Pennsylvania Pharmacist November/December 2014

November/December 2014 z Volume 95 z Issue 6

The official publication of the Pennsylvania Pharmacists Association

Annual Conference Highlights

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

Thank you to everyone who joined us in Mars from September 18 – 21 for Pharmacy’s Future is in the Stars!

www.papharmacists.com

Selected the EXCLUSIVE Program for NCPA, Federation of Pharmacy Networks, 50+ Buying Groups & Wholesalers.

papharmacistoctoberinnovation.indd 1

9/23/14 9:17 AM

PPA Board of Directors PPA Officers: President: Eric R. Esterbrook, RPh President-Elect: Donna Hazel, RPh First Vice President: Eric Pusey, RPh, CDE Second Vice President: Nicholas Leon, PharmD, BCPS, BCACP Immediate Past President: J. Scott Miskovsky, RPh

Our Vision

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

PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Communications Coordinator: Jenna Karge jkarge@papharmacists.com Membership Coordinator: Courtney Box cbox@papharmacists.com Program Manager: Sara Powers spowers@papharmacists.com Government Relations Manager: Donald L. Smith, III dsmith@papharmacists.com

Ext. 3 Ext. 2 Ext. 1 Ext. 4 Ext. 6

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 nonmembers; 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, PharmDPP Bernard Graham, PhD Brian S. Plager, RPh, MBA Associate Editor: Jenna Karge Editor/Manager: Pat Epple Designed and Published by: Graphtech Sarah DiCello, Publications Manager (717) 238-5751 x118 sarah@thinkgraphtech.com For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 x119 alexis@thinkgraphtech.com Pharmacist State Board of Pharmacy Members: Gayle A. Cotchen, PharmD, MBA – Institutional” Janet Hart, RPh – Community Chain Robert Frankil, RPh – Community Independent Theresa M. Talbott, RPh – Community Chain Mark J. Zilner, RPh – Community Independent Board of Pharmacy Meeting Dates: November 12, 2014 December 9, 2014 January 20, 2015 February 17, 2015 March 17, 2015 On the Cover: Photographs are from our 2014 Annual Conference

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

Regional Directors: Central: Ellen Nastase, BS Pharmacy, MS Pharmacy Northeast: Thomas Franko, PharmD, BCACP Northwest: Elliott Cook, PharmD Southeast: Mark Lawson, PharmD, MBA Southwest: Lauren Simko, PharmD Academy Directors: Academy of Alternative Pharmacy Practice: Jamie McConaha, PharmD, CGP, BCACP Academy of Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA, RPh Academy of Community Pharmacists: Martin J. Kendra, RPh Academy of Health System Pharmacists: Richard Demers, RPh, MS, FASHP Academy of Long Term Care and Consultant Pharmacists: Brant Gahr, RPh Academy of Pharmacy Industry Associates: Todd Eury Academy of Pharmacy Technicians: Vacant to be filled by the Board of Directors Academy of Student Pharmacists: Benjamin Andrick

Our Mission

MAGAZINE

Departments

President’s Message................................................................................... 3 Calendar of Events..................................................................................... 5 Campus Checkup.................................................................................... 22 New Members.......................................................................................... 38 Time Capsules......................................................................................... 43 Member News.......................................................................................... 43

Features PPA Foundation Grant Report: Jamie L. McConaha & Sean T. Lasota........ 6 Financial Forum........................................................................................ 14 Pharmacy Quality Measurement............................................................... 15 The Price to Save a Life: Pharmacists’ Role in the Growing Area of Specialty Drugs........................................................................ 20 Rx and the Law: Marijuana – Medical or ??.............................................. 24 Top Tier.................................................................................................... 40

Association News PPA Educational Foundation....................................................................... 9 Pennsylvania Pharmacist Care Network.................................................... 11 Updates from PPA Interns........................................................................ 19 In Memory of David P. Rosenfield.............................................................. 19 Pharmacists Care..................................................................................... 26 Pharmacy’s Future is in the Stars.............................................................. 28 Leadership and Awards Reception & Dinner............................................. 34 PPA’s Mid-Year Conference...................................................................... 42 News from Our Affiliated Counties............................................................ 44

Industry News Small Doses............................................................................................. 12 2nd Annual Pharmacist Tweet-a-thon....................................................... 13 ADVERTISERS INDEX American Pharmacy Services Corporation 9 AmerisourceBergen 25 Buy-Sellapharmacy.com 5 Cardinal Health 4 Hayslip & Zost 43 Independent Pharmacy Buying Group 18 Jefferson School of Pharmacy Back Cover The Keystone Pharmacy Purchasing Alliance 27

Pharmacists Mutual Insurance Company 2 Pharmacy Technician Certification Board 12 PRS Pharmacy Services Inside Front Cover R.J. Hedges & Associates 41 Rochester Drug Company Inside Back Cover S&L Solutions LLC 17 Value Drug Company 10

DISCLAIMER — The opinions of the authors reflected in this publication do not reflect PPA’s position in any way.

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Departments

Eric Esterbrook, RPh PPA President 2014–2015

Message from the President

I

hope you enjoyed PPA’s 2014 Annual Conference “Pharmacy’s Future is in the Stars” in Mars, PA as much as I did. The conference highlights the best that PPA has to offer: great CE programs, networking opportunities, student competitions, and an opportunity to recognize the best and the brightest during our Leadership

the Harrisburg Hilton. The job pharmacists do has grown far beyond dispensing medications, a few examples are comprehensive medication reviews, chronic disease management, disease education and prevention and patient education. Pharmacists must be a part of the health care team in order for patients to get the full benefit of their medications.

Pharmacists must be a part of the health care team in order for patients to get the full We must be recognized as benefit of their medications. We must be providers and recognized as providers and compensated compensated accordingly. accordingly.

The & Awards dinner. Congratulations Pennsylvania Pharmacist Care to all the award winners this year!

Network (PPCN) is making Your leadership and hard work is progress. The PPA Board of making the practice of pharmacy Directors are doing all we can to stronger in Pennsylvania. ensure the success of the network.

Please join us at the Mid-Year It is our goal that soon pharmacists Conference “Pharmacists: Providers in Pennsylvania will be able to of Patient Care” which will be provide patient care through this held February 19 - 22, 2015 at network which will allow patients

to get the full benefit of their medications and decrease the overall expense of healthcare in Pennsylvania.

Our Educational Foundation is growing as well. The mission of our Foundation is to foster research, education, and the development of practice models that advance patient care. The Foundation benefits all pharmacists in Pennsylvania. A simple and effective way to support them is to sign up with Amazon Smile. A portion of all purchases will go directly to them and costs you nothing other than a few moments to sign up.

As the holiday season approaches please take an opportunity to reflect on all you are thankful for and spend time with those you love.

Eric Esterbrook, RPh PPA President 2014–2015 z

Pennsylvania Pharmacist I November/December 2014 I 3

You are

a leader. an educator. a trusted advisor. a counselor.

Cardinal Health is Charged with balancing the demands of delivering excellent patient care with top operational performance, you understand the need for quality solutions and integration at every step along the way. So do we.

That’s why we’re combining our full suite of pharmaceutical management offerings to deliver solutions and insight across the continuum of care. Now is the time for you to concentrate on what matters most — your patients.

Cardinal Health is eager to discuss your business needs.

For more information contact one of our Pharmacy Business Consultants. Visit cardinalhealth.com/allaboutyou

© 2013 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. Lit. No. 1RI12495 (09/2013)

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

DIAMOND LEVEL

Calendar of Events November

5–7

ASCP Annual Meeting — Orlando, FL

December 7–11

ASHP Mid-Year Clinical Meeting — Anaheim, CA

February

PLATINUM LEVEL

GOLD LEVEL

SILVER LEVEL

BRONZE LEVEL

19–22

20

PPA Mid-Year Conference — Harrisburg, PA PPA Educational Foundation Board of Director

22

PPA Board of Directors

25–28

IACP Educational Conference — Fort Lauderdale, FL

March

27–30

APhA Annual Meeting — San Diego, CA

7–11

ASHP Mid-Year Clinical Meeting — Anaheim, CA

April

7–10

AMCP Annual Meeting — San Diego, CA

10–14

ACCP Updates in Therapeutics — Rosemont, IL

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

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Features

PPA Foundation Grant Report Each year, the PPA Educational Foundation awards several grants to explore innovation in pharmacy practice.

All awardees are required to submit a report of their work. Below is the report from two of the 2013 awardees, Jamie L. McConaha and Sean T. Lasota. Reports are also retained on the website under the Educational Foundation section.

Appropriate Analgesic Use in the Elderly Jamie L. McConaha, PharmD, CGP, TTS, BCACP; Sean T. Lasota, PharmD

Background There is a growing concern of prescription pain medication abuse amongst the elderly. Seniors aged 65 and older represent 38 million people and account for 13% of the US population today.1 This population is projected to grow to an estimated 71 million by the year 2030.1 According to an epidemiologic study presented at the American Academy of Addiction Psychiatry (AAAP) 23rd Annual Meeting & Symposium, 20% of people 65 and older take analgesics several times a week.2 Within this population, the rates of abuse and/or addiction in the chronic pain population can be as high as up to 18%.2 The elderly population, particularly those in the community setting, has increased access of wide ranging analgesic agents. A Medscape report states that “people get prescription pain medications from a friend or a relative, not from a drug dealer on the street. Or they get it from one physician.”3 This report continues on to imply that there is an

abundance of over-prescribing narcotic agents by primary care prescribers.

With a growing population of elderly patients that is at risk for misuse, abuse, or addiction to pain medications, the purpose of this study is to determine whether analgesic medications are used appropriately by an elderly population. For the purposes of this study, appropriate use will be defined by the Pharmacological Management of Persistent Pain in Older Persons.4 The guidelines set within this article explain that significant pain involves a lack of physical function or decrease in quality of life. Proper usage of analgesics requires a “thorough initial assessment” by a physician in order to relieve pain in the most accurate physiological sense. Under the guidelines, pain management and comfort levels must be established between the physician and patient.4 Patients must be appropriately treated by the least invasive route of pharmacotherapy while also considering proper timing. For

6 I Pennsylvania Pharmacist I November/December 2014

example, patients with aroundthe-clock pain should be treated with medications that provide “steady-state analgesic blood concentration.” These types of patients should also have a fast-acting, breakthrough agent included in their medication profile. Treatment regimens need to be properly established for patients who have both chronic and non-chronic pain types. An assessment of activities of daily living needs to be performed in order to determine the complexity of the patients’ pain and its impact on his or her everyday living.5 Patients are also to be screened for the type and duration of pain they are experiencing in order to differentiate between chronic and acute pain, while also determining the underlying disease state.5 These areas of assessment are integral for proper medication management.

