32 page Quarterly Magazine

1. Spring 2012 / Volume 55, No. 2
Scholarship Scramble
August 26, 2012
Willows Run Golf Course, Redmond, WA Pg. 28
Special Features
Member Northwest Pharmacy New Requirement for
Highlight Convention CE Partcipants
See page 8 See page 6 See page 27

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are partnering with retail independents to
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© 2009 Cardinal Health, Inc. or one of its subsidiaries.
All rights reserved. Lit. No. 1LDR1280 (0409)

3. WSPA Board of Directors
President
Julie Akers
President-elect
Brian Beach
Immediate Past President
Ron Williams Spring 2012/Volume 55, No. 2
Secretary/Treasurer
Steve Singer
Features
board members
Beth Arnold mEMBERSHIP 4
Kurt Bowen (Student) Why you should renew your membership
Brenda Bray
Northwest Pharmacy Convention 6
Jill Carrier (Technician)
Don Downing
member highlight 8
Shaelah Easterday (Student)
Heather Ferguson
Legislative and Regulatory Affairs Council News 10
Christopher Foley (Student)
Legislative Update
Melissa Hansen
Andrew Heinz (Student) School News 12
Kirk Heinz Get the Latest WSU/UW Information
Anne Henriksen
Paul M. Iseminger (Technician)
Greg Matsuura
Amanda Norman (Student) departments and specials
Mary Slate Williams (Student)
Cindy Wilson Continuing Education 19
Roger Woolf
Health Information Exchange 15
managing editor Rx and the Law 31
Kathleen Goodner Upcoming Events 32
Publisher
The Washington Pharmacy is owned and published
advertisers
by the Washington State Pharmacy Association
to provide information, news and trends in the
profession of pharmacy. Opinions expressed by the Agility Recovery 31
contributors, whether signed or otherwise, do not Bi-Mart 30
necessarily reflect the attitudes of the publishers nor Cardinal Health 2
are they responsible for them. Subscription rate is
$24 per year domestic / $59 foreign (including first Good Neighbor Pharmacy 16
class postage.) McKesson 17
Per copy rate is $6. Pace Alliance 18
Washington Pharmacy ISSN (1539-1469) is
published quarterly for $24 per year domestic / $59
Pharmacists Mutual 27
foreign including first class postage by Washington RxRelief 30
State Pharmacy Association at 411 Williams Ave. S,
Renton, WA 98057. PERIODICALS Postage paid at
Renton, WA and at additional mailing offices.
Staff
POSTMASTER
Please send address changes to: Jenny Arnold, Director of Pharmacy Practice Development
Washington State Pharmacy Association
411 Williams Avenue S Kathleen Goodner, PR & Communications Manager
Renton, WA 98057
Danyal Henderson, Administrative Coordinator
MISSION STATement
The Washington State Pharmacy Association exists Dedi Hitchens, Director of Government Affairs
to advocate on behalf of its members to ensure
Maria Lieggi, Membership & Education Administrator
pharmacy professionals are recognized, engaged
and valued as essential to the health care team. Jeff Rochon, Chief Executive Officer
Visit wspa’s website at
www.wsparx.org

4. Why you Should renew today!
IT’S YOUR FUTURE STRENGTHEN YOUR SKILLS
Health care is in a dynamic state of Opportunities abound for you as a WSPA
change. Decisions impacting pharmacy member. Participate in quality conferences,
are made all the time. As the adage goes, seminars, and workshops that will contribute
“If you are not at the table, you are on the to your continuing education and professional
menu.” The WSPA is your invite to the table. development. Attending WSPA events helps
Since health care reform is implemented to build your network and meet key players
at a state level, it is crucial that you are in pharmacy, while learning about new and
engaged and involved in those decisions. upcoming therapies, products, services, issues
and developments.
The WSPA is your voice to advocate for
advancing the profession and protecting Whether you are looking for high-quality, timely
your livelihood. CE that is relevant to your practice, or you want
to learn about best practices from experts in
AMPLIFYING YOUR VOICE your specialty, the WSPA has something for you.
WSPA advocates for the profession on MAKE CONNECTIONS
numerous levels to: strengthen and
expand our role in patient care; protect WSPA provides opportunities to meet and
access to pharmacy-provided services network with people in the pharmacy
and products; and reinforce the value of profession. When you join the WSPA, you have
pharmacies in ensuring patient safety and the opportunity to join one or more practice
member only information quality health outcomes. academies to connect with professionals from
similar practice settings that allows you to:
WSPA works within multidisciplinary • Solve problems
WSPA is the source for news and information about
committees, patient advocacy groups, • Share ideas
the pharmacy profession and the members it serves,
regulatory agencies, public health • Move your practice forward
and routinely provides members with relevant,
jurisdictions, other professional
valuable and timely information on the latest safety,
associations, health insurance payers and WSPA academies include:
regulatory and legislative news. Members receive:
employers. • Ambulatory/Community Practice
• Health Systems
• Access to “Members Only” online Resource
On a legislative level, WSPA works within • Independent Pharmacy
Centers for Audit Avoidance & Protection,
LRAC to ensure lawmakers understand the • Long Term Care
Handling of Hazardous Drugs, Billing for Patient
pharmacy profession. • Students
Care Services, Compliance and Regulations,
• Technicians
Medication Safety, Medicaid, Medicare, Labor and
Industries Resource Centers, Pharmacy Security,
Whatever your practice setting or background,
Non-English Communication Tools and much
WSPA offers plenty of resources to build a
more
powerful network of professionals in pharmacy
• Timely and valuable information via email alerts
who can serve as mentors and support.
and Washington Pharmacy, the association’s
quarterly magazine
The Washington State Pharmacy Association
• WSPA Career Center and Salary Survey
offers a comprehensive suite of benefits and
• Quality On Demand Online CE
services that give members of all practice
• If you are Washington State Legislative and
settings and career levels the tools they need
Regulatory Affairs Council (LRAC) member,
to succeed. Take a look at all WSPA has to offer
you will also receive LRAC updates. It’s easy to
and join your colleagues who are dedicated to
become a member! Just mark the LRAC box on
pharmacy. Become a member today!
the membership form
Together we are stronger!
Washington State Pharmacy Association
411 Williams Avenue South
Follow the WSPA on Facebook, Twitter, and LinkedIn!
Renton, WA 98057
425-228-7171
Fax 425-277-3897
4 Washington Pharmacy www.wsparx.org

