Pharmacy offers anticoagulation therapy • Intranasal flu vaccine for children • What to know about compliance
tablet
published by the British Columbia bia Pharmacy Association | www.bcpharmacy.ca | Volume 24. No. 5
NOV/DEC 2015
Vancouver Pot Shops A growing over-the-counter culture
40810576
A voice for community t pharmac pharmacy cy
Regulatory Compliance Support
1
Regulatory Compliance Bootcamp This workshop will address regulatory compliance issues
2
NEW! Compliance Officer Training Course
This program is a follow-up to our Regulatory Compliance
and is designed to help mitigate the risks of penalties
Bootcamp and is designed to train a pharmacy technician
associated with audit assessments. It will also address
or assistant to become your pharmacy’s compliance
privacy practices, as well as College of Pharmacists of BC
officer, particularly with regards to payer audits. While the
regulations.
Regulatory Bootcamp assisted pharmacists and owners in increasing their awareness of practice and business risks
This workshop is essential for pharmacists, pharmacy
(including audits), the Compliance Officer Training Program
managers and owners. It is a hands-on event using real
will focus on preparing your technician or assistant to
life situations and the errors we have seen in many
maintain a systematic self-audit process.
different audits. Wednesday, November 18, and Thursday, November 19 Two sessions from 6:00pm to 9:00pm Live online webinar (log in from a computer) The total registration fee for both days is $400.
Wednesday, November 25, 2105 9:00am to 4:00pm (breakfast and lunch provided) Lower mainland Member rate $600 100% Corporate member staff $450 Discounted rate for Bootcamp attendees $300 (only one discount per person that attended the Regulatory Compliance Bootcamp)
Learn more at www.bcpharmacy.ca/regulatory-compliance-support
BCPhA eTraining
BCPhA Event
NEW! Travel Medicine Program
Fall Professional Development Day
BCPhA’s Fall Professional Development Day is an • Self-paced learning
Some programs are complimentary for members
• Interactive elements
exciting new program of continuing education focused on subjects that matter to pharmacists in B.C.
• Quiz questions • Final assessment
Sunday, November 22, 2015 Lower mainland Member Price $199 Non-Member Price $249
BCPhA eTraining Programs
Schedule of Events
NEW! Travel Medicine Program
Changes in Managing Heartburn in Pharmacy Practice
Cardiovascular Program Training Course
Medical Marihuana: New Regulations and Current Issues
Medication Management for Patients on Psychiatric Medications
Hypertension: Taking Forward the Pharmacists’ Role
Anticoagulation Therapy Management for Pharmacists
Subsequent Entry Biologics Current Events in B.C.’s Pharmacy Landscape
www.bcpharmacy.ca/etraining
www.bcpharmacy.ca/pdd-fall
THE TABLET
NOV/DEC 2015
|
VOLUME 24. NO. 5
contents Editor in Chief Angie Gaddy 604.269.2863, angie.gaddy@bcpharmacy.ca Senior Editor Matilda Meyers 604.269.2866, matilda.meyers@bcpharmacy.ca The Tablet is published by the BCPhA. Views expressed herein KV UV[ ULJLZZHYPS` YLĂ…LJ[ [OVZL VM [OL (ZZVJPH[PVU *VU[YPI\[LK material is not guaranteed space and may be edited for brevity, clarity and content.
20 Managing warfarin
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24 Flu season update
Publication agreement #40810576
16 Pot shops
Features 16
On the Cover:
Columns
Regulars
6
President’s Message Promote and get involved in your profession
5
Meet Isobel Mackenzie Seniors Advocate, Province of British Columbia
7
CEO’s Message What’s in a name?
8
10
Member Services Regulatory compliance program
DPIC Hot ushes: Pharmaceutical nonhormonal therapies (part 2)
15
Pharmacy Practice Support Pharmacists and medical marijuana
Clinicare Pharmacists Lichen planus of the vulva
25
Career Listings Find a job in pharmacy
Vancouver Pot Shops A growing over-the-counter culture
20 24
Pharmacy managed warfarin Safe, quick and convenient for patients Flu season update Pharmacists can give intranasal spray to kids under 5
12 13
Financial Trends Market moves
14
Coach Callie Build resilience through self-care
Got a suggestion for an article in The Tablet? Email info@bcpharmacy.ca with your story ideas.
A voice for community pharmacy
www.bcpharmacy.ca
Nov/Dec 2015
THE TABLET
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SMALL TALK
In the news 2016 BCPhA annual conference
Mark your calendars for British Columbia’s premier annual pharmacy conference. The BC Pharmacy Association’s conference will be held in Kelowna from May 26 – 28, 2016, at the Delta Grand Okanagan Kelowna. Attended by more than 300 delegates in the pharmacy sector, from key decision makers in the industry in B.C. and from across Canada, this is one event you won’t want to miss. This year’s theme is The DNA of Pharmacy. Topics and presentations will explore the building blocks of pharmacy – from core business and pharmacy practice to the future of personalized medicine in pharmacy. Registration will begin later this year. Watch for more information online at www.bcpharmacy.ca.
Travel Medicine for Pharmacists
Upcoming BCPhA training programs
In collaboration with Dr. Fawziah Marra Lalji, the BCPhA recently announced a new e-training program on travel medicine for pharmacists.
This fall, the BCPhA will run a number of educational programs to help support members in expanded scope of practice and changes in practice. Visit www.bcpharmacy. ca for more information about the following:
The program builds on the knowledge from the basic immunization competency program, with a greater focus on diseases and conditions related to travel. The goal of this course is to prepare pharmacists to write the International Society of Travel Medicine certification exam, and it will equip participants to conduct pretravel risk assessments, provide travel advice around prevention, immunization, chemoprophylaxis, and self-treatment, as well as recognize post-travel infections and refer patients to specialists or emergency care when necessary. This program is CCCEP accredited for 32.5 CEUs. Registration for the course is $550 for BCPhA members and $900 for non-members. Dr. Fawziah Marra Lalji (BSc (Pharm.), ACPR, Pharm.D., FCSHP) has been a professor in the Faculty of Pharmaceutical Sciences at UBC since 1996. Visit www.bcpharmacy.ca/travel-medicine for more information or contact Nelson Chen at nelson.chen@bcpharmacy.ca.
Fall Professional Development Day This is a single-day program on the therapeutics and business of pharmacy in BC. It will take place on November 22 at the Executive Plaza Hotel and Conference Centre in Coquitlam. More information on the speaker lineup can be found on the BCPhA website. Compliance Officer Training Program This is a brand-new program designed to train a pharmacy technician or assistant to become your pharmacy's compliance officer. It is a follow-up to the Regulatory Compliance Bootcamp, which addresses common payer compliance issues with PharmaCare audits. It is designed to help mitigate the risks of the penalties associated with audit assessments by implementing a systematic self-audit process. BCPhA e-training programs These are designed to be an easy-to-use, time-efficient and cost-effective way for pharmacists to meet their training and education needs. There are now more than 10 programs available. Topics range from vaccines, dispensing, medication reviews and privacy consent. A number of them are complimentary for members. There are also a number of paid programs, on topics including travel medicine, anticoagulation therapy management and cardiovascular health coaching.
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MEET ISOBEL MACKENZIE
Meet...Isobel Mackenzie Seniors Advocate, Province of British Columbia Regional District Housing Corporation. Isobel currently serves on the University of Victoria’s Board of Governors. Isobel received both her undergraduate and graduate degrees from the University of Victoria and has a Certificate in Health Care Leadership from the University of Toronto. Isobel lives in Victoria with her husband, and they have two children attending university. What would you like to accomplish in the next five years?
Isobel Mackenzie has more than 20 years’ experience working with seniors in home care, licensed care, community services and volunteer services. Isobel led BC's largest not-for-profit agency, serving more than 6,000 seniors annually. In this work, Isobel led the pioneering of a new model of dementia care that has become a national best practice. She led the first safety accreditation for home care workers, among many other accomplishments. Isobel has been widely recognized for her work and was named BC CEO of the Year for the not-for-profit sector in 2012. She was nominated as a Provincial Health Care Hero in 2013. Prior to her appointment as the Seniors Advocate, Isobel served on a number of national and provincial boards and commissions including the BC Medical Services Commission, the Canadian Home Care Association, BC Care Providers Association, BC Care Aide and Community Health Worker Registry, and the Capital
Firstly, I want to continue to elevate the conversation about respecting the wishes of seniors, particularly around their right to live at risk if they so choose. Living at risk means perhaps living alone with mobility challenges or with increasing frailty and managing many medications, including insulin. The other is ensuring that low income seniors have the supports they need, particularly dental care, eyeglasses, hearing aids and mobility aids. What are some things that pharmacies are doing a good job of when it comes to serving their seniors? Increasing the role of the pharmacist has been, and will continue to be, key. Undertaking a review of all medications, discussing side effects of drugs, recommending further discussions with doctors and, of course, the flu shot. These are all things that are invaluable to seniors, and pharmacists are more accessible to them than physicians. Are there things you would like to see pharmacies engage more in to support their seniors?
still depends on the senior coming into the pharmacy, but I think there is a role for pharmacists to play, especially around medication reviews, for our more frail seniors who may only be receiving medications through home delivery. There are pockets of this work being done, but I think we can expand it greatly. What are some key messages that you think pharmacists should be aware of when interacting with seniors in the community? My number one message would be to use plain language and remember that smart people can know nothing about drugs. Explaining what a drug is for, the underlying condition it is treating, and the possible side effects are important. The best way to control medication errors is to get the senior to assume as much ownership as possible, but they need effective information to achieve that. Your report “Placement, Drugs and Therapy… We Can Do Better” once again touches on the issue of overprescribing to seniors, especially in long-term care. Is there any advice you can provide about how a pharmacy can start a review within the facilities they service? Pharmacists might want to start by ensuring they are up-to-date on the latest non-pharmacological interventions used to treat some of the behaviours associated with dementia and depression. I think prescriptions for drugs are issued to help solve a problem but we need to realize that there are other solutions.
I think we should be looking at how pharmacists can reach out into the community more. The current model
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Nov/Dec 2015
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ALLISON NOURSE
|
PRESIDENT
Promote and get involved in your profession
As I start my term as president of the Association, I know there are many items I would like to work on over the next year. However, there are two issues in particular that I believe all pharmacists need to start thinking about: Promoting your profession and getting involved in your profession. I still find it hard to believe that the average patient barely knows what a pharmacist really does. Aside from counselling the patient about their prescription, most patients never see all the hard work that goes on behind the scenes. Maybe it’s because pharmacists are so efficient that they make filling a prescription look too easy. There are also numerous clinical checks that a pharmacist does inside their head that are impossible for a patient to see. We may discuss all this work with our peers, but we should really be relaying the message of how much work goes on behind the scenes to our patients. I would encourage you to talk to your patient about what you did for them today while filling their prescriptions: Ensuring that the medication requested is necessary, safe (correct dose/no interaction), effective, affordable, and if applicable, covered by their health benefit plan. We need to show value in what we do. I hear stories of pharmacists completing comprehensive medication reviews (medication review – pharmacist consultation) that resolve several drug therapy problems, but the pharmacist refers to the work they did as a basic medication review. We need to take pride in the work we do. We need to
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show that when we do medication reviews we are finding and solving drug therapy issues. We need to share our skill set with other health-care professionals, other health associations, MLAs, and the general public. I challenge all pharmacists to talk to someone who may have minimal pharmacy exposure. Explain the detailed steps that are involved in filling a prescription. Discuss the full scope of practice that pharmacist can do, from adaptations to injections. Promoting the pharmacy profession goes hand-in-hand with getting involved in your profession. Sometimes involvement can be as simple as sharing your challenges with other pharmacists. I often hear a pharmacist discuss their challenges and frustrations with their peers, but rarely does the information get passed on to the appropriate people, such as the staff or Board of our Association, so that we can try to find solutions to make change happen. Pharmacists are needed to participate in working groups and committees, to share their knowledge and ensure solutions are appropriate for front-line pharmacists. Everyone should consider joining a committee when the opportunity arises. Why not call the Association and get involved in the MLA outreach program? Talk to the College to see if any more pharmacists are needed for committees. Make yourself available when other health associations or patient advocacy groups are looking for presentations on medications. Get involved in charity organizations that support health-care and chronic diseases. Show everyone that pharmacy is a lot #MoreThanPills.
