2015-02 georgia pharmacy

Lost in Translation

Inside:FLu shoT deniers

AeTnA And MedicAre

TechniciAn crAckdown

How electronic prescriptions are causing more errors— and wHat you can do

February/March 2015

Coverage You Need.Service You Deserve.A Price You Can Afford.

SHOW YOUR SUPPORT! Attend this year’s Aip Fall Meetingplease fill out and fax this form to (404) 237-8435)

Member’s Name: Nickname:

pharmacy Name:

Address:

E-mail Address: (plEAsE priNt)

Will you be joining us for lunch? (12-1pm) q Yes q No # of additional staff/Guests:

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Sunday, March 15, 2015 • Macon Marriott & Centreplex Macon, GA

AIP SPRIng MeeTIng

AgendA 8-9am Registration & continental breakfast

9-11am Measuring Pharmacy Performance: Who’s doing the measuring and what does that mean to me?

11-12am Network with partners

12-1pm Lunch

1-3pm High Performance Networks— Putting the Pieces Together

3-4pm Legislative Update

• CE programs on “star ratings”• Medicaid and legislative Updates• Network with Colleagues• Meet with partners

CoNtiNENtAl BrEAkFAst& lUNCh providEd!

GP.AIP.HouseAd.indd 1 1/19/15 7:30 PM

Georgia Pharmacy 1February/March 2015

president’s note

If you were born in the pre-vious century like me, some-times it’s hard to believe that we’re in the year 2015. But here we are.

Let me catch you up on some of the things going on as we start this new year.

The big news. We have our first pharmacist/owner in the

U.S. Congress, and it’s our own Buddy Carter. GPhA — along with NCPA and APhA — spon-

sored a reception the evening of his swearing-in, and Buddy was appreciative of our support throughout his campaign. It’s nice to have some-one in Washington who really understands our profession, and we are looking forward to great things from him.

The home front. We need your help to achieve success with our legislative priorities this year. We have two important bills in the legislature: one to expand the immunizations you’re allowed to give without a prescription, and the other to make MAC pricing fairer and more transparent.

If you aren’t up-to-speed on those issues, you should visit GPhA.org/spreadtheword where you can see three great videos GPhA has produced, featuring three of our members explaining how MAC pricing affects patient care. You’ll also find one-page talking points for both our issues, and

tips for talking to your legislators about them. Day at the Dome. Make a point to attend our

annual Legislative Breakfast and legislative visits on Thursday, February 5 at the Gold Dome in Atlanta. We have a great day of advocacy planned, and we’re expecting more than 500 pharmacists and students to help us flex our political muscles. Student pharmacists will be conducting health screenings in the Capitol, representing GPhA.

Nominations. If you haven’t nominated some-one for one of GPhA’s prestigious awards for 2015, including the Bowl of Hygeia, I hope you’ll take the time to do that. You’ll find all the information at GPhA.org/2015awards.

And if you’re interested in running for GPhA second vice president, remember to contact your region president soon and let him or her know so your name can be forwarded to the Nominating Committee.

I hope to see you at Day at the Dome, and maybe at the APhA annual meeting in San Diego in March!

bobby moody

Spreading the word

It’S nIce to have Someone In WaShIngton Who underStandS our profeSSIon

43%of Americans say they believe the flu

vaccine causes the flu

WAKEUPCALL

60,307 cases of flu in the U.S.*

45children have died*

of women surveyed did not intend to

get a flu shot

The 2014 vaccine is HALF AS EFFECTIVE as usual thanks to virus mutation

49%

*From Sept. 28, 2014 to Jan. 10, 2015

IN THE 2014-15 FLU SEASON…

pharm facts

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6

6 newsNews, trends, and what’s hap-pening in the pharmacy worldCaremark tobacco surcharges, GDNA crackdown, metric-ified kids’ meds, and of course the flu, the flu, the flu.

12 pharmacy businessStories, tips, and news for the independent pharmacistThe Aetna/Medicare issue, Medicaid overpayments, big changes to Part D, and more.

15association notesHow GPhA is working for youA (Georgia!) pharmacist in Con-gress, Board of Pharmacy changes, spreading the (legislative) word, and more.

24PharmPACInvestors in the future of the pharmacy profession in Georgia

28calendarUpcoming events and other dates for Georgia pharmacists

29contact usWe’re your association: Reach out to us!

30postscript Last-page commentary from our editorAn eagle eye is one way to reduce prescription errors — just not a very good one.

Electronic prescriptions were supposed to help cut down on medical errors, but that turns out not to be the case. What went wrong? Who’s to blame? And what can you do to help fix the problem? Answers inside.

18 cover Story: LoSt In tranSLatIon

contents

8

15

Georgia Pharmacy 4 February/March 2015

calendar

february 52015 Pharmacy Day at the Dome AtlantaThis is it: the biggest day of the year for our legislative efforts. Hundreds of Georgia pharmacy professionals will descend upon the state capitol — the Gold Dome — to meet with their legislators about the issues critical to our profession. Be there.Get details at GPhA.org/dayatthedome.

Get together with fellow pharmacists and pharmacy professionals from your neck of the woods for an evening of good food, great conversation, and a chance to hear the latest information from one of GPhA’s industry partners.

Keep an eye on your inbox (or GPhABuzz.com) for the details as the dates approach.Locations TBD

Tuesday aPril 14Region 3 - ColumbusRegion 7 - AcworthRegion 8 - Waycross

Thursday aPril 16Region 1 - SavannahRegion 4 - FayettevilleRegion 12 - Dublin

Tuesday aPril 28Region 6 - MaconRegion 10 - AthensRegion 11 - Augusta

Thursday aPril 30Region 2 - ValdostaRegion 5 - AtlantaRegion 9 - Jasper

SprIng regIon meetIngS

March 15AIP Spring MeetingMacon Centreplex, MaconGeorgia’s independent pharmacists meet for a day of news updates, continuing education, and vendor exhibits — not to mention a great chance to connect with your peers from across the state.

March 27-30APhA Annual Meeting 2015San Diego

May 12-13NCPA Legislative ConferenceHilton Crystal City at Reagan National Airport, Arlington, Va.

July 8, 12GPhA Board of Directors meetings at the GPhA ConventionOmni Amelia Island Plantation Resort, Amelia Island, Fla.

140th GPhA Convention Omni Amelia Island Plantation Resort, Amelia Island, Fla.

You won’t want to miss the biggest event of the year for Georgia pharmacists: GPhA’s annual convention. We’ll offer hours of continuing education, lots of family fun, a chance to mingle with hundreds of your fellow pharmacists, pharmacy technicians, pharmacy students from across the state, and an exhibit hall full of top-notch industry vendors.

July 9-12


It’s in my job description. Heck, it is my job descrip-tion: Keep all the frogs in the wheelbarrow.

It’s harder than it looks. Frogs can be, well... jumpy, you know. If even a few of them leap out and go hopping hither and thither, croaking indiscriminately,

you’ll have a mess that will only distract or an-noy others.

But keep all those frogs in the wheelbarrow, different though they be from one another: tree frogs and wood frogs and bullfrogs and even a toad or two, and somehow set them to croaking together… and you can raise quite a racket. You can command attention, make your point, get things done.

