minnesota pharmacist · 2018. 4. 2. · minnesota pharmacist • fall 2017 • 5 upfront views and...

Inside this Issue

ALNE Recap

New School year, New Dean

Current Treatment Modalities and Clinical Standards for HIV Patients

...and more!

Fall 2017

MINNESOTA PHARMACIST

INSIDE Fall 2017Volume 71, Number 4

On the Cover

Congratulations to our 2017 award winners!

Minnesota Pharmacists AssociationYou’ll find quick updates about what is happening at MPhA and more photos

from our events!

You can find us at www.twitter.com/minnpharmassoc

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www.linkedin.com/groups/MPhA-Minnesota-Pharmacists-

Association-4268388

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UPFRONT VIEWS AND NEWS

A Message from the MPhA President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Message from the Interim Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

NATIONAL NEWS

Pharmacists and the War on Opioid Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

CLINICAL NEWS

Current Treatment Modalities and Clinical Standards for HIV Patients . . . . . . . . . . . 16

MPhA NEWS

Member Spotlight: Allyson Schlichte, PharmD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

2017 MPhA Annual Learning Networking Event & MTM Symposium a Success! . . 13

Fourth Quarter 2017: Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

MPhA News & Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Get Smart about Your Student Loan Repayment Options . . . . . . . . . . . . . . . . . . . . 26

Technicians: Get a Discount on Power-Pak Continuing Education . . . . . . . . . . . . . . 26

MINNESOTA NEWS

New School Year, New Dean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Socks n’ Sandwiches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Going Above and Beyond For Mom, Daughter With Rare Disease . . . . . . . . . . . . . 15

GLOBAL PERSPECTIVE

International Spotlight: FIP Provides Opportunity for Pharmacists to Expand Their

Horizons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

MPhA RESOURCE GUIDE

MPhA Resource Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Minnesota Pharmacist • Fall 2017 • 3

MPhA Board of Directors

President: Michelle Aytay Past President: Molly Ekstrand

President-Elect: Jason Varin Secretary-Treasurer: Doug Lobdell

Speaker: Tony OlsonRural Board Members:

Reid Smith Michelle Johnson

Metro Board Members: Tim Affeldt Ann Byre

At-Large Board Members:Sarah Anderson

Amanda BrummelCheng Lo

Rebecca PicklerSarah Westberg

Student RepresentationDuluth MPSA Liaison: Jorgen Kvaal

Minneapolis MPSA Liaison: Lauren Lemke

Ex-Officio Vice Speaker: Alison Knutson

College of Pharmacy Representative: Bruce Benson

Pharmacy Technician Representative: Cheryl Hetland

Minnesota Pharmacist

Official publication of the Minnesota Pharmacists Association. MPhA is an affiliate of the American Pharmacists Association, the American Society of Consultant Pharmacists, the Academy of Managed Care Pharmacy, and the National Community Pharmacists Association.

Editor: Laurie Pumper, CAE

Managing Editor, Design & Production: Jillian Blanc

The Minnesota Pharmacist journal is published quarterly by the Minnesota Pharmacists Association, 1000 Westgate Drive, Suite 252, St. Paul, MN 55114-1469. Phone: 651-697-1771 or 1-800-451-8349, 651-290-2266 fax, [email protected].

Send address changes to Minnesota Pharmacist, 1000 Westgate Drive, Suite 252, St. Paul, MN 55114-1469.

ARTICLE SUBMISSION/ADVERTISING: For writer’s guidelines, article submission, or advertising opportunities, contact Laurie Pumper at the above address or email [email protected].

Copyright 2017. Bylined articles express the opinion of the contributors and do not necessarily reflect the position of the Minnesota Pharmacists Association. Articles printed in this publication may not be reproduced in any manner, either in whole or in part, without specific written permission of the publisher. Acceptance of advertisement does not indicate endorsement.

Upcoming EventsSouthwest Minnesota Pharmacists/MPhA Town HallNovember 30, 2017New Ulm Country Club, New UlmRegister Today!

MPhA Virtual Coffee Break: Medicare Part D Enhanced MTMDecember 20, 2017Online WebinarRegister Now!

Pharmaceutical Care LyceumJanuary 3-5, 2018Deep Portage Learning Center, HackensackApply Today!

Minnesota Pharmacy Legislative DayFebruary 27, 2018Capitol Ridge Best Western Plus, St . PaulSave the Date!

APhA’s Delivering Medication Therapy Management ServicesMay 4, 2018Ewald Conference Center, St . PaulRegister by April 9!

MPhA Leadership Summit and House of DelegatesMay 31, 2018Midland Hills Country Club, RosevilleSave the Date!

The Minnesota Pharmacists Foundation collaborates with and invests in the profession

of pharmacy for the enrichment of public health .

VISIT MNPHARMACISTS .ORG FOR MORE INFORMATION .

MPhA Mission: Serving Minnesota Pharmacists

to advance patient care. The Minnesota Pharmacists Association is a state professional

association, whose membership is made up of pharmacists, pharmacist students, pharmacy technicians, and those with a business

interest in pharmacy . MPhA will be the place where pharmacists go first for education, information and resources to become empowered

to provide optimal patient care . MPhA will be the recognized and respected voice of pharmacy with legislators, regulators, payors,

media and the public .

4 • Minnesota Pharmacist • Fall 2017

The PATF, which is co-chaired under the leadership of MPhA Past President Jill Strykowski, has served as a body that represents “one voice” for pharmacy at the legislature . Although we are joined together as “one voice” for pharmacy, we heard loud and clear last legislative session that pharmacy needs to expand its stakeholders and collaborate with others . This year MPhA continues to co-lead the PATF and has been working tirelessly to reach additional stakeholders . We have already had discussions with the Minnesota Medical Association (MMA), physician stakeholders, key groups such as project Clear Way, big Pharma, the Board of Pharmacy and many legislators interested in advancing patient access to medications .

Another goal from 1978 was to “develop an allegiance of students to the practice and the association” so that students could understand MPhA and the importance of being involved . This brings us to our second goal this year, which is to develop future pharmacy leaders . Once again, a lot has changed since 1978; for example we now have the Minnesota Pharmacy Student Alliance (MPSA), which is a strong voice for student pharmacists . MPhA is working closely with MPSA . Recently, along with Past Presidents Molly Ekstrand and Jill Strykowski, I presented at an MPSA meeting . This meeting was planned by MPSA Policy and Advocacy Liaison (PAL) Kyler Anderson, and it provided an opportunity to share MPhA’s legislative agenda with the students . I am also presenting on behalf of MPhA at meetings in October and December . MPhA continues to work with pharmacy students to engage them in action and provide opportunities that show the importance of being involved and becoming future leaders . A great example of this is Legislative Day, which highly leverages the work of our students . The students develop the written materials to educate our legislators . Mark your calendars now for this year’s Legislative Day on February 27, 2018.

Our third goal this year for MPhA is to advance pharmacy practice by expanding the role of the pharmacist in patient care . This looks very familiar to a goal in 1978, which was “to create a positive public image of the practice of pharmacy .” When Lowell wrote this goal, he stated that one of the most significant professional problems was the

President’s Desk

A Message from the MPhA President


A MPhA President’s Agenda Then (1978) and Now

The Minnesota Pharmacists Association’s (MPhA) mission is to serve Minnesota pharmacists to advance patient care . Throughout the years, the health care landscape has evolved and pharmacists have become more engaged in providing direct patient care . As an association, MPhA has lead and supported pharmacists through our profession’s changes and although much has changed, much has also stayed the same .

Former MPhA President Lowell Anderson shared his president’s agenda from 1978 with me. As I read through his pages of wisdom and guidance, I was amazed by how much had changed in our profession; but then again, I was amazed by how much had stayed the same . I am going to share a glimpse of some of the similarities with you as well as how much has changed since 1978! I hope you enjoy this journey as much as me!

