March: Volume 19 Issue 2

NEW YORK CITY PHARMACISTS SOCIETY
VOLUME 19, ISSUE 2 PSSNY HELPLINE 1-800-632-8822
The Voice of Pharmacy in the Big Apple
PRESIDENT’S MESSAGE
Where do we go from
here?
This is the question I
posed to all the attendees
at
the
Pharmacy Owners
Lobby Day, which
took place in Albany
on March 3rd. Over 100 pharmacists
joined the NYCPS leadership team
that day to talk to legislative members
to explain to them the devastating
effect the September 26th reduction in
AWP has had on the independent
pharmacy owners.
The goal we had on March 3rd
was to ask for a differential in the reimbursement for independent pharmacies. We asked the legislatures to
have this differential be included in the
budget for this year. NYCPS has been
strategically planning this lobby day
CHAIRMAN’S REPORT
1
SEE
PAGE
Chairman’s Report. . . . . . . . . . . . . 3
Treasurer’s Perspective . . . . . . . . . 4
In Memoram . . . . . . . . . . . . . . . . . 4
Secretary’s Report. . . . . . . . . . . . . 6
Retail Council . . . . . . . . . . . . . . . . 8
The NCPA Report . . . . . . . . . . . . . 9
Rx and the Law. . . . . . . . . . . . . . 10
Investment Corner. . . . . . . . . . . . 11
News from Around the
Pharmacy World . . . . . . . . . . 12
ISMP . . . . . . . . . . . . . . . . . . . . . . 14
Legal War Chest Update . . . . . . . 19
PRSRT STD
631-434-3399
PAGE
Grassroots Consumer
Support Needed . . . . . . . . . . . . 1
U.S. POSTAGE
Jim Schiffer, Senior Editor
Designed, Printed & Mailed by:
Prestige Envelope
and Lithographic Corp.
IN THIS ISSUE
President’s Message . . . . . . . . . . . 1
PA I D
PSSNY REGIONAL REPS
Ray Macioci
Bronx, Manhattan
Ron DelGaudio
Brooklyn, Staten Island
Charles Catalano
Queens
RECORDING SECRETARY
Rosemarie Tomasseti
917-750-6273
NEWSLETTER
SEE
1
The New York City Pharmacists Society
41 E. 11th Street, 11th Fl., New York, NY 10003
BOARD OF DIRECTORS
Jim DeTura, Chairman
718-292-1856
Mike Agovino
718-543-3116
Charlie Ciaccio
718-452-3261
Ron DelGaudio
718-230-3535
Russell Gellis
212-877-3480
Ray Macioci
718-823-1085
Boris Mantell
718-591-1040
John Navarra
212-213-5570
Joseph Navarra
212-213-5570
Parthiv Shah
718-292-4244
continued on page 14
HICKSVILLE NY
PERMIT NO. 842
EXECUTIVE DIRECTOR
James A. De Franco
516-330-9906
continued on page 22
ADDRESS SERVICE REQUESTED
718-358-1300
718-835-2000
718-655-5558
212-616-7040
Fight4Rx is a non-partisan grassroots effort of the
National
Community
Pharmacists
Association
aimed at educating and
recruiting
pharmacy
patients
nationwide
as
grassroots
activists.
Pharmacists play a role
everyday in the lives of
patients
by
improving
health care while reducing
costs. During a constant
health care debate in
Washington, DC, it is vital
that
patients
remain
engaged in protecting their
access to safe and afford-
IF THERE IS A “D” ON YOUR LABEL...
YOU’RE DELIQUENT. PLEASE REMIT.
FOR FURTHER INFORMATION CALL 1-800-632-8822
OFFICERS
Charles Catalano, President
Alex Perchuk, Vice Pres.
Bill Scheer, Treasurer
Jim Schiffer, Secretary
PAGE
GRASSROOTS
CONSUMER SUPPORT
OF PHARMACY NEEDED
ever since the September 26th cuts
took effect. Earlier this year we meet
with
Speaker
Shelly
Silver,
Assemblyman Dick Gottfried, Chair of
the Health Committee in the
Assembly, Senate Majority Leader
John Sampson, Senator Tom Duane,
Chair of the Health Committee in the
State Senate, Senator Malcolm Smith,
President of the State Senate,
Senator Eric Adams and Senator Jeff
Klein to discuss a differential reimbursement for independent pharmacies.
Our lobbyist Tracy Tress and I
also meet with Officials of the
Governor’s office, Division of the
Budget, and key senior staff of the
State Senate and State Assembly.
The message we sent was consistent. The independents are a different business model than the chains
and therefore we need a differential
reimbursement The independent com-
GRASSROOTS CONSUMER
SUPPORT NEEDED
PRESIDENT’S MESSAGE
SEE
MARCH 2010
www.NYCPS.org
3
PAGE 2 MARCH 2010
NYCPS NEWSLETTER
NYCPS NEWSLETTER
MARCH 2010 PAGE 3
CHAIRMAN’S REPORT
WHAT’S THE DIFFERENTIAL?
