax advice.

Before taking any action that would have tax consequences, consult with your tax and legal professionals. This article is for informational purposes only. It is not meant to be a recommendation or solicitation of any securities or market strategy.

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24 I Pennsylvania Pharmacist I May/June 2013

Association News

Pennsylvania Article Head Goes Student Here Pharmacists Attend PPA’s Annual Government Relations Advocacy for Student Pharmacists (GRASP) Program The Pennsylvania Pharmacists Association selected 18 students from Duquesne University, Lake Erie College of Osteopathic Medicine (LECOM), Temple University, University of Pittsburgh and Wilkes University to participate in the Seventh Annual GRASP program held February 15-17, 2013 in Harrisburg, PA. Program attendees this year included Duquesne University students Shane Donnelly (class of 2015), Rachel Marini (2014), Michelle Mikus (2013), Jordan Moore (2015), and Ilana Portman (2014); LECOM students Jennifer Addo (2015), Alex Covey (2015), Hawa Fall (2014), and Chris Sedgwick (2015); Temple University students Michael Bellano (2015), Indira Friel (2016), and Matthew Hoctor (2015); University of Pittsburgh students Brandon Antinopoulos (2014), Trey Draude (2015), and Gordon Watkins (2015); and Wilkes University students Sarah Bellanco (2014),

Alysha Lopez (2015), and Sarah Maheady (2014).

The program included presentations on: advocacy, leadership, legislative issues and being involved in professional organizations. Featured guest speakers included Representative Seth Grove (R-York), who spoke

about a legislator’s prospective; Edward Bechtel, R.Ph., Chairman of the State Board of Pharmacy and Kerry Maloney, Esq., Board Counsel, who spoke about the role of the State Board of Pharmacy; and PJ Ortmann, R.Ph., MBA, President of the Lancaster Continued on page 27

Pennsylvania Pharmacist I May/June 2013 I 25

Š 2011 Cardinal Health. All rights reserved. KINRAY and the KINRAY logo are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. Lit. No. 1R16734 (11/2011)

Association News GRASP Recap

Continued from page 25

County Pharmacists Association, who delivered a presentation on pharmacy leadership. Additionally, the program included practice letter writing sessions and advocacy role-playing.

This program is a weekend leadership and advocacy-building retreat, designed for students.

A limited number of student pharmacists from across the Commonwealth are accepted annually to participate in the program through an application process. Upon successful completion of the course and related assignments, students are presented with a Certificate of Achievement and a GRASP lapel pin which can be proudly worn, especially on their pharmacy white coat, to pharmacy events.

Those who participate in the program walk away with a better understanding of state government and its impact on pharmacy and the importance of being a pharmacy leader – information which is important for all areas of pharmacy practice.

Students interested in attending the 2014 GRASP program should look for details which will be available this fall on the PPA website. For more photos, please visit our Facebook page at www.facebook.com/PAPharmacy/ z

Pennsylvania Pharmacist I May/June 2013 I 27

Association News

Pennsylvania Pharmacy Legislative Day “Making It Fair for Local Care”

O

n April 9, more than 350 pharmacists, pharmacy students and technicians from all across Pennsylvania converged in Harrisburg to advocate for their profession. The focus of the day was the promotion of “Making It Fair for Local Care”, which centered around advocating for pharmacy benefit manager (PBM) regulation and transparency, fair pharmacy audits and expanding immunization capabilities.

PPA’s Legislative Day began with a continental breakfast in the East Wing of the Capitol, along with screenings, displays and information provided by Pennsylvania’s seven schools of pharmacy. Legislators, staff and the public learned ways to better manage their health by participating in blood pressure and hearing screenings, medication reviews and more.