Recent research suggests that opioid misuse may be linked to depression in patients with no history of substance abuse.

The treatment of pain in this

participant over the age of 65 years. No other exclusion Current Pain Level Effectiveness of NonEffectiveness of criteria were used. Due to (scale 0-10) Opioid Medications Opioid Medications (scale 1-5) (scale 1-5) the length of the survey, Senior Community Center (n=13) 1.7 (n=13) 3.5 (n=8) 3.2 (n=5) participants were incentivized by receiving a small gift bag Pharmacy Location 1 (n=7) 2.3 (n=7) 2.7 (n=7) 3 (n=1) upon completion. The gift bags Pharmacy Location 2 (n=5) 4 (n=5) 2.6 (n=5) 3.5 (n=2) contained a variety of over-thePrimary Care Physician Office (n=4) 5 (n=4) 4 (n=3) 3 (n=1) counter health and wellness Average Across All Locations 3.25 3.2 3.18 products, such as Kleenex®, population of patients should (PHQ-2).6,7 The Wong-Baker shampoo or conditioner, hand typically include an adjuvant FACES scale is a popular visual sanitizer, toothpaste, lotion, or agent, such as an antidepressant. scale that uses facial expressions dental floss.

Taking into account the proper to help illustrate the patient’s pain Results management of pain given the level. The PHQ-2 questionnaire During the three month data aforementioned guidelines, the inquires about the frequency of collection phase, a total of 29 overall objective of this study is depressed mood and anhedonia surveys were completed in their to provide insight into the selfover the past two weeks. The entirety and able to be used for management of pain in older PHQ-2 questionnaire is meant statistical analysis. Specifically, 13 adults. Specific aims include: to be utilized as a means to surveys were collected from the determining whether there is screen for depression and not as senior community center, 4 surveys a gap in care with regards to a diagnostic tool. Patients who were collected from the primary pain management within this screen positive (score of >3 out care physician office, and 7 and 5 population, defining the abuse of 6) should be further evaluated surveys were collected from each and misuse prevalence within this utilizing the PHQ-9 to determine of the independent pharmacy age group, and assessing potential whether they meet the criteria for locations. correlations between depression a depressive disorder.7 The survey Demographics collected from and medication abuse through utilized in this study can be seen the surveys revealed that the the use of the Patient Health in Figure 1. average age of participants was Questionnaire-2 (PHQ-2).

The project was approved 75.4 years (range 65-93). Sixty-two by the Duquesne University Methods percent of the respondents were Institutional Review Board This study was conducted female (n=18).

(IRB). Following IRB approval, utilizing survey methodology.

Table 1 depicts respondent survey distribution began on A non-validated survey was answers to the survey questions January 4, 2014 and concluded developed by the researchers for regarding their current level of on March 4, 2014. Surveys were the purpose of this study. The pain control as assessed by the distributed at several ambulatory survey collected the following Wong-Baker FACES scale, as well locations. Specifically, surveys information: respondent as how well they felt their nonwere distributed at 4 locations demographics such as gender and opioid or opioid medications throughout the city of Pittsburgh, age, a respondent assessment of helped to control their pain. Table PA: a senior community center, two their current pain control utilizing 2 illustrates how respondents independent pharmacy locations, the Wong-Baker FACES scale, a selected their over-the-counter and a primary care physician description of the respondent’s pain medication (through referral, office. At each of these locations, current pain and treatment for advertisement, or self-selection). the surveys were distributed by it, and a brief assessment of Each table shows these results one of the research pharmacists depression status utilizing the and/or student pharmacists to any Patient Health Questionnaire-2 Continued on page 8 Table 1: Assessment of Effectiveness of Medications for Current Pain

Pennsylvania Pharmacist I November/December 2014 I 7

Features individually for each study location as well as aggregate averages.

Three of the 29 participants screened positively on the PHQ-2 questionnaire (score of >3 out of 6). Two of these participants rated their current pain level as 8 out of 10. The third participant stated that they were not currently having any pain.

Discussion This study was done as a pilot to assess the potential improper utilization of pain medication in an elderly population. The study locations selected to participate in this study were chosen due to their proximity of a pharmacy attempting to implement a pharmacist-managed pain center.

Results of this study showed that, on average, participant’s pain levels were well-controlled.

Survey results also showed that participants were most likely to select an over-the-counter pain medication as the result of physician referral or by their own self-selection. Lastly, there appeared to be a slight correlation between potential depressive disorders and enhanced perception of pain; however, more data is needed to fully substantiate this claim.

The largest limitation to the study was the small sample size.

Data was collected for a time period of three months with the hope of collection at least 100 surveys. Despite gift bag incentives, participants were often unwilling to complete the survey.

Of those that did, some did not complete the form in its entirety, making statistical significance impossible to prove. Another limitation to the study was that the questions were subjective in nature and patient-reported. This could potentially lead to inaccurate or incomplete information gathered.

Despite the study limitations, the qualitative pieces of the survey did reveal that as a whole, the participant’s pain was being treated in accordance to guidelines for the management of pain in older adults. Additionally, interaction with the research pharmacists during survey collection resulted in many counseling sessions on proper utilization of pain medications as well as nonpharmacologic options to help alleviate pain.

Future plans are to continue this study to gather more data in order to assess the feasibility of a pharmacist-managed pain center in this area of the city.

The researchers wish to thank the Pennsylvania Pharmacists Association Educational Foundation for the funding of this study.

See the survey used at www.papharmacists. com/?page=GrantProgram under 2013 grants and find Sean Lasota’s information.”

References 1. US Census Bureau. International database. Table 094. Mid year population by age and sex. Available at: http://www. census/gov/population/www/projections/ natdet-D1A.html. Accessed October 2, 2013.

2. American Academy of Addiction Psychiatry 23rd Annual Meeting and Symposium. Abstract 25. Presented December 8, 2012.

3. Lowry F. Prescription opioid abuse in the elderly an urgent concern. Medscape.

December 13, 2012.

4. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009; 57(8):1331-46.

5. Kaye AI, Baluch A, Scott JT. Pain management in the elderly population: a review. Ochsner J. 2010; 10(3):179-87.

6. Wong-Baker FACES Foundation. 1983.

Available at: www.wongbakerfaces.org.

Accessed April 20, 2014.

7. Pfizer. The Patient Health Questionnaire-2. 1999. Available at: http:// www.cqaimh.org/pdf/tool_phq2.pdf.

Accessed May 1, 2014.

Table 2: Person Responsible for Pain Medication Selection Nobody

Doctor

Pharmacist

Nurse

Advertisment

Family, Friend or Neighbor

Not Applicable or No Response

Senior Community Center (n=13)

1

4

0

0

0

0

8

Pharmacy Location 1 (n=7)

1

1

2

0

1

0

2

Pharmacy Location 2 (n=5)

2

0

0

0

1*

2

1

Primary Care Physician Office (n=4)

0

2

0

0

0

0

2

Total Across All Locations

4

7

2

0

2

2

13

* = respondent selected more than one answer to the question

8 I Pennsylvania Pharmacist I November/December 2014

Educational Foundation Advancing Patient Care

My Profession...My Practice...MyCORPORATION Philanthropy INDEPENDENT PHARMACY COOPERATIVE

“I support the Foundation with my personal contributions because it supports all pharmacists in our activities to advance patient care. I have to Synergize your “voice” with theadmit, that originally it took a bit of peer pressure to make me realize that “voices” of your colleagues for donating to the Foundation is something all of us should do. stronger legislative representation

But once I understood all it does and can do, from our grant program to the student poster presentations and programs on substance abuse, I beHave access to industry leading came a firm believer. Now it’s your turn - donate today to the PPA Educadrug pricing and a transparent tional Foundation.” rebate structure Receive dividends and purchasing rebates on your prime vendor Melissa “Missy” Sherer Krause, PharmD, Consultant, Pharmacy Healthcare Solutions, Inc. (PHSI) and Foundation Board member purchases Have access to many educational programs and services including a variety of CE opportunities

For more information on how you can make a difference, www.papharmacists.com/foundation.

102 Enterprise Drive, Frankfort, KY 40601 800-928-2228 | apsc@apscnet.com | www.apscnet.com

Educational Foundation Advancing Patient Care

My Profession...My Practice...My Philanthropy “I support the Foundation with my personal contributions because it supports all pharmacists in our activities to advance patient care. I have to admit, that originally it took a bit of peer pressure to make me realize that donating to the Foundation is something all of us should do.

But once I understood all it does and can do, from our grant program to the student poster presentations and programs on substance abuse, I became a firm believer. Now it’s your turn - donate today to the PPA Educational Foundation.”

Melissa “Missy” Sherer Krause, PharmD, Consultant, Pharmacy Healthcare Solutions, Inc. (PHSI) and Foundation Board member For more information on how you can make a difference, www.papharmacists.com/foundation.

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INTRODUCING...

The Pennsylvania Pharmacist Care Network (PPCN) will be the premiere professional network of pharmacists collaborating to optimize appropriate medication use to promote positive patient health outcomes.

The network’s goals are to:  Create an enhanced standard of care and expectation of medication management services in pharmacy practice  Improve patient medication use  Avoid unnecessary healthcare costs and provide support services for pharmacists within the network

Thank you for helping us choose our logo!

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Pennsylvania Pharmacist I November/December 2014 I 11

Industry News

Small Doses Book Announcement: African American Home Remedies For a significant portion of the African American population, the use of home remedies and herbs was an important component of health care when they had no health insurance and/or no funds and were unable to regularly visit conventional health care practitioners.

African American Home Remedies utilizes information obtained from two studies conducted in affiliation with the University of Michigan to demonstrate the use of over one hundred home remedies and herbs and their relation to socio-demographic characteristics in the African American community. Information includes what the respondents used the remedies to treat,

what the remedies have been used to treat in the past, clinical or scientific support for use of the remedies, and precautions and toxicities, if any, associated with use of the remedies.