Lowell began his president’s agenda by mentioning that it was an extremely busy time for pharmacy; this definitely sounds familiar to today’s landscape! His agenda was 11 pages long and laid out 14 goals, so I will only share the “Cliff’s Notes” version. I will illustrate how MPhA’s agenda from 1978 parallels our agenda for this year . To do this, I will focus on the three goals that I presented in my president’s agenda for MPhA this year which are: 1. Continue and expand collaboration with stakeholders . 2 . Develop future pharmacy leaders . 3 . Advance pharmacy practice by expanding the role of the pharmacist in patient care . I think you will be amazed at how similar they are .

Let’s start with the first goal for this year, “continuing and expanding collaboration with stakeholders.” MPhA’s goal in 1978 looked very similar, “to have regular discussions between the profession and the college and the State Board .” A quick look back shows us that a lot has happened since 1978 — including the formation of the Pharmacy Advocacy Task Force (PATF), which is comprised of stakeholders from the profession, the college, and consists of regular communication with the state board .

By Michelle Aytay

Message From the President continued on page 5



abuse or misuse of prescription drugs .

Today, the national opioid epidemic is on the forefront of everyone’s minds. Only two years ago, naloxone became available in Minnesota pharmacies . MPhA is continuing to lead the charge when it comes to working with legislators and stakeholders to help pharmacists be part of the solution to the opioid epidemic . The third goal of MPhA this year is to advance pharmacy practice by expanding the role of the pharmacist in patient care . MPhA continues to work with PATF on this initiative and our priorities this year include pharmacist prescribing privileges for Naloxone,

self-administered contraceptives, travel medications, and smoking replacement . In addition, we are supporting pharmacists as mental health professionals and pharmacist administration of injectable medications .

The successes of associations, as of people, are the sum of previous decisions . I will continue to build on the programs of previous leaders of the association while also providing leadership that respects the rapidly evolving health care delivery marketplace .

Message from the President continued from page 4

Interim Executive Director continued on page 6

Message from the Interim Executive DirectorBy Marsha Millonig

Did you miss the MPhA Annual Learning Networking Event/MTM Symposium on September 7-8, 2017? If so, then you also missed a fantastic lineup of speakers, interactive sessions, networking opportunities and the chance to develop a personal/professional/practice action plan! The meeting emphasized continuing professional development for the more than 250 pharmacists, student pharmacists, pharmacy technicians and other industry professionals . The popular MTM symposium drew a great crowd of participants and the Pharmacy Practice/Management and Clinical Interest Tracks were also well received .

Pharmacists’ involvement in team-based care was evident throughout the two-day program — starting with Dr . Mark Loafman’s inspiring look from a physician’s point of view of how we can best contribute to team-based care and become members of the team . That continued with the afternoon general session that was led by University of Minnesota Pharmaceutical Care Leadership Resident Anjoli Punjabi, who was joined by Southern Prairie’s Medical Director Norris Anderson . Finally, on Friday, MPhA Past President Molly Ekstrand, Dr . Rajiv Shah and pharmacy technician and former MPhA Board member Barb Stodola had an entertaining and educational look at creating the dream team .

I’ve just finished summarizing all the comments we received from our participants and the feedback is extremely positive, from the content to the new Thursday-Friday format and the capstone luncheon with new University of Minnesota College of Pharmacy Dean Lynda Welage . I want to sincerely thank all our volunteers who provided input to the event’s planning under the leadership of our Education and Events Committee Co-chairs Michelle Johnson and Denise Frank .

The meeting’s first day capped off with the Great Minnesota Pharmacy Event raffle and wine pull that raised funds for the Minnesota Pharmacists Foundation (MPF) to support student scholarship and other activities . Anjoli Punjabi worked closely with a team of volunteers under the co-leadership of MPF President Michelle Aytay and the event was a success . More to come on the Foundation in the near future as we look at holding a wine tasting to round out our newly energized MPF .

I’d also like to point out our celebration of recognition for our many well-deserved award winners at the Awards Reception prior to the MPF event . Congratulations to all of them . I encourage you to read more about the event and our winners in this issue of the Minnesota Pharmacist .



We also realize not all pharmacists are able to participate in the ALNE/MTM Symposium, especially our Greater Minnesota friends . We have an active member outreach effort underway through our reenergized Town Halls . We just completed a hugely successful Southeast Minnesota Pharmacists event in Rochester with nearly 40 participants coordinated by Sherwood Peterson . Dean Welage and President Aytay were both on hand to share insights and our agendas . Please mark your calendars for Town Hall events being planned Nov . 30 with the Southwest Minnesota Pharmacists, and Jan . 24, 2018, in St Paul . We hope to see you all there!

Finally, MPhA committees are working on the themes echoed in President Aytay’s column in this issue. Serving on an MPhA committee is a great way to meet new people while furthering your professional development . Most committees meet once a month for an hour and provide the ability to phone in for convenience . More information can be found at MPhA’s website, www.mpha.org.

I can tell you as an MPhA member, I’m so impressed with and proud of all the volunteers who give their time, talent and energy to all that is part of MPhA — from advocacy

to learning to networking and connecting . MPhA is truly a volunteer-driven organization and one that I am so fortunate to work with . Given the excellent team efforts we have made with our volunteer leaders and staff the past few years, I know we will continue to move MPhA forward in meeting its mission to serve Minnesota pharmacists to advance patient care .

We look forward to your feedback on the website and MPhA . Feel free to call me at any time or email me with any input you may have for YOUR association . My number is 651-366-6094 and my email is marsham@mpha .org . My personal goal is to ensure your needs are met in a responsive and positive manner and we can direct you to the right resources in an easy to access way . I look forward to being on the Minnesota pharmacy team this year and to your calls and input!

Best regards,

Marsha

Interim Executive Director continued from page 5

FEBRUARY 16-18, 2018Holiday Inn Des Moines-Airport & Conference Center

SAVE THE DATE!

High Quality Live CE: Up to 16.5 hrs for pharmacists and 10 hrs for pharmacy technicians

Clinically Intensive Program: Friday, Feb. 16, will feature high-level clinical programming designed for those who have or are seeking advanced certification

Keynote by Jacques Turgeon, BPharm, PhD: Dr. Turgeon is the chief scientific officer at Tabula Rasa HealthCare and will give the Saturday keynote on precision medicine.

...And More!

Highlights (so far) for the 2018 Midwest Pharmacy Expo include:

Agenda & Registration Coming in November!

www.MidwestPharmacyExpo.com


MPhA Pharmacy Advocacy FundThis form can also be completed at:

Minnesota Pharmacists Association | 1000 Westgate Drive, Suite 252 | St. Paul, MN 55114ph. 651-697-1771 | fax 651.290.2266

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Thank you for your continued support of pharmacy!

Please mail your payment to:

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MPHA NEWS

Allyson Schlichte, PharmD, is the Medication Therapy Management Provider and Operations Lead at the Fairview Specialty Services Pharmacy in Minneapolis . “I work at our company offices three days a week, and then two days per week I take care of patients at the Fairview Uptown Clinic .”

Allyson studied at Drake University in Iowa, where she received her Doctor of Pharmacy degree . Originally upon enrolling in postsecondary school she wanted to become a dentist, saying, “I really wanted to help people and thought being a dentist would be a great way to get to know patients, but then I started learning more about drugs and found them to be absolutely fascinating . Thank goodness for that very wise admissions counselor!”

With 11 years’ experience working in the pharmacy profession, Allyson started her career at Walmart pharmacy . She ultimately worked her way to Fairview Health Services in Minneapolis . When asked what she likes most about her profession, she responded, “I get to work one-on-one with patients and their medications. It’s so rewarding to watch patients reach their health goals. It’s also really fun to help people whittle down their medication lists — I watched one of my patients go from high doses of basal and bolus insulin, down to just 500mg of metformin over the course of a year while he made substantial changes to his diet and exercise . He feels so much better and is so much happier — that’s what is so great about what I get to do . I love building the relationships with people as they go through their own health care journeys .”