I am writing this month’s article on the heals of our 2nd annual Pharmacy Owner’s Lobby Day
in Albany. This year’s message
focused on two important issues.
The first issue was regarding a
differential reimbursement for
independent pharmacies. The
second dealt with OMIG abuses.
I would like to focus on the
Differential Reimbursement issue
which is extremely important for
independent pharmacy.
We
made it perfectly clear to our legislators that a reduction in reimbursement impacts the independent more than any other pharmacy business model. Independent
pharmacy has 93% of its business derived from the prescription department. In contrast, the
chains have about 60% and the
big-box stores such as Wal-Mart
and the supermarkets have
about 1-6% of its revenue
derived from the aforementioned
prescription department. So anyone can plainly see the impact
which this latest 4% roll-back had
on us.
Quite directly what we proposed was that the state eliminate the current AWP minus
structure and impart a WAC plus
structure. They were told that in
approximately 2 years, AWP will
be a thing of the past anyway so
we need to move forward now.
The proposed rate for independents would be WAC plus 4.68%
which would make us whole
based on the pre-September 26th
reimbursement.
The chains
would remain at the same AWP
minus 16.25% or WAC plus 0.5%.
We are at a major crossroads
here and those of us who made
the trip to Albany painted a very
clear and straightforward picture
as to what needs to be done. We
also made it clear that this needs
to be added to the budget and
NOT through any legislative bills.
The budgetary process is where
this needs to be driven home.
Now I know many of you were
not able to make the trip due to
staff cuts in your pharmacies and
now some owners have no
means of freeing themselves to
make this trip. We made this
clear to the legislators as the reason for a smaller turnout then last
year. Let’s face it, reduced reimbursements translate to reduced
services
and
reduced staffing.
We carried that
message for you
but now we need
you to call your
legislators and get
them on board for
a
Differential
Reimbursement
and clearly state
for Independent
Pharmacies. This
will not have a
major impact on
the state as they
might think.
With the recent
takeover of Duane
Reed
by
Walgreen’s, it is
clear that we are
down to three
major chains and
soon it could be
two as Rite Aid is still reeling and
will have major financial issues
once again in 2011. The legislators were told that they need
independent pharmacy in New
York as an insurance policy
against the chains. You might
ask why? Well it’s simple. If
independent pharmacy goes out,
that will in fact leave probably 2
major chains and once that happens, the chains will rule the
roost! It does not take great wisdom to see the writing on the wall
here. The chains will then dictate
reimbursements to the state and
if the rate is not right, the chains
will walk thus creating a real
access problem for the neediest
in our healthcare system.
We were confronted by the
$10 billion budget shortage in
New York State but we pled our
case with energy and enthusiasm
continued on page 6
PAGE 4 MARCH 2010
NYCPS NEWSLETTER
the paperwork, which they statTREASURER’S PERSPECTIVE submitted
ed in the form could take 3-4 weeks to
process and set up. I checked back
around the end of January to see the status of my application. After one half hour
on the phone and 5 different people I was
transferred to Member Services (go figure) and was promised it would be referred to
Customer Services (appropriately) and answered
within 72 hours. I received email confirmation of
this promise and waited. A week after this phone
call I began receiving checks from Medco with no
explanation of payment. I was extremely confused
, how do I reconcile the payments I again contacted customer service and to this day have received
no response to either question.
Aetna was even better, in filling out the form
they required you to go onto the website and to get
a user I D and password in order to submit the
application. This was done , but I received no
response by email. Then I tried the old fashion way
, I called Aetna, however they explained (again
after speaking to 5-6 different people ) everything
must be done online, none of them had no capacity to help me. I had attempted to elicit some e-mail
response numerous times , but to no avail.
Do we see a pattern here or what, here we
have
probably
the
two
biggest
insurers/payors/PBMs and they are seemingly
unwilling or unable to expedite payments to their
providers . Is it ineptitude or purposeful to not
allow us what we can get from other providers,
prompt payment? It is tough enough to survive in
the current atmosphere without having to jump
through hoops to speed up our payments. This is
just another example of the arrogance of the insurers/payors/PBMs we deal with daily! 3
Bill Scheer © 2010
PROMPT PAY
The New Year has finally brought with it the
promise of more speedy reimbursement for Part D
claims. The insurers are required to process payment within 14 days for any “clean” claim. By
“clean” it is meant those adjudicated and accepted
for payment by the PBM . This helps to shorten the
time between the dispensing of a product and the
payment, especially important with our current
profit margins. Another useful tool useful in helping
our bottom line is Electronic Fund Transfer (EFT),
the direct deposit of funds into our banking
accounts by the PBMs. It bypasses the dependence on the efficiency of the PBMs mailroom and
the pitfalls of regular mail delivery from the USPS.