GERALDINE VANCE
|
CEO
What’s in a name? Pharmacy should protect words like 'dispensary' from those seeking legitimacy
As someone who went to journalism school and has spent my career in the business of words, I am increasingly concerned about how sloppy we seem to have become about language. Precision in language is a big deal to me. Recent events related to Vancouver’s pot shops and the horrific problems with overdoses of street drugs laced with bathtub fentanyl have brought the importance of language into sharp focus for me. In this issue, we have devoted several pages to issues related to marijuana. In light of how much attention the issue is getting in the media, we thought it was important to provide information about what exactly is classified as medicinal marijuana and what the current law requires in terms of distributing it for prescribed medical purposes. Some may say the loosening up of pot rules in Vancouver is just a reflection of where society is going. What’s the harm in selling pot in pizza flavours from the equivalent of the corner store? After all, it’s not really harmful and some studies show it has helped people manage pain, seizure disorders and other health issues. “Lighten up,” many have said to those advocating imposition of the criminal code requirements. But I don’t think it is that simple. Some of you may be aware of the concerns we have raised about these illegal drug retailers calling themselves dispensaries. Drive down almost any street in Vancouver and other cities in the province and you will see “medical marijuana” being sold in a “farmacy” or "dispensary”. It is no accident that the people
operating these businesses have carefully chosen those words to add legitimacy to their place of business and the products they are selling. The simple truth is none of these retail operations are selling marijuana for medical purposes -- the federal legislation doesn’t allow that to happen. And the corner pot shops are not pharmacies or dispensaries as we know them. I think it matters very much that these businesses have been allowed to highjack these terms. And I think pharmacists should be very concerned that their profession is being misrepresented every time a new “dispensary” opens its doors. At the height of the recent fentanyl overdose episodes that emerged in the late summer, I was watching a national news broadcast when one of the country’s most respected journalists referred to fentanyl as a “dangerous street drug”. It’s true, the imposter drug that has flooded the recreational drug market is indeed dangerous. However, this is a real drug used for palliative care and to treat severe pain. It is an essential tool in the arsenal that health-care professionals have for treating patients with dignity and respect. Could playing fast and loose with how fentanyl is described lead prescribers to shy away from giving it to patients in need? To me, both these examples are important reminders that how language is used matters. Pharmacists should protect the important role they play as medication experts working in tightly regulated dispensaries by reminding regulators and legislators that what you call something matters to them.
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Nov/Dec 2015
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DRUG AND POISON INFORMATION CENTRE
Hot flushes: Is there any evidence for pharmaceutical nonhormonal therapies? (Part 2 of 2 in a series.)
By Bev Louis, B.Sc. (Pharm.), R.Ph., CSPI, Drug and Poison Information Pharmacist, BC Drug and Poison Information Centre Reviewed by C. Laird Birmingham, MD, M.H.Sc., FRCPC This article continues on from our discussion of popular herbal nonhormonal treatment options for hot flushes (HFs) in the previous issue of The Tablet, with a review of pharmaceutical nonhormonal options. Hot flushes, which are very distressing, are the main menopausal complaint for which women visit their physicians or pharmacists. As a clinician, it is important to be aware of the effectiveness of nonhormonal therapies promoted in the treatment of HFs. Clonidine HFs are thought to be associated with an increase in central norepinephrine levels, which narrow the thermoregulatory or thermoneutral zone. Clonidine, an alpha-adrenergic agonist, blocks central norepinephrine release, thereby widening the thermoneutral zone and increasing the sweating threshold in symptomatic women. Clonidine is approved in Canada for the treatment of vasomotor symptoms (VMS). Many of the early placebo-controlled trials that investigated the use of clonidine for VMS were flawed and had conflicting results. The benefit, when demonstrated, was small to moderate. In a trial (n=45) comparing estrogen and clonidine for moderate to severe vasomotor symptoms in women with >/= 6 HFs daily at baseline, clonidine decreased HF frequency by 60% at the end of the treatment period compared to a 70% reduction with estrogen. Side effects with clonidine include dry mouth, drowsiness, dizziness, constipation and sleep disturbances. These adverse effects, combined with only a modest benefit, suggest clonidine therapy for HFs is most appropriate in patients with concurrent hypertension.
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Selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) Estrogen is involved in the production, release and receptor activity of both serotonin (5-HT) and norepinephrine (NE). Fluctuation in the level of estrogen can dysregulate 5-HT and NE, resulting in HFs. During menopause, serotonin and estrogen levels decrease. Estrogen treatment for HFs normalizes serotonin levels. Theoretically, regulation of central nervous system 5-HT and NE levels with an SSRI and SNRI should improve vasomotor symptoms. Meta-analyses of SSRIs and SNRIs, comprehensive reviews and expert opinion have concluded that paroxetine and venlafaxine are more effective than placebo in decreasing HFs. One meta-analysis reported that paroxetine and venlafaxine were more effective than sertraline and fluoxetine, while two randomized doubleblind placebo-controlled (RDBPC) trials found that fluoxetine was no better than placebo. Other randomized placebo-controlled trials found no difference in the effectiveness of desvenlafaxine, citalopram, paroxetine and venlafaxine in the treatment of HFs. Two RDBPC trials involving patients with 7-8 moderate-to-severe VMS daily, found paroxetine 7.5 mg daily decreased HF frequency and severity in both 12-week (n=614) and 24-week (n=570) studies. Paroxetine 7.5 mg daily is the only nonhormonal medication currently approved in the United States for the treatment of VMS. Venlafaxine decreases HF frequency and severity. In a recent double-blind trial, venlafaxine 75 mg daily extended-release (n=96) was compared to oral 17Ð-estradiol 0.5 mg daily (n=97)
and placebo (n=146) over eight weeks. The mean VMS frequency at baseline was 8.1 daily and by week eight, it had decreased by 47.6% in the venlafaxine group, 52.9% in the estradiol group and 19.6% in the placebo group. Results were similar for VMS severity, bother and interference. Low-dose estradiol and venlafaxine were both effective and well-tolerated in the treatment of bothersome VMS. Desvenlafaxine at doses of 100 and 150 mg significantly decreased the frequency and severity of HFs as quickly as one week after the start of therapy. In a randomized controlled trial (n=365), desvenlafaxine 100 mg daily decreased moderate-to-severe HFs by 5.35 HFs/day in 62% of patients compared to 41% with placebo. This effect was maintained at one year. Side effects of SSRIs and SNRIs include nausea, dizziness, dry mouth, nervousness, constipation, somnolence, sweating and sexual dysfunction, but most resolve with time or with a decrease in dose. Side effects with SSRIs and SNRIs can be minimized by initiating therapy at a low dose and titrating slowly to the effective or maximum dose.
Gabapentin Gabapentin may affect the thermoregulatory center in the hypothalamus, by an unknown mechanism. Gabapentin 2.4 g daily decreased moderate to severe VMS (>/=50 HFs/week at baseline) similar to 0.625 mg estrogen daily. In a meta-analysis, gabapentin was similar to SSRIs and SNRIs in efficacy. Common side effects include dizziness, somnolence, unsteadiness and peripheral edema. To minimize adverse effects, the dose should be initiated at 300-400 mg at bedtime and titrated every 3-7 days to a maximum daily dose of 2.4 g in 2-3 divided doses. Women with night sweats that disrupt sleep should take gabapentin at bedtime because of its sedative effect. Conclusion There are a number of nonhormonal pharmaceutical options for the treatment of HFs. Current evidence supports the use of SSRIs and SNRIs, specifically paroxetine, venlafaxine and desvenlafaxine. Gabapentin is an alternative, especially for women with interrupted sleep and night sweats. Clonidine could be considered in patients with HFs and hypertension. References available upon request at info@bcpharmacy.ca.
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CYRIL LOPEZ
|
CHIEF OPERATING OFFICER
Regulatory compliance program A total of 67 per cent of our membership has now completed our Regulatory Compliance Bootcamp program. During these sessions, our discussions revealed to participants that audit risks commonly stem from these four areas: 1. Appreciation of the separate sources of regulation. Although the Ministry of Health chose not to enroll 28 pharmacies in PharmaCare last summer, 75 per cent of these pharmacies remain licensed by the College of Pharmacists of BC. This is a reminder that the payers’ rules and processes are different from the College rules. Therefore, a pharmacy could be “onside” with College rules yet “offside” with payer regulations. PharmaCare, third party payers and the College are separate bodies with some common interests but you need to be fully aware of their respective rules. 2. Awareness and interpretation of the law. Some attendees said “The pharmacist’s primary responsibility is to the safe care of our patients and not the refill date by a non-compliant physician.” While others argued “Surely, when patients arrive with a prescription, it is clear that they want the prescription filled - that is consent, nothing more needs to be done by the pharmacist.” Members need to spend the time to read and understand the College regulations that apply to their practice. If you require interpretation of the regulations we recommend that you get advice from a lawyer, contact the College or contact the BCPhA Pharmacy Practice Support team.
days/quantity supply. Another example is where pharmacists have developed their own forms to meet their interpretation of payer requirements, without approval from the payer. Payers may impose their own limits under their contract with you. This is not overridden by College bylaws or your own interpretation. 4. High volume and repetitious transactions. Once a workflow process has been established in a community pharmacy, it is common for that process to be replicated for every transaction for years to come (despite whether or not it is right), until discovered by an auditor. Depending on your error rate, you could then be on the hook for an average of $200,000 for any given year. There is no rewind button. Good intentions do not matter, they simply ask for the money back. And the clincher: They will also recover the drug cost from you, while the patient loses nothing. The only way to combat these risks is to ensure that you are comprehensively aware of every rule in detail. When our Regulatory Compliance Bootcamp sessions concluded, members commonly responded with: “While the bootcamp provided me with great knowledge and awareness of what we need to do, how exactly should we do it?” To help with this, we provided attendees with a self-audit tool kit that they could use to identify weaknesses in their existing processes. And now we are following up with next stage of the process, the Compliance Officer Training Program.
3. Understanding where professional judgement and payer rules diverge. An example of this can be seen in relation to the College bylaw 10 (1) “A registrant may adjust the quantity of drug to be dispensed if (a) a patient requests a smaller amount.” Some might interpret this to mean they are authorized to ignore payers’ restrictions on
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The objective of the Compliance Officer Training Program is to provide attendees with: 1. An overview of the role of a pharmacy compliance officer. 2. A clear understanding of the most significant rules and regulations that impact pharmacy claims. 3. A logical and reliable approach to interpret and apply these rules and regulations. 4. A systematic process to self-audit pharmacy claims to identify areas of weakness. To ensure the program is an effective investment that can be implemented with minimum impact to the pharmacy workflow and business, we recommend that a pharmacy technician takes on the role of compliance officer. We estimate that the position is no more than a 0.20 full-time equivalent, meaning a trained compliance officer can be shared between stores in a banner or chain, or owners of another store. Over time the compliance officer will build an intrinsic body of knowledge that will increase the effectiveness of the compliance program. The most critical factor for a successful program that mitigates the risk of a $200,000 annual audit is the owner’s commitment to compliance and to supporting the role of a compliance officer.
Compliance program process
1 2 4 3 Identify your main errors* by self auditing. Be self-critical
Analyse the cause and source of attitudes in your pharmacy
Be aware of your legal obligations and contracts**
Refine procedures and educate your staff
**There is a checklist that covers all applicable rules
*Typical prescription errors Methadone: Missing Rph/ Patient sig/ Ingestion Log Qty mismatch (RX vs PNET) Expired prescription Wrong prescriber on PNET (RX vs PNET) FOD/Plan C missing docs
20% 16% 15% 10% 10%
Daily Dispense not handwritten Prescription not signed or dated by physician Missing prescription Others Total
9% 9% 7% 4% 100%
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DEREK DESROSIERS |
DIRECTOR, PHARMACY PRACTICE SUPPORT
Pharmacists and medical marijuana There’s been a lot of attention in the news lately about medical marijuana after the City of Vancouver decided to regulate pot shops. Over the past number of years in my role at the BC Pharmacy Association, I’ve received calls from pharmacists asking about medical marijuana and what role, if any, pharmacists have.