The schools of pharmacy provided information on the following topics: • Duquesne University Mylan School of Pharmacy: Smoking Cessation, Hearing Tests, and Carbon Monoxide Monitor • Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy: Medication Adherence • Temple University School of Pharmacy: Immunization Awareness • Thomas Jefferson University

28 I Pennsylvania Pharmacist I May/June 2013

School of Pharmacy: Hypertension Assessment • University of Pittsburgh School of Pharmacy: Smoking Cessation • USciences/Philadelphia College of Pharmacy: Medication Safety (Disposal) • Wilkes University Nesbitt College of Pharmacy: Heart Health and Blood Pressure Screenings Attendees then filled the grand staircase in the Main Rotunda at 10:00 a.m. for the “Making It Fair for Local Care” rally and press conference. As PPA CEO Pat Epple began to address the media and public, it was impossible to deny that PPA made an impression. We filled the steps to capacity, which is not an easy feat! The rally focused on the need for PBM regulation and transparency, covered by President Rob Frankil, fair and uniform standards for pharmacy audits discussed by Eric Esterbrook, First Vice President, and expanding opportunities for pharmacists to provide immunizations in Pennsylvania by lowering the age and permitting trained student interns to immunize, covered by Immediate Past President Adam Welch. We did get some media attention from local news outlets which also helped garner greater attention for our issues.

Before and after the rally and press conference, attendees met individually or in groups with

legislators and staff to discuss PPA’s priority issues. We visited more than 140 legislators during the day – more than ever before! However, there are 253 legislators in the General Assembly, so we still have some work to do. Wouldn’t it be nice if more pharmacists attended Legislative Day so that we could say we visited all 253!

Additionally, several special meetings were set up for small groups of attendees in the PPA office. These informal meetings included presentations and/or discussions with: Michael Wolf, Acting Secretary, Pennsylvania Department of Health, Representative Seth Grove (R-York), Senator Mike Stack (D-Philadelphia), Marlene Tremmel, Executive Director, House Professional Licensure Committee and Melissa Knepper, Legislative Director and Jeremy Shoemaker, Communications Director, from Senator Rich Alloway’s (R-Franklin) office.

In less than six hours, pharmacy made quite an impact in the legislative and media arenas. We understand it’s not easy to take a Tuesday off of work to come to Harrisburg and we thank all those who made the trip. We chose a Tuesday in early spring to hold this event because based on the legislative calendar and the session schedules, along with the pharmacy school schedules, it is

Association News the best time. We hope you will consider adding your voice to the more than 350 pharmacists, pharmacy students and technicians next year.

PPA extends its sincere gratitude to all those who came out to support pharmacy. More photos can be viewed on PPA’s Facebook page at www.facebook. com/PAPharmacy. z

Temple University School of Pharmacy

Duquesne University Mylan School of Pharmacy

Thomas Jefferson University School of Pharmacy

LECOM School of Pharmacy

University of Pittsburgh School of Pharmacy

Philadelphia College of Pharmacy

Wilkes University Nesbitt School of Pharmacy

Pennsylvania Pharmacist I May/June 2013 I 29

Association News

PPA Election Information & Ballot Important Message – PPA Elections for 2013 – 2014 Voting is now open!

P

PA will again utilize an online electronic system for voting for our officers and Board of Directors.

The benefits of this program are many including ease of use for most members, reduction of mailing, eliminating paper waste, and simplifying the ballot count and verification process. Your vote is confidential and the system is tied to only allow a person to vote only one time!

To cast your vote – here is what you need to do: 1 – Go to this website: www. associationvoting.com/ papharmacists/ 2 – Login by entering your last name and member ID that were emailed to you – or contact the office.

3 – Review the candidate options for the categories in which you are entitled to vote (see below), check your selected candidates, and cast your ballot!

4 – Please note that ballots MUST be cast before midnight on May 15.

Voting is open beginning now and will continue until Midnight on May 15, 2013. At which time, shortly thereafter the Nominating Committee will certify the results.

Your ballot will be matched to

30 I Pennsylvania Pharmacist I May/June 2013

your ID and Last name, so you will only be able to vote for the offices for which you are entitled.

However, if you believe there is an error in the options you have – do not cast your vote, exit, and please contact us. If you have any problems in doing this or have any questions, please contact the PPA office at (717) 234-6151 and speak with either Corey Wenger or Pat Epple. Or email one of these individuals at cwenger@ papharmacists.com or pepple@ papharmacists.com. Any member who prefers to receive a paper ballot, may do so by contacting the office, prior to May 10 and we will send you one.

The following elections are scheduled for this year and the Nominating Committee announces the candidates for each: Please note many of these positions have more than one candidate. Please carefully review their brief biographical information available on-line at the voting site, to aid you in selecting the best candidate to represent you, the profession, and PPA! You can also submit a write-in vote.

