the arkansas pharmacists summer 2009
DESCRIPTION
The Arkansas Pharmacists Summer 2009TRANSCRIPT
TheArkansasPharmacist
ArkansasPharmacistsAssociation
Jan Hastings, Pharm.D.
President 2009 - 20102009 Summer
Quarterly Edition
The Arkansas Pharmacist2
Board of Directors
Arkansas State Board of Pharmacy
President ................................................Lenora Newsome, P.D., Smackover
Vice President ....................................................Benji Post, P.D., Pine Bluff
Secretary ..............................................................Marilyn Sitzes, P.D., Hope
Member..........................................................Ronnie Norris, P.D., McGehee
Member ..........................................................Steve Bryant, P.D., Batesville
Member ..................................................Justin Boyd, Pharm.D., Fort Smith
Sr. Citizen Public Member ..................................Ross Holiman, Little Rock
Public Member............................................................Larry Ross, Sherwood
Arkansas Association of Health System Pharmacists
President ..............................................Maggie Miller, Pharm.D., Batesville
President Elect............................................Jason Derden, Pharm.D., Benton
Past President ............................................Justin Boyd, Pharm.D., Ft. Smith
Executive Director................................Dennis Moore, Pharm.D., Batesville
Treasurer ..............................................Sharon Vire, Pharm.D., Jacksonville
Secretary ..................................................Paula Price, Pharm.D., Sherwood
Member at Large......................................Brandy Owen, Pharm.D., Conway
Member at Large ............................Jody Smotherman, Pharm.D., Batesville
Member at Large ................................Jennifer Priest, Pharm.D., Little Rock
District 1
Eddie Glover, P.D.
U.S. Compounding
2515 College Ave.
Conway, AR 72034
District 2
Brent Panneck, Pharm.D.
St. Francis Pharmacy
210 Cobean Blvd. #10
Lake City, AR 72437
District 3
Danny Ponder, P.D.
Ponder Economy Drug, Inc.
400 S College St,
Mountain Home, AR 72653
District 4
Laura Beth Martin, Pharm.D.
Family Pharmacy
810 S. Main St.
Hope, AR 71801
District 5
Lynn Crouse, Pharm.D.
Eudora Drug Store
140 S. Main St.
Eudora, AR 71640
District 6
Michael Butler, Pharm.D.
Village Health Mart Drug #1
4440 N. Highway 7
Hot Springs, AR 71909
District 7
John Vinson, Pharm.D.
Area Health Education Center
612 South 12th Street
Fort Smith, Arkansas 72901
District 8
Christy Campbell, P.D.
Lowery Drug Mart #2
123 Central Ave.
Searcy, AR 72143
2008 - 2009 Officers
President ......................................................Jan Hastings, Pharm.D., Benton
President Elect..................................................Mike Smets, P.D., Fort Smith
Vice President............................................Gary Bass, Pharm.D., Little Rock
Past President ........................................Paul Holifield, Pharm.D., Batesville
Area Representatives
Area 1 (Northwest)....................................Gary “Buzz” Garner, P.D., Mena
Area 2 (Northeast) ..............................Dennis Moore, Pharm.D., Batesville
Area 3 (Central) .............................Kenny Harrison, Pharm.D., Little Rock
Area 4 (Southwest/Southeast) ......................Mike Stover, Pharm.D., Rison
Ex-Officio MembersAPA Executive Vice President ................................................................................................................................................ Mark Riley, Pharm.D., Little Rock
Board of Health Member ...................................................................................................................................................................John Page, P.D., Fayetteville
Board of Pharmacy Representative ..............................................................................................................................Charles Campbell, Pharm.D., Little Rock
UAMS College of Pharmacy Representative (Dean)........................................................................................Stephanie Gardner, Pharm.D., Ed.D., Little Rock
Harding College of Pharmacy Representative (Dean) ....................................................................................................Julie Hixson-Wallace, Pharm.D., Searcy
UAMS College of Pharmacy Student Representative............................................................................................................................Collin Ward, Little RockHarding College of Pharmacy Student Representative ..........................................................................................................................Celia Proctor, Little Rock
APA’s Academy of Consultant Pharmacists
President..........................................................Jim Griggs, P.D., Fayetteville
President Elect ..................................................................To Be Announced
APA’s Academy of Compounding Pharmacists
President ..........................................Gary Butler, P.D., Hot Springs Village
President Elect ..................................................................To Be Announced
The Arkansas Pharmacist 3
Contents
Mark S. Riley, Pharm.D.
Executive Vice President
Barbara McMillan
Director of Administrative
Services & Meetings
Scott Pace, Pharm.D.
Associate Executive Vice President
Debra Wolfe
Director of Public Affairs
Helen Hooks
Communications Specialist
Celeste Reid
Administrative Assistant
APA StaffOffice E-mail Address
PharmacistThe Arkansas
Arkansas Pharmacists Association
417 South Victory
Little Rock, AR 72201
501-372-5250
501-372-0546 Fax
The Arkansas Pharmacist (ISSN 0199-3763) is
published quarterly by the Arkansas Pharmacists As-
socia tion, Inc. It is distributed to members as a reg-
ular service paid for through allocation of
membership dues ($5.00). Non-members subscrip-
tion rate is $30.00 annually. Periodical rate postage
paid at Little Rock, AR 72201.
Editorial Staff:
Editor:
Mark Riley, Pharm.D.
Executive Vice President
Art & Design Editor:
Helen Hooks
Communications Specialist
Opinions and statements made by contributors, car-
toonists or columnists do not necessarily reflect the
attitude of the Association, nor is it responsible for
them. All advertisements placed in this publication
are subject to the approval of the APA Executive
Committee.
POSTMASTER:
Send address changes to
The Arkansas Pharmacist
417 South Victory
Little Rock, AR 72201.
From the President......................................................................................4
The Executive’s Perspective ......................................................................5
Compounders Report..................................................................................7
Rx and the Law ..........................................................................................8
Calendar of Events ....................................................................................9
In Memoriam..............................................................................................9
Safety Nets................................................................................................19
Member Classified Advertising................................................................21
AAHP Report ..........................................................................................22
Harding Report ........................................................................................25
2009 Salary Survey ..................................................................................27
Medicaid Alert ..........................................................................................32
APA Board of Directors Minutes..............................................................33
Pace Alliance ............................................................................................6
Pharmacy Quality Commitment ..............................................................20
Arkansas Pharmacy Foundation Legacy ................................................23
Pharmacists Mutual ................................................................................24
Arkansas Pharmacy Support Group ........................................................32
2009 Annual Convention Highlights ........................................................10
Arkansas Healthcare Access Foundation..................................................26
2009 District Meeting Schedule ..............................................................31
Features
Departments
Index to Advertisers
The Arkansas Pharmacist4
From the President
Our profession is a wonderful profession and I LOVE IT! I am very grateful for
the opportunity you have given me to serve as President of our Association for
the next year.
Didn’t we have an excellent convention? What an amazing time of learning, fel-
lowship and networking! We are lucky to have very committed pharmacists in
the state who take time out of their schedules to attend convention and I hope
that you got as much out of it as I did.
As I mentioned in my acceptance speech, I read a book last fall that really hit
home with me. The title is “How Full Is Your Bucket? Positive Strategies for
Work and Life” by Tom Rath and Don Clifton. Let me share an excerpt from the
book:
The book further states that if we don’t have a higher ratio of fills to dippers our
bucket is ‘emptied’ and we are drained. This saps our energy and the result is
that we become negative in our interactions, which causes stress in our jobs and
in our personal relationships. The book even states that people whose bucket is
emptied all the time have more accidents on the job. For pharmacists, this could
translate to medication errors which could put our patients at risk.
I am a positive person and I tend to see my glass as half-full! At this time nation-
ally we are in a discussion about health care reform and pharmacists have much
to offer, not only to our patients but the health care system in general.
Pharmacy has many positives going for us as a profession. We are respected by
our patients and other medical professionals for our wealth of drug knowledge.