Health Canada will treat the following Authorizations to Possess, Personal-Use Production Licences, and Designated-Person Production Licences as extending beyond March 31, 2014, until a decision in Allard is rendered. As per the Federal Court interim injunction, the following criteria must be met:
Many don’t understand why pharmacists are prohibited from dispensing medical marijuana. It turns out that the whole issue of marijuana for medical purposes is a complex web of sub-issues related to old and new regulations.
•
Probably the first thing to note is that according to the Health Canada website: “Dried marijuana is not an approved drug or medicine in Canada. The Government of Canada does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a healthcare practitioner.” The Marihuana for Medical Purposes Regulations (MMPR) came into force in June 2013. Previously, access to marijuana for medical purposes was controlled under the Marihuana Medical Access Regulations (MMAR), which were repealed on March 31, 2014. Marijuana is commonly spelled with a “j”; however , its legal name and the way Health Canada uses it in its regulations is with an “h”. The new MMPR includes a ban on all home-growing of marijuana. However, just days before the April 1, 2014, effective date of the new MMPR, Neil Allard and three other individuals asked the Federal Court for an injunction that would allow them to continue producing their own pot or have a designated person do so for them. The courts awarded a temporary injunction against the homegrowing ban, allowing patients to continue cultivating until the case of Allard v. Health Canada is decided. While it has been heard, as of September 9 when I was writing this column the court had not yet given its decision. The Health Canada website states the following: “As a result of ongoing litigation and uncertainty arising from court decisions,
•
Individuals must have held a valid Authorizations to Possess license under the MMAR on March 21, 2014. Individuals must have held a valid Personal-Use Production Licence or Designated-Person Production Licence under the MMAR on, or after, September 30, 2013, where there is also an associated valid ATP as of March 21, 2014.
Under the new MMPR, a patient must obtain their product from a Health Canada Licensed Producer (LP). Essentially, a patient must obtain a valid prescription for marijuana from a practitioner and send that prescription to the LP of their choosing. To register with an LP under the MMPR, a patient needs to complete the following steps: • •
• •
Step 1: Consult with a health-care practitioner. Step 2: Obtain a medical document completed by their healthcare practitioner (an authorized health-care practitioner includes physicians in all provinces and territories, and nurse practitioners in provinces and territories where prescribing dried marijuana for medical purposes is permitted under their scope of practice). Step 3: Register and order with an LP. Step 4: Obtain delivery of their marijuana for medical purposes.
There are currently 26 LPs for dried marijuana. Of these, 19 are licensed to cultivate and sell the product, five are licensed to cultivate only and two are licensed to sell only. Six of the 26 are located in British Columbia. There are also 11 authorized LPs of fresh marijuana and cannabis oil but none of those 11 are licensed to sell those products. Meanwhile, we currently have in excess of 120 retail outlets operating in the Greater Vancouver area and the City of Vancouver is attempting to regulate these outlets from a business perspective by
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FINANCIAL TRENDS
Market moves Fluctuations in the financial markets are normal.
By Glenn Schoenroth, CFA You may have found yourself scrutinizing your monthly statement with a piercing stare recently, as it has been a summer of frustration and fear. Markets are concerned that global growth is slowing; however, the impact of quantitative easing by central banks around the world is helping prop up equity markets, albeit in a volatile manner. If you understand the norms of market fluctuations it should be business as usual.
typically the largest input cost for most businesses so, on a net basis, this drop is benefiting both them and consumers alike. Base metal prices have soured on the back of China slowing and precious metals aren’t so precious when there aren’t serious signs of inflation. Supply/demand fundamentals will soon right themselves, with a bit of pain felt in various sectors, but this too is a normal part of a more protracted economic cycle.
Overall, three main headwinds continue to weigh on the equity markets:
In a recent interview, legendary investor Warren Buffett said that he was “bullish” on China because of its long-term potential. He also said he doesn’t make long-term investment decisions based on the Federal Reserve raising rates from rock bottom levels. Just like Buffett, as an investor in equities you must:
• • •
The rate of economic growth in China is slowing and policymakers are seen as making poorly timed decisions; The period surrounding the Federal Reserve’s first interest rate hike isn’t certain and markets don’t like any uncertainty; Commodity markets remain fragile, with supply demand fundamentals recalibrating due to advances in technology and lower global growth forecasts.
One must realize that it was only a matter of time before the rate of growth in China’s economy started to cool down. Perhaps the transition from a manufacturing-led economy to a consumer-led one is, in fact, showing signs of happening. These types of transitions are never smooth, but they are inevitable and necessary. As for the Federal Reserve hiking rates, economically speaking it’s hard to believe that a 25 basis points rate increase will do much damage to the real economy. Unemployment is where the Federal Reserve wanted it, the last Gross Domestic Product report was great, housing is booming again, and we’re starting to see U.S. wage growth. But the markets don’t always view it that way in the short run. The massive drop in the price of oil certainly impacts the economy and the markets, both domestically and abroad. Energy, however, is
• • •
Have a longer-term time horizon, recognizing that you’ll likely be adding to or relying on your portfolio for 20 years or more; Make sure you know what you’re investing in as this knowledge will help you ride out the volatility, peaks and valleys included; Remember that emotions are often a contrary indicator. When you feel like you want to jump ship, revisit the first two bullet points here.
This article is supplied by Glenn Schoenroth, CFA, vice president and portfolio manager with RBC Dominion Securities Inc., member CIPF. This article is for information purposes only. Please consult with a professional advisor before taking any action based on information in this article. Schoenroth can be reached at 604.257.7196. The Wealth Management Referral Service is a program that enables BCPhA members the opportunity to have a complimentary 45-minute consultation with an investment advisor at RBC Dominion Securities who has an understanding of the pharmacy business. Contact Cyril at 604.269.2869 for more information.
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COACH CALLIE
Build resilience through self-care By Callie Bland, B.Sc., BSN, RN, CPCC, PCC A patient walks into a pharmacy at 11:00 pm asking to refill a narcotic prescription. The pharmacist looks at the patient’s prescription but finds that there are no more refills available, and the pharmacist is unable to dispense the medication. She tells the patient that he must get a new prescription from his doctor. Although the pharmacist attempts to educate the patient about why she is unable to dispense the narcotic and offers other options such as Tylenol, the patient becomes angry. The encounter does not go as the pharmacist intended, and both she and the patient leave the interaction dissatisfied.
mentor, coach, or counsellor. Choosing someone who is motivated to help you learn from the interaction in a non-judgmental way, rather than rehashing the details of the story to determine who was right, is critical.
I’m sure many of you have experienced a similar, difficult situation with a patient that has left you feeling frustrated. You might have found yourself ruminating over the encounter for days or weeks and were unable to let it go. In order to gain insight and learn from such an interaction it’s important to reflect on difficult interactions in a healthy way. Healthy reflection involves being open, curious, compassionate and receptive to learning from the encounter, rather than judging yourself or the patient.
To illustrate how peer-to-peer critical reflection works in practice, here is an example of how two pharmacists might discuss the challenging situation I described earlier. I’ll call these pharmacists Jane and Bob. Jane uses Bob as her trusted peer.
A regular practice of self-reflection will help you build confidence and resilience. It will enable you to recognize the type of communication skills that help you engage patients and build connection, even during non-ideal circumstances like the scenario mentioned above. Research also supports the benefits of a healthy, reflective practice. In one study that was conducted by Michael Krasner et al., from the University of Rochester Medical Center in New York, the mindful communication and reflective practices of 70 primary care physicians were analyzed over the course of a year. They found significant improvements in both measures of personal well-being and relationship-centered qualities of care. They also found improvements in mindfulness, burnout and mood states. The physicians’ ability to consider their patients’ psychosocial dimensions increased and their capacity to empathize was enhanced. When I interview health-care professionals about their reflective practices, I often find that they reflect on patient encounters in isolation and while doing another activities, such as exercising or commuting to work. While doing so is beneficial, I recommend a regular and consistent practice of reflection with a trusted peer,
A regular reflective practice can improve your self-awareness about how you relate to and communicate with your patients. I strongly encourage you to make reflection an essential component of your professional practice.
An example of the reflective process
Jane: About three weeks ago I had a really difficult situation with a patient in the pharmacy, and I can’t stop thinking about it. Bob: Can you set the context and describe the situation for me? Jane describes her encounter and situation. Bob: How did you feel when things got difficult? Jane: It was a frustrating situation. Bob: What frustrated you the most? Jane: The patient didn’t understand why I couldn’t dispense the medication even after I educated him on the policies and my scope of practice. The guidelines and policies are clear and I explained this to him and he still got quite upset. Bob: It sounds like you wanted some understanding from the patient. Jane: Yes, exactly! Bob: What were some of the assumptions you were making? Jane: I guess I assumed that after the patient knew why I couldn’t dispense the narcotic, he would calm down. I assumed that patient education was what the patient needed. Bob: What do you think the patient wanted? Jane: Well, now that we are talking about it, I interrupted the patient several times to try to explain the policies and guidelines and I think he just wanted me to listen.
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CLINICARE PHARMACISTS
Lichen planus of the vulva By Larry Leung, B.Sc. (Pharm.), R.Ph., and Jason Min, B.Sc. (Pharm.), R.Ph. We think one of the most challenging situations for any pharmacist is when a patient is referred for a medication assessment without a confirmed diagnosis. We recently experienced this with a patient who was referred for management of symptoms arising from an uncommon condition of the vagina. The patient: - 41-year-old female - Possible erosive vulvar lichen planus - Unremarkable past medical history - No known allergies Medication history: - Clotrimazole 1% external cream BID to vulva x 2 weeks, not helpful. The patient described symptoms of itching in the external vaginal area over the previous two weeks and had tried unsuccessfully with clotrimazole cream, thinking she might have a yeast infection. She then experienced pain with coitus and noticed inflammation of the surrounding vaginal area, which led her to see her family physician. Her physician diagnosed her as having possible vulvar erosive lichen planus and referred her to a specialist for confirmation. Erosive vulvar lichen planus is one of several subtypes of the broader diagnosis of lichen planus. It is an uncommon condition affecting the skin in and around the vagina, causing pruritis, painful sores, patterns of white lace, and dyspareunia. A biopsy is usually required to confirm a diagnosis. Unfortunately, there is no cure for erosive vulvar lichen planus and the goal of therapy is for disease remission and patient comfort. When working with an unconfirmed diagnosis, we had to rule out any drug-related causes for her symptoms. Drug-induced lichen planus can occur with many commonly used medications including ACE-inhibitors, thiazide diuretics, beta-blockers, NSAIDs and some antibiotics. Lichenoid drug eruptions can occur within weeks or months of starting the offending medication. Fortunately, she was not taking any other medications or supplements.
Guidelines for treating erosive vulvar lichen planus are not well established, but local administration of a topical corticosteroid is generally considered first-line therapy. In conducting a literature search for available options, we found that super high potency steroids were commonly used, including clobetasol propionate and halobetasol propionate. Success rates with high potency steroids varied widely, with one small study showing a success rate of up to 94 per cent. Other options included oral corticosteroids, tacrolimus and other immunosuppressants. Typical application for topical corticosteroid therapy is a very thin layer to the affected area once daily at night. To help guide patients, the amount of ointment needed to cover the labia majora, labia minora and the perianal skin is a line from the tip of the finger to the first skin-crease. Unfortunately, corticosteroids are commonly ineffective in the vulvovaginal area. One of the contributing factors for this is the relatively high treatment resistance of the vulvar vestibule, requiring more aggressive therapy. This is further complicated by the fact that the surrounding tissues, including the labiocrural folds and perianal area, are very sensitive to corticosteroids and are at risk of skin thinning, striae formation, and other adverse effects. After discussions with the patient’s physician, we recommended clobetasol 0.05% ointment, applied once nightly for possible erosive vulvar lichen planus. The patient’s specialist appointment was one month away and in the event that the diagnosis was determined to be incorrect, we considered that corticosteroids are generally well tolerated, it may help reduce the inflammation the patient was experiencing at the time, and it can be stopped abruptly if needed. Larry Leung and Jason Min are Directors of Clinicare Pharmacists Inc, Lecturers at UBC and patient care practitioners at the UBC Pharmacists Clinic. They have a passion for interdisciplinary care and the development and implementation of innovative clinical pharmacy services in the community. References available upon request at info@bcpharmacy.ca.
