Judy Chi

As that well-known song put it so aptly, there is a time for everything. For 

, it's time for us to plunge deeper into the digital world. Starting with our February issue, 

 has decided to produce five editions every month-one print version and four digital ones. This means our magazine will now be published every month, rather than every two weeks. We believe this change will help us save on our printing costs, without sacrificing timeliness, since we will be supplemented by a digital edition every week.  

has been published at various frequencies. We started out as a monthly publication and moved to a weekly schedule in the 1930s. As of July 1943, we became a biweekly due to war shortages and remained at that frequency after the war.  So we have been coming out as a fortnightly for the past 64 years.

For us to go from a biweekly to a monthly schedule for our print edition is a momentous decision. We think it will work out for the best. For those who like paper, you'll still have a hard copy that you can hold on to or pass along to others on your staff. For those who prefer reading by computer, our digital edition is just the ticket for you. 

So far, the feedback to our frequency change is positive from many quarters. They understand why we are making this move and accept it, given the realities of today's business climate. 

The response to our digital edition is also very heartening, as the results to our online survey indicate. If you have not yet seen our digital edition, which we launched on Oct. 8, please visit our Web site, 

, where all our back issues are archived. Our digital edition isn't just a carbon copy of our print version; it contains content not found in our magazine. While our print edition will contain our regular sections, along with the Health-System Edition and CE, our digital edition features a series of articles from pharmacist-lawyer Ken Baker about drug errors and how to avoid them as well as articles of interest to students. So if you're not taking advantage of our digital edition, you're missing out on a lot of exclusive content. 

To access our digital edition, which is free of charge to pharmacists, students, and technicians, there are two ways to do so. You can get it by going to our Web site on your own volition, or we can e-mail it to you. If you're interested in the second option, you can subscribe to our digital edition at this link: 

									http://https://www.advanstar.com/subscriptions/subscribe.asp?subid=232/

Finally, our 150th anniversary, which took place last year, is now history. If you participated in our anniversary celebrations, such as by contributing items for our time capsule or for display at our conference show booths, a big thank you from the bottom of our hearts. 

Articles

Drug Topics announces a new publication frequency and adds an expert in specialty pharmacy to its board.

Drug Topics to expand in the digital world

First, the good news. Congress is now considering National Health Service Corps legislation that would provide partial school loan forgiveness to healthcare professionals who agree to work in rural or underserved areas for a set number of years. Although the Senate legislation does not expressly name pharmacists as among the health professionals, a Senate committee report mentions the group's intent to include them. On the House side, ASHP has submitted language to include pharmacists in the bill. Joseph M. Hill, director of federal legislative affairs at ASHP, told attendees he's confident this legislation would get Congress' approval. 

Another piece of news ASHP can crow about is the recent passage of a Food & Drug Administration bill that would require the agency to standardize restricted drug distribution programs. Before the bill was passed, ASHP had expressed concerns to FDA that restricted distribution programs are overly burdensome and can pose a barrier to access to drugs. Heeding ASHP's concerns, a section of the Prescription Drug User Fee Act calls for a committee composed of physicians, pharmacists, and others to be set up for the purpose of standardizing restricted distribution programs. Hill cautioned, though, that FDA has revealed no details yet on how such programs would be standardized. He added that FDA would not proceed until it gets funding from Congress. 

Moving along to plans for this year, ASHP officers announced to attendees, estimated at a record-setting 24,000, that it will hold an IV Safety Summit this spring. The summit is designed to counteract such drug errors as the recent one that befell Dennis Quaid's twins at Cedars-Sinai Hospital in Los Angeles. The actor's newborns were inadvertently given an overdose of heparin, a problem that has happened in other hospitals before. Speaking at a press conference, ASHP's executive VP Henri Manasse said that such errors are a result of staff noncompliance with hospital protocol. Can you imagine if nuclear medicine professionals were to deviate from protocol? he asked rhetorically. To be held with the Institute for Safe Medication Practices, the U.S. Pharmacopeia, and others, the summit will attempt to develop a set of recommendations to standardize the use of concentrated electrolytes and prevent errors associated with infusions. 

Also on tap for 2008 is the presidential election. So which candidate will the association support? Manasse told reporters that it's still too early to back any one in particular. However, he added that ASHP has policy on its books supporting universal coverage and access to care. 

One issue ASHP will push for strongly going forward is the standardization of technician training. The association will work with state legislators to require that technicians complete not just a tech training program but also one that is accredited by ASHP before they can be registered by their state boards. Manasse disclosed that besides Walgreen, CVS has now signed on to participate in ASHP's tech accreditation program. Since each of these chains encompasses about 6,000 pharmacies and ASHP is in discussion with other chains, he hopes to reach a tipping point on this issue soon. 

Besides the education of technicians, the postgraduate training of residents is also high on ASHP's agenda. Association officials declared at the press conference that even though the American Association of Colleges of Pharmacy recently came out against requiring residency training as a prerequisite to direct patient care, ASHP is still committed to this resolution, which it passed last summer. Graduation from pharmacy school doesn't make one competent to provide care, Manasse insisted; it's just the beginning.

At its 2008 midyear meeting, ASHP reemphasized its intent to push for the accreditatin of technician training programs and postgraduate training of residents.

ASHP pushes on with training of technicians and residents

Community pharmacists can expect problems on their hands over average manufacturer price (AMP) at the start of the year, followed by the need for tamper-resistant Rx pads in April. For hospital R.Ph.s, they have to guard against hospital-acquired infections, since Medicare won't be paying for the care associated with HAIs next year. Both community and hospital pharmacists can look forward to a knockdown, drag-out Presidential race in November that could determine how health care is provided in the future. 