The Gallup Poll each year shows that pharmacists are one of the most trusted
professionals. We are accessible to our patients and that access has been proven
to improve patient’s health. They come to us for advice on a myriad of subjects
from ‘what can I take for my headache’ to ‘I’m having some chest pain. Do I need to go to the doctor?’ And we help them every day, in
every way that we can. Pharmacists help their patients.
In addition, pharmacy is doing well financially. (Check out the UAMS Salary Survey in this issue.) Yes, I know we struggle with reim-
bursement issues and figuring out how to get paid for our services is paramount to our success in the future, but overall pharmacists are
doing well financially no matter the practice setting. Salaries are high, benefits are good and life is great. Today’s students only need to
dream their perfect employment situation upon graduation and they can probably make it happen!
I am not blind to the challenges we face- they are real and they will have to be faced. Reimbursement has to be fair and allow us to stay in
business. We need less red-tape from the federal government when it comes to serving our patients. We need respect from employers that
afford us basic human rights, like lunch and bathroom breaks. We need to be able to spend less time as ‘insurance’ agents and more time
with our patients. But if we can somehow put a positive spin on all these issues- even if they don’t go away completely- at least our focus
will be less negative and our patients will benefit from that positivity when we interact with them.
I guess I sound like a cheerleader and sometimes that’s how I feel. This year, when I come into your pharmacy as I travel across our state, I
plan on trying to fill your bucket. I want you to feel better when I leave than when I arrived. When I represent you on the local, state and
national levels I will try my best to present a positive viewpoint. The health care landscape is changing and pharmacy can have a tremen-
dously positive effect. Help me this year to improve our recognition as a health care provider by using positivity to improve our profession,
our patient’s lives and as a results our own lives.
Now, let’s get to work because you and I together can make 2009-2010 the most productive year our Association has ever known. Thank
you!
Jan Hastings, Pharm.D.
Associate Professor
UAMS College of Pharmacy
“Each of us has an invisible bucket. It is constantly emptied or filled, de-
pending on what others say or do to us. When our bucket is full, we feel
great. When it is empty, we feel awful. Each of us also has an invisible
dipper. When we use that dipper to fill other people’s buckets- by saying
or doing things to increase their positive emotions- we also fill our own
bucket. But when we use that dipper to dip from other’s buckets- by say-
ing or doing things that decrease their positive emotions- we diminish our-
selves.”
The Arkansas Pharmacist 5
The Executive’s Perspective
Has it really been 16 years since the last time we had a national debate on health
care? It’s hard to believe, but it was 1993 the last time our federal government
took a serious look at overhauling the health care industry. Back in 1993, the
U.S. spent a total of almost $700 billion a year on health care (among all payers,
private and governmental). This year, the total expenditure is expected to reach
almost $2.5 trillion. If we keep on the current trajectory, by 2016, we will be
spending upwards of $4.3 trillion a year on healthcare. These numbers were
staggering in 1993 and they are even more alarming in 2009. As a country, we
now spend four times more on health care than we do on national defense. On
the whole, the U.S. spends more money than any other industrialized nation on
health care costs (including countries with universal coverage for all citizens),
yet our health outcomes are lagging behind and we still have over 46 million
Americans who are uninsured. The growth in the health care industry is unbe-
lievable and, according to economists, is unsustainable; so the question is not ‘do
we need to change the health care system,’ but ‘how do we best change the health
care system.’ This is the multi-trillion dollar question.
This debate is now underway in Washington, with both the House and Senate
crafting legislation that would extend coverage to most of the 46 million unin-
sured in the U.S. Much of the early focus in the health care debate has centered
on ways to reduce health care expenditures through the management and reduc-
tion of chronic diseases. Pharmacists are featured prominently in early drafts of
legislation that we have reviewed as the providers of medication therapy man-
agement (MTM) services for patients with chronic diseases, such as diabetes and
asthma. However, the big unknown for the pharmacy community is what an out-
patient prescription benefit would look like under any of the current reform
plans.
The APA supports the MTM initiatives that are being proposed, but the APA also
believes that it is vital that any outpatient prescription benefit created under a
health care reform plan should preserve the relationship between the patient and
their local community pharmacist. Specifically, a health care reform plan must
preserve the patient’s right to select the pharmacist of their choice, it must pay
pharmacists fairly for their dispensing and cognitive services, and it should not
incentivize or coerce patients to use mail-order pharmacies. Dr. Mark Riley,
APA’s executive vice president, has taken this message to Washington three times
in the last month, and he remains in constant communication with our representa-
tives and senators as the health care debate moves forward.
Remember, the strength of the APA in every political debate, is the vigor and ve-
racity of our pharmacists. I encourage each of you to stay informed and engaged
as health care reform unfolds this summer. Call and e-mail your congressman
and senators. Ask them to make sure that pharmacists are a vital part of health
care reform.
Scott Pace, Pharm.D.
Associate Executive
Vice President
The Arkansas Pharmacist6
The Arkansas Pharmacist 7
Compounders Report
Fact: The legislative history of the FDC Act shows that Congress
did not intend to interfere with the practice of medicine. Depriving
physicians and patients of access to compounded drugs at a time
when there were no alternatives for most diseases would have
caused an extraordinary disruption with medical practice, and
would have been contrary to Congress’s intent.
Fact: There is absolutely no indication from the legislative history
that anyone in Congress expected or intended for the FDC Act to
turn compounding pharmacists into criminals. FDA says that this
silence shows that Congress did not intend to confer an exemption
upon pharmacists. In fact, the contrary was true no expressed ex-
emption was needed because nobody every contemplated that com-
pounding would be deemed illegal. Compounding had been
practiced since the early colonial days. Under FDA’s theory, Con-
gress fundamentally changed the health care delivery system with-
out anyone in Congress saying, or even hinting, that they had just
abolished compounding as a lawful activity.
Fact: As of 1938, every state permitted compounding. Pharmacists were licensed and trained to compound in every state. These
state laws did not change after passage of the FDC Act. Compounding remained a state-sanctioned, state-licensed activity. Under
FDA’s theory, every state was authorizing pharmacist to and often even requiring pharmacists to commit illegal acts.
Fact: As of 1938, pharmacy schools trained pharmacists to compound. Under FDA’s theory, these schools of pharmacy were teach-
ing and have continued to teach illegal conduct.
Fact: The pharmacy groups were among the strongest supporters of the FDC Act. The President of the American Pharmacists Asso-
ciation (APhA) was persistent in supporting the bill, and praised Congress for passing the law. In fact, pharmacy groups wanted the
law passed because they were already heavily regulated, and their competitors drug manufacturers were not. Under FDA’s theory,
the pharmacy groups were supporting legislation that caused virtually every pharmacist in the United States to become criminals.
Fact: The United States Pharmacopeia (USP) contained monographs for compounded drugs in 1938. In fact, Congress gave the USP
special status under the FDC Act. Under FDA’s theory, the USP monographs for compounded drugs established criteria for illegal
products. In fact, since 1939 the USP has added monographs for new compounded drugs, and more recently, standards for com-
pounding. Under FDA’s theory, each new monograph has represented another formula for another illegal product.
Fact: The United States government has long engaged in the act of compounding. Documents from the early 1940s give military
pharmacists instructions on compounding. The Department of Defense has continued to support and utilize compounding. The U.S.
Army offered formulas for pharmacists to compound drugs from bulk. Under FDA’s theory, every military pharmacist who com-
pounds is breaking federal law. This would create a terrible dilemma for military pharmacists because filling an order to compound a
drug would mean following an illegal order.
Fact: The federal government provides reimbursement coverage for compounded medications. Under FDA’s theory, the U.S. Gov-
ernment is paying for an illegal product.
Fact: The FDA itself did not take the view in 1938 that compounding is illegal. There is no evidence whatsoever that FDA, in the
wake of the passage of the law, told pharmacists that their behavior was illegal. In fact, in subsequent publications for pharmacists
talking about the FDC Act, FDA described multiple provisions of the law, but did not tell pharmacists that one effect of the law was
that compounding had become unlawful.