Authors: Eddie L. Boyd and Leslie A. Shimp Format: Softcover Pages: 160 Price: $20.00 ISBN: 978-1-935754-32-9 Contact: Melissa Teutsch, Sales & Marketing Director, 337-482-1163, mgt0187@louisiana.edu z

The Pennsylvania Project Improving medication adherence across the health care system is an ingredient that is vital to improving patient outcomes and reducing downstream health care costs. The Pennsylvania Project, a large-scale community pharmacy demonstration study, evaluated the impact of a pharmacy-based intervention on adherence to five chronic medication classes. An article about the project can be viewed on our website at http://www. papharmacists.com/?page=PatientCare under Additional Resources. z

Pharmacists Say it Best …

Certification Excellence “PTCB Certified Pharmacy Technicians continually demonstrate the highest excellence of professional performance across practice settings. They are among the best qualified to participate in operational functions of dispensing and inventory management. Our pharmacy simply couldn’t function without our team of PTCB CPhTs.” —Jeanie Barkett, RPh, Long Term Care Pharmacy Lead Pharmacist, Providence Specialty Pharmacy Services, Portland, OR

12 I Pennsylvania Pharmacist I November/December 2014

Since 1995, the Pharmacy Technician Certification Board (PTCB) has certified over 400,000 technicians nationwide and is the only pharmacy technician certification program endorsed by the American Pharmacists Association, the American Society of HealthSystem Pharmacists, and the National Association of Boards of Pharmacy.

Do it for your pharmacy.

Do it for your patients.

Do it for you.

Encourage your technicians to become certified today!

Candidates may apply to take the Pharmacy Technician Certification Exam online at www.ptcb.org.

CONNECT ONLINE:

Industry News Thank you to all who Tweeted!

PPA proudly participated in the 2nd Annual Pharmacist Tweet-a-thon on October 2nd. The Tweet-a-thon was coordinated by NCPA to celebrate American Pharmacists Month. The Tweet-a-thon used the #Pharmacist and gained participation from State, National, and International Organizations.

The goal of this event was to encourage pharmacists to share their story and tell the public about the good work they are doing. Thank you to the PPA Public Relations Committee for promoting the Tweet-a-thon and encouraging members to participate! z Here is what some of you had to say:

Pennsylvania Pharmacist I November/December 2014 I 13

Features Financial Forum:

What Constitutes a “Successful” Retirement?

Sustained affluence? Personal growth? A feeling of contentment?

This series, Financial Forum, is presented by PRISM Wealth Advisors, LLC and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

H

ow do you know if your retirement is living up to its potential? There isn’t a standard definition of a successful retirement. (Maybe there should be, but there isn’t.) It is interesting to see how different people define it.

Maybe income is the yardstick.

Make that income replacement.

A recent article in Financial Advisor Magazine put it this way: “Successful retirement is defined as the ability to replace current income in retirement.”

The Employee Benefit Research Institute, which tracks workplace retirement savings trends in America, defines retirement success in similar, if narrower, terms. To EBRI, “success” equals a combination of Social Security income and 401(k) savings that replace 80% of preretirement income after adjusting for inflation.1,2 Maybe health matters most.

Perhaps a successful retirement equates to successful aging – staving off mental and physical decline. In a poll of 768 nonretired investors conducted for the John Hancock Financial Network, 49% of respondents said being

healthy best signifies retirement success. ( Just 27% said having enough income represented success.) While we’d all like to feel like we are 30 when we reach 80, MarketWatch’s Elizabeth O’Brien notes that physical and mental independence shouldn’t be the only definition of successful aging: “We lionize the person living alone at 95, and while that’s certainly laudatory, we could also celebrate those who remain connected to their communities despite their infirmities, or those who have saved enough to afford whatever care is needed.3,4 Or maybe our capacity to make a difference or grow matters most. We can make the most of the “second act” in many ways – through service, through adventure, through learning, via some blend of personal growth and leaving a legacy. Many baby boomers expect nothing less.

A successful retirement is ultimately one meeting your expectations. Within months or years after you retire, you will probably consider how things are proceeding – and if your retirement looks something like the life you had in mind or the life

14 I Pennsylvania Pharmacist I November/December 2014

you planned for, then you can call it a success. z Citations 1. fa-mag.com/news/working-with-advisorimportant-to-retirement--success--studyshows-14074.html [4/25/13] 2. kiplinger.com/article/retirement/T001C022-S001-automatic-401k-saving-featuresno-fail-safe-to-ret.html [5/14/13] 3. johnhancockfinancialnetwork.com/blogentry/survey-non-retired-investors [1/11/13] 4. marketwatch.com/story/ successful-aging-protects-health-andwealth-2013-05-31 [5/31/13] Pat Reding and Bo Schnurr may be reached at 800-288-6669 or pbh@berthelrep.com. Registered

Representative of and securities and investment advisory services offered through Berthel Fisher & Company Financial Services, Inc. Member FINRA/SIPC. PRISM Wealth Advisors LLC is independent of Berthel Fisher & Company Financial Services Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note - investing involves risk, and past performance is no guarantee of future results.

The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional.

This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment

Pharmacy Quality Measurement Medicare Part D star ratings—a practitioner’s Q & A

by Lisa Schwartz, PharmD

This article originally appeared in the August 2014 issue of America’s Pharmacist, published by the National Community Pharmacists Association, Alexandria, Va. Reprinted with permission.

T

he Medicare Part D Star Ratings program has generated a lot of buzz in the past year, and pharmacy owners are asking questions about quality measurement, the ratings, and what effect they will have on their pharmacy. NCPA is running a series of short articles that discusses each of the measures published by the Pharmacy Quality Alliance, beginning with the five that are part of the Medicare Part D Star Ratings program. The first article appeared in the June 2014 issue; this and all subsequent articles will be available at www. americaspharmacist.net.

data to determine pharmacy performance on key areas that influence Part D Star Ratings, and creates a pharmacy-specific scorecard or dashboard to track performance.

Several wholesalers, pharmacy services administration organizations, franchises, and other groups have announced that their customers have access to PQS’s EQuIPP dashboard. A list of these groups is available on the News page of www.pharmacyquality. com.

How do I find out my pharmacy’s star rating?

At this time, Medicare does not give individual pharmacies a star rating. Pharmacy claims data is analyzed in the aggregate to assign a star rating to a Medicare Part D Prescription Drug Plan (PDP) or Medicare Advantage Plans with prescription drug benefits (MAPD).

What are the pharmacy quality measures that factor into plans’ star ratings?

They are high-risk medication use, diabetes treatment, medication adherence for oral diabetes medications, medication adherence for hypertension (in patients with diabetes), and medication adherence for cholesterol.

Technical definitions for calculating these scores is available in the technical notes for the 2013 plan year.

How do I find out if my pharmacy is helping or hurting the plans’ ratings?

The first company to market a tool for the management of pharmacy quality measure reporting is Pharmacy Quality Solutions. PQS accesses claims

Why is there a sudden interest in measuring pharmacy performance?

Recent changes to health care laws have put a greater emphasis on paying for health care that creates improved patient outcomes and reducing spending that does

PQA Published Measures 1. Proportion of days covered 2. Antipsychotic use in children under 5 years old 3. Adherence to non-warfarin oral anticoagulants 4. Diabetes medication dosing 5. Diabetes: appropriate treatment of hypertension 6. Medication therapy for persons with asthma 7. Use of high-risk medications in the elderly 8. Drug-drug interactions 9. Cholesterol management in coronary artery disease 10. Completion rate for comprehensive medication review 11. Antipsychotic use in persons with dementia

not. Health plans want healthy members and want to avoid spending money on services, tests, and treatments that do not improve patient health outcomes. Medicare Part D plans with five stars are allowed to market the plan year round and beneficiaries may make a one-time switch into a five-star plan. Plans that have lower than a three-star rating may be terminated after three years.

How do I improve my performance on the five quality measures tracked by medicare?

Three of the five measures are adherence-related. There many Continued on page 16

Pennsylvania Pharmacist I November/December 2014 I 15

Features resources and tools available to help improve patient adherence to prescription drugs. Coordinated refills and regular contact with a local pharmacy have been shown to improve adherence. Many pharmacy software systems have programs that help pharmacies identify maintenance medications due for refill, but automatic refills fall short when communication with the patient is not part of the picture. Contact NCPA for information about the Simplify My Meds® coordinated refill adherence program (www.ncpanet.org/smm).

I understand that network pharmacies contribute to the plan’s star rating, but what else figures into the rating?

In total, there are 18 measures for PDPs and 51 for MA-PDs. Plans are rated on customer services (such as call center hold times, timely enrollment, complaints, and members leaving the plan), pharmacy hold time at the call center, the appeals process, patient safety, and, specific to MA-PDs: health screenings, vaccination, and managing chronic conditions (such as diabetes, osteoporosis, blood pressure, and fall risk). Patient

safety measures are more heavily weighted and the pharmacy measures fall into this category.

Do non-part D plans have star ratings?

No and yes. The Star Ratings program belongs to the Centers for Medicare & Medicaid Services and Medicare Part D (there is also a Star Ratings program for nursing homes). That said, the pharmacy quality measures that CMS uses are published by the Pharmacy Quality Alliance (PQA) and it is likely they will be used by plans and pharmacy benefits managers

PQA Published Measures High Risk Medications: Pharmacy Quality Measures Explained

By Sarah Squires, MBA, PharmD Where does this measure fit into the overall Medicare Part D Star Ratings?

This measure is classified under “Drug Pricing and Patient Safety” in the Part D Domain and specifically targets patient safety.

What does this measure analyze?

This measure compares the number of patients who received at least two prescription fills for the same high-risk medication during the measurement period with the number of people in the eligible population. The eligible population is defined by patients who are 66 years or older on the last day of the measurement year (typically 12 months), continuously enrolled, and have at least two prescription fills for any medication over the course of the measurement period.* What impact can this have on my pharmacy?

This measure, related to the number of patients in your pharmacy that fit the eligible population criteria regarding high risk medications, can affect the star rating of plans that include your business in their network. Should your population of patients on high risk medications reduce the plan’s star rating rather than improving it, your pharmacy may not be included in their network in the future.

What impact does this have on patient safety?

High risk medications in patients over 65 have everything to do with patient safety. The Beers’ list, updated in 2012 by the American Geriatrics Society, is referenced for this Medicare Part D Star Rating measure. Patients who fit criteria of this measure are deemed to be at a higher risk for an adverse drug event (ADE) than they would be if they were on a medication not recognized as “high risk.” If patients who fit the criteria remain on high risk medications and have an ADE due to that medication, the star rating of the plan and the patient’s health and safety would suffer.

What can I do improve performance in my pharmacy?

Patients who are age 65 or older and are on at least one high risk medication that has been filled at least two times over the measurement period could be compiled into a list for reference purposes to reconcile these problems. Medication therapy management (MTM) sessions could be conducted in the pharmacy to evaluate the status of these patients’ regimen. It would be beneficial to describe to patients what adverse drug events could take place with the high risk medication and for what signs or symptoms they are looking. With the consent of the patient and physician, therapy changes may be made to switch the high risk medication to an alternative not found on the Beers’ list.