When discussing why her membership to MPhA is a value to her career, Allyson said, “I’ve met some amazing and supportive people within the MPhA community . I keep up my membership because it’s always fun to meet new pharmacists, technicians, students and other pharmacy friends as well as catch up with the ones I’ve known quite a while .” She also noted that a topic worth exploring within the association and its membership is pharmacist burnout, saying, “I would love to see MPhA start discussions and dialogue about pharmacist burnout . We hear so much about physician burnout and now nursing burnout, but no one is talking about pharmacists . We have to start taking better care of ourselves!”

When she isn’t working with patients at the Fairview clinics, Allyson likes to bike (weather and seasons permitting) . “I spend a lot of time on a bicycle; during the summer out on the lovely trails in Minneapolis and St . Paul, usually sampling some local craft brews along the way . In the winter you’ll find me in cycle class at Lifetime Bloomington South .”

The last movie she saw was HBO’s The Immortal Life of Henrietta Lacks. “I understand it’s a book many U of MN students read. It was definitely a difficult, but enthralling watch .”

Allyson’s favorite meal is a culinary classic: “My favorite food is still Kraft Macaroni and Cheese (only the kind in shapes, no elbow macaroni for me). I’m not sure there is even anything one would consider real food in there, but it’s awesome!”

Member Spotlight: Allyson Schlichte, PharmD

Have You Visited the MPhA Website Recently?

You can find information to become a more effective advocate for pharmacy and get

the latest news about state and federal legislation affecting pharmacy!

www.mpha.org


Member Spotlight: Allyson Schlichte, PharmDMINNESOTA NEWS

New School Year, New DeanBy Lynda Welage, PharmD, FCCP, Dean, University of Minnesota College of Pharmacy, [email protected]

I’m very excited for this school year, my first as Dean of the University of Minnesota College of Pharmacy .

Throughout my career (most recently as dean and professor at the University of New Mexico, and prior to that as faculty and associate dean for Academic Affairs

at the University of Michigan College of Pharmacy and associate director in the Michigan Institute for Clinical and Health Research), I heard great things about the Minnesota pharmacy community . I am very excited to now be a part of it .

Over the past several months, I’ve had the pleasure of meeting with many of you and learning more about pharmacy practice in Minnesota . I am very eager to meet with more practitioners and hear your thoughts on the college and the practice in the state .

Over the next several months, I will travel around the state to meet as many people as I can . I was at MPhA’s Southeast Minnesota Pharmacist Night Extravaganzapalooza in Rochester on Oct . 12, and have tentatively scheduled an event in Duluth for later in the month . I will share the dates of other get-togethers as the details are confirmed. Please watch for an invitation soon in your inbox, and join us if your schedule allows .

One of my top goals as Dean is to work with you to develop new and enhance existing partnerships to further practice transformation and meet the health care needs of all Minnesotans, particularly those in rural and underserved areas. I’d also like to continue to build momentum in advancing our innovative models of education, and new discoveries and translational research .

Looking ahead, we at the college are excited to launch our new five-year strategic plan that includes these goal areas: education (professional and graduate), research, practice, people and diversity, outreach/community engagement/global, resources and alumni affairs . We are now working to develop and implement specific strategies and tactics to meet these goals .

We are also excited to be a part of the largest philanthropic initiative in U of M history, Driven: The University of Minnesota Campaign. Our college-specific campaign focus is on our innovation and impact . You can learn more at www .pharmacy .umn .edu/alumni/give

I would also like to share that we recently welcomed another exceptional class of incoming students .

Our Class of 2021 is made up of 168 students – 60 students in Duluth and 108 students in the Twin Cities . The class has an average PharmCAS GPA of 3 .4, which is typical of our high-quality students we accept each year . Approximately 77 percent are Minnesota residents, while others come from 17 states and 35 other countries, including Ethiopia, Kenya, China, the Philippines, Thailand and Mexico, to name a few . This year, we again welcomed two students from China through a partnership program between the College of Pharmacy and several Chinese universities .

Additionally, our incoming class has a well-rounded education. Approximately 92 percent have Bachelor’s degrees with majors in more than 35 disciplines . Five students have a Master’s degree, and one already has a doctoral degree .

Our students were busy prior to matriculating into the College of Pharmacy . They have work experience as a pharmacy technician, soccer coach, dietary assistant, server, research assistant, lifeguard, medical scribe, nanny and more . Collectively, they have dedicated more than 300,000 hours to volunteer and extracurricular activities .

The Class of 2021 has much to offer each other, the College of Pharmacy and the profession of pharmacy . Please join me in welcoming them .

Once again, thank you for your kind welcome . I am honored to have been selected to serve as Dean of this great College of Pharmacy . I look forward to becoming part of the Minnesota pharmacy community .


MINNESOTA NEWS

Socks n’ SandwichesBy Vu Ha, APPE Pharmacy Student, University of Minnesota, College of Pharmacy

In the practice of pharmacy, we truly never know what to expect on a daily basis as there are always obstacles that challenge our mental and emotional capabilities . Pharmacists continually face adversity in their practice setting whether it be inpatient or outpatient, and yet they always manage to find their way through for the sake of the patient . At times, it may seem that too much focus may be spent on drug therapy problems and insurance issues at the expense of recognizing our own patients’ personal adversity . Some have gone through numerous hardships in their lives while others may come from difficult backgrounds that have affected their views on medication experience .

Since 1991, Wilder Research has published a study every 3 years regarding the state of the homeless population in Minnesota in terms of demographics and factors affecting the population . Their researchers interview members of the population in order to gauge numerous variables, such as family status and nights spent without a place of stay . The most recent publication in 2015 showed a 9% decrease in the number of homeless individuals in Minnesota compared to the 2012 report, but highlighted the unfortunate truth that many are afflicted with mental health conditions and lack the basic needs to access health care services . There is an alarming need to bring more awareness to the homeless population and help bring resolution to a patient subset that tends to be overlooked by even the most astute health care professionals .

My name is Vu Ha. I’m currently a fourth-year pharmacy student from the University of Minnesota. I am a first generation Asian American and the first to receive an actual college education in my family . I am not originally from the United States; I was born in a refugee camp in Thailand as my parents sought out a clear passage to the U.S. When we finally came to America, our family had zero dollars to our name . With no house, no job, no sense of belonging anywhere just yet, it would be an understatement to say that my family struggled initially . I can recall sleeping as a cozy family of 5 on the floors of our family friends’ apartments and using coupons to get free lunches at my elementary school . My grandpa (at the age of 56) was laying tiles and bricks, my mom worked at a nail salon, and my uncle cut hair . My unique background taught me this — that hardships of any sort ultimately teach you the value of hard work . I am forever thankful for those who have changed my life for the best

and influenced me to strive for more. Those around me have inspired me to do more for those who cannot help themselves .

During this past year, I began a volunteer initiative known as Socks n’ Sandwiches after developing a strong passion for community work and volunteering in underserved communities for many years at the College of Pharmacy . For this campaign, I aim to create 60 sandwiches monthly and deliver them on the fourth Thursday of every month to local homeless shelters around the Minneapolis-St . Paul metro area. Each sandwich is affixed with a positive saying or quote on a notecard for the individual to read once they open their sandwich bags . Socks are fundraised monthly as well, and there has been an outpouring of support from the world of pharmacy . The College of Pharmacy – Pharmaceutical Care and Health Systems Department, Park Nicollet Medication Therapy Management Team, Mayo Clinic Austin Pharmacy, Walgreens Specialty St . Cloud and many more have helped me each month to create these sandwiches and donated socks on their own behalf . Although the process is meant to help those who cannot help themselves, I have found that coming together for this activity promotes team building and brings awareness for the cause . Pharmacists and pharmacy students alike have offered countless hours and their services to Socks n’ Sandwiches to demonstrate our profession’s ability to understand the culture of our underserved patients and continue our philanthropic ways . As a whole, we have fundraised over 200 pairs of socks and more than 300 sandwiches have been passed out this past year thanks to our efforts .

