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Association News

TPA Welcomes New Public Affairs Staff

Stephanie Chiarello and Karen Reagan
Stephanie Chiarello and Karen Reagan have joined the TPA public affairs team.

The Texas Pharmacy Association is proud to announce two new members of our public affairs team as we prepare for the 2019 Texas legislative session, which begins in January. Stephanie Chiarello joined the Association this week as division director, public affairs. Chiarello brings extensive Texas legislative experience to the Association, having worked for 11 years during six biennial legislative sessions at the state capitol—three in the House and three in the Senate. She most recently served as senior policy analyst and district office director for Senator Kirk Watson (D-Austin), where she advised the senator on several issues including health care and managed constituent communications. She was also executive director of the Kirk Watson Campaign Academy, directing college students in political engagement. Her previous experience includes serving as the executive director of the Texas Senate Democratic Caucus, political director for State Representative Mike Villarreal (D-San Antonio), and deputy campaign manager for State Representative Diana Maldonado's 2008 campaign. Chiarello specializes in policy advocacy, constituent relations, campaign strategy, fundraising, and data management and analysis. She earned her bachelor’s degree in biology and theatre and dance from the University of Texas at Austin in 1998 and a decade later earned her master’s degree from the UT LBJ School of Public Affairs. Before entering the political arena, she performed scientific analysis and was an environmental consultant. Originally from Arlington, Chiarello enjoys playing soccer, ballet dancing, and performing improvisational comedy.

In addition, TPA is happy to welcome Karen Reagan back into the fold at TPA as our contract lobbyist for the upcoming session. Karen is a principal at the Texas Star Alliance, a top-ranked lobby firm in Austin. She has played a pivotal role in shaping public policy for numerous Fortune 500 companies, Texas-based businesses, and influential trade associations. Her roots run deep in pharmacy, where she has served as Vice President of TPA and as Executive Director of the Texas Federation of Drug Stores. Karen has worked as a contract lobbyist for Walgreens, the National Association of Chain Drug Stores, and Cardinal Health.

The 2018 Election: What Does It Mean for Pharmacy?

2018 Election Recap Webinar

The 2018 election is (finally) over! But what does that mean for Texas pharmacy? The Texas Pharmacy Association held an election recap webinar yesterday to discuss who won, who lost, and pharmacy's agenda for the upcoming 2019 legislative session. If you missed the live webinar, don’t worry! Members may log in to watch and listen to a recording online.

Texas Pharmacy Congress Holds Fall Meeting

Texas Pharmacy Congress Nov 2018 meeting attendees Texas Pharmacy Congress tours UH COP
The Texas Pharmacy Congress members toured the University of Houston College of Pharmacy.

University of Houston College of Pharmacy Dean Lamar Pritchard (center) touts his school's new facilities.

The Texas Pharmacy Association attended the final 2018 meeting of the Texas Pharmacy Congress November 13–14, hosted by the University of Houston College of Pharmacy. The Congress is a coordinating body designed to serve as a forum on pharmacy matters of common interests to the nine Texas pharmacy schools, Texas State Board of Pharmacy, TPA, TFDS, and TSHP. The Congress discussed AACP’s new pharmacists campaign, “Pharmacists for Healthier Lives” (view video) and continued its visioning process to advance the pharmacy profession through public policy positioning, pharmacy education, and practice advancement. Meeting attendees had the opportunity to tour the College’s new home in the Health and Biomedical Science Building 2, completed in 2017. The new facilities include numerous tools and technology to provide student pharmacists more experience to better prepare them for real-world pharmacy practice.

TPA Participates in UT Austin Pharmacy Legislative Panel

Texas Pharmacy Association representatives participated in a legislative panel Monday evening hosted by The University of Texas College of Pharmacy student chapters of the National Community Pharmacists Association, Student National Pharmaceutical Association, Student Societies of Health-System Pharmacy, and Texas Coalition of Student Pharmacists. Panelists included TPA President Mark Comfort and CEO Debbie Garza, Texas State Board of Pharmacy Executive Director Allison Benz, John Heal of Texas TrueCare Pharmacies, and Dr. Mark Newberry, immediate past president of the Alliance of Independent Pharmacists. The panel discussed key issues for pharmacy in the upcoming 2019 legislative session and how student pharmacists can get involved in pharmacy policy before and during the session. John Heal shared with the students a quote he once heard to “get into politics or get out of pharmacy,” as he described the role legislation and regulation plays in our profession. The student pharmacists learned their voice is vital in shaping the future of this great profession.