Sarah Squires, MBA, PharmD, is a 2014 graduate of the Harding University College of Pharmacy *Additional Resources: • Use of High-Risk Medications in the Elderly (HRM): http://pqaalliance.org/images/uploads/files/HRM%20Measure%202013website.pdf • Pharmacy Quality Alliance: http://pqaalliance.org/measures/cms.asp • Beers’ list: http://www.americangeriatrics.org/files/documents/beers/PrintableBeersPocketCard.pdf

16 I Pennsylvania Pharmacist I November/December 2014

to build networks if they are not already doing so. PQA has published 11 pharmacy quality measures (see box), though only five are used by CMS. For more information about PQA’s published measurements and measurements under development, visit http:// pqaalliance.org/measures/.

How soon will the star ratings program affect my pharmacy?

The Star Ratings Program affects your pharmacy right now.

Medicare Part D plans have been given Star Ratings since the 2012 plan year, which means data as far back as 2010 was analyzed to rate the plans before open enrollment in October 2011. While the preferred networks that popped up in the 2012 plan year appear to

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be based on business negotiations instead of performance, CMS has released reports of claims data analysis that show preferred net works did not always lead to savings over pharmacies not in the preferred network. Legislation (H.R. 4577) has been introduced that would allow any pharmacy located in a medically underserved area to participate in all Medicare Part D Plan networks, including the plan’s discounted or “preferred” network.

What happens if I do nothing?

If you are already meeting performance goals, the answer might be nothing. Keep in mind that the Star Ratings program may add additional pharmacy quality measurements or change the

goals. The hope early was that high-performing pharmacies could negotiate higher reimbursement, but it’s more likely that highperforming pharmacies will be allowed to stay in the network.

If you are not meeting performance goals, it is possible that the patients of your pharmacy are not meeting drug therapy goals or are taking inappropriate medications. A Medicare Part D Plan could exclude you from its network to improve its Star Ratings. By dropping underperformers, the plan can steer patients to a pharmacy that is meeting performance goals. z Lisa Schwartz, PharmD, is NCPA senior director, management affairs.

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Association News

Updates from PPA Interns – Where Are They Now? Courtney B. Graham, PharmD Wilkes University, Nesbitt College of Pharmacy, Class of 2014 Future Plans: Pharmacist, Weis Pharmacy, Pennsylvania Current City: Laporte, PA Other Plans: I plan to travel and continue my involvement with PPA. Reflections/Advice for Students: My advice is to take risks academically for rotations. Explore a side of

pharmacy you don’t have any experience in, travel somewhere you didn’t think you would, and learn as much as you can. Keep with you all of the great things each of your mentors have taught you. Use the skills you have developed with confidence and be the best you can be! z We have not heard from Michael Lehr and Ilana Portman at this time. We hope to bring you details about them in the near future!

In Memory of David P. Rosenfield PPA President 1972-1973 David was born in Pittsburgh, Pennsylvania on November 29, 1925.

He served in WWII as a medic, receiving the Medal of Honor and the Purple Heart for his service to our country.

He saw action in the Army as a medic. His unit liberated Mauthausen (a concentration camp in Germany). He saw first-hand the skeleton victims of the Germans.

After the war, Dave returned to Pittsburgh where he attended The University of Pittsburgh’s school of pharmacy. He knew at the age of 13 that he wanted to be a Pharmacist. He worked in a pharmacy as a teen.

Dave owned Taxey Drug Store in the Hill District until the riots of 1968 burned the building completely

to the ground. Dave then purchased and ran Bell’s Drug Store in Canegie, PA for 25 years, then selling it to a chain and then retiring.

During his active years in pharmacy, Dave served as President of Mu Chapter of Alpha Zeta Omega Pharmacy Fraternity President of National Alpha Zeta Omega Pharmacy Fraternity, President of Allegheny County Pharmaceutical Association and President of the Pennsylvania Pharmaceutical Association. He loves his profession and was proud to hold these positions.

He also was a pharmacy consultant for Blue Cross of Western Pennsylvania.

Dave passed away on June 21, 2014, at age 88, from complications of a brain tumor.

Surviving Dave are three grown children: Mindy (Peter) Goodman, Stuart (Nancy) Rosenfield, Elyse (Mark Sweitzer) Rosenfield, ex-wife and devoted friend, Elaine Rosenfield, three grandchildren: Matt Rosenfield, Steve Rosenfield and Ari Goodman. z

Pennsylvania Pharmacist I November/December 2014 I 19

Features

The Price to Save a Life: Pharmacists’ Role in the Growing Area of Specialty Drugs By: Nellie Jafari, PharmD Candidate 2015, Virginia Commonwealth University

A

ccording to PharmaVoice, specialty drugs are considered “typically high-cost, scientifically engineered drugs used to treat complex, chronic conditions that require special storage, handling, and administration, and involve a significant degree of patient education, monitoring, and management.”1 These medications can be oral, injectable, or biologic products. They can be used to treat a variety of diseases such as cancer, multiple sclerosis, rheumatoid arthritis, and rare genetic conditions.2 The exact definition of the term “specialty drugs” is a challenge to find as various stakeholders have their own definitions. The Center for Medicare and Medicaid Services specifically says that specialty drugs are those that cost more than $600/month.1 Regardless of the exact definition, these drugs are certainly going to have a huge impact on pharmacy practice and health care spending.

Specialty medications are a continually growing portion of the prescription drug market.

According to Express Scripts, there will be a 40% growth by 2014 and 67% by 2015 in the development of specialty drugs.1 Since 2010, specialty drugs have had a higher number of approvals

than traditional drugs.3 Specialty drugs also have a disproportionate share of overall drug spending because each course of therapy is so expensive.4 In 2013, specialty drugs made up 25% of the $263.3 billion U.S prescription drug spending.3 It is projected that in 2018, 6 of the 10 best-selling drugs by revenue will be specialty drugs.1 These drugs provide hope in saving lives for diseases like cancer but at a cost that many cannot afford. It could cost almost $750,000 per year for a

20 I Pennsylvania Pharmacist I November/December 2014

patient to be treated with some of the most expensive specialty drugs.3 Another example is the drug Sovaldi for hepatitis C. The treatment seems to be very effective, but one pill costs $1,000, totaling $84,000 for the entire treatment course.1 Due to these high costs, many exchange plans have decided that consumers will have to pay out of pocket costs.5 Although these innovative treatments can be lifesaving for some patients, the costs overtime add financial stress on our health care system and patients.

According to America’s Health Insurance Plans (AHIP), there are a number of reasons why these drugs are so expensive. A small percentage of patients utilize specialty medications, which drives up the cost per patient as manufacturers try to make up for the cost of developing the agents.

Another contributing factor is the length of biologic drugs exclusivity period. Traditional medications are given a 5 year exclusivity during which other companies may not bring a similar drug, or generic, onto the market. Conversely, biologic drugs are given twelve years until other companies may bring a similar drug, in this case a biosimilar, to market.3 Although the Affordable Care Act did create a way for the FDA to approve interchangeable biosimilars, none have been approved. The lack of biosimilars on the market and a long exclusivity period mean that there are few or no lower cost alternatives for these medications.4 Pharmacists’ patient care services can help ensure that these high cost drugs are used safely and effectively and thus maximize their value. Pharmacists in all practice settings can counsel their patients taking specialty medications on proper administration, how to manage side effects, and the importance of adherence.6 Pharmacists that choose to specialize in these high cost medications may work in a specialty pharmacy that focuses on dispensing these products along with providing services such as medication therapy management, patient advocacy and treatment adherence.2 Health plans can

contract with specialty pharmacies who focus on providing care to patients related to the complex medication deliveries and treatments associated with specialty medications.7 One way to reduce the cost impact of specialty drugs on overall health care spending is to implement policies to increase adherence. Studies have shown that adherence and persistence leads to better health outcomes which reduce cost.8, 9 According to WellPoint, “adherence for specialty drugs is critical to quality care, maybe more so than anywhere in medicine.”10 Complex diseases and medications lead to adherence challenges. This is an issue for specialty drugs since many of them have to be injected or require patient specific dosing and clinical management.8 To help improve patient adherence, pharmacists can provide education to patients about their disease state as well as how to administer or take the medication, offer emotional support, and follow up about their disease management.10 Pharmacists in all settings play a key role in reducing health care costs and ensuring quality by assisting patients and providers in the appropriate use, management, and administration of specialty drugs. z

4. AHIP Coverage. NYT: Specialty drug prices “soaring”. 18 April 2014. <http:// www.ahipcoverage.com/2014/04/18/nytspecialty-drug-prices-soaring/>.

5. Pearson CF. Consumers likely face high out of pocket costs for specialty drugs in exchange plans. Avalere Analysis. 20 February 2014. <http://avalerehealth. net/expertise/managed-care/insights/ consumers-likely-face-high-out-of-pocketcosts-for-specialty-drugs-in-excha>.

6. NASP. Specialty pharmacy certification board recognizes first wave of certified specialty pharmacists. 11 November 2013. < http://www.spcboard.org/certification/ eligibility-requirements/>.

7. Weingart SN, Brown E, Bach PB et al. NCCN Task Force Report: Oral chemotherapy. J Natl Compr Canc Netw.

2008; 6 Suppl 3: S1-14.

8. Ruddy K, Mayer E, Partridge A. Patient adherence and persistence with oral anticancer treatment. CA Cancer J Clin.

2009; 59(1): 56-66.

9. IMS Institute. “Avoidable Costs in U.S. Healthcare: The $200 Billion Opportunity from Using Medicines More Responsibly.”

19 June 2013. <http://www.theimsinstitute. org>.

10. Sipkoff M. Payers struggle to ensure high level of adherence to costly specialty drugs. Managed Care. 2008; 17(7):24-6, 29, 31.

1. Specialty Drugs: An evolving commercial model. PharmaVoice. 2014; 14(2): 12-19.

2. American Pharmacist Associations.

Accessed 27 May 2014. <http://www. pharmacist.com/specialty-pharmacy>.

3. AHIP. Specialty Drugs-Issues and Challenges. America’s Health Insurance Plans Issue Brief. 2014; 1-7. < http:// www.ahip.org/IssueBrief/Specialty-DrugsChallenges-Issues/>.

Pennsylvania Pharmacist I November/December 2014 I 21

Departments

Campus Checkup LECOM This past month, LECOM was very excited to attend the PPA Annual Conference in Mars, PA. We had a great showing of students in attendance and were extremely excited to compete in the Achieving Independence Competition for the first time. All of our students learned a lot from the student programming and residency showcase. At the Leadership and Awards Dinner on Saturday night, we were thrilled to win two of the student awards â&#x20AC;&#x201C; The Membership Award and the Public Awareness and Relations.

