CEO Message December 7, 2007

Author: Lynn Rolston
On Wednesday, Kathy Lynch and I attended a Board of Pharmacy meeting. The primary agenda item dealt with ePedigree.  The meeting was held to collect additional testimony and public comment on the ePedigree regulations, which are to go into effect on 1/1/09.  CPhA testified about the great difficulty that pharmacists will have implementing this law if all manufacturers and wholesalers are not ready in advance and if implementation requires significant personnel and monetary investments.  Along with CPhA, NCPA provided testimony, delivered by Dave Wilcox, Pharmacy Owner from Fresno and past CPhA President.  NCPA called for the board to use its statutory authority to extend the implementation date until 1/1/11.  CPhA also supports a delay in implementation and is asking for a phased in approach as well, which will allow pharmacy more time to comply.  There were about 300 people present who were from pharmaceutical companies, generic manufacturers, wholesalers, chain drug stores, technology vendors, health systems and many others.  The next meeting on January 23 will be a critical meeting in that the Board is expected at that time to make a decision about the delay.  There is a template on the Board’s web site that can be used as a testimony preparation guide for that meeting.  We will again be testifying and will keep you posted regarding the results.

ePedigree Workshop
On Thursday, Kathy Lynch attended an all day California ePedigree Workshop at McKesson's headquarters in San Francisco.  Representatives from a variety of manufacturers, wholesalers and other pharmacy providers were in attendance. The meeting brought all parties in the drug supply chain together to discuss various issues in complying with the California ePedigree law and the importance of gathering data through pilot studies.  This group has been meeting continuously for months, working aggressively toward the 2009 implementation date.  While great progress has been made, there is still much work that needs to be done.


Medicare Part D Plan Changes for Dual Eligible’s
As you know, open enrollment for Part D will continue through the end of December. However this year, there are some significant changes in the plan coverage for dual-eligible patients.  Seven of the current 14 plans available in 2007 will no longer be an option come January 1. It’s estimated that approximately 400,000 dual eligible patients will be automatically re-assigned to a different plan, with another 100,000 dual-eligible patients having to choose another plan on their own. This is likely to create some confusion with patients and complications in the pharmacy after the first of the year. Some recommended steps in preparation of these changes include: 
 
1. Evaluate your dual-eligible patients on the Medicare website, using the Prescription Drug Program Plan Finder.

2. Be advised that the following benchmark plans will be eliminated for dual-eligible patients:
AARP Medicare Rx Plan-Saver
Bravo Rx II
Cignature Rx Value Plan
Humana PDP Standard
Prescription Pathway Bronze Plan Reg 32
Sierra Rx Basic
Wellcare Signature

3. Visit the Partners in D website to learn more about the program and to find contact information for schools of pharmacy that may have trained student pharmacist volunteers to assist with outreach in the pharmacy setting.

4. Download Partners in D fact sheets in a multitude of languages to hand out to patients

Next week, CPhA will send  a subsequent Medicare Part D broadcast with additional information.

Partners in D Program Outreach Event
UCSF Doctor of Pharmacy students explained Medicare Part D in Mandarin, Cantonese, Russian, Spanish and English at recent workshop in San Francisco. The event was hosted by Mission Creek Community Mercy Housing of California. It was attended by more than 40 student pharmacists from UCSF, UOP and TouroU as part of the Partners in D statewide Medicare outreach project. Of the residents who attended, student pharmacists helped more than half enroll into a more cost-effective and more appropriate Part D plan. This is the essence of the Partners in D Program- utilizing trained pharmacists and student pharmacists to assist low-income senior citizens in choosing the prescription drug program plan that best suits their needs. Directly put from Rajul Patel, Pharm. D. PhD and Assistant Professor at the Thomas J. Long School of Pharmacy and Health Sciences at University of Pacific: 

 “We need to get the word out that there are student pharmacists from almost every California school that are specially trained in Part D.  Other pharmacists who work with students should ask them if they have received the training so they can help to meet the Part D needs of the patients they serve.”

Negrete Teaches and Learns at Taiwan Pharmacy Meeting
This week, Michael Negrete, CEO Pharmacy Foundation, returned from a conference hosted by the Taipei Awakening Association (a consumer advocacy organization) and the Taiwan Department of Health Pharmaceutical Affairs Bureau.  The purpose of the
conference was to inform the attendees on how pharmacy is being used in other parts of the world to improve and protect public health.  During his talk, Michael discussed a variety of efforts in the U.S. including pharmacy access to vaccinations and emergency contraception, counseling requirements on new and changed prescriptions, medication therapy management services, and the incorporation of pharmacy into disaster preparedness efforts.  Michael also learned a great deal about the practice of pharmacy in other parts of the world.  Of particular interest were the incredible efforts being made in many countries to further the separation of prescribing- and dispensing-related activities.  One obvious reason for this is to ensure that medications are prescribed to provide the best benefit to the patient, NOT because they will provide the prescriber with the biggest profit margin.  The other obvious reason is to ensure an independent verification of the appropriateness of the prescription in terms of drug, dose, interactions, etc.  It is interesting to see how, in some respects, the pendulum in the U.S. is swinging in the opposite direction with growing activity around physician dispensing and the opening of retail clinics in pharmacies.  Other interesting learning’s related to the broad use of electronic prescribing (even in “emerging” countries), and a pharmacist “Home Medicines Review” service currently being offered by Australia’s Medicare program.