I belong to a buying group that has contracted
with most of the PBMs to allow the buying group
to receive payment for all its member stores and
then EFT directly to the individual pharmacy bank
account. The payments arrive within a day of the
date of release. What used to be a nerve racking
wait for the checks to arrive in time has been eliminated. There were those who resisted the EFT
transfer including a local HMO . This HMO constituted a major portion of my business and to prevent delayed checks I even went to the extraordinary method of having them send them our
FEDEX. With the approaching implementation of
Prompt Pay , they too finally implemented EFT .
I was left with two payors who did not allow our
buying group to use EFT, but required we apply
individually Aetna and Medco, perhaps the biggest
players . Medco’s form was straight forward and I
Zupko. I had quite
a bit of interaction
with him in my
tenure as a student, during the
late 1960’s to 1973 when I graduated. Dr. Zupko has recently
passed on to eternity. I am sharing the memorandum prepared
about Dr. Zupko of Dean David
Taft, the current dean of A&M
Schwartz College of Pharmacy,
on Dr. Zupko’s passing below.
Dr. Zupko was a passionate
IN MEMORIAM OF
DR ARTHUR G. ZUPKO
To those of you who graduated from the Brooklyn College
of Pharmacy or BCP as it was
affectionately known, or from
the Arnold & Marie Schwartz
College of Pharmacy of LIU,
going back as far as the early
1980’s you may remember the
Dean (and later the President)
of the College, Dr. Arthur G.
pharmacist who was always concerned about progressive pharmacy concepts, in many ways he
was ahead of his times. Jim
Schiffer
Dr. Arthur G. Zupko, 1917-2010
Dr.
Arthur
G.
Zupko,
President Emeritus of the Arnold
& Marie Schwartz College of
Pharmacy and Health Sciences,
Long Island University, died on
January 21, 2010 in North Ft.
continued on page 23
NYCPS NEWSLETTER
MARCH 2010 PAGE 5
PAGE 6 MARCH 2010
NYCPS NEWSLETTER
from the current
meager rates of
reimbursement
for the community pharmacies
MARCH
2010
who
service
Medicaid, Family
and Child Health
Plus, ADAP and EPIC patients. Leave
the existing rates in place for the chain
industry.
I have heard from many of you concerning the financial pain that we have
been living with as a result of the drastic reduction in state pharmacy reimbursement since the implementation of
the
First
Databank
Litigation
Settlement, which became effective
September 26, 2009. The leadership of
your pharmacy organizations (NYCPS
and PSSNY) want to hear from you concerning any of your adverse financial
business issues relating to this round of
cuts. If you are willing to share your
individual concerns you can email them
to me at [email protected], and I will
forward without your information (without your name or pharmacy being identified unless you so desire to go public)
to our society leadership as a means of
documenting the financial strain the
decreased reimbursement caused by
the First Databank Settlement.
There is another problem which I
want to address that I have been discovering in communications with our
membership. As audits both from the
commercial and government side of
pharmacy claims are increasing with
intensity, some of our members are
being assessed fines and audit recovery demands for simple bookkeeping
errors. I realize that many of our mem-
SE C R E T A R Y ’S
REPORT
As we prepare for another month of
legislative issues in this new year, it
seems that our state government is in a
bigger turmoil than ever before, even
worse than it was last year when the
NYS Senate went on strike for many
weeks. By the time you get this
newsletter, we may have had a moving
van empty out the Governor’s Mansion
as Governor Paterson’s days, as we
now know, are numbered (he
announced he has chosen not to run for
election in his own name) and he may
not even serve out the remaining
months of his official term.
According to the latest news stories, New York State is facing a $9 billion deficit for the coming fiscal year
(April 2010 to March 2011) and the
prospects for the following year (April
2011 to March 2012) will be even worse
- - estimated at $15 billion. With these
horrific statistics, the leadership of
NYCPS and PSSNY have been visiting
the leadership of both democratic and
republican assemblypersons and senators in Albany to explain the value of
both community pharmacists and also
their pharmacies value added to the
communities we service.