PPA Officers: (All of the following are for one-year terms) (Only active pharmacist categories of membership vote for these positions) President-Elect – Eric Esterbrook, RPh. First Vice President – Donna

Hazel, RPh. Second Vice President – choose one: Richard Demers, RPh, MS, FASHP or Eric Pusey, RPh, CDE PPA Board of Directors: (All are for two year terms) (ONLY members of the respective Academy/practice setting may vote for the Director) Director – Alternative Practice Settings Pharmacists – choose one: John Barrett, RPh, BSPharm; Mark Conklin, PharmD, MS; Nick Leon, PharmD, BCPS, BCACP, or Jamie McConaha, PharmD, BCACP Director – Health-System Pharmacists – choose one: Paul Kocis, PharmD, CACP, FASCP or Melissa Shiner, PharmD, CGP, BCPP, MHA Director – Long Term Care and Consultant Pharmacists – Brant Gahr, RPh. Director – Pharmacy Industry Associates – Todd Eury (Only pharmacist members of the respective region may vote for Director) Director – Northwest Region – Elliott Cook, PharmD, BCPS or Mary Ray, PharmD Director – Southeast Region – John Barrett, RPh, BSPharm; Nick Leon, PharmD, BCPS, BCACP, or Brad Tabaac, RPh PPA Student Advisory Board: (only student members cast their Continued on page 37

Association News

Passion for Your Professional Association: My Rotation at PPA By: Abbie Morgan, Pharm.D. Candidate 2013, Philadelphia College of Pharmacy

P

rior to starting my rotation at PPA, I was not a member.

However, within the first week I was empowered to not only become a member myself, but also to hold a membership drive at my school, Philadelphia College of Pharmacy. I had a passion to help my colleagues see the importance of PPA sooner than I. During my rotation, I gained insight into the true importance of being involved in my state pharmacy association.

Not only did I experience the dedication of the staff members and their important role in the functioning of PPA, but also the passion of PPA’s members for their profession. Overall, my experience with PPA taught me the importance of collaboration, networking, lobbying for my rights as a health care provider and patient rights, and being involved in organizations that unite my profession to have a collective voice for a greater impact on legislation.

Although I had many daily responsibilities at the PPA, Pat Epple and all the staff supported

me in the development of two projects that would promote student membership and the value of pharmacy associations. The first, a membership drive, allowed me to share my vision of the value of PPA membership with students.

With the help of PCP’s student representative, Terry Pak, I was not only able to increase membership at PCP, but also educate students on the benefits of being involved in their state association along with methods for getting involved. The second was the development of a new residencies and fellowships page for the PPA website. When I realized my desire to pursue a residency, navigating the labyrinth of residencies information seemed impossible. Over the past few months, I have heard similar gripes from many of my fellow students.

Thus, I took it upon myself to meet the needs of my fellow students and create a centralized location for the information and links students will need to successfully find the residency or fellowship that meets their personality and professional goals. Now, students can be directed to the student section of the PPA website for information about residency programs and fellowships. This will help them recognize that their state association can provide a wealth of information and useful tools to advance their pharmacy career.

Education and membership are not the sole workings of this astounding organization; advocacy for the profession of pharmacy is, in my opinion, PPA’s most important role. Shortly after my arrival at the PPA, the presidential election transpired. Although the election had just ended and the legislative session had come to a close, I still had the opportunity to experience PPA’s advocacy role. I was enthralled with the creation of a plan of action for the next legislative session and the collaboration of PPA’s committees that keep PPA’s lobbying alive. The ability to sit in on these planning sessions taught me that successful lobbying does not just stem from being passionate about your profession, but also from the ability to remove emotion and create a tactical plan of action.

The PPA rotation experience has taught me various invaluable lessons, which I will share with my colleagues throughout my career. Now that I have realized and experienced the importance of being involved in my state pharmacy association, I will continue to support the efforts of PPA or any pharmacy association for the state in which I will live in the future. z

Pennsylvania Pharmacist I May/June 2013 I 31

Association News

Save the date!

