The Tablet: 2012 April/May by BC Pharmacy Association

Internet RX • Pharmacy Services Agreement Update • BCPhA Board Elections

tablet

published by the British Columbia Pharmacy Association | www.bcpharmacy.ca | Volume 20. No. 8

APR/MAY 2012

May 24 - 26

Conference Preview: Meet the Keynote Speakers

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

THE TABLET

APR/MAY 2012 | VOLUME 20. NO.8

contents Senior Editor Elise Riedlinger 604.269.2866, elise.riedlinger@bcpharmacy.ca

8 DPIC

16 on the cover

Advertising sales Shannon Ward, OnTrack Media 604.639.7760, tablet@ontrackco.com The Tablet is published by the BCPhA. Views expressed herein do not necessarily reflect those of the Association. Contributed material is not guaranteed space and may be edited for brevity, clarity and content. BCPhA offices: #1530-1200 West 73rd Avenue Vancouver, BC V6P 6G5 telephone: 604.261.2092 or toll-free in bc: 1.800.663.2840 fax: 604.261.2097 toll-free fax: 1.877.672.2211 e-mail: info@bcpharmacy.ca web: www.bcpharmacy.ca

26 up close

Pharmassist: 1.800.667.2190 For confidential counselling referral for employment or addiction related assistance Publication agreement #40810576

Features 16

Cover Article: Conference 2012 Preview

Columns

Regulars

President’s Message No time like the present

DPIC Food Allergy Awareness Month

CEO’s Message The Pharmacy Services Agreement

Frontline Pharmacy To the new grads

Professional Services Drug shortages

Active Ingredients Pharmacy Awareness Week

Member Services Time for conference

Up Close Pertussis response

Financial Matters Prescribed Rate Loan Strategy

Career Opportunities Find a job in pharmacy

Internet RX Seasonal allergies

Products in Focus Rivaroxaban

Meet the keynotes

12 22

Pharmacy Services Agreement Update Member briefings BCPhA Board Elections Nominee biographies

Got a suggestion for an article in The Tablet? Email info@bcpharmacy.ca with your story ideas.

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

SMALL TALK

In the news Pharmacists and Immunization Working Group recognized for achievements

College of Pharmacists of BC appoints new registrar

New patient blogs updated on medsforme!

The BC Patient Safety & Quality Council recently held its third annual BC Quality Awards to acknowledge and support those who are making positive, sustainable changes across BC’s health system. Bryce Wong, Manager of Professional Services at BCPhA, was on hand along with the representatives of the Pharmacists and Immunization Working Group (PIWG). They were presented with the “Staying Healthy” award and recognized for facilitating authorized pharmacists administering publicly funded influenza vaccine to 48,502 BC residents in the 2010/11 provincial campaign. This initiative improved public health while reducing costs for the health system across the province.

The Board of the College of Pharmacists of BC (CPBC) recently announced the appointment of Bob Nakagawa as Registrar of the College. Nakagawa assumed the position on April 2, 2012, after his role as Assistant Deputy Minister of the Pharmaceutical Services Division with the Ministry of Health.

New blogs continue to be posted on www.medsforme.ca, promoting the difference that pharmacists are making in their patients’ lives. The latest blog details how a close relationship with a community pharmacist helped a patient on the Sunshine Coast overcome a difficult time.

Nakagawa has a pharmacy degree from UBC and a residency in hospital pharmacy from St. Paul’s Hospital in Vancouver, and is a Fellow of the Canadian Society of Hospital Pharmacists. He has worked both in hospital and government in developing innovative services and policies for the last three decades. He has served as President of the College of Pharmacists of BC as well as the Canadian Society of Hospital Pharmacists.

The Pharmacists and Immunization Working Group receive their “Staying Healthy” award.

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

MEET THE BOARD

Meet…Ken Foreman Why is it important for pharmacists to be part of a professional association?

Where can we find you when you’re not at work?

I believe that it is important to be involved in the advancement of the profession and to take pride being a member of a wellrespected profession. Being a part of a professional association representing the interests of the members of the profession provides this opportunity.

Most likely spending time with my wife Marcia, family members and friends, enjoying a wide variety of non-pharmacy related activities such as travelling, golfing, boating and of course time at our home in Abbotsford.

You have been very involved on the Board of Directors – what are you most proud of?

Ken Foreman graduated from UBC in 1976 with a BSc (Pharm) and went on to work for Shoppers Drug Mart until 2001, holding positions as a pharmacist and associate/ owner, as well as working at the regional office. From 2001 to 2005, he served as BCPhA’s deputy CEO and director of professional services. Since 2005, he has worked as a manager for Pharmasave Drugs (Pacific) Ltd. He is leaving the BCPhA Board of Directors after six years of service. Why did you become a pharmacist? My father was a pharmacist/pharmacy owner for many years. I saw how professionally rewarding being a pharmacist had been for him so it was my only career choice from a very early age.

I am very proud of the various roles that I have played and the committee involvement that I have had as a member of the BCPhA Board of Directors over the last six years. Also, the many achievements of the BCPhA in advancing the scope of practice of pharmacists and the associated reimbursement models that have been put into place. You will be leaving the Board of Directors after six years of service, any parting words? I will miss my direct involvement with the Board and I wish future Board members all of the very best in their endeavor to serve the members of our profession well. What do you think graduating pharmacists need to know when entering the profession? The more practical knowledge and “real life” pharmacy experiences that new grads have when entering the profession, the easier they will find the transition from being a student to being a registered pharmacist.

What’s next for you? My position at the Pharmasave Pacific regional office keeps me extremely busy, but no doubt I will also continue to be involved in the activities of the BCPhA in one capacity or another! What direction would you like to see the profession of pharmacy go? I believe that we are on the right track and that we need to keep working at the expansion of our scope of practice and appropriate reimbursement for the services being provided. If you could have any talent in the world, what would it be and why? I would love to have the artistic talent of the world’s greatest professional photographers. Being a scientist at heart I realized many years ago, when I couldn’t make the two ends of a circle meet, that my artistic talents were pretty much non-existent. Photography has provided an opportunity for me to develop a very modest degree of artistic talent…plus it also provides a good excuse for travel to interesting and scenic destinations!

Board of Directors Greg Shepherd, Vancouver (604) 317-9608, gshepherd@pharmasavebc.ca

Don Cocar, Kelowna (250) 808-1308, don@dycksdrugs.com

David Pavan, Vancouver (604) 301-2620, david.pavan@gmail.com

Ralph Lai, Langley (604) 881-3882, ralph_lai@owfg.com

Derek Desrosiers, Richmond (604) 276-5236, derekd@unipharm.com

Allison Nourse, Vancouver (604) 276-5280, allisonn@unipharm.com

Shakeel Bhatti, Langley (604) 534-6605, shakeelbhatti@shaw.ca

Ken Foreman, Cloverdale (604) 575-5740, kforeman@pharmasavebc.ca

John Tse, Richmond (604) 272-7650, jtse@londondrugs.com

Bill Bright, Calgary (403) 410-4805, bbright@shoppersdrugmart.ca

Caren Heughan, Victoria (250) 388-5181, carenheughan@gmail.com

Nadeem Zia, Surrey (604) 585-5666, nadeem.family.pharmacist@gmail.com

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

GREG SHEPHERD | PRESIDENT

No time like the present I try to live my life following

some fairly simple philosophies, especially in times of uncertainty. The first one is that “everything happens for a reason,” and the second is that “it’s all about timing.” And every once in a while, the saying “don’t sweat the small stuff” comes to mind and helps me get through certain issues. Overall, I find this optimistic approach works well for me. So let’s now consider the decision by government in February to cancel the Pharmacy Services Agreement (PSA). I wouldn’t call this ”small stuff,” so there goes that particular approach. Indeed, this is significant for our profession and has the potential to really change how BC pharmacists practice. I am concerned that the BC government, like those in other provinces, has opted for what it sees as a simple solution to dealing with the issue of escalating drug costs within the health care budget.

be politically-driven than based on sound economics or good public policy. Even after months at the negotiating table, it all comes down to how a government looks to the voters, hoping to demonstrate its ability to make decisions that positively impact voters directly. In the end, it’s all about timing, right? So what do we do now? Churchill said, “if you’re going through hell, keep going.” So onwards we go. Not to blatantly steal from my last Tablet column, but the timing is clear to me. The general population has declared that pharmacists are the number one trusted professional. I argue that there is a very powerful difference between TRUSTED and VALUED. And we need to

“we need to capitalize on the trust we have with our patients”

In the time between having written this column and you reading it, there will likely have been legislation introduced in Government that will give the Minister of Health direct control over many aspects of how our profession functions, including how we are reimbursed for the services we provide. Our objective is to be sure we are involved in a real way in the development of the regulations that will follow the legislation. Now back to my guiding philosophies. One could argue (and they have!) that there was a clear “reason” for the government to terminate the PSA. Through no fault of our own, the projected savings were not achieved. We now know that is because the generic companies were granted a very high level of exception pricing. As we quickly approach a provincial election in May 2013, decisions like the one to terminate the PSA are more likely to

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

capitalize on the trust we have with our patients and demonstrate to them our value. BCPhA continues to work to be the voice of our profession in BC. I joined the Board a few years ago so I could help promote pharmacy and the amazing things pharmacists do every day, and to help secure our place in the health care team. The timing couldn’t be more critical than it is now. As you will read in this issue, we’ve planned a series of member information session in late April and May. The goal of these sessions is to answer your questions regarding the PSA, what it means in the short term, and to hear directly from you on the current state of the nation.

GERALDINE VANCE | CEO

The Pharmacy Services Agreement On February 29, 2012 the Minister

of Health, Michael de Jong, announced he was terminating the Pharmacy Services Agreement (PSA) with the BCPhA and CACDS effective April 1, 2012. Your PSA negotiating team and Board were profoundly disappointed by this decision and continue to find the Minister’s decision hard to understand. Last fall the Minister announced that he was unhappy with the fact the original savings that were predicted in the agreement had not been met. He used a clause in the agreement that allowed him to re-open the agreement and bring the parties together to see if it was possible to renegotiate the agreement to meet the needs of government, pharmacy and patients.

pharmacy. Since we have no role in managing the exception pricing, this seems curious – at best. The Minister’s announcement indicated that he will proceed with legislation that will “control and further lower the prices for generic drugs.” It makes sense for the government to introduce framework legislation to provide oversight of the PharmaCare program. It is a billion dollar program that has no governing legislation. What remains to be seen is both what authority is granted the government in the legislation and, more importantly, how that expresses itself in the regulations that will follow the passage of the legislation.

“We have made it a primary objective to have a strong voice”

While I wasn’t here for the discussions that went on in the fall, I can tell you that pharmacy brought to the table both creativity and a commitment to solving the issues. Both organizations believed that the collaborative relationship that was being built was of value to all parties – most notably British Columbians who were gaining access to some much needed primary care services as a result of the agreement that was in place.

It is true that during the first two years of the agreement the savings were less than everyone hoped. And the source of the savings shortfalls was clear. The government had granted the generic drug manufacturers much greater than anticipated exceptions to the newly set prices. On average about 30 per cent of the total PharmaCare budget for generics was granted an exception price – small wonder there was a savings shortfall. Perhaps one of the most concerning things is that the Minister lays the blame for the savings shortfalls at the feet of community

Community pharmacy must be a key contributor to the development of the regulations. They will affect the way in which pharmacy can continue to play a key role in patient care across the province. It is easy to forget the many communities where there are only one or two pharmacies and the pharmacist is often the first point of care for patients. I know the government’s decision came as a shock to many of us. It definitely raises questions about how pharmacy will continue to operate in a sustainable fashion. We have made it a primary objective to have a strong voice with government as it charts the future of pharmacy. We are planning a series of member meetings across the province. I look forward to meeting many of you and hearing your thoughts about our best path forward.

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

DPIC

May is Food Allergy Awareness Month

Written by Raymond Li, BSc(Pharm), MSc. Reviewed by Laird Birmingham, MD, FRCPC, MHSc

Food allergies appear to be on the rise in industrialised countries. They have been dubbed “the second wave of the allergy epidemic.”1 Food allergies lessen quality of life and can be life-threatening.2,3

Food allergy vs intolerance Food allergies are due to an immune response to food or food components and may be Immunoglobulin E (IgE)- or non-IgEmediated.3,4 Food allergies can present as anaphylaxis. However, food allergies can present with a wide range of signs and symptoms involving the gastrointestinal, cutaneous, and respiratory systems or a combination. Food intolerances, on the other hand, are mainly non-immune mediated reactions and include lactose intolerance, glutamate and aspartame sensitivity, or reactions to preformed toxins or vasoactive amines in foods.

There are more than 170 foods known to cause IgE reactions,4 but most food allergies are caused by peanuts, tree nuts, seafood (fish and shellfish), eggs, milk, sesame, soy, and wheat.5 Medications may contain some of these potential allergens (Table 1). Some medications can worsen allergic reactions to food (Table 2).