5. Washington Pharmacy 5

6. NW Pharmacy Convention
Thank You Convention Exhibitors and Attendees
T hank you to all who came to this year’s convention. We had nearly 500 participants! In addition to great weather, the weekend was filled with
energized conversations, networking, CE opportunities, and of course, golf! A special thank you to our sponsors - AmerisourceBergen, Cardinal Health,
and McKesson for their support. Also a big thank you to the nearly 60 exhibitors who participated.
Mark your calendars for the 2013 convention - May 30 - June 2, 2013! You won’t want to miss it!
Thank You 2012 Convention Exhibitors
Abbott Diabetes Care Rexam Prescription Products
AHRQ Roche Diagnostics
American Associated Pharmacies RX Relief
American Regent Inc. RX Systems Inc
Ameridose RxPlus Pharmacies
AmerisourceBergen ScriptPro
AmerisourceBergen Technology Smart Fill
Amylin Teva Neuroscience
Boehringer-Ingelheim, GmbH University of Florida Online
Cardinal Health Master of Science in Pharmacy
Career Staff RX Walgreens
Codonics
CP Advantage
CSL Behring
Cubist Pharmaceuticals
Designer Greetings
Fred Meyer Pharmacy
Genelex - You Script
Health Engineering Systems
ICU Medical, Inc.
Idaho State Pharmacy Association
Independent Pharmacy Cooperative
Janssen Pharmaceutical Companies of Johnson &
Johnson
Kirby Lester
Legally Mine
Lilly USA, LLC
McKesson
Merck Vaccines
MTS Medication Technologies
Nephron Pharmaceutical Corp
Nipro
Omnicell
Oregon State University Management & HR Skills for
Pharmacists Online
P.C.C.A.
Parata
PBA Health
Pharmacists Mutual
Pharmacy Software Reviews
PharMEDium Services, LLC
PioneerRX
QS/1
Qualis Health
6 Washington Pharmacy

7. Community Pharmacy
Contributed by: National Community Pharmacists Association
The Adherence Challenge pharmacy. Maybe you think your patients are perfectly adherent and do
not need any assistance. Try the following experiment— it won’t take
A
dherence seems to be the buzzword these days, from think tanks long.
such as the New England Healthcare Institute to our own shop
here at NCPA. During his address at last year’s annual convention, Research tells us that the greatest opportunity to improve medication
then-NCPA Executive Vice President and CEO Bruce T. Roberts, RPh, is- adherence is with patients who have diabetes, hypertension, depression,
sued an adherence challenge to the profession. He said that as one of its hyperlipidemia, and asthma. We’ve chosen the top two prescribed medi-
most crucial and basic functions, community pharmacists must advo- cations for each disease state and listed them in the box at right. Select
cate and promote to patients the importance of taking their medication one to three of the medications listed and check your pharmacy’s da-
as prescribed. tabase or dispensing report to see how many patients are refilling their
medications every 30 days, or as regularly as the prescription indicates.
You might be thinking, “What’s in it for me?” or “Why should I care
about improving patient adherence?” As a society, we’re all affected by How did your experiment turn out? As you expected? Better or worse?
non-adherence. The costs associated with non-adherence are stagger- Do you see potential for additional refills and improving your patients’
ing, with our health care system being “taxed” $290 billion in avoidable health? Now would be a perfect opportunity to take note of a few
medical spending every year when patients don’t take their medications names on the non-adherent list. The next time you see these patients,
as prescribed. emphasize how important it is to take their medications regularly as
prescribed and refill them on time. Try to find out if there is a larger issue.
The health consequences of non- adherence are alarming as well. A
reported 125,000 patients die annually of cardiovascular disease alone Alternatively, you could give these patients a call right now. As phar-
as a result of non-adherence to prescribed medication. macists, it is our duty to promote the adherence that helps our patients
It’s a perplexing and huge puzzle to grapple with and it won’t be solved maintain or improve their health. Your patients will respect and appreci-
overnight, but we must recognize the critical role pharmacists play in ate the personal interest you show in their well-being.
improving medication adherence and the beneficial opportunities that
follow. Think about it: we are the medication experts and the most ac- Over the course of the next month, conduct this experiment with all
cessible health care providers in the community. We serve as key touch medications on the list and see if you can practice at least two adher-
points for patients and can effectively monitor their medication use as ence interventions a day. We think you’ll be impressed with the results.
they move through the health care system.
Do you have an adherence idea, tip, or program that is working in your
NCPA believes that attention to patient adherence must become the pharmacy? Let us know. Send an e-mail to adherence@ncpanet.org, or
standard of practice for pharmacists in the future, and we are working call 800–544–7447.
toward achieving a goal we have set for our profession. It is our associa-
tion’s vision that in five years the actions taken by community pharma- Diabetes
cists will result in measurable improvement in patient adherence. Glucophage (metformin)
Actos (pioglitazone)
So in every corner of the association, from student affairs to the govern-
ment and legislative department, NCPA is taking strides to ensure that Hypertension
medication adherence becomes a consistent practice for every pharma- Prinivil (lisinopril)
cist. Lopressor (metoprolol)
NCPA is committed to sharing clinical pearls, best practices, communica- Depression
tion tips, and the business case behind improving patient medication Lexapro (escitalopram)
adherence. We’ll show you how adherence only takes a minute. Zoloft (sertraline)
Take care of your patients and the rest will follow. It’s a win-win.
Hyperlipidemia
Reprinted with permission from National Community Pharmacists Asso-
Zocor (simvastatin)
ciation in the July 2010 issue of America’s Pharmacist. For more informa-
Lipitor (atorvastatin)
tion about NCPA, visit www.ncpanet.org.
Asthma
Quick Adherence Experiment Proventil-HFA (albuterol)
Singulair (montelukast)
E
veryday medication adherence practices can take just a few min-
utes, yet reap rewards for you and your patients. Reprinted with permission from National Community Pharmacists As-
sociation in the August 2010 issue of America’s Pharmacist. For more
You may wonder how to start addressing the adherence topic in your information about NCPA, visit www.ncpanet.org.
Washington Pharmacy 7