Pharmacy Compounding Subject to FDA Approval?
The Facts Just Don’t Fit, Part Two
A continuation of the fact that show why the FDA should not have jurisdiction over Compounding Pharmacists.by: Gary Butler, President, APA Compounding Academy
The Arkansas Pharmacist8
Rx and the Law PHARMACY MARKETING GROUP, INC
AND THE LAWBy Don. R. McGuire Jr., R.Ph., J.D.
JURISDICTION
This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association
through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
Because the United States has many different court sys-
tems, the law applied to your case can have a dramatic
impact on the outcome. One important factor in any
legal dispute is the jurisdiction. But what does that
mean? Jurisdiction is defined as the power to hear and
determine a case.1 Courts can have general jurisdiction
or limited jurisdiction.
General jurisdiction courts can hear and decide almost
all types of cases. An example would be the district or
superior court in your county. In a typical situation
where a pharmacist is sued by a patient, this would be
the forum where the case would be heard. However,
there are other situations where this would not be true.
Pharmacies that do a significant amount of business out
of state and have registered as a non-resident pharmacy
with that state’s board of pharmacy are probably subject
to the jurisdiction of that state’s courts. Long Arm
Statutes have been enacted in most states. These laws
allow local courts to have jurisdiction over non-resident
defendants in certain circumstances. If an error occurs
on a prescription sent to another state and the patient is
harmed, the pharmacy could have to defend the case in
that patient’s locale. This can be inconvenient and ex-
pensive for the pharmacy, but it is a potential price the
pharmacy would pay for doing business in that state.
Pharmacists could also end up in another state’s court
due to a contract which they signed. Parties to a contract
may agree to a particular jurisdiction in the contract.
Then in the event of a breach of that contract, the parties
do not have to contest the proper jurisdiction because it
has been agreed upon in advance. Pharmacies may enter
into contracts with many different vendors, each of
which may stipulate to a different jurisdiction. This
could result in the pharmacy defending a breach of con-
tract claim in a far away state.
Courts of limited jurisdiction are limited to hearing only
certain subject matters. Examples of these would be a
small claims court or a probate court. Patients could
bring cases against their pharmacist in small claims
court, but their ultimate recovery would be limited by
the jurisdictional limit of the small claims court.
Interestingly, Federal courts are courts of limited juris-
diction. The structure of the Federal court system paral-
lels the structure of most state court systems. While the
trial courts in state systems are courts of general jurisdic-
tion, the Federal trial courts are not. Federal court juris-
diction is limited to two types of cases. Federal
Question jurisdiction consists of cases involving disputes
arising under the U.S. Constitution or the laws and
treaties of the United States. The other Federal jurisdic-
tion is Diversity jurisdiction. This occurs when the op-
posing parties come from different states. Therefore, it
is possible that the case described above where the phar-
macist sent prescriptions out of state could be brought in
Federal court if the jurisdictional amount was met. Di-
versity jurisdiction requires the amount in controversy to
exceed $75,000. Smaller cases will be relegated to the
state courts even though the opponents are from different
states.
In either a general or a limited jurisdictional court, the
court must have both subject matter and personal juris-
diction. That is, the court must have jurisdiction over
both the subject of the case and over the parties in-
volved. Most often, courts of limited jurisdiction are
limited because of the subject matter of the case. A
court’s jurisdiction over a person results from the per-
son’s physical presence in the state, but jurisdiction over1 Barron’s Law Dictionary Second Edition; 1984; edited by Steven
H. Giftis
The Arkansas Pharmacist 9
Calendar of Events
a person can be expanded by the Long Arm Statutes pre-
viously mentioned.
If a party feels that the court doesn’t have the power to
hear and decide the case, the party should file a motion
asserting the lack of personal or subject matter jurisdic-
tion (or both) with the court. The judge can also rule on
the subject of jurisdiction on their own initiative. If a
court does not have jurisdiction, then the judge should
dismiss the case from that court’s docket. However, the
plaintiff is then free to file the case in the proper court.
A court without jurisdiction over a case cannot issue a
valid decision in that case. Any judgment issued by a
court without proper jurisdiction is void.
In summary, most cases involving pharmacists or phar-
macies will typically be heard in their local courts.
However, certain activities or contractual agreements
could result in the pharmacist dealing with a case in a
distant jurisdiction. The law in that jurisdiction may or
may not have an impact on your case, but nonetheless
the distance involved will make the case more bother-
some.
© Don R. McGuire Jr., R.Ph., J.D., is General Counsel at Pharma-
cists Mutual Insurance Company.
This article discusses general principles of law and risk manage-ment. It is not intended as legal advice. Pharmacists should con-sult their own attorneys and insurance companies for specificadvice. Pharmacists should be familiar with policies and proce-dures of their employers and insurance companies, and act accord-ingly.
September 8 - 30, 2009
Arkansas Pharmacists Association District Meetings
See page 31 of this issue for the complete schedule.
2009
October 8 - 9, 2009
AAHP 43rd Annual Fall Seminar
Holiday Inn Airport
Little Rock, AR
October 17 - 21, 2009
NCPA 111th Annual Convention and Trade Exposition
Ernest N. Morial Convention Center
New Orleans, LA
2010June 24 - 26, 2010
APA Annual Convention and Trade Exposition
Holiday Inn and Fort Smith Convention Center
Fort Smith, AR
Calendar of Events
In Memoriam
Dr. Jamie GaultWard, AR
The Arkansas Pharmacist10
2009 Annual Convention
2009 Convention ContributorsAAHP
AmerisourceBergen
Cardinal Health
Conexus Health
Harding College of Pharmacy
H & H Wholesale
The Health Law Firm
NASPA
Nonprescription Medicines Academy
Pace Alliance
Rx Systems, Inc.
UAMS Alumni Association
UAMS College of Pharmacy
Vemco
ZRT Labs
The Arkansas Pharmacist 11
Convention Golf
Thir
d P
lace
Tea
m
Fir
st P
lace
Tea
m
Fir
st P
lace
Tea
m
Clo
sest
to t
he
Pin
Longes
t D
rive
The Arkansas Pharmacist12
Exhibitors
H & H Wholesale
Liberty Computer Service
Walgreens
RxMaster Pharmacy System
Abbott Diabetes Care
Meda Pharmaceuticals
Merck & Co, Inc.
PBA Health
Roche
Ark. Foundation for Medical Care
U.S. Army Healthcare
HCC
Rexam Prescription Products
Sagent Pharmaceuticals
RPH on the Go
Wyeth
Pharmacists Mutual
Southern Pharmacy Cooperative
Takeda Pharmaceuticals
Retail Designs, Inc.
Member Health, LLC
Cardinal Health
Berry Plastics Corp.
Smith Drug
QS 1
GlaxoSmithKline
Harding University
Dr. Comfort
Morris & Dickson
UAMS College of Pharmacy
McKesson Corp.
Bio-Tech Pharmacal, Inc.
Leadsonlabs
Robert P. Potts & Associates
AmerisourceBergen
Top Rx
Pace Alliance
Arkansas Healthcare Access Foundation
AAHP
Registered Exhibitors
The Arkansas Pharmacist 13
Wholesale Partner Appreciation Karaoke Party
Left: Dr. Jan Hastings opens with the
first song
Below: Ron Trusty of
AmerisourceBergen serenades
Becky Shinabery
Left: APA Past
Presidents join
together to entertain
the crowd
Right: UAMS
students and Dr. Anne
Pace “rock the house”
Left: Brandy Cook with
Smith Drug was
awarded “Best Female
Vocalist”
UAMS men’s trio
As Paul sings his way
“out”, Jan sings
her way “in”Dr. Michael Smith of Russellville
really sounds like Elvis
The Arkansas Pharmacist14
CE SessionsPharmacists from all over Arkansas earned as many as 19
hours of continuing education credit at the 127th Annual APA
Convention at the DoubleTree hotel in downtown Little
Rock, June 11th – 13th. Convention attendees participated in
educational sessions that covered a wide range of topics, such
as: treating hospital-acquired infections, asthma, marketing
your professional services, Arkansas pharmacy law update,
osteoporosis treatment, and appropriate usage of methadone.