Prevention of food allergies For patients with known food allergies, avoiding the allergen is the goal. Thus, if a patient is suspected as having a food allergy, they must have the diagnosis confirmed and the specific allergen determined. Probiotics have been shown to reduce eczema, but there is insufficient evidence that probiotics prevent or treat food allergies.22,23

Treatment of anaphylaxis Details on treatment are beyond the scope of this article – see Additional Resources.

THE TABLET

Apr/May 2012

Accidental injection of epinephrine into an extremity such as a finger can cause tissue ischemia. However, such accidents can sometimes be managed at home – contact the Poison Control Centre immediately. Adjunctive treatments: Bronchodilators can help relieve bronchospasm not responding to epinephrine, but they do not relieve laryngeal edema and EPINEPHRINE MUST BE GIVEN. Antihistamines relieve itching and urticaria but do not relieve shortness of breath, wheezing or shock and EPINEPHRINE MUST BE GIVEN. Table 1: Potential food allergens found in some medications*

Food allergies and medications

First-line: epinephrine. Guidelines and local experts recommend a 0.3 mg dose for children weighing more than 20 to 25 kg.3,24 Optimally, patients should have a back-up dose available, and all patients with a severe reaction should be sent immediately to the hospital.25

www.bcpharmacy.ca

Peanut oil, soybean oil, sesame oil (in capsules, depot injections, lipid emulsions, nasal and topical products)

Refined peanut and soybean oils have low allergen content and some studies suggest that ingestion is safe, but since there is no threshold for patients with known allergy, avoidance is still recommended.3,6,7 Data on parenteral administration is lacking and severe allergy to lipid emulsion has been reported.8 Most sesame oils are not refined enough to be safe, either.9

Soy lecithin (in capsules, tablets, oral liquids) and egg lecithin (in lipid emulsions)

Although some soy-allergic patients can eat soy lecithin, and egg lecithin seems to be safe in cooked foods, intravenous administration may cause serious reactions.10

Egg protein (in vaccines)

MMR vaccine and Imovax® rabies vaccine are generally safe in egg-allergic patients.11 Influenza vaccine is not contraindicated in egg allergy, but graded administration with trained resuscitation personnel and equipment is recommended.12 Avoid yellow fever and RabAvert® rabies vaccine.11

Table 1 (continued)

Wheat

Table 2: Medications that can exacerbate food allergies Wheat allergy is different from celiac disease.13 Most medicines are gluten-free. Wheat starch is found in some tablets (e.g. Imunovir®, Trosec®). Tardan® shampoo contains hydrolyzed wheat protein. Protamine (NPH insulin, heparin antidote) is isolated from salmon testes and may be contaminated with fish proteins. Patients with fish allergy may react.14

Seafood

Iodine-containing drugs like amiodarone, contrast dyes, or povidone-iodine are not contraindicated in patients with fish or shellfish allergy. “Iodine allergy” is a misnomer.15

Tree nuts

Medications do not contain tree nuts, but paclitaxel is found in hazelnuts. A patient with hazelnut allergy developed hives, itching and dyspnea shortly after a paclitaxel infusion was started.16

Miscellaneous (nonimmune reactions)

Salicylates are found in fruits, vegetables, herbs and spices but are tolerated by most patients with ASA sensitivity.17 Carmine red was the cause of anaphylaxis purported to be due to azithromycin.18 Sulfite sensitivity is not the same as sulphonamide allergy.

*Not a comprehensive list. Consult specific product information.

ASA and NSAIDs

May predispose to bronchoconstriction.19 ASA increases food-dependent exercise-induced anaphylaxis (possibly by increasing GI uptake of allergens).20

Beta blockers and alpha blockers

Do not worsen allergies per se but may blunt the therapeutic response to epinephrine.3

ACE inhibitors

May interfere with production of endogenous vasoconstrictors that help in allergic reactions.3

Tacrolimus

Tacrolimus immunosuppression is associated with increased food allergy.21

Additional resources • L earn more about food allergies and anaphylaxis, and print out a personalised emergency treatment plan at www.allergysafecommunities.ca • Health Canada food allergies and intolerances: www.hc-sc.gc.ca/fn-an/securit/allerg/index-eng.php • Guidelines for the diagnosis and management of food allergy in the United States (2010) www.niaid.nih.gov/topics/foodallergy • Patients can call 811 and speak to a HealthLinkBC allergy dietician. Thank you to Linda Kirste, RD, Dietician Services, HealthLinkBC, for her expert advice. References are available on request or visit www.dpic.org

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

PARKASH RAGSDALE | DIRECTOR, PROFESSIONAL SERVICES

Drug shortages – Are your patients impacted?

Drug shortages have been the focus of

media attention lately, but our members have been reporting shortages to us for several years. The recent events at the Sandoz Canada plant in Boucherville have only escalated the situation further. These shortages have affected patients throughout the health care system, from hospitals to the community. As you know, the provision of drugs relies on a complex supply chain involving raw materials producers, manufacturers, wholesalers and distributors. Disruptions to any part of that process may result in shortages at the pharmacy level. A 2010 report by the Canadian Pharmacists Association identified shortages ranging from cephalexin to diltiazem. Since the report, we have continued to experience shortages of a variety of medications including antibiotics, anti-hypertensives and anti-epileptics. This problem is not limited to BC or even Canada, with the US also facing significant drug shortages. There are many global factors affecting the North American supply chain. To support our members when there are shortages, BCPhA works closely with the Ministry of Health and other payers to help fill the gaps and ensure alternate coverage is provided. Most recently, we assisted in ensuring alternative coverage was in place in a timely manner for numerous shorted Sandoz products, in addition to regular discussions with the Ministry and Sandoz on how to address the shortage. BCPhA alerts pharmacists to PharmaCare benefit drugs that are unavailable at any given time, and what the possible alternatives are. BCPhA continues to promote to patients and the media that pharmacists are the medication experts. We have been encouraging patients to “talk with your pharmacist” to learn how to take medications, when to take them, what to avoid when you are on certain medications and possible interactions with other drugs. Pharmacists in BC have the skills and training to provide alternatives for their patients during shortages,

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

and work with doctors to minimize the negative impact of these shortages. In certain circumstances, pharmacists are compounding prescriptions to ensure patient access to their medications. Help your patients avoid being impacted by these drug shortages. You know from experience that a better understanding of your patient’s health and self-adherence issues can ensure your recommendations are tailored to their needs and suitable alternatives are identified. It is also helpful to remind your patients to inquire about refills well ahead of their last dose so there is enough time to find alternatives in case their medication is not available. BCPhA will continue to monitor the drug shortage situation and keep members informed.

Injection Authority stats: • 1,605 pharmacists authorized to administer injections • Over 100,000 publicly funded influenza vaccine doses administered in 2011-2012 • Over 6,000 publicly funded Adacel (Tdap) vaccine doses administered in the Fraser Health Region in response to whooping cough February - March 2012

Adaptation Stats: • $916,708 in clinical services claims paid (renewals and adaptation) in fiscal 2010/2011 • 74% renewals, 5% therapeutic substitution, 9% dosage change, 7% formulation change, 5% direction for use modified

CYRIL LOPEZ | CHIEF OPERATING OFFICER

Time for conference

We’ve escaped the harsh winter forecast and

spring is finally here! The good news is that it’s time to gear up for our annual conference. This year’s theme is Pharmacy Innovation, illustrating the ways in which pharmacy in British Columbia is continuing to innovate, improve patient care and lead the way nationally. There are two keynote sessions: Do you really know your customers? with Darrell Bricker and John Wright, and Creating a true pharmacy experience in BC, with Joseph Michelli.

Ocean Pointe in Victoria. We have kept the member registration rate the same low $400 (another member benefit). And, UBC 2010 and 2011 grads who undertook injection training at UBC can still redeem their free registration to this year’s conference. So many reasons why you just must attend!!

“If you’re not visiting the member site regularly, you are missing many benefits – from wealth management to extended health insurance and journal subscriptions.”

Bricker and Wright, Canada’s premier pollsters, know what Canadians are thinking, the changes taking place in Canada, and what these trends mean for your organization. Dr. Michelli is the bestselling author of The Starbucks Experience: 5 Principles for Turning Ordinary to Extraordinary. His national and international presentations aid corporations and individuals as they focus on the ultimate customer experience, develop innovative cultures, learn success principles, maximize their potential, manage change, and enjoy the magic of daily life. Every sector of our society faces challenges and needs to manage the changes. These keynote addresses will provide useful techniques to planning for those changes.

Spring also brings thoughts of tax returns. Remember that your BCPhA membership fee is partly tax deductible - the amount of mandatory professional liability premium - which is $115 for 2011. While the tax deduction is useful, there are other member benefits as well. If you’re not visiting the member site regularly, you are missing many benefits – from wealth management to extended health insurance and journal subscriptions. Besides, there is a trove of other useful information. If you want more information, just let us know and we will We have a social media expert sharing strategies to enhance your do our best to provide. Do not neglect our other services: emotional business. In addition, there are sessions on smoking cessation, counselling, employment practices advice and critical incident progroup_ad_v3.ai 13/11/2008 4:23:24 PM cardiovascular risk management and immunizations. The keynote and counselling, all provided by external professionals. education sessions qualify for CEUs. C

The conference isn’t only about serious stuff. We’ll have fun at the Thursday night opening tradeshow and networking evening (it’s a pirate theme) and celebrate achievements at the awards dinner on Friday. So take the time off to think back, plan forward, meet your peers, and get refreshed and reenergized. Be there – May 24 to 26 at the Delta

NEW CAR PURCHASE PLANS

All Makes & Models

member benefit partner since 1985

CMY

Te l: 6 0 4 - 2 7 0 - 4 4 6 6 To l l F r e e : 1 - 8 8 8 - 3 8 5 - 4 4 6 6 390 H owa r d Av e. B ur na by, B C , V5B 3P 8

www.bcpharmacy.ca

visit us online:

P R O GROU P B C . C A

Apr/May 2012

THE TABLET

PHARMACY SERVICES AGREEMENT

GLENN SCHOENROTH | FINANCIAL MATTERS

Member information meetings on the PSA and what comes next On February 29, 2012, Health Minister Michael

de Jong announced the termination of the Pharmacy Services Agreement effective April 1, 2012. He also announced that legislation will be introduced in this session of the Legislative Assembly that ends on May 31, 2012. A specific date for the introduction of the legislation is not available. The legislation will provide a legislative framework to govern the now billion dollar PharmaCare program. In many regards, such legislation is long overdue and in keeping with governance mechanism the provincial government has in place for other major programs. It is expected this “enabling” legislation will grant the Minister and/ or Ministry a broad range of powers. What will be key is what is included in the regulations that will follow the passage of the legislation. BCPhA and other key stakeholders have been promised an active role in the consultation process around the development of regulations. This is essential as they will have a significant influence over the day-to-day operations of community pharmacy in BC. We know that many members want information about the proposals that were made to government over several months in the fall of 2011 and during the first two months of this year. Also, members will want as much information as is available about the medium and longerterm impact on pharmacy as a result of the impending legislation. While we can’t predict when we will have information about the legislation and regulations, we think it is important to connect with members in person as soon as possible. A series of member information meetings have been scheduled for April and May. The dates and locations are as follows: Kelowna (Delta Grand Okanagan): April 17 Prince George (UNBC):

April 25

Vancouver (River Rock):

May 1

Victoria (Delta Ocean Pointe):

May 2

Note, the Kelowna meeting will be web-cast. More information on that will follow. Please take the time to come out to the meeting closest to you. New CEO Geraldine Vance is looking forward to the opportunity to meet you. Watch for updates on the meetings.

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

A historic opportunity: The Prescribed Rate Loan Strategy If you pay taxes at the highest

marginal tax rate, you know just how punishing Canada’s marginal tax system can be. For many Canadians, taxes are their largest annual expense. But if you have family members that earn little or no taxable income, you currently have a historic opportunity to reduce your family’s overall tax bill by making prescribed rate loans to family members. Until March 31, 2012, the Canada Revenue Agency (CRA)prescribed interest rate on family loans is at a historic low of one per cent, creating an unprecedented opportunity to maximize this proven strategy. The one per cent loan rate can be locked in for life regardless of future rate increases. There are two ways you can use this strategy: The Spousal Loan Strategy and the Family Trust Strategy. With the Spousal Loan Strategy, you make a loan to your spouse, which is backed by a simple promissory note and loan agreement setting out the terms of the loan. Then your spouse invests the entire loan amount in their own name. This way, the income attribution rules are avoided and the entire investment income is taxed at your spouse’s lower marginal rate – reducing your family’s overall taxes. To ensure the income is taxed in your spouse’s hands – and not yours – your spouse must pay you interest at the CRA-prescribed interest rate by January 30 of the following year (and by January 30 following the end of every subsequent year during which the arrangement continues). With the Family Trust Strategy, you establish a family trust for your younger family members (children or grandchildren). You loan money to the trust at the CRA-prescribed interest rate. The monies are then invested in the trust and all the investment income (less one per cent paid to you by January 30 of the following year) can be taxed in the hands of the children or

grandchildren. If they have no other income, then each child or grandchild can earn approximately $10,000 of interest income, $20,000 of capital gains or $50,000 of Canadian public company eligible dividend income tax-free every year (depending on the province of residence).