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ON THE COVER | MARIJUANA
Vancouver’s pot shops
By Angie Gaddy
It's understandable bl th thatt one might think marijuana is legal in Vancouver. Across the city, the number of st stores advertising the sale of marijuana for medical purposes has exploded in recent years. In 2013 there were only 14 pot shops in Vancouver. In the first six months of 2015, the number of shops grew from 60 to 100.
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ON THE COVER | MARIJUANA
Dispensaries act under guise of medicine Proclaiming to sell marijuana for medical purposes, many – including media – refer to these retailers as dispensaries. “We are gravely concerned,” says Geraldine Vance, CEO of the BC Pharmacy Association. “Allowing these shops normalizes marijuana as a harmless product. If this is a medical product, then it should go through the same rigorous standards that all medications must go through and be handled by health-care professionals.” The BC Pharmacy Association made a written submission to the city of Vancouver during its public consultation before councillors voted 8-3 to approve the new regulations in late June. At issue is not only the legality of these operations but their deliberate choice in using the word dispensary or “farmacy” to describe their business. “Dispensary is clearly defined in the Pharmacy Operations and Drug Scheduling Act (PODSA). They are calling themselves clinics or dispensaries to gain legitimacy as pseudo health-care providers,” Vance says. “They’re not. You’ve got untrained individuals handing out drugs to patients under the guise of medicine.” Pot shops are still illegal
The growth of pot shops in Vancouver has exploded in recent years, from 14 in 2013 to nearly 100 this year. Many try to legitimize their services by calling themselves “dispensaries”, “farmacies” or “clinics”.
In June, the city of Vancouver became the first city in Canada to start regulating marijuana shops, requiring owners to apply for a $30,000 business licenses. Shops must be set up in commercial zones and at least 300 metres away from schools, recreation centres and each other. Compassion clubs only have to pay $1,000 for their license.
Selling pot outside of the federal medical marijuana program is illegal based on Canada’s Controlled Drugs and Substances Act. The program, which went into effect in 2013, allows approved licensed producers to grow marijuana for medical purposes. Vancouver’s medical marijuana shops are not only selling, but obtaining, their supply illegally. While some have been reported as saying they’re getting their supply from home growers who were able to keep growing while a court case continues, these home growers’ authorizations from Health Canada don’t allow them to sell their supply to retailers. So how have these illegal pot shops been allowed to flourish?
The city gave a 60-day notice period for these shops and received 176 applications before its August 21 deadline.
Over the years, the Vancouver Police Department and the city of Vancouver have taken a lenient approach to medical marijuana shops. Police have said these retailers are not a priority and will only take action if there’s a public risk or they are selling to minors. The police department has executed search warrants for 11 locations, according to media reports.
But make no mistake, according to the federal government, these shops are illegal, even if the city of Vancouver chooses to regulate them.
In September, the city’s police board voted to dismiss a complaint by Pamela McColl, of the group Smart Approaches to Marijuana Canada, who alleged the police
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ON THE COVER | MARIJUANA
1999:
2001:
June 2013:
March 2014:
Qualified patients in Canada allowed to possess marijuana for medical purposes under the federal Marijuana Medical Access Program.
Canadian Medical Marijuana Access Regulations (MMAR) granted access to cannabis for certain patients – those with HIV/AIDS or other illnesses. Patients could be authorized to grow their own pot or get it from Health Canada or other approved producers.
New regulations ban all homegrown marijuana and shift access to commercial growers for supply. Nearly 38,000 people authorized to possess marijuana under the federal program, compared to less than 100 people in 2001. The old MMAR program scheduled to end March 31, 2014.
Several British Columbian residents asked the Federal Court of Canada for an injunction that would allow them to continue producing their own pot or have a designated person do so for them before the March 31, 2014, deadline.
Sources: Canadian Press, Health Canada, Globe and Mail, Vancouver Sun, and the City of Vancouver.
hadn’t done its duty in enforcing the law against illegal pot shops. While all of these legal wranglings continue, health professionals are left to talk about the efficacy of marijuana for patients and how to handle their care. The Canadian Medical Association (CMA) maintains its position that there is not enough scientific evidence to demonstrate risks and benefits of using marijuana for clinical purposes. The CMA says not enough research has been done on proper dosing and its potential interactions with other medications. The BCPhA agrees. In August, the BCPhA Board of Directors approved
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a position on medical marijuana that supports the CMA position, expresses concern about using the word “dispensary” and views Vancouver’s pot shops as illegal. The Board also says more research should also include pharmacists as medication experts. “Patients are totally on their own” Pharmacist Tammy Coderre-Kells, who works for the Fraser Health Authority and who is part of a multi-disciplinary team working on developing policies on how to deal with medical marijuana, says the entire issue has become muddied for health-care providers on many fronts.
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Patients have complained about wanting to use medical marijuana while they’re in the hospital, and complaints get referred to the pharmacy. “Every hospital is grappling with it,” she says. Not only is there an issue of whether a patient has an authorized supply of dried marijuana, patients can’t smoke it on hospital grounds. Health Canada licensed producers have to go through stringent security and quality controls, ensuring qualitycontrolled product, proper packaging and standard labeling.
ON THE COVER | MARIJUANA
Coderre-Kells says licensed producers are now experimenting with different strengths of tetrahydrocannabinol (THC). Under the old regulations, THC strength was standardized at 12.5 per cent. A recent review of current product available from licensed producers revealed a range in THC strength from 0.5 to 25 per cent. Patients also have to consider what strength of cannabidiol (CBD) is in the strain they’re ordering. Products may range in CBD strength from 0 to 16 per cent – typically the higher the THC, the lower the CBD. For patients, the THC causes a cerebral high that can include mild to moderate analgesic effects, while CBD can cause drowsiness for
some users. If a person is using marijuana at night the higher CBD concentration may assist with sleep without the psychoactive effects of THC. “The patient is totally on their own. Some may not know what TCH or CBD is and how the strength works for them,” she says. “The dosing is pretty much a black hole.” Even prescribers are turning to pharmacists for help with information on how to prescribe medication. “We don’t have much information,” she says. “It puts us in a very difficult position.” Add in the fact that some patients may choose to purchase their marijuana from
March 21, 2014:
June 11, 2015:
June 24, 2015:
A federal judge approves temporary injunction, which allows patients to continue growing their own marijuana for medical purposes.
Supreme Court of Canada rules that medical marijuana patients can consume all forms of marijuana, including extracts and derivatives. Before, federal regulations said patients could only consume dried marijuana.
Vancouver city council votes 8-3 to regulate medical marijuana retailers. The city becomes the first in the country to regulate storefronts selling pot.
illegal retail pot shops, where there are even less stringent controls. Ian Waddell, former trial lawyer and MP, who now works with licensed medical marijuana producers on packaging and security, agrees. “If I were a pharmacist I would be concerned that unprofessional people are distributing drugs with very little control quality, packaging or labelling,” he says. “I would be especially concerned that cannabis is not being sold in childproof containers. We are now back to baggies, if you can imagine.”
August 21, 2015:
September 9, 2015:
Vancouver receives 176 applications for medical marijuana shops.
Health Canada sends warning letters to 13 operators saying they have two weeks to shut down or they will be raided by the RCMP.
What's in a name? Under the Pharmacy Operations and Drug Scheduling Act, “dispense” is defined as “the preparation and sale of a drug or device referred to in a prescription and taking steps to ensure the pharmaceutical and therapeutic suitability of a drug or device for its intended use and taking steps to ensure its proper use.” Under section 1 of the Pharmacy Operations and Drug Scheduling Act — Bylaws, “dispensary” means the area of a community pharmacy that contains Schedule I and II drugs. (Above and on facing page) Pot shops have set up across Vancouver using terms like 'dispensary' in their advertisements.
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ANTICOAGULATION THERAPY
Pharmacy managed warfarin is safe, quick and convenient for patients By Matilda Meyers For the almost 1.5 per cent of people in BC who need treatment to prevent blood clotting, warfarin is a powerful drug that can mean the difference between life and death. Warfarin is also one of the most complicated medications available, requiring careful dosage adjustment and diligent monitoring. A patient’s international normalized ratio (INR) must be kept within a narrow window. INR values that are too high or too low can lead to adverse bleeding or clotting that can result in bleeding in the brain or heart attacks. Peoples Drug Mart in the small town of Chase is one of a number of pharmacies in BC that is demonstrating a commitment to improving patient care by offering anticoagulation therapy services to patients. This service enables the pharmacy to take the lead in monitoring a patient’s INR drug levels, a task that would normally fall under the scope of a family physician (FP). In Chase the service is run by pharmacists Ellen Bovair and Robert Caravan, who are both anticoagulant specialists. “It was a program born out of need," says Bovair. The pharmacy decided to start offering anticoagulation services in November 2006 because of the aging population in the town, combined with a shortage of family physicians to take care of them. In Chase, the 65-plus age group represents
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Peoples Drug Mart in Chase is one of a number of pharmacies in BC that are demonstrating a commitment to improving patient care by offering anticoagulation therapy services to patients. The pharmacy team includes (left to right) locum Pharmacist Bobbi Wahlstrom, Pharmacist Nicole Szegedi, Pharmacist Ellen Bovair (who runs the anticoagulation program) and Pharmacy Assistant Nana Clayton. Other members of the team not pictured include Debbie Mockford (customer service), Rob Caravan (pharmacist), Ila Watson (customer service) and Maria Beaurain (pharmacy assistant).
the largest percentage of the population at 25.2 per cent. A story of success Bovair says the success of the program in Chase can be attributed to a number of factors including a strong pharmacy
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team, patients’ willing participation and the support of local doctors. Before it was rolled out, the pharmacy held a meeting with FPs and administrators at the Chase Primary Health Care Clinic to explain why the service was important and to devise a plan for how it would work.
ANTICOAGULATION THERAPY
How anticoagulation therapy works at Peoples Drug Mart in Chase, BC
Patient registers with the pharmacy for anticoagulation therapy.
Pharmacy educates the patient about the service.
Patient's physician is given a policy and procedures manual and signs a oneyear authorization form.
“The service has been positive for all parties involved: the patients, the physicians and ourselves,” says Bovair. "Our patients find it very convenient. I know for a fact that it has aided us in having new patients come to our pharmacy strictly for that purpose.” There are currently eight doctors in Chase, Salmon Arm and Kamloops who have signed forms authorizing the pharmacy to manage anticoagulation therapy for 23 different patients. Over the past nine years, the number of patients who have been taking advantage of the service at any one time ranged from 60 to 10, depending upon their patient load.
Pharmacist phones the patient the next day and advises of the correct dose.
Patient gets a blood test from the lab. Results faxed to the pharmacy that evening.
the effectiveness of the program and says it has been an extremely positive experience. "I feel my pharmacist and I are really working together with my doctor to
Pharmacy notifies the physician of dosage change.
she says. “Because physicians have a working relationship with us they feel more comfortable asking us questions or referring other patients to us. They value
While there are new anticoagulant drugs on the market that are easier to manage... Bovair says warfarin is a "tried and true" medication that has been around for more than 60 years
Chase resident and warfarin patient Norm Lapointe feels very confident about
control my problem,” Lapointe says. “I feel bad for anyone who does not experience the same security that I am experiencing.” Bovair says it has helped build strong relationships with the local health-care community. “I know it’s a matter of trust,”
what we’re doing, have confidence in us and rely on us.” Dr. Cornel Barnard, a physician at the Chase Primary Health Care Clinic, appreciates how safe it is for his senior patients to have their INR monitored and dosage adjusted in the Continued on page 22
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ANTICOAGULATION THERAPY
same location. “It takes out the guesswork and confusion that many patients experience with warfarin dosing,’’ Barnard says. Salmon Arm’s Dr. Darren Lorenz, a family physician, agrees that the experience with pharmacists has definitely been positive. “Their availability to consult with patients, by phone or in person, regarding changes to dosing, drug interactions and other pertinent factors, make this a very worthwhile program and decreases risk factors to patients on warfarin therapy,’’ he says. The importance of warfarin therapy "Proper management of warfarin makes a huge difference in patient outcomes," says Bovair.