When it comes to advocacy, in particular — the work GPhA does in the Georgia Legislature to protect your pharmacy practice and business — success depends on us keeping all of our metaphorical frogs in the wheelbarrow, croak-ing in unison.

If we mean to get our priority legislation passed,

we have to stick together. We have to speak with one voice, regardless of practice setting or person-al opinion. We have to understand that the GPhA Board of Directors did its due diligence, and the

priority issues it has approved are the right issues, and that we’ve prepared our advocacy strategies with care so that our priority bills pass. We have to support both priority bills, even if you may feel more strongly about one than the other.

United front.The legislature is back in session and a lot is at

stake. It’s all-frogs-on-deck time (as it were). If you’re with us, let me hear you ribbet.

Scott Brunner is GPhA’s executive vice president and purveyor of tortured metaphors.

sCott brunner

prescript

Georgia Pharmacy magazine is the official publication of the Georgia Pharmacy Association.

Unless otherwise noted, the entire contents of this publication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. Direct any questions to the editor at [email protected].

President Bobby Moody

Chair of the Board Pam Marquess

President-Elect Tommy Whitworth

First Vice President Lance Boles

Second Vice President Liza Chapman

Executive Vice President & CEO Scott Brunner, CAE [email protected]

Vice President of Communication and Engagement Phillip Ratliff [email protected]

Director of Communication / Editor Andrew Kantor [email protected]

Art Director Carole Erger-Fass

Sales Coordinator (Advertising) Katie Bodiford [email protected]

ADVERTISING All advertising inquiries should be directed to Katie Bodiford at [email protected] or (770) 252-1284. Media kit and rates available upon request.

SUBSCRIPTIONS Georgia Pharmacy is distributed as a regular membership service, paid for with membership dues. Non-members can subscribe for $50 per year domestic or $65 per year international. Single issues are $10 issue domestic and $20 international. Practicing Georgia pharmacists who are not members of GPhA are not eligible for subscriptions.

POSTALGeorgia Pharmacy (ISSN 1075-6965) is published bi-monthly by the GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324. Periodicals postage paid at Atlanta, GA and at additional mailing offices. POSTMASTER: Send address changes to Georgia Pharmacy magazine, 50 Lenox Pointe NE, Atlanta, GA 30324.

Keeping the frogs in the wheelbarrow

If We mean to get our prIorIty legISlatIon paSSed, We have to StIck together. We have to SpeaK wIth one voIce.


Anyone with a child in school knows how quickly the disease of the month spreads in class… and in the neighborhood. How many times have you nodded sagely at a parent picking up a bottle of Mucinex and said, “Yeah, it’s going around”?

It turns out that it can work the other way, too. If enough kids in a community are vaccinated against the flu, the rate of infection of the entire neighborhood drops — dra-matically.

A University of Florida study found

that when half of school-aged chil-dren in Alachua County, Fla., received seasonal flu vaccinations, the flu rate in the entire age group fell 79 percent.

So 50 percent vaccination means a 79 percent drop in the flu.

Further, it found that even kids not yet in school felt the effect: “[T]he flu rate among children aged 4 and younger decreased by 89 percent, even though they weren’t included in the vaccination program.”

So add that to the litany of reasons to get vaccinated this year.

Flu shots For school kids make entire communities less sick

Georgia joins the rest of the nation suffering from the 2014-2015 flu epidemic.

According to the CDC, there have been more than 13,000 reported cases of the flu in Region 4 (which includes Alabama, Florida, Georgia, Kentucky, Missis-sippi, and the Carolinas), with 13 children dying of the flu.

The Georgia Department of Community Health reports more than 1,000 people have been hos-pitalized this season so far, with at least 20 confirmed flu deaths.

The good news is that the flu appears to have peaked at the end of December... although the season is far from over.

GeorGia hit hard by the flu

news

save the

date

Mark your calendar: July 9 – 12It’s the 140th GPhA Convention at the Omni Amelia Island Plantation Resort on beautiful Amelia Island, Fla.

This is GPhA’s flagship event and the place to see and be seen in 2015 (for Georgia pharmacy professionals, anyway) .

There are hours of continuing education classes, a resort’s worth of family fun, and the best chance all year to connect and reconnect with hundreds of your fellow pharmacists, pharmacy technicians, and pharmacy students from across the state (not to mention the exhibit hall and the great food).

Watch your inbox for more information!!


More than 40 percent of Amer-icans actually believe that the flu vaccine gives you the flu.

If that’s not bad enough, get this: A new study found that the ignorance runs deeper. The more facts you give vaccine deniers, the less likely they are to get vaccinated.

In a study published in the journal Vaccine, researchers at Dartmouth and the University of Exeter found that, after they were told that the flu vaccine doesn’t give you the flu, sub-

jects said A) they now believed that the vaccine was safe, but B) they still weren’t going to get a shot.

Their excuse: They were now afraid of the side effects.

Apparently the issue may never have been about safety, but people’s general negative attitude about getting vacci-nated. So they create excuses. And when one misconception is challenged, they come up with another reason.

Flu vaccine deniers: Even giving them good information doesn’t help

the FluBy thE

numBErs

49%

also said the flu was the most serious vaccine-preventable threat to their health.

of u.s. adult women ages 26 to 74 said they believed the flu vaccine causes the flu, according to a survey by Nfid and rite aid.

44%

Misinformation is helping make

this flu season even worse.

read more @gphabuzz.com

The Affordable Care Act (ACA) requires physicians and other eli-gible practitioners who order, pre-scribe and refer items or services for Medicaid beneficiaries to be enrolled in the Georgia Medicaid Program. On October 1, 2013, phar-macy claims began being denyied if the prescribing provider was not enrolled as an OPR or rendering provider with DCH. On June 1, 2014, service claims began denying claims if the ordering, referring or prescribing provider was not en-rolled in Georgia Medicaid and the OPR provider’s NPI number was not submitted on the claim.

Effective January 1, 2015, medical residents may obtain an NPI and Medicaid ID in order to prescribe

outpatient prescription medications. Pharmacies may submit the NPI of the medical resident who has signed the prescription on the pharmacy claim in the prescriber ID field.

Alternatively, facilities may con-tinue to use a prescription that is countersigned by the attending or supervising physician if they do not wish to enroll their residents and those claims should be billed under the attending’s NPI number. Med-ical residents may only prescribe medications; they may not order, refer or bill other services.

—Linda Wiant, Pharm.D., Director of Pharmacy, Georgia Department of Community Health Division of Medical Assistance Plans

CmA going paperless (sooner than previously reported)


The word of the day is zoopharma-cognosy. It means, roughly, animals medicating themselves. (Technically it’s “animals knowing about drugs,” but you get the picture.)

It’s the subject of a cool feature from the National Academy of Sci-ences, titled, appropriately, “Animals that self-medicate.”

And when we say “self medicate,” it doesn’t just mean animals eating something that’s good for them. In

self-medicating animals? Yeah, we got those

the context of the article and the studies it talks about, zoopharma-cognosy means that the animal eats something that has medicinal value, and that isn’t part of its regular diet, with the intent of alleviating a symptom.

Want some examples? Did you know that some lizards

are believed to respond to a venom-ous snake bite by eating a certain root to counter the venom?