“By loaning the money instead of giving it, you retain control” By loaning the money instead of giving it, you retain control of the funds, and the investment income can be used for their benefit (e.g. to pay for school expenses, lessons, gifts, etc). Bear in mind that CRA-prescribed rate may be different after March 31, 2012, so make sure to ask for the latest rate. This article is provided by Glenn Schoenroth, Vice President & Portfolio Manager, RBC Dominion Securities Inc., which is a member of the CIPF. This article is for information purposes only. Please consult with a professional advisor before taking any action based on information in this article. Glenn Schoenroth can be reached at 604-257-7196.

LARRY LEUNG AND JASON MIN | INTERNET RX

Popular questions we hear from patients are: what are my sources of allergies, why are my allergies worse in April, and when should I take an allergy medication? A great tool is the Pollen Forecast on the Weather Network website at www.theweathernetwork.com/pollenfx/poyvr or as a free App on most smartphones. Pollen Forecast indicates the concentration of a particular pollen in the air on a scale of low, medium and high. This helps to determine what the main triggers for allergies might be and if the patient should treat with a prophylactic antihistamine before going out. The Pollen Forecast also has a handy table that shows you seasonal trends for popular pollens. Currently the Pollen Forecast is limited to the Vancouver, Victoria and Kelowna areas. Another common question that we get from patients is: what are the differences between the oral antihistamines? Desloratadine (Aerius) is most likely to provide the best relief for concomitant nasal congestion while Cetirizine (Reactine), which is a metabolite of hydroxyzine (Atarax), is most likely to cause sedation among all of the “non-drowsy” preparations. To help guide your recommendations for drug therapy, use this easy-to-read table that you can download at http://ow.ly/9FpLz. The table, compiled by a recent review published in the Lancet, highlights the advantages and disadvantages of both oral treatment and topical nasal treatments.

“why are my allergies worse in April, and when should I take an allergy medication?” That review also detailed some interesting results from a study entitled “Evidence-based strategies for treatment of allergic rhinitis” by Portnoy et al. on the number of patients needed to be treated before one patient benefits (NNT) on a particular regimen. Here are the ones that we found most interesting: – – – –

Seasonal allergies While many seasonal allergy cases seen

by pharmacists are relatively simple, one in five patients still experiences uncontrolled symptoms even with the best pharmacotherapeutic interventions. It is important to remind ourselves why allergy symptoms are clinically relevant as they can cause decreased productivity at work or school, and impaired social relationships. There are numerous internet resources we can use to further improve patient care. Here are three simple tools for simple problems.

Oral antihistamines NNT = 15.2 Montelukast (Singulair) NNT = 14.3 Immunotherapy (allergy shots) NNT = 4.6 Nasal Corticosteroids NNT = 4.4

Finally, check out Healthlink BC at www.healthlinkbc.ca/ kb/content/conditioncenter/center1001.html as your go-to resource for all things related to seasonal allergies. There are useful, printable handouts for patients on various topics such as avoiding indoor and outdoor allergens. Stay connected with us on Facebook at Clinicare Pharmacists for all of our seasonal allergy resources and regular posts on other great pharmacy tools.

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

FRONTLINE PHARMACY

To the new grads: from an “old grad” By Gina Chang

It’s that time of the year again – another 200 new grads are about to pour out from lecture halls into local pharmacies, changing their white coats with proud blue stitches of “Rx UBC” into brand new coats with their employers’ logos on the left chest. As a “new grad” about to become an “old grad” this May, I can testify that – just as four or eight weeks of practicum can go by like a blur – so does a year in the workforce. My ninemonth experience working for a chain store as a novice relief community pharmacist has been a journey through failing and learning, embarrassment and pride, exasperation and satisfaction, and countless moments of gratitude and laughter. As a “floater” entering a new environment every week, I find it challenging to learn every store’s system and workflow. For example, while many stores have baskets for temporarily docking drug bottles to be re-shelved, I found myself freely dunking medications in a waste basket, which were “rescued” by a prudent pharmacy assistant. There are patients whose daily medication pick-ups require a certain way of processing; differences in methadone recording logs and procedures; billing methods tailored to individual customers; and 100 meticulous ways of processing blister packs. These small details make all the difference in preventing medication errors. Students may ask, “In reality, what’s it like working in a pharmacy?” If truth be told, my creativity and reasoning skills are daily put to test when a patient in desperate need to fill his Tylenol #3 watches my attempt to find the physician with a mysterious signature spilling across the prescription. One activity I grew to enjoy is being part of the caucus as one pharmacist holds a prescription against the ceiling light and

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

slowly turns it 360 degrees in hopes of deciphering it – an amusing scene that commonly occurs! All jokes aside, while solving clinical questions regarding medication use are important, I discovered that establishing a trusting relationship with patients also depends on our ability to solve many other logistical issues surrounding a patient’s pharmaceutical needs. My first few months consisted of learning things like how to order over-the-counter products requested by customers, brainstorming alternatives in the face of drug shortages, figuring out how to bill through a patient assistance card so a customer can walk away with a free glucose meter, and going back and forth between a doctor’s office to obtain approval on a refill request. My first week included an unforgettable moment of almost ordering 24 boxes of Fragmin when the patient only needed 24 syringes. Once you witness the expression on a manager’s face when you break the news to him, you’ll never make the same mistake again! And I learned that if we can’t handle these seemingly mundane but essential tasks for patients, how can they truly trust us? I also found that patient-pharmacist relationships come in surprising forms. Some patients express enormous gratitude for clarifying a prescription with their physician, while others do not appreciate me explaining why Zyban is not free under the smoking cessation program when the doctor scribbles “free” all over the prescription. Mid-20s may be a young age to many: some patients glance nervously at my name tag every five

FRONTLINE PHARMACY

seconds to ensure that I am a registered pharmacist, while some tell fascinating stories (just for “the young new pharmacist”) of oxycodone tablets accidentally going down the drain.

Though we have been one of the most trusted professions for a long time, I noticed a subtly different sense of trust and bonding when I raised a needle towards our patient!

It is not uncommon for patients to ask about things never taught at school: what is a good antibacterial soap for pre-surgery? Should I prime my Victoza pen every time I inject myself? Are potassium salt substitutes good for me? It is through these moments that I gradually trained myself to say goodbye to that old self who looked to my competent preceptor for the answer, and to turn instead to the trained pharmacist I’ve become.

Whether doing a medication review with a concerned son for his father with Alzheimer’s, discussing how to take glucose readings with a senior newly-diagnosed with diabetes, or finding a delicious flavour of antibiotic for a sick five-year-old child, these moments paint a fulfilling picture of what a pharmacist truly does and loves to do.

Despite the challenges and frustrations, my first year has been rewarding and gratifying. Vaccinating people during the busy flu season was new to me (and many experienced pharmacists). Through conversations with patients, I discovered that our contribution to the program is much appreciated by the public.

As one of the “old grads”, I wish all of our new grads good luck. We shall meet in the pharmacy very soon!

Your Roche representative can show you how to increase testing adherence and store loyalty by enrolling patients in Circle+

Now for everyone using insulin.

Complete your patient’s care with a meter that’s right for them.

Receive up to $7 in patient assistance on every box of Accu-Chek strips or cassettes† One-on-one courtesy care calls FREE care packages††

For more information on Circle+, call Accu-Chek Customer Care at 1-800-363-7949 † ††

Certain conditions apply. See accu-chek.ca/care for details. Valid for Canadian residents only. Certain conditions apply. While quantities last. Valid for Circle+ members only. Allow 6 to 8 weeks for shipping once the Circle+ card has been activated. ACCU-CHEK, ACCU-CHEK AVIVA, ACCU-CHEK AVIVA NANO and SOFTCLIX are trademarks of Roche. © 2012 Roche Diagnostics. All rights reserved.

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

ON THE COVER | BCPHA 2012 CONFERENCE PREVIEW

Meet the 2012 BCPhA Conference keynote speakers By Elise Riedlinger

With the BC Pharmacy Association conference just around the corner (May 24 to 26 in Victoria!), we took some time to sit down with two of our scheduled keynote speakers, Darrell Bricker and Joseph Michelli, to get an idea of what to expect from their exciting presentations.

Darrell Bricker and John Wright: “Do you really know your customers?” Q: First of all, for those who don’t know, can you tell us a little bit about Ipsos Reid? Darrell Bricker: Ipsos Reid is the third biggest market research company in the world and the largest market research company in Canada. We conduct about 500 polls per year in the public domain, and thousands of other polls. We do market research specifically for clients – sometimes they want to know about curious things, while we often ask questions just to inform public debate. I really believe that experts shouldn’t remain silent. If we have information that is of use to decision makers, we should share it. I feel that it’s our responsibility to tell the truth about what Canadians think. Information is power.

Q: How does Ipsos Reid conduct these polls? Mostly in two ways – in a decreasing amount over telephone, and increasingly through online research. We have about 200,000 participants on a panel, and we also use Twitter, Facebook, and other forms of social media.

Q: How did you get started in the business of polling Canadians about what they think? Well I have a background in political science, and began in the market research business in the mid-1980s. I worked for the Prime Minister for a while as the Director of Research, and was hired by Ipsos Reid from there. I’ve always been interested in public opinion and social trends, and how our values are evolving. It was a natural progression to polls.

Q: You and your partner, John Wright, have been deemed “Canada’s premier pollsters.” – Why? Currently, I’m the worldwide CEO of Public Affairs for Ipsos Reid, which is one of our five units. John Wright, who will be speaking with me at the BC Pharmacy Association conference, runs GlobalAdvisor, which does a monthly survey of 24 countries around the world. He brings in the perspective on global issues. Together, we’ve authored two books, Canuckology and What Canadians Think: About Almost Everything. Canuckology is about the art and science of being Canadian, and about looking the various parts of the country. Canada is a pretty cool place to live in – especially when compared to other countries, there’s a lot of tolerance here. But the biggest thing we find is the number of myths and stereotypes about how other groups of Canadians think. If you have misleading information about the world you’re part of, it can lead you in to making some pretty bad decisions.

Q: Can you give me an example of one of these myths? When we poll people across the country about British Columbian’s attitudes, they’re actually quite opposed to what we think they are. One of the most interesting things we’ve found out about BC is people’s attitude towards the environment. The rest of the country considers BC the most environmentally conscious, and instantly vote BC as the most environmental province. Yet, when we poll British Columbians, we find that they are some of the least environmental in the country. You could almost say they are ‘environmented out.” I think that at one time they really were environmentally focused, but it comes down to the disparity between philosophy and

Darrell Bricker is Chief Executive Officer of Ipsos Public Affairs, the division of Ipsos that conducts corporate reputation and social research around the world, with offices in 25 countries and a staff of 700 research professionals. Located in Toronto, Bricker has a long history in social and corporate reputation research, as well as research for political campaigns. Prior to joining Ipsos Public Affairs in 1990, Bricker was Director of Public Opinion Research in the Office of Canada’s Prime Minister. He also worked as a research consultant with firms in Ottawa and Toronto. His latest book (with John Wright), “Canuckology,” published by HarperCollins in September 2010, is a national bestseller, as are all of his previous books: “We Know What You’re Thinking” (with John Wright, 2009), and “What Canadians Think About Almost Everything” (with John Wright, 2005). Bricker appears frequently in the media as a commentator on political, social and business issues. And, he speaks regularly at industry, government and academic conferences. He holds a Ph.D. in Political Science from Carleton University in Ottawa, and a Bachelor of Arts and Master of Arts from Wilfrid Laurier University in Waterloo.

ON THE COVER | BCPHA 2012 CONFERENCE PREVIEW

practice. Other parts of the country tend to be more philosophical, while here the residents have had to be quite practical around the environment for quite some time. Another oddity about British Columbians – as much rains as exists in this province -British Columbians are actually the most likely to water their lawns!

Q: What sort of implications do your polls have for our audience of pharmacists? We also look into attitudes about health care in Canada and how they’ve changed over the years. We compare myths to facts and show that you don’t know Canada or British Columbia as well as you think you do. There’s been a huge evolution in terms of how attitudes and demography has transformed over the last 40 to 50 years. People haven’t necessarily brought this on board into their thinking. A new census came out recently (February, 2012). While most people think, for example, that there’s a lot of equality in terms of immigration in Canada, in fact the census revealed that it’s basically Ontario west. We’re seeing a shift in immigration to the west of the country, and this has huge implications. We also are seeing an aging Canadian population – but disproportionately – as more of the aging population is in the rural areas, while the younger people stick to the more urban areas. This naturally brings about other health care issues. This kind of information ties into business aspects of pharmacy – what the retail experience will be like, what consumers will be like, and how they have changed and continue to change.