As is
described elsewhere in this newsletter,
the leadership of your local and state
pharmacist’s organizations are requesting a “differential rate of reimbursement”
which means we are requesting a separate, higher rate of reimbursement apart
Chairman’s Report
from page 3
and I would like to believe we won over many legislators who either did not get it or was sitting on the
fence. With all of you making calls and, if possible,
planning local trips to your legislators’ offices, the
message can continue to be driven home. This is
no time to take a backseat approach. Rather it’s
time for intense action and all we are asking for are
phone calls and possibly local visits.
bers have been putting the well being of
their patients ahead of the recordkeeping requirements of the Board of
Pharmacy, Department of Health and
the various commercial insurance companies who manage the prescription
benefit for our patients. I would like to
remind one and all, that it is nice to be a
caring pharmacist, a concerned member of the health care delivery team, but
in today’s very regulated environment,
please remember to cross your “t’s” and
to dot your “I’s”. For instance, I will list
a few of the simple items that members
are overlooking. These are simple
things to overlook, but they can be costly, failing to transcribing a telephone
request by a prescriber for an order of rx
medication into a formal telephone prescription which is logged into your rx
files, failing to properly file in numerical
order your daily prescriptions, failing to
follow up delinquent prescribers who
promise to mail cover prescriptions
where so required by the plan or by
state regulation, failing to calculate the
accurate days supply for eye drops, and
insulin for patients on third party plans,
and just defaulting to a 30 day supply. I
can continue with other examples but
the point is made here. Remember it is
nice to be nice, but also remember to be
consistent, accurate and document your
professional actions, and be warned
because the costs for not doing so may
be very, very expensive. Please keep
up to date and involved in the almost
daily initiatives which NYCPS and
PSSNY have been planning. 3
Stay well, and stay strong and I will
be in touch next month,
Jim Schiffer
Your NYCPS board has continued to work hard
and I am delighted to see more people are stepping
up to the plate. I encourage you to be one of them.
Keep a close eye on your e-mails and faxes so you
can stay up to date on any new developments. If
you snooze, WE lose!! 3
Professionally,
Jim Detura R.Ph.
Chairman
[email protected]
NYCPS NEWSLETTER
MARCH 2010 PAGE 7
PAGE 8 MARCH 2010
CHECK
NYCPS NEWSLETTER
YOUR CREDIT CARD PROCESSING
STATEMENTS REGULARLY
Did you know if you participate in the Retail
Council’s Credit Card Processing Program you can
review your account as often as you choose online
instead of waiting to receive your statement in the mail
each month? Checking your account frequently really
pays off, as the following example demonstrates.
In a regular review of his credit card account, a
Retail Council processing program participant noticed
he was missing $7,000, a full day’s worth of transactions. He immediately called one of the Retail Council’s
in-house credit card processing experts, Michele
Coons, who helped him resolve his problem and get
his
money.
What was the
key to success
here?
This
b u s i n e s s
owner regularly
reviews
his
processing
account online
and compares
them to his
income ledger
to make sure
everything
matches up.
For those
NYCPS members in the
Retail Council’s
processing program,
we
review
your
statements on
a
quarterly
basis
in
a
search
for
errors through
our Watchdog
Program.
However, you
should make a
practice
of
checking statements
frequently
too.
The
Retail
Council’s Merchant Services Team suggests reviewing
your account at least monthly, if not weekly, to be sure
there are no errors. Our free online service through
Global Payments Direct, Inc. makes checking your
account convenient and easily accessible.
Another tip to prevent processing errors: You
should always run a test transaction with your credit
card processing company whenever you get your terminal programmed or reprogrammed to be sure it is
working properly.
Call Michele or Nicholl in the Retail Council’s
continued on page 21
NYCPS NEWSLETTER
MARCH 2010 PAGE 9
T HE N C P A R E P O R T
GO GREEN, MAKE
SOME TOO
Recently I spoke to one of my
pharmacist colleagues about a prescription take back program that she
had initiated. She was amazed at
the vast amounts of unused medications that were being returned—
mostly from other pharmacies and
many from mail order pharmacies.
We talked about the potential environmental good that this service provided to the community as well as
removing the danger of unused
drugs falling into
the hands of small
children or being
abused
by
teenagers.
She
also
mentioned
that the program
has attracted new
and
returning
patients that she
had not seen in
some time. In
coordination with
Earth Week, April
17-24,
we’re
pleased to launch
N C P A ’ s
Prescription Drug
Disposal Program.
A year ago we
released information about take
back programs as
part of our Protect
Your
Pharmacy
Now!
Program.
This year NCPA’s
Prescription Drug
Disposal Program
is a voluntary way
for pharmacies to
offer a new service
to their community
that may also generate
increased
foot traffic in their pharmacy.
Participation is at a very low cost —
$55, which represents a nearly 20%
discount on the Sharps TAKEAWAY™ Environmental Return
System, plus free shipping as well
as customizable marketing materials
from Sharps. (NCPA members will
also have access to marketing
materials commissioned by NCPA
from PharmFresh Media).
Hopefully, your curiosity is
piqued. In Iowa, where a
Prescription Take Back program has
already demonstrated its capabilities
through a statewide pilot program,
your fellow pharmacy owners offer
actual testimonials.