8. WSPA Member Highlight
W
SPA member, Dr. Nancy Hecox has been highlighted in 2012 by APhA as an Honorable Mention as an
Immunization Champion and by the Washington State Public Health Association as a Health Champion
for her outstanding work around immunizations.
Nancy works at Tieton Village Drug who has partnered with Yakima Health District to provide free vaccines
to children and adults in conjunction with the Yakima Health District. Tieton Village Drug, an independently
owned pharmacy, was the first pharmacy in the state to become a Vaccine for Children then a Washington
Vaccine Association provider. Nancy and Tieton Village Drug created the Vaccine for Adults program to provide
free vaccine to uninsured and underinsured adults. Vaccines are administered on site and also through off site
immunization clinics in businesses, schools, impromptu clinics, the local Mission, day care centers, senior citizen
centers, long term care facilities, state fairs, boardrooms, treatment centers and nursing homes. This program
protects community health by ensuring the uninsured and underinsured in the Yakima Valley have free access to
an important service. When asked about her pharmacy service Nancy says “I am trying to provide a new delivery
model, as most of these citizens can’t take time off of work to make a doctor’s appointment, pay for childcare
and miss work for the most vital of all preventative healthcare. That is vaccines.”
Nancy’s dedication to improving health goes beyond both immunizations and her community alone. She has
published an article in the Journal of the American Pharmacists Association titled “Tuberculin skin testing by
pharmacists in a grocery store setting.” Nancy has taken her experience providing TB testing to other pharma-
cies to expand the number of pharmacists providing this service to their patients. This is a clear example of
Nancy’s interest in better serving her patients by identifying needs, and overcoming barriers to solving prob-
lems.
Nancy is an Associate Professor of Pharmacology at Pacific Northwest University of Health Sciences College of Osteopathic Medicine. Nancy has been mar-
ried to Ray Hecox for 32 years, who is willing to be her with vaccine clinics when necessary. Together they have a passion for serving their community.
CALL FOR AWARD NOMINATIONS
“Don't worry when you are not recognized, but strive to be worthy of recognition.”
-Abraham Lincoln
T
he Washington State Pharmacy Association annually honors the accomplishments of deserving pharmacy professionals. The 2012 Award winners will
be recognized at the Distinguished Awards Banquet during the WSPA Annual Meeting November 2-4, 2012 at the Great Wolf Lodge in Centralia, WA.
We urge you to take a moment and nominate a colleague that you believe deserves to be recognized for their accomplishments. Awards include:
• Bowl of Hygeia
• Washington State Pharmacist of the Year
• Washington State Health System Pharmacist of the Year Award Sponsored by Pfizer
• Washington State Pharmacy Student of the Year
• Washington State Pharmacy Technician of the Year
• Washington State Distinguished Young Pharmacist of the Year Sponsored by Pharmacist Mutual
• Bill Mueller Outstanding Mentor Award
• David Almquist Award
• Distinguished Leadership Service Award
• Innovative Pharmacy Practice Award
• Rodney D. Shafer Achievement Award
• Cardinal Health Generation RX Champions Award
For a list of previous award winners and award descriptions, please go to www.wsparx.org and click on “About WSPA” and “Awards”. Please complete the
2012 Award Nominations form and submit by August 27, 2012. We look forward to hearing from you!
8 Washington Pharmacy

9. National News
Contributed by: APhA
Health care teams with pharmacists best for
The Community Preventive Services Task Force described the compo-
hypertension nents involved in TBC as adding new staff or changing the roles of existing
staff; forming teams that included the patient, the primary care provider,
C
ommunity Preventive Services Task Force gives team-based care for and other health professionals; and having the team support and share
patients with high blood pressure its highest recommendation based responsibilities for hypertension care. Team activities included facilitating
on reviews of nearly 80 studies. communication and coordination of care; enhancing use of evidence-based
guidelines; establishing regular, structured ways to monitor patient prog-
Pharmacists on patient care teams dealing with hypertension received a ress and schedule additional visits; and engaging patients actively in their
major boost recently when the Community Preventive Services Task Force own care with education, support, and other tools and resources.
endorsed team-based care (TBC) including pharmacists to improve blood
pressure control. The task force, an independent, nonfederal, uncompen- Based on these findings, the task force called for "health care and public
sated group of public health and prevention experts appointed by the CDC health organizations [to] consider implementing a multidisciplinary team-
director, gave the evidence supporting TBC its highest recommendation. based approach to improve the effectiveness of hypertension care for
patients." The task force added that the benefits of TBC could also apply to
"APhA and America's pharmacists applaud the findings of the Community other heart disease risk factors, such as high cholesterol and diabetes.
Preventive Services Task Force," said APhA Executive Vice President and CEO
Thomas Menighan, BSPharm, MBA, ScD (Hon), FAPhA. "Patients need all In addition, the Community Preventive Services Task Force credited the
of us in health care to work together as a team focused on helping them CDC/CMS-led Million Hearts initiative, which incorporates TBC as a central
achieve the goals they set with their physicians and other providers on the component in preventing 1 million heart attacks and strokes by 2017. The
team." task force noted that blood pressure control is one of the four health behav-
iors targeted by the initiative using the acronym ABCS, along with aspirin
Based on a review of nearly 50 studies conducted between 2003 and 2012 use, cholesterol management, and smoking cessation.
as well as a systematic review of nearly 30 studies published in 2006, the
Community Preventive Services Task Force concluded that TBC for patients "We celebrate CDC's support and the Community Preventive Services Task
with high blood pressure increased the proportion of patients with con- Force's recommendations to use team-based care to improve blood pres-
trolled blood pressure, decreased systolic and diastolic blood pressure, and sure control," said Rebecca Snead, BSPharm, Executive Vice President and
improved patient outcomes for diabetes and blood lipid levels. CEO of the National Alliance of State Pharmacy Executives. "Pharmacists
are strong supporters of the Million Hearts initiative to achieve the goal of
The teams investigated in these studies included a patient and a primary preventing 1 million heart attacks and strokes by 2017, and the task force's
care provider, with most adding a pharmacist, a nurse, or both. Only four recommendations will maximize the team-based care necessary to achieve
studies did not incorporate a pharmacist or nurse. Pharmacists and nurses this goal."
improved both systolic and diastolic blood pressure comparably, while
studies including pharmacists significantly increased the proportion of "The affirmation that team-based care clearly improves patient outcomes
patients who were able to control their blood pressure. makes our work to accelerate expansion of interprofessional education
across all health professions even more timely and important," said Lucinda
"Pharmacists have been building the capacity to provide enhanced care for Maine, PhD, BSPharm, Executive Vice President and CEO of the American
decades while the 'system' catches up," Menighan noted. "We have been Association of Colleges of Pharmacy (AACP). "AACP is pleased to provide
gratified by the mounting evidence and public notice that shows that when leadership to such initiatives."
pharmacists get involved in medication use, costs go down and patient
care quality goes up. Today, we are eager to work with our colleagues in Reprinted with permission from the May 22, 2012 issue of APhA’s FocusXtra
medicine and nursing to build the kinds of collaborative practices that most and Alex Egervary. For more information about APhA, visit their web site at
benefit our patients." http://www.pharmacist.com”
Washington Pharmacy 9