22 I Pennsylvania Pharmacist I November/December 2014

We are looking forward to attending the Mid-Year conference this February in Harrisburg, PA. With October approaching, LECOM is now looking forward to American Pharmacists Month. We have planned a lot of exciting activities for this month including a rotating health fair with local Rite Aids in the Erie area as well as a Juvenile Diabetes Research Foundation Walk and a special monthly meeting starring Loren Kirk, a national representative from APhA-ASP. z

University of Pittsburgh The University of Pittsburgh’s PPA chapter has been busy recruiting, fundraising and organizing our events for the semester. We had a great time promoting PPA and recruiting members at our annual APhA-ASP welcome back picnic in August.

Our membership ambassador, Jenn Fever, has been doing a great job and we are happy to welcome thirteen new members to our chapter thus far! We were also thrilled to host our very first general body meeting at the beginning of September and are excited to continue hosting meetings on a monthly basis. In order to increase our fundraising efforts to support PharmPAC we have been selling a newly designed item, Pitt PPA T-shirts.

Many of our members had a great time at the Allegheny County Pharmacists Association Picnic in August. We always enjoy the opportunity to mingle and network with fellow pharmacy students and practicing pharmacists in Allegheny County. Unfortunately we had to surrender our bragging rights to Duquesne for the second year in a row when they beat us in the annual dodgeball tournament,

but both teams still had a great time! The PPA Annual Conference is always a highly anticipated event and all 18 members that we sent all had a great and rewarding experience.

An event, that our fellow pharmacy students always look forward to, is the fall leadership retreat hosted by our Pitt APhAASP and Phi Lambda Sigma chapters. During this event we are given the opportunity to expand our leadership capabilities and brainstorm ideas for our Dean’s Theme Projects. Each year our APhA-ASP chapter selects a “Dean’s Theme” that each of our organizations in the School of Pharmacy are encouraged to participate in. They can select various events or presentations that fall under this category, and the goal is to impact as many people as possible throughout the academic year by raising awareness or educating on this topic. This year’s Dean’s Theme is Operation Self-Care and our PPA chapter is excited to participate in events that will provide information on OTC products for women’s sexual health. We plan to coordinate events with the

various women’s classes offered on Pitt’s campus, the University of Pittsburgh Student Health Center/ Pharmacy, and various clubs that are largely comprised of females.

Continuing to look into the future our PPA chapter is excited to host our kick-off event for American Pharmacists Month with our APhA-ASP chapter where we will be hosting Pat Epple, the CEO of Pennsylvania Pharmacists Association. We are grateful for the time she will spend with us and our students are excited to hear the Legislative Update that will be provided. During this meeting our APhA-ASP chapter has also written a pledge advocating for pharmacist provider status that all of our students will be able to sign! Additionally, we are hoping to work with our local Poison Prevention Center in order to organize a couple of Katy’s Kids events throughout the Fall Semester. Finally, we are already planning ways to get as many of our fellow classmates as informed and excited as possible before attending Legislative Day in the spring. z

Student members: Did you know you have the opportunity to win $50?

For every new student pharmacist that you recruit to become a PPA member (make sure your name is on the application) you will be entered for a chance to win $50. A winner will be drawn at random and announced at PPA's 2015 Annual Conference. You do not need to be present to win. The competition ends August 31, 2015!

Invite your friends to join PPA today!

Pennsylvania Pharmacist I November/December 2014 I 23 Student members: Did you know you have the opportunity to win $50?

For every new student pharmacist that you recruit to become a PPA member (make sure your name is on the application) you will be entered for a chance to win $50. A winner will be drawn at random and announced at PPA's

Features

and the Law

By Don. R. McGuire Jr., RPh, 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.

MARIJUANA â&#x20AC;&#x201C; MEDICAL OR ??

M

arijuana, medical and otherwise, has certainly been in the news for the last several months. As more states legalize marijuana, for medical or recreational use, pharmacists are presented with a unique legal challenge to balance patient needs and legal requirements.

It is beyond the scope of this article to examine the literature and clinical research that would support or refute a medical use for marijuana. We will assume there is a legitimate medical use for marijuana, or its components, while we look at the legal question.

Some states have passed various laws to address the use of marijuana within their borders.

There is not a universal approach.

In many states, pharmacists are not involved in the dispensing of medical marijuana. If you were presented with the opportunity to do so, what should you consider?

The main question is; how legal is legal?

Marijuana remains a Schedule I drug under Federal law. Schedule I drugs are deemed to have no legitimate medical use and

have a high potential for abuse.

A state has no power to lower this classification. The United States Constitution provides that Federal law is supreme to state law.1 Generally, states may enact laws that are more stringent than Federal laws, but not more lenient.

For example, a state can move a Schedule III up to a Schedule II or move a non-controlled drug into Schedule IV within their borders.

But a state is unable to move a Schedule II down to Schedule III. This is a basic tenet in the relationship between Federal and state laws. If this is so, how are the states legalizing marijuana?

The answer is a concept called enforcement discretion.

This occurs when an agency responsible for the enforcement of a law decides to not enforce that law. An earlier example of this concept was the importation of prescription drugs from Canada.

The Food & Drug Administration (FDA) stated that all importation was illegal, but they exercised their discretion and would not prosecute those bringing in these drugs for their own use. In essence, the activity is still illegal,

24 I Pennsylvania Pharmacist I November/December 2014

but we choose to do nothing about it. The caveat here is that the agencies always have the ability to change their minds.

The Drug Enforcement Administration (DEA) current position is that they have enforcement priorities for marijuana. They are; 1) prevent distribution to minors, 2) prevent revenue from the sale from going to criminal enterprises, 3) prevent diversion from states where it is legal under state law to those states where it is not legal, 4) prevent state-authorized marijuana activity from being used as a pretext for trafficking other illegal drugs or other illegal activity, 5) prevent violence and the use of firearms in the cultivation and distribution, 6) prevent drugged driving and the exacerbation of other adverse public health effects, 7) prevent the growth on public lands, and 8) prevent possession or use on Federal property.

The DEA will not take any action in states that have legalized marijuana if the states agree to help with these priorities.

Therefore, individuals who possess marijuana for personal use on

Features private property in those states will not face DEA prosecution at this time. Because they do not possess it for personal use, a pharmacist dispensing marijuana is not covered by this exception. A pharmacist would also have to be diligent to make sure their dispensing did not violate one of these enforcement priorities.

The DEA has made it clear that it will change its stance if they believe a state is too lax in assisting with their enforcement priorities.

So how legal is legal? It is definitely not a rock solid legal foundation. Depending on your point of view, it could be seen as temporarily solid or merely illusory.

The uncertainty of this foundation may keep a number of pharmacists from engaging in the dispensing of marijuana. For those who decide to proceed, one

would hope that the medical benefit for their patients would far outweigh the risk to the patient and the legal risks for the pharmacist. The actual outcome remains to be seen. z 1: Article 6 - This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding. Š Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company.

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.

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Pennsylvania Pharmacist I November/December 2014 I 25

The Pennsylvania Pharmacists Association is pleased to announce the upcoming launch of Pharmacists CaRe, our external blog. This blog will promote the value of pharmacists and their role on the healthcare team.

We need YOUR help to make the blog a success!

Please consider serving as a blog author or a blog post reviewer. The guidelines for blog authors can be found on www.papharmacists.com/resource/resmgr/Blog/Guidelines_for_Pharmacists_C.pdf Questions? Contact PPAâ&#x20AC;&#x2122;s Communications Coordinator, Jenna Karge.

Blog Promotion!

Consider sharing the blog with your customers, patients, friends, and family to help us provide information to the public about the value of pharmacists!

Target Audience: The public (any non-pharmacist) This blog will promote the value of pharmacists, the services they provide and their role on the healthcare team.

26 I Pennsylvania Pharmacist I November/December 2014

Over $8.5 Million disbursed to participating members in 2013

Association News

Pharmacy’s Future is in the Stars Sheraton Four Points Pittsburgh North, Mars, PA Thank you to everyone who joined us in Mars from September 18 – 21 for Pharmacy’s Future is in the Stars!

The theme for our 2014 Annual Conference was fitting for those who attended to learn more about pharmacy and where the industry headed in the future. More than 350 attendees came together to attend continuing education programs, the exhibit hall, the Leadership & Awards Dinner, and other social events. For additional photos from the conference, please visit PPA’s website and Facebook page. z

28 I Pennsylvania Pharmacist I November/December 2014

Contest Winners Bring a Pharmacist Win a Free Registration Contest: One lucky winner received a complimentary registration to the 2015 Mid-Year Conference in Harrisburg or the 2015 Annual Conference in Grantville.

In order to be eligible for the drawing, you needed to have your name listed in the recruited by section of the conference registration by someone who has not attended a PPA conference in the past two years.

Congratulations to this year’s winner, Scott Miskovsky!

Member-Get-a-Member Contest: This marks the seventh year for our Annual Member-Get-Member Challenge and we awarded a $250 prize for helping us build our membership. Congratulations to Stephanie McGrath, our winner who was selected randomly and announced at the 2014 Annual Conference. Be sure to recruit new members from now until August 31, 2015 for your chance to win!

Student-Member-Get-a-Member Contest: Student members had the chance to win $50 by recruiting a PPA Student member. Congratulations to Kyle McCormick, Alyssa Jones, and Amanda Jaber, our winners who were drawn at random and announced at the 2014 Annual Conference. Be sure to recruit new members from now until August 31, 2015 for your chance to win!

Pharmacist Grand Prize: This year, PPA gave you many chances to win a variety of prizes during the Exhibit Hall. Members picked up game pieces at the PPA Registration desk and brought them to the Exhibit Hall on Friday and Saturday. On Saturday afternoon, after the Exhibit Hall vendors finished selecting winners for their prizes, PPA selected a winner for the Overall Pharmacist Grand Prize. Congratulations to this year’s winner, John Gans! z Residency Showcase: On Saturday afternoon, PPA’s Annual Residency Showcase was held. Over 100 students attended and took advantage of this opportunity to learn more about residency programs in Pennsylvania and the surrounding areas. Nearly 20 programs attended; representing over 120 positions!