Pharmacy is an ever-changing field that is filled with obstacles that challenge us mentally, physically, and sometimes emotionally almost every single day . Our profession demonstrates resilience and aptitude to adapt to any given situation . My challenge to you is this — join me in making a sandwich one day in the near future or donate a pair of socks and help bring awareness to the campaign against hunger in the homeless patient population .

Thanks for reading .

YouTube Video Promotional Video – Socks n’ Sandwiches


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MPHA NEWS

More than 200 pharmacists, technicians, pharmacy students and sponsors gathered in September for MPhA’s biggest event of the year . From the compelling keynote presentation by Dr . Mark Loafman to open the event to a closing presentation from new College of Pharmacy Dean Lynda Welage, our speakers kept everyone engaged and sparked new ideas and conversations .

A packed room of intrigued participants greeted Dr . Mark Loafman for his presentation on integrating medication management into primary care .

Our round table sessions, including this one on COPD (led by Lisa Krohn of Park Nicollet MTM in St . Louis Park) were very well attended and generated thought-provoking discussion .

Congratulations to Our Award Winners! Distinguished Young Pharmacist award: Kati Dvorak of FirstLight Health System in Mora, Minn ., received the award that recognizes one pharmacist in each state

for individual excellence and outstanding contributions . The prestigious award is presented by Pharmacists Mutual Companies, nationally recognized as a leader in providing

insurance products and risk management solutions to pharmacy professionals .

Bowl of Hygeia award: Denise Frank of Frank Consulting in Princeton, Minn . The “Bowl of Hygeia” Award is presented annually by participating pharmacy associations

in each of the 50 states, the District of Columbia, and Puerto Rico . The recipients are selected by their respective associations for their outstanding record of community service . The Bowl of Hygeia award is sponsored by the American Pharmacists Association Foundation and the National Alliance of State Pharmacy Associations .

Cardinal Generation Rx award: Laura Palombi of the University of Minnesota College of Pharmacy in Minneapolis . The Cardinal Health Generation Rx

Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention . The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem . It is also intended to encourage educational prevention efforts aimed at patients, youth, and other members of the community .

Excellence in Innovation award: Anjoli Punjabi of the University of Minnesota College of Pharmacy in Minneapolis . The Excellence in Innovation award is a national

award coordinated by the National Alliance of State Pharmacy Associations, and generously sponsored by Upsher-Smith Laboratories, Inc . to recognize and honor a qualified pharmacist who has demonstrated significant innovation in their respective practice, method or service

2017 MPhA Annual Learning Networking Event & MTM Symposium a Success!

ALNE Recap continued on page 14


directly or indirectly resulting in improved patient care and/or advancement of the profession of pharmacy .

Pharmacy Technician of the Year award: Baron Tisthammer of Fairview Specialty Pharmacy in Minneapolis . The Pharmacy Technician Award

recognizes pharmacy technicians in any practice setting who demonstrate leadership in their work and in their community .

Harold R . Popp Award: Todd Sorensen of the University of Minnesota, the current Executive Director for AIMM and a co-investigator on the ACCP grant . This

recognition, sponsored by MPhA, was established in 1969 in honor of the late Senator Harold R . Popp who was known to support the profession tremendously during his lifetime . This award recognizes one pharmacist annually for their outstanding service to the profession of pharmacy and is the highest honor bestowed by this association, and has been presented yearly since 1969 .

For additional photos from ALNE, visit the MPhA Facebook page .

Thanks to Our Sponsors

Many thanks to our sponsors for ALNE! We couldn’t enjoy this continued success without their support .

Platinum SponsorsMcKesson Drug Pharmacists Mutual

Gold SponsorNovartis

Silver SponsorsAmeriSourceBergen AstraZeneca Charterpoint Wealth Strategies HealthEast PharmacyNovo NordiskNutri-DynSanofi Upsher Smith Laboratories

Bronze SponsorSmart-Fill

Specialty SponsorsFriday Lunch Sponsor University of Minnesota College of Pharmacy

Coffee SponsorNACDS

ALNE Recap continued from page 13

Pharmacy Time Capsules are written by Dennis Worthen, who makes them available for state pharmacy associations to share with their members .

1992 – 25 years ago• For fiscal 1992, the total amount Medicaid spent on drugs in

1992 approached $6 .8 billion .• National health care spending was $854 .1 billion or $3287/

person .• There were 75 accredited colleges of pharmacy (compared

to 130 in 2015) .

1967 – 50 years ago• For fiscal year 1967, the total amount Medicaid spent on

drugs exceeded $182 million .• National health care spending was $51 .6 billion or $253/

person .

1942 – 75 years ago• Marijuana was removed from the US Pharmacopeia in 1942 .

It had been included since 1854 .• Premarin first marketed by Ayerst.

1917 – 100 years ago• Dean Rufus Lyman of the University of Nebraska calls for

the formation of a national pharmacy honor society that is eventually realized with the founding of the Rho Chi Society .

One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year.

To learn more, check out: www.aihp.org

Fourth Quarter 2017: Pharmacy Time CapsuleBy Dennis B. Worthen, PhD, Cincinnati, OH


Fairview Home Infusion recently celebrated an important milestone: reaching a patient census of 1,000 IV patients! This achievement was made even more special by the exceptional work the Fairview Pharmacy Services team did to make the patient—or rather, the patients—feel comfortable and cared for .

Meet Nancy and RachelNancy Larkey and her 11-year-old daughter Rachel have many things in common—their brunette locks, their quiet nature and their love of movies, to name a few . The two also share Fabry disease, a rare genetic disorder caused by a defective gene .

“I tested Rachel when she was two months old,” says Nancy. “I was really hoping she wouldn’t have it.”

For Nancy, the disease manifests in a burning sensation in her hands and feet, decreased ability to sweat and muscle pain. Rachel hasn’t had many symptoms yet, other than an occasional migraine .

Even so, Nancy wanted Rachel to start treatment for the disease early in hopes that it would keep the symptoms at bay and lead to a longer lifespan . As she started seeking treatment for her daughter, Nancy decided that it was the right time to start her own treatment as well .

In it TogetherIn searching for the right place to receive treatment, Nancy found her way to Fairview Home Infusion, part of Fairview Pharmacy Services, where she had a special request: she wanted to be able to receive her treatment together with Rachel .

Whereas many infusion centers offer only pediatric or adult infusions, Fairview Home Infusion serves people of all ages and was able to make a few special arrangements so that Rachel and Nancy could get their first treatments side by side .

“I knew Rachel wouldn’t be comfortable by herself because she doesn’t like needles,” says Nancy. “This way she could see what they were doing to me first and know it was OK.”

Home Sweet HomeAfter being monitored on-site during their first treatment, Nancy and Rachel have been able to start receiving infusions from Fairview in their own home .

Not having to travel for treatment gives the family more time for the things they love to do together, like playing cards and having family dinners at their grandparents’ house .

“Fairview was helpful and nice,” says Nancy. “I’m happy about it .”

Going Above and Beyond For Mom, Daughter With Rare Disease

MINNESOTA NEWS

By Fairview Health Services

Fourth Quarter 2017: Pharmacy Time Capsule


By Daniel Jude, PharmD, AAHIVP, CSP, Manager of Specialty Clinical Services, Fairview Specialty Services Pharmacy, Minneapolis

Current Treatment Modalities and Clinical Standards for HIV Patients

CLINICAL NEWS

HIV Treatments... continued on page 17

The world of HIV medicine is complex and can be intimidating, but there are good reasons for this . What sets HIV apart from other complex disease states are the many advances in research, drugs for treatment and delivery systems . Even though most of us are not working in settings where HIV disease state management programs are warranted, pharmacists still have an obligation to recognize areas where we can improve outcomes and patient care . My goal is to provide a high-level review of current treatment guidelines and products, dig into prevention strategies, and describe new medications expected in the near future .