10. LRAC News
By Dedi Hitchens, Director of Government Affairs
T
he Washington State Legislature has spent a great deal of time pharmacy and she is up for re-election. If you live in the Eatonville, Ort-
trying to come to an agreement on how to balance the biennial ing, Rainier or Yelm area, please consider giving her you support.
budget. Over the last two years, the Governor has called three
special sessions resulting in the addition of three months to the legisla- Preparing for 2013
tive session. Here’s how it works: Washington State’s legislative cycle is LRAC has already begun the interim work to prepare for the 2013 Legis-
two years long. Regular sessions begin the second Monday in January lative session. Issues of importance include Pharmacy Benefit Manager
and alternate between 105 day and 60 day sessions. Special sessions are Transparency/Audit, anti-mail mandatory mail order legislation, includ-
called by the Governor to address specific issues, usually the budget. ing pharmacists in the Legend Drug Act, allowing electronic prescribing
There can be any number of special sessions within the two-year cycle, of controlled substances, and increasing penalties for crimes against
and they can last no more than 30 days. pharmacies.
Of the major budget issues that faced legislators, several were perti- To see my end of session bill report and my budget report on the
nent to health care and impacted pharmacy. Considerations included 2011-13 Supplemental Operating Budget Washington State Lawmakers
elimination of Medicaid prescription coverage for adults, implementing passed during Special Session, you can go to the WSPA website at www.
prescription drug co-payments, and the elimination of the Basic Health wsparx.org.
Plan. The Washington State Pharmacy Legislative and Regulatory Affairs
Council (LRAC) successfully fought off those proposed cuts. If you have additional issues, please contact us. All issues will be consid-
ered by the LRAC Steering Committee and the bills will be reviewed and
During the 2012 Legislative Session, LRAC defended the profession approved by the LRAC Legislative Review Committee.
against numerous bills and budget proposals that would have negative-
ly impacted pharmacy. A bill introduced by the Department of Health November Elections
(DOH) to increase your license fee by $25 annually to fund the Prescrip- This year we have the opportunity to vote in several elections. At a state
tion Monitoring Program was introduced. While the WSPA has sup- level, we will be electing a new Governor. In addition, the entire Wash-
ported the PMP and has helped to find other funding mechanisms, LRAC ington State House of Representatives and half of the State Senators are
opposes this funding approach and was successful in getting the issue up for re-election. Federally, we have a Presidential election.
tabled until next year. A budget proviso authorizing the Health Care
Authority (HCA) to implement a competitive bidding process for generic We have had a few state legislators who stood out this year. Senator
drugs was inserted in the House budget which potentially could have Mike Carroll, Republican from the Lakewood area (28th district), who sits
led to HCA selecting one preferred generic drug for Medicaid clients for on the Senate Health and Long Term Care and Senate Judiciary com-
specific diseases. Lawmakers didn’t get the opportunity to hear concerns mittees is a supporter of pharmacy bills. He sponsored our Pharmacy
from stakeholders. This quickly became a priority during the Special Robbery bill and was instrumental in moving the bill out of the Senate.
Session. When the final version of Washington State’s Operating Budget He has a tight race. Pharmacy needs “champions” in the legislature and
was released, the competitive bidding provision was included in the Senator Carroll was our champion on our Pharmacy Robbery legislation.
budget. LRAC switched gears and fired up our grassroots efforts. LRAC,
WSPA, and NACDS sent out Action Alerts to members to urge Governor Representative Kirk Pearson, a Republican in the Monroe area (39th
Gregoire to veto the provision in the budget. After weeks of meetings district), is running for a Senate seat. He sponsored our Pharmacy Benefit
with the Governor’s staff, Fiscal Policy staff, and various legislators, the Manager (PBM) Transparency legislation and would be a great pharmacy
Governor vetoed the generic competitive bidding process provision and supporter in the Senate. He said he is willing to continue to work on PBM
signed the budget into law. This was a huge success for pharmacy. Thank transparency legislation.
you to each of you who took the time to contact the Governor office!
Lt. Governor Brad Owen has been an avid supporter of pharmacy issues.
In addition to defensive efforts, LRAC saw an opportunity to work on He is a regular speaker at Pharmacy Day on the Hill in Olympia every
advancing the recognition of pharmacists as care providers through year. He is approachable and his office is always open to LRAC. Please
a bill requiring all Medicaid Managed Care plans to abide by certain give him your vote and a campaign contribution if you can.
provisions including paying for certain chronically ill patients to receive
a comprehensive medication review by a primary care provider. Work- A list of lawmakers who have gone above and beyond for Pharmacy is
ing in conjunction with the Washington State Hospital Association, the available in the Advocate section of the WSPA website at www.wsparx.
Washington State Medical Association, and a pharmaceutical manu- org. If you have any questions about your local legislator or where they
facturer, LRAC respectfully asked the sponsor of the bill, Senator Randi stand on pharmacy issues, please do not hesitate to call me. I am more
Becker, Republican from the 2nd District and Ranking Minority for the the happy to answer any questions.
Senate Health Care Committee, if we could amend her bill to include
Washington pharmacists. We shared the recent Report to the US Sur- LRAC is making great strides in Olympia. Please continue to support our
geon General with Senator Becker highlighting the value of pharmacists efforts by maintaining your membership. If you haven’t joined, please do
provided care services. She agreed to the amendment. This was a big so today. A lot of changes are going on with Health Care and you can bet
step for pharmacists- gaining consensus with stakeholders on the role of there will be more to come. Get involved, support LRAC.
pharmacists in patient care and chronic therapy management. Unfor-
tunately, the Health Care Authority applied a substantial fiscal note and Thank you to all of you who have given your continued support to the
killed the bill in committee. Senator Becker proved to be supportive of Washington State Pharmacy Legislative and Regulatory Affairs Council .
10 Washington Pharmacy