We would like to thank the following programs for attending this year’s showcase: • Allegheny General Hospital • CJW Medical Center – Chippenham and JohnstonWillis Hospitals • Conemaugh Memorial Medical Center • Duquesne University • Geisinger Medical Center • Magee – Women’s Hospital of UPMC

• • • • • • • • • • • • •

Millcreek Community Hospital (LECOM) Moses Taylor Hospital Ohio Northern Penn State Hershey Medical Center Rutgers Institute for Pharmaceutical Industry Fellowships Saint Vincent Hospital St. Elizabeth Health Center University of Pittsburgh UPMC Hamot UPMC Health Plan UPMC Mercy UPMC St. Margaret West Virginia University Healthcare z

Continued on page 30

Pennsylvania Pharmacist I November/December 2014 I 29

Association News Achieving Independence Competition: This year, four schools of pharmacy participated in the Achieving Independence Competition. The teams that participated were from Jefferson University, Lake Erie College of Osteopathic Medicine, Philadelphia College of Pharmacy, and University of Pittsburgh. Thank you to all of the schools who participated and congratulations to the 2014 winning team, University of Pittsburgh! z Annual Golf Outing – Pittsburgh National Golf Club: The PPA Annual Golf Outing to benefit PharmPAC and the Educational Foundation took place at Pittsburgh National Golf Club on Friday, September 18, 2014. Thank you to all of the golfers who participated and to all of our Golf Tee Sponsors! Special thanks to RDC for their coordination of the golf tee sponsorships.

This year our top teams were tied and the tie was broke with a match of cards on #3. The winning team this year was Robert Frankil, David Epple, Rick Demers, and Steve Connell. The second place team was Scott Miskovsky, Mark Bucklaw, Ed Costello, and Mark Kuhns. Other golf outing winners included: Closest to the Hole on #8, Rob Frankil; Closest to the Hole on #16, Tom Franko; Longest Putt on #18, Jon Ference; Women’s Longest Drive on #7, Ellen Nastase; and Men’s Longest Drive on #7, Tom Franko. z

Special Thanks to the 2013-2014 Conference Committee Chair: Lauren Simko Members: Luke Barnes, David Cunningham, Tanya Dougherty, Al Emmans, Patricia Epple, Eric Esterbrook, Kimberly Ference, Robert Frankil, Donna Hazel, D Scott Himler, Jacqueline Klootwyk, Sean Lynch, Jamie McConaha, Barbara McNeal, Katie Naper, Ellen Nastase, Bruce Sigman, and Leigh Webber.

Their ideas and hard work helped coordinate a fantastic conference! z

30 I Pennsylvania Pharmacist I November/December 2014

Exhibit Hall: Thank you to the companies who exhibited with us this year! Congratulations to John Gans winner of the overall grand prize drawing and congratulations to all those who exhibitor prizes!

Our exhibitors this year included: Abbvie Allegheny County Pharmacists Association AmerisourceBergen BucksMont Pharmacists Association Cardinal Health Chattem- A Sanofi Company Codonics Duquesne University School of Pharmacy Health Plus, Inc. iMedicare Independent Pharmacy Buying Group Janssen Jefferson School of Pharmacy Johnson & Johnson Diabetes

Solutions Companies Lifescan Keystone Pharmacy Purchasing Alliance Kinray Lake Erie College of Osteopathic Medicine School of Pharmacy Mass Mutual Financial Group MedImmune Merck Merck & Co. Vaccines McKesson Novo Nordisk, Inc. Otsuka- US Pharmaceuticals Pennsylvania Pharmacists Association Pennsylvania Pharmacists Association Educational Foundation Pfizer Vaccines Pharmacists Mutual Companies Pharmacy Quality Solutions Pharmacy Technician Certification Board PharmPAC Philadelphia College of Pharmacy

PPCN PRS Pharmacy Services / NASI QS/1 Repeat Rewards Rite Aid Pharmacy R.J. Hedges & Associates Rochester Drug Cooperative S & L Solutions LLC Sanofi U.S. SARPH ScriptPro Temple University School of Pharmacy The Compliance Team, Inc. Tri-State Distribution University of Pittsburgh School of Pharmacy U.S Micro-Solutions, Inc. Value Drug Company Walgreens Wal-Mart Stores/Samâ&#x20AC;&#x2122;s Club Health and Wellness Wilkes University School of Pharmacy z

Continued on page 32

Pennsylvania Pharmacist I November/December 2014 I 31

Association News Special Thanks to our Conference Sponsors Much appreciation to these companies whose sponsorship helped to provide key funding for this year’s conference!

Diamond Level Conference Sponsors: H.D. Smith Keystone Pharmacy Purchasing Alliance, Inc. Kinray Rite Aid Pharmacy Pearl Level: Janssen Golf Tee Sponsors: Special thank you to the companies who sponsored a golf tee sign to benefit PharmPAC & the Educational Foundation!

Amerisource Bergen Bayer Consumer Becton Dickinson BSN- Jobst DJO Global – Bell Horn/ Dr. Comfort

Saturday Breakfast: Rite Aid Pharmacy Sunday Breakfast: Johnson & Johnson Diabetes Solutions Companies, Lifescan Other Contributions: Lancaster County Pharmacists Association NACDS Drive Medical Independent Pharmacy Buying Group Johnson & Johnson Consumer, Lifescan Keysone Pharmacy Purchasing Alliance McKesson Medline Merck Consumer Novartis Consumer

Thank you also to….

RDC for coordination of the golftee sponsorships and golf’s gift Rx Systems for providing the themed note pads for the conference z

Owen Mumford Pharmacists Mutual Companies Principle Business Enterprises Proctor & Gamble Consumer Quality Care Pharmacies RDC Roche Diagnostics Sellersville Pharmacy US Nutrition – Nature’s Bounty/ Sundown Value Drug Company z

Rite of Roses: We extend our deepest sympathy to the families, friends, and business associates of these members. Their contributions to the profession of pharmacy and the Pennsylvania Pharmacists Association will be forever etched on our memory to not be forgotten.

In Memory Of… Daniel Bender, Beaver Falls, Pharmacist of College Hill Pharmacy; PPA Member since May 24, 2010 John Erik, one of the early members, board member and President of SARPH. He was a graduate of Temple School of Pharmacy.

Henry Klaus, Upper Darby, Pharmacist of Public Drug David Rosenfield, Pittsburgh, Past President of PPA; PPA Member since January 1, 1973 Harry Toran, graduate of Temple School of Pharmacy, class of 1949 z 32 I Pennsylvania Pharmacist I November/December 2014

PPA Educational Foundation Meet Pharmacy’s Shining Stars: The PPA Educational Foundation hosted an active booth during the Conference Exhibit Hall. Attendees were encouraged to purchase stars in the sky to honor pharmacy’s shining stars! Individuals could purchase one in their own name or in someone else’s honor. Stars were only $1.00 per star. We then posted the “sky” of stars on the front of our head table during the Leadership and Awards Dinner, where the theme was “An Evening beneath the Stars.”

The Foundation raised approximately $130 from this effort and also added four new monthly contributors to its roster AND received several other contributions. This money helps the Foundation with its Grant program, sponsoring the Pain Competition, and hosting the Poster Presentations.

Congratulations to our Pharmacy Stars: Abayasekara, Sharon Antinopoulos, Brandon – 2 Astle, Janet Bacci, Jenny

Bechtel, Ed Becker, Lisa Brodsky, Mel

Copatofsky, Kristin Costa, Stacy – 3 Demers, Rick DiCello, Carmen Dillon, Jim Doud, Larry Downs, George Drab, Scott Drew, Greg Englehart, Ida May Epple, Pat Esterbrook, Eric – 2 Ferri, Bill Fisanich, Lisa Frankil, Rob Garmond, Gale Gerhart-Rothholz, Julie Hart, Janet Hartman, Cory Hazel, Donna Horger, Steph Hussar, Dan and Sue – 2 Jeffries, Maura Jonas, Stan Johnston, Terry Jordan, Chrissy Joyce, Tam Kasbekar, Nish Kay, Doug Kayden, Bob Kayden, Coleen – 2 Kendra, Marty – 2 Kirk, Jenn Klootwyk, Jacki Kosty, Tim Krause, Missy Lee, Sherri McCormick, Kyle – 2 McGrath, Stephanie McManus, Mary

McGivney, Melissa Miller, Bethany Miskovsky, Scott – 2 Mitchells, Caitlin Montgomery, Pauline Musheno, Michele Musheno, Jerry Osborne, Maria Para, Lauren Patel, Trina Pater, Karen Richter, Rachel Robold, Ashley Rothholz Family Rothholz, Evan Rothholz, Mitch S., Brenne S., Katie Shaffer, Grey

Sigman, Bruce Smiga, Rich – 2 Smith, Dave Smith, Jennie Smith Cooney, Stephanie Talbott, Terry Turco, Linda Turco, Neil Value Drug Warunek, Letitia Weigand, Megan Welch Family Wiggin, Andrew z

Pennsylvania Pharmacist I November/December 2014 I 33

Association News

Leadership and Awards Reception & Dinner The 2014 Leadership and Awards Reception & Dinner was a stellar evening for all who attended. President Eric Esterbrook introduced the 2014-2015 Board of Directors and shared his vision for leading PPA. In addition to this, the dinner honored PPA Past Presidents, Special Guests, and Award Winners. More information on these awards and their history can be found at http://www.papharmacists.com/?page=Awards.

The 2014 Award Winners are: Julie Gerhart-Rothholz: Bowl of Hygeia Award Sponsored by the APhA Foundation, NASPA and Boehringer Ingelheim Julie Gerhart-Rothholz is a 1994 graduate of the Philadelphia College of Pharmacy and Science (now University of the Sciences in Philadelphia). Now an Associate Director of Pharmacy Affairs at Merck, she became a pharmacist because she had a passion for helping people and began her career serving patients in nursing homes, those with intellectual and physical disabilities who were in group homes, and those who were in psychiatric care. For many years, Gerhart-Rothholz chaired or served as site captain for drives that collected food, clothing, cleaning supplies, toys, and school supplies for the disadvantaged people served by the Keystone Opportunity Center. As the mother of a child with Down syndrome, she and her husband, Mitchel Rothholz, worked with their county and created welcome packets for new parents of children with Down syndrome. Gerhart-Rothholz has volunteered for Children’s Hospital of Philadelphia Buddy Walk, running the auction and raffle in 2013 on just three weeks’ notice and raising more money than prior years’ auctions. Gerhart-Rothholz is a selfless and dedicated individual to her family and community and is an active Board member, Committee chair, and committee member for the PPA Educational Foundation.

Julie Nowak: NASPA Excellence in Innovation Award Sponsored by Upsher-Smith Laboratories A 1977 graduate of Duquesne University, Julie Nowak has a pharmacy practice that serves as a model for other pharmacists. In her duties as Lead Pharmacist and Consultant Pharmacist at Magee-Womens Hospital of University of Pittsburgh Medical Center, Nowak can in any one day be positively impacting patient care literally along the entire continuum of life – from the earliest of the early in the NICU to the oldest of the old on the acute care and transitional care floors. It is in these daily duties that she looks for opportunities and new and innovative ways to further improve patient care. In 2007, she was chosen as one of nine pharmacists from seven hospitals in greater Pittsburgh to conduct a year-long demonstration project expanding the role of pharmacists in medication management substantiating that appropriate administration of medications leads to improved safety and quality of care. The results of this pilot project revealed the relative ease at which comprehensive medication reconciliation can be incorporated into clinical practice. Through Nowak’s efforts, this practice is still being conducted at Magee, and the team has expanded this work through the use of pharmacy interns who gain valuable experience in patient and professional communication skills, while enhancing the care the patients receive.