2013 Annual Conference September 26-29, 2013

Unite For Change Wyndham Gettysburg Gettysburg, PA

A Focus on the Pharmacists’ Role in the Patient Centered Medical Home

Join us for the Exhibit Hall & Prizes, Continuing Education, Pre-Conference Substance Abuse Programming sponsored by the PPA Educational Foundation, the 2013 PPA Golf Outing and our annual Awards & Leadership Dinner! www.papharmacists.com/annualconference

Information available on the PPA website later this summer!

32 I Pennsylvania Pharmacist I May/June 2013

Association News

Pharmacy Technician Corner Technician Trainer

I

f you are a technician who wants to advance your career, this is a course worth looking into.

The service is a new online prep course for successfully passing the PTCB National Certification Exam. With no text books and a 99% success rate of passing the exam, this course becomes a convenient option complete with practice quizzes and sample questions. Adapted from a 12-week course taught at higher education institutes, The Technician Trainer allows students to move at their own pace and even print study materials. The service was created

by Mary Anna Marshall, CPhT, a certified technician turned educational instructor who has designed and taught courses, written course curriculum, edited

pharmacy technician texts for major publishing companies and been asked to speak by numerous industry organizations about pharmacy technician education. For more information on this service, please visit the service’s comprehensive and user-friendly website at http:// www.thetechniciantrainer.com/ index.html. When signing up for the course, remember to mention that you are a PPA member, and a donation will be made to the association.

Legislation Update HB 370 has been introduced in the House by Rep. Tony DeLuca (D-Allegheny) and referred to the House Professional Licensure Committee. The bill would provide

for registration of pharmacy technicians along with training and an exam requirement.

SB 574 has been introduced in the Senate by Sen. John Rafferty (R-Montgomery) and referred to the Senate Consumer Protection & Professional Licensure Committee.

The bill is a simpler one, which would call for criminal history, background check and registration for pharmacy technicians.

PTCB Announces New Certification Program Changes: Submit Your Comments Online PTCB has announced future changes to the PTCB Certification Program. The new changes Continued on page 37

certified pharmacy technicians:

join today & receive free cpe! receiVe 10 free hours of cpe Become a PPA Pharmacy Technician Member in 2013 and receive the Pharmacy TEAM Series - a new benefit which will give you free access to quality, acpe-accredited cpe activities.

The complete TEAM Series of 10 CPE activities are available Jan. 2013.

Go to www.Gotocei.org (under OF INTEREST) to review this year’s TEAM activity topics.

Pharmacy Technician Education for Association Members

Pennsylvania Pharmacist I May/June 2013 I 33

Association News

Join PPA for the following webinars this spring and summer! All webinars are complimentary for PPA members! Non-members may register as well. All pricing and registration information can be found under the Calendar section of the PPA website.

May 21, 2013 at 7 p.m. – CE Webinar: Trains, Planes, and Vaccines: A Journey into the World of Travel Medicine

May 29, 2013 at 12 p.m. – New Practitioner Lunch & Learn CE Webinar: Cure for the Summertime Blues: Review of Treating Lyme’s Disease and Sunburn June 4, 2013 at 12 p.m. – Health System Pharmacist Lunch & Learn CE Webinar: Preceptor Development: Laying the Groundwork www.papharmacists.com/calendar

Welcome New Staff Member!

P PA is proud to announce the hiring of PJ Ortmann as the Executive Director for PPCN – Pennsylvania Pharmaceutical Care Network, a subsidiary company owned by PPA. PPCN is developing a program for the delivery of pharmacist provided medication therapy management services. We will be developing a pharmacist network to do this and will be marketing these services to a variety of payers. PJ will be working part-time for PPA/PPCN and will be communicating news about the network as it progresses to our members.

After graduating from the Philadelphia College of Pharmacy

34 I Pennsylvania Pharmacist I May/June 2013

and Science in 1977, PJ served as an active-duty pharmacy officer in the US Army; worked as a Hospital supervisor at Lancaster General Hospital; led two mid-sized Managed Care Plans in Central Pennsylvania as Pharmacy Director; worked as an Account Manager for Novartis Pharmaceuticals providing educational and adherence programs to pharmacists and physicians; and continues practicing community pharmacy part-time in the Lancaster area. In 2011 he and his partner formed Medvisors to bring transparency and a better understanding of PBM, and pharmacy benefits to

employers. PJ has been the multiyear VP of the Lancaster County Pharmacists Association, and was elected as President of LCPA for 2013. He is an active member of PPA, and the Academy of Managed Care Pharmacy as well. z

Association News

Member Services Strength in numbers.