Pharmacist Nicole Szegedi (right) and Pharmacy Assistant Nana Clayton working at the Chase pharmacy.
The maximum length of time a patient on warfarin should go for tests is four weeks. If INR levels are not consistent, a patient would have to have more regular testing. Typically testing is done at laboratories. Normally the laboratory reports the results back to their physician, who then contacts the patient to provide instruction on any necessary dosage adjustments. These adjustments are often made at a community pharmacy. When Peoples Drug Mart launched its service, Bovair says they saw patients who hadn't received an INR test for more than six months. When patients initially enrolled in the service, pharmacists ensured they had INRs at regular intervals until their drug levels stabilized, and then established a schedule for how frequently they should be tested in the future. For more information on how the service works at Bovair's pharmacy, see the chart on page 21.
Pharmacist Ellen Bovair is one of two certified anticoagulant specialists who help patients manage their warfarin at the Peoples Drug Mart in Chase.
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While there are new anticoagulant drugs on the market that are easier to manage as they don't require INR monitoring, Bovair says warfarin is a "tried and true" medication that has been around for more than 60 years and is very safe if managed properly. It also costs only around $30/ month versus more than $100 for some of the newer medications.
ANTICOAGULATION THERAPY
Warfarin patient Ron Fairhurst is one of the 23 patients receiving anticoagulation therapy through the Chase pharmacy.
Becoming an anticoagulant specialist Bovair was trained as an anticoagulation specialist in September 2006 through Wendy Leong. Leong is a Vancouver pharmacist who specializes in anticoagulation therapy management and also helped the Chase pharmacy set up the clinic’s policies and procedures. Bovair says they chose not to use POCT in their pharmacy because most of their patients have co-morbid conditions and require additional tests during their visits to the laboratory. “Our lab services are very valuable to us,” she says. The future of anticoagulation therapy While the pharmacy is very pleased with how the service has improved patient care, Bovair strongly believes that pharmacists
should be reimbursed for this vital work. "I think it's time that pharmacists get paid for this,” Bovair says. “We need to be recognized for this service that we're giving." She estimates that the pharmacy as a whole dedicates at least seven hours per week to anticoagulation management. The BCPhA issued a Clinical Service Proposal for a Community PharmacistLed Anticoagulation Management Service (CPAMS) in 2013. The proposal recommends that government fund a service in BC, allowing patients to access to INR testing in their community pharmacy. Studies have demonstrated that a pharmacist-led service can result in improved anticoagulation control, reduced frequency of warfarin-related hospital admission, lower frequency of
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drug interactions, and improved patient compliance and satisfaction. The strategy would also allow patients greater access and immediate results for their blood testing needs. Studies have shown that it would improve quality of life and patient outcomes, as well as having a potential cost avoidance of approximately $1,000 per patient each year. When applying it to BC’s population this could mean total savings to the health-care system of approximately $50 million per year. "I really believe in anticoagulation therapy and encourage other pharmacies to do it," says Bovair. “Especially for those communities who have an elderly population such as ours. It really is a wonderful service for patients.”
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FLU SEASON UPDATE
Pharmacists can now give intranasal flu spray to kids under five By Angie Gaddy This flu season, it will be more convenient for families with young children to get their flu vaccines together.
The College said it will look at broadening pharmacists’ injection authority at a later date.
For the first time, pharmacists in BC will be able to administer intranasal flu vaccine to children as young as two years old. That means busy families can show up to a community pharmacy after work or on the weekends and be immunized for influenza at the same time.
“We’ll continue to push for an expanded authority to immunize children under five via injections,” Vance says. “It’s a win for both patients and the health-care system. It’s easier access for patients to get immunized or have other products administered at their local pharmacy, especially in areas where there are no doctors or health units.”
“This decision supports pent-up demand from the public, who want more convenience in accessing health care,” says Geraldine Vance, CEO of the BC Pharmacy Association. “Community pharmacists are a key health-care provider for patient immunizations. The numbers show it.” In 2009, BC pharmacists were given the authority to administer vaccines. That first year, pharmacists administered 30,000 flu shots. That number increased more than tenfold just a few years later. During the 2014/15 flu season, pharmacists gave more than 430,000 flu shots to British Columbians.
There are more than 3,400 pharmacists in BC authorized to give immunizations. Nearly 94 per cent of all pharmacies have at least one pharmacist authorized to give immunizations – from flu, pneumonia, human papillomavirus (HPV), shingles, tetanus and measles. Abbotsford pharmacist Sunny Dhillon says pharmacists should be able to provide both intranasal flu vaccine and injectable vaccines to children as young as two.
In September, the College of Pharmacists of BC passed amendments to the Health Professions Act (HPA) bylaws that will allow pharmacists to administer intranasal flu vaccine to children two years and older. The age restrictions for injections will remain five years and older. At the time of writing, the bylaw amendments were still to be approved by the Ministry of Health, but it is anticipated that they will be in force at the beginning of the flu campaign.
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“This is what qualifies as providing total patient health care and minimizes wait times for patients, as well as demonstrates to the general public that their pharmacist is able to provide a wide array of health services for their entire family.” Dhillon says that allowing pharmacists to provide intranasal flu spray to children is a good first step, but pharmacists should be able to do more. He believes patients expect it, and the profession needs it. “Pharmacists need – and have to be able – to do more in order for health-care costs to remain affordable as well as for the profession to remain viable,” he says.
Intranasal flu vaccine: What pharmacists need to know
Abbotsford pharmacist Sunny Dhillon says pharmacists are well-positioned to help families needing the flu vaccine.
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“I can't count the number of times I've had to turn parents with young kids away who wanted me to immunize the whole family at one time against the flu,” says Dhillon, pharmacy manager of the Pharmasave Health Centre in Clayburn Centre.
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The College of Pharmacists requires all pharmacists who are authorized to administer injections and planning to provide intranasal flu vaccine to children to complete an online educational program that should be available on their website. The BCPhA will also be integrating this content into its pre-existing Administration of Injections Certificate program. For upcoming training dates and locations, visit www.bcpharmacy.ca/ administration-of-injections-program.
Continued from page 12 passing bylaws requiring applications and a $30,000 annual business license. That doesn’t mean these businesses are legal. From a federal perspective, every one of these outlets is still illegal. The issue will become clearer in the coming months, especially after the Allard case decision has been handed down by the courts. There is currently no provision for pharmacies to be able to dispense marijuana for medical purposes and none is contemplated in the future. References available upon request at info@bcpharmacy.ca.
Continued from page 14 Bob: What would be different if you had listened more? Jane: I think I would have been able to address how he was feeling. He was probably quite angry and maybe even confused. He thought he had refills and he came in that night expecting to get his medication. I probably could have been more empathetic. Bob: What would you do differently next time? Jane: I think I’m going to listen more and talk less initially. I’ll try to hear the patient’s emotions and perspectives before I launch into providing education. This is going to take some practice. The solution seems so clear reflecting back on it, but in the moment it’s not as easy. Bob: Reflecting on this difficult interaction is a great start to making change and now you're clearer about what you’ll do differently next time. By talking through with her peer, Jane was able to not only reflect on the situation but make plans on how she would handle it in the future. It decreased her stress, which helps her as a pharmacist deliver the best patient care. Callie Bland is an executive coach and registered nurse with more than 15 years’ experience in both public and private healthcare systems. She specializes in partnering with health-care professionals and leaders to build capacity to lead themselves, others and systems more effectively. She is writing a new column for The Tablet on developing your non-clinical skills. Contact Bland via www. coachcallie.com. References available upon request at info@bcpharmacy.ca.
CAREER LISTINGS
ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS? Pharmacy members can place free Career Opportunities listings in this section and on the BCPhA website. Job postings for pharmacy technicians and assistants are also distributed by the Pharmacy Technician Society of British Columbia (PTSBC). A new enhancement to the best pharmacy job board in BC! Pharmacist members looking for new career opportunities can post their resumes for free on the Hire-aPharmacist page. To learn more, visit the Recruitment section of bcpharmacy.ca
profession and business of pharmacy, strong financial acumen, excellent communication and organizational skills, strong customer/patient satisfaction orientation, and strong leadership and decision making skills. Please submit resumes online at www.rexallcareers.ca. CHILLIWACK Pharmacy manager - full-time Seeking a highly motivated, driven pharmacy manager with great interpersonal skills who is able to operate a very busy pharmacy with a large staff. This position is best suited for individuals with strong HR skills and excellent clinical services skills. Please send resumes to Krystal Kieser, associate/owner at asdm217@shoppersdrugmart.ca or online at www.shoppersdrugmart.ca, fax 604.792.7307 or call 604.792.7377.
ABBOTSFORD
CRANBROOK
Pharmacy assistant - part-time
Pharmacist - full-time
We are currently seeking a part-time pharmacy assistant. Pharmacy is located inside the Abbotsford Regional Hospital. Remuneration based on experience. Please contact Shaf by phone only on 604.866.7453.
Peoples Pharmacy #388, the outpatient pharmacy for the East Kootenay Regional Hospital in Cranbrook is seeking a full-time pharmacist. We offer competitive salaries, benefits and a professional atmosphere. Our pharmacy specializes in long term care, the BC renal program, mental health, addiction services, immunization, sterile compounding, pain and wound care and hormone consulting. Please send resumes to Rick Lockhart, manager, at peoplespharmacy@telus.net, fax 250.420.4135 or call 250.420.4133.
BARRIERE Pharmacy technician - full-time Barriere IDA Pharmacy in Barriere is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a fast-paced, detail-oriented environment, work well with both patients and other health care professionals, manage and maintain inventory, have good communication skills and a willingness to learn. Barriere IDA Pharmacy is a member of the Munro Pharmacy Group. We operate a number of pharmacies throughout the BC interior. Our stores are equipped with the latest technology. We take pride in offering prompt friendly prescription service and helpful advice on patients' pharmacy needs. Please send resumes to Regan, pharmacist/pharmacy operations manager, at regan@teamrx.net or Dona at llida@telus.net or phone 1.855.99. REGAN toll-free. BURNS LAKE Pharmacy manager - full-time The pharmacy manager is responsible for managing store pharmacy operations and maintaining a professional and cohesive working relationship with the front store manager and staff. Required skills: pharmacy license to practice in the province in which you are applying, experience in retail pharmaceutical systems and dispensing procedures i.e. Nexxsys, previous pharmacy management experience preferred, ability to maintain the optimum balance between the
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CRESTON Pharmacy manager - full-time We are an independently owned, thriving community pharmacy, with a focus on delivering superior patient care. We are looking for a motivated, experienced professional to lead our pharmacy team. This position is best suited to an individual who possesses a strong work ethic and a desire to develop the pharmacy business, particularly in the areas of clinical practice and specialty compounding. We offer a generous compensation package, which is negotiable based on experience. There is also an opportunity for part ownership for the right individual. If this opportunity interests you, please submit a resume and cover letter to owner/pharmacy manager Mr. Jody McBlain at pharmasave282@gmail.com. Pharmacist – full-time or part-time We are currently looking for a full-time or part-time pharmacist to join our friendly, professional team. We take pride in providing superior patient care in a thriving community pharmacy. Pharmacists overlap on weekdays and work alongside two or three pharmacy assistants to allow the provision of prompt and courteous services. Visit www.crestonvalleybc. com to learn more about our community and surrounding area. If you are a motivated
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pharmacist looking for a rewarding career, please send your resume to owner Jody McBlain at pharmasave282@gmail.com or fax 250.428.9082 or please call 250.428.9080. DEASE LAKE Pharmacy technician - full-time Pharmasave telepharmacy in Dease Lake is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a high paced detail oriented environment, work well with both health care professionals and the general public, manage and maintain inventory, balance cash, have good communication skills and a willingness to learn. Please send resumes to Alan Williamson, owner, at ps214@shaw.ca.
Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the OFG and make your career prescription complete. Please send resumes to Denise Nilsen, regional manager, pharmacy operations at denise_nilsen@owfg.com.
tasks: work in a high paced detail-orientated environment, work well with both health-care professionals and the general public, manage and maintain inventory, balance cash, have good communication skills and a willingness to learn. Please send resumes to Alan Williamson, owner, at ps214@shaw.ca.
GOLD RIVER
London Drugs has a part-time opportunity in Kamloops. Join a clinical and patient focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager at ssangha@londondrugs.com or fax: 604.448.1075.
Pharmacy technician - part-time Part-time pharmacy technician required in Gold River. This is a telepharmacy location. Successful candidate must be energetic, adaptable, work well with other health-care professions and the public. Please email resume to Colleen, owner, at collhogg@hotmail.com or fax 250.285.3375 or please call 250.285.2275.
DELTA Pharmacist - full-time
GOLDEN
We are looking for full-time pharmacists for our Lower Mainland pharmacy. Experience with WinRX/Kroll and Microsoft Office (Word, Excel, etc.) are necessary. The successful applicant is required to have at least one to two years of experience working in a community pharmacy and to be injection certified. Pharmacists must also have a good working knowledge of PharmaCare and third party billing policies, medication reviews, and experience with blister packing. Pharmacists must be strong communicators, clinically-oriented, and willing to further their pharmacy practice and patientcentered care. Wages start at $37/hour and increases steadily with experience. Full medical/ dental after three months. If interested, kindly send a resume and cover letter to shafik@wescanapharmacy.com.
Pharmacist - full-time
Pharmacy assistant - full-time Looking for an experienced pharmacy assistant or registered pharmacy technician with at least one to two years of community pharmacy experience. Must be aware of all PharmaCare and third party billings and regulations as well as College bylaws. Additionally, must be proficient in Microsoft Office (e.g., Word, Excel, etc.) and familiar with PharmaCare related service paperwork (e.g., medication reviews, flu and travel vaccinations, adaptations, methadone, compounding, etc.). Mandarin, Punjabi, Hindi, or Italian language fluency is an asset. The ideal candidate must be comfortable taking on a supervisory and leadership role. This job is 40 hours/week and the wage ranges from $15-20/hour depending on qualifications and experience. Forward your resume and cover letter to shafik@wescanapharmacy.com. FORT MCMURRAY
We are hiring a full-time pharmacist to work in our independently owned pharmacy in Golden, attached to the only medical clinic in town. Pharmacy hours are Monday to Friday 9am to 5pm, with no weekends or holidays. The wage for this position is $50/hour with a benefit package. For more information on Golden and all it has to offer visit www.golden.ca. If you would like to apply for this position or need further information, please contact Darren Belik at gourlayscanmore@telus.net or fax 403.678.3916 or please call 403.678.5288. HAZELTON Pharmacy manager - full-time A new pharmacy in Hazelton, BC is looking for a pharmacy manager. If you are interested in learning more about this opportunity or would like to apply please send your resumes to Alan Williamson, owner, at ps214@shaw.ca. Pharmacy technician - full-time Pharmasave telepharmacy in Hazelton is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable and energetic and demonstrate an ability to perform the following tasks: work in a high paced detailoriented environment where accuracy is of utmost importance, work with both the general public and health-care professionals, manage and maintain adequate inventory levels, balance cash, have good communication and phone skills, have good computer skills and a willingness to learn. If you are interested in the position please email your resume and references to Alan Williamson, owner, at ps214@ shaw.ca or call 604.926.5331. HUDSON HOPE
Two permanent part-time positions are available. Overwaitea Food Group (OFG), one of Western Canada’s leading food and consumer-goods retailer, operates more than 100 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers
Pharmacy technician - full-time
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Pharmacist - part-time
Pharmacist - part-time Manshadi Pharmacy is looking to hire a part-time motivated pharmacist to work in a well-established independent retail pharmacy. Experience working in a busy pharmacy is a requirement. We specialize in diabetic care, compounding and home health-care products. Great team that supports our pharmacist. We prefer a long-term commitment. Kamloops is a great place to be. We are close to two ski hills, Sun Peaks and Harper Mountain, and dozens of nearby lakes. Good community to raise a family with all needed amenities. Thank-you for your interest but only qualified applicants will be contacted. Please send resumes to Missagh Manshadi, Pharmacist/owner at missagh@manshadipharmacy.com or online at www.manshadipharmacy.com or fax: 1.250.434.2527 or please call 1.250.574.0111. Pharmacy technician - full-time Manshadi Pharmacy is looking to hire a full-time motivated pharmacy technician or pharmacy assistant to work in a well-established independent retail pharmacy. We specialize in diabetic care, compounding and home healthcare products. Great team that supports our pharmacist. We prefer a long-term commitment. Kamloops is a great place to be. We are close to two ski hills, Sun Peaks and Harper Mountain, and dozens of nearby lakes. Good community to raise a family with all amenities you will need. Please send resumes to Missagh Manshadi, pharmacist/owner at missagh@manshadipharmacy.com or fax 1.250.434.2527 or call 1.250.574.0111. KELOWNA Pharmacist - part-time
Pharmacist - part-time
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KAMLOOPS
Nov/Dec 2015
Pharmasave Telepharmacy in Hudson Hope is looking for a full-time registered pharmacy technician to join the team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following
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Overwaitea Food Group (OFG), one of Western Canada’s leading food and consumer-goods retailer, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy
practice environment and are committed to: challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the OFG and make your career prescription complete. For more information on career opportunities, please contact or forward your resume in confidence to Sammy Lee, regional manager, pharmacy operations at sammy_lee@owfg.com. Pharmacy technician - full-time We are currently seeking an experienced regulated pharmacy technician. The successful applicant must be committed to providing excellent patient care, be very organized, and be able to perform in a fast-paced environment. Those interested in a professional, challenging, rewarding full-time career can forward your resume to Merrie-Jean.Mulhern@remedysrxsp. ca, or online at www.dycksdrugs.com or call 778.478.8128.
LOGAN LAKE
MCBRIDE
Pharmacy technician - full-time
Pharmacy technician - full-time
Logan Lake IDA Pharmacy in Logan Lake, is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a fast-paced, detail oriented environment, work well with both patients and other health care professionals, manage and maintain inventory, have good communication skills and a willingness to learn. Logan Lake IDA Pharmacy is a member of the Munro Pharmacy Group. We operate a number of pharmacies throughout the BC interior. Our stores are equipped with the latest technology. We take pride in offering prompt friendly prescription service and helpful advice on patients' needs. Email Regan Ready, pharmacist/pharmacy operations manager, at regan@teamrx.net or Dona at llida@telus.net or call 1.855.99-REGAN toll-free.
Robson Valley IDA Pharmacy in McBride is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a fast-paced, detail oriented environment, work well with both patients and other health-care professionals, manage and maintain inventory, have good communication skills and a willingness to learn. Robson Valley IDA Pharmacy is a member of the Munro Pharmacy Group. We operate a number of pharmacies throughout the BC interior. Our stores are equipped with the latest technology. We take pride in offering prompt friendly prescription service and helpful advice on patients' pharmacy needs. Please send resumes to Regan Ready, Pharmacist/Pharmacy Operations Manager at regan@teamrx.net, Dona at llida@telus.net or call 1.855.99.REGAN toll-free.
LANGLEY Pharmacy manager - full-time
LOWER MAINLAND
Seeking a highly motivated, charismatic, driven pharmacist to operate pharmacy. This position is best suited for individuals with a well-developed business acumen and excellent clinical service skills. Starting wage $43-45/ hour depending on experience, and quarterly performance bonuses. Qualifications/skills: Bachelor of pharmacy, licensed to practice in BC, superior interpersonal skills, strong verbal and written communication skills, commitment to providing exceptional customer service, computer proficiency (Kroll), and experience/certification in geriatrics is an asset but not required. Please send resumes to pharmacycareltd@gmail.com.
Pharmacist - part-time
MIDWAY
London Drugs has a part-time opportunity in the Lower Mainland. Join a clinical and patient focused team using the latest robotic dispensing machines plus counseling booths and counseling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager at ssangha@londondrugs.com.
Pharmacy technician - part-time
Pharmacy manager - full-time
Pharmacy technician - full-time
We are seeking a pharmacy professional services manager for our national office in Langley. Responsibilities include: the development, training, communication and support of pharmacy professional services, establishing relationships with health-care organizations and patient advocacy groups, working with the pharmacy team, training and education plans to support core pharmacy programs, providing information and support to capture all opportunities afforded by current scope of practice. You must: be a registered pharmacist and have a minimum of five years’ experience in retail pharmacy, in progressively more senior positions. Pharmacist certification or specialization an asset but not required. Please email your resume and salary expectations by October 1. Please send resumes to careers@bc.pharmasave.ca.
Must have completed a pharmacy technician course or equivalent. Self-motivated and fast learner with good communication and interpersonal skills. Duties to include: manage drug inventory and receiving, assist in preparing prescriptions, maintain workplace in good order and capable of working under minimum supervision. Competitive wages. Apply in person or send cover letter and resume to: DrugStore Pharmacy 8551, 22427 Dewdney Trunk Rd, Maple Ridge, V2X 7X7 or call 604.467.0753.
Pharmacist - full-time or part-time We are looking for a pharmacist to work four to five shifts per week. Hours of operation are 9:30am to 5:30pm, Monday to Saturday, closed Sundays and holidays. Please email resume. Please send resumes to Pinder Mann, manager, at pinder@langleyrx.com, fax 604.532.1937 or call 604.532.1996.
MAPLE RIDGE
MASSET Pharmacy technician - full-time Pharmasave telepharmacy in Masset is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a high paced detail orientated environment, work well with both health-care professionals and the general public, manage and maintain inventory, balance cash, have good communication skills and a willingness to learn. Please send resumes to Alan Williamson, owner, at ps214@shaw.ca.
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Boundary telepharmacy in Midway is looking to hire a part-time registered pharmacy technician to work one to two days per week in a unique pharmacy environment. Telepharmacy uses cutting edge video conferencing technology to connect technician and public to pharmacist in another location. The technician has a fantastic opportunity to use all their learned skills, as compared to a regular pharmacy environment. Good communication and management skills are essential. Pharmacy is located 1.5 hours drive from Kelowna or Penticton, on the US border. Competitive wage. High job satisfaction as we are an integral part of this small community's health-care team. Please send resumes to Cris Bennett, pharmacy manager/ owner at boundarypharmacy@gmail.com, fax 250.449.2867 or call 250.449.2866. NAKUSP Pharmacy technician - full-time Pharmacy technician position available in picturesque Nakusp. Try a change of pace in this beautiful and relaxed West Kootenay town located only 2.5 hours from the Okanagan. Enjoy skiing, hiking, fishing and the famous hot springs in this spectacular unspoiled lakeside paradise. Talk about job satisfaction. Come practice in a community which really appreciates their pharmacy. Work as an integral part of the health-care team, where you get the support you need to practice patient oriented care. Flexible schedule and vacation (no evenings, Sundays or holidays) Competitive wages. Come enjoy your life. Please send resumes to Troy Clark, owner at troyclark6@ gmail.com, online at www.peoplesdrugmart.com or call 250.265.2228.