Or that when a fruit fly is infected by a parasitoid wasp, it will lay its eggs in plants containing high etha-nol levels to kill the parasite?

Or that chimps and bonobos suf-fering from constipation (or internal parasites) will eat a certain rather noxious plant leaf whole, because the leaf’s rough surface will literally clean out its intestines?

This kind of behavior is seen not just in the kinds of animals we think of as pretty smart (e.g., chimps and elephants), but also among birds, bees, and lizards. They eat things that make them feel better, or that prevent disease — even if they don’t under-stand how the food works. Other temporary meals will kill parasites like flatworms, or act as antibiotics or antivirals… or just aid in digestion.

Whether the behavior is a result of basic evolution, learned behavior, or traits passed down from parents isn’t clear. But the result is that there are a lot of animals, including some with brains the size of pinheads, that know when a trip to the pharmacy is in order.

news

The FDA has issued new regula-tions for how prescription drugs will be labeled to give information for women who are pregnant or breastfeeding.

Out are the letter categories — A, B, C, D and X — as well as the “Labor and delivery,” and “Nursing mothers” sections in favor of “Lac-tation,” and “Females and Males of Reproductive Potential” sections.

Also new are several data sub-sections: “Risk summary,” “Clinical considerations,” and “Data.”

Get the details at FDA.gov.

New labeling rules for pregnancy and lactation


You’re probably familiar with “doctor shopping” when it comes to painkillers and amphetamines (and other drugs). But drug abusers run into a problem: getting caught thanks to state reporting rules.

So what do they do? They start doc-shopping across state lines, taking advantage of the lack of a national network to monitor drug use.

A study found that about a third of doc shoppers crossed state lines to get their scripts and their meds, and — not surprisingly — it was more prev-alent in smaller states where it was easier to do.

“Part of the problem is that state systems all vary — they’re either home-grown or operated by different vendors and they’re not interoperable,” said Douglas McDonald of Abt Associates, who co-authored the NIH-funded study published in Pharmacoepidemiology and Drug Safety. “There are also legal questions about what you can share about patient data.”

CMS targetS doCS preSCribing too Many painkillerS

The government is cracking down on doctors who prescribe too many pain meds: It’s look-ing more closely at those who tend to be at the far right of the bell curve when it comes to giving them to patients.

The Centers for Medicare and Medicaid Services is look-ing at prescription data, and using that to identify poten-tially problematic doctors. In fact, next year Medicare will be able to kick doctors out of the program if they write too many prescriptions for these easily abused drugs.

Many of the doctors who prescribe a lot of painkillers

and amphetamines have already been in legal trouble. According to a Gannett News story, 12 of the top 20 prescrib-ers of painkillers and amphet-amines have already been in hot water with their state med-ical boards; some have even had criminal charges filed.

In Alabama, in fact, it was pharmacists who sounded the alarm about one doctor who was prescribing opioids a little too frequently. An undercover investigation found he was prescribing drugs without an exam — and writing prescrip-tions in exchange for a simple cash payment.

doc-shoPPers lookiNG for oPioids are crossiNG state liNes

As America is cutting spending on medical research, other countries are picking up the slack — and will reap the benefits.

That’s from a new report pub-lished in the Journal of the Amer-ican Medical Association that showed how reductions in U.S. spending on research could have long-term consequences.

Some stats from the report:From 1994 to 2004 U.S. investment

in medical research rose about six percent a year. But from 2004 to 2010 , it rose less than one percent a year. From 2004 to 2012 China has tripled its investment.

Private industry, which used to account for less than half of U.S. spending, now pays 58 percent of the total.

The U.S. share of total global re-search spending (public and private) has gone from 57 percent in 2004 to only 44 percent in 2012, as other nations — notably China — invest more.

Why is this an issue?If we don’t do the research, we

don’t get the patents and the inven-tion, and we don’t get the money they bring in (and the jobs and tax dollars they enable).

It’s already happening.In 2011, it was China that filed 30

percent of all global life science pat-ent applications; the U.S. was down to only 24 percent. In 1981, American inventors accounted for 73 percent of “highly valuable” patents filed just in the United States. In 2011 it was down to just 59 percent.

u.s. cuts medical research funding


GdNa cracking down on unregistered techsThe GDNA is warning pharmacy technicians and the pharmacists who supervise them to be sure the tech’s registration is up to date. During recent inspections, the GDNA found pharmacies with technicians in the prescription department who had expired technician registrations.

“If they do not have a current technician registration with the Board,” said GDNA deputy director Dennis Troughton, “they cannot be in the pharmacy working as a technician.”

news

Thanks to a combination of high pay ($116,670 on average), a rosy employment outlook (14 percent predicted growth), and a good work environment (i.e., no heavy lifting, toxic fumes, or many peo-ple shooting at you), pharmacist was ranked as the number one job in healthcare. This ranking comes from the folks at CareerCast, so there you have it: bragging rights.

Sing along: “Five milliliters of sugar* helps the medicine go down, medi-cine go down, medicine go down…”

It seems that makers of over-the-counter children’s meds are going to drop “teaspoons” as dosages and switch to strictly milliliters. The idea is that using mL instead of tsp will eliminate confusion and make dos-ing a bit more uniform, as there can be a difference between a measured teaspoon and what the silverware in the kitchen drawer holds.

The Consumer Healthcare Products Association released these (voluntary) guidelines for dosing of liquid pediatric OTC meds, and the association says that manufacturers are on board. The CDC certainly is, as is the National Council on Prescrip-tion Drug Programs and the FDA.

Fun fact: Only the United States, Liberia, and Burma have not adopted the metric system.

*Actually 4.93 ml.

otc kids’ meds are GoinG metric

With so many warnings on so many meds, it’s easy to think of the stick-ers as boys crying wolf. “May Cause Drowsiness,” “Don’t Operate Heavy Machinery,” etc. seem to be on so many bottles, it’s easy to forget that, well, they mean something.

That’s especially true when it comes to mixing medication with alcohol, because it’s easy to forget about those pills you took a few hours ago when you’re having a glass or two of wine with dinner, or drink-ing a beer while watching the game.

A new study from the National Institutes of Health found that “Nearly 42 percent of U.S. adults who drink also report using medications known to interact with alcohol.”

And we’re not talking about simply making the effect of alcohol

stronger. There’s potential — de-pending on the meds and the drink-er — of some serious reactions.

And get this: “Among those over 65 years of age who drink alcohol, nearly 78 percent report using alco-hol-interactive medications.”

Takeaway: If something you’re selling has the potential to interact with alcohol, you might considering using that as a patient touchpoint.

nIh report: mixing meds and alcohol is too common

Pharmacist is the best healthcare job there is


We’ve reported — as have other sources — that CVS’s Caremark PBM will begin imposing up to a $15 surcharge for meds purchased at pharmacies that sell tobacco.

This turns out not to be the case. Not exactly.

Caremark is not imposing a surcharge. It is offering to impose one — up to $15 — on behalf of any clients who request it.

So if a company’s employee health insurance uses Caremark, the company will have the option of imposing a surcharge on em-ployees who use non-tobacco-free pharmacies.

Caremark is adding that option because, it says, several of its clients requested it.

Compounding pharmacies sue express Scripts

Three compounding pharma-cies are suing Express Scripts for refusing to cover about 1,000 ingredients in com-pounded medications.