In addition, Rebecca Snead, executive vice president of the
National Alliance for State Pharmacy Associations, gave a
fascinating keynote address entitled “Good to
Great: Key Concepts to Transform Your Prac-
tice.” APA would like to extend our thanks to
all of the speakers who helped to make this
year’s convention CE so successful.
The Arkansas Pharmacist 15
An Evening with the Presidents
APA Executive Vive President, Mark
Riley presents the Guy Newcomb
Legislative Leadership Award to
Representative Allen Maxwell
APA President, Paul Holifield presents
the “Pharmacist of the Year” award to
Dr. Tony Bari
Left: Dr. Eddie Dun is honored
with the APA Community
Leadership Award
Joe Baker of Pharmacists Mutual presents
Dr. Sarah Frank with the “Distinguished
Young Pharmacist” award
Above: The APA President’s gavel
is presented to Incomming
President, Jan Hastings
Left: Senator Percy Malone is honored
with the newly established Percy
Malone Public Servic Award
Dr. Paul Holifield is honored as the
Immediate Past President
The Arkansas Pharmacist16
Awards Ceremony
Dr. Mike Scribner is
honored as the UAMS Roche
Preceptor of the Year
Dr. Lenora Newsome honors
fifty year certificate holders
The Honorabel Marion Berry
presents Dr. George Wimberly with
a Lifetime Acheivement Award
UAMS ASP President, Collin
Ward is presented with the
Charles M. West Leadership
Award, sponsored by the Arkansas
Pharmacy FoundationDr. Jan Hastings is presented with the
NCPA Presidents Award
Pat Keller and Dr. Dan Spadaro of
Arkansas Healthcare Access Foundation
honor Dr. Kammy Krissel and Dr. Lisa
Henson with the 2009 Spirit of Service
Award
Right: Dr. Paul
Holifield is
presented with
the APA
Outgoing
Presidents Award
The Arkansas Pharmacist 17
2009 APA Award Winners
Tony Bari, P.D.
Pharmacist of the Year
Eddie Dunn, Pharm.D.
Bowl of Hygeia and
APA Comminity Service Award
Sarah Frank, Pharm.D.
Distinguished Young
Pharmacist
Michael Thames, Pharm.D.
Innovative Pharmacy
Practice Award
Rep. Allen Maxwell
Guy Newcomb Legislative
Leadership Award
Sen. Percy Malone
Percy Malone
Public Service Award
2009 Incoming Board Members
Left to Right: Collin Ward, UAMS ASP President; Dr. Jim Griggs, Consultant Academy President: Dr. Laura Beth Martin, District 4
President; Dr. Eddie Glover, District 1 President; Dr. Brent Panneck, District 2 President; Dr. Gary Bass, Vice President; Dr. Mike Smets,
President Elect; Dr. Jan Hastings, President
Not in Photo: Dr. Kenny Harrison, Area 3 Representitive
The Arkansas Pharmacist18
AP-PAC LuncheonSaturday's convention schedule featured the Arkansas Pharmacists Political Action Committee (AP-PAC) luncheon. Approximately 60 peo-
ple attended. This luncheon is not only a fundraiser for our PAC, but also serves as a venue to dissiminate information about the political land-
scape to APA members who are dedicated to making APA successful in the political arena. Dr. Mark Riley reported on the 87th General
Assembly and on national issues including the Health Care Reform debate. Dr. Randy Shinabery, Chairman of AP-PAC, wants to extend his
sincere appreciation to those who attended this important event, and to all who contribute to our PAC.
The Arkansas Pharmacist 19
Safety Nets
SafetyNets
We present a Safety Net that shows how a thoughtfulpharmacist and a caring physician collaborated to
promote both the comfort and the safety of a particularly vulnerable patient.
A pharmacist from Northwest Arkansas received the original pre-
scription illustrated in Figure One. The prescription was for an 89 y/o
female who had just been discharged from the hospital. The pharma-
cist, who had filled prescriptions for this patient for many years, knew
the patient was being treated for heart failure and coronary artery dis-
ease. Part of her drug regimen included high doses of nitrates for
chest pain. The pharmacist also knew the patient was opioid naïve.
Upon questioning the patient’s caregiver, the pharmacist learned the
patient had been prescribed morphine sulfate for chest pain because ni-
troglycerin was not relieving the chest discomfort as it once did. The
caregiver went on the say the prescriber had instructed the patient to
place the medication under her tongue in a manner similar to sublin-
gual nitroglycerin. After this, the pharmacist handed the prescription
to the pharmacy technician for entry into the computer.
The technician entered the prescription information as Roxanol®
(morphine sulfate) Oral Solution (concentrate) 20 mg/mL, quantity
30 mL, with directions of “place ¼ to ½ teaspoonful under the tongue
every four hours as needed for chest pain”. The same technician filled
the prescription and placed it in line for verification and patient coun-
seling.
As the pharmacist examined the filled prescription for accuracy, he
became increasingly concerned about the morphine sulfate dose to be
administered. If dispensed as written, the frail, opioid naïve, 89 y/o
patient could have potentially received 50 mg of morphine sulfate
every four hours. The pharmacist decided to telephone the prescriber
to verify this extremely high morphine sulfate dose. After listening to
the pharmacist’s concerns, the prescriber stated that he intended to
write directions: Take “¼ to ½ mL every four hours” not “¼ to ½ tea-
spoonful”. After this, a corrected prescription label was affixed to the
medication container and the patient’s caregiver appropriately coun-
seled.
The prescription presented for study shows exactly how the problem
occurred. The first point is actually the order for morphine itself. The
prescription was written for “morphine SL”, which would point many
pharmacists to a tablet. However, the following concentration ex-
pression steers the reader back to the right track. The second point is
the use of “cc” in the concentration statement. The proper abbrevia-
tion is “mL”, a usage specifically indicating a liquid product. The
“cc” as is copied here could be construed correctly (as 1 mL), or as a
loosely-written symbol for fluiddrachm (fl). The third point is the use
of avoirdupois notation (“tsp” for teaspoonful ≈ 5 mL) along with a
fraction. Both sorts of notation are unofficial for prescription use.
The liquid volume must be expressed as mL in this case. The fraction
of a mL must be expressed as a decimal fraction (in this case 0.25 –
0.5 mL). The prescription ends with use of “30 cc”, instead of “30
mL” to indicate the volume to dispense.
The above issues show the importance of adopting metric notation in
prescriptions, and never wavering from its correct use. One can add
the small concern that the Sig is also written in a common, but unof-
ficial, format. The order, according to USP standards, should be writ-
ten out fully as “every four hours as needed to relieve chest pain.”
The use of computer-generated prescriptions – even for CII drugs at
some future time – ought to eliminate the temptation to write shortcut
expressions such as “prn”, which is fairly safe, or “CP”, which can be
interpreted in several ways.
This patient benefits from having a committed caregiver, who helped
the pharmacist at the beginning. The patient also is well served by a
physician who recognizes the need to relieve pain, and who under-
stands that morphine provides life-enhancing value to the patient in the
grip of cardiac pain. We can all hope for a future level of practice in
which the notations of the past can no longer trip up good intentions
for our patients.
Figure One
Dr. Jon Wolfe Dr. Eddie Dunn
The Arkansas Pharmacist20
The Arkansas Pharmacist 21
Member Classified AdvertisingFOR SALE
Kirby Lester counting machine still in box $1,000.00. Contact Cliff
Robertson at North Heights Pharmacy, Texarkana, Arkansas
870-774-3666.
NIGHT PHARMACIST NEEDED
Washington Regional Medical Center
7 days on/ 7 days off. Hospital experience desired not required.
Contact Jonell Hudson, Ramona McLean, or Melissa Williams,
Employment Manager
Washington Regional Medical Center
Office: 479-463-1066
Fax: 479-463-1297
3215 N. North Hills Blvd.
Fayetteville, AR 72703
RELIEF PHARMACIST NEEDED
Relief pharmacist needed for independent pharmacy in Van Buren.