Current Guidelines and TreatmentsThe United States DHHS Guidelines continue to be the gold standard for care of people living with HIV/AIDS (PLWHA) in the U .S . The guidelines can easily be found by typing “HIV Guidelines” into a search engine or visiting https://aidsinfo .nih .gov/guidelines . The guidelines were recently given a facelift and have a much more modern online interface .1 The PDFs are still available on the site, should you want to download a copy for reference offline. A few notable tools within the guidelines include 1) drug:drug interaction tables that address Area Under the Curve (AUC) changes for both antiretrovirals (ARVs) and the interacting medication; 2) co-infection considerations for Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and tuberculosis (TB); 3) detailed ARV dosing for renal/hepatic insufficiency; 4) very in-depth review of perinatal data and recommendations on use of ARVs before, during and after pregnancy . A helpful “Tables Only” link also provides a fast way to get to key information without the full discussion included .

Current data support the long-held standard starting treatment-naïve patients on two nucleoside/nucleotide reverse transcriptase-inhibitors (NRTIs) along with one other “anchor” ARV .1 You might remember non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease-inhibitors (PIs) as being popular in the past, but that is no longer the case . Integrase strand transferase-inhibitors (INSTIs or integrase-inhibitors) now account for four out of the five “Recommended Regimens” (see table 1).1

Table 1 (adapted from the guidelines)2

Recommended Regimen Options

Recommended regimens are those with demonstrated durable virologic efficacy, favorable tolerability and toxicity profiles, and

ease of use .To improve readability, the ‘anchor’ ARV has been bolded,

boosting agents have been italicized, and the active NRTI has been underlined .

INSTI plus 2-NRTI Regimen:• Triumeq

• Dolutegravir/abacavir/lamivudinea—only for patients who are HLA-B*5701 negative (AI)

• Tivicay + either Truvada or Descovy• Dolutegravir plus either tenofovir disoproxil

fumarate/emtricitabinea (AI) or tenofovir alafenamide/emtricitabine (AII)

• Genvoya or Stribild• Elvitegravir/cobicistat/tenofovir alafenamide/

emtricitabine (AI) or Elvitegravir/cobicistat/ tenofovir disoproxil fumarate/emtricitabine (AI)

• Isentress + either Truvada or Descovy• Raltegravir plus either tenofovir disoproxil

fumarate/emtricitabinea (AI) or tenofovir alafenamide/emtricitabine (AII)

Boosted PI plus 2 NRTIs:• Prezista + Norvir + either Truvada or Descovy

• Darunavir/ritonavir plus either tenofovir disoproxil fumarate/emtricitabinea (AI) or tenofovir alafenamide/emtricitabine (AII) a • Lamivudine may substitute for emtricitabine or

vice versa .

INSTIs have offered generally increased tolerability over PIs and NNRTIs while offering comparable efficacy and durability .1 INSTIs as a class can interact with aluminum and/or magnesium-containing antacids if given concomitantly; it is critical to counsel patients and re-educate as necessary to prevent an easily avoided Rx:OTC interaction .1 Because of dolutegravir and elvitegravir’s hepatic clearance, drug:drug interactions are still plentiful especially since elvitegravir is given with a pharmacokinetic boosting agents, such as ritonavir or cobicistat .1 For all INSTIs a single resistance mutation is clinically significant. If resistance is suspected or proven,


dolutegravir is approved for twice daily dosing .1 This could mean a patient could be prescribed a single tablet regimen (STR) of dolutegravir/abacavir/lamivudine along with another tablet of dolutegravir 12 hours later, leading to confusion for the pharmacy and patient .

Tenofovir disoproxil fumarate (TDF) has been common- place in HIV regimens . A new prodrug form was recently approved: tenofovir alafenamide .3 The new form has a longer plasma half-life, allowing the target cells to gather up the medication over a longer period of time . This allows a smaller milligram dose of the alafenamide to achieve similar efficacy. In clinical studies, the lower exposure appears to prevent two notable adverse effects of the TDF form: decrease in bone-mineral density, and renal toxicities .4,5 The DHHS guidelines have included the new prodrug in recommendations at the same strength (A) but admittedly with less evidence (II) .1

While the DHHS guidelines list which regimens a naïve-patient should be offered, many patients encountered in the pharmacy will be on older and sometimes much more complex regimens. Switching a patient’s ARV regimen is a complex process, is not always appropriate, and includes multiple factors: resistance mutations, viral response, immune response, adverse effects, renal and hepatic function, experience with previous regimens, etc .1 A pharmacist should consult with an HIV specialist before offering alternative therapies .

Prevention StrategiesPrevention of new HIV infections is multifaceted and includes syringe-exchange/access programs, treatment-as-prevention strategies, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) . Each of these concepts can benefit from the inclusion of pharmacists.

The Minnesota Pharmacy Syringe/Needle Access Initiative allows pharmacies to voluntarily sell up to 10 syringe/needles to a patient at a time without a prescription .6 Providing unused and clean syringes to a population decreases the sharing of syringes and helps decrease HIV and HCV transmission . In response to the HIV outbreak in Scott County, Indiana, in 2015 that included 190 new cases, a syringe-access program was initiated to help stem the overwhelming growth of new infections due to syringe sharing while connecting people to substance-abuse treatment resources .7 Minnesota pharmacists can help decrease the risk of HIV transmission by providing clean syringes at all outpatient or ambulatory care pharmacies . To learn more, please visit: http://www .health .state .mn .us . When a PLWHA is able to achieve the goal

of “undetectable,” it means that their most recent viral load assay showed a level below the limits of detection . Studies have shown that patients with undetectable levels of virus have a very low risk of transmitting HIV to an uninfected partner .1 The CDC released a letter in September 2017 stating this perspective, and many organizations have begun educational campaigns equating “undetectable” to “untransmittable” .8 Pharmacists can help patients achieve the goal of “undetectable” through supportive adherence services and removing access and clinical barriers to the patient therapy .

In 2014 the FDA approved tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for pre-exposure prophylaxis (PrEP) to prevent HIV acquisition in high-risk HIV-negative patients . You might recognize TDF/FTC as a common NRTI backbone for treating HIV infection . The FDA also mandated a REMS program with only “Elements to Ensure Safe Use” component be created for TDF/FTC when used for PrEP .9 Health care provider educational material, screening checklists and training are available online through the FDA’s and manufacturer’s websites. Of note, a prescription for TDF/FTC for PrEP should never contain more than a total of a 90-day supply; this is due to the requirement that the patient have an HIV test performed by their provider at least every 2-3 months .Post-exposure prophylaxis (PEP) can be broken into two sections: occupational (oPEP) and non-occupational (nPEP) . Both scenarios are detailed in DHHS guideline documents .10,11 Of note, oPEP is much more straightforward due to occupational health laws and requirements . Timing is important in both, with 28-30 days of ARV regimens that need to be initiated within 48-72 hours after the time of exposure. Difficulties with nPEP include timing of presentation to care (often on weekends), insurance coverage (unexpectedly high costs with high deductible plans), psychosocial needs of patient (sexual assault victim, “blackout” situations), provider lack of knowledge (unfamiliar with urgency, order requirements) and system barriers (lack of care coordination in the ER) . While some health systems and clinics have processes in place, they can be inconsistent . Pharmacists can help support by providing emotionally supportive and expedient care to nPEP patients .

Future Treatment OptionsLong-acting injectables are currently being explored for treatment and prevention of HIV . Cabotegravir, a new INSTI, given with rilpivirine in a long-acting injectable form


HIV Treatments continued from page 16


has shown to maintain 87-94% of patients virologically suppressed after an oral lead-in period .12 Both 4- and 8-week intervals of the injectable were studied along with an oral comparator, as well as the acceptability of the different regimens . Cabotegravir has also been studied on its own for PrEP use and will continue into phase III studies .13 Oral lead-ins will need to occur to ensure safe use of long-acting injectable formulations once approved; pharmacists are in a position to ensure optimal outcomes when patients transition dosage forms .