Express Scripts says that the prices are too high — that the cost of one medication, for example, has gone up “to about $1,100 from $90,” according to the Wall Street Journal. (It doesn’t specify whether that was in a day, a month, a year, or a decade, though.)

The compounders say that not only is Express Scripts

violating federal law, but is only making the changes to improve its own bottom line — at patients’ expense.

The lawsuit claims that “In order to cover up its finan-cially driven scheme, Express Scripts… is issuing intention-ally deceptive and misleading letters to patients informing them that there is an unspeci-fied change in their compound medication benefits and that there is a purported lack of FDA approval for compound medications, which is untrue.”

read more @gphabuzz.com

1 CONTACT LOCAL MCKESSON REPRESENTATIVE FOR ASSISTANCE WITH HEALTH MART

caremark tobacco surcharGes clarified


You may have heard about the issue with some Medicare Part D patients who have Aetna insur-ance, and who are surprised to discover that your pharmacy is not part of the Aetna network.

Here’s what’s what and what you can do.In 2014, Aetna apparently told thousands of

pharmacies that they were included in one of its networks. The company also sent that list of in-network pharmacies to the Centers for Medi-care and Medicaid Services (CMS), where it was included in the public Medicare Plan Finder. The list was even posted on the Aetna website.

So when people chose Aetna for their Medicare Part D coverage, they believed that these pharma-cies were part of Aetna’s network.

But it turned out that those pharmacies were not in it after all. Simply put, Aetna made a mistake.

Jump to 2015, and suddenly thousands of patients are learning that they can’t get their med-ication from their pharmacy of choice because — surprise, surprise — the pharmacy isn’t in the Aetna network.

Aetna’s solution: In late December (the 29th was the earliest the National Community Pharmacists Association could find), the insurer told the affect-ed pharmacies how they could send their patients to another pharmacy.

Not good enough.NCPA has been working with CMS 0n the issue.

After all, if the insurance company gave incorrect information, why should patients have to find a new pharmacy?

Setting aside the issue of Aetna asking people to find new healthcare providers because of its error,

The Aetna Medicare issue: What it is and what you can do

pharmacy business

If the Insurer Gave incorrect information, Why should patients have to find a neW pharmacy?

there are a lot of people who simply don’t live near a participating pharmacy — they chose Aetna be-cause their pharmacies of choice were (supposedly) in network.

Apparently CMS agreed.

Here’s what you can doCMS is allowing anyone affected by Aetna’s error to switch to a different Part D plan as part of a “Special Enrollment Period.”

If one of your patients has an issue, have him or her call 1-800-MEDICARE (633-4227) and explain that he or she needs to select a new Part D plan be-cause of Aetna’s error. (NCPA suggests letting them use your phone right there.) This will also let CMS know how widespread the problem is.

The bad news, per NCPA: “New enrollments won’t take effect until February at the earliest, so patients may be forced to use another pharmacy for their January prescriptions. However, patients may qualify for a one-time in-network cost sharing refund from Aetna if they pay full price for their prescription at your pharmacy before March 31.”

NCPA staff is also working with pharmacy ser-vice administrative organizations to “coordinate a response from community pharmacy to Medicare and Congress to achieve maximum impact.”


You might be aware that the Georgia Department of Community Health is looking to recoup money from phar-macies because of overpayments for escitalopram starting more than two years ago.

Federal law requires DCH to recoup any such overpayments. In this case, though, they occurred because of an error by DCH’s contractor, Catamaran.

We don’t think it’s right that phar-macists should have to repay so long after they occurred — after books were closed and taxes paid.

In a letter to DCH Commissioner Clyde Reese, GPhA CEO Scott Brunner explained the issue:

The amount of any recoupment in this situation should be paid by the entity that committed the error, not by scores of Georgia pharmacies that were affected by Catamaran’s mistake. This approach would be consistent with DCH’s policy for recouping funds when a pharmacy makes an error in billing.

GPha calls foul on overPayment recouP

AIP HelPIng MeMbers We receive messages like this all the time, including many similar to this one in the early part of the year.

In this case we were able to get this pharmacy signed up with Sil-verScripts within hours of receiv-ing this e-mail.

Part of the service AIP provides our members is solving problems they can’t solve on their own. If you have an issue with a private compa-ny, CMS, or any other organization, don’t hesitate to contact us!

My name is _______, and I’m the manager at ______ Drug Store. I have been having a problem with Silver-Script. I was somehow left off the “basic” list for 2015. I have called them and e-mailed, filled out forms, and jumped through hoops.

They told me I would have a resolution to this problem in 48 hours. That was four days ago. Any help you could give me would be greatly appreciated — most of my Part D customers are on SilverScript!


There are some significant changes in Medicare Part D coverage this year.

First, a lot more plans are going to be requiring co-pays from patients. In fact, two-thirds will in 2015 — that’s up more than 80 percent from 2014.

Top PDPs will cover fewer drugs. Nine out of the top 10 prescription drug plans say they will cover fewer of the total number of Part D drugs available in 2015 compared to 2014. How much less? Those top 10 PDPs are only going to be covering between 50 and 68 percent of all the drugs available.

big changes are coming to Medicare Part D in 2015

All Part D plans will now have at least four tiers. This is the first time since 2006 this has been the case. That’s in part because…

For the first time, all PDPs will incorporate a specialty tier.From NCPA: “In Part D, plans can only place a drug on the specialty tier if the total drug price nego-tiated between the plan and pharmacies exceeds $600 month. Coinsurance, or the cost-sharing responsibilities of the beneficiary, is limited to be-tween 25% and 33%, depending on the size of the deductible for a given plan. Unlike drugs placed on all other tiers, beneficiaries cannot appeal the cost sharing for drugs placed on the specialty tier.”

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Georgia’s own Buddy Carter, RPh, was sworn in to the 114th Congress, becoming the only pharmacist currently serving there, and the first since 2011.

Buddy won Georgia’s 1st district in part thanks to GPhA members who helped spread the word and get out the vote.

“We received a tremendous amount of support from pharmacists all throughout the country, and we were just humbled by that,” Carter told Pharmacy Today. “You know a pharmacist from Georgia can represent a pharmacist in Idaho or Illinois or any other part of the country.”

Although it’s still early in his term, Carter has mentioned several healthcare issues already in interviews and on his website. He supports legislation that would enable patients to receive Medicare Part B services from state-licensed pharmacists in medically underserved communities. He also promised to work to repeal Obamacare in favor of a re-turn to “market-driven solutions to our health care system,” including “allowing insurance companies to compete across state lines.”

Although he describes himself as “a free-market guy,” Carter also said he’s seen how that has worked against his customers. In the same Pharmacy Today interview, Carter expressed concern that customers’ freedom of choice has been limited too much by their insurance companies. “Either they can’t get coverage in our pharmacy because we’re not a preferred provider,” he said, “or the differ-ence in the copay is so significant that it’s just not even reasonable for them to come to our pharmacy.”

He was clear that pharmacists can’t ignore politics: “Any pharmacist who thinks politics

association notes

, CFP TM

does not play a role in their profession is simply wrong. Politics plays a role, and government plays a role.”

You can read more about Buddy’s positions on the issues at his website, BuddyCarterforCongress.com or at buddycarter.house.gov.