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NEW AIYANSH Pharmacy technician - full-time Pharmasave telepharmacy in New Aiyansh is looking for a full-time pharmacy technician. Please send your resume in confidence to Alan Williamson, owner at ps214alan@shaw.ca or call 604.926.5331. NEW WESTMINISTER Pharmacist - full-time Key responsibilities include: checking prescriptions for accuracy, counseling on prescription medications, OTC counseling, health management consulting, and collaboration with pharmacy assistant to accurately dispense prescription medications. Qualifications: Bachelor of Pharmacy, license to practice in the province seeking employment, superior interpersonal skills, strong verbal and written communication skills, commitment to providing exceptional customer service, and computer proficiency. Work hours: flex schedule - some weekends and evenings. Please send resumes to sabeeh@globalhealthmanagement.ca. Pharmacy assistant - full-time or part-time Pharmasave Columbia Square is looking for a full-time/part-time compounding technician/ assistant. Experience with compounding is preferred. PCCA or Medisca compounding training is a definite asset. Minimum two years’ experience working as an assistant and experience with Kroll software is required. Candidates must be hard-working, organized, quick to learn, and good with calculations. Excellent communication and customer service skills are a must. Located across the street from New Westminster Skytrain Station. Please send resumes to pharmacy.ps275@shaw.ca or fax 604.525.5608. PORT HARDY Pharmacy manager - full-time The pharmacy manager is responsible for managing store pharmacy operations and maintaining a professional and cohesive working relationship with the front store manager and staff. Required skills: pharmacy license to practice in the province in which you are applying, experience in retail pharmaceutical systems and dispensing procedures i.e. Nexxsys, previous pharmacy management experience preferred, Ability to maintain the optimum balance between the profession and business of pharmacy, strong financial acumen, excellent communication and organizational skills, strong customer/patient satisfaction orientation, strong leadership and decision-making skills. Please submit resumes at www.Rexallcareers.ca. Pharmacist - full-time Demonstrate strong sales ability, leadership, energy, passion and communication skills as we strive to be recognized as the Canadian leader in pharmacy health-care. Consult with patients to maximize Rx and OTC sales. Provide professional advice and applicable dialogue with patients on prescription and OTC products
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to provide excellent customer service. Be aware of any in-store events and support these events within the store. Supervise pharmacy technicians. Ensure company standard operating procedures, policies, professional standards and applicable laws and regulations are followed. Implement proper pricing and receiving procedures to minimize shrinkage. Maintain the dispensary inventory level within the prescribed guidelines through accurate perpetual inventory records. Please submit resumes at www.Rexallcareers.ca. POWELL RIVER Pharmacy manager and pharmacist - full-time Overwaitea Food Group (OFG), one of Western Canada’s leading food and consumer-goods retailers, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the OFG and make your career prescription complete. We are currently seeking a pharmacy manager and pharmacist for our location in Powell River. Please forward your resume in confidence to Sammy Lee, regional manager, pharmacy operations at Sammy_lee@owfg.com. PRINCE GEORGE Pharmacy manager - full-time Reporting to the regional pharmacy director, the pharmacy manager is responsible for managing the store pharmacy operations according to company guidelines, professional standards, all applicable provincial and federal laws and regulations and the provision of patient focused services. Responsible for maintaining a cohesive working relationship with the front store manager and staff. Please send resumes to Chantelle Holoiday, talent acquisition consultant - western Canada, at choloiday@rexall.ca or online at www.rexallcareers.ca. Pharmacist - full-time Overwaitea Food Group (OFG), one of western Canada’s leading food and consumer-goods retailers, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the OFG and make your career prescription complete. Forward your resume in confidence to: Livia_Chan@owfg.com. Pharmacist - full-time Job description: Key responsibilities of a Shoppers Drug Mart pharmacist include: Checking prescriptions for accuracy, counseling on prescription medications, OTC counseling,
www.bcpharmacy.ca
health management consulting, participation in SDM programs, including cognitive/ enhanced services (these programs may evolve over time and as required by the business), collaboration with pharmacy assistant to accurately dispense prescription medications. Qualifications: Bachelor of Pharmacy, license to practice in BC, superior interpersonal skills, strong verbal and written communication skills, commitment to providing exceptional customer service, computer proficiency. Work hours: Flex schedule - some weekends and evenings. Please send resumes to Richard, associate owner at asdm268@shoppersdrugmart.ca, online at www.shoppersdrugmart.ca or call 250.562.8169. Pharmacist - full-time Demonstrate strong sales ability, leadership, energy, passion and communication skills as we strive to be recognized as the Canadian leader in pharmacy health-care. Consult with patients to maximize Rx and OTC sales. Provide professional advice and applicable dialogue with patients on prescription and OTC products to provide excellent customer service. Be aware of any in-store events and support these events within the store. Supervise pharmacy technicians. Ensure company standard operating procedures, policies, professional standards and applicable laws and regulations are followed. Implement proper pricing and receiving procedures to minimize shrinkage. Maintain the dispensary inventory level within the prescribed guidelines through accurate perpetual inventory records. Please submit resumes at www.Rexallcareers.ca. Pharmacist - part-time London Drugs has a part-time opportunity. Join a clinical and patient focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager at ssangha@ londondrugs.com or fax 604.448.1075. RICHMOND Pharmacist - full-time, part-time or relief We are an independent pharmacy looking for a regular part-time pharmacist that may lead to a full-time managerial position. The ideal candidate will be fluent in English, Cantonese and Mandarin, highly motivated, have a strong work ethic and good communication skills. We offer stability and a competitive wage. Please email your resume to continentalpharmacy@ hotmail.com with the subject line: "Apply for a pharmacist position." We will contact you based on your qualifications. Or call 604.276.8938. SICAMOUS Pharmacy technician - full-time Eagle Valley IDA Pharmacy in Sicamous is looking for a full-time registered pharmacy
technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a fast-paced, detail oriented environment, work well with both patients and other health care professionals, manage and maintain inventory, have good communication skills and a willingness to learn. Eagle Valley IDA Pharmacy is a member of the Munro Pharmacy Group. We operate a number of pharmacies throughout the BC interior. Our stores are equipped with the latest technology. We take pride in offering prompt friendly prescription service and helpful advice on patients' needs. Please send resumes to Regan Ready, pharmacist/pharmacy operations manager at regan@teamrx.net or Dona at llida@telus.net or call 1.855.99.REGAN toll-free. SORRENTO Pharmacist - Full-time Munro’s Sorrento Prescriptions is accepting applications for a full-time pharmacist for primarily the Sorrento store plus some shifts at stores in Salmon Arm, Enderby, Sicamous and Armstrong. We are looking for a full-time pharmacist who is enthusiastic and energetic, wants to use their full scope of practice for medication reviews and injections, can assist in setting up clinic days for 10 stores and work with telepharmacy, is willing to travel and interested in becoming a store manager in a progressive and innovative setting. We offer competitive salary, paid fees and educational programs, travel expenses, and a chance to see different areas of BC. We are open seven days a week, with our latest shift until 7pm. Applicant would be expected to work two weekends per month. Please send resumes to llida@telus.net or fax: 250.523.6541. SPARWOOD Pharmacist - Full-time Work and live in the Rocky Mountains. Enjoy sking, biking, hiking, golfing and fishing all at your doorstep. Sparwood is located 25 minutes from Fernie Ski Hill and Resort. Our independent pharmacy/natural health store is looking for a full-time pharmacist. We take pride in our patient care with efficient, knowledgeable and friendly service. Qualifications: BC licensed pharmacist (new grads welcome), injection certified, computer savvy, superior customer service skills, strong written and verbal communication skills, high attention to detail, ability to work independently and under pressure, experience in natural health, adaptations, medication reviews and Kroll is an asset. We open Monday-Friday 9am5:30pm. A one to two-year contract is required and negotiable. Please send resumes to sparwoodpharmacy@remedysrx.ca or online at www.remedys.ca/sparwood. SURREY Pharmacy manager - full-time We are looking for a pharmacist manager for our new pharmacy opening January 2016. We are an independent, community-based
pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and with a strong work ethic, strong customer service skills, good communication and leadership skills, ability to work proactively as a member of a dynamic and energetic team, willingness to actively participate in patients’ health-care outcomes, and various managed care initiatives. We offer stability, a competitive wage, and a benefits package. We pride ourselves on our dedication to our employees and interest in long term relationships. Please send resumes to hr@nazpharmacy.com or fax 604.608.3230.
Pharmacy technician - full-time
VALEMOUNT
Pharmacy technician - part-time
Pharmacy technician - full-time
We are looking for an experienced pharmacy technician who can speak English and Cantonese. It would be a bonus if they can also speak Mandarin. This position will begin as part-time (three days/week) but will lead to five days/week. There are no evening or Sunday or statutory holiday shifts. Please send resumes to pharmacytechsearch@outlook.com.
Valemount IDA Pharmacy is looking for a full-time registered pharmacy technician to join our team. The successful candidate must be reliable, energetic and demonstrate an ability to perform the following tasks: work in a fast-paced detail oriented environment, work well with both patients and other health care professionals, manage and maintain inventory, have good communication skills and a willingness to learn. We are a member of the Munro Pharmacy Group, which operates a number of pharmacies throughout the BC interior. Our stores are equipped with the latest technology. We take pride in offering prompt friendly prescription service and helpful advice on patients' needs. Please send resumes to Regan Ready, pharmacist/pharmacy operations manager at regan@teamrx.net, or Dona llida@ telus.net or call 1.855.99.REGAN toll-free. VANCOUVER Pharmacist - full-time We are a well-established, fast-paced independent community pharmacy currently looking for a motivated, focused and diligent full-time Pharmacist to join our expanding team. We are a dynamic, clinical-based dispensary who works with multidisciplinary healthcare professionals to provide excellent customer service and quality patient focused care. Successful candidates must be registered and in good standing with CPBC, possess strong and effective communication and organizational skills, and the ability to work effectively in a team environment as well as independently. Experience with adaptations, administering injections and med reviews an asset. No evenings. Position to start immediately. If interested, please send in a cover letter and your resume. New grads are welcome to apply. Please send resumes to vancouverpharma@gmail.com. Pharmacist - part-time Part-time pharmacist position available, experienced in retail pharmacy, exceptional communication and organization skills, familiar with Telus RxA or RxT program, and able to work productively as a member of a dynamic team. Please, no phone calls about this job. Please send resumes to ymm@yyoung.com or fax 604.630.1001.
www.bcpharmacy.ca
We have an immediate opening for a pharmacy technician or pharmacy assistant at the Medical Centre Pharmacy, an independent pharmacy in downtown Vancouver. The position is 30-36 hours a week, working between 10am-6pm Monday to Friday. The successful candidate must possess the following characteristics: excellent communication skills, detail-oriented, effective time management skills, strong work ethic and pleasant demeanor, fluent in English, and an ability to use Microsoft Office (Word/ Excel). Please send resumes to purewald@shaw.ca.
Pharmacy assistant - full-time Accredited pharmacy assistant required to cover maternity leave starting November 2015. Good communication and customer service skills required. Knowledge of Kroll system an asset. Please send resumes to Zaitoon Karim, manager at ps077@telus.net. Pharmacy assistant - full-time Established independent pharmacy seeking full-time pharmacy assistant to join our team. Responsibilities include: Greeting patients at prescription drop-off and pick-up, receiving and entering prescriptions, preparing and compounding medications, cashier duties and inventory maintenance, general work place organization. Assets: Good customer service skills, prior pharmacy experience or graduation from a pharmacy assistant school, general knowledge of government/private insurance, ability to operate Kroll computer software, Cantonese and/or Mandarin speaking skills desirable. We offer competitive wages with excellent training and support. Please submit your resume with email address and phone number to mjsrxmanager@gmail.com. VERNON Pharmacist - part-time Overwaitea Food Group (OFG), one of Western Canada’s leading food and consumer-goods retailers, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: Challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the OFG and make your career prescription complete. We have part-time pharmacist positions available in Kelowna and Vernon. Please send resumes to Sammy Lee, regional manager, pharmacy operations at sammy_lee@owfg.com.
