CEO Message May 2, 2008
Author: Lynn Rolston
Dear Member,
Budget Cut Update
This week we continued to move full steam ahead with our PR campaign. We had calls with many supporters around the state including pharmacists, the Alliance for Patient Care, our pharmacy coalition, APhA staff members and with the California Chronic Care Coalition (CCCC). The members of the CCCC are extremely concerned about the potential disruption of prescription coverage for their members. They are preparing an all-out campaign to help gather signatures for the petitions and to urge their members to contact the Legislature about this impending disaster. We thank them for all of their support and assistance! We have made significant progress with other elements of our campaign including media outreach. Jerry Shapiro's first-person account of how the provider cuts will affect his pharmacy and the patients he serves was published in the California Progress Report today. You can read his piece here. If you are interested in telling your story regarding the adverse impact of these cuts to your pharmacy, or if you have a patient willing to talk about the negative impact of these cuts, please email Bill Bradley at bill@perrycom.com. On Thursday, Kathy Lynch delivered another thick stack of petitions to the Governor's office; she carried our message to numerous legislative offices; and we are starting to see media coverage on this issue from around the state. We will keep you posted on further progress.
3rd Annual Student & New Practitioner Summit Update
Over the weekend, more than 100 students from all of the California schools of pharmacy traveled to San Diego for the 3rd Annual Student & New Practitioner Summit. It was a great event. Attendees gave insightful feedback about the many valuable sessions including business etiquette, financial planning, careers roundtable, how to survive residency, leadership and conflict resolution. We also held some excellent social events including an opening reception, a wine tasting class and a Saturday night outing at a local establishment. There are many generous sponsors to thank including Asereth Medical Services, El Tejon Drugs, Kaiser Permanente, Ralphs Pharmacy, Rite Aid Corporation, Vons/Safeway, Walgreens, Wal-Mart, Pharm Aid, and Providence Little Company of Mary Hospital and numerous individuals and locals. Our congratulations go Adrian Wong, our Student Summit chairman, and to the members of his committee for putting on this outstanding program.
PACE Alliance Meeting
Today, Veronica Van Orman, VP of Community Pharmacy Relations, and I are traveling to Cincinnati to attend a PACE Alliance board meeting of which I am a member. The meeting will continue through Sunday and then at this same location, on Sunday through Tuesday, President-Elect Jeff Goad and I will be meeting with the other state pharmacy association executives and their president-elects for a leadership and planning conference. This conference has proved extremely valuable to our past president-elects in preparing for their presidential year. I will include more information about this session next week.
Strategic Plan for Asthma
The California Department of Public Health released its new Strategic Plan for Asthma in California, 2008-2012. One of the highlights of the report is:
· CDPH will establish collaborative partnerships with research institutions, health plans, health care providers, pharmacists, independent practice associations, medical groups, managed care providers, Medi-Cal and Medicare, community based organizations, and others to identify a range of asthma research priorities, to study asthma and to evaluate and translate interventions for preventing and managing asthma.
You can download the entire strategic plan by clicking here.
UCSF Students Win Patient Counseling Competition
Congratulations to UCSF students Linh Nguyen, Yoona Kim, DeAnna Sosnowchik and Aimee Loucks on winning the AMCP Patient Counseling Competition two weeks ago in San Francisco. We are proud of all the contestants and we congratulate the great UCSF winning team!
CPhA Membership Renewals
July 2008-2009 Membership Renewals are on their way! For those members whose membership runs from July 1 to June 30, renewals will start coming to either your email inbox or mailbox beginning next week. Pharmacists who renew their membership prior to June 30, 2008 will receive an early bird discount of $30 off of their membership dues. We cannot stress how important it is to remain a member of CPhA. Your continued membership helps us work on your behalf with the various government agencies and the Legislature. The number of members in CPhA is crucial when representing pharmacists and pharmacy. To renew your membership, visit www.cpha.com/renew or email Theresa Andrews at tandrews@cpha.com to have a renewal invoice emailed to you.
McKesson Announcement
McKesson just announced that Jeanine Singer has been promoted to Vice President of Sales for California. We are very excited about working with her in this new position. We wish you the best of luck, Jeanine.
Reminder - Online Business
We have received reports that a company is trying to get pharmacies to fill prescriptions for an online business. We felt it was important to remind you that filling prescriptions for Internet pharmacy operations can be a major legal nightmare. Many pharmacies in California have been caught in this trap and the ones that survive have incurred large fines and legal fees.
Digitek Recall
Actavis Totowa LLC, a United States manufacturing division of the international generic pharmaceutical company Actavis Group, is initiating a Class I nationwide recall of Digitek® (digoxin tablets, USP, all strengths) for oral use. The tablets may contain twice the approved level of active ingredient than it appropriate. You can read the FDA news release here.