“I’ve seen new people walk in
who have never been to our pharmacy, maybe as many as 30% of the
people returning medicines for disposal,” explained John Forbes of
Medicap Pharmacy. “It presents an
opportunity to acquaint them with
who we are and what we do.”
Connie Connolly of Osterhaus
Pharmacy added, “We knew there
was a huge need for medication
return programs. For us, it was a no
brainer. It lets us be environmentally responsible as well as get unused
continued on page 21
PAGE 10 MARCH 2010
AND
THE LAW
NYCPS NEWSLETTER
NEVADA RULES ON PHARMACIST’S DUTIES
This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and the New York City Pharmacists Society through
Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
The Nevada Supreme Court
has ruled on the case asking
whether seven chain pharmacy
owners and one independent owner
were rightfully dismissed from the
civil case, Sanchez v. Wal-Mart
Stores, et al1. The case arises from
a June 2004 car accident caused by
Patricia Copening. She was driving
along a busy Nevada highway while
under the influence of prescription
medications. The accident killed
one man, Gregory Sanchez, Jr., and
injured another, Robert Martinez.
Prior to the accident, in June
2003, the Nevada Prescription
Controlled
Substance
Abuse
Prevention Task Force sent letters
to 14 Las Vegas area pharmacies
informing them that Copening may
be abusing drugs.
The letter
informed the pharmacies that
Copening had received approximately 4,500 hydrocodone tablets
from 13 different pharmacies during
the previous year. She continued to
receive multiple prescriptions for
hydrocodone-acetaminophen and
carisoprodol between June 2003
and June 2004 when the accident
occurred. She appeared confused.
The police found prescription bottles and loose tablets in the vehicle.
She
was
found
to
have
hydrocodone in her system. She
served nine months in jail after
pleading guilty to reckless driving.
A civil case was filed by the
Sanchez family, Mr. Martinez and
his family against Copening, the
doctors prescribing for her, and the
pharmacies. The district court dismissed the pharmacies because Nevada
law did not impose a
duty on the pharmacies to take action after
receiving the Task
Force letter.
The Supreme Court
of Nevada reviewed
the
case
and
answered two questions; First, did the
pharmacy have a duty
to act to prevent their
patient from injuring
members of the general public, and Second,
did Nevada law allow
third parties to maintain a negligence per
se claim. The case
was decided by a 5-2
margin, with a strong
dissent.
The majority and the
dissent agreed that
under Common Law
principles, a person has no duty to
control the dangerous conduct of
another person or to warn others of
the dangerous conduct. There is an
exception to this rule however. If
there is a special relationship and
the harm is foreseeable, the there is
a duty to act. The majority and dissent diverged on the analysis of
whether a special relationship existed in this case because they weren’t
consistent on which parties form
this special relationship. The majority talked about the relationship
between the pharmacy and the victim, while the dissent talked about
the relationship between the pharmacy and the patient. The majority
notes that the pharmacy had no
relationship with the victims and that
they were, in fact, unidentifiable
prior to the accident. This is an
important point in the analysis
because it is clear that there is a
special relationship between a pharmacy and its patients.
The majority noted that the
pharmacy had no requirement to act
after it received the Task Force letter. However, they pointed out in a
footnote that the regulations had
changed since this incident, but
declined to opine as to whether the
decision would be different because
of the rule changes. The ruling in
the case was that the pharmacies
had no duty to act because the law
didn’t require them to act and there
was no special relationship formed
that would require them to act. The
majority also ruled that a negligence
per se claim could not be maintained because the laws in question
were not intended to protect against
the injuries that the plaintiffs had
sustained.
While the pharmacies were discontinued on page 22
NYCPS NEWSLETTER
MARCH 2010 PAGE 11
THE INVESTMENT CORNER
USING RELATIVE STRENGTH TO TRADE ETF”S
I mentioned in the last issue that I would be writing
on how to safely buy ETF’s (exchange traded funds).
Actually there are two Relative strengths used in technical analyses. One is in relation to the stock market.
In other words how the individual stock is faring
against the market. The other is how the stock itself
performs in relation to its own rate of change. We will
presently deal with the latter and using ETF’s as examples. ETF’s hold assets such as stocks or bonds and
trades at approximately the same price as the net
asset value of its underlying assets over the course of
the trading day. Most ETFs track an index, such as the
S&P 500 or Dow Jones. ETFs may be attractive as
investments because of their low costs, and stock-like
feature. I will explain how you can safely buy ETF’s
using Relative Strength.
Developed by J. Welles Wilder and introduced in
his 1978 book, “New Concepts in Technical Trading
Systems”, the Relative Strength Index (RSI) is an
extremely useful and popular momentum oscillator.
The RSI compares the magnitude of a stock’s recent
gains to the magnitude of its recent losses and turns
that information into a number ranging from 0-100.