Power of protection.

A

s a member of the Pennsylvania Pharmacists Association, you are eligible to receive up to 30% in premium discounts on Individual Disability Income insurance from Principal Life Insurance Company.

One of your most valuable assets While many people recognize the need to insure personal belongings like cars and homes, often they neglect to insure what provides those belongings – their income! Your income is the foundation of your financial security. Would you be able to maintain your current lifestyle without it? If you’re like most people, the answer is “no.”

Why take advantage of the association program?

In addition to the significant premium discounts, you receive: • Quality coverage from a leading provider

It’s 3:00 PM. Where is your data?

P

36 I Pennsylvania Pharmacist I May/June 2013

This is a general summary only. Additional guidelines apply. Disability insurance has limitations and exclusions. For costs and complete details of coverage, contact your Principal Life financial representative. Policy Forms HH 750 Insurance issued by Principal Life Insurance Company, a member of the Principal Financial Group, Des Moines, IA 50392. www.principal.com

hardware – setup is carried out over the phone.

The implementation has no cost, and for PPA members, the service is offered for only $35/month.

“Net-Rx” Offsite Backup Service PA members are eligible to receive an exclusive offer on offsite data backup services through the association’s collaboration with Net-Rx. Net-Rx is a company that provides operational and technical services for pharmacies by providing industry-specific technology solutions. This company’s focus is to help independently owned pharmacies operate smoothly

• Excellent claims handling and service • Access to From Here to SecuritySM educational tools on www.principal.com/ disabilitysecure

and efficiently. The offsite data backup service is designed for pharmacies, with an IT team that has pharmacy specific training, including familiarity with many of the software dispensing system vendors. There is no installation

For more information on this service, visit the Net-Rx website at www.net-rx.com or contact Corey Wenger at cwenger@papharmacists.comor (717) 234-6151 ext. 101. z

Association News PPA Election Information & Ballot

Continued from page 30

vote for these) Director – Kyle McCormick Chair – Eliza Daubert or Trey Draude Corresponding Secretary – Gale Garmong, Sarah MaHeady, and Jessica Mountain Recording Secretary – Courtney Graham Allegheny County Pharmacists: Candidates Available online (only ACPA members may vote for these positions) BucksMont Pharmacists: Candidates Available online (only BMPA members may vote for these positions)

Proposition Votes In addition to the election of officers – PPA is also conducting a straw vote on members’ positions on the following topics: (all members have access to these items) 1. PPA’s plan to launch a Pharmacists’ provided care network 2. Whether achieving provider status is important and how important.

3. How important membership is in professional organizations 4. And most importantly, what NFL team are you rooting for this fall?

(Just for fun and to humor our President!) z

Pharmacy Technician Corner

Continued from page 33

(available at http://www.ptcb. org/about-ptcb/crest-initiative) will advance pharmacy technician qualifications by elevating PTCB’s standards for national certification and recertification. During the next seven years, PTCB will phase in the changes, including mandatory background checks, accredited education requirements, and changes in acceptable continuing education (CE) programs for recertification. You are invited to submit comments at ptcb.org on the best ways to implement the changes. z

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APSC is the resource for you! Visit our website to learn more about our programs and services.

apscnet.com

Pennsylvania Pharmacist I May/June 2013 I 37

Independent Pharmacy Buying Group Pays Your PPA and NCPA Dues So You Don’t Have To!