Oakland Holiday Parade
In last week’s message, I mentioned that pharmacy was going to be represented in the Oakland Holiday parade.  I am pleased to say that we had a successful showing of more than 50 pharmacy professionals.  You can view photos of this exciting event here.  Again, we congratulate the Alameda local for using this opportunity to bring greater attention to the world of pharmacy. 


Strategic Planning and Synergy Follow Up
I met with Dennis Tootelian today, our consultant that has been helping with many of our projects including strategic planning.  We set up a process of incorporating all of the feedback from the workshops at Synergy.  Attached you will find the draft notes from those workshops and we will be adding those things that fit our budget and our overall strategic plan into the 2008 operating plan. We will keep you posted as the operating plan in finalized.


Sad News
Virginia Herold, Executive Officer of the California State Board of Pharmacy, asked me to pass along the following information regarding the death of Bill Marcus on Tuesday: 

“Many of you may not have known Bill Marcus, but Bill was our AG liaison for a number of years -- probably close to 20 (the function now performed by Joshua Room).
Bill was very instrumental in a multitude of ways over the years -- he was a great drafter of legislation and regulation proposals, was vigorous as an anti-drug diverter litigator and pain management advocate.  He advised the board, and assisted the board in many issues over the years during the 1980s and 1990s, and certainly had a profound effect on pharmacy law and therefore pharmacy practice in California.  In recent years, he taught pharmacy law at UCSD's and UCSF's schools of pharmacy.  He will be missed by the many of us who had the opportunity to work with him and enjoy the passion he felt for pharmacy law.  Per Bill's wishes, he will be cremated and his ashes scattered.  There will be a memorial service at some point, but not in the immediate future.”  We offer our deepest sympathies to Bill’s family and all that knew him. 

On Tuesday, we also learned about the death of a long-time CPhA member, Anthony “Tony” D’Altorio. He passed away in October from pancreatic cancer. Anthony was the owner of Bushard Pharmacy and a member of CPhA for over 20 years. He leaves behind a legacy of caring for others as detailed in this article that describes him as a ‘good, good man.’ Our sympathies are with Anthony’s family and friends. Sheila Buschard, Anthony’s long-time partner in the pharmacy, informed us that the family established a memorial fund at USC/Norris Cancer Center and has requested that donations be made to the Center, in lieu of flowers.
 
USC/Norris Cancer Center
The Anthony D'Altorio PharmD Memorial Fund
RM8302MC9181
University of Southern California
P.O. Box 77902
Los Angeles CA 90099
 
Otherwise, condolences/donations can be sent to:
 
The Family of Anthony D'Altorio
29356 Kensington Drive
Laguna Niguel, CA 92677

In the News:
A new book, Heroes of Pharmacy: Professional Leadership in Times of Change, has just been released.  The book focuses on major issues of the profession of pharmacy, including association organization and management, education, industry, governance, and practice addressed through an examination of the lives and careers of the pharmacy professionals who dealt with them.
 
FDA's Behind-the-Counter Drug Plan Riles Docs
On NPR’s All Things Considered, a piece ran regarding how the Food and Drug Administration is considering creating a new category for drugs — a class that would sit on shelves behind the register. These would be drugs that need to be used carefully but do not require a prescription. The idea is that pharmacists could help people decide whether these drugs are right for them. Some doctors are opposed.

Question of the Week:

Dear Lynn:

In this week’s Legislative Update, CPhA reported on a recent DEA decision to allow prescribers to write multiple prescriptions with different effective dates on the same day for Schedule II controlled substances for the same patient. The federal rule limits the multiple orders to a 90 day supply, which fits within the California requirement to fill a prescription for a controlled substance within 180 days of issuance.  This rule becomes effective on December 19 of this year.  How does this fit with California law?     

Thanks,

Paul Lofholm
Ross Valley Pharmacy


Dear Paul,

We contacted the Board of Pharmacy with this question.  They are familiar with the new federal rule and have indicated that these types of multiple prescriptions are allowed under California law.  As additional guidance, the Board has indicated that the prescriber needs to prepare separate prescription orders for each month's regimen.  They will all be dated with the date they are actually written, but will also include language such as "do not fill until __."  Once the new federal regulation goes into effect on December 19, if the prescriptions meet these requirements, they may be filled on the future effective dates without violating federal or state law. We have made a copy of the DEA Notice available in this message.


Thank you for the question,

Sincerely,



Lynn Rolston
Chief Executive Officer
California Pharmacists Association

Rating: 5.00
1	2	3	4	5
Number of ratings: 1