The first single-tablet regimen containing a PI is expected in the near future . Darunavir boosted by cobicistat with emtricitabine and tenofovir alafenamide (TAF) has been part of a switch study where patients were switched to this regimen after suppressed on a boosted PI plus emtricitabine and tenofovir disoproxil fumarate (TDF) .14 There was no statistical difference between rates of success for those who switched versus those who did not switch . With the change from TDF to TAF in the regimen backbone, an expected increase in cystatin c-based eGFR occurred in the TAF arm .

A new oral INSTI, bictegravir, is being studied for treatment naïve patients in two head-to-head trials versus dolutegravir . Dolutegravir is paired with an abacavir/lamivudine backbone for the first trial and tenofovir alefenamie/emtricitabine in the second trial .15,16 In both studies, the bictegravir performed similarly to the dolutegravir arms . Safety data were similar except for greater nausea, neuropsychiatric and sleep-related symptoms in the dolutegravir/abacavir/lamivudine arm .Doravirine, the first new NNRTI in many years, is being studied along with lamivudine/tenofovir disoproxil fumarate in treatment-naïve patients versus efavirenz/emtricitabine/tenofovir disoproxil fumarate .17 The doravirine arm showed similar virologic efficacy at week 48 but had significantly less neuropsychiatric adverse effects .

Regimen simplification typically means switching complex regimens for simpler regimens that preserve efficacy with higher tolerability . Multiple studies are being conducted examining if reducing regimens to either a dolutegravir or boosted-darunavir along with a single NRTI is an acceptable regimen .1 Though the studies show hopeful data, there are still not enough data at this time to recommend this type of switch outside of a clinical trial setting .

SummaryHIV treatment continues to evolve with each passing year, to the benefit of PLWHA and their quality of life. Pharmacy

practice offers unique opportunities to support prevention and treatment of HIV-infection . Though it might seem intimidating, knowing where to find quality information, such as DHHS guidelines, that can aid in treatment decisions is key to supporting optimal patient outcomes .

Citations1 . Panel on Antiretroviral Guidelines for Adults and Adolescents . Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents . Department of Health and Human Services . Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL .pdf Accessed 2017 October 8 .

2 . Panel on Antiretroviral Guidelines for Adults and Adolescents . Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents . Department of Health and Human Services . Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL .pdf Accessed 2017 October 8 . Table 6 .

3 . Descovy Prescribing Information . Gilead Sciences . Available at https://www .descovy .com/ Accessed on 2017 October 8 .

4. Arribas JR, et al. Significant Efficacy & Long-Term Safety Difference With Taf-Based Str In Naïve Adults . Croi 2017 . Abstract 453 .

5 . Orkin C, DeJesus E, Ramgopal M, et al . Switching from rilpivirine/emtricitabine/tenofovir disoproxil fumarate (RPV/FTC/TDF) to rilpivirine/emtricitabine/tenofovir alafenamide (RPV/FTC/TAF): Safety and efficacy through 48 weeks. Program and abstracts of the 2016 International Congress of Drug Therapy in HIV Infection; October 23-26, 2016; Glasgow, United Kingdom . Abstract O124 .

6 . Minnesota Pharmacy Syringe/Needle Access Initiative . Minnesota Department of Health . Available at http://www .health .state .mn .us/divs/idepc/diseases/hiv/syringe/mnpharmacy .html Accessed on 2017 October 8 .

7 . Rudavsky S . An Indiana town recovering from 190 HIV cases . Indianapolis Star . Available at http://www .indystar .com/story/news/2016/04/08/year-after-hiv-outbreak-austin-still-community-recovery/82133598/ Accessed on 2017 October 8 .




8 . McCray E, Mermin J . Dear Colleague Letter . Centers for Disease Control and Prevention . Available at https://www .cdc .gov/hiv/library/dcl/dcl/092717 .html Accessed on 2017 October 8 .

9 . Truvada for a Pre-Exposure Prophylaxis (PrEP) Indication . Gilead Sciences . Available at: https://www .truvadapreprems .com/ Accessed on 2017 October 8 .

10 . Kuhar DT, et al . Updated U .S . Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis . Infect Control Hosp Epidemiol . 2013 Nov;34(11):1238 .

11 . Dominguez KL, et al . Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV—United States, 2016 . Centers for Disease Control and Prevention . Available at https://stacks .cdc .gov/view/cdc/38856 Accessed on 2017 October 8 .

12. Eron J, et al. Safety and efficacy of long-acting CAB and RPV as two drug IM maintenance therapy: LATTE-2 week 96 results . IAS 2017 . Abstract MOAX0205LB .

13 . Landovitz R, et al . Safety, tolerability and pharmacokinetics of long-acting injectable cabotegravir in low-risk HIV-uninfected women and men: HPTN 077 . IAS 2017 . Abstract TUAC0106LB . ClinicalTrials .gov . NCT02178800 .

14. Molina JM, et al. Efficacy and safety of switching from boosted-protease inhibitor plus emtricitabine/tenofovir disoproxil fumarate regimens to the single-tablet regimen of darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) in virologically-suppressed, HIV-1-infected adults through 24 weeks: EMERALD study . IAS 2017 . Abstract . TUAB0101

15 . Gallant J, et al . A phase 3 randomized controlled clinical trial of bictegravir in a fixed dose combination, B/F/TAF, vs ABC/DTG/3TC in treatment-naïve adults at week 48 . IAS 2017 . Abstract MOAB0105LB .

16 . Sax PE, et al . Phase 3 randomized, controlled clinical trial of bictegravir coformulated with FTC/TAF in a fixed-dose combination (B/F/TAF) vs dolutegravir (DTG) + F/TAF in treatment-naïve HIV-1 positive adults: week 48 results . IAS 2017 . Abstract TUPDB0201LB .

17 . Squires KE, et al . Fixed dose combination of doravirine/lamivudine/TDF is non-inferior to efavirenz/emtricitabine/TDF in treatment-naïve adults with HIV-1 infection: week 48 results of the Phase 3 DRIVE-AHEAD study . IAS 2017 . Abstract TUAB0104LB .

Complimentary On-Demand Virtual Coffee Break Webinars Available to MPhA Members

Listen to a presentation on HIV treatments by Daniel Jude for more information. MPhA offers educational webinars that provide you with education from experts on best practices, trends, effective solutions, and quality resources to help you

advance your career as an pharmacy professional. E-learning is ideal for those who are unable to travel or are looking for educational opportunities in between conferences. The program provides opportunities to obtain CEs from the comfort of

your home or office with both live and on-demand options. These webinars are free for MPhA members — another benefit of membership! More than 20 webinars are available on a wide range of topics.



GLOBAL PERSPECTIVE

International Spotlight: FIP Provides Opportunity for Pharmacists to Expand Their HorizonsBy Alina Cernasev, PharmD, PhD student and Jason Varin, PharmD

Change in a pharmacist’s world is ever-present. What is happening in our immediate, personal domain can sometimes be overwhelming and often monopolizes our professional thoughts. By taking a step back and looking beyond our environs, we may be able to learn how to manipulate change based on what others have done, are doing or will be doing to effect change. In this recurring series, we will share several “snapshots” of what is happening beyond the confines of our borders.

For over a century, pharmacists from around the globe have been gathering annually to discuss current issues in the field of pharmacy. The Pharmaceutical International Federation (FIP) conference provides a forum to share ideas and to discuss existing and develop new directives in pharmacist provided health care . The 2016 FIP conference took place in Buenos Aires, Argentina . This meeting produced an

excellent venue for pharmacists and pharmacy students to learn more about the latest patient care processes, international practice guidelines, and pharmacy curriculum developments from across the globe . The conference theme was “Reduction in Global Disease” with a focus on educating the patient .

Dozens of keynote speakers, panel discussions and poster presentations provided the structure of the meeting . It was very difficult to choose which events to attend, as many I was interested in were presented concurrently . Every session I attended was interesting and focused on important topics . For example, a topic that captured my attention was medical marijuana . I now have a better understanding of the current research and how other countries are using cannabis for medical purposes and are implementing legislation affecting its use .