Stocks are notorious for moving in erratic waves as
you can see below as depicted by the ETF SPY. The
Relative Strength Index (RSI) will actually smooth out
the erratic movement and fills in the need for a constant upper and lower boundary. The actual formula is
as follows:
RSI = 100 – 100
1+RS
RS = Average of x days’ up closes
Fourteen days are used in the calculation.
Fourteen weeks are used in weekly charts. To calculate the average down value, add the total number of
points lost during the down days and divide the total by
14. Do the same with the average up value. Then
divide the up average by the down average.
When the RSI reading is 70 or higher. It means it’s
in an overbought position and time to sell. When it’s
30% or lower it usually means it’s in an oversold potion
and may be time to buy the stock or ETF. Of course
it’s very helpful to find the trend of the ETF. It’s in an
uptrend, which can be defined by using a moving average as you see in the chart below (the wavy line crossing the price bars) when the moving average is rising.
Another factor in RSI analysis is the divergence. Look
at the chart. Do you see the RSI line ending 61.33?
Also, do you notice the price of SPY at 112.64? If Spy
makes a new high and the RSI does not, that is a
divergence and it’s time to be very cautious. Also if you
see the RSI above 80 and starts to fall down and
through the 80 line, it may possibly be time to sell. The
same holds true when the ETF is going though and
above the 30 line, it may be time to buy.
For a good depiction of the RSI, go to the following
Web Site: WWW.YAHOO.COM Then go to FINANCE
in the left bar then click on the INVESTING tab on the
top. Scroll down and click on stocks. In the stocks field
put in any symbol and hit go. Then click on
Charts/interactive in left bar. Once in charts expand
the time to six months and set the indicator tab to RSI.
And there you have it. Do this with a few charts by
placing a different symbol in the field. Study the different charts comparing the RSI to the stock prices and
notice some disparity. I suggest you learn more about
RSI simply by putting RSI into Google and you’ll get a
wealth of information links. Learning about a basic
technical analysis cannot be done in just a couple of
pages. I hope I’ve at least given you a starting point
and you can take it from here. RSI can be a powerful
technical analysis tool in determining whether or not to
buy a particular stock.
SPY is the ETF representing the S&P 500 and is
the most popular and heavy traded ETF
Good Luck Trading
James De Franco, R.Ph
Executive Director NYCPS
Organizer
Long Island Stock Traders Meetup Group
www.meetup.com/listmmg
PAGE 12 MARCH 2010
NYCPS NEWSLETTER
JIM SCHIFFER REPORTING...
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News from Around
The Pharmacy World
MARCH 2010
Health Care Reform Update
As I was preparing to close this
newsletter,
Congress
finally
approved the sweeping reforms to
health care via the massive health
care re-write legislation. It was a
close call in the final analysis but
Speaker Nancy Pelosi (whom I do
not care for) pulled one out of her hat
for President Obama.
I give
President Obama credit, because I
did not believe this bill had a chance
of passage once the democrats lost
the Massachusetts Senate seat held
by the late Ted Kenney. The not so
massive rewrite of legislation regulation the insurance industry is about to
start.
At press time, President
Obama is planning on signing this
historic legislation into law. The
President delayed a trip to Asia in
order to be around to help push
through this historic legislation. It
remains to be seen how the passage
of this legislation will be accepted by
the public and whether or not the
democrats will lose their majority in
the House of Representatives and
the United States Senate. Now that
this bill has been passed and awaiting the signature of President
Obama, it is more important than
ever to attend the NCPA Legislative
Conference which is being held in
Washington D.C. on May 10th
through May 12th.
President
Obama’s success as a leader of this
nation is now up to the historians to
decided, when this legislation
becomes law and if it is helpful, this
will go down in history as a great
accomplishment, but if this statute
becomes a nightmare as so many
other well intended issues turn out in
passage into law, then unfortunately,
President Obama might be looking
for a new job come November 2012.
With a bill that is nearly 2,000 pages
long, has so many quirks and special
favors for certain area of the country,
I do not know if I can say I like what
appears in this legislation, I guess
time will tell as we sort out the details.
Chain News
As I had mentioned back in the
end of 2009, I had believed that
Duane Reade was making itself pretty for a marriage to a bigger drug
chain, I think I had even predicted it
would be Walgreens and not CVS
some of you out there thought I was
nuts. Sure enough in mid February, it
was announced that Walgreens had
come to terms to purchase Duane
Reade’s 257 retail pharmacy operation for the sum of 1.1 billion (including the assumption of a significant
chunk - - $ 457 million of current
debt). According to Walgreens, they
plan on keeping the Duane Reade
name for the present time, along with
keeping the existing Duane Reade
management team, Duane Reade
has been an icon in the metropolitan
New York market for many years,
starting out as a one store pharmacy
owned by the Cohen family, in lower
Manhattan on Broadway between
Duane and Reade Streets. It is hard
to believe that Duane Reade has had
so many different owners since its
inception in 1960 (the company was
sold a total of four times in the 50
year span). Does anyone remember
Rock Bottom, another local chain
which was acquired by Duane Reade
in 1998 which raised the number of
Duane Reade locations to about 100
and during the direction of Anthony
Cuti as Duane Reade CEO the chain
grew to 249 locations in 2005?