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Membership Dues for PPA and NCPA Paid in Full (not just a percentage off of your dues) Paid Membership Fee to DeaLookUp.com Pharmacy Audit Assistance Service (PAAS) Yearly Fee Paid 100% of all rebates received from Federation Pharmacy Network (FPN) contracts returned to our members Up to $1,200 for attending AmerisourceBergen’s Wholesale Expo in Las Vegas Free Seminars on Accreditation and Competitive Bidding, FSA Certification, and Fraud, Waste and Abuse Compliance

$3,500,000 was distributed to our members in the form of rebates and end of year bonuses

IPBG and it’s Members Proudly paid the PPA over $76,000 for dues and Political Lobbying Efforts during the last 12 months Mention This Ad and Receive $50 Off Processing Fee

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Industry News

Pharmacy in World War II

P

harmacy in World War II tin tubes when supplies of both were controlled by the enemy.

by Dennis B. Worthen has Discover how practitioners coped been out of print for several years. It has just been reprinted with the shortage of some materials in soft cover and Kindle versions and what ingenuous methods and at: http://www.amazon.com/ expanded roles that they put into Pharmacy-World-War-Dennisplace to meet the needs of patients and customers. Through accounts Worthen/dp/1481054422/ref=sr_1_ stored in archives and told first1?s=books&ie=UTF8&qid=13601489 hand, you’ll learn about the work 43&sr=1-1&keywords=pharmacy+in of the Selective Service committees +world+war+II to preserve an adequate pool of Learn the real story of pharmacists for civilian practice, pharmacy’s “greatest generation” the bond drives that would buy during the war years-at home and on the battlefield! World War hospital airplanes and trains, and II was a historical a great deal more.

Pharmacy education watershed in Research in the was in a state of American history, pharmaceutical flux with accelerated including the practice industry developed of pharmacy. classes, an increase new products, such Pharmacy in in women, and the as the morphine World War II is a disappearance of Syrette, plasma comprehensive young men into the and sulfa packages military. Research in history of American the pharmaceutical pharmacy, both to meet battlefield industry developed in the military and conditions. new products, such on the home front, as the morphine from 1941 to 1945.

Syrette, plasma and sulfa packages The book provides a unique to meet battlefield conditions. insight into the profession and its practitioners.

Whole new classes of therapeutic Read about civilian practice agents, ranging from penicillin activities, such as the quinine to Atabrine to blood products, emerged from industry. Among collection and the drives to reclaim

the experiences are those of the Japanese American pharmacists and almost 120,000 others unjustly imprisoned in the most desolate spots of America.

The 70-year struggle to establish an Army Pharmacy Corps was finally successful in 1943. Pharmacists could be commissioned as officers and practice pharmacy. More important, the distribution system for men and women in the military was given the same safety oversight enjoyed by civilians. Over 12,000 pharmacists and pharmacy students served in military assignments, some as pharmacists or in the medical field. Many served in combat roles as pilots, combat soldiers, and sailors, others as medics or corpsmen. A number did not come home.

Pharmacy in World War II documents the events and people who experienced a turbulent time and changed a profession. z

Pennsylvania Pharmacist I May/June 2013 I 39

We set you apart from the competition Value Drug Company, incorporated in 1936, is a wholesale purchasing cooperative soon moving to our new distribution center at 195 Theater Drive in Duncansville, PA. We are a full line distributor founded by independent pharmacists, and to this day, we continue to only service independent pharmacies. We don’t make money from our members, we make money for them!

Here’s what one of our member’s had to say….

world where large corporations “andIn amega wholesalers are looking at the short term bottom line in order to increase their profits, Value Drug Company is an example of a company that takes a long term view with the best interest of its shareholder pharmacies in mind.

“

Multi pharmacy Value Drug Owner NW PA

Our New Distribution Center and Specialty Pharmacy fulfills our ongoing commitment in offering our members the best value in products and services obtained in today’s competitive marketplace. Combining your strength with ours together, we form a more powerful distribution channel to help you service your customers’ needs.

Value Specialty Pharmacy: • Services provided at no cost to you and no patient loss to mail order specialty pharmacies on remainder of patient profile • Access to limited drug distribution networks • Access to high cost drugs that you choose not to stock in inventory • Access to insurance/PBM payers for specialty networks • Providing specialty drugs and billing • Drugs shipped directly to your pharmacy for patient pick up or delivery • Enables your pharmacy to promote new professional service to local physicians

follow us on www.ValueWorldConnect.com

If independent pharmacy is your business and we’re not partners, contact Karla Moschella, VP Sales & Marketing today at 800-252-3786 ext. 126 to discuss how we can make you more profitable.

toll free: 800-252-3786 | fax: 814-944-9553 www.valuedrugco.com

Industry News

The Adherence Challenge

A

dherence seems to be the buzzword these days, from think tanks such as the New England Healthcare Institute to our own shop here at NCPA. During his address at last year’s annual convention, then-NCPA Executive Vice President and CEO Bruce T. Roberts, RPh, issued an adherence challenge to the profession. He said that as one of its most crucial and basic functions, community pharmacists must advocate and promote to patients the importance of taking their medication as prescribed.