We need someone for approximately 20 hours per week and 1 or 2
Saturdays per month. Please call 479-474-3431 or 479-806-4365 or
email Elizabeth Morrison at [email protected].
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
COLLEGE OF PHARMACY
Job Description
Job Title: Hospital Experiential Director
Rank: Assistant Professor (non-tenture track), Pharmacy Practice
Individual being sought to oversee hospital/institutional component
of UAMS College of Pharmacy Experiential Education Program.
Candidate will also contribute to the college’s service and scholarly
missions. For more information contact:
Schwanda K. Flowers, PharmD.
Assistant Dean for Experiential Education
Assistant Professor, Pharmacy Practice
College of Pharmacy
University of Arkansas for Medical Sciences
501-686-7920 office
PHARMACIST NEEDED IN HOT SPRINGS
Full-time overnight Pharmacist position open at St. Joseph's Mercy
Health Center in Hot Springs. Position scheduled overnight and has
7 days on / 7 days off. We offer a competitive salary, overnight dif-
ferential pay, excellent benefits including vacation (2 periods during
the year with 21 days off in a row), sick leave, medical/dental/vision
insurance, retirement and 401k plan.
Our pharmacy is state-of-the-art with automated dispensing cabinets
and clincial services.
To apply go online at www.saintjosephs.com or contact the Lori
Wozniak in Human Resources at [email protected]
or 501-622-2127.
INDEPENDENT PHARMACIES WANTED
Independent pharmacist interested in purchasing independent
pharmacies in Arkansas. Pharmacies will remain independent after
purchase. Purchaser has solid independent pharmacy background.
If interested in selling your pharmacy, please contact Vance at
870-897-1204 or via e-mail at [email protected].
VOLUNTEER PHARMACISTS NEEDED
Shepherd’s Hope Neighborhood Health Clinic is a ministry of
Fellowship Bible Church and Oak Forrest United Methodist Church
serving uninsured and indigent patients in the South Midtown area
of Little Rock. The Clinic is located at 2404 Tyler Street (behind
Oak Forrest). The hours of operation are 6:00 p.m. to 8:30 p.m.
every Tuesday and Thursday night. Current needs are pharmacists
willing to volunteer every 4 weeks. If you are available to volunteer
and help with this ministry, please contact Bren May at
501-993-0729. Thank you!
IVANRX4U, INC.,
Pharmacist Relief Services, Career Placements.
Relief pharmacists needed - FT or PT. Based in Springfield, MO
and now in Arkansas. Staffing in Missouri, Arkansas, Eastern
Kansas and Oklahoma. We provide relief pharmacists for an
occasional day off, vacations, emergencies -- ALL your staffing
needs. Also seeking pharmacists for full or part-time situations.
Please contact Tracy Byrd, Marketing and Recruiting Director, or
Mike Geeslin, President for information regarding current openings
throughout Arkansas - temporary as well as permanent placements.
Let IvanRx4u help staff your pharmacy, call 417-888-5166. We
welcome your email inquiries, please feel free to contact us at:
[email protected] or [email protected].
PHARMACIST IN CHARGE WANTED
Competitive salary with up to 3 weeks paid vacation and major
medical coverage plus 401K plan. Great schedule - Monday thru
Friday, hours 9:00 a.m. to 6:00 p.m. Contact Alan Tweddell at
870-931-2881 or send resume to:
Country Mart Pharmacy,
208 Lincoln Dr., Fredericktown, MO 63645
Positions to be filled in S.E. Missouri.
PHARMACISTS NEEDED
Full time pharmacists needed in Mena. Competitive salary with
excellent benefit package. No nights or Sundays. Contact Alvin
Groves at 479-619-6343.
RELIEF STAFFING AVAILABLE THROUGH STAFF RPH, INC.
We provide quality pharmacists and technicians that you can trust
for all your staffing needs. Our current service area includes AR,
TX, OK and TN. For more information call Rick Van Zandt at
501-847-5010 or email [email protected].
PHARMACISTS NEEDED
Kroger is looking for part-time pharmacist in Hot Springs. Please
contact Jamie Shoemaker at 501-650-1715 or Julie Dean at
901-765-4204.
PHARMACY FOR SALE
In beautiful North Arkansas. Established in 1974. Family owned
with exceptional reputation in dynamic community. Excellent
schools, recreational & retirement center, golf courses, lakes, rivers,
2.5 hours from Little Rock, AR; Memphis, TN; and Springfield,
MO. Pharmacy is ideally located: a) across from doctor’s complex
and new treatment, diagnostic, and emergency facility, b) next door
to ophthalmologist and optometrist. Contact Mike Sprague at
512-799-5265.
The Arkansas Pharmacist22
AAHP Report
AAHP July 2009 Reportby: Maggie Miller, President
Fall Seminar 2009
The 43rd Annual AAHP Fall Seminar will be held October 8-9, 2009, at the Holiday Inn Little Rock
Airport Conference Center. There will be over 11 hours of live continuing education provided.
Something new for the Fall Seminar this year is a Thursday night CE event that will provide 3 hours of
live CE. You can register for those 3 hours even if you are unable to attend the entire seminar. Please
check our website at www.aahponline.org for more information. Everyone is welcome to attend.
Listserver for AAHP Members
AAHP in conjugation with ASHP is now offering a Listserve for AAHP members. To join the
Listserver, visit our website at www.aahponline.org. Once you subscribe you will have ongoing contact
with other Arkansas pharmacists. This will be a great opportunity to increase communication with our
members and for members to share ideas and experiences with one another.
Residency Task Force
AAHP has created a residency task force aimed at improving communication between students and
residency providers. The task force is currently working on compiling a list of all the residencies
offered in Arkansas along with the respective contact information and a brief description of the
residency. This list will be available on the AAHP website www.aahponline.org once it is completed.
The task force will also do a needs-assessment throughout the state for institutions or retail pharmacies
that have interest in participating in a residency program.
If you are interested in the task force please contact Lanita Shaverd, Pharm.D. by email
Student Chapters
The Harding College of Pharmacy has started a Student Society of Health-System Pharmacy (SSHP).
They recently learned that they received the 2009 American Society of Health-System Pharmacists
(ASHP) Student Society Development Grant Program. The program is intended to encourage the
development of student societies of health-system pharmacy in colleges of pharmacy.
The UAMS College of Pharmacy SSHP chapter has applied to be an ASHP Recognized Student Society.
In order to be recognized, the SSHP chapter has to meet specific criteria set by ASHP. This will reflect
the “triad” relationship between, ASHP, AAHP, and SSHP, as well as provide a direct relationship
between ASHP and SSHP.
Congratulations
AAHP would like to congratulate AAHP members Chris Duty, Pharm.D. at Arkansas Methodist Medical
Center in Paragould for being awarded Employee of the Year and Jody Smotherman, Pharm.D. at White
River Medical Center in Batesville for being awarded Preceptor of the Year from the UAMS COP
graduating class of 2009.
Arkansas Association of Health-System Pharmacists (AAHP)
The Arkansas Pharmacist 25
Harding Report
Harding University College of Pharmacy
Hosts First Annual Pharmacy Camp
Nineteen high school students from ten states attended Pharmacy Camp at
Harding University College of Pharmacy June 21-26. Students from Alabama,
Arkansas, Florida, Illinois, Indiana, Louisiana, Missouri, Oklahoma, Ten-
nessee, and Texas arrived on campus and began their journey into the profes-
sion of pharmacy. This program was funded in part by the Walgreens
Diversity Foundation.
Students began the week by learning about the many career opportunities
available to pharmacists. Camp sessions included pre-
vention and treatment of diabetes and hypertension, train-
ing for the pharmacy technician license, pharmaceutics
and compounding, professional shadowing, many pharmaceutical laboratory ex-
periences including a simulated epidemic and DNA fingerprinting. These hands-
on learning experiences taught by faculty from the College of Pharmacy and
assisted by pharmacy students gave the campers an opportunity to envision them-
selves in this important health care role.