Newly-inaugurated congressman Buddy Carter speaks with GPhA president Bobby Moody in the halls of the Capitol in Washington, D.C.

GPhA member Buddy Carter joins CongressSupportS “any-willing- pharmacy” legiSlation


association notes

Five state legislators from southeast Georgia recently got a two-and-a-half-hour peek at a day in the life of a pharmacist.

Four Valdosta-area phar-macists, including Charlie Barnes, owner of Barnes Health Care Services, host-ed the legislators, showing them first-hand that the job is about a lot more than counting pills.

The idea was to gain support not only for the upcoming GPhA legisla-tive agenda, but to lay the foundation for the future. Once they understand the ins and outs of running a pharmacy and being a pharmacist, the state reps can appreciate why we’re fighting for our issues.

The pols got to see not only patient interac-tions, but the back-end issues — including how MAC pricing affects pharmacies. (On seeing how the pharmacy lost money on some common ge-neric meds, one legislator called it “eye-opening.”)

Not wanting to miss an opportunity with a captive audience, the pharmacy’s guests also watched short presentations on each of GPhA’s 2015 legislative priorities.

Sometimes all it takes for someone to under-stand your point of view is to have them walk a mile in your shoes — or at least spend a couple of hours walking with you.

(If you’re interested in hosting some local legislators, we can make it happen. Drop a note to Andy Freeman at [email protected].)

Southeast Georgia pols get a peek at the life of a pharmacist

Charlie Barnes, owner of Barnes Health Care Services in Valdosta, welcomed his legislative visitors.

GPhA has partnered with the Pharmacy Society of Wisconsin to offer an online, continuing education course on the DEA’s “Final Rule for the Disposal of Controlled Substances.”

The DEA has explicit and expanded methods for disposing of controlled substances by community members, patients, and long term care facilities. The rule has significant implications for pharmacies, hospitals/clinics, long term care facilities, hospice, law enforcement, and others. This webinar provides an overview of the DEA Final Rule.

The registration fee for this course is $95. CE for this webinar is available for pharmacists and pharmacy technicians.

What does your $95 get you? The access to the webinar itself, a written analysis of the rule, copies of the webinar slides, and links to additional resources from DEA.

To register for this course, go to pswi.org/Education/Online-CE. Select the “log-in” option and create a user account so PSWi can process your registration.

Got questions? Send them to [email protected].

webinar available: the Dea Final rule For DiSpoSal oF controlleD SubStanceS

Even after Pharmacy Day at the Dome, we need to get the word out about the issues we’re fighting for.

Help us spread the word about our 2015 legislative agenda. We’ve created a Web

page with the info you need to get and share the message, including talking points about our two major issues (expanded immunization and MAC-pricing transparency), tips for reaching out to your

legislators, and three shareable videos from Georgia pharma-cists about how MAC pricing affects their businesses and their patients.

It’s all at GPhA.org/spreadtheword.

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As a firm providing wealth management services to clients, we offer both investment advisory and brokerage services. These services are separate and distinct, differ in material ways and are governed by different laws and separate contracts. For more information on the distinctions between our brokerage and investment advisory services, please speak with your Financial Advisor or visit our website at ubs.com/workingwithus.UBS Financial Services Inc., its affiliates and its employees are not in the business of providing tax or legal advice. Clients should seek advice based on their particular circumstances from an independent tax advisor. CIMA® is a registered certification mark of the Investment Management Consultants Association, Inc. in the United States of America and worldwide. Chartered Retirement Plans SpecialistSM and CRPS® are registered service marks of the College for Financial Planning®. ©UBS 2014. All rights reserved. UBS Financial Services Inc. is a subsidiary of UBS AG. Member FINRA/SIPC. 7.00_Ad_7.5x4.875_AX0220_WileConsultingGrp2 GphA

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two gpha memberS electeD to leaD boarD oF pharmacy

Here’s an enthusiastic shout-out to the three Georgia pharma-cists who will be serving on the Georgia Board of Pharmacy, including two officers.

Laird Miller, RPh, from Medical Park Pharmacy in Gainesville was elected president of the board by his fellow board mem-bers. Miller is a member of the GPhA board of directors, and a past chair of the AIP board as well.

Mike Faulk, RPh, of Shoppers Pharmacy in Eatonton was elected vice president, and Vicki S. Arnold, pharmacist in the Critical Care Pharmacy at Northeast Georgia Medical Center, was appointed to the board by Governor Deal.

Every year, GPhA presents four awards to outstand-ing members of the Georgia pharmacy community. We rely on your nominations. For 2015, you have until March 1 to submit them.

Those nominations are reviewed by our awards committee, which selects the recipients — so make them thorough and detailed. The awards will be pre-sented at a ceremony at GPhA’s convention in July.

Nominees must be licensed Georgia pharmacists and members of the Georgia Pharmacy Association.

You can find more requirements for each award at GPhA.org/2015awards, but here are the basics:

• Bowl of Hygeia AwardRecognized as the most prestigious award in pharmacy, the Bowl of Hygeia is presented annually by GPhA and all state pharmacy associations to pharmacists with outstanding records of service to their communities.

• Distinguished Young Pharmacist AwardThis has become one of GPhA’s most prestigious. It honors a pharmacist who has been in the profession fewer than 10 years but already shows involvement in and dedication to the pharmacy profession.

time’s running out for GPhA awards nominations

• Innovative Pharmacy Practice AwardThis award is presented annually to a practicing pharmacist who has demonstrated innovative pharmacy practice that has resulted in improved patient care.

• Generation Rx Champions AwardThis award is presented annually to a pharmacist who has demonstrated work with prescription drug abuse. This award honors the recipient with a plaque and $500 to the charity of the recipient’s choice.


cover story

What happens When the fix for a problem doesn’t really fix it? And whAt

if it ActuAlly costs phArmAcies more? we’re getting the Answer every dAy.

by andreW Kantor

Lost in transLation


Start with the age-old jokes about doctors’ handwrit-ing. Deciphering the scribble was, and is, a bit of science and a bit of an art. But there’s a lot on the line. Prescription errors cost. They cost directly and indi-rectly, and they cost in cash and, potentially, in lives.

What’s a fix for bad handwriting and confusing instructions? Computers, of course. Typing means no issues with reading the swirls of rushed cursive. Drop-down menus and check boxes mean the right medication in the right dosage. A smart system would even know if a particular medication was available at a particular dosage.

Problems couldn’t be eliminated — to err is still human after all — but electronic prescriptions would clearly make things a lot better, right?

Unfortunately, as with many “obvious” fixes, the cure brought up an entirely different set of problems.

best-laid plans

The idea of e-scripts, as they’re typically called, is part of the broad umbrella of electronic health records (EHRs). And that idea was rolled out with much fanfare within the last decade, touted as a tool to


improve patient care by aiding communication between healthcare providers, including between doctors and pharmacists. (See the sidebar, “One big happy.”)

Physicians embraced the new technology: In 2008, just five percent of Georgia physicians were prescribing electronically; by April 2014, that num-ber had risen to 65 percent.

And with the rise of EHRs, e-scripts also grew. From 2008 through this past spring, the number of Georgia community pharmacies equipped to accept e-prescriptions grew from about 78 percent to 95 percent. In 2013 the state crossed the halfway point when about 53 percent of new and renewed prescriptions were sent electronically.