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VICTORIA Pharmacist - part-time Join a clinical and patient focused team at London Drugs using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager at ssangha@londondrugs.com or fax 604.448.1075. Pharmacy technician - full-time Registered pharmacy technician required to work at Heart Pharmacy IDA owned and operated by Naz Rayani. Our focus is on patient-centered practice with a desirable and friendly population. All applications are confidential. Compensation is commensurate with experience. Please send resumes to jobs@victoriapharmacy.com. Pharmacy assistant - full-time The Overwaitea Food Group is one of western Canada’s largest grocery retailers. We have over 110 locations in many communities across BC and Alberta. The company operates under multiple banners including SaveOn-Foods, PriceSmart Foods, Overwaitea Foods, Coopers Foods and Urban Fare. We distinguish ourselves through five core values: Service, people, innovation, integrity and of course, fun. We’re different and we’re proud of it. Our commitment: To foster a work environment that encourages personal growth, training and opportunities to be promoted from within. Required: Completion of an accredited pharmacy assistant program or two years dispensary experience. Candidates must possess excellent communication and customer service skills. Kroll computer experience is an asset. Please send resumes to pharmacyemployment@owfg.com.
mobilizes the organization in the pursuit of its vision, mission and strategic objectives. He or she will work closely with the member stores and the Pharmasave national office to identify innovative ways to ensure the organization is poised for sustainable growth while maintaining the values of a community-based health service provider. Please submit resumes at www.pfmsearch.com. Pharmacist – relief The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 110 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industry’s finest. New grads are welcome to apply. Please send resumes to pharmacyemployment@owfg.com. Pharmacy technician - full-time. Pharmacy technicians required for various Costco Pharmacy locations across BC (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 is equipped with semi-private and private counselling areas. We have a great working environment, opportunities for advancement in addition to highly competitive rates. We are seeking ambitious, high-energy pharmacy technicians, who enjoy working in a fast-paced team environment. If you are highly motivated to provide excellent pharmacy care and customer service, please email your resume to etoth@costco.com, call 604.444.9344 or fax 425.427.7735.
Pharmacy assistant - full-time We are seeking an experienced full-time pharmacy assistant to join the team of our growing pharmacy. Excellent customer service skills and a positive attitude are essential. Wages based on experience. Please send resumes to bmprx@outlook.com.
OPPORTUNITIES OUTSIDE BC Pharmacist - full-time
OPPORTUNITIES ACROSS BC Chief executive officer, Pacific Region, BC - full-time CEO needed for Pharmasave, Pacific Region. With over 500 stores in nine provinces, Pharmasave is one of Canada’s leading independent pharmacy and drugstore retailers. The CEO is responsible for developing and implementing Pharmasave’s long-term strategic plan for all operations within BC, providing collaborative leadership that engages and
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Pharmacy assistant - part-time We are currently looking for a part-time pharmacy assistant for our pharmacy in Grande Prairie, Alberta. The successful applicant should have excellent communication and customer service skills. The following skills would be considered an asset: previous pharmacy dispensary experience, experience using the Kroll pharmacy software, pharmacy assistant or technician certification. The pharmacy assistant/technician will be reporting to the pharmacy manager and staff pharmacists. The duties may include but are not limited to: typing new prescriptions, counting and labeling prescriptions, receiving and entering drug inventory, preparation of compliance packs, unpacking and stocking drug orders. Only shortlisted applicants will be contacted. Please send resumes to pharmacyemployment@owfg.com. MANITOBA Pharmacist - full-time Advance your pharmacy career with SaveOn-Foods. With over 100+ pharmacies in over 50+ communities across BC and Alberta, and growing in Saskatchewan and Manitoba, our pharmacy team members share a passion for healthy living and quality patient-centered care. Our pharmacy team members are made up of hardworking people who thrive in a demanding and changing environment and are deeply committed to their patients. We offer: friendly, professional and supportive work environments, flexibility, stability and great compensation packages and opportunities to develop your leadership skills, expand your scope of practice and advance your career. Pharmacist positions are available in: Winnipeg and Manitoba. Please send resumes to Livia Chan, regional manager, pharmacy operations at livia_chan@owfg.com. SASKATCHEWAN Pharmacist - full-time
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training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industry’s finest. Please send resumes to pharmacyemployment@owfg.com.
The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We are a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. Thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth,
www.bcpharmacy.ca
Advance your pharmacy career with SaveOn-Foods. With over 100+ pharmacies in over 50+ communities across BC and Alberta, and growing in Saskatchewan and Manitoba, our pharmacy team members share a passion for healthy living and quality patient-centered care. Our pharmacy team members are made up of hardworking people who thrive in a demanding and changing environment and are deeply committed to their patients. We offer: Friendly, professional and supportive work environments, flexibility, stability and great compensation packages, opportunities to develop your leadership skills, expand your scope of practice and advance your career. Pharmacist positions available in: Regina and Yorkton. Please send resumes to Livia Chan, regional manager, pharmacy operations at livia_chan@owfg.com.
BUSINESS OPPORTUNITIES LOWER MAINLAND - PHARMACY FOR SALE The pharmacy for sale is a patient care focused pharmacy, strategically located next to a medical walk-in clinic. This is a truly turnkey opportunity with trained staff and an established clientele in place. It is located in a densely populated area that includes commercial and residential developments. This pharmacy is driven by sales of medically required products, making the revenue of this business recession resistant. As the pharmacist and owner you will be supported by one of Canada’s leading health-care companies. Asking price is $249,000. If you are interested in buying this pharmacy contact Paul Savage at Pacific Business Brokers Inc at psavage@pacificbusinessbrokers.com or call 604.218.3001. SURREY - PHARMACY FOR SALE Are you thinking of buying a pharmacy? We have one for sale in Surrey. The pharmacy is patient care focused and has well-established methadone clientele in place. If you would like to get more information please contact via email only. Contact nancycooper59@hotmail.com. Are you thinking of selling your pharmacy? OVERWAITEA FOOD GROUP may be interested. If you would like more information please contact via email only: pharmacybuyer1@gmail.com.
FOREWEST HOLDINGS partners with local pharmacists and currently own 34 Pharmasave locations. We have been partnering with local pharmacists for more than 30 years. We are currently looking for opportunities to acquire more community pharmacies in BC and Alberta. Please contact us if you are ready to sell all or part of your store. Forewest is also always looking for pharmacists who would like to become part-owners of a pharmacy. Under the Forewest program you become a shareholder of your store and receive your full pro-rata share of its income in addition to your normal salary. We have several ownership opportunities available at this time. Please contact Don Fraser, CEO and president, via phone: 604.788.9315 or email: dfraser@forewest.ca. PEOPLES DRUG MART is an established and proven pharmacy banner that will make your pharmacy business more successful and profitable. We provide outstanding marketing support and services for a low monthly fee. Unlike other banners, we do not charge a percentage of sales. Our belief is that the profits from your hard work should stay in your business. With Peoples, you get the best of both worlds, outstanding support and services, and the ability to maintain your profits. If you are interested in purchasing, selling or opening a new pharmacy, please contact Frank Cucca via email: frankc@pdmstores.com, toll
ASSOCIATION CONTACTS Geraldine Vance *OPLM ,_LJ\[P]L 6ɉJLY 604.269.2860 geraldine.vance@bcpharmacy.ca Cyril Lopez *OPLM 6WLYH[PUN 6ɉJLY 604.269.2869 cyril.lopez@bcpharmacy.ca Derek Desrosiers Director, Pharmacy Practice Support 604.269.2862 derek.desrosiers@bcpharmacy.ca Angie Gaddy Director, Communications 604.269.2863 angie.gaddy@bcpharmacy.ca Vince Lee Manager, Marketing 604.269.2867 vince.lee@bcpharmacy.ca Bryce Wong Manager, Pharmacy Practice Support 604.269.2865 bryce.wong@bcpharmacy.ca Matilda Meyers Manager, Communications 604.269.2866 matilda.meyers@bcpharmacy.ca Nelson Chen Coordinator, Pharmacy Practice Support 604.269.2880 nelson.chen@bcpharmacy.ca
Welcome to the newest members of the BCPhA! Pharmacist (General) members: Leila Abotaleb, Ana Baskalovic, Darren Belik, Laura Beresford, Christopher Chan, Joyce Chan, Adam Chang, Sunny Chau, Joshua Cheung, Lawrence Cheung, Glynis Cynthia Chow, Nelson Lopes Costa, Brian Cregan, Bradley William Cromwell, Leanne Dale, Harpreet Deol, Jaspreet Dhatt, Junah Tan Dinsay, Jennifer Duong, Robert Ford, Julie Gagnon, Vaneet Gill, Nasim Hatami, Stephanie Ho, Lori Holtorf, Romneek Hundal, Shafaq Jaarah, Ayman Jalloul, Jianing Jin, Sukhjeet Kaur Kalar, Da Seul Kim, Emma Kim, Nathan Ko, Aayusha Koirala, Tzu-Yie Koo, Lokesh Kumar, Winnie Lai, Shyrr Magne Lelis, Yuan Ping Liang, Courtney McDougall, Heidi McGregor, Melissa R. Meerkerk, Famida Mirchi, Mehdi Mirzaei, Phillip Scott Nelson, Ikedinobi Ofong, Christina Park, Gurneil Parmar, Dhruval Patel, Jainak Patel, Harpreet Kaur Prihar, Gurpreet K. Purewal, Yolande Reinecke, Siddharth Shah, Willy C. Shum, Sogol Siah Makoon, Esther Suzanne Simmons-Foot, Lisa Stevens, Edmund Tan, Alex Tang, Christina Tang, Suna Meral Taslicay, Gillian Wang, Olivier Wellman-Labadie, Huiyi Wen, William Cheng-Chien Weng, Riley Whyte, Mena Yaft and Ahmed Zaiton.
www.bcpharmacy.ca
Ray Chow Database Administrator, Member & Corporate Services 604.269.2882 ray.chow@bcpharmacy.ca Maria dela Cruz Executive Assistant & Project Coordinator 604.269.2861 maria.delacruz@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864 linda.tinnion@bcpharmacy.ca Starr Rempel Administrative Assistant Member & Corporate Services 604.261.2092 starr.rempel@bcpharmacy.ca 604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy
Nov/Dec 2015
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BC Lions Canucks Car rental Cineplex Hotels around the world PNE and Playland Show tickets and much more!
Affinity BCPhA prescribed member discounts
BONUS: Credits back, accessories, waived fees $150 in cash and credits for new activations* $50 bill credit for upgrades/renewals* A free Gel Skin Case for your smartphone* No activation fee Free shipping in Canada Free SIM card
$60/month*
$70/month*
Est. retail value $95/month
Est. retail value $115/month
• 3GB of data • Unlimited calling from Canada to Canada • Unlimited text, picture and video messaging in Canada • Voicemail 25 • Caller ID, call conference, call waiting
• 5GB of data • Unlimited calling from Canada to Canada • Unlimited calling from Canada to US** • Unlimited text, picture and video messaging in Canada • Voicemail 25 • Visual Voicemail • Caller ID, call conference, call waiting
*A new activation means either transferring from another wireless provider or opening a new account with TELUS with a brand new phone number on a new 2-year contract. The $150 in cash and credits is a $100 bill credit and a $50 Visa cash card. The $50 Visa card is only available while supplies last. Upgrades/renewals means that you are an existing TELUS customer signing up for a new 2-year contract. All bill credits will be applied to your account over a 5-month period if you are eligible. You must be subscribed on our plan for at least 6 months or an additional cancellation fee equivalent to the applicable bonus credits/cash will be applied. The free Gel Skin Case is only available whlie supplies last. **Canada to US calling is not US roaming, it is when you place a call while you are in Canada on the TELUS network to a US phone number.
Save from
Save from
24 - 32%
10 - 45%
Affinity Rx price: $8 per ticket Regular price: up to $11.75 per ticket
Upper bowl tickets starting at as low as $69
Save from
15 - 25% Affinity Rx price: $8.50 per ticket Regular price: up to $11.99 per ticket
Visit our website for more offers! • Car rentals around the world • Financial services • Hotels around the world • Musicals, shows and restaurants • PNE/Playland • Retail products and services • Sporting Events (BC Lions, Whitecaps, Vancouver Giants) • Subscriptions
HOW TO ACCESS THE DEALS Log into www.bcpharmacy.ca and go to the Member Benefits - Affinity Rx section or email vince.lee@bcpharmacy.ca