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Pharmacist salaries are still climbing, but at a slower rate. Our exclusive survey shows who gets top dollar.

A new specialty certification may be on the horizon. The Board of Pharmaceutical Specialties (BPS) could offer ambulatory care certification as early as 2008. "BPS got the ball rolling, but we have not committed to the development of this specialty," said BPS executive director Richard Bertin. "It is up to the profession to present arguments, pro and con, before that decision can be made."

As many pharmacists are aware, all Medicare Part D plans must offer medication therapy management (MTM) to assist beneficiaries who (1) have multiple chronic diseases, (2) take multiple medications, and (3) are likely to spend more than $4,000 on medications annually. MTM services are intended to promote patient understanding about medication use, increase adherence to drug regimens, and detect drug-related problems.

The National Community Pharmacists Association is warning that implementation of a proposed rule for reimbursement for generic drugs through Medicaid may result in many pharmacies pulling out of the program or going out of business. Citing the results of a recent Government Accountability Office study and its own internal polling of members, Bruce Roberts, NCPA executive VP/CEO, warned that under the new rule patients would face a "serious danger of losing access to lifesaving prescriptions. What we're faced with is not a natural disaster but a public policy disaster."

As part of the 1987 international Montreal Protocol treaty to reduce/eliminate substances depleting the ozone layer, CFC (chlorofluorocarbon) propellants in albuterol metered-dose inhalers (MDIs) are gradually being replaced by HFAs (hydrofluoro-alkanes). The transition need not be complete until Dec. 31, 2008, when albuterol CFC-MDIs must be discontinued as mandated by the Food & Drug Administration. But the change is well under way. As Patty Johnson, spokeswoman for GlaxoSmithKline, noted, "We [GSK] already transitioned to Ventolin HFA MDI in early 2006."

The Agency for Healthcare Research & Quality (AHRQ) recently released guides for clinicians and consumers on the use of analgesics for treating pain associated with osteoarthritis (OA). The guides draw on a report, called "Comparative Effectiveness and Safety of Analgesics for Osteoarthritis," based on a review of 351 published research studies. It represents the most comprehensive analysis to date of analgesics for osteoarthritis pain.

A major change in the treatment of advanced or metastatic colon cancer has been made in a new update from the National Comprehensive Cancer Network (NCCN). The network's "Clinical Practice Guidelines in Oncology: Colon Cancer," published in January, were revised to reflect new scientific data and expert judgment.

Migraines are now viewed as a chronic disorder with episodic manifestations, and emphasis should be put on evaluating impairment between headache attacks. This is the gist of a new consensus statement recently released by the National Headache Foundation (NHF), an organization focusing on migraine prevention.

Pharmacy representatives attending an American Medical Association's Current Procedural Terminology (CPT) editorial panel meeting recently in San Diego have asked the panel to make codes for medication therapy management (MTM) permanent.

The notion of a fully integrated electronic healthcare record across the entire health system is no longer pie-in-the-sky thinking. In reality, however, few hospitals have attained that level of technology penetration. But for those that have, the benefits are immense.

The basic principle of health-care treatment-"First, do no harm"-should apply also to the proper disposal of hazardous pharmaceutical waste. A new product, EcoRex, from Vestara in Irvine, Calif., is designed to achieve that end, using customized software to reduce the potential harm of such waste.