Throughout the week, campers worked in teams as they developed a health
awareness poster which was presented to faculty judges on the last day of the
camp. The poster presentation was included in the camp curriculum to improve
the student’s ability to write in a scholarly manner, improve their oral communi-
cation skills, and to help develop leadership skills.
The week concluded with a banquet where certificates of recognition and awards were given to the stu-
dents who participated.
Casey from Tennessee said, “All of the labs were great. Our counselors were amazing. This camp def-
initely increased my interest in becoming a pharmacist!”
Pharmacy Camp 2010 is tentatively set for June 20-25. Applications will be available on the College
of Pharmacy website after January 1, 2010, and the enrollment will be limited to 30.
Ms. Carol Kell
Director of Admissions
2009 Campers and
Counselors
Dr. Dan Atchley and two campers
discuss DNA fingerprinting.
Campers compounded lip balms
and lollipops.
Dr. Lana Gettman talks to the campers
about treatment of diabetes.
The Arkansas Pharmacist26
Arkansas Healthcare Access Foundation
How would you like to help someone in your
community who is in need?Now you can – and it only takes a few minutes!Arkansas Health Care Access Foundation (AHCAF) is working in conjunction with the Arkansas Pharma-
cists Association and other Arkansas organizations to provide non-emergency medical care to Arkansas’
uninsured and under-privileged population.
As we are all aware, the number of people without medical coverage is growing daily due to loss of jobs,
companies cutting benefits, and our weakening economy. We want to do what we can to see that the low-in-
come, uninsured people of Arkansas get the medical care they need before their health gets to a critical
stage.
What YOU can do to help
All we ask that you sign up with AHCAF as a volunteer pharmacy and fill prescriptions for our clients at no
cost to them. You will then be reimbursed by one of the pharmaceutical manufacturers who work with us,
or AHCAF will do a one-time purchase at cost of prescriptions, which are written by our volunteer doctors.
How it works for the client/patient
A potential client fills out our application at their local DHS or Health Department. Once approved, they
are given a yellow authorization sheet. When they need to see a doctor, they call us and we give them the
name of the doctor at the top of the list.
The patient then calls the doctor’s office for an appointment and identifies themselves as an Arkansas
Health Care Access client. When they visit the doctor’s office for their appointment, they must present their
yellow authorization.
Following the visit, this doctor’s name then goes to the bottom of the referral list.
How it works for the pharmacy
The doctor sees the patient free of charge. If prescriptions are needed, the doctor will attempt to write from
a formulary of name-brand drugs provided by AHCAF. If the patient needs medications that are not on the
list, we have a grant from the Attorney General’s Office with which we can do a one-time purchase of those
medications for the patient, which the pharmacy agrees to provide to us at cost.
Currently, Pfizer, Johnson & Johnson, and Blansett Pharmaceutical Manufacturers donate approximately
$414,822 a year in brand name medication through our volunteer pharmacies. We hope to be adding addi-
tional pharmaceutical manufacturers to our donor list in the near future.
What you get
You get the satisfaction of knowing you helped someone in need by donating just a few minutes of your
time! And you get undying gratitude from Arkansas Health Care Access Foundation for being part of our
program!
To request further information or sign up, please contact Penny Boyer, Public Relations Specialist, at 501-
680-4424 or our office at:
AHCAF
Attn: Penny Boyer
PO Box 56248
Little Rock, AR 72215
Phone: 501-221-3033
Toll Free: 800-950-8233
Fax: 501-221-7977
The Arkansas Pharmacist 27
2009 UAMS Salary Survey
UAMS
College of Pharmacy
2009 Salary Survey Results
Paul O. Gubbins, Pharm.D.
Professor, UAMS College of Pharmacy
In the year since we conducted our last graduate salary survey to evaluate the marketplace and gather data on salaries being offered, the economy has tumbled to lowsmost of us have not seen in our lifetimes. Across the nation, the jobless rate and paymentof unemployment benefits have skyrocketed. Despite the economic downturn, the demand for pharmacists has continued to increase and pharmacist salaries show contin-ued growth.Last year, our survey revealed that our graduates’ average salary was $104,328, a 6.9%increase over the previous year. For 2009 graduates, the trend continued but growth hasslowed somewhat. The average salary this year was $108,896, a 4.4% increase. Increasingsalaries indicate that demand remains high, which we predict will not change in the nearfuture.
About the same percentage of students had loans (2008-88%,2009-85%), but the average loan amount increased by 9% thisyear to $66,066.
Paid vacations, health insurance, and retirement plans, and paid holidays continued to be ranked as the top four most important benefits. Sign on bonuses are also identified as part of the typical benefits package and the average bonus amount increased again this year. The mean bonus reported last yearwas $9,582, while this year it was $13,417.
Thanks to our graduates for providing this information eachyear and to Dr. Paul Gubbins for graciously agreeing to analyzeand summarize the data. Best wishes to our new graduates asthey enter the profession!
~ Dean Stephanie Gardner
Average Salaries Reported byUAMS College of Pharmacy
Graduates since 20002009 $108,896
2008 $104,328
2007 $97,552
2006 $93,555
2005 $88,197
2004 $84,318
2003 $80,271
2002 $76,860
2001 $73,347
2000 $65,279
The Arkansas Pharmacist28
Summary• 91 UAMS COP P4 students completed the survey
• 96% have accepted a position
• 72 % believe the position opportunities available were excellent or good
• Over 50% have accepted a position in a community/retail setting
• 4 students have accepted a residency/fellowship position
• 24% will receive a sign-on bonus
• Approximately 55% will practice pharmacy in central Arkansas
• 13% of the students accepting positions will practice pharmacy out-of state
• Top benefits include: paid vacation, health insurance, retirement, and paid holidays which are
the same as in 2008; 10% of graduates will receive APA membership dues paid by their
employer
• Average salary for a pharmacist (not residency) position is $108,896; an increase of $4,568
(4.4% increase) from 2008
• Approximately 13% plan to own a pharmacy in the future
• Approximately 85% have student loans, with an average amount of $66,066
Table 1: Demographics
Variable
Ages No. Students (%)
18-21 years old
22-25 years old
26-30 years old
31-35 years old
36 or greater
0 (0%)
48 (52.7%)
42 (46.2%)
0 (0%)
1 (1.1%)
Gender
Male
Female
32 (35%)
59 (65%)
Marital Status
Single-no children
Single, with children
Married-no children
Married-with children
50 (55%)
3 (3%)
30 (33%)
8 (9%)
Plan to Own Pharmacy in Future
Yes
No
12 (13%)
79 (87%)
The Arkansas Pharmacist 29
Table 2: Position Information*
Accepted a position
Yes
No
87 (96%)
4 (4%)
Position requires moving to different city/state
Yes
No
22 (25%)
62 (71%)
Previous employment with employer*
Yes, as intern
Yes, during rotations
No, have no working relationship
44 (51%)
17 (20%)
23 (26%)
Ranking of Position Opportunities
Excellent-found exact position wanted
Good-satisfied with opportunities
Fair-wish there were more opportunities
Poor-few opportunities
Very poor-trouble finding position
23 (27%)
38 (45%)
20 (24%)
4 (5%)
0 (0%)
Table 3: Salary Information by Position Environment
Position Environment# Students
N=85Mean Salary
Per Year Salary Range
Mean Number ofHours Worked
Per WeekIndependent 12 $108,663 $88,400-$125,000 39
Chain (e.g., USA Drug) 16 $113,735 $104,000 - $124,000 40
Mass Market (e.g., Wal-Mart) 20 $117,588 $105,000 - $129,900 40
SuperMarket (e.g., Kroger) 6 $119,500 $111,000-$150,000 40
Hospital Pharmacy (includes outpa-
tient pharmacies in institutions, VA
system)
23 $95,467 $86,000 - $110,240 39
Nuclear Pharmacy 2 $110,250 -
Residency/Fellowship 4 $40,750 $40,000 - $43,000 42.5
Graduate School (e.g., MS or PhD
program)- - -
Sales - - - -
Home Health - - - -
Other 2 $82,000 - -
For all students except those
completing residencies80 $108,896 $86,000- $150,000 40
The Arkansas Pharmacist30
Table 4: Salary Information by Location in State*
Location Number of Students Locating in theArea (n=79) Mean Salary Per Year
Northwest AR (Fayetteville) 7 $111,228
North Central AR (Mountain Home) 4 $100,356
Northeast AR (Jonesboro)* 3 $106,667
West Central AR (Russellville) 2 -
Western Arkansas (Fort Smith) 2 -
Central AR (Little Rock)* 45 $104,000
East Central AR (Forrest City) 2 -
Southeast AR (Monticello area) 3 $111,360
Southwest AR (Hope) 1 -
Out of State 10 $112,370
*does not include residency positions
Table 5: Benefits
Rank Benefit1 Paid Vacation (mean number of days = 13)
2 Health Insurance
3 Retirement Plan
4 Paid Holidays (mean number of paid holidays = 7)
5 Profit Sharing
6 Paid Liability Insurance
7 CE Expenses Paid by Employer
8 Paid License Fees
9 Sign-on Bonus (mean bonus = $13,417)
10 Other Bonuses (e.g., tuition, bonus based on profit)
11Shift Differential
Moving Expenses
13 Arkansas Pharmacist Association Dues Paid by Employer
14 Other*
*other includes gas/mileage, disability/dental insurance, overtime, parking, childcare, etc.
