Texas Pharmacy Today - Texas Pharmacy Association

TPA Has You Covered: Texas State Board of Pharmacy Meeting Part II of III
This week’s TPT will take a closer look at the proposed rules/amendments as laid out in the Texas state Board of Pharmacy’s August 4th meeting.

C.2.1 Concerning Grounds for Discipline – The Board approved moving forward with proposed amendments to Section 281.7 and 281.9 in order to address the disciplining of a pharmacist, pharmacy technician or a pharmacy owner who may be demonstrating abusive, intimidating or threatening behavior toward a Board employee or any member of the Board. See More

C.2.2 Concerning Graduates from the Canadian Council for Accreditation of Pharmacy Programs - The amendment to Section 283.2 will clarify that those pharmacy graduates of a Canadian college/school from 1993-2004 are not to be considered foreign graduates for the purposes of licensure. See More

C.2.3 Concerning Notification Requirements of Senate Bill 460 – The Board approved the proposed amendment to Section 291.3, addressing notifications requirements for change of location, of the pharmacists-in-charge and of electronic messaging as required by the passage of Senate Bill 460 during the recent 84^th Texas Legislative Session. See More

C.2.4 Concerning Inventory Requirements – The Board approved publishing the proposed amendments to Section 291.17, designed to update and clarify the record-keeping regarding the time inventory shall be taken. See More

C.2.5 Concerning the Pharmacist-in-Charge – The Board approved publishing the proposed amendments to Sections 291.32, 291.53 and 291.73, which are designed to address a pharmacist that is serving as a pharmacist-in-charge of multiple classes of pharmacy. See More

C.2.6 Concerning Prescription Transfer Requirements – Following a lengthy discussion, the Board agreed to publish a proposed amendment to Section 291.34 to address the requirement that a prescription must be transferred within four business hours, and to update the rules regarding the distribution to include dangerous drugs. See More

C.2.7 Concerning Military Services Members, Military Veterans, and Military Spouses - These proposed amendments implement Senate Bill 807 and Senate Bill 1307 of the 84^th Legislative Session, which establish a waiver for examination and fee requirements for occupational licenses issued by state agencies, including the Board of Pharmacy. See More

C.2.8 Concerning Procedures Relating to Immunizations and Hand Sanitizing – The proposed amendment to Section 295.15 will require that a pharmacist cleanse his or her hands with alcohol-based waterless antiseptic hand-rub, or shall wash his or her hands with soap and water between immunizations. If gloves are used, they must be changed between patients. See More

C.2.9 Concerning Administration of Epinephrine by a Pharmacist – This proposed rule implements House Bill 1550 from the 84^th Texas Legislative Session, which was promoted by TPA. House Bill 1550 and the proceeding rules authorize a pharmacist to administer an epinephrine auto injector to an individual in an emergency situation without the need for a written protocol. See More

C.2.10 Concerning House Bill 751 Interchangeable Biological Products – This proposal seeks to establish rule section 309.5 and to amend 291.33, 291.34, 309.1-309.4 and 309.6-309.8. The rule and amendments seek to implement House Bill 751 from the 84th Texas Legislative session. See More

National News

NABP Stresses Need for Accountability in Enforcing Internet Policies to Protect the Public From Illegal Online Drug Sellers

Last week, National Association of Boards of Pharmacy (NABP) issued a report urging greater accountability by the stakeholders charged with ensuring that action is taken against websites illegally selling medications online. As detailed in the Internet Drug Outlet Identification Program Progress Report for State and Federal Regulators: July 2015 (PDF), thousands of websites illegally distribute medications and avoid retribution. Such sites often distribute dangerous counterfeit drugs, putting at risk the health of the consumers who use them. Many of these rogue sites use domain names obtained from

a small number of registrars who turn a blind eye to their illegal activity. The report highlights the need for the Internet Corporation for Assigned Names and Numbers (ICANN) and domain name registrars – the stakeholders responsible for facilitating the use of Internet domain names – to enforce policies forbidding illegal use of websites and to take more accountability for shutting down rogue sites.

As noted in the report, NABP holds online drug sellers accountable to the laws and standards that govern pharmacy practice and, since 2008, the Association has been collecting data on websites selling medicine illegally online to United States patients. NABP has reviewed over 11,000 Internet drug outlets, finding that 96.13% of the sites reviewed operate out of compliance with US pharmacy laws and practice standards, and identifying these sites as "Not Recommended.” Approximately 85% of Not Recommended sites are selling prescription drugs without requiring a valid prescription. Nearly 50% offer drugs that are either foreign or not approved by the US Food and Drug Administration (FDA). Further, of the 10,588 Not Recommended sites, 87% can be traced to affiliate networks of rogue Internet drug outlets.