So we’re clearly on the way to solving that whole prescription-errors problem, right?

Well… not so fast.

mistakes were made

E-scripts, it turns out, can also be riddled with errors. Sure, the text is readable; it just doesn’t always make sense. And it’s as easy to click the wrong button (lamotrigine vs lamotrigine XR) as it is to physically write the wrong medication — maybe even easier.

The National Community Pharmacists Association has a sheaf of examples: An ointment prescribed instead of suspension. SIGs that are in-adequate or incomplete. Dosages that are weight-based, but that aren’t calculated for the patient. Quantities that aren’t specified, such as “take each daily dose all in AM” without indicating how many tablets are in a dose.

Some errors are potentially dangerous, such as prescribing an adult dosage for a child, or simply prescribing the wrong medication. When you’re choosing from an electronic menu, it’s easy to click the box above or below what you actually mean to, such as “Joe Smith Sr.” instead of “Joe Smith Jr.” or “50mg” instead of “25mg.”

Others would seem to be simply administra-tive but aren’t because of the legal implications: the dosage incorrectly put in the quantity field, or writing “brand written” but leaving the DAW box unchecked, for example.

The latter, apparently, happens often, and pharmacists are bound by law.

“We have been receiving [prescriptions] with ‘Brand Written’ above the drug name but nothing denoted for the DAW code,” said Christopher Per-sons, a student at the Mercer University College of Pharmacy (who also works in a retail pharmacy). “We are bound to fill the generic, as it is not cor-rectly denoted as a true DAW prescription.”

The most common error is perhaps the mis-use of the “Notes” field. A doctor will indicate one thing using the software’s menus, but give conflict-ing instructions in the notes.

One prescription from the NCPA examples requested one pint (8 oz.) with three refills in the

“We are seeinG an increase in the number of people who don’t know

how to properly use their softwAre. they send something like ‘one tAblet

dAily,’ but write ‘tAke 1 tAblet bid’ in the comments.”

cover story

surescripts has the capability of sending a “change script” request back to the prescribing doctor if there’s an error in a prescription, some-thing that could save pharmacies that double fee they’ve been paying for a resent e-script.

Unfortunately, neither the pharmacies’ nor the physicians’ software vendors has imple-mented it yet.

Why not? “there have been a number of issues including competing vendor priorities, the ‘chicken or the egg’ dilemma between phar-macies’ and prescribers’ technology vendors, as well as business-model and workflow concerns that have delayed adoption,” said surescripts’ ajit Dhavle.

His advice: tell your vendor that you’d like to see the “rxChange” and “rxCancel” transac-tions implemented. Without a little squeaking, you’ll never get the grease.

Keeping the change


electronically generated section, but the doctor requested six ounces and one refill in the notes. Another, for eye drops, had conflicting instruc-tions about the number of drops and the number of eyes to put them in.

“We are seeing an increase in the number of people who don’t know how to properly use their software,” said Carole Richardson, PharmD, a phar-macist at St. Francis Hospital in Columbus, Ga. “They send something like ‘1 tablet daily,’ but then write ‘Take 1 tablet BID’ in the comments. I’ve seen this routinely with e-scripts and hospital [order entry systems].”

Sometimes the software tries too hard to help, such as by defaulting to certain dosages or other options for medications. A rushed doctor or phy-sician’s assistant may not realize that the default isn’t correct for that patient.

“There is a particular doctor’s office in my area that constantly sends prescriptions that are [dis-pense as written],” Richardson said. “I continue to regularly call their office, and their excuse is that their software ‘defaults’ to DAW. I know pharma-cists who ignore it, but that doesn’t seem to be a real solution. How are we to know if the patient really does need something DAW?”

One Georgia pharmacist — who prefers anonymity — said, “Unfortunately, I am seeing so many problems (technical and therapeutic) that there are not enough hours in the day for me to call on them all, and I don’t have enough help in the pharmacy that I can spend the whole day on the phone. Many times, they are just not ad-dressed, I have to take liberties interpreting what the physician intended, or the patients don’t get their meds in a timely fashion while I am waiting on a return phone call from the doctor.”

Joke all you want about suppositories with instructions for oral delivery (or vice versa), but every one of these mistakes requires a correction — a call to the doctor. And that costs.

an error’s an error, no matter how small

When a pharmacist spots an error, he or she needs to contact the prescriber to clear it up. That sounds straightforward, but the reality is less rosy.

Pharmacist John Tucker of Henry’s Profes-sional Pharmacy in Griffin is blunt about electron-ic prescriptions: “I don’t see that they’re solving

any issues at all,” he said. “In my opinion e-scripts cause more problems than they solve.”

It’s not just a matter of frustration. It’s a mat-ter of cost.

Unlike doctors who were paid to adopt elec-tronic prescriptions as part of their EHR systems (See the sidebar, “One big happy”), pharmacies have to pay for each e-script they receive — an average of about 17 cents apiece to their pharmacy management system vendors, according to NCPA.

That means each erroneous prescription costs the pharmacy not only the original 17 cents, but an additional 17-cents for the corrected version.

Over time, that adds up.“It truly rubs salt in the wound to know that

we are being charged for the erroneous scripts that we then have to expend more resources on to get corrected,” Tucker said. “The additional slap in the face comes from the knowledge that my certified technicians are not allowed by law to take phoned-in prescriptions, yet they are the very indi-viduals that generally catch the electronic errors before I even see the script.”

And it’s not as if it’s an unknown problem. National healthcare organizations are certainly aware of it.

“In 2012, 788 million prescriptions were routed electronically,” wrote NCPA CEO B. Douglas Hoey in a letter to his counterpart at the American Med-

One big happy

in 2009, the Health information technology for Economic and Clinical Health (HitECH) act passed as part of the overall government stimulus plan. it means that the United states would spend as much as $36.5 billion to upgrade the nation’s healthcare recordkeeping, which include electronic prescriptions.

Medicaid has been paying incentives to doctors for upgrading to electronic health records — up to $63,750 over six years — while Medicare will pay them up to $44,000 over five years. (Medicare will also penalize those doctors who don’t upgrade by 2015.) Doctors and hospitals can choose between the two programs.

and, while they aren’t being paid to upgrade the way physicians are, pharmacists also stand to ben-efit, experts said, because they would spend less time transcribing phoned-in instructions or trying to discern physicians’ famously difficult-to-read handwriting. time saved is money saved, so the presumed benefit to pharmacies should be clear.

oops.


ical Association. “If even one percent of these re-quired follow-up (which in our experience is a very conservative estimate), and the average pharmacy pays $0.17 per e-prescription transaction, the cost to pharmacies was approximately $1.3 million.”

And that’s only the direct cost. Before a corrected prescription can be sent,

the pharmacist or pharmacy technician has to track down the prescribing physician. Depending on the doctor and the doctor’s staff, this could set off a game of telephone tag that takes hours to resolve. Only then will the doctor send or dictate another prescription.

As frustrating as this might seem for the pharmacist, consider the patient — someone who doesn’t know about what happens behind the scenes. At best, it means more time sitting and waiting. More likely, though, it means a significant delay in getting medication, and the frustration that entails.