The Arkansas Pharmacist 31
APA District Meetings
DATE DISTRICT TIME LOCATION PRESIDENT PHONE NO.
Sept. 8
Tuesday2 7:00pm
Jonesboro
St. Bernard’s Auditorium Brent Panneck 870-237-8215
Sept. 9
Wednesday2 7:00pm
Forrest City
Forrest City Country ClubBrent Panneck 870-237-8215
Sept.10
Thursday8 7:00pm
Batesville
Lyon College Ed. Dining HallChristy Campbell 501-268-1900
Sept. 14
Monday6 7:00pm
Russellville
Arkansas Tech University
(East Banquet Room)
Micheal Butler 501-922-0777
Sept. 15
Tuesday7 7:00pm
Fort Smith
Hardscrabble Country ClubJohn Vinson 479-424-3166
Sept. 16
Wednesday3 7:00pm
Rogers
Embassy SuitesDanny Ponder 870-425-5145
Sept. 17
Thursday3 7:00pm
Mt. Home
Big Creek Golf and Country ClubDanny Ponder 870-425-5145
Sept. 21
Monday4 7:00pm
Texarkana
Park Place RestaurantLaura Beth Martin 870-777-2263
Sept. 22
Tuesday4 7:00pm
Camden
Camden Country ClubLaura Beth Martin 870-777-2263
Sept. 23
Wednesday5 7:00pm
Monticello
Monticello Country ClubLynn Crouse 870-355-2046
Sept. 24
Thursday5 7:00pm
Pine Bluff
Pine Bluff Country ClubLynn Crouse 870-355-2046
Sept. 29
Tuesday6 7:00pm
Hot Springs
Clarion Resort on the LakeMichael Butler 501-922-0777
Sept. 30
Wednesday1 7:00pm
Little Rock
Chenal Country Club Eddie Glover 501-327-1222
2009 District Meetings Schedule
The use of antipsychotic medications to treat children has increased over the past few years. Unfortunately, there is very limited clinical
data regarding the safety and effectiveness of these medications in children under 12 years of age.
The Arkansas Department of Human Services found that in fiscal year 2008, 11,404 Medicaid-covered children took atypical antipsychotics
for more than 30 days, including 893 children under the age of 5 and 5,602 children between the ages of 6 and 12. Many preschoolers in
Arkansas are prescribed atypical antipsychotics as an initial treatment intervention, often without diagnosis for a disorder for which such
medications are first-line treatment.
Working with psychiatrists and pharmacists, the Arkansas Department of Human Services has developed a plan to monitor and limit the un-
necessary prescribing of antipsychotics to vulnerable patients. Beginning in July 2009, DHS will require prior authorization for prescrip-
tions of all antipsychotics for children under the age of 5. In addition, dose limits for the oral atypical antipsychotic agents, clonidine, and
guanfacine will be put in place for children younger than 18 (see chart). Higher doses will require prior authorization at the time of sale.
The Medicaid Prescription Program point-of-sale (POS) system will also identify therapeutic duplications of antipsychotic drugs with over-
lapping days’ supply and will reject the in-process antipsychotic drug claims. Division of Behavioral Health Services child psychiatrists will
serve as consultants to the College of Pharmacy Call Center staff to facilitate rational prescribing and minimize disruption in treatment. In
addition, DHS is actively planning new efforts to expand the availability of psychosocial services in communities throughout the state.
All calls about prior authorization for all antipsychotic agents, clonidine and guanfacine for recipients under 18 years old should be directed
to the PDL PA Call Center, 1-866-250-2518 or 501-526-4200 (fax 501-526-4188). To minimize response time, the PDL PA Call Center may
need a copy of the patient’s medical records and progress
notes.
The complete dosage chart and explanation of the therapeutic
duplication criteria may be reviewed on the Medicaid Web
site, www.medicaid.state.ar.us, under Provider Information,
then Prescription Drug Information.
This link
https://www.medicaid.state.ar.us/Download/provider/pharm/PM090427.doc
will provide you with the memorandum mailed in April to providers. The sub-
ject of the memorandum is as follows:
Effective July 7, 2009: Antipsychotics oral agents, clonidine, & guanfacine
therapeutic duplication edits, age edits, and quantity and dose edits in recipi-
ents < 18 years of age; manual review on all antipsychotic agents for recipi-
ents < 5 years of age; clinical edits on oral dissolvable tablets or liquids for
atypical antipsychotics for all ages; quantity and dose edits for the following
drugs: chloral hydrate liquid and capsules, Transderm Scōp® patch, Bac-
troban® nasal oint, Tyzine® nasal spray and drops; manual review for
Milipred®; Effective July 21, 2009: ADD/ADHD medications listed for pre-
ferred and non-preferred status, addition of preferred medications, Strattera® clinical edits and manual review for recipients < 5 years of
age; Effective August 11, 2009: Asthma medications listed for preferred and non-preferred status, edits for select non-preferred agents used
in asthma; Singulair® clinical edits for asthma monotherapy or allergic rhinitis; Effective immediately: to prevent billing errors, dose and
quantity edits on Moxatag ER 775 mg & Proquin XR 500 mg.
The Arkansas Pharmacist32
Medicaid Alert
Summary of oral atypical antipsychotic maximum daily doses for
age categories for recipients < 18 years of age
Drug <5y/o** 5-12y/o 13-17y/o
Abilify® 5 mg daily 30 mg daily 45 mg daily
Risperdal® 4 mg daily 6 mg daily 8 mg daily
Invega® 3 mg daily 6 mg daily 9 mg daily
Seroquel® 150 mg daily 600 mg daily 1000 mg daily
Geodon® 40 mg daily 80 mg daily 160 mg daily
Zyprexa® 10mg daily 20mg daily 30mg daily
**PA required through manual review for recipients < 5 years of age.
Summary of oral clonidine and guanfacine maximum daily
doses for recipients < 18 years of age
Drug NameAvailable
Strengths
Max Daily Dose
EditMax Daily dose
Clonidine tablets 0.1 mg, 0.2 mg 2 per day 0.4 mg
Clonidine tablets 0.3 mg 1 per day 0.4 mg
Guanfacine tablets 1 mg, 2 mg 2 per day 4.0 mg
The Arkansas Pharmacist 33
APA Board of Directors Minutes
Minutes
Arkansas Pharmacists Association Board of Directors
March 22, 2009
Hosto Center – Little Rock
Members Guests and Staff
Dr. Paul Holifield-presiding Dr. Gary Bass Dr. Richard Hanry - treasurer
Dr. Maggie Miller Dr. Dennis Moore Harold Simpson – legal counsel
Dr. Brandon Cooper Dr. John Page Dr. Scott Pace
Dr. Danny Ponder Dr. John Vinson Barbara McMillan
Dr. Buzz Garner Dr. Stephanie Gardner
Dr. Kenny Harrison Dr. Mark Riley
Dr. Jan Hastings Dr. Cliff Robertson
Dr. Stephanie Goodart-O’Neal Dr. Mike Smets
Dr. Lynn Crouse Ms. Celia Proctor
Dr. Mike Stover Ms. Collin Ward
Dr. Muncy Zuber
CONSENT ITEMS
President Paul Holifield called the meeting to order at 9:40 a.m.