Association Board Meeting Celebrates Successes, Plans for Advocacy

The Texas Pharmacy Association Board of Directors held its monthly meeting November 15 via conference call. The Board acknowledged the Association’s positive trajectory, applauded continued membership growth, welcomed new staff, and reviewed advocacy efforts for the upcoming 2019 Texas legislative session. As a reminder, save the date for Pharmacy Day at the Capitol on February 26! Participants will have a breakfast briefing to review key pharmacy legislative priorities and will receive talking points before going to the capitol to attend meetings with legislators and staff to educate them on the issues and how they affect pharmacy and patient outcomes. Stay tuned for more details and registration!

Alvarado Helps Govern Hispanic Pharmacists Association

NHPA with Chris Alvarado
Chris Alvarado (back, center) is a board member of the National Hispanic Pharmacists Association.

Chris Alvarado, the immediate past chair of PharmPAC and chair of the Bexar County Pharmacy Association, has been named to the Board of Directors the new National Hispanic Pharmacists Association. The group, which is affiliated with the National Hispanic Health Foundation, held a webinar launch November 14.

Happy Thanksgiving from TPA!Happy Thanksgiving!

Rather than gathering news, the Texas Pharmacy Association staff will be busy late next week giving thanks for you, our members.

Texas Pharmacy Today will return to your inbox in two weeks, on November 30.

In the State

DSHS Offers Flu Webinar Nov. 30

The Association of Immunization Managers (AIM) is offering a webinar to discuss the research and benefits of the flu vaccine, as well as how best to communicate this important message to patients. The webinar will also discuss the new flu dashboard and flu ordering from the DSHS Immunization Unit. L.J. Tan, chief strategy officer for the Immunization Action Coalition, will present this webinar Friday, November 30, from 11 a.m. to noon. Register online.

Texas Medicaid: Updated Crosswalk and Drug Labeler File Available

HHSC has published an update to the Texas National Drug Code (NDC)-to-Healthcare Common Procedure Coding System (HCPCS) crosswalk. It’s important to note that inclusion of a HCPCS code on the crosswalk does not guarantee coverage or payment. Utilize the Fee Schedule to confirm that the procedure is payable. Clinician-administered drug (CAD) processing instructions and frequently-asked questions are also available.

Bonnen Says He Has Votes to Become Texas House Speaker

Announcing support from 109 out of 150 Texas House members, state Rep. Dennis Bonnen, R-Angleton, declared the speaker’s race over Monday. Seventy-eight Republicans and 31 Democrats committed to supporting Bonnen, according to a list his office released late Monday. Bonnen said members would decide the chamber’s top priority.

Austin American-Statesman (November 12, 2018) Silver, Johnathan

Child Dies Days Before Flu Shot Appointment

KXAN has learned that there are groups trying to change the state law which would allow pharmacists to give flu shots to kids. A spokesperson with The National Association of Chain Drug Stores, which includes CVS, HEB pharmacies and Walgreens, says they hope to work with lawmakers next session. In a statement, a spokesperson with the Texas Medical Association said, "TMA believes that vaccinations for children and adolescents should be given only under the direction of a physician in the context of a preventive care exam, so critical aspects of health and development can also be assessed."

KXAN-TV (November 11, 2018) Doost, Arezow

Naloxone Accessibility under Standing Orders at Community Pharmacy Chains in Texas

An audit of chain pharmacies in Texas assessed the availability of naloxone, which reverses the effects of opioid overdose, since state legislators made it legal for pharmacies to provide it without a doctor's prescription. Because there is not a blanket "standing order" for the entire state, the arrangements vary from pharmacy to pharmacy and are not tracked by the Texas State Board of Pharmacy. Pharmacy responses suggest that barriers to naloxone access persist in Texas nearly three years after it sanctioned pharmacies to provide it under standing orders. To improve access, the researchers point to consistent naloxone supply in all pharmacies, better pharmacist education on standing orders, and comprehensive insurance coverage for third-party purchasers.

Journal of the American Medical Association (November 13, 2018) Evoy, Kirk E.; Hill, Lucas G.; Groff, Lindsey; et al.

Anti-Vaccine Texas Families May Take Their Fight to Day Cares Next

A leading anti-vaccine group claims that day cares are breaking the law by denying kids who haven't been vaccinated. Experts say the group is misinterpreting the law.