And no matter how the problem is resolved, though, it costs the pharmacist valuable staff time and resources.

“It is absolutely horrendous, the number of errors we receive on scripts on a daily basis,” Richardson said. “I spend a large portion of my day on the phone with physicians’ offices clarifying these.”

How much does it cost? “Factoring in three minutes of labor by a phar-

macy technician or pharmacist,” Hoey wrote, “the cost jumps to $6.7 million to $22 million.”

How is this happening? Weren’t e-scripts sup-posed to reduce errors? If there’s a problem with the software, why not fix the problem?

towers of babel

Here’s why.Pharmacies have about 40 vendors of pharma-

cy management software to choose from, such as Meditech and PharmNet, according to Ajit Dhavle, vice president of clinical quality at Surescripts. Doc-

tors, he said, have about 700 options. And no two are quite alike.

“Vendors consider the user interfaces as distinguishing them in the marketplace,” Dhavle explained. On a simple level, that could be as simple as using checkboxes instead of drop-down menus for choosing medications, but the reality is that the systems’ interfaces, even though they do many of the same things, are completely different.

That means that what could be confusing on one doctor’s software might be clear as day on an-other’s. It also means that there’s no such thing as a universal problem, at least with software. Different packages and different doctors mean, as Dhavle put it, “There is no silver bullet.”

Surescripts should know, of course. It was formed in 2001 by pharmacy associations as a way to create a back end for sharing data between healthcare providers. But today’s Surescripts was born in 2008 as a merger of that company and RxHub — which had been formed for the same reason by pharmacy benefits managers Express Scripts, Medco Health (now part of Express Scripts), and Caremark.

Today, the company dominates behind the scenes of the e-scripts market, serving as the elec-tronic glue between doctors’ and pharmacies’ soft-ware as it routes prescription information between them. Whatever brand of pharmacy management software you use, it almost certainly integrates with Surescripts.

Surescripts certifies those 740+ software pack-ages that work with it, but how well each works, — and how easy it is to misuse — depends on the manufacturer. Hence the lack of a silver bullet to make all physicians’ e-script systems error-proof; Surescripts can’t know what doctors’ software packages might need an interface tweak, or which doctors’ offices might need a bit of retraining from the vendor.

So you might think there’s little you can do oth-er than deal with doctors who make those mistakes.

Good news: You’d be wrong.

cover story

“it is absolutely horrendous, the number of errors we receive on

scripts on A dAily bAsis. i spend A lArge portion of my dAy on the phone

with physiciAns’ offices clArifying these.”


Do something

Surescripts doesn’t control all the software that uses its system, but the company is very interested in making the process as error-free as possible. (Dhavle is co-author of a paper, “Towards creating the perfect electronic prescription,” published in July 2014 in the Journal of the American Medical Informatics Association.)

If there’s a problem with software — either with how it works or how it’s being used — the company wants to know about it. Among other things, Surescripts tracks prescription-error com-plaints, even if the problem seems to be user error.

If one doctor has a problem using a software, it could be any number of issues. But if Surescripts sees many doctors making the same kinds of errors — say, the wrong dosage — with the same piece of software, it will reach out to the software maker to suggest changing the way it operates.

Similarly, if the company sees repeated issues coming from a particular doctor’s office, it may work with that doctor’s software vendor to help retrain the staff.

In order for this to happen, though, it needs to know about the issues. “We don’t know what we don’t know,” Dhavle said. It depends on phar-macists to report problems — something that’s rarely done because most people assume the error is with the user, when it could be a matter of better software design.

And it’s in the software maker’s interest to listen to what Surescripts has to say because each package needs to be recertified regularly with the company. Too many unresolved complaints could jeopardize that.

The bottom line is that it’s best for everyone involved when electronic prescriptions work and work well. You don’t want to have to call doctors to get a correct script, and they don’t want to spend the time, either. Software vendors want the process to be as painless as possible. And of course patients don’t want to deal with the wait time that an error might mean.

Humans are involved, so the chances of a perfect system is just about zero. But the chances for an improved e-scripts process? At least in part, that’s up to you.

In the meantime, mistakes will be made. So, as John Tucker said, “We just hope and pray that we’re catching all of the errors.”

e-script errOr? here’s what yOu can dO

even if the error appears to be human, not a software problem, the first step is to contact your pharmacy management system vendor. yes, your vendor, even though the problem is on the doctor’s end.

remember, pharmacy and doctors’ software is all connected through the surescripts network. your door-way to change is through your vendor, who will report the issue, no matter how small.

“typically, when the pharmacist logs the case with their pharmacy technology vendor, the pharmacy tech-nology vendor researches the matter,” said surescripts’ Ajit dhavle. “if it is determined to be a prescriber or a standards issue, [the vendor] refers the case to sure-scripts. the surescripts support team in turn conducts additional research and then, if need be, forwards the case to the physician technology vendor for resolution.”

that’s not to say you shouldn’t let the doctor’s office know as well, but it’s through the software vendors that real change is more likely to happen.

“oftentimes the prescriber and their office staff need to be retrained on the software so that they can begin to generate accurate and appropriate prescrip-tions,” dhavle said. Just reporting these issues back to the prescriber will not likely result in issue resolution.” the software vendor is a much better bet.

And if you don’t get satisfaction from your software vendor? not only does surescripts have a direct line for the very purpose of logging prescription errors, it actively promotes it. make no mistake: surescripts really really really wants you to get in touch.

said dhavle: “pharmacies should … persist with the cases that they log until they hear complete resolution on the issue.”

surescripts independent pharmacy help linePhone: (877) 877-3962E-mail: [email protected]: (703) 880-0149


pharmpac

Investing in PharmPAC is investing in your business.

GPhA’s lobbying can only be as effective as the support behind it.The association works every day to help ensure that legislation passed

in Georgia is the best possible for you and your business.

Visit GPhA.org/PharmPAC to find out more.


The Georgia Pharmacists Political Action Committee — PharmPAC — provides the resources for your association to lobby and advocate on behalf of pharmacy professionals across the state.

GPhA works at the local, state, and even federal level, leading the way in influencing pharmacy-related legislation.

Investors in PharmPAC understand the importance of this to their business, and they make financial commitments of support.

2014 PharmPaC investorsIn 2014, the following pharmacists, pharmacy technicians, students,

and others have joined GPhA’s PharmPAC. The contribution levels are based on total investment for the calendar year.

Diamond Investors ($4,800 or more)

Titanium Investors ($2,400)

Fred ShArPe

rAlPh BAlChin GreG hiCkmAn SCott meekS JeFF SikeS

“I don’t have time or the knowledge to keep up with all the legislative bills that can affect pharmacy.