11. School News
personnel at a firefighter training center in Spokane. The first respond-
T
he College held its first ers training simulated a hospital wing collapsing due to heavy snow
stand-alone commence- on roof and multiple injuries resulting. Faculty members Brenda Bray
ment ceremony on May and Colleen Terriff teach emergency preparedness and response
4 at the Masonic Center in to third-year pharmacy students and emphasize the importance of
Spokane. More than 1,000 pharmacists being involved in community-wide disaster planning and
students, their families and exercises. A third faculty member – Megan Willson – helped stage a
College faculty and staff were
there. For the past decade, WSPA Member Greg Gibbons Named WSU
WSU pharmacy graduates have 2011 Outstanding Alum by WSU College of
attended the WSU Spokane
ceremony and prior to that, the Pharmacy
WSU Pullman ceremony. Both ceremonies are still options for those
G
graduates, but the College also created its own ceremony this year to
be able to focus more attention on its students and pharmacy. WSPA reg Gibbons, Class of 1982, was recently named “Outstanding
CEO Jeff Rochon and WSPA President Julie Akers administered the Alumnus of the Year” by the WSU College of Pharmacy. Greg
Oath of a Pharmacist to the PharmD graduates near the end of the received the award in April at the WSU College of Pharmacy’s
ceremony. annual “Donor Appreciation and Awards Night” held in Spokane. The
Alumni of the Year Award was established to recognize a WSU Pharmacy
alumnus whose contributions to the community and the health care
A web cam has been set up for viewing the construction underway
profession have brought distinction to the WSU College of Pharmacy.
on the College’s new building in Spokane, which began last August.
The web cam can be accessed from this page on the College’s web
Greg is the owner of Gibbon’s Pharmacy
site: www.pharmacy.wsu.edu/information/
in Toppenish, Washington, and is part of a
newbuilding.html The College is on track
multi-generational pharmacy family. His
to move its Pullman facilities to Spokane
father, Everett Gibbons, is a 1956 WSU
by the end of the summer of 2014.
pharmacy graduate. In 1982, after gradu-
ation from the WSU College of Pharmacy,
The College created a new position of
Greg returned to Toppenish to work in his
“Ombudsman for Students” and Associate
dad’s pharmacy. He also worked at other
Professor Mark W. Garrison was appoint-
pharmacies in the area including the
ed. Garrison will serve as an additional
Indian Health Clinic and at a local hospital
resource for students, allowing the College
pharmacy. He was always working hard to
to separate student support on admin-
expand his base of knowledge about his
istrative issues from student support on
profession.
academic issues, such as advising. Garrison
has been a pharmacy faculty member
For the past three decades, Greg has been
since 1989 and recently finished a term as
very involved in his community. He is a
assistant dean for student services. He has
member of the Yakima Valley Pharmacy
received a “teacher of the year” award six
Association, was named the Washington State Pharmacist of the Year in
times, including the past four years. His appointment as ombudsman
2008, and is a member of the Cardinal Health Northwest Retail Advisory
is effective through June 30, 2013.
Committee. Greg has served as a member of the WSU College of Phar-
College Dean Gary M. Pollack, who is also the vice provost for WSU
macy Dean’s Advisory Council, and has played an instrumental role in ef-
Health Sciences, was awarded $1.8 million in grants for recruitment
forts to increase scholarship support for students. He and his family have
of two new faculty researchers and for two pieces of critically needed
been long time supporters of the College, and have recently established
laboratory equipment from the Health Sciences and Services Author-
an endowed scholarship for future pharmacy students.
ity of Spokane County. Dr. K. Michael Gibson is one of the researchers
and will be joining the College on July 1 from Michigan Technological
For more information about the WSU College of Pharmacy, please con-
University. Negotiations are underway with the second researcher.
tact Communications Director Lorraine Nelson at lanelson@wsu.edu.
Pharmacy students and faculty participated in a disaster training
exercise in April with firefighters, paramedics, and search and rescue
Washington Pharmacy 11