Scott Drab: PPA Pharmacist of the Year Award Scott Drab is an associate professor at the University of Pittsburgh School of Pharmacy and holds an adjunct clinical instructor appointment at Duquesne University Mylan School of Pharmacy.

Drab exemplifies the pharmacy profession and leads by example every day to educate patients, students and other health care professionals on how to care for patients with life-long chronic conditions. Throughout his career, he has served as a mentor, a colleague and a friend to many, and has always demonstrated the true meaning of “care provider” through his involvement in community service, professional organizations and dedication to the advancement of the profession in provision of direct patient care. His approach to clinical practice has truly been patient centered.

He is well respected in the pharmacy community for his dedication to patient care and his passion for teaching, with a world-wide reputation as a leader in diabetes education, having served as the Director of Curricular Design of DM Educate™ since its inception in 2005. Under his leadership, this diabetes management course truly lives up to its’ mission of improving diabetes education worldwide.

34 I Pennsylvania Pharmacist I November/December 2014

Nick Leon: Pharmacists Mutual Companies Distinguished Young Pharmacist Award A 2007 graduate of Philadelphia College of Pharmacy, Dr. Nicholas Leon is an actively involved member of several pharmacy associations. On the national level, he has served on the American Pharmacists Association’s (APhA) national policy review committee, was invited to present continuing education (CE) programs at American Society of Health System Pharmacist (ASHP) meetings, served on the Education Steering Committee for the ASHP Ambulatory Care Section, and more. In addition to his role as an Assistant Professor of Pharmacy Practice at Jefferson School of Pharmacy, he is the school’s faculty advisor to APhA-Academy of Student Pharmacists and PPA. He has presented several CE programs, chaired the Health Policy Committee, and currently serves on the Pharmacists Advocacy Committee, Pennsylvania Pharmaceutical Care Network Steering group, and chairs the Accountable Care Organization/Patient Centered Medical Home Work Group. He created PPA’s Pre-Residency Excellence Program and guided it through its first successful year. After serving a term on PPA’s Board of Directors as Director of the Southeast Region, this year he was elected to an Officer position as Second Vice President.

Jamie McConaha: PPA Preceptor of the Year Award A 2007 graduate of Duquesne University Mylan School of Pharmacy, Jamie McConaha is a preceptor for Duquesne University and Preferred Primary Care Physicians and is an Assistant Professor at her alma mater. She serves as an amazing role model to her students, expressing her professional yet warm and welcoming personality to everyone she encounters. Her capability to have so many responsibilities, yet still remain so positive and excited to come to work every day is continuously inspiring to her students. McConaha pushes her students to understand what to look for and to ensure that they have the most accurate and complete information. She is an encouraging voice guiding pharmacy students to become better clinicians, and motivates them to be progressive members of the pharmacy profession. She embodies what all pharmacists and healthcare providers should strive to accomplish.

Tina Gulick: PPA Pharmacy Technician of the Year Award A pharmacy technician with Millennium Pharmacy Systems, Inc., Tina Gulick is a certified pharmacy technician, but more than that, she is a patient care advocate. She is on the front lines as she accepts calls from nurses and physicians and has to make split-second decisions that determine a level of patient care for the resident. She has molded her career into a rewarding and fulfilling position where she interacts with pharmacy staff as well as staff inside the nursing home. Besides her professional accomplishments, she also finds time to volunteer with a local homeless shelter and coach children at bowling. Gulick is very deserving of PPA’s recognition and an excellent role model for those considering a technician career.

Stanton Jonas: Mortar and Pestle Award Jonas has had an illustrious pharmacy career following his graduation from the University of Pittsburgh where he was a Rho Chi member. He joined the Air Force and served as a chief pharmacist. After being honorably discharged he joined Thrift Drug and then managed Penn-Wood Pharmacy and the Carlton Pharmacy. Selected by the Allegheny County Health Department in 1965 to start their pharmacy, he obtained a Pennsylvania pharmacy license and initiated mailing penicillin to their Rheumatic Fever Registry patients and pre-packaging Tuberculosis Clinic medications.

In 1967, he was the Pharmacist Coordinator for the 60 site countywide mass Measles program.

He again held that position in 1970 for the 130 site mass Rubella program. During his years with the Allegheny Health Department, Jonas accomplished much and was always a champion of the community pharmacist and the role they play in healthcare. He served as President of the Allegheny County Pharmacists Association (ACPA) in 1983, and remains on their Board of Directors today. In 2005, Dean Patricia Kroboth appointed Jonas as Curator of the Elmer H. Grimm, Sr. Pharmacy Museum at the University of Pittsburgh School of Pharmacy. As one of Pitt’s outstanding graduates, a true believer in the community pharmacists and a passionate advocate for pharmacists’ role in healthcare, this award is certainly richly deserved.

Continued on page 36 Pennsylvania Pharmacist I November/December 2014 I 35

Association News Cal Shipley: J. Allen Duffield Pharmaceutical Industry Award Cal Shipley, a Sales Representative for Kinray and Cardinal Health, has served on PPA’s Membership Committee, the Pharmaceutical Industry Associates Advisory Board, the Legislative Committee, the Conference Committee, chaired the Finance Committee, and was involved in fundraising efforts to eliminate PPA’s debt. Shipley is, as his nominator put it, “a walking commercial for PPA”. Throughout the years, whenever the opportunity presented itself, he has always promoted the value of PPA membership to the appropriate audience.

George Downs: Cardinal Health Generation Rx Champions Award Dean Emeritus and Professor of Clinical Pharmacy at the Philadelphia College of Pharmacy, George Downs received a federal grant in the 1990s to develop a prevention program on campus, Students Heightening Awareness for Prevention and Education (SHAPE). He has been active at the local, state and national level helping individuals and supporting programs to make the profession aware of the issues involving alcohol and drug dependence. Believing strongly that addiction is a disease and that recognizing and understanding the related issues is key to working on diversion and abuse, he has created and delivered several programs on substance abuse for PPA and is now leading the PPA Educational Foundation on a major initiative around this topic. The pharmacy community thanks him immensely for his interest and commitment to this topic.

Joseph Fulginiti: George H. Searight Community Service Award Fulginiti, a 2015 PharmD Candidate at Thomas Jefferson University School of Pharmacy, truly makes an impact in the community, and is extremely humble about everything he does. He is a compassionate person who wants the best for everyone and has the ability to touch someone’s heart. In the summer of 2013, he worked with The Urban Tree Connection, an internship program through which he led a group of teenagers from West Philadelphia to plant and harvest local crops in community gardens. His involvement with these teens went far beyond his formal role, as he helped them construct resumes, apply for jobs, and talk about college. Wanting to make a true difference in his community, Fulginiti has also volunteered with Our Brothers’ Place, where he prepares and serves dinners to the homeless; Jefferson University’s American Pharmacists Association chapter and the Generation Rx Committee, Jefferson University’s Student Body Governance Philanthropy Committee, and the International Society for Pharmacoeconomics and Outcomes Research Charity Committee.

Janet Hart: George S. Maggio Memorial Award A 1984 graduate of Duquesne University School of Pharmacy, Janet Hart has worked for Rite Aid Corporation for her entire professional career. She has been a pharmacist manager, pharmacy district manager, and has been in the Government Affairs Division since 1995. During her tenure in the Government Affairs division, she has been instrumental in fostering changes that have improved the profession. Among her many accomplishments are working with the DEA to issue new guidelines on the theft or significant loss of controlled substances; authoring the pharmacy act in the state of Maryland; providing testimony on pharmacy practice at the state and federal level; leading grassroots campaigns on pertinent issues; and serving on various task forces for national organizations. In November of 2013, Hart was appointed to the Pennsylvania State Board of Pharmacy. Her multi-state knowledge and expertise has been instrumental in ensuring the board’s mission of advancing the profession and providing for public safety is secure. She has had and will continue to have a tremendous impact on the profession during her tenure on the board. Hart has dedicated her professional career to the advancement of pharmacy. Through her work on regulatory and government affairs, she has positively impacted the profession not only in the Commonwealth, but across the nation.

36 I Pennsylvania Pharmacist I November/December 2014

Ten Under Ten Awards More information about the award winners and their individual pictures can be found at http://www.papharmacists.com/?page=TenUnderTenAwards

Jennifer Bacci: University of Pittsburgh School of Pharmacy Michael Dejos: Philadelphia College of Pharmacy Jennifer Elliott: Duquesne University Mylan School of Pharmacy Suzanne Higginbotham: Duquesne University Mylan School of Pharmacy Jessica Kaczinski: Philadelphia College of Pharmacy Jacqueline Klootwyk: University of Sciences of Philadelphia Karleen Melody: University of Pittsburgh School of Pharmacy Justin Scholl: University of Pittsburgh School of Pharmacy and Lake Erie College of Osteopathic Medicine Stephanie Smith Cooney: Wilkes University Nesbitt School of Pharmacy

PPA Board of Directors – From left to right – Front row: Scott Miskovsky (Immediate Past President), Donna Hazel (PresidentElect), Eric Esterbrook (President), Nicholas Leon (Second Vice President), and Eric Pusey (First Vice President) Back row: Directors: Marty Kendra, Ellen Nastase, Elliot Cook, Lauren Simko, Rick Demers, Jamie McConaha, Benjamin Andrick, and Pat Epple (CEO)

From left to right – Front row: Justin Scholl, Stephanie Smith Cooney, and Kimberly Metka Welch Back row: Suzanne Higginbotham, Jacqueline Klootwyk, Jennifer Elliot, and Jenny Bacci

Kimberly Welch: Wilkes University Nesbitt School of Pharmacy

PPA Educational Foundation Board of Directors and Ambassadors – From left to right – Front row: Maria Osborne, Nish Kasbekar (Vice President), Jonathan Ference (Prsident), Julie GerhartRothholz, and Nick Wytiaz Back row: Greg Shaeffer, Missy Sherer Krause, Stephanie Smith Cooney, Michele Musheno, Pat Epple (Secretary-Treasurer) Continued on page 39 Pennsylvania Pharmacist I November/December 2014 I 37

Departments

Welcome! New Members PPA welcomes the following New Members who joined the association – August 5–September 26, 2014. Please make these new members feel welcome and part of Pennsylvania pharmacy!