Q: Do you remember the Ipsos Reid-released poll results at the beginning of this year, stating that pharmacists are the number one most trusted profession in Canada? Yes, pharmacists have remained relatively stable in terms of trust – they’ve now actually placed at the top of that poll for two years running. People tend to trust first responders like doctors, nurses - but most professions have seen decreases in the double digits. The only profession that’s experienced a significant increase is the Canadian soldier, which has gone up 17 points over the last decade.

Q: What are some results in the polls that have really surprised you? I think people tend to be overwrought about social media. In reality, polls reveal that only one out of 10 have heard of it, while less than one of one per cent have tweeted themselves. Same with technology, when we look at how it’s actually integrated into people’s lives. People tend to assume a wider spread than there actually is – we’ve all heard the story of a two-year old who touches the TV assuming everything is touch-screen. There’s an assumption that this is more common than it may be in the every day home. The point is – what you think is obvious, isn’t. I’ve been doing this for a long time and I’m completely surprised every day. We’re supposed to have the best gut in the business and I get it wrong all the time. But the numbers don’t lie.

Q: So what should your audience expect looking forward to your keynote speech at the 2012 BC Pharmacy Association conference? John and I are pretty easy-going guys. Sometimes we don’t know what we don’t know, but we’re always willing to talk – have a conversation with us when we’re there. We won’t just be sitting there spitting out a bunch of statistics. We’ll expose you to some really interesting information that’s going to make you think. Not in a way that you feel like you just went to a lecture and are worn out, but actually fun. Come in with an open mind, assuming that you’re going to learn something. We’re more than happy to help you out. It won’t be just dry statistics nor just fun facts, but a better understanding of who Canadians are and having fun as you learn!

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

John Wright is Senior Vice President and Managing Director of Ipsos Reid’s North American Public Opinion Polling Division and has been its Media Polling Partner architect and spokesperson since he arrived at the company in 1989. For the decade before that, he was Vice President with an advertising and public relations firm and served in both the political and corporate worlds in government relations. In all, he’s worked for almost 30 years on Public Affairs assignments for clients of every dimension. Wright has had his own radio show on CFRB for almost 15 years with one of the top political commentary panels in the country, and regularly cohosts and anchors Canada’s business news network’s (BNN’s) daily market closing show SqueezePlay. He’s also appeared on every major news channel-from CNN to Al Jazeera-and been quoted, literally, everywhere in print around the world.

Joseph Michelli: “Creating a true pharmacy experience in BC” Q: Can you provide our members with a little background about yourself?

customer is with their brand. I utilize best standards of practice that other brands use, and strategies I’ve developed with companies.

I work as an organization consultant, author and professional speaker – I often work directly with companies and write books about them. For example, I’ve worked with Starbucks, the Ritz-Carlton Hotel Company, Zappos shoes, and - close to your home – the world famous Pike Place Fish Market in Seattle.

It’s designed around a lot of science that shows behaviour is not just based on the product, but how a customer feels when receiving that product. There’s an opportunity from a business strategy standpoint to build loyalty through a consistent brand experience. There’s a whole science to what causes people to be loyal.

Q: Is your focus on customer service with these companies?

Q: How do you apply this to our members, pharmacists and pharmacy owners?

Yes, I focus on the customer service team and achieving an operational excellence platform in service – how things should be done at each stage of the customer journey. Are you consistently driving certain service behaviours that the customers can rely on? That’s the service excellence platform. But more importantly, I look at the customer experience – some brands create emotional connections with the people they serve. My goal is to help people in the pharmacy space really define what the customer, or patient, experience is beyond service excellence. It’s about what you want your customers to feel every time they think of your brand – whether that’s getting an informational experience, knowledge, safety, or feeling empowered. You want to be able to provide your customers with emotional value, and deliver that consistently.

Q: Can you give us an example of this emotional experience? A good example is the coffee-company Starbucks (one of Dr. Michelli’s best-selling books includes The Starbucks Experience: 5 Principles for Turning Ordinary to Extraordinary). We see that their branded experience is about nurturing, feeling home-like. They want their customers to feel like they are in the “living room of the community”.

Q: What do you base your advice and theories on? It’s all based on my work with world class providers of customer experiences – these brands have empirical data that show they are among the top in world when measuring how emotionally engaged a

It’s about looking at how you define emotional value in the pharmacy space. First of all, how do you want your patients to leave feeling? What is their end-state experience? Then, how do you select people who can deliver this goal and train them to improvise in the direction of it? I’ll discuss how to make workers understand the destination every customer should have when in contact with your brand. It’s not just about following a checklist, but about making your employees understand how you want patients to feel. Customers come into a store with very different wants and needs, different emotional states. How do you help your employees take that and still make sure they leave feeling a certain way? My keynote address will be specific to pharmacy, not just in general but in Canada, with your country’s political issues. My first career was actually as an organizational development specialist in health care. My book, Prescription for Excellence: Leadership Lessons for Creating a World-Class Customer Experience from UCLA Health System, is based on improving the patient experience in their health system. At the conference, we can discuss the patient experience specific to the pharmacies in BC. Having that emotional patient experience not only builds loyalty among patients, but also advocacy. They’ll be out there telling stories to their friends and family about the experience they had with their pharmacist.

Meet Dr. Joseph Michelli, a international presenter who transfers his knowledge of exceptional business practices in ways that develop joyful and productive workplaces with a focus on the total customer experience. His insights encourage leaders and frontline workers to grow and invest passionately in all aspects of their lives. Dr. Michelli will be presenting at the 2012 BCPhA conference as one of two keynote addresses on Friday, May 25th.

BOARD ELECTIONS

BCPhA Board elections There are nine candidates for election for three positions on the BC Pharmacy Association Board of Directors. Below, in alphabetical order, are biographies for each of the candidates. All BCPhA members were sent a letter and ballot papers in March. The deadline for returning them by mail or in person to the BCPhA offices is April 15, 2012.

Omar Alasaly Omar Alasaly is very excited about the potential opportunity to represent BC pharmacists on the British Columbia Pharmacy Association (BCPhA) Board. From his time at the UBC Faculty of Pharmaceutical Sciences, where he represented all undergraduate students on the Dean Selection Committee that selected Dean Robert Sindelar, Omar has been very active in the profession of pharmacy. Most recently, Omar was a facilitator at the 2011 BCPhA Annual Conference for the BC Medication Management Review Program Workshop. Omar has worked as a pharmacist and associate-owner in both urban and rural cities in BC. He is currently the associate-owner of two Shoppers Drug Mart franchises in Victoria, one of them being the only 24-hour community pharmacy on Vancouver Island where a pharmacist is on duty 24 hours a day, 365 days a year.

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

Omar Alasaly

Over his career, some of Omar’s awards and achievements include:

Pharmacists called Okanagan Resident Plus Pharmacy.

• British Columbia Pharmacy Association (BCPhA) New Horizons Award

Don is currently involved on various provincial boards and Interior Health Authority committees including Residential Services Medication Reconciliation committee and the Antipsychotic Medication and Behavioral/Psychological Symptoms of Dementia (BPSD) committee. He has sat on the Board of Directors of British Columbia Pharmacy Association (BCPhA) for the past three years and is involved in various subcommittees involving government (Pharmacare) and the negotiations with PSA for cognitive services reimbursement and long term care. He also sits on the Board of Directors of Kelowna General Hospital Foundation and Central Okanagan Association for Cardiac Health (COACH) and is an active speaker for the COACH program. In his free time, he enjoys skiing and spending time with his wife and two daughters.

• Canadian Pharmacists Association (CPhA) Centennial Award • Canadian Association of Pharmacy Students and Interns (CAPSI)/Tilak Award of Professionalism • Honourary Student Activity Award From Omar’s experience working in pharmacies in both urban and rural cities in BC, he feels that he has gained a good understanding of pharmacy practice in British Columbia and feels well positioned to represent BC pharmacists on the BCPhA Board. Omar is fully committed to the BCPhA mandate and is also fully committed to being a strong advocate for our best interests as pharmacists. He feels that more can be done to engage pharmacists in BCPhA Board decisions. Omar plans to improve communication between the BCPhA Board and BC pharmacists and solicit more feedback on important issues through enhanced interactive technology. Omar is very excited about the future of pharmacy and is absolutely dedicated to ensuring that pharmacist interests are protected.

Brad Davie Brad Davie graduated in 1993 from UBC then completed a clinical pharmacy hospital residency in 1994 at Lions Gate Hospital. During his career, Brad has worked as a dispensary pharmacist and as a clinical pharmacist for a variety of lower mainland hospitals including St. Paul’s Hospital, MSA General Hospital,

Don Cocar Don Cocar was born in Saskatchewan and raised in Kelowna, BC. He graduated from UBC in 1991 with a BSc in Biology and continued his education, graduating in 1994 with a BSc Pharmacy. Don moved back to Kelowna after graduation and started his pharmacy career at an independent local pharmacy. From there,

Brad Davie Don Cocar he and another business partner expanded the business and cofounded Paragon Pharmacies Limited, where they transitioned the company from a privately based company to a publicly traded company on the TSX Venture exchange. Don resigned from Paragon pharmacies in November 2007 and became an owner/partner with Dyck’s Pharmacists with five locations in the Kelowna area. Don currently works as a pharmacist dividing his time between all five of the Dyck’s Pharmacists locations but he focuses mainly on the long term care division of Dyck’s

Langley Memorial Hospital and Surrey Memorial Hospital. His community experience includes working as a pharmacist for Murrayville Healthcentre Pharmacy, Fraser Heights Pharmacy and Pharmasave Grandview Corners. Brad has worked as a contractor for Network Health Care on Healthlink BC, Alberta Pharmacy Practice Models Initiative and the BC Medication Management Project. Outside of pharmacy, Brad works as a first responder and firefighter for the city of New Westminster. Currently, Brad owns and operates Glover Family Pharmacy in Langley. Brad is a medication management specialist with advanced experience in general practice, cardiology, and emergency related clinical services, and injection administration. For the future, Brad believes that expansion of reimbursable clinical pharmacy services would provide an opportunity to create long-term, sustainable rewarding careers for both pharmacists and pharmacy

development for her parent’s family business. Julie’s recreation activities include skiing, mountain biking, running and travel.

owners alike. Brad Davie is a hospital pharmacist, community pharmacist, pharmacy owner, medication management specialist, and a firefighter! Brad’s breadth of practical and clinical knowledge would be an asset to BCPhA.

Victor Ikari

Julie Ford

I graduated from UBC in 1992 and have been practicing in pharmacy for the past 20 years. I have extensive experience in retail pharmacy

Julie Ford was raised in Williams Lake, BC. As a boarding student, she completed her final three years of high school at St. Michael’s University School in Victoria, graduating in 1989. In 1994, Julie graduated with a BSc Pharmacy from UBC. She began her career as a pharmacist at an independent pharmacy, Kornak & Hamm’s, in Williams Lake. She then went on to work for Shoppers Drug Mart in Vancouver and during this time she worked part-time as a practice consultant for the College of Pharmacists covering the northern region of BC. Pursuing her keen interest in business, Julie went on to complete her MBA, graduating from the Ivey School of Business in 2000. She then applied her strong business acumen working with a Toronto based company developing electronic prescription software. Her next position was business affairs leader, pathology & lab medicine at the BC Cancer Agency.

Victor Ikari in both chain and independent organizations. I have held positions as a staff pharmacist, pharmacy manager, professional services manager and recently pharmacy owner.

Julie Ford In this position Julie was responsible for $20M budgets, 70 plus staff, and was a key decision maker at the Cancer Agency. Julie left that position to start a family and work on various contracts for the Provincial Health Services Authority. These contracts included clinical trials and diagnostic imaging. Julie now resides in Kamloops with her family working part time as a pharmacist at Glover’s Medicine Centre – a compounding pharmacy. Julie has been passionate about delivering pharmacy services with detailed attention to each client focusing on their individual needs. She is also acutely aware and involved in the business aspect of operating a pharmacy service. Julie exhibits excellent financial analysis, communication and people skills. She has experience chairing, presenting to and effectively contributing to meetings. Julie has two daughters and is actively involved in their activities, including volunteering as treasurer at her daughter’s school Parent Advisory Committee. Julie also contributes in business

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

I want to ensure that community pharmacies are viable financially and our scope of practice will continue to expand to allow us to practice to the fullest. Pharmacies should be able to maintain current practice while utilizing the new professional service model (medication management) to allow pharmacists to benefit professionally and financially. Through my experiences as a practicing pharmacist and ex-board member, I believe I have an extensive understanding of the issues and concerns facing pharmacy. I would like the opportunity to represent the interests of pharmacy and pharmacists and ask for your support.