I learned that several states in the U .S . have legalized marijuana use in one form or another, and that its use was (at the time of the meeting) illegal in Australia . I also learned that in 2013, Uruguay became the first country in the world to completely legalize marijuana . Private citizens may cultivate up to six cannabis plants within their homes . However, all sales of cannabis must be conducted through the federal government .

A workshop that drew my interest was the application of health literacy to optimize patient counseling and outcomes . I found the experience relevant because it offered me a more complete understanding of how to apply simple and appropriate terminology while avoiding medical jargon and overly technical terms when counseling patients .

These sessions provided an excellent opportunity to network with other pharmacists with similar interests from around the world and exchange ideas and experiences . For example, David (a British pharmacist) explained the expanding role of pharmacists in clinics in the United Kingdom . Michelle, a Swiss pharmacist, outlined the use of adherence methods used in treatment of HIV/AIDS populations . Tommy, a scientist from Sweden, described regulations that govern OTC distribution in Europe .

In conclusion, I feel that the FIP conference is the best opportunity to learn about pharmacy practice from around the world . I was able to improve my understanding about pharmacists’ implications in research and health care campaigns, pharmacy curriculum, medications usage and application of guidelines from an international perspective . I met many pharmacists with whom I formed professional and personal relationships, that I believe will last a lifetime .

This was an incredible opportunity to expand my professional development horizons . I am grateful that the University of Minnesota College of Pharmacy and the Minnesota pharmacy community encourages and helps support student pharmacists to take advantage of these opportunities that will in turn create patient care initiatives and improve patient outcomes, here and abroad .


MPHA NEWS

MPhA News & NotesRemembering William “Bill” VidmarLong-time MPhA member William John “Bill” Vidmar passed away peacefully at home surrounded by loved ones on August 18 at age 82 . Bill was born in Chisholm, Minn ., and graduated from Chisholm High School . Upon graduation, he enlisted in the Army . After two years of service, Bill continued his education at the University of Minnesota Duluth and graduated from the University of Minnesota College of Pharmacy . Bill started his career in 1959 as a pharmacist, store manager and district manager for Walgreens .

Bill continued a successful career with Target, Gambles and Snyder Drug . At Snyder Drug, Bill was a Vice President and partner until his retirement in 1999 . Bill is survived by his wife of 58 years, Elizabeth, and by 9 children, 26 grandchildren and 3 great grandchildren, as well as a sister, sister-in-law and many nieces and nephews . He was involved in the University of Minnesota College of Pharmacy, the Minnesota Pharmacists Association, the University of Minnesota Foundation Presidents Club, the University of Minnesota Century Mortar Club, and many other church and civic organizations .

Lucinda Maine Receives Alumni Service AwardLucinda Maine, a 1985 graduate of the University of Minnesota College of Pharmacy, received the University of Minnesota Alumni Service Award at the Alumni Association’s celebratory event on Oct . 19 . “So much of my career success was shaped by my time at the University of Minnesota and by the people affiliated with the College of Pharmacy. I’m grateful,” Maine said . Maine has been executive vice president and CEO of the American Association of Colleges of Pharmacy since 2002 . Previously, she held several senior VP positions over a 10-year period at the American Pharmacists Association . She also served as associate dean and director

of professional relations at Samford Universtiy School of Pharmacy .

APhA Pinnacle Award Goes to MPhA Member, HealthPartnersMPhA member Daniel Rehrauer, PharmD, and his team at HealthPartners received a Pinnacle Award from the American Pharmacists Association . Watch a video describing the impressive outcomes of HealthPartners’ Medication Therapy Management Program .

The Minnesota-based HealthPartners MTM Program is an integrated health organization that provides care delivery and health plans functions through a network of community and clinic-based pharmacists, according to its video . The largest consumer-governed nonprofit health care organization in the country, with nearly 900,000 members across all 50 states now, HealthPartners began in 2006 and is unique in that it integrates insurance and care delivery . All providers are able to share data and work together as a team to achieve patient care goals .

“Everything we do is related to the triple aim,” Rehrauer said in his remarks . He spoke of “proving the value a pharmacist can provide when integrated with a patient’s care,” and said HealthPartners has the data to show its work positively affects patient experience, outcomes, and cost of care .On September 19, Rehrauer was the featured guest speaker at the Pinnacle Awards Innovations in Pharmacy Practice Lecture held at APhA headquarters . His lecture, From Medicare to Coverage for All: The Evolution of an MTM Program Over a Decade, showcased the Health Partners MTM program .

James Cloyd Receives Award for Excellence in Epilepsy CareJames Cloyd, PharmD, has been selected to receive the American Epilepsy Society (AES) 2017 J. Kiffin Penry Award for Excellence in Epilepsy Care . Established in 1997 with an

original gift from Abbott Laboratories and now supported through the J . Kiffin Penry Fund of AES, this award honors Dr. Penry’s lifelong focus on and genuine concern for the patient with epilepsy . It recognizes individuals whose work has had a major impact on patient care and improved the quality of life for persons with epilepsy as well as recognizing excellence in the care of persons with epilepsy .

“The award is particularly meaningful to me as I worked closely with Dr . Penry during the early years of my career,” said Cloyd . “He set a standard for excellence in patient care, education, and research that I’ve tried to emulate.”

Cloyd will receive the award at the 2017 AES Annual Meeting in Washington, D .C . on Dec . 4 .

Thrifty White Is Improving Patient Outcomes with New Diabetes PilotFrom Drug Store News, Sept. 22: Thrifty White Pharmacy wants to enhance patients’ lives through a new diabetes care program that places recipients into a medsync program . The program features comprehensive medication therapy management sessions, patient disease management goal setting, and follow through . Thrifty White also offers a compliance packaging service, HealthyPack Rx, that helps organize and manage a patient’s medication.

“The diabetes program allows us to connect with that diabetes patient on a deeper level,” Ben Shanahan, regional sales manager, Thrifty White Pharmacy, told Drug Store News . “Ultimately the goal is to improve the total health outcome of that patient,” he said . “Where our sweet spot is, [it’s] improving and/or increasing the adherence to medications, ensuring they’re on the right medication and layering what’s important to [the patient] from a goal standpoint, so working with them and their care team to align on the two or three goals they’ve identified that

News & Notes continued on page 23


Kojima), sister Elin (Dan) Cadmus, brothers David (Julia) Hoag and Donald (Jo Ann) Hoag, grandchildren and many beloved nieces and nephews .

In lieu of flowers, memorials may be made to the Colleges of Pharmacy at the University of Minnesota, Drake University, North Dakota State University, Ohio Northern University or the Alzheimer’s Association.

A celebration of his life was held on Oct . 28, 2017 in Duluth .

Pharmacy Alumni Society HonoredThe University of Minnesota has honored the College of Pharmacy Alumni Society as the

2017 Outstanding Society of the Year . The award was presented on October 23 .

MPHA NEWS

MPhA News & Noteswill really engage them to improve their care of diabetes .”

Thrifty White recently introduced the dedicated diabetes pilot across 20 markets with plans to roll out the program to all stores in October . The Thrifty White Pharmacy diabetes care program follows diabetes management guidelines set forth by Minnesota Community Measurements, which is comparable to CMS’ STAR ratings, Shanahan said . Read the full article .

COP Students Receive NCPA Scholarships

Kelsey Trahms, left, presented MPhA student members Max Thompson

(Duluth), second from left, and David Vermeulen (Minneapolis), third from left with National Community Pharmacists Association (NCPA) Foundation Presidential Scholarships during the NCPA conference (MPhA President-Elect Jason Varin is at right in the photo) . The scholarships are awarded based on leadership qualities and accomplishments with a demonstrated interest in independent pharmacy, as well as involvement in extracurricular activities . Each student received a check for $2,000 made payable to the University of Minnesota College of Pharmacy, plus a travel stipend and complimentary registration to the NCPA conference .