GPhA puts the bills into terms I can understand so I am able to communicate effectively with my representatives.“

—Sharon Zerillo


Get invested today.Visit GPhA.org/PharmPAC or contact Andy Freeman

[email protected] • (404) 419-8118

Platinum Investors ($1,200)

CAtherine Moon Andrew FreeMAnBArry BilBro huGh ChAnCydAle CokerAl dixon PAtriCk dunhAM BruCe FAulk ted hunt MArshA kAPiloFF irA kAtzGeorGe lAunius J. thoMAs lindsey BrAndAll loVVorneddie MAddeniVey MCCurdyhouston roGersBen ross dAnny toth

Gold Investors ($600)

williAM CAGlekeith ChAPMAnroBert hAttonJeFF lureyChris thurMondosGood MillertoMMy whitworthJiM BArtlinG williAM BrewsterMiChAel MCGee dAniel royAl MiChAel tArrAntdAnny tuCkerAlex tuCker

2014 PharmPaC investors (Continued)

Silver Investors ($300)Bobby MoodySherri MoodyLiza ChapmanJack DunnRose PinkstaffBrian RickardW. ConleyBill Prather Wade Scott Danny SmithBruce BroadrickKevin FlorenceSharon ZerilloLance Boles Robert Cecil Chandler Conner Charles Earnest Kerry GriffinMartin GrizzardMichael Iteogu

Kalen ManascoBill J. McLeerLaird MillerMark ParrisDonald Piela, JrJeff RichardsonJohn T. Sherrer Sharon Sherrer Richard Smith James ThomasArchie Thompson Flynn Warren William Wolfe

Bronze Investors ($150)Fred Barber Benjamin DuPreeCharles WilsonAustin TullBecky Hamilton Pamala Marquess

Sujal PatelAnthony RayAndy RogersNelson AnglinBonnie Ali-Warren Rick Allen Mandy Davenport John Drew Susan Kane Susan McLeerLeonard Reynolds Diane Sholes Krista Stone

Member InvestorsLarry HarkleroadAmanda GaddyWillie LatchHenry JoseyRenee AdamsonClaude Bates Michael Crooks

Hannah HeadBrenton LakeRalph Marett Drew Miller Kimmy Sanders Jim Sanders Terry ShawNicholas BlandCorey RieckRobert BentleyWaymon Cannon Rabun DekleRobert Dickinson Gregory DrakeAmy GrimsleyCarroll LowreyMax MasonRoy McClendonSheila D. MillerSheri MillsMark NidayCharles WilsonMark CooperLise HennickOlivia Santoso Stuart BradleyKristin BrooksJames DarleyJeffrey SmithKameron HuffmanGeorge WuAnonymous Contributor

PharmPACBoard of DirectorsDean Stone, Region 1Keith Dupree, Region 2Judson Mullican, Region 3Bill McLeer, Region 4Mahlon Davidson, Region 5Mike McGee, Region 6Jim McWilliams, Region 7T.M. Bridges, Region 8Mark Parris, Region 9Chris Thurmond, Region 10Stewart Flanagin, Region 11Henry Josey, Region 12Bobby Moody, Ex-OfficioR. Scott Brunner, Ex-Officio


reach out to us

contact

1

FLAT COLOR

OPENBLACK & WHITE

GLOSS/GRADIENT

Georgia PharmacyA S S O C I A T I O N

For questions about our events, or about CPe creditsSarah Bigorowski Director of Events (404) 419-8126 [email protected]

For questions about our lobbying, governmental affairs, or political activitiesAndrew “Andy” Freeman Vice President of Government Affairs (404) 419-8118 [email protected]

For questions about our magazine Web sites, or social mediaAndrew Kantor Director of Communication (404) 419-8109 [email protected]

For questions about engagement with the Georgia pharmacy communityPhillip Ratliff Vice President of Communication and Engagement [email protected]

For membership questions Tei Muhammad Director of Membership Operations (404) 419-8115 [email protected]

For questions about any of our insurance productsDenis Mucha Manager of Insurance Services (404) 419-8120 [email protected]

For questions about the Board of directors or for scheduling the executive Committee or evPRuth Ann McGehee Executive Assistant and Governance Manager (404) 419-8173 [email protected]

For operational or accounting questions:Dan Griggs Vice President of Finance & Administration (404) 419-8129 [email protected]

Patricia Aguliar Accounting Coordinator [email protected](404) 419-8124

Our phOne number is 404.231.5074Our Website is GPhA.orGOur blOg is GPhABuzz.Com

GPha LeadershiP

President BoBBy [email protected]

Chair of the BoardPaM Marquess [email protected]

President-elect toMMy [email protected]

First vice President LanCe [email protected]

second vice PresidentLiza [email protected]

executive vice President and CeosCott Brunner, Cae [email protected]

For assistance with independent-pharmacy issuesJeff Lurey, R.Ph. Vice President of Independent Pharmacy & Director of AIP (404) 419-8103 [email protected]

For questions about your aiP membershipVerouschka “V” Betancourt-Whigham Manager of AIP Member Services (404) 419-8102 [email protected]

aiP Member service representativesRhonda Bonner (229) 854-2797 [email protected]

Charles Boone (478) 955-7789 [email protected]

Melissa Metheny (404) 227-2219 [email protected]

Gene Smith (423) 667-7949 [email protected]


Not too long ago, my wife was in the hospital in Cin-cinnati with complications from carrying our soon-to-be newborn son. The nurse came around to give Karen her evening meds.

She took the pills from the nurse… then stopped. “These are the wrong ones,” Karen said.

“It’s what’s on the chart,” said the nurse. “They look wrong,” Karen insisted, handing

them back. “Check with the doctor, please.”A few minutes later the nurse returned, cha-

grined. Yep, they were the wrong meds.We assumed the hospital pharmacy made a mis-

take. It turned out that the doctor had prescribed the wrong meds. Karen, luckily, had noticed the difference because the pill was a different shape.

At that same hospital, during another stay (can you tell this was not an easy pregnancy?), a nurse again brought Karen her meds. Again Karen shook her head. “I get three of these,” she said. The doctor had apparently forgotten to update her chart.

Fast forward to 2013. Karen went to our local pharmacy to pick up a prescription for our son. When she got home she looked at the bottle. “This is wrong,” she said.

Thanks to an all-but-unreadable prescription, we had been given triazolam instead of trazodone.

When it comes to doctors and medications, my wife is not the trusting sort. She reads the labels, inspects the pills, and generally doesn’t take (or give) anything until she’s sure it’s correct. It comes from being allergic to a number of drugs — she can’t be too careful.

Andrew KAntor

postscript

In at least three instances since we’ve been to-gether, that attention to detail has caught at least two serious medication errors, and one (the low dosage) that could have been.

What if Karen was like most people, who simply take the pills the nurses give them? Or who don’t bother to read the bottle? It’s not a hypothetical to me, having been that close to finding out what half a milligram of triazolam would have done to my then-10-year-old son.

As I wrote about medication errors for this issue, I had no trouble realizing how easy it is for something to go wrong. People are human; they make mistakes. That’s why we put fail-safes in place, so that a lot of mistakes have to happen before disaster strikes.

We’re going in the right direction with medica-tion, but we’re not there yet. An electronic pre-scription would have prevented that triazolam/trazodone confusion, but even e-scripts didn’t help in the hospital.

People are human — they’re rushed and forget-ful. There’s no such thing as a fool-proof system, but that doesn’t mean we don’t try… at least until we run out of fools and other error-prone humans. Andrew Kantor is GPhA’s director of communica-tion, and, admittedly, an occasional fool.

We Were that close To finding ouT WhaT half a milligram of Triazolam Would have done To my son.

trust but verify

SHOW YOUR SUPPORT! Attend this year’s Aip Fall Meetingplease fill out and fax this form to (404) 237-8435)

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