You might be thinking, “What’s in it for me?” or “Why should I care about improving patient adherence?” As a society, we’re all affected by non-adherence.

The costs associated with nonadherence are staggering, with our health care system being “taxed” $290 billion in avoidable medical spending every year when patients don’t take their medications as prescribed.

The health consequences of non- adherence are alarming as well. A reported 125,000 patients die annually of cardiovascular disease alone as a result of non-adherence to prescribed medication.

It’s a perplexing and huge puzzle to grapple with and it won’t be solved overnight, but we must recognize the critical role pharmacists play in improving medication adherence and the

beneficial opportunities that follow. Think about it: we are the medication experts and the most accessible health care providers in the community. We serve as key touch points for patients and can effectively monitor their medication use as they move through the health care system.

NCPA believes that attention to patient adherence must become the standard of practice for pharmacists in the future, and we are working toward achieving a goal we have set for our profession. It is our association’s vision that in five years the actions taken by community pharmacists will result in measurable improvement in patient adherence.

So in every corner of the association, from student affairs

to the government and legislative department, NCPA is taking strides to ensure that medication adherence becomes a consistent practice for every pharmacist.

NCPA is committed to sharing clinical pearls, best practices, communication tips, and the business case behind improving patient medication adherence. We’ll show you how adherence only takes a minute.

Take care of your patients and the rest will follow. It’s a win-win. z Reprinted with permission from National Community Pharmacists Association in the July 2010 issue of America’s Pharmacist.

For more information about NCPA, visit www.ncpanet.org.

Pennsylvania Pharmacist I May/June 2013 I 41

2012 Recipients of the “Bowl of Hygeia” Award

John Harmon Alabama

Lyle Fibranz Alaska

Hal Wand Arizona

Donald L. Hedden Arkansas

Melvin K. Renge, Jr California

Jeannine Dickerhofe Colorado

Paul Limberis Colorado*

Scott Wolak Connecticut

Kimberly Couch Delaware

Angela D. Adams Florida

William Moye Georgia

Kelly S.M. Go Hawaii

Randy Malan Illinois

Gerald Roesener Indiana

Eugene Lutz Iowa

Marvin E. Bredehoft Kansas

George Hammons Kentucky

Roxie Stewart Louisiana

Joe Bruno Maine

Frank Nice Maryland

Edward S. Radock Massachusetts

Gregory Baise Michigan

Larry Leske Minnesota

Waymon Tigrett Mississippi

Matt Hartwig Missouri

Jim Seifert Montana

Edward M. DeSimone, II Nebraska

Joe Kellogg Nevada

George Bowersox New Hampshire

Frank Breve New Jersey

Kenneth Corazza New Mexico

Nasir Mahmood New York

Beverly Lingerfeldt North Carolina

Dennis DelaBarre North Dakota

Mimi Hart Ohio

John Foust Oklahoma

Marcus Watt Oregon

Richard Smiga Pennsylvania

Santa E. Nieves Puerto Rico

Michael Simeone Rhode Island

Julian Reynolds South Carolina

Galen Jordre South Dakota

Marion Crowell Tennessee

Dennis Song Texas

Lloyd J. Thomas Utah

Empsy Munden Virginia

Michelle Valentine Washington

Eric Belldina West Virginia

Gary Bongey Wisconsin

Tonya Woods Wyoming

The “Bowl of Hygeia”

The Bowl of Hygeia award program was originally developed by the A. H. Robins Company to recognize pharmacists across the nation for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks for their high example. The American Pharmacists Association Foundation, the National Alliance of State Pharmacy Associations and the state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia by emailing current contact information to awards@naspa.us. The Bowl of Hygeia is on display in the APhA Awards Gallery located in Washington, DC. Boehringer Ingelheim is proud to be the Premier Supporter of the 2012 & 2013 Bowl of Hygeia program. *2011 recipient awarded in 2012

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