Duane Reade was even a publically
traded company from 1998 until 2004
when it became a private corporation
as Oak Hill Capital Partners took control of Duane Reade. Nevertheless,
in spite of their growth and surface
success (to the eyes of the public)
the red ink and financial bleeding did
not stop even when the chain was
sold time and time again. In the first
six months of 2008 the chain lost 33
million bucks. I remember attending
a CE program in March 2009 in New
Jersey along with about 100 local
pharmacists. The folks at my table
were talking shop and one guy who
worked at Stop and Shop was troubled that the chain wanted to take his
comfortable one store position and
convert him to a floater. He being
over 50 resisted and finally decided
to jump ship and he moved to Duane
Reade. I remember his words at that
program. He said, “boy did I make a
mistake, [by leaving Stop and Shop] I
went from Stop and Shop to Duane
Reade, where they are struggling, I
guess I zigged when I should have
continued on page 13
NYCPS NEWSLETTER
MARCH 2010 PAGE 13
AROUND THE PHARMACY
FROM PAGE
12
zigged!” during the first six month
period of 2008, Duane Reade lost
$33.1 million. You may be asking
what other predictions do I have for
the chain drug industry? How about
Target acquiring RiteAid? Yes, I
believe that Target would make a
good fit of the RiteAid pharmacies as
part of the Target family. I have been
a student of this industry/profession
for several decades and I see synergies where others see problems.
Some Wall Street folks are predicting
that Wal-Mart will make an offer for
RiteAid. Other industry folks believe
that RiteAid may be broken up into
several components and will be
devoured by several regional drug
store/or food chains and some body
parts shipped off to Walgreens and
CVS. That is not in my vision of the
company. I see a national company
coming along and making an offer
that the leadership of RiteAid will not
refuse. There was a time when I had
believed that Medco might be interested in a takeover of RiteAid.
However since CVS/Caremark is getting some pretty bad press, I believe
that Medco would rather stay out of
the combination drug store/pharmacy
benefit management hybrid and stick
to their core business. Another possible synergy, for RiteAid is the possibility of the Sears/Kmart group taking a
shot at merging with RiteAid. One
never knows and nobody expected
KMart to grab Sears while Kmart was
still in bankruptcy. This marriage of
Kmart and Sears is still somewhat
shaky, but in the corporate world we
live in nothing should surprise you.
Guess what, Walgreens has also
announced the acquisition of a small
group of 17 pharmacies under the
Super D and Ike’s label in the
Memphis Tennessee area in the middle of March 2010. That is on top of
the 25 store Snyder’s Drug Store
chain purchased in late January 2010
in the Minnesota trading area.
Walgreens is definitely on an aggres-
sive expansion kick!
More Chain/ PBM News
Walgreens moves the pharmacy
benefit issues from a PBM approach
to a chain approach. It seems that
Walgreens has been successful with
their creative way of handling the
thousands of nationwide employees
of the Caterpillar Inc. which started on
January 1, 2010. Although the plan is
only a few months old, both the pharmacies and the plan sponsor appear
happy that the plan is accomplishing
its intended goal of saving money to
Caterpillar and also bringing in new
business to Walgreens and Wal-Mart.
Currently, there are more than 70,000
Caterpillar employees, retirees and
eligible dependents who have access
to prescription drugs purchased under
the Walgreens program known as the
Pharmacy Management Excellence
(“PME”) program. Caterpillar has
concluded that as nearly 85 percent of
all Americans live within ten miles of a
Walgreens or Wal-Mart and 95% of all
Americans who live in an urban area,
have access to a Wal-Mart or
Walgreens within three miles of their
home, they, Caterpillar, could change
PBM processors and go to this new
concept of a PME program administered in a transparent format by
Walgreens. Additionally, Walgreens
and Wal-Mart have continued to offer
mail order services to the Caterpillar
population as well. Although the program allows for the introduction of
additional plan participating providers,
currently no outside pharmacies have
been welcome into the program. If a
patient chooses a non participating
pharmacy, the patient is permitted to
do so, and the patient will be reimbursed by the plan administrators, the
prevailing rate that would have been
charged if the prescription was presented at an a Walgreens or Wal-Mart
pharmacy.