12. School News
At the UW School of Pharmacy graduation in June, Karen Craddick
received the Alumni Professional Excellence Award. Stephanie Friedman
received the Faculty Excellence Award.
Pharmacy student Denise Ngo, ’14, and Associate Dean Nanci Murphy
School/Faculty News have received a Project CHANCE award from the American Pharmacists
Association - Academy of Student Pharmacists and the Health Resources
Impel Neurophama, a company started by Professor of Pharmaceu- and Services Administration. The $10,000 funding from the award will
tics Rodney Ho, John Hoekman, PhD, ‘10, and a UW business school go to create a cardiovascular disease prevention project at Community
alumnus, was recently showcased in a ‘Pacific Northwest’ magazine Health Care in Lakewood, Wash.
article about Seattle’s booming invention market. Impel is developing a
technology platform for nose-to-brain drug delivery. Graduate Student News
In June, Professor of Pharmaceutical Outcomes Research and Policy Lou
Garrison moderated a plenary session at the 17th International Meeting Medicinal chemistry grad student Jean Dinh and pharmaceutics grad
for the International Society for Pharmacoeconomics Outcomes and students Diana Shuster and Jenna Voellinger received Institute of
Research (ISPOR) in Washington, D.C. The session focused on best prac- Translational Health Sciences TL1 Multidisciplinary Predoctoral Clinical
tices for the design, implementation and evaluation of performance- Research Training Awards.
based risk-sharing arrangements.
Medicinal chemistry grad student Shannon Kruse has been awarded
Clinical Professor of Pharmacy Micki Kedzierski and her students were an NIH National Institute of General Medical Sciences T32 Predoctoral
profiled on the magazine-style TV show ‘UW360’ for their work with Molecular Biophysics Training Grant.
chemically dependent populations. The episode aired on UWTV and
KOMO4 throughout the month of May. Medicinal Chemistry grad student Eri Nakatani received a prestigious
University of Washington Magnuson Scholarship.
Kelly Lee, Assistant Professor of Medicinal Chemistry, has been awarded PORPP grad student Heidi Wirtz received a two-year postdoctoral fellow-
a five-year, $1.45 million grant from the NIH to study influenza virus ship in health outcomes from the PhRMA Foundation.
membrane fusion.
Amy Cizik, graduate student in the Pharmaceutical Outcomes Research
The UW/Hearthstone Pharmacy Education and Service Program (origi- & Policy Program, has received a UW Thomas Francis, Jr. Global Health
nally co-founded by Professor Emeritus of Pharmacy Joy Plein) will re- Travel Fellowship. Cizik will travel to Tanzania this summer to pilot test a
ceive the Leading Edge Care and Services Award from Aging Services of mobile phone application for surgical follow-up with surgeons from the
Washington. The UW/Hearthstone service program is one in which UW Muhimbili Orthopaedic Institute.
pharmacy faculty and students provide education and care to residents
of Seattle’s Hearthstone Continuing Care Community.
WSPA Member Awarded UW 2011
Sean D. Sullivan, Director of the School’s Pharmaceutical Outcomes
Research & Policy Program, has been named the Stergachis Family Distinguished Alumnus Award in Pharmacy
Endowed Professor and Director. The Stergachis Family Endowment
was established in January 2012 and is named after Andy Stergachis,
Practice
Professor of Epidemiology and Global Health and Adjunct Professor of
T
Pharmacy and his wife, JoAnn Stergachis.
he School of Pharmacy’s 2011 Distinguished Alumnus Award in
Professor of Pharmaceutics Jashvant Unadkat has started a new venture Pharmacy Practice will go to a young pharmacist who has already
at the UW School of Pharmacy — the UW Research Affiliates Program made significant contributions to pharmacy technology, clinical
on Transporters. It is a cooperative effort between the school and phar- pharmacy and pharmaceutical outcomes research. Ryan Hansen is the
maceutical research companies AstraZeneca, Genentech and Merck. vice president and director of technology at Kelley-Ross Pharmacy, the
Researchers across the four institutions are collaborating on research president of a clinical pharmacy consulting business, and has recently
that will facilitate drug development. completed his PhD in the School of Pharmacy’s Pharmaceutical Out-
comes Research & Policy Program (PORPP).
Pharmacy Student News
“I am very humbled and honored to receive this recognition,” said Han-
The UW student chapter of the American Pharmacists Association - sen. “I have so many colleagues who are also very worthy of this award.
Academy of Student Pharmacists (APhA-ASP) won the Chapter Achieve- Joining this list of esteemed colleagues and alumni offers a welcome
ment Award in the AAA Division at the March APhA meeting in New challenge to my career.”
Orleans. Hansen received his Doctor of Pharmacy degree in 2003. Prior to that,
he graduated cum laude with a Bachelor of Arts in chemistry and phi-
12 Washington Pharmacy

13. School News
losophy from Carroll College in Montana. He will graduate from PORPP increased care for patients.
this spring with his dissertation investigating the association between
sedative hypnotic insomnia treatments and motor vehicle crashes. “Since joining Kelley-Ross as an intern in 2000, Ryan Hansen has
fundamentally changed our practice for the better,” said Ryan Oftebro,
Hansen has played a key role in helping Kelley-Ross Pharmacy gain president and principal of Kelley-Ross. “His grasp of technology in
recognition for its innovative pharmacy practice models. The phar- healthcare, business acumen and leadership have enabled Kelley-Ross
macy operates one of the few community pharmacy-centered mail to grow and thrive. Ryan's dedication and service to the profession
service businesses in the country. This business allows Kelley-Ross sets an example for us all.”
to compete directly with national mail service corporations in order
to preserve the integrity of regional community pharmacy practice. As a consultant, Hansen is working with other pharmacies to help
The result is a thriving business that serves local and regional clients them enhance their own technology initiatives. He also helps them
interested in mail services. They have also created a practice model develop models and evaluations for improving cost effectiveness.
that other community pharmacies can follow.
Hansen works with UW pharmacy students at Kelley-Ross locations
Hansen, who was named a 2010 Next Generation Pharmacist Technol- who are interested in applying and evaluating new technologies in
ogy Innovator of the Year Finalist, led the implementation of robotic their practice settings. In addition, he teaches the material related to
technology within Kelley-Ross. At its long-term care location, Kelley- pharmacy pricing and reimbursement in “Pharmacy, Health Care and
Ross uses two robots that automate much of the dispensing services. Society,” a core PharmD course.
This is not only making mail service pharmacy more cost efficient for
clients; it is also giving pharmacists greater opportunity to provide Hansen has worked for many years in support of the technology initia-
tives of the School of Pharmacy’s Bracken Pharmaceutical Care Learn-
ing Center (PCLC). In this role, he works to enhance students’ access to
state-of-the-art pharmacy technology. This past year, when the PCLC
received new computers, he volunteered his time to help update the
pharmacy management system’s computer network.
Hansen and his wife, Keli, have also endowed a scholarship for incom-
ing PharmD students. The Hansens are also long-time School of Phar-
macy Dean’s Club members.
In his role as a PhD candidate in PORPP, Hansen’s research interests in-
cluded investigating the economic cost of opioid prescription misuse,
evaluating pharmacotherapy options for treating epilepsy and model-
ing treatments for chronic respiratory diseases. He has presented at
conferences for the International Society for Pharmacoeconomics
and Outcomes Research and the Agency for Healthcare Research and
Quality, among others. He has been published in multiple journals,
including the Clinical Journal of Pain and the American Journal of
Health-System Pharmacy.
“I have worked with countless pharmacists and students over my 30-
plus years as a pharmacist and academic,” said Professor of Pharmacy
and PORPP Director Sean Sullivan. “I have witnessed firsthand a variety
of styles of work ethic, attitude, commitment and demeanor. Ryan
exhibits the very best of all these attributes, and at such a young
age. He embodies everything we should value and acknowledge in a
distinguished alumni.”
He will be presented with the Distinguished Alumnus Award by the
School of Pharmacy and the Pharmacy Alumni Association at the
Dean’s Recognition Reception on April 5 at the Museum of Flight in
Seattle.
Washington Pharmacy 13