Optimism reigns for community pharmacists

How optimistic are pharmacists? When asked what kind of business year they were expecting for 2008, 80% of the 460 respondents indicated that it was good, very good, or excellent. That figure represents a 15% jump over last year's figures, reversing a five-year downward trend. Not since 2002 have R.Ph.s expressed that level of optimism. Interestingly, while only 65% of pharmacists surveyed last year expected a good, very good, or excellent year for 2007, in the current survey, 74% reported that this year will actually be good or very good, and another 10% expect this to be an excellent year. 

Undoubtedly higher Rx volume plays an important role in the overall optimism and pharmacists are expecting a healthy growth in sales for next year. More than half of all respondents-59% in fact-predict that sales will increase in 2008 by an average of 10%. In addition, 67% of respondents predict that operating expenses will rise. 

The optimism and improved profits came despite a sense of increased competition. While last year Medicare Part D topped the list of worries, this year's focus turned to increased competition from big box and supermarket pharmacies offering discounted generics. When Kmart first introduced its discounted generic plan last year-followed shortly thereafter by Wal-Mart's own plan-it set in motion an increasingly competitive market, with chains and big box pharmacies offering steeply discounted and even free generic medications.  

Although cash customers make up only 10% of the business for most pharmacies, it is clear that the discounted generic movement is having an impact. Respondents pegged the discounted generics as their top concern, with 33% of respondents indicating that it was a negative factor impacting their company, followed by Medicare Part D (32%) and the move of some cough and cold medicines behind the counter (19%).  

Now that Medicare Part D has moved out of the initial shock-and-awe phase, pharmacies are beginning to get a better grip on its true impact. Nevertheless, Part D was the top news item for 2007, with 28% of respondents selecting it as the top story, followed by the release of the AMP rule (17%), the drug error TV exposé on "20/20" (10%), and the growth of in-store clinics (9%).  

While the Presidential election is less than a year away and will certainly be a top news story for 2008, many pharmacists are ambivalent about how important it will be for pharmacists. Forty-three percent of respondents indicated that they did not expect the new President to have an impact, while 25% said that they did. The remaining 31% were unsure of the impact. Still some respondents hoped that "the elections will focus on the healthcare issues and, thus, will impact the delivery of health care." 

Respondents were more comfortable commenting on the importance of specific government programs. When asked specifically about how Part D was impacting their business, 28% of respondents indicated it had a positive impact on their pharmacy, while 37% felt it had a negative impact. The remaining 35% did not know what impact the program has had on their pharmacy. In comparison, last year, 55% of respondents felt the impact was negative, while only 24% saw it as a positive. As one respondent this year noted, "Part D had a dual effect. First, it created severe problems with reduced cash flow and lower profit margins, but it increased the volume of business and helped many patients take medications that they previously were not taking because of cost. Many patients qualified for additional help with their prescriptions and had no help previously." 

One of the promising aspects of the Part D program has been the increased opportunity to deliver medication therapy management services to patients. 

' survey found that 34% of community pharmacists reported they are providing MTM services, although only 18% were actually reimbursed for it.

Among the questions asked were what is expected for sales, salaries, and staffing for 2008.

FAIR OR FOUL?

Pharmacists Planning Service Inc. (PPSI) honors former Surgeon General Richard Carmona, M.D., and Julie Gerberding, M.D., director of the Centers for Disease Control and Prevention.

R.Ph.s told they're critical to public health

 Which pharmaceutical companies came out on top last year? When measured by retail   dollars, nine out of the top 10 companies were brand-name firms, with Teva Pharmaceuticals   being the only generic representative that made the list. When measured by number   of prescriptions, three out of the top 10 companies were generic drugmakers,   including Teva, Mylan, and Watson Pharma. Of the two lists, only one companyAstraZenecalogged   double-digit increases by both dollars and units. What follows are two tables,   one by dollars, one by units. The data were provided by market research firm   Verispan.

Top 10 corporations by retail dollars in 2006

Top 10 corporations   by total Rxs in 2006

When measured by retail dollars, nine out of the top 10 companies were brand-name firms, with Teva Pharmaceuticals being the only generic representative that made the list. When measured by number of prescriptions, three out of the top 10 companies were generic drugmakers, including Teva, Mylan, and Watson Pharma.

Manufacturers extraordinaire: The top 10 drug firms of 2006

This was what Dimitra Travlos, Pharm.D., BCPS, assistant executive director of ACPE, told attendees of the ASHP midyear meeting in Anaheim, Calif., last month. 

According to Travlos, other CE changes are coming or are under consideration. For instance: 

So are there too many pharmacy schools in development? Vlasses said he really doesn't know. ACPE's job, he commented, is only to accredit pharmacy schools, not to control supply and demand. 

What is certain is that, based on stakeholder feedback, ACPE will be implementing new accreditation standards for pharmacy schools starting this July, Vlasses said. Designed to ensure consistency in the accreditation process, the standards will have some new wrinkles, such as requiring regional accreditation, meaning that not only must pharmacy schools be accredited but the institutions in which they reside must have corresponding approval as well. 

Complying with these new standards will be challenging enough, but that's not all. Vlasses added that the U.S. Department of Education (USDE), which surveys ACPE once every five years, has asked for some changes, such as new documentation requirements that schools must meet. He reassured the audience that ACPE will offer training to help schools meet both the ACPE and USDE requirements.  

Until now, pharmacy faculty authoring continuing education programs had only to disclose if they had any conflicts of interest to program participants. However, under new standards the Accreditation Council for Pharmacy Education (ACPE) is planning to implement this year, CE authors will also have to resolve any conflicts in order for their programs to pass muster. Conflicts can be resolved by requiring the CE content to be reviewed by a committee beforehand or presenting both pro and con sides to any given debate.