MPhA Members Speak at NCPA Conference

Tim Gallagher of Sterling Specialty Pharmacy and Amanda Schroepfer of

Goodrich Pharmacy were among the speakers this week at the National Community Pharmacists Association (NCPA) in Orlando, Fla .

COP Student Chapter Honored by AMCP

The University of Minnesota College of Pharmacy’s student chapter of the

Academy of Managed Care Pharmacy (AMCP) took the second place award as 2017 Chapter of the Year . The award recognizes outstanding accomplishments of the AMCP student chapters on a year-to-year basis, and inspires chapters to strive for new, innovative managed care pharmacist programming .

Remembering Stephen Guttormor HoagSon, husband, father, grandfather, pharmacist, professor, dean, provost, golfer, curler sailor and friend . All of these are titles he wore well and left behind on October 16, 2017 when his long journey with Alzheimer’s disease ended and he became one with the universe . He was a graduate of East High School in Duluth, North Dakota State University BS in Pharmacy and Purdue University MS and PhD in Clinical Pharmacy .

Stephen’s professional life was spent in academia first as a professor then Dean (at several universities) and Provost . He possessed all the qualities that made him successful in his profession . He was humble, dedicated, generous, trustworthy, kind, loyal, honest and filled with integrity . He was a gentleman, respected by all who knew him . He relished and embraced the many successes of his family, faculty and colleagues . His accomplishments were varied and many . He lived his life well . He was never happier than when he was at the helm of his sailboat Aerandir with his family aboard .

He will be profoundly missed by his wife of 52 years, Jill, son Arthur Leverett (Amy), son Joel Stephen (partner Kay

Submit Your News or Article!

The Minnesota Pharmacists Association welcomes information on career

milestones, awards, etc., for our News & Notes section of the

Minnesota Pharmacist. We also welcome articles on clinical

topics and other issues related to any pharmacy setting.

Contact Laurie Pumper at [email protected].


NATIONAL NEWS

Pharmacists and the War on Opioid AddictionBy Laurie Pumper, MPhA

Leading up to and following President Trump’s declaration of a national public health emergency on opioids, Congress and several pharmacy associations are taking action. The president’s action came on Oct. 26; it does not release any additional funds to deal with a drug crisis that killed more than 59,000 Americans in 2016 . It does allow for some grant money to be used to combat opioid abuse and expand the use of telemedicine services to treat people in rural areas — many of them ravaged by opioid abuse but lacking doctors .1

The U .S . House Energy and Commerce Committee held a hearing on Oct . 25 on federal efforts to combat the opioid crisis . The National Community Pharmacists Association (NCPA) joined the American Pharmacists Association (APhA), Academy of Managed Care Pharmacy (AMCP), American Society of Consultant Pharmacists (ASCP), American Society of Health-System Pharmacists (ASHP), College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance of State Pharmacy Associations (NASPA) in submitting a statement for the record at the hearing encouraging the committee to pass H .R . 3991, the Expanded Access to Opioid Abuse Treatment Act of 2017, a bill that would enable pharmacists to obtain a Drug Addiction Treatment Act (DATA) waiver in the same manner as physician assistants and nurse practitioners .

The committee heard from witnesses from the FDA, DEA, SAMHSA, CDC, and NIH on agency efforts to address the crisis and to implement the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act . Chairman Greg Walden (R-OR) detailed the committee’s ongoing bipartisan investigation into alleged pill dumping in West Virginia and chided the DEA for its lack of cooperation in providing documents and answers to the committee on shipments from distributers . Committee members focused on a range of problems contributing to and possible solutions for the crisis; of note, Rep . Buddy Carter (R-GA) raised the need for non-opioid alternatives to pain treatment and the incentive that PBMs have created through greater reimbursement for opioids over non-addictive alternatives .

On Nov . 8, the National Association of Chain Drug Stores (NACDS) reported on a study it funded on how to better utilize community pharmacy and improve public health . The study by the Johns Hopkins Center for Health Security found that chain and independent U .S . pharmacies are an untapped resource in the efforts to curb the opioid

epidemic — as well as to halt the spread of antibiotic resistance and bolster pandemic and emergency preparedness and response . Pharmacists already play a critical role on the care team, but “more can be done to ensure pharmacy professionals practice at the ‘top of their license’ — the peak of what they are capable and licensed to do to support public health,” said Gigi Kwik Gronvall, PhD, the study’s corresponding author. The study found the most pressing need to adjust policy in favor of community pharmacy is the fight against the opioid crisis . Reform could also help reduce the onerous liability, payment, and legality issues in some states that continue to limit a pharmacy’s role in opioid abuse intervention and education . NACDS President and CEO Steven C . Anderson said, “We hope the recommendations in this report will foster new partnerships to address pressing needs, including the development of collaborative and comprehensive solutions for the opioid abuse epidemic .” 2

On Nov . 9, The Hill published an opinion piece by National Community Pharmacists Association CEO B . Douglas Hoey, “Here’s a Pharmacist’s Perspective on Addressing the Opioid Crisis .” Hoey wrote, “Independent community pharmacists, many of whom practice in rural communities that are feeling the brunt of the problem… are on the frontlines of this battle .”

Hoey went on to explain the work that NCPA is doing through testimony in Congress, at the Centers for Medicare and Medicaid Services and elsewhere . He noted, “NCPA strongly endorses further empowering pharmacists to help save lives . Naloxone rapidly reverses the effects of opioid overdoses . All 50 states have passed laws expanding access to this lifesaving drug, but only a few states give pharmacists the ability to act independently in dispensing naloxone .”

Citations

1 Source: Trump Declares Opioid Crisis a “Health Emergency” but Requests no Funds, New York Times, Oct . 26, 2017 . https://www .nytimes .com/2017/10/26/us/politics/trump-opioid-crisis .html Accessed Nov . 14, 2017 .2 Source: National Association of Chain Drug Stores website, Nov . 8, 2017 . https://www .nacds .org/news/study-highlights-opportunities-for-pharmacies-to-help-curb-u-s-opioid-epidemic-bolster-other-public-health-efforts/ Accessed Nov . 14, 2017 .


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OUR MISSIONServing Minnesota pharmacist providers to advance patient care

OUR VISIONWe will be a vital organization of engaged Minnesota pharmacy professionals. We will be recognized for leadership in advancing patient care.

OUR VALUES• Engagement• Patient Care• Inter-professional Collaboration• Economic Viability of Practice• Advocacy• Workforce• Lifelong Learning and Professional Development• Pharmacy Teamwork Development• Diversity in Membership• Professional Collaborations and Relationships

ACCOMPLISHMENTSAdvocacy: We are actively engaged in advocacy efforts to ensure that laws and regulations keep pace with the evolution of the profession, and to increase public awareness of the role of pharmacists in advancing patient care.This year MPhA members, partners and volunteers worked tirelessly representing Minnesota pharmacists interests at the Capitol and at regulatory agencies.

KEY ACCOMPLISHMENTS INCLUDE:BiosimilarsLegislation was passed that allows pharmacists to substitute, without the need for prescriber approval, biosimilars that have been deemed by the FDA as interchangeable. This legislation also eliminated outdated language that required pharmacists to pass ALL of the savings between the cost of a brand and the generic on to the customer when a generic substitution is made.Opioid AbuseMPhA worked with legislators to stop and/or temper legislation aimed at combating opioid addiction that would have had little effect on the problem and would have been very burdensome or onerous for community pharmacies.Other LegislationMPhA also worked very hard to build support for legislation that would give pharmacists the authority to prescribe naloxone, self-administered hormonal contraceptives, travel medications and nicotine replacement products. We continue to work between sessions to build support from other stakeholders for our continued efforts on this legislation next session. MPhA also continues to work to pass legislation that would bring Minnesota into compliance with CMS mandates to restructure the methodology for Medicaid reimbursement to pharmacies. This legislation would provide a significant increase in aggregate reimbursement to community pharmacies.

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