Moh Jaswal

I graduated from University of British Columbia in 1992 and I am a licensed pharmacist. My pharmacy career has encompassed all aspects of retail pharmacy, starting as a pharmacy technician in 1990, to my current role of senior director of pharmacy operations for BC and Yukon with Loblaw. My experience working for a national employer has given me the opportunity to experience the reality of drug reform and an expanded scope of practice in other provinces. With current drug reforms occurring in BC, pharmacy needs a strong united voice to facilitate positive outcomes for an expanded compensation model for other services pharmacists provide. I would consider it a great privilege and an honour to serve BC pharmacists as a Board member of BCPhA.

Shenaz Lakhani My name is Shenaz Lakhani and I am seeking election to become a BCPhA director. I have worked in the pharmaceutical industry since 2004 and graduated from UBC with a Bachelor of Pharmacy in 2009. After graduating I gained invaluable experience as a floater pharmacist, working in a wide array of community pharmacies in locations ranging from the Fraser Valley to downtown Vancouver. In that time I gained an understanding of the different strengths, weaknesses, opportunities and threats facing pharmacies and our profession. I have worked in busy walkin pharmacies, senior-centered pharmacies, overnight pharmacies,

Randy Konrad We are in the midst of important changes in pharmacy - changes that are already affecting how pharmacy is practiced and reimbursed for services. BCPhA is the organization that will guide pharmacy through this time of change as reflected in its goals and objectives: strengthen BCPhA as the voice for pharmacy; ensure the future economic viability of our profession; look to expand current, and add new reimbursement opportunities for pharmacy services; support pharmacies and pharmacists in making practice and economic transitions; promote pharmacists as medication experts with our stakeholders.

Shenaz Lakhani quiet small community pharmacies and many other settings. This vast array of experience makes me well qualified to speak on behalf of our profession.

Randy Konrad I have a broad range of experience that I can bring to the BCPhA Board to help navigate the transition of pharmacy. I am a 1986 UBC graduate and have experience in independent and chain community pharmacy and in hospital pharmacy. In my current position as a regional pharmacy manager, I oversee 18 community pharmacies and am involved in all aspects of pharmacy operations, including professional programs, human resources and policy and procedure. I have previously served as Chair of the College Board and Chair of the Chain Drug Association of BC as well as various committees with the College and BCPhA. I look forward to the contribution I can make to pharmacy in British Columbia.

In 2010 I became a pharmacy manager in Whalley (a neighborhood in Surrey, BC). I used my previous experience to improve and grow the business and took over as owner in March, 2011. Since then I have expanded this business substantially. We have increased the quality of patient-care and provide many additional services which have improved the satisfaction of our patients. I am a supporter in advancing our profession and I am a provider of newer professional services including vaccine injections, medication reviews and telehealth (the public Healthlink 8-1-1 program). If elected, my goal is to assist BCPhA in representing the best interests of pharmacists and the business of pharmacy in British Columbia. I bring a unique perspective, being a successful community pharmacy owner of a busy pharmacy in a blue-collar neighborhood. If elected, I will be dedicated to helping seek out resolutions that will serve pharmacists, their businesses and their patients. I will also go the extra mile to advocate on behalf of our members with the government. I am a hard-working, driven individual and if elected, I will put tremendous time and effort into my role and represent the voice of our members.

Ellie Rahmani Dr. Ellie Rahmani is enthusiastic about the opportunity to enhance the professional image of pharmacists and the profession of

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

BOARD ELECTIONS

pharmacy practice, in 2011 she joined Rexall Pharma Plus as a pharmacy manager of a clinic pharmacy located in Coquitlam. In this position, she has successfully provided excellent pharmacy services, improved practice with regards to adherence to federal and provincial regulations while achieving corporate objectives, enhanced store financial performance, recruited and trained new staff pharmacists and technicians, controlled inventory and budget, and assisted nursing homes in enhancing patient care management.

Ellie Rahman pharmacy in British Columbia by applying her pharmaceutical research knowledge, management, and leadership expertise. Dr. Rahmani received her BSc in pharmaceutical sciences from Tehran University in 2000 and then began her career in community pharmacy. She completed her PharmD training in industrial pharmacy in 2002, becoming a research assistant in the department of pharmaceutics at Tehran University. She was an active member of the Iranian Pharmacy Association for six years and worked as a pharmacist with several independent and hospital pharmacies. In 2006, Dr. Rahmani was recruited as a research assistant by UBC Department of Surgery for her expertise in topical and transdermal delivery system design. She merged this work with graduate studies, receiving her PhD from UBC in 2011. During her PhD training, she actively participated in prestigious government funded research grant applications. She collaborated in writing new drug applications for Health Canada. She was also an investigative member of CDRD at UBC.

“Amazing programs and great services when you join the Peoples group ” Chris Dreyer Lytton Peoples Pharmacy

If being a successful owner operator in retail pharmacy is part of your life plan, Peoples Drug Mart is the proven program that will help you achieve your goals. For as little as $100 per month, the Peoples program offers opportunities that are unique to independent pharmacies and provides financial benefits that are unparalleled. If you own an independent pharmacy or have plans to, call us today.

Helping People Live Better Lives To learn more about the Peoples Drug Mart and Peoples Pharmacy programs, contact:

In 2010, Dr. Rahmani joined Shoppers Drug Mart as a part time pharmacist. To further her career objectives in management and

THE TABLET

Apr/May 2012

Dr. Rahmani currently writes the skin pharmacy column in The Tablet. She is beginning extensive collaboration with the BC College of Pharmacists and CACDS. In 2012 she was included in the Stanford Who’s Who Black Book, in recognition of her outstanding leadership and achievement in her profession.

www.bcpharmacy.ca

Frank Fidyk 778-678-6717 or Ian Maxwell 604-431-3595 ext 23 email: fgfidyk@telus.net email: ianm@pdmstores.com www.peoplesdrugmart.com

ACTIVE INGREDIENTS

Pharmacy Awareness Week at UBC Our BC Pharmacy Association student ambassadors JD Puri, Aaron Sihota, Dawei Ji, RenĂŠe Dagenais and Melissa Patton recently staffed the BCPhA information booth at Pharmacy Awareness Week held in the Student Union Building at the University of British Columbia. Not only did they tell their fellow students about BCPhA and sign up new student members, but they also recruited five additional student members to join in the BCPhA-sponsored Sun Run team.

Student ambassadors JD Puri and Aaron Sihota show off a recent issue of The Tablet magazine

UBC pharmacy students (from left to right): Melissa Twaites, Melissa Patton, Jordan Stewart (top row), France Carriere, Amy Le, and Andrea Silver

Student ambassador JD Puri (left) with fellow UBC pharmacy students, France Carriere and Masih T.

Dawei Ji, BCPhA student ambassador, mans the BCPhA information table at UBCâ&#x20AC;&#x2122;s PAW.

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

UP CLOSE

Pharmacists step up to tackle pertussis outbreak by Elise Riedlinger Community pharmacists have been helping to tackle an outbreak of pertussis, having already administered vaccines to more than 6,000 patients in the Fraser Health Authority. The outbreak of pertussis, or whooping cough, began in Hope this past December and quickly spread through the Fraser Valley. Whooping cough is a highly contagious bacterial infection in the lining of the respiratory tract. It can be particularly dangerous to infants and young children. In response to this outbreak, community pharmacists in the region stepped up to administer pertussis vaccines, taking pressure off local health units and physicians. “We’ve been hearing from our members that one pharmacy chain in the Fraser Valley administered more than 500 injections in only two days, while another pharmacy chain already administered more than 700 whooping cough vaccines in the first few weeks,” said Geraldine Vance, CEO of the BC Pharmacy Association. “Whooping cough vaccinations are yet another way in which pharmacists are demonstrating their value as key members of the primary health care team.” John Jeong, pharmacy manager at Safeway #082 in New Westminster, knows just how important the pharmacist’s role is in providing vaccinations, particularly during the whooping cough outbreak.

THE TABLET

Apr/May 2012

www.bcpharmacy.ca

GIG3135

John Jeong in his new Safeway pharmacy consultation room

Anyone can make an error. Protect yourself. Preventing dispensing errors and the potential injuries to clients is the focus of this educational series. To help you understand and deal with these issues, Grain Insurance and Guarantee Company has commissioned a series of articles from Ms. Marie Berry, B.A., B.Sc. (Pharm), LL.B. Ms. Berry is a pharmacist and lawyer specializing in health care law. You can find her article at http://graininsurance.com/ pharmacy/page_bcpa.html For more information about the specialized insurance products that can protect all you’ve worked for, contact Stephen or Stuart Adams at 604-251-3571 or 1-877-251-4079, or email pharmacy@theadamsgroup.ca

NEW MEMBERS General

His pharmacy staff includes three pharmacists, all of whom are authorized to give injections, and one pharmacy technician. “I would love to see all BC pharmacists certified to inject,” he said. “I find it’s very rewarding. Providing immunizations is a fairly large responsibility and your patients really trust you when they know you can give them their shot.” His pharmacy has been actively involved with pertussis vaccinations since they first became available through the Fraser Health Authority in late February “We’re asked about pertussis and give vaccinations on a daily basis,” Jeong said, noting that they are able to provide whooping cough vaccines to those patients aged nine and up. “It’s particularly parents with young children in the household who are concerned.

Amro Ahmed Abdo, Mohanad Abdul-Ahad, Miyoung Baek, Ashley Briggs, Shawna Broten, Rodger Brown, Allan Bryson, Emily Chan, Nancy Chan, Kathleen Anne Coburn, Binda Dasondi, Shema Dharssi, Nicole Finlayson, Gurbax Hayre-Sihota, James Hill, Gurpreet Johal, Helen Johnson, Heekyung Kim, Hon Shing Lam, Joo Hye Lee, Julian Lee, Daniel Li, Lufianti Low, Lisa Main, Farzad Matin, Mohamed Naser, Nebal Nosh, Amanda Pang, Silvia Poelstra, Twinkle Ruparel, Gurmail Shawn Sandhu, Sukhvir Seehra, Hao Yuan Song, Tim Tailfeathers, Werner Umali, Drew Wei Corporate Family Care Pharmacy #2 Pharmasave #098

“Also, as we’re filling prescriptions and doing OTC counseling, we’re always monitoring and identifying candidates who may want vaccines.” Jeong often hears feedback from patients who appreciate the extra services available at his pharmacy. “Our patients love the fact that they can shop, fill their prescriptions, and receive their immunizations all in one place. It’s convenient and highly accessible. They don’t need to make a set appointment and we’re open seven days a week.” In addition to contributing to pertussis vaccinations, the New Westminster Safeway is also breaking ground with a brand new consultation room. Modeled off a concept in the United States, where every new Safeway is being designed in the Chief Executive Officer’s vision, Jeong’s pharmacy also boasts a closed-door space with chairs for patients to get more comfortable. “I believe we’re only the second store in Canada to have this design,” Jeong stated. “And the only one so far in BC. The other is in Edmonton.” The new consultation room is completely sectioned off from the busy Safeway storefront and pharmacy shelves. “I’m really excited about it,” he said. “We’ve been using the space for immunizations and medication reviews and it will also be used as a waiting room. “It’s private and away from the store, and done up in earth tones for a calming effect. Here we can provide our patients with information on our additional services.” The consultation room is also used for Safeway’s “Health Awareness Days,” where patients make appointments for clinics on diabetes counseling, cholesterol testing and blood pressure testing. Most recently, the New Westminster pharmacy held a clinic on osteoporosis, testing patients’ bone density. Although things are still somewhat calm in the brand new store – the pharmacy only opened in December of 2011 – the added services of these clinics, medication reviews, and immunizations are sure to make repeat customers of Jeong’s patients. Jeong is not alone – many pharmacists are seeing injections in particular as an opportunity to build relationships and establish trust with their patients. As the H1N1 epidemic and pertussis outbreak demonstrates, there is more need for pharmacists to provide expanded services to patients. With more than 6,000 patients in the Fraser Health Authority who have already received pertussis vaccinations, it’s a good indication that patients will continue to turn to pharmacists for clinical pharmacy services in the future.

www.bcpharmacy.ca

ASSOCIATION CONTACTS Geraldine Vance Chief Executive Officer 604.269.2860, Geraldine.Vance@bcpharmacy.ca Parkash Ragsdale Deputy CEO, Director, Professional Services 604.269.2862, parkash.ragsdale@bcpharmacy.ca Cyril Lopez Chief Operating Officer 604.269.2869, cyril.lopez@bcpharmacy.ca Elise Riedlinger Manager, Communications 604.269.2866, elise.riedlinger@bcpharmacy.ca Krista Davidson Communications Specialist 604-269-2867, krista.davidson@bcpharmacy.ca Riva Pickering Coordinator, Professional Services 604-261-2092, riva.pickering@bcpharmacy.ca Bryce Wong Manager, Professional Services 604.269.2865, bryce.wong@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864, linda.tinnion@bcpharmacy.ca Laura Chok Event Coordinator, Member Services 604.267.7081, laura.chok@bcpharmacy.ca Ray Chow Database Administrator Member & Corporate Services 604.269.2868, ray.chow@bcpharmacy.ca Pam Ratcliff Executive Assistant 604.269.2861, pam.ratcliff@bcpharmacy.ca Starr Rempel Receptionist and Administrative Assistant 604.261.2092, starr.rempel@bcpharmacy.ca

604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy.ca, www.bcpharmacy.ca

Apr/May 2012

THE TABLET

CAREER OPPORTUNITIES resume to Kelly Loewen at 1-866-246-7749 or email Kelly. subica@mckesson.com, Phone 1-866-246-0096.

ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS?

GRAND FORKS Pharmasave Grand Forks is looking for full-time pharmacists (40hrs/wk). Potential for possible future ownership. Join our team and help deliver pharmaceutical care to our friendly, loyal customers. Our pharmacy staff are encouraged to spend time with patients and go beyond the pharmacy counter to use their professional training to its fullest potential. We enjoy giving our customers the best service and at the same time create a pleasant working environment with friendly staff and customers. We offer competitive wages and benefits as well as payment of professional dues and continuing education. Grand Forks is nestled in the Sunshine Valley, and offers outstanding summer and winter recreation. Check out www.city.grandforks.bc.ca. Interested candidates are invited to send their resume to: Pharmasave 106, Box 998, Grand Forks, BC. V0H 1H0, fax 250.442.3225, email ps106@shaw.ca or phone Laura at: 250.442.3515.

Corporate Members can place free Career Opportunities listing in these columns and on the web. General Members looking for new career opportunities get free access to PostYour-Resume. To learn more, log in and visit the Career Opportunities. The BCPhA Career Opportunities connects our members like no other job board, bringing member employers and potential employees together, and it is free! ABBOTSFORD Pharmasave in Abbotsford looking for full-time and parttime pharmacists. No evenings and occasional weekends. Pharmacy is located inside the new Abbotsford Regional Hospital. Renumeration paid according to experience. Contact Shaf or Shabita at 604-870-5600 or info@pharmasaveabby.com, fax: 604-870-2955. BURNABY Medical clinic pharmacy requires full-time and/or parttime professional pharmacists to join our dynamic team. The work environment is patient care focused, team oriented and busy. We pride ourselves on providing strong customer service. Excellent compensation and real growth opportunity with new pharmacy openings scheduled for the fall. Requirements: minimum two years work experience. Excellent communication skills, written and verbal. Demonstrated track record in delivering exceptional customer service. Team Player; flexible. Ability to work independently and manage technicians and pharmacy. If you are looking for a position that gives you the opportunity to practice clinical pharmacy with modern practice tools, please email your cover letter and resume to Hr@inwell.ca. Please include “Pharmacist” in the subject line. We thank all candidates for their applications. Only shortlisted candidates will be contacted. Full-time pharmacy technician position (20hr to 32hrs per week, Monday to Friday) available in retail pharmacy in Crystal Mall, Burnaby. Candidates must possess high level of customer service skills and have patience working with seniors. Mandarin speaking or Cantonese speaking ability is highly preferred. Starting wage is $13/hr. Should employment continue after a 3 month probation period, the wage will then increase to $16/hr. Please email or fax resume (604-433-2830). Email: crystalpharmacy@hotmail.com, phone: 604-433-2821.

COQUITLAM Full-time pharmacy technician needed. Specialized, high quality patient care pharmacy looking for an energized full-time technician. Very unique and rewarding environment with a focus on high level patient support with exceptional customer service. Succesful applicant must be able to work well in fast paced environment. Organization, attention to detail, and excellent communication skills are a must. Sterile prep experience an asset. A perfect opportunity to be challenged with continual learning opportunities and advancement. Hours: Mon-Fri; Competitive salary and benefits. Please fax

THE TABLET

Apr/May 2012

KELOWNA We are looking to fill a pharmacy assistant position in a busy customer-service oriented pharmacy, open 7 days per week, in Kelowna. The position will be for 28 to 40 hours weekly. The candidate will be responsible for, but not restricted to, filling prescriptions, compounding, ordering, inventory management and compliance packaging. The candidate should be self-motivated, and be able to work with minimum supervision. We are looking for a person who is pleasant, courteous and able to provide excellent customer service. Must be able to work cooperatively with other staff members. If this sounds like a good fit for you, please contact Jim Nishi at 250-7175330 or email ps242jim@gmail.com, fax: 250-717-5332. Part-time technician required for permanent Monday, Tuesday position at Pharmasave. Will have additional hours during vacation time. Duties include blister packing, filling prescriptions, customer service and running pharmacy/front store till. No previous experience necessary. Please contact Kayleen at 250-764-6410, email: ps042kayleen@gmail.com, Fax: 250-764-6439.

CHEMAINUS Full time or part time staff pharmacist needed. To be considered, applicants must be licensed to practice in BC; have experience in retail pharmaceutical systems and dispensing procedures ;exceptional communication and organizational skills; strong customer/patient satisfaction orientation; ability to maintain the optimum balance between the profession of pharmacy and business of pharmacy; strong problem solving and analytical skills; and ability to work productively as a member of a dynamic and fast-paced team. Katz Group Canada Ltd. offers excellent base salary rates, annual bonus opportunity, full benefits package, educational allowances, paid med. checks, career growth opportunities. Successful applicants may be required to complete a criminal record screening before commencing employment with Katz Group Canada Ltd. Contact Email: njoshi@rexall.ca

INVERMERE Full-time position for pharmacist at Lambert Kipp Pharmacy - a family owned business located in the Columbia Valley. Opportunities for outdoor and indoor activities abound. We are a compounding pharmacy with a fully equipped lab. Our compounding interests include bio-identical hormone replacement therapy, topical analgesics, veterinary prescriptions and dermatology. For more information, Contact: Doug Kipp at 250.342.6612. Submit resumes to: Doug Kipp, BSc Pharm, Lambert Kipp Pharmacy, Box 2919, Invermere, BC, V0A 1K0.

Full time or part-time staff pharmacist needed. To be considered, applicants must be licensed to practice in BC; experience in retail pharmaceutical systems and dispensing procedures; exceptional communication and organizational skills; strong customer/patient satisfaction orientation; ability to maintain the optimum balance between the profession of pharmacy and business of pharmacy; strong problem solving and analytical skills; and ability to work productively as a member of a dynamic and fast-paced team. Katz Group Canada Ltd. offers excellent base salary rates, annual bonus opportunity, full benefits package, educational allowances, paid med. checks, career growth opportunities. Successful applicants may be required to complete a criminal record screening before commencing employment with Katz Group Canada Ltd. Please send resumes to njoshi@rexall.ca. LANGLEY Murrayville HealthCentre Pharmacy Inc. is looking to recruit and train a full-time clinical pharmacist. Suitable applicants will want to practice pharmacy in a community pharmacy setting, under the mentorship of Dr. Shakeel Bhatti Pharm. D. and Mr. Brad Davie BScPharm., and their team of pharmacists. Dr. Bhatti is a former Hospital Pharmacy Resident Clinical Coordinator and Mr. Davie is a former Hospital Pharmacy Resident. The trainee will be enrolled in a 6 month (intensive) in-house tailored training program that will provide training and mentorship to develop both clinical and business skills. The successful candidate will be paid according to Key Performance Indicators, leading to a performance based pay scale, including performance bonuses. There will be

www.bcpharmacy.ca

a requirement for dispensary shifts (not to exceed 50%). The successful candidate will be expected to make a 3 year commitment to the company. Interested? To apply: email a cover letter and resume to shakeelbhatti@shaw.ca or phone (604) 534-6600. A part-time pharmacist is required for a pharmacy in a medical building in downtown Langley city. Store hours are Monday to Friday, 9am - 6pm, and Saturday, 9am - 5pm. The pharmacy is closed Sundays and holidays. Experience on Applied Robotics would be an asset. For further information, please contact Gerry Kitson, Email: valphar@hotmail.com. NORTH VANCOUVER Medical clinic pharmacy requires full-time and/or parttime professional pharmacists to join our dynamic team. The work environment is patient care focused, team oriented and busy. We pride ourselves on providing strong customer service. Excellent compensation and real growth opportunity with new pharmacy openings scheduled for the fall. Requirements: Minimum two years work experience. Excellent communication skills, written and verbal. Demonstrated track record in delivering exceptional customer service, team Player; flexible; ability to work independently and manage technicians and pharmacy. If you are looking for a position that gives you the opportunity to practice clinical pharmacy with modern practice tools, please email your cover letter and resume to Hr@inwell.ca. Please include “Pharmacist” in the subject line. We thank all candidates for their applications. Only shortlisted candidates will be contacted. Pharmasave in North Vancouver is looking for a full-time pharmacy technician for 40 hours per week, 9:00 am 5:00 pm Monday to Friday (no weekends or evenings). Requirements: Experience as a pharmacy technician or pharmacy technician certification. Strong communication skills and customer service; excellent computer, data and entry skills; roll knowledgeable to work independently at a wide variety of pharmacy and general retail store tasks including: pharmacy and front store ordering and receiving, till operation, deliveries etc. Please email resume. We will contact the applicable applicants. Email: alvinesingh@yahoo.ca, Phone: 604-988-5015. Pharmax Health Inc. is a program based pharmacy site located in North Vancouver and Vancouver. Pharmax Health has a full-time position open for a clinical pharmacist. The focus is on hospice, VCH community palliative care team, geriatric outreach, professional and patient engagement through attending rounds, providing cognitive services and presentations. Opportunity also exists for involvement in clinical trials. Interested candidates should email amin@cheos.ubc.ca, phone 778-229-5139. OSOYOOS Pharmasave Osoyoos is seeking a friendly, full-time, BC licensed pharmacist to join our team in continuing to offer excellent health care support and customer service to our community. Would you like to have the opportunity to actually get to know your patients and build a strong rapport with the local health care professionals? We are not your average pharmacy. For the past year we have made medication management counseling a priority and offer various clinical services to our patients; we encourage our pharmacists to get out from behind the counter and connect with the community. If you are interested in joining our Pharmasave family you are invited to submit your resume in confidence to Pam Davis and Jolly Gill at pdavis@pharmasave011.com. Pharmacist needed in Osoyoos, BC for July, 2012. Come live, work and play in one of the only two resort communities in BC. Steps from Canada’s warmest lake, you will have access to golf courses, hiking, water sports, dozens of world class wineries, orchards, skiing and all sorts of other activities. Our small town hours allow for the perfect balance between work and play. Osoyoos has a large percentage of retirees so will offer you ample opportunity to play an integral role in the health of our patients and develop positive working relationships with them. We give you the freedom to get as involved in the community as you wish and will help you any way we can with your professional development. A RRSP plan, continuing education allowance, competitive wage, one of the best employee discount programs available, as well as a yearly conference are some of the many benefits included. We have a team that believes in working hard for our customers but having fun while we do it. If you

wish to get further training, or specialize your career in any direction, we will do everything we can to help you. Enjoy the best of the Okanagan lifestyle. Contact Steven at Shoppers Drug Mart 262. (250)495-6055 or email asdm262@shoppersdrugmart.ca. PORT ALBERNI Vancouver Island Health Authority is seeking a full-time pharmacy coordinator and casual pharmacists for the West Coast General Hospital in Port Alberni on Vancouver Island. 3 years running, VIHA has been a Top Employer in Canada and BC. Comprehensive benefits accompany the competitive salary. To learn more and apply: https://viha.hua.hrsmart.com/ats/job_search.php. PORT COQUITLAM Pharmasave in Port Coquitlam is looking for a parttime or full-time pharmacist to join our team. The ideal candidate will be self motivated and possess excellent communication skills. Prior knowledge of Kroll, compounding experience, injection training certification and compression stocking fitting would be an asset. We are a community based pharmacy focused on customer care. If you would like to be part of our pharmacy team please email your resume in confidence to Darin Fenton at ps190job@telus.net. Costco Pharmacy in Port Coquitlam is looking for a part-time pharmacist and a limited part-time pharmacist. Part-time pharmacists must work 5 days per week and will be guaranteed at least 25 hours. Limited part-time pharmacists are not guaranteed hours but will have the opportunity to pick up more hours during vacations or holidays. Preferably someone who is looking to work 1-3 regular shifts a week. Qualified candidates must be an effective communicator, customer service oriented, team player, efficient and able to multitask, able to work in an extremely fast-paced, high stress environment, familiar with doing over 300 prescriptions a day, detailoriented, Kroll experience, current pharmacy experience, and in good standing with the College of Pharmacists. Responsibilities include: Dispensing prescriptions, counseling and supervising technicians. Preference will be given to candidates with more experience and please note that only successful candidates will be contacted/selected. If interested, please respond to this ad with your resume/ cover letter and an indication of which position you prefer. Email: w255phm@costco.com, phone 604-552-2298. Costco Pharmacy in Port Coquitlam is looking for a part-time technician. Part-time technicians must work 5 days per week and will be guaranteed at least 25 hours. Qualified candidates must be effective communicators, customer service oriented, team-player, efficient and able to multitask, able to work in an extremely fast-paced high stress environment, familiar with doing over 300 prescriptions a day, detail oriented, Kroll experience and current pharmacy experience. Responsibilities include stocking OTC aisles, dispensing prescriptions, ordering/receiving Rx and OTC items and operating the register. Preference will be given to candidates with more experience and please note that only successful candidates will be contacted/selected. If interested, please respond to this ad with your resume/cover letter. Email: w255phm@costco.com, phone 604-552-2298. PRINCE GEORGE Costco Pharmacy operates 63 pharmacies in 8 provinces across Canada. Our pharmacies provide an environment that enhances patient care. Costco offers great salary, benefits and opportunities. If you are seeking a challenging and rewarding career in a professional retail pharmacy, we are looking for you. Qualified candidates will be highly motivated to provide excellent pharmacy care and customer service. Costco Pharmacy in Prince George is looking to hire a part-time staff pharmacist. If you are interested in a great opportunity, please apply by emailing or faxing your resumes to: Ed Toth, B.S.P Pharmacy Operations Manager, Western Canada. Phone: (604) 4449344, fax: (425) 427-7735; email: etoth@costco.com. RICHMOND Pharmasave in Richmond is now accepting resumes for a full-time pharmacist position. The candidate should be friendly, outgoing, and be fluent in English. The ability to speak a second language would also be an asset. Experience welcome but not necessary and new grads are welcome to apply! Please submit resume in confidence to stevestonpharmasave@gmail.com attention: Peter Tong. Phone: 604-232-0159.