Texas Tribune (November 13, 2018) Evans, Marissa

Project SHINE Offers Free Health Care to Valley Residents in Mission

Continuing their efforts of providing basic health care screenings for people in the Rio Grande Valley, students have brought Project SHINE to Mission, Texas, for the second time in 12 years. Project SHINE (Service & Help through Interprofessional Networking Experience), run by pharmacy students, was present at the Mission Parks and Recreation Center last Saturday. Developed by the American Pharmacists Association Academy of Student Pharmacists (APhA-ASP) at Texas A&M (College Station) according to Irma Lerma Rangel College of Pharmacy, these Aggie students have been setting up pop-up clinics all over the RGV once or twice every school semester since it began.

Progress Times (November 12, 2018) Trevino, Jaime

National News

With Divided Congress, Health Care Action Hightails It to the States

Newly-elected leaders in the states will be in a stronger position than those in Washington to steer significant shifts in health care policy over the next couple of years as a divided Congress struggles with gridlock. State Medicaid work requirements, prescription drug prices, insurance exchanges and short-term health plans have potential for change.

Roll Call (November 13, 2018) Williams, Misty

Incoming Dem Chairman: Medicare Negotiating Drug Prices Is a Priority

Rep. Frank Pallone Jr. (D-N.J.), slated to be the next chairman of a House committee overseeing drug prices, said Wednesday that his top priorities on the issue are allowing Medicare to negotiate prices and speeding the approval of cheaper generic drugs. Pallone, pointed to Trump’s support for those two policies in expressing hope for a deal.

The Hill (November 14, 2018) Sullivan, Peter

U.S. to Restrict e-Cigarette Flavors to Fight Teenage Vaping 'Epidemic'

FDA Commissioner Scott Gottlieb on Thursday announced he is seeking changes that would have all flavored electronic nicotine delivery systems products (other than tobacco, mint and menthol flavors or non-flavored products) sold in age-restricted, in-person locations and, if sold online, under heightened practices for age verification.

U.S. Food and Drug Administration (November 15, 2018) Felberbaum, Michael

FDA Approves Return of Popular Primatene Mist Asthma Inhaler

A new version of the once-popular asthma inhaler Primatene Mist will soon return to U.S. stores. The Food and Drug Administration approved the over-the-counter aerosol inhaler late last Wednesday. It's for temporary relief of mild, intermittent asthma symptoms in people ages 12 and up.

Associated Press (November 8, 2018) Johnson, Linda

Cigarette Smoking Among U.S. Adults Lowest Ever Recorded

New data show that cigarette smoking has reached the lowest level ever recorded among U.S. adults, with an estimated 14% (34 million) adults saying they were current cigarette smokers in 2017. The report—from CDC, FDA, and the National Cancer Institute—noted, however, that about 47 million adults still used a tobacco product last year.

Centers for Disease Control (November 8, 2018)

FDA Takes Steps to Strengthen Oversight, Reporting of Inspections for Sterile Injectable Drugs

The FDA is taking new steps to modernize its inspections program for sterile injectable drugs, which have been the subject of sterility problems and shortages in the past. The New Inspection Protocol Project involves "a new way of assessing, recording, and reporting the data from surveillance and pre-approval inspections for sterile drug products."

U.S. Food and Drug Administration (November 9, 2018) Walsh, Sandy

HHS Recommended that DEA Ban Kratom, Documents Show

The Department of Health and Human Services has recommended a ban on the chemicals in kratom that would make the popular herbal supplement as illegal as heroin or LSD, according to documents obtained by STAT. HHS asserted that two chemicals in kratom should be classified as Schedule I substances and have “a high potential for abuse.”

Stat (November 9, 2018) Swetlitz, Ike

U.S. Regulators Snip Red Tape for Medical Devices to Curb Opioid Crisis

Laura Perryman expected her medical company would have to wait several years for its painkilling device to win U.S. approval as treatment for chronic migraines. She now thinks it could be done in months, thanks to a new FDA initiative to use medical device-based treatments, diagnostic tests and mobile medical apps to address the opioid crisis.

Reuters (November 9, 2018) Mathias, Tamara

Trending News

More States Taking on PBMs, Demanding to See Savings in Medicaid

An increasing number of states are demanding to see how PBMs are spending taxpayer dollars in Medicaid, and are reining in the industry's role in taxpayer-funded programs. Louisiana and Ohio are replacing their old PBM contracts, and putting transparent models in place. Virginia, Kentucky, and Georgia all passed bills requiring more disclosure.

Philadelphia Inquirer (November 9, 2018) Dunn, Catherine

Surgery Patients Use Only One-Quarter of Prescribed Opioids, and Prescription Size Matters

Many surgeons write opioid prescriptions four times larger than what their patients will actually use after common procedures, according to a new study. The size of that prescription was the strongest predictive factor of how many opioids the patient will take, more so than their pain scores, the intensity of their operation, and personal factors.