President Holifield asked Dr. Richard Hanry to lead the invocation.
Dr. Buzz Garner made a motion to approve minutes. The motion passed.
President Holifield introduced Ms. Collin Ward and Ms. Celia Proctor as new board members from the UAMS and
Harding Colleges of Pharmacy, respectively.
DISCUSSION ITEMS
Upcoming Events and CE Meetings
CE at the Races was held on Friday, March 20th at Oaklawn. The event was a great success.
The 2009 APA Convention will take place at the DoubleTree Hotel June 11-13th in downtown Little Rock. There
will be 19.5 hours of live CE at the convention.
Arkansas Mission of Mercy free pharmacy and dental clinic will take place May 8th & 9th at the Holiday Inn NW
located in Springdale, AR. Pharmacist volunteers are needed for this event.
Arkansas State Board of Pharmacy Report
Dr. Mark Riley gave a brief update on recent happenings with the State Board of Pharmacy. An update on faxed
prescriptions was given, and language is being changed.
Arkansas Academy of Health-System Pharmacists (AAHP) Report
Dr. Maggie Miller reported that the AAHP Fall Seminar will take place in Little Rock at the Holiday Inn – Airport in
October. AAHP is working with Harding to establish a student chapter. In addition, AAHP is conducting a survey
on residencies.
The Arkansas Pharmacist34
Arkansas Academy of Consultant Pharmacists
Dr. Muncy Zuber reported that Dr. Hasam Kamel will be presenting the CE session for the Consultant Academy at
the APA Annual Convention in June.
UAMS College of Pharmacy Report
Dr. Stephanie Gardner reported that the new UAMS Hospital is now open and is phenomenal. Dr. Gardner reported
that UAMS will soon get a new chancellor, Dr. Dan Rahn. Dr. Rahn is currently at the Medical College of Georgia.
Dr. Gardner also reported that the college is currently processing applications and conducting interviews for fall
2009 admission.
Dr. Paul Holifield then opened a discussion on the UAMS Pharmacy Camp. The Camp is open to rising high school
juniors and seniors. Dr. Holifield suggested to the Board that the Association should consider sponsoring the camp.
Harding College of Pharmacy
Ms. Celia Proctor reported that Harding just completed their most recent ACPE site visit.
Arkansas Board of Health Report
Dr. John Page reported that because the cigarette tax passed that the state now has the money for a trauma system.
Dr. Page discussed the different designation levels that hospitals may choose if they want to be involved in the
trauma system.
State Legislation Update
Dr. Mark Riley reported on the 87th General Assembly. He reported that the PBM Bill will soon become law, and it
will apply to all state-funded prescription programs. The Bill has been hard fought, but Dr. Riley thanked all of the
pharmacists for their efforts.
Dr. Riley next discussed the possibilities of running legislation in the future that would codify the State Board of
Pharmacy appointment agreement that has been in place for years.
Community Health Centers was the next topic of discussion. Some of the tobacco tax dollars were allocated to these
centers. Pharmacy is concerned because many of the community health centers are obtaining pharmacy licenses and
are competing with privately owned pharmacies. Dr. Riley is working on language to encourage community health
centers to work with locally available pharmacies.
Dr. Riley reported that SB120, an update to the Arkansas Pharmacy Practice Act, passed the legislature. The new
changes cleaned up language for the State Board and also allows for broader collaborative practice between pharma-
cists and physicians.
Medical Assistants
Dr. Scott Pace reported that a bill passed the legislature that allows non-licensed, non-trained medical staff to be del-
egated the ability to administer medications. This includes the delegation of ability to administer immunizations. In
light of this, the APA should encourage our Board of pharmacy to lessen the rigid training requirements that pharma-
cists must obtain before being able to administer medications.
Federal Legislation
Dr. Pace reported that HR 616 and S511 have been filed that would exempt pharmacists from the Federal DME ac-
creditation requirements. These bills are still pending, and as it currently exists, the accreditation is still schedule to
go into effect on September 30, 2009.
The Arkansas Pharmacist 35
CCRx
Dr. Riley reported that CCRx has fundamentally changed since their purchase by Universal American. Dr. Riley be-
lieves that the Board should revisit the original endorsement of the CCRx program. Dr. Holifield recommends that
APA monitor the CCRx program over the next three months and to reconsider removing the endorsement at the June
board meeting.
Misc.
Dr. Riley reported that APhA wants the APA to buy a paver in their stone walkway at their new building. The paver
would cost $5000. The Board tabled this issue at this time.
Dr. Kenny Harrison asked if there is a way to consider lowering retired members’ annual dues.
ACTION ITEMS
APA Elections
Dr. Riley reported on the nominations that have been received thus far for APA Officers and Annual Awards, such as
“pharmacist of the year”. The executive committee will make the award selections after the nominations close.
Financial Report
Dr. Richard Hanry reported on the financials of the Association, and he stated that the merger of the APA Services
Company into the Association is complete and makes managing the Association’s financial affairs much easier.
Dr. Jan Hastings made a motion to accept the financials as presented. It was seconded and passed.
Misc.
President Holifield then opened up discussion on the UAMS Pharmacy Camp. Dr. Robertson made a motion to sup-
port the Pharmacy Camp with $15,000 sponsorship, with any additional funding at the discretion of the executive
committee. Motion was seconded by Dr. Danny Ponder. Motion passed.
CCRx
Dr. Buzz Garner made a motion to cease APA’s support of CCRx. Motion was seconded. Discussion occurred.
Dr. Jan Hastings made a motion to table the previous motion to cease APA’s support of CCRx, pending Dr. Riley’s
upcoming meeting with Mike Bukach from CCRx. Motion seconded & passed.
Adjournment
A motion was made and seconded to adjourn the meeting at 1:47p.m. The motion passed.
The Arkansas Pharmacy Foundation is pleased to announce the beginning of our Pharmacy Walkway of Honor. The walkway will be
composed of bricks on which the names of pharmacists, pharmacies, and other business-related companies (i.e. wholesale, drug, design,
computer, etc.) can be placed to show appreciation for the profession of pharmacy. The walkway will be located outside the entrance to
the Lester E. Hosto Conference Center. The Foundation will place the first brick in memory of Dr. Lester Hosto.
Please use the form below to personalize your brick(s). Make copies as necessary. Print the name and other information as you would
like it to appear on your brick. You have a maximum of three lines per brick with up to 18 characters per line, including spaces.
Please use the ampersand (&) instead of “and” and omit periods.
Name: ___________________________________________________________________
Address __________________________________________________________________
City ______________________ State ____________________ Zip _________________
Phone (_______)___________________________________________________________
I wish to order ________________ bricks @ $125.00 each for a total of $ ______________
Method of Payment
_____ Check, payable to APF
_____ Visa ______ Mastercard _____ Discover _____American Express
Credit card number _____________________________________________________
Expiration Date _______________ Signature ____________________________________________
Your support is sincerely appreciated. Please mail to APF, 417 South Victory, Little Rock, AR 72201 or fax to
501-372-0546 or visit www.arpharmacists.org to order.
Proceeds will help provide funds to sponsor, support and conduct educational programs, thereby promoting the Foundation to effi-
ciently perform the objectives for which it is organized.
Personalize your brick here.
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Show your pride on the