Pharmacy Immunization Training 2008
The American Pharmacists Association and CPhA have partnered to offer the Pharmacy-Based Immunization Delivery Certificate Training Program. This program provides 20 hours of CE credit. The training program will take place on Saturday, May 31 from 7:30am to 6:00pm in San Francisco. This program will give pharmacists the requisite training to become a primary source for vaccine information and administration. The program covers the basics of immunology and focuses upon practice implementation and legal/regulatory issues. To register, please click here.
FDA Risk Communication Advisory Committee Meeting
We want to let you know that the FDA Risk Communication Advisory Committee will meet on May 15-16, 2008 in Rockville, Maryland. The committee will discuss direct-to-consumer advertising, including how it relates communicating to subsets of the general population such as the elderly, children, and racial and ethnic minority communities. For more info, you can read the FDA Risk Communications flyer here.
APhA-APPM Elections
Heads-up! APhA's elections will be held from May 30 to July 25, 2008. CPhA member Vinay Patel is running for APhA-APPM Academy Office. We wish Vinay the best of luck!
In the News
Earlier this week, the Stockton Record ran an article regarding the 10 percent Medi-Cal provider cuts and the impact these cuts will have on pharmacy. CPhA members Charlie Green, Ed Sherman, Doug Bennett and I were interviewed for the piece. To read the article, click here.
WRGB Channel 6 in New York ran the following story on Medicare Part D pharmacy benefit manager profits and how some seniors are forced to choose between medications and food when they reach Medicare Part D's "doughnut hole." Craig M. Burridge, Executive Director of the Pharmacist Society of the State of New York, was interviewed for the story. To watch the video, click here.
Gov. Arnold Schwarzenegger announced that he will, once again, work on a health care reform package for Californians who lack health care insurance coverage. To read the San Jose Mercury News article, click here. The Governor's announcement was in response to a recent Field Poll showing that nearly three quarters of the state's voters would have approved the Governor's failed health care reform plan had it been on the ballot.
Question of the Week
Dear Lynn,
We have a question concerning "Article 9 - Hypodermic Needles and Syringes", Section 4145 of the 2008 California Law Book. We hope that you can help clarify the issue for us.
Section 4145 (a) (1) states that "a pharmacist or physician may, without a prescription or a permit, furnish hypodermic needles and syringes for human use, and a person may, without a prescription or license, obtain hypodermic needles and syringes from a pharmacist or physician for human use, if one of the following requirements is met":
(1) The person is known to the furnisher and the furnisher has previously been provided a prescription or other proof of a legitimate medical need requiring a hypodermic needle or syringe to administer a medicine or treatment.
The issue at hand is that the law does not specify the number of syringes we can sell at one transaction.
We understand that if we are registered with the Disease Prevention Demonstration Project within a county in California that sponsors it (e.g. Los Angeles County), we have the right to dispense ten (10) or less syringes at a given time to patients 18 and older, pursuant of Section 4145 (a) (2).
However, if the patient is known to the pharmacy and their medical record shows that they are using syringes as an insulin delivery device, what is the quantity of syringes we can dispense in a single transaction (i.e. 10 syringes or 100 syringes - one box)?
We also understand that the hypodermic needle logbook is no longer required in the state of California (source?). Does this also apply if we sell 100 syringes (one box) to a patient known to the pharmacy who qualifies for purchase under Section 4145 (a) (1)?
Your response is greatly appreciated!
Best regards,
Daniel Liou
Pharm.D. 2008 Candidate
Western University of Health Sciences
College of Pharmacy
Answer
Dear Daniel,
I have asked John Cronin, Pharm.D., J.D. with the law firm of Fredrickson, Mazeika & Grant, LLP to provide the answer to this week's question:
"Section 4145 lists conditions under which needles and syringes can be sold by a pharmacy without a prescription. Section 4145(a)(1) deals with patients with a known medical need; Section 4145(a)(2) deals with individuals registered with a Disease Prevention Demonstration Project. Section 4145(b) allows sales without a prescription for use on animals. The quantity limitation you describe (10 syringes and needles) is contained in Section 4145(a)(2) and applies only to individuals who receive needles and syringes as part of the Disease Prevention Demonstration Project.
There are no legal quantity limits on sales to persons with a known medical need as described in 4145(a)(1) and it is not unusual or illegal for a patient to receive 100 syringes or more at a time. However, the pharmacist must evaluate the circumstances under which these sales occur. If the pharmacist suspects that the syringes are not being used for a legitimate medical purpose he or she should check further to clarify the situation.
The logbook for syringe sales is no longer required under California law. It is good practice, however, to have documentation in the pharmacy records of a patient's medical need for syringes and needles, either in the form of a prescription or other notation in the patient profile."
Daniel, thank you for the question. John, thank you for providing the answer.
Sincerely,
Lynn Rolston
Chief Executive Officer
California Pharmacists Association