EurekAlert (November 7, 2018) Gavin, Kara

New Cholesterol Management Guidelines Call for Personalized Risk Assessments

Leading heart experts released cholesterol management guidelines Saturday that call on doctors to tailor treatment to more personalized risk assessments of each patient and recommend the use of two new kinds of drugs for those at the greatest danger of disease. The guidelines give clinicians a better idea of how to do that via treatment categories.

Washington Post (November 10, 2018) Bernstein, Lenny

Fish Oil, Vitamin D Pills No Guard Against Cancer or Serious Heart Trouble

A widely anticipated study has concluded that neither vitamin D nor fish oil supplements prevent cancer or serious heart-related problems in healthy older people, according to research presented at the American Heart Association. Researchers defined serious heart problems as the combined rate of heart attacks, stroke and heart-related deaths.

Kaiser Health News (November 10, 2018) Szabo, Liz

With Better Drugs for High Cholesterol, Doctors Become More Ambitious with Treatment Goals

When recommending the more aggressive treatment of those at highest risk of heart attacks and strokes, “it helps patients and providers when you give them numbers and targets.” But while 78 million Americans (about 37% of the adult population) either take or should consider taking medication to lower their cholesterol, close to half don’t do so.

Los Angeles Times (November 10, 2018) Healy, Melissa

Pharmacist Interventions Decrease Risky Medication Use

A study says pharmacists have a key role in preventing medication harm in seniors by coordinating with physicians to reduce prescriptions for risky medications. Interventions by pharmacists in the study assisted 43% of users of sedative-hypnotics and 58% of users of anti-inflammatory drugs to safely stop taking unnecessary medications.

Medical Xpress (November 14, 2018) Heinrich, Jeff

The Growing Trend of Pharmacy Automation

The expansion of artificial intelligence and machine learning, along with the lower cost of automated systems, has put automation within reach for even smaller pharmacies. The benefits of automated systems include filling orders more quickly while freeing up personnel to do tasks that cannot be automated, such as engaging face to face with patients.

Forbes (November 7, 2018) Chilcott, Meghann

Something Happened to U.S. Drug Costs in the 1990s

U.S. drug spending tripled between 1997 and 2007, followed by a slowdown until about 2013, when spending shot up again. By 2015, annual spending on prescription drugs reached about $1,000 per person. Though Americans take a lower proportion of brand-name drugs, the prices of those drugs are a lot higher than in other countries.

New York Times (November 13, 2018) Frakt, Austin

Two Big Employers Say No to Costly Copay Cards

Home Depot and Walmart have embraced employee drug plans by CVS Health and Express Scripts, respectively, that limit the use of drugmaker copay cards and coupons that encourage patients to use expensive medications when equally effective alternatives are available for a lower price.

Reuters (November 13, 2018) Humer, Caroline and Erman, Michael

Medication, Vaccination Uptake Improved by Involving Pharmacists in Older Adult Cancer Care

A recent study in The Oncologist found that integrating pharmacists into care for older adults with cancer was feasible, could improve medication management, and demonstrated a positive effect on vaccination rates. In all, 96.6% of the intervention patients met the pharmacist. Influenza and pneumonia vaccination rates were also higher.

Oncology Nurse Advisor (November 9, 2018) Garlapow, Megan

Express Scripts to Let Drugmakers Reduce Prices with New Formulary

Express Scripts is launching a formulary option for clients under which drugmakers can lower prices instead of offering rebates. The new National Preferred Flex Formulary, available to all clients starting Jan. 1, includes nearly all the same medications as its National Preferred Formulary, which covers roughly 3,000 brand-name and generic treatments.

Reuters (November 13, 2018) Beasley, Deena

America Worried about Antibiotic Resistance

Sixty-five percent of Americans believe antibiotic resistance is a public health problem, and 81% believe antibiotic resistance will make more infections difficult to treat, according to a survey. Ninety-two percent of those surveyed believe doctors should only prescribe the drugs when necessary.

HealthDay (November 14, 2018) Preidt, Robert

Startup for Diabetes Patients will Only Get Paid by Insurers if Service Works

Insurers and employers will now only pay an ambitious startup that uses digital coaching and monitoring to try to help patients reverse type 2 diabetes if its service works. A health plan or employer will pay Virta a fee only if the patient is sufficiently engaged with its program after a month. A second payment comes after a year if patients lower their A1C.

Stat (November 14, 2018) Robbins, Rebecca

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