SAANICHTON Part-time or full-time staff pharmacist wanted for Shoppers Drug Mart in Saanichton (Victoria). While experience with SDM is an asset, newly registered pharmacy graduates are also welcome. We offer a competitive package with extended medical and dental coverage and RRSP. Must be patient, focused and willing to work flexible shifts and weekends, either full-time or part-time. Please reply with resume and references to: asdm2122@shoppersdrugmart.ca . SALT SPRING ISLAND Dreaming of a vibrant and challenging pharmacy career for yourself? If so, you might want to talk to us about joining the Pharmasave team and become part of our beautiful island community. Our stores are just over 5,000 square feet in size, well-merchandised and fully equipped. Each location has its own specialty departments; the downtown dispensary has a new compounding facility while the uptown store focuses on blister-packaging for nursing homes. Our growing business requires additional pharmacy staff to join our team of experienced and dedicated professionals. As part of the independently owned and operated Pharmasave chain, our downtown store has won â&#x20AC;&#x153;store of the yearâ&#x20AC;? twice. Our standards are high and we aim to offer our customers the best service and pharmacy counseling available. If you want to be part of our team, we can offer a career that is exceptionally rewarding. Our compensation and benefits package is extremely competitive. We would love to talk to you about opportunities at Pharmasave on Salt Spring Island. Please do not hesitate to call me for a personal interview at 250-537-5534 or contact me through email at gary@saltspringpharmasave.com. SECHELT Do you enjoy working and living in a small community as a pharmacist where you can truly get to know your patients and build relationships with other health care practitioners? Pharmsave in the lovely seaside community of Sechelt is looking for a friendly, outgoing part-time BC licensed pharmacist, dedicated to offering outstanding patient care. The successful candidate must possess excellent communication skills and should be able to work independently and as part of a team. Sechelt Pharmasave offers great working hours; no evening shifts required and the hours of the position are negotiable (anywhere from 2 to 4 days per week). This will leave you with plenty of time to enjoy all that the Sunshine Coast has to offer. This family-oriented community is ideal for the outdoor enthusiast, and is only a short 40 minute ferry ride to Vancouver. Interested candidates are invited to submit their resume or inquiries to John Kennedy at pharmasave257@dccnet.com or via fax: 604-885-7257. SUMMERLAND Pharmacy Manager required for Summerland Medicine Centre Pharmacy. This is a well-established pharmacy business in a new location in a medical building. Strong Rx and home health care business with experienced, competent staff. Opportunities for clinical services including medication reviews and injections. Email: allisonn@unipharm.com, phone: 604-276-5280 or 1-800-665-9776 ext. 280 Fax: 604-276-5255. SURREY Community Care Pharmacy is looking for a full-time licensed pharmacy technician. Community Care is a pharmacy specializing in long term care. You would be working with 6 pharmacist and 4 pharmacy technicians. Our wage and benefit package is competitive. Hours are 9 to 5:30, no Sundays. Your work schedule would be more conductive to family life. Please call Godfriet Keller, work at 604.583.5312, email godfriet@shaw.ca. Part-time pharmacist needed for independent community pharmacy. Friendly environment, flexible shifts and no evenings. We offer a competitive wage. Must be able to work some weekends. New Grads Welcome! Please fax your resume. Contact: Tel. 604.543.6677, Fax 604.543.4433. Full-time staff pharmacist required at Pharmasave Ocean Park. If you are a pharmacist who is looking for a great opportunity that provides growth, development and a great work environment then we have the opportunity for you! Email: cformosa@telus.net, phone 778-772-4636. Full-time and part-time pharmacists required for Surrey/ Delta. Pharmacy specializes in mental health and addiction services. Experience in methadone maintenance an asset. Excellent wages and flexible hours. If interested,

www.bcpharmacy.ca

please email your resume C/O of Cheli McDonald to healthcentrerx@gmail.com or fax to 604-608-3230. TSAWWASSEN The Pharmasave in Tsawwassen is seeking a full-time BC licensed pharmacist. We offer competitive compensation, an excellent working environment and flexible hours with no evenings. The goal of our pharmacy is to become an integral part of the community by focusing on patient care and building relationships with area healthcare providers. It is essential that candidates possess strong interpersonal skills and have a commitment to providing exceptional customer service in a team environment. Please contact or send your resume to: Henry Tsang, Tel: 604.943.5066, Email: ps286@shaw.ca. VANCOUVER A busy pharmacy is looking for a self-motivated, wellorganized, efficient registered pharmacy technician to join our team in our Vancouver store. This position will be full-time. You must work well under minimal supervision, handle pressure effortlessly, and be able to work as a team player. Excellent hours; no evenings, and no weekends. You must be able to take initiatives and prioritize your work load. In addition, you must have strong and efficient technical skills as this position is very fast paced. We offer a very good competitive wage starting at $25.00 - $28.00 per hour based on experience and a medical and dental package provided after three months. We also cover your liability insurance through the BCPhA and the College of Pharmacists annual fee. Interested candidates that fit this criteria should fax your resume to (778)737 2889 or email to khtong@shaw.ca. Two regular part time pharmacists who are able to work two of the three shifts from Friday to Sunday (no evenings or holidays). Available to provide paternity leave and vacation coverage in May and July 2012 and Jan 2013. Experienced in retail pharmacy and have exceptional communicational and organizational skills. Able to work productively as a member of a dynamic team. If required, willing to work at two different pharmacy locations, both in the Lower Mainland. Having a second language is an asset. Please apply via email at: ymm@yyoung.com or by fax 604-324-1727, Phone: 604-324-1727. Peoples Drug Mart, Champlain Square, Vancouver, is looking for a pharmacy manager to lead our pharmacy team. The store hours are Monday to Friday, 9:00am to 7:00pm, Saturday 9:00am to 5:00pm and Sunday 12:00 to 4:00pm, and closed on holidays. You will be able to share your expertise in counselling and health management with the community. The successful candidate will be able to develop clinical programs in a service oriented setting. Cantonese would be an asset in this position. We offer competitive wage and benefits, incentive bonus based on profits, continuing education and career development. If you are interested in this opportunity please forward your resume to: Don Hicks, Operations Manager, phone: 250.788.5593, fax: 250.788.2810, email: donhicks@pdmstores.com. The Chemist Pharmacy is seeking a Pharmacy Manager. Punjabi or Hindi speaking would be an asset. Competitive wages plus profit sharing or partnership opportunities. Full extended medical & dental coverage. Please send resumes to careers@thechemist.ca or call 604-630-2350 ext. 2231, email: careers@thechemist.ca; phone: 604-630-2350 ext. 2231. The Chemist Pharmacy is seeking a staff pharmacist. Punjabi or Hindi speaking would be an asset. Competitive wages plus profit sharing or partnership opportunities. Full extended medical & dental coverage. Please send resumes to careers@thechemist.ca or call 604-630-2350 ext. 2231, email: careers@thechemist.ca. Pharmax Health Inc. is a program based pharmacy located in North Vancouver and Vancouver. Our practice is clinically grounded and is focused on patient-centered care. We work closely with health professionals to ensure the best pharmaceutical care. Currently, we are looking for a pharmacist who is motivated by a clinically focused practice and is well-organized, efficient and patient centered. If you would like to be part of a great pharmacy team, please email your resume in confidence to Amin Jan at amin@pharmaxhealth.com , phone: 778 229 5139. Immediate opening for fulltime (32-40 hours weekly) pharmacist in beautiful Cambie Village area. Competitive salary and benefits. Underground parking for pharmacists. Please email your cover letter and resume to asdm2234@shoppersdrugmart.ca, phone 604-708-9090.

Apr/May 2012

THE TABLET

Full-time and part-time pharmacists required for Vancouver and Surrey/Delta area. Pharmacy specializes in mental health and addiction services. Experience in methadone maintenance an asset. Excellent wages and flexible hours. If interested, please email your resume C/O of Cheli McDonald to healthcentrerx@gmail.com or fax to 604-608-3230. We’re looking for highly effective & professional pharmacists to join our winning team. We offer a competitive remuneration package and the opportunity for you to contribute to bettering how we provide our service instead of just clocking your hours. We’re looking for perfectionists and people who by nature produce high quality work through their checking. Do you have an inner drive to be the best at whatever it is that you do? Do you want to improve and learn new things? We provide the opportunity to grow within our company and we’d like people on board who step up to the plate and want to contribute. Are you the sort of person that always has an opinion? We want people who are going to challenge the status quo with better ways of doing things. Are you self motivated? Responsibilities will include processing and checking prescriptions, attending care conferences, liaising with doctors and nurses. No checking of regular rolls required as we have a robotic checking machine. Opportunity to specialize in field of your choice - hospice or geriatrics. LTC pharmacy experience preferred but not essential. Only successful applicants will be contacted. Contact sam@markspharmacy.ca, phone: 604-872-6762, Fax: 604-872-6764. VICTORIA Forbes Pharmacies are a local success story, located in beautiful Victoria, BC. To support our growth and expansion we are accepting resumes for part-time and full-time Pharmacists to join and add to our success. When you join the Forbes Pharmacy Group you become one of the family. We strive to be an employer of choice, and have been described by our team as: *We are like a family.*It is FUN! We work hard and well as a team... sometimes it doesn’t even feel like work.*Your strengths and passions are recognized. You have the opportunity to include what your passionate is at Forbes.*I am confident in the services we provide, I recommend Forbes to family and friend.*Forbes is cutting edge in the services they offer their patients.*We have an amazing team and great customers.*Respect, what you put in is reciprocated.*The work is rewarding, we have the opportunity to really get to know our patients.*Forbes continues to keep their grass root culture while we continue to grow.*Forbes is generous and stays active in giving back to their community. We offer a competitive salary and benefits package, and full pharmacy technician coverage. If you are interested in working for Forbes Pharmacies please submit your CV along with cover letter to Forbes’ President, Mike Forbes, at mforbes@forbespharmacy.ca. Attractive opportunity for a full-time pharmacist in Victoria. Excellent wages, health and professional benefits, great hours in a friendly neighbourhood pharmacy. Contact: Sunil 250-818-1468 or email: jobs@4455@gmail.com. Part-time pharmacist position available in a professional and friendly pharmacy. We are currently looking for between 8 and 16 hours (1 to 2 full shifts) per week. We have full pharmacy assistant coverage, so you are never without help. Interested candidates are invited to call (250) 595-1471 and ask for the pharmacy manager. Please reference that you are calling regarding the BCPhA advertisement. Email: scott_monette@hotmail.com, phone 250-595-1471, fax 250-595-1911. Part-time or full-time licenced pharmacy technician position available at a professional and friendly pharmacy. Work experience is necessary, and we are happy to provide any further training to integrate you into the team. Wage and benefits are negotiable based on strength of references and work experience. Eligible candidates are welcome to call the pharmacy manager at (250) 595-1471 between 12pm and 4pm, weekdays. Email: scott_monette@hotmail.com, phone 250-595-1471, fax: 250-595-1911. Full time pharmacist required for pharmacy in Victoria (Sidney). Must have a minimum of 1 year of pharmacy experience. Must be registered with the BC College Of Pharmacists. Must be able to work alternating shifts on Saturdays. Responsibilities include liaising with long term care facilities, attending to practice issues and quality control standards. Candidates must display strong interpersonal skills, a positive attitude and an affinity for great customer service. We provide a competitive compensation package, together with the necessary resources and support to help advance your career. We also pay for professional development courses for you to 30