14. Grow your business,
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14 Washington Pharmacy

15. Health Information Exchange (HIE)
Q&A on HIE
prescriber
New Possibilities for Health Information • Sending a current medication profile to a hospital admitting a
patient
Exchange (HIE), E-Prescribing and Beyond • Reporting immunizations to the Washington State immunization
registry
Contributed by Susan Teil Boyer, MS, RPh, HIE Consultant • Checking the immunization registry for a patient history of
immunizations reported
O
ver the past two months WSPA and OneHealthPort, the
state’s Health Information Exchange, gathered feedback
during conversations with pharmacists around the state. As stated above, pharmacists who are part of the HIE can receive
We talked with pharmacists about opportunities to use the HIE to Continuity of Care Document (CCD) for their patients. The Continuity
improve quality of care and reduce administrative cost. Our primary of Care Document is the new standard for exchanging a patient record
focus has been promoting e-prescribing to pharmacies in the state summary. It is designed to simplify what physicians share on a patient
that have not yet adopted it. The HIE’s federal partner, the Office referral or other care transition.
of the National Coordinator (ONC), has challenged us to improve Information contained in the CCD includes:
e-prescribing participation to 97% of pharmacies throughout the • Basic Patient information
nation in 2012. • Patient problems
• Medications
In the course of our conversations we found that pharmacists • Immunizations
who are not e-prescribing have a number of concerns. Among • Alerts
the top concerns are transaction costs, vendor costs to connect, • Vital signs
completeness of the information, and lack of interest among the • Functional statistics
pharmacies’ local prescribers. WSPA and OneHealthPort will be • Results
working together to try and identify solutions for these concerns • Plan of Care
and move forward on electronic prescription transmission. While
e-prescribing is a key focus of our outreach effort, it is not the only
reason for pharmacists to adopt HIE. As streamlined patient care becomes increasingly important and
care teams, including pharmacists, become more prominent, the
The HIE is a flexible and robust communication channel for HIE Community Referral and Consult Report offers an intriguing
pharmacists to exchange clinical and business messages with other opportunity to package and share clinical information with your
healthcare providers. Through the use of HIE, pharmacists are able prescriber colleagues. For example, you may report adverse effects of
to quickly obtain information and improve the quality of patient care. a drug back to the prescriber, and the prescriber may refer a patient
Examples of transactions that a pharmacy participating in HIE could for immunizations or blood pressure monitoring to you. The referral
send and receive include: and consult tool is very flexible. Matched with the CCD and other
information described above, this tool and the HIE have great potential
• Receiving lab results to support the ongoing integration of pharmacists with their broader
• Receiving Continuity of Care Document (CCD) with clinical community care teams.
information
• Receiving admission and discharge information from the For more information on these possibilities and opportunities you can
nursing home for long term care pharmacies. contact us at OneHealthPort.
• Community referral form, for the physician to request
monitoring by the pharmacist http://www.onehealthport.com/HIE/index.php
• Consult form, for the pharmacist to report back monitoring
results, issues, concerns
• Sending a consult report or continuity of care document to a
Washington Pharmacy 15

16. 16

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With McKesson and Pace Alliance
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The Pace Performance Rewards program now In addition to monthly rebates of up to 13% A Complete Solution for
provides even greater rewards based on your (or more) on qualified OneStop purchases, Independent Pharmacy
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requirements. So all Pace members who use through the Pace Peak Performance working on behalf of independent
McKesson as their primary wholesaler and Rewards program.1 Pace Peak Performance community pharmacies to help
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Washington Pharmacy 17

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18 Washington Pharmacy

19. continuing education for pharmacists
Volume XXX, No. 4
FDA Safety Warnings and Prescribing Updates: Simvastatin,
Acetaminophen, Ondansetron, and Dronedarone
Mona T. Thompson, R.Ph., containing entity labeling has to muscle injury.
PharmD always carried a risk of muscle Furthermore, 22 patients
injury (myopathy), FDA issued a (0.4 percent) in the 80mg group
Dr. Thompson has no relevant financial drug safety communication in June versus zero patients in the 20mg
relationships to disclose.
2011 making several restrictions, group developed rhabdomyolysis.
contraindications, and dose limita- Rhabdomyolysis was defined as
tions for simvastatin to reduce the unexplained muscle weakness or
Goal. The goal of this lesson is to risk of muscle injury based on the pain with serum CK >40 times the
provide a review of significant U.S. agency’s ongoing safety review of upper normal limit. This adverse
Food and Drug Administration therapy with high-dose simvasta- event can range in severity from
(FDA) safety warnings and associ- tin. These recommendations are asymptomatic elevation of muscle
ated prescribing updates that were currently reflected in the updated enzymes to life threatening electro-
recently issued regarding simvas- product information leaflets for all lyte imbalances, acute renal fail-
tatin, acetaminophen, ondansetron, products. ure, multi-organ failure syndrome,
and dronedarone. In 2010 nearly 30 million and death.
prescriptions of simvastatin were The greatest risk of develop-
Objectives. At the completion of dispensed from one generic manu- ing myopathy was observed in the
this activity, the participant will be facturer alone, ranking it 7th among first year of simvastatin 80mg daily
able to: the Top 200 medications dispensed. therapy. In addition, an increased
1. demonstrate an understand- It addition, in 2010 it was esti- risk of myopathy was seen in pa-
ing of the safety warnings and mated that more than two million tients taking simvastatin 80mg in
associated prescribing changes, if Americans were prescribed what is combination with amiodarone.
applicable, issued for each of the now considered an unsafe dose of Secondary to SEARCH and oth-
entities discussed; simvastatin. er safety data, the revised recom-
2. determine the patient popu- Among the studies that led to mendation states that the previous
lation at risk for adverse events in the new FDA recommendations highest approved dose of simvas-
relation to the safety warnings for was the Study of the Effectiveness tatin 80mg should only be used in
each of the entities discussed; and of Additional Reductions in Choles- patients who have been taking this
3. identify fundamental patient terol and Homocysteine (SEARCH). dose for 12 months or more without
counseling points secondary to the The study was a seven-year, evidence of myopathy. Patients
safety warnings and associated randomized, double-blind clinical already taking lower dosages of
prescribing changes, if applicable, trial that compared the efficacy the drug should not be titrated to
for the entities discussed. and safety of simvastatin 80mg to the 80mg dose. If additional LDL
simvastatin 20mg, with or without reduction is necessary, alternate
Simvastatin vitamin B12 and folate in patients therapy is recommended.
Simvastatin is an HMG-CoA who had survived a myocardial in- Atorvastatin 40mg and rosuva-
reductase inhibitor (“statin”) that farction. In SEARCH, 53 patients statin 10mg are effective in reduc-
was initially approved in 1991 as (1 percent) in the 80mg group ing LDL levels by 45 to 50 percent
an adjunct to diet to reduce the lev- versus two (0.03 percent) in the which is comparable to simvastatin
els of low-density lipoprotein (LDL) 20mg group developed myopathy, 80mg. Table 1 compares the rela-
or “bad” cholesterol. It is marketed which was defined as unexplained tive LDL-lowering efficacy of avail-
as Zocor® or in combination with muscle weakness or pain with a able statin agents at all doses.
ezetimibe as Vytorin® by Merck. serum creatine kinase (CK) greater Myopathy is often the result
Abbott markets Simcor® which than 10 times the upper normal of simvastatin used in combina-
contains simvastatin and extended limit. CK is a muscle enzyme tion with certain drugs including
release niacin. While simvastatin- which becomes elevated secondary CYP3A4 inhibitors. Therefore,
Washington Pharmacy 19