ASSOCIATES Ann Benyo PFOA Nazareth Mark Bucklaw Luttner Financial Pittsburgh

NEW PRACTITIONER 2 Jaclyn Brucker Chartwell Pittsburgh

PART-TIME PHARMACIST Deborah Augustine CVS Devon

ACADEMIA CORPORATE Lucas Berenbrok University of Pittsburgh School of Pharmacy Pittsburgh Zach Heeter LECOM Erica Hoot Wilkes University-Nesbitt College of Pharmacy Bethlehem Jessica Koos Wilkes University-Nesbitt College of Pharmacy

ACTIVE PHARMACIST Patricia Traubert-Baum Rite Aid Wexford James Capuzzi Shop N Save Rx Jason Jerusik Advanced Rx Conshohocken Pamela Martinetti APhA Pittsburgh

Debra Mehosh Harrisburg Bob Patel VCARE Discount Pharmacy Umesh Patel Care Plus Pharmacy Francis Ranier Ranier’s Pharmacy Jeannette Troy Rehrig Marina Soyfer Community Care Rx

RESIDENT Ashley Campbell UPMC St. Margaret Pittsburgh

PHARMACY TECHNICIAN Diane Gusikoff Milford Kelly Irwin Cigna Home Delivery Pharmacy Lansdale Suzanne Lightcap Rite Aid Linfield Catherine Romanick McKesson Pharmacy Systems Dacula Eric Rosales Philadelphia

STUDENT Duquesne University Brianne Dixon Alyssa Gabany Shanice Levy Christina Lichtinger Valerie Markley Derek Michalski Nicholas Signorella Christopher Smurthwaite Michael Strein Jennifer Wood

38 I Pennsylvania Pharmacist I November/December 2014

LECOM School of Pharmacy John Aleman Lindsay Brown Nicholas Bucci Chelsea Ferguson Teresa Garcia Travis Grey Mason Koehle Kristopher Marchewka Victoria Matteson Kayla Mumaw Pratik Shah Alicia Shontz Northeast Ohio Medical University Ashley Byrne Elizabeth Legros Ohio Northern University Emily Brown Temple University Jesse Bak Ashley Raney Jieun Her Marcus Opraseuth Hetakshi Patel Sharon Pierre Oxana Placinta Fidel Raposa Nistha Shah Christine Starrs Carissa Tirotto University of Pittsburgh School of Pharmacy Archita Achanta Samantha Adams Anna Bondar Anthony Boyd Mariah Brown Taylor Buck Brice Dick Hayley Fedorek Mary Grace Fitzmaurice Kimberly Frantz Matthew Greene Heather Heiney Alexa Hospodar Linda Huang Hilare Kimmel

Kasey Martik Abby Meyer Sierra Milton Kerry Moore Maeghan Moss Michelle Myers Ryann O’Neill Christine Ross Nicholas Ruzzi Allyson Seitz Emily Smith Erin Spinelli Kristen Sroka

Brittany Stocks Regina Ulis Harry Wilkinson Rebecca Wytiaz Nazar Ughryn Wilkes University Nesbitt College of Pharmacy Christopher Abbazio Kayla Bardzel Katie Bressler Christopher Bright Kelli Clemons Shane Daugherty

Urvish Desai Sarah Fillman Danielle Koch Michelle Kuzma Terra Landis Rachel Miller Paige Pientka Demi Rissmiller Kristofer Rivers Elena Stambone James Steigerwalt

Leadership and Awards Reception & Dinner Continued from page 37

Student Organization Awards Membership: Lake Eric College of Osteopathic Medicine: The membership award recognizes the school that excelled at membership recruitment, retention, and involvement. This school not only significantly grew its membership in the past year but is continuing to do so.

They were particularly creative in developing a series of 10 emails in 10 days with the top ten reasons to join.

PR & Communications: Lake Erie College of Osteopathic Medicine: This award recognizes the school that really worked at developing and participating in public awareness and community activities promoting the role of the pharmacist and participation in generation Rx and Katy’s Kids. Credit was also provided based on communications activities with PPA through the Student Voice, articles in the journal, and media outreach and of course imagination and creativity were rewarded. This school had multiple Katy’s Kid and Generation Rx presentations plus numerous community health fairs. We loved their billboard for American Pharmacists Month and their numerous news articles and mayoral proclamation

Government Relations: University of Pittsburgh: This award appropriately salutes the school which has gone above and beyond in the area of advocacy work. Points were awarded for participation in legislative day, meetings with legislators, PAC awareness, and other innovative advocacy efforts. This school had 126 attendees at Legislative Day with 42 appointments, participated in a legislative media event on immunizations, and had numerous meetings on legislative and policy matters.

PPA Past Presidents – From left to right – Front row: Front row: Scott Miskovsky, Sharon Abayasekara, Terry Talbott, Michele Musheno, and Scott Himler Back row: Greg Shaeffer, Bruce Sigman, Dave Smith, Rob Frankil, and Adam Welch

Pennsylvania Pharmacist I November/December 2014 I 39

Features

TOP TIER

TOP TIER

2014 - 2015 Residents

2014 - 2015 Residents

Brandon Antinopoulos, PharmD University of Pittsburgh, University Pharmacy & Pennsylvania Pharmacists Association University of Pittsburgh School of Pharmacy 2014 Research Question: What are elderly Pennsylvanians’ geographic accessibility to community pharmacists to receive MTM and immunization services?

Rebecca Clarke, PharmD Duquesne University & Giant Eagle Pharmacy.

Duquesne University School of Pharmacy 2014 Research Question: What impact does a standardized documentation and screening tool in a pharmacist led diabetes education program in a grocery store pharmacy chain have on influenza, pneumococcal, and hepatitis B vaccination rates for enrolled patients as defined by the American Diabetes Association (ADA)?

Gale Garmong, PharmD University of Pittsburgh & Rite Aid Pharmacy Lake Erie College of Osteopathic Medicine 2014 Research Question: What is the impact of a pharmacist coaching program on targeted medication review completion rates in a traditional chain community pharmacy?

Christine Jordan, PharmD University of Pittsburgh & Giant Eagle Pharmacy University of Pittsburgh School of Pharmacy 2014 Research Question: How do brief interventions provided by pharmacists and student pharmacists in a regional grocery store chain pharmacy impact patient medication adherence and customer loyalty?

Kyle McCormick, PharmD University of Pittsburgh & Gatti Pharmacy University of Pittsburgh School of Pharmacy 2014 Research Question: What is the correlation between patient activation and percentage agreement among prescribers’ and pharmacists’ medication lists?

P p

•

•

W Viet Nguyen, PharmD SuperValue-ACME Pharmacy & Temple University Temple University 2014 Research Question: What is the impact of community pharmacists’ medication therapy management based interventions on adherence to medications that affect Medicare star ratings?

Lori Schildroth, PharmD Hartzell’s Pharmacy &Wilkes University University of New England 2014 Research Question: What are physician perspectives on accepting recommendations from community pharmacists for changes to high risk medications that cause an increased fall risk in patients 65 years and older?

A Community Pharmacy Residency Research Course 40 I Pennsylvania Pharmacist I November/December 2014

D p

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PPA’s Mid-Year Conference Hilton Harrisburg, Harrisburg, PA February 19—22, 2015

Join PPA for our Mid-Year Conference as we recognize Pharmacists as Providers of Patient Care!

Highlights of this Year’s Mid-Year Conference Include: Annual Student OTC Competition A team from each school of pharmacy will compete for the traveling companionship trophy and attendees will obtain CE credit. Come cheer on your favorite school!

Student Posters Students will present and display their posters on the theme Exploring the Emergence of Patient Care during the Beer & Banter reception. This program is sponsored by PPA’s Educational Foundation.

Know Pain, Know Gain Competition The PPA Educational Foundation is hosting a Patient Pain Counseling Competition for Students, which will offer 1.5 hours of CE credit to all attendees.

PPA’s conference will also offer...     

Continuing Education Programs Student Programming Technician Programming PPA Educational Foundation Auction Social Events

More Information Coming Soon:

www.papharmacists.com/?page=Conferences

42 I Pennsylvania Pharmacist I November/December 2014

Departments

Pharmacy Time Capsules 2014 (Fourth Quarter) 1989 There were 74 accredited colleges of pharmacy in the United States (including Puerto Rico).

1989 graduates figures included: 5721, BS; 836 PharmD (1st professional degree); and 222 PharmD (2nd degree).

The conservative Heritage Foundation published “Assuring Affordable Health Care for All Americans,” which called for a mandate to purchase health insurance.

Losec (omeprazole) was first marketed in U.S. by Astra. In 1990, FDA required name change to Prilosec to avoid confusion with Lasix.

1964 1964 graduates figures included: 2029 BS and 166 PharmD (1st professional degree)

Keflin (cephalothin sodium, Lilly) was the first cephalosporin to be marketed in the Unites States.

Average cost of prescription was $3.41

Luther L. Terry, M.D., Surgeon General of the U.S. Public Health Service, released the first report of the Surgeon General’s Advisory Committee on Smoking and Health linking cigarette smoking to lung cancer and other lung problems.

1939 The first Blue Shield plan was begun as an insurance to cover physicians’ fees.

1914 Cocaine, used in many patent medicines and tonics, was widely available in pharmacies and other retail establishments until banned in 1914. y: Dennis B. Worthen, PhD, Cincinnati, OH B One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

Member News Congratulations to Harrold’s Pharmacy for being featured in the October edition of America’s Pharmacist, the official publication of the National Association of Community Pharmacists (NCPA). Be sure to read their story on page 34 of the issue and see the photos of their attractive new pharmacy.

Lionville Natural Pharmacy of Lionville, PA (outskirts of Philadelphia) is featured also in the same issue. Read their story on page 45 about their emphasis on wellness and alternative therapies. z

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

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

Pennsylvania Pharmacist I November/December 2014 I 43

Association News

News from Our Affiliated Counties ACPA: The Allegheny County Pharmacists Association once again held their annual end of summer â&#x20AC;&#x201C; welcome back to school fall picnic on September 3. The event was held at Camp David Lawrence Pavilion at Schenley Park and at a great turnout especially of students from Duquesne University and University of Pittsburgh. It was a great casual opportunity for students and pharmacists to mix, mingle, relax, and enjoy! Make plans to join us next fall! z

BMPA: The BucksMont Pharmacists Association held a social event â&#x20AC;&#x201C; attending a Phillies Game on Sunday, July 13. It was the Phillies vs. Nationals at 1:35 PM. The event started with tailgating at 12 PM in Citizens Bank Park parking lot. z

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