THE TABLET

Apr/May 2012

maintain professional excellence. All interested candidates are invited to submit a covering letter and resume to: Ken LeeVP Pharmacy Operations, BC Remedy’s Rx, email: ken@buckshonrx.com; 604.254.1585; Fax: 604.254.3364. WHITE ROCK Full-time staff pharmacist required at Peoples Drug Mart at White Rock. If you are a pharmacist who is looking for a great opportunity that provides growth, development and a great work environment then we have the opportunity for you! Email: cformosa@telus.net; phone: 778-772-4636. CAREER OPPORTUNITIES THROUGHOUT BRITISH COLUMBIA COSTCO PHARMACY - part-time staff pharmacists and certified technicians required for various locations across British Columbia (Vancouver, Burnaby, Richmond, Surrey, Port Coquitlam, Langley, Langford, Nanaimo, Kelowna, Kamloops and Prince George). Costco Pharmacy provides a practice environment which enhances patient care and equipped with semi-private and private counseling areas. We have a great working environment, opportunities for advancement in addition to highly competitive rates. Our benefit package includes, extended health coverage, contribution to company pension, RRSP plans and CE reimbursement. Costco Pharmacy is seeking ambitious, high-energy Certified Pharmacy Technicians, who enjoy working in a fast-paced team environment. If you are highly motivated to provide excellent pharmacy care and customer service and would like to inquire about available positions please call, fax or email your resumes to: Ed Toth, BSP, Pharmacy Operations Manager, Western Canada, phone: 604.444.9344, Fax: 425.427.7735, email: etoth@costco.com. HBC PHARMACY GROUP - Discover a challenging and rewarding career as a pharmacist with Zellers or Bay Pharmacy, and help to ensure the quality of life for all Canadians! It’s not just about filling prescriptions: you’ll serve as a primary health care advisor who gives patients guidance to help them make good choices about their health. Making a difference in your life and the life of others! Please forward your resume in confidence to either: Zellers Head Office, Attn: Pharmacy Human Resources Manager, Stores, catherine.williams@hbc. com , BC Regional Pharmacy, Attn: Regional Pharmacy Operations Manager, tel: (604) 340-8179, janey.johnson@hbc.com. LONDON DRUGS is accepting applications for pharmacist positions throughout BC. Pharmacists will have the opportunity to be involved with various patient care initiatives offered at London Drugs such as INR monitoring, Long Term Care, Certified Diabetes Education, immunization and various clinics such as osteoporosis screening, heart health, diabetes, sun and smoking cessation. We offer competitive salary and benefits package, moving allowances, professional working environment, scheduled meal breaks, semiprivate counseling booths, automated robotic dispensing machines and employee discounts. Please apply in confidence to: Shawn Sangha, B.Sc. (Pharm), London Drugs Ltd., Pharmacy Operations Manager, BC. tel: 604.272.7469, fax: 604.448.1075 email: ssangha@londondrugs.com OVERWAITEA FOOD GROUP - consisting of Overwaitea Foods, Save-On-Foods, PriceSmart Foods, Urban Fare and Coopers Foods are hiring. Staff pharmacist positions are available in 100 Mile House, Campbell River, Chilliwack, Cranbrook, Creston, Fort Nelson, Grand Forks, Kelowna, Kitimat, Parksville, Prince George, Quesnel, Squamish, Terrace, Williams Lake, Fort McMurray, Red Deer and Lethbridge in Alberta. Relief pharmacist floater positions and pharmacy technician positions in British Columbia and Alberta are also available. We provide an excellent pharmacy practice environment with personal growth and career development potential. Very competitive wages and benefits including a pharmacist incentive plan. We thank all applicants, however only shortlisted candidates will be contacted. Contact: Chi Quon, Regional Pharmacy Manager, 604.881.3574, fax: 604.882.7896, chi_quon@owfg.com, www.saveonfoods.com. PEOPLES DRUG MART and Peoples Pharmacy have several locations throughout beautiful British Columbia offering a desired combination of employment opportunity and unbeatable lifestyle. Contact: Smita Natha, Professional Services Manager, Peoples Drug Mart, 520-4400 Dominion Street, Burnaby, BC. V5G 4G3. Tel: 604.431.3595 ext. 26, fax: 604.431.3596, email: smitan@pdmstores.com. REXALL – Since 1904, Rexall has been a trusted name in retail pharmacy. Rexall is also the flagship pharmacy for Katz Group Canada, a leading drug store company

www.bcpharmacy.ca

and the largest integrated retail pharmacy network in Canada, with more than 1,800 corporate, independent and franchise pharmacies across the country. As the umbrella brand for a family of pharmacies including the Rexall, Rexall Pharma Plus, The Medicine Shoppe, Guardian and I.D.A. banners, Rexall is dedicated to the health and well-being of our customers and patients and strives to provide the best possible pharmacy care in a pharmacy first environment. Our long term care pharmacists and pharmacy technicians provide highly specialized clinical and medication management services for residents of nursing homes, retirement residences, assisted living facilities and group homes through dedicated pharmacies. If you are interested in applying or would like to learn more about the opportunities we have, please visit our website at www.rexallcareers.ca or contact a member of our team: Neerav Joshi, Pharmacy Recruitment Manager njoshi@rexall.ca. SHOPPERS DRUG MART - is one of the most recognized and trusted names in Canadian retailing. The company is the licensor of full-service retail drug stores operating under the name Shoppers Drug Mart (Pharmaprix in Québec). With over 1,000 Shoppers Drug Mart and Pharmaprix stores operating in prime locations in each province and three territories, the company is one of the most convenient retailers in Canada. At Shoppers Drug Mart, we have always remained true to our belief that the root of our success lies with our people. We pride ourselves on the quality and commitment of our employees who thrive on exciting challenges. Pharmacy Operations Specialist (British Columbia) position summary: Reporting directly to the Vice President, Operations the incumbent monitors and achieves projected counts, sales and profit margins and optimizes the performance of Pharmacy components by identifying performance gaps, providing guidance, information and direction to improve results. The incumbent drives to maximize pharmacy business growth and performance to achieve or exceed financial goals as set out in the common year plan. This position does not supervise any other position; however it does provide advice and collaborates with pharmacy employees on operational issues. This position is also responsible for solving store level problems for the pharmacy when necessary. This may involve changing or altering processes or procedures as necessary. This role is the corporate resource to Pharmacists and Associates and the store level expert in all pharmacy driven store operations. Learn more at www.shoppersdrugmart.ca. THRIFTY FOODS - Bring your professionalism and your dreams to Thrifty Foods new frontier and become an important part of our company as we grow together. Pharmacy manager and staff positions available. Thrifty Foods Pharmacy is committed to offering a comprehensive pharmacy service to these communities. Competitive wages and benefits. Interested candidates are invited to submit their resumes to Nafeesa Shaikh, Pharmacy Recruitment and Retention Specialist, Sobeys Pharmacy Group. Toll Free #: 1-800-790-0733 x. 7704; phone #: (902) 468-1000 x. 7704; fax #: (877) 662-1955 BUSINESS OPPORTUNITIES Port Alberni - A super community pharmacy for sale. Viable Rx department. Price will include 2700 sqft. Strata lot. Easier financing if required. Alberni Valley economy is on rebound. Tel: 250.723.9323, fax: 250.723.8221. At PHARMASAVE we understand that you want to be in business for yourself, not by yourself. You can have the best of both worlds! Maintain your freedom and independence while having access to the most comprehensive retail and professional programs in the industry. Pharmasave’s proven products, programs and strong national Brand are always at your service. Pharmasave is unlike any other independent pharmacy venture in Canada. We are a true cooperative that is 100% member owned and governed. With Pharmasave, not only do you benefit from owning your own business, but you also share in the economic advantages of a 400+ strong group of stores. Plus, you will be an owner in an organization that delivers all of its profits directly back to you, the shareholder. Allow us to demonstrate the advantages of Pharmasave. If you are a store owner or a pharmacist interested in purchasing a pharmacy, or if you are planning on selling your business, please give us a call. PHARMASAVE’S only priority is you and your success! Contact: Dave Reston, CEO, Pharmasave Pacific, tel: 604.575.5730 or 1.800.665.3344, email: dreston@pharmasavebc.ca. Are you thinking of selling your pharmacy? Overwaitea Food Group may be interested. If you would like more information contact us at pharmacybuyer2012@gmail.com.

PRODUCTS IN FOCUS

Rivaroxaban approved for stroke prevention Rivaroxaban (Xarelto) is the first oral anti factor Xa inhibitor to be approved in Canada for the prevention of stroke or systemic embolism in atrial fibrillation. It is administered once daily and requires no coagulation monitoring.

Rivaroxaban in atrial fibrillation (Rocket AF Study)

ketoconazoleor ritonavir (contraindicated). These inhibitors may potentiate the anticoagulant effect of rivaroxaban. Strong inducers of 3A4 and p-glycoprotein such as rifampin, carbamazepine and St. Johns Wort could decrease the anticoagulant effect of rivaroxaban. Combining rivaroxaban with antiplatelet agents such as ASA, clopidogrel, prasugrel or ticagrelor increases the bleeding rate, and caution is warranted.

ROCKET AF was a double-blind clinical trial in over 14,000 patients with two or more risk factors for stroke. Rivaroxaban 20 mg orally once daily (15 mg daily for CrCl of 30-49 mL/minute) was compared to dose adjusted warfarin (INR target 2-3).

Patient selection

In the on treatment analysis there was a 21 per cent lower rate of stroke or systemic embolism in the rivaroxaban group compared with warfarin. There was no difference in major and clinically relevant non-major bleeding between the two; however, there was a significantly lower rate of intracranial hemorrhage and fatal bleeding in the rivaroxaban group.

Rivaroxaban is a suitable alternative to warfarin in patients with atrial fibrillation who prefer to use a once a day agent that does not require coagulation monitoring. Rivaroxaban should not be used in patients with a CrCl less than 30 ml/minute, and a reduced dose of 15 mg daily should be used in those with a CrCl of 30-49 ml/minute.

Atrial fibrillation (20 mg or 15 mg once daily) vs orthopedic surgery (10 mg/day)

Warfarin could be continued in patients with reasonable INR control, however those with unstable INRs (less than 65 per cent in therapeutic range) could be considered for rivaroxaban.

British Columbia pharmacists are already familiar with the rivaroxaban 10 mg daily dose which is widely used for the prevention of venous thromboembolism following elective orthopedic surgery (TKR/THR). Pharmacists should not use 10 mg tablets to fill a prescription for the 20 mg per day dose. The 10 mg tablets are priced over $8 per day (in the same range as low molecular weight heparins) compared to $2.84/day for the 20 mg and 15 mg tablets.

Pharmacokinetics Rivaroxaban has rapid onset of action with peak plasma levels occurring two to four hours after a dose. About 66 per cent of rivaroxaban is hepatically metabolized by P450 3A4, 3A5 and 2J2 and CYP-independent mechanisms and about 33 per cent is renally excreted unchanged. The half life is five to nine hours in the young and 11 to 13 hours in those greater than 65 yrs of age.

Drug interactions

Rivaroxaban has not yet been studied in patients with mechanical heart valves, and should not be used for this indication.

Summary Rivaroxaban is a welcome addition to currently available agents for stroke prevention in atrial fibrillation. It is at least as effective as warfarin with a comparable bleeding rate, convenient oncedaily dosing, no requirement for coagulation monitoring and a lower rate of intracranial hemorrage and fatal bleeding.

Submitted by Reginald E. Smith, Pharm.D. Clinical Specialist Cardiology & Thrombosis Royal Jubilee Hospital Victoria, BC

Rivaroxaban is susceptible to drug interactions involving systemic strong inhibitors of both P450 3A4 and p-glycoprotein such as

www.bcpharmacy.ca

Apr/May 2012

THE TABLET

Join us May 24 to 26, 2012 at the Delta Ocean Pointe in Victoria, BC Visit www.bcpharmacy.ca to register now!

Thank you to our sponsors:

Partner

Diamond

Gold

Platinum

Silver

Bronze

Partner: College of Pharmacists of British Columbia Diamond: Bayer Inc., LifeScan Canada Ltd., Merck Platinum: Boehringer Ingelheim (Canada) Ltd. Gold: Apotex Inc. Silver: London Drugs, Safeway, Shoppers Drug Mart Corporation Bronze: Pacific Blue Cross, Roche, Manulife Financial Exhibitors: ACR Systems Inc., Adams Cambie Insurance Services Ltd., Afexa Life Sciences Inc., Apotex Inc., Bayer Inc., Boehringer Ingelheim (Canada) Ltd., Desante Financial, Galenova, Heel Canada, Hydration Pharmaceuticals Canada Inc., Jamp Pharma Corporation, Johnstoneâ&#x20AC;&#x2122;s Benefits, LifeScan Canada Ltd., Lundbeck Canada, McKesson Canada, Medical Futures Inc., Medisca Inc., Odan Laboratories Ltd., Pacific Blue Cross, PCCA Canada, Pendopharm, Purdue Pharma Canada, Roche, Sanofi, Scotiabank, Trudell Medical International, Xenex Laboratories

Visit www.bcpharmacy.ca