20. Table 1
Relative LDL-lowering efficacy of statin agents**
Atorvastatin Fluvastatin Pitavastatin Lovastatin Pravastatin Rosuvastatin Simvastatin % LDL-C
Reduction
40 mg 1 mg 20 mg 20 mg 10 mg -30%
10 mg 80 mg 2 mg 40 mg 40 mg 20 mg -38%
20 mg 4 mg 80 mg 80 mg 5 mg 40 mg -41%
40 mg 10 mg 80 mg -47%
80 mg 20 mg -55%
40 mg -63%
**Adapted from FDA drug safety communication last updated December 15, 2011
the second part of the FDA safety tiazem, while the 20mg dose should crease the risk of adverse skeletal
communication resulted in a not be exceeded with amlodipine, muscle effects. Lastly, simvastatin
new simvastatin label with more amiodarone, or ranolazine. prolongs INR when used in com-
stringent drug interaction and Also, large quantities of grape- bination with warfarin, rendering
drug-drug dosing limits. Simvas- fruit juice should be avoided (>1 frequent INR monitoring when
tatin is now contraindicated with quart per day). It is important to initiating or altering therapy. The
itraconazole, ketoconazole, posa- note that several of these medica- most common adverse events re-
conazole, erythromycin, clarithro- tions are prescribed together for lated to therapy are: upper respira-
mycin, telithromycin, HIV protease the treatment of various cardiovas- tory infections, headache, abdomi-
inhibitors, nefazodone, gemfibrozil, cular-related diseases, and health- nal pain, constipation, and nausea.
cyclosporine, and danazol. The care providers may need to adjust Table 2 includes safety infor-
10mg dose should not be exceeded therapy to avoid drug interactions. mation for simvastatin to convey to
in patients taking verapamil or dil- Merck launched a new website, patients.
www.simvastatininfocenter.com,
with information for patients about Acetaminophen
Table 2 these changes. Acetaminophen or paracetamol
Simvastatin Patient The simvastatin label contin- (N-acetyl-p-aminophenol or APAP)
Safety Counseling Points ues to issue other contraindica- is the most widely used analge-
tions, warnings, precautions, and sic and antipyretic agent in the
• All patients starting simvastatin- monitoring recommendations that United States and the world. It is
containing entities should be advised remain consistent and are worthy available over-the-counter (OTC)
of the risk of myopathy, and should of review. Simvastatin is contrain- as a 325mg and 500mg immedi-
be told to report promptly any unex- dicated in patients with active liver ate release tablet, and as a 650mg
plained muscle pain, tenderness, or disease (or persistent unexplained extended release preparation mar-
weakness. elevated hepatic transaminase keted for the treatment of arthri-
• Patients using the 80mg dose
levels), women who are pregnant tis. It is also available in several
should be informed of the greater risk
of myopathy. or may become pregnant (category infant and children’s formulations
• Patients should be informed that X), and nursing mothers. Other consisting of chewable tablets, oral
there are certain types of medications predisposing factors for skeletal suspension and elixir, as well as a
that should not be taken in combina- muscle effects (myopathy and rhab- component of many OTC and pre-
tion with simvastatin, and urged to domyolysis) include advanced age scription cold and analgesic combi-
inform providers when a new medica- (>65), female gender, renal impair- nation products.
tion is prescribed or when the dose of ment, and uncontrolled hypothy- Unfortunately, its commonality
an existing medication is increased. roidism. Liver function tests (liver and comfort with use may have led
• Patients should be advised to report
enzymes) should be obtained prior to presumed safety among Ameri-
any symptoms that may indicate liver
injury such as fatigue, anorexia, right to initiation of therapy and semi- cans who are either not aware of
upper abdominal discomfort, dark annually for the first year. More the maximum safety dose or who
urine, or jaundice. frequent monitoring is warranted do not fully comprehend the extent
• Women of childbearing age must for patients with elevated transam- of harm that is associated with
use an effective method of birth inase levels until normalization oc- exceeding the safe dose. Therefore,
control to prevent pregnancy while curs. Discontinuation should occur unintentional overdosing may oc-
using simvastatin. If they become if ALT/AST is persistently >3 times cur in patients who are ingesting
pregnant, simvastatin therapy should the ULN (upper limit of normal). multiple acetaminophen-containing
be discontinued immediately. Women
In addition to the drug interac- products.
who are breastfeeding should not
take simvastatin. tions listed above, fibrate products Acetaminophen is not always
and niacin (>1gm/day) may in- clearly labeled as an ingredient
20 Washington Pharmacy