Websites illegally selling drugs to patients in the US and in other countries hide behind the anonymity of the Internet, and in the gray areas between enforcement boundaries where the question of who should take responsibility for enforcing Internet policies goes unanswered. Many stakeholders, however, believe that domain name registrars and ICANN could play a greater role in protecting consumers. Registrars can make an impact by fulfilling their responsibility to shut down domains that are being used for illegal activities, and ICANN can hold registrars accountable for meeting this obligation.

The full news release is available on the NABP website. The full report with detailed findings on the characteristics of rogue websites and the list of Not Recommended sites is available on the AWAR_XE^® Prescription Drug Safety Program website.

Help Improve the HHSC Website
As the state’s health and human services system prepares for legislatively-directed reorganization, the Texas Health and Human Services Commission and other HHS agencies are looking for ways to improve their websites. You can help inform this process by taking a short online survey where you’ll answer questions about your experience with the HHSC website (www.hhsc.state.tx.us). The survey will be open through August 18.

Medicaid/CHIP Vendor Drug Program News
VDP Advisory: July 2015 P&T Committee PDL Decisions Available
The Texas Pharmaceutical and Therapeutic Committee met July 24 to make recommendations about which drugs and drug classes to include on the Medicaid Preferred Drug List (PDL). The approved list of decisions, and other meeting documents, is now available at the Vendor Drug Program website. Decisions from the July and October P&T meetings will be incorporated into the next release of the PDL, scheduled for January 2016. The October 2015 P&T Committee drug class review schedule is also available.

Vendor Drug Program News

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"During that time, I also worked as a janitor at Lee’s Drugs in Edna,” says Moore. "I’d clean up the store after hours. I got to thinking that as a chemical engineer I’d be sitting most of the time, and I don’t like to sit. Looking around at the pharmacy, I decided to go to pharmacy school."

Moore took a job working construction and saved enough money to go to The University of Texas College of Pharmacy in 1956.

"While I was a student, I had a full-time job for the state doing night watch for the Texas Department of Public Safety. That’s how I earned my money to go to school. I’d sleep from 7:00-11:00 p.m. at night, and I’d study on the job. Then I’d go to school 9:00 a.m. to 5:00 p.m. every day. I’d only sleep four hours a night, and then sleep 15 hours Saturday to Sunday.”

Moore and his wife Barbara (now deceased) have one daughter and two sons, some of who are following in the healthcare tradition.

"My daughter is a nurse, and one son is a pharmacist,” says Moore. "And my grandson Robert Joel Moore is on his way to becoming a pharmacist. He was just elected president of the Pharmacy Council at The University of Texas at Austin College of Pharmacy.”

Moore graduated from the UT College of Pharmacy in 1960 with a BS in Pharmacy and went to work in an independent pharmacy called Ratliff’s in Ganado, TX before working for Harding and Parker Drugs in Victoria.

That gave me a background in independent pharmacy,” says Moore. "In ’65 I bought a store in Sinton. It’s called Moore’s Pharmacy and we’ll celebrate our 50^th anniversary on August 30^th,” says Moore, who was mayor of Sinton in 2014.

"It cost me $51,000 for the inventory and the fixtures. I rented the building from the owner,” says Moore. "I opened a Beeville location, which closed in 2013 when I moved my compounding operation and consolidated. Now I have two stores— the one in Sinton, and Moore’s Compounding Pharmacy in Corpus Christi which opened in 2003.

Despite rumors of struggling independents, Moore says both stores are doing excellent.

"I attribute that to customer service, and being willing to change our pharmacy practices to keep our businesses going in the current environment,” says Moore. "There were three stores in Sinton when I started, and now there’s just Moore’s Pharmacy. I’m on my sixth generation of customers, and have a very loyal customer base. In Corpus, we’re unique in that we’re a compounding-only pharmacy. We have a full wellness center, and we host free monthly seminars in our 70-seat classroom on public health issues. For example, we’ll cover topics like breast cancer, diabetes, or heart disease, as well as nutrition and supplements. The seminars are always well-attended. Sometimes outside companies ask us to put on special wellness seminars for their employees,” he says.

Counting himself, Moore employs five full-time pharmacists for his two stores and seven pharmacy technicians – two compounding, and five regular, while the Corpus Christi location has an additional four compounding technicians. Savvy business skills and a solid work ethic have kept his businesses thriving.

"Because of pricing issues, you need a high volume to stay in business,” says Moore. "You build on your different services, and incorporate them into your business model.”

Moore has taken a lesson from his own wellness classes, and now follows healthy habits– as does his wife, Linda.

"I used to eat things like cheeseburgers and fries routinely, until I learned about heart issues the hard way,” says Moore. "I had open heart surgery 17 years ago and had four bypasses. Since then, I’ve embraced the wellness that we teach. I only eat meat once or twice a week, and stick with low-fat proteins and have some nuts or a nutrition bar at lunch. I keep my weight down and stay active. Also, I take about 20 supplements a day. I recently thought I was going to need additional heart surgery for arterial blockages, but the doctor said my heart had built paths around the blockages, so I don’t need it. We teach wellness, but I also live it. That’s the only way to beat these things!”

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