Building on their creative success
in this PME concept, Walgreens is
reaching out to other national employer groups to expand the Caterpillar
concept. Rumors are abounding that
Walgreen’s is taking this PME program to Delta Airlines that would give
the same type of program to the more
than 81,000 full time employees,
which would convert to many more
total Delta covered lives. I will keep
all informed. It seems that between
the Duane Reade deal, prior deals in
the specialty pharmacy market and
the moves into creative PBM/PME
concepts Walgreens is trying to
maneuver around the control that
CVS Caremark is exerting on the
pharmacy marketplace. With the
recent fold into Express Scripts of the
Wellpoint business, it seems that
Express Scripts is ranked number one
in total covered lives and total number
of prescriptions dispensed. According
to AIS Directory of Health Plans, 2010
edition, Express Scripts is representing nearly 25 million covered lives
while Medco is in second place and
CVS/Caremark is a close third.
CVS/Caremark continues to fight off
bad publicity between their manner of
conducting the Caremark business,
and their mail order component being
rammed upon sponsoring groups in
the promotion of saving the plan
money, and the worst part of this scenario is that patients appear to be
throwing in the towel and giving up in
the fight to have their local neighborhood pharmacy care for all of their
prescription medication needs. I will
keep all informed as developments
come into my possession. Mail Order
appears to be getting a bigger and
bigger chunk of the prescription marketplace. Interesting to note that with
the passage of health care reform, the
PBM stock prices go up and up and
up.
Fox watching the Medicare Part D
Hen House
Now that Medicare Part D is into
its fifth year of operation some of the
fine tuning is starting to really take
shape. CMS is finally putting teeth
into the meaning of the word
ENFORCEMENT. Take a look at the
Prescription Drug Plan Fox Insurance
Company. As of March 9th, CMS
abruptly cancelled their PDP Contract
for “significant deficiencies” within the
PDP plan coverage policies. Fox
continued on page 16
PAGE 14 MARCH 2010
NYCPS NEWSLETTER
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MEDICATION SAFETY • PREVENTING ERRORS
By the Institute for Safe Medication Practices
Have you experienced a medication error or close call? Report such incidents in confidence to the USP—ISMP Medication Errors Reporting (MER)
Program at 1-800-fail-safe to activate an alert system that reaches manufacturers, the medical community, and FDA. Your information may also be
published anonymously to alert professional colleagues.
What’s in a name? Preventing
errors linked to name confusion
The Institute for Safe Medication
Practices (ISMP) regularly hears about
confusion between products with similar
names. We have described errors related to name confusion between
MUCOMYST (acetylcysteine) and
MUCINEX (guaifenesin); EVISTA (raloxifene) and AVINZA (morphine sulfate
extended release); and hydrALAzine
(APRESOLINE) and hydrOXYzine
(ATARAX), just to name a few. With so
many different products on the market,
it’s no wonder that clinicians and
patients consistently report confusion.
Although manufacturers should review
new trademarks for error potential
before use, there are some things that
practitioners can do to help prevent
errors with products that have look- or
sound-alike names.
Practitioners should look for the
possibility of name confusion before a
product is used. Use the concepts of
failure mode and effects analysis to
assess the potential for error with new
medications that will be prescribed or
added to your inventory. If the potential
for confusion with other products is
identified, take the steps listed below to
help avoid errors.
Prescriptions should clearly specify
the drug name, dosage form, strength,
complete directions, as well as its indication. Most products with look- or
sound-alike names are used for different
purposes. If the indication is not avail-
able, pharmacists and nurses should
verify the purpose of the medication with
the patient, caregiver, or physician
before it is dispensed or administered.
Reduce the potential for confusion
with name pairs known to be problematic by including both the brand and
generic name on prescriptions, computer order entry screens, prescription
labels, and medication administration
records (MARs).
When accepting verbal or telephone orders, require staff to write down
the order and then perform a read back
(or even spell back) of the medication
name, strength, dose, and frequency of
administration for verification. Change
the appearance of look-alike product
names on computer screens, pharmacy
product labels, and MARs by emphasizing, through bold face, color, and/or tall
man letters, the parts of the names that
are different (e.g., hydrOXYzine,
hydrALAzine).
Pharmacists should work under
good lighting and use magnifying lenses
and copyholders (keep prescriptions at
eye level during transcription) to
improve the likelihood of proper interpretation of look-alike product names.
Install computerized reminders for
the most commonly confused name
pairs at your site so that an alert is generated when entering prescriptions for
either drug. If possible, make the
reminder auditory as well as visual.
Store commonly confused products
in different locations. Avoid storing both
GRASS ROOTS:cont’d
FROM PAGE
1
able medicine.
Patients are encouraged to sign up for
a monthly newsletter and action alerts.
Pharmacists also play a key role in distributing a monthly newsletter and
encouraging patients to subscribe to
email publications.
Anyone can sign up to receive this
products in a “fast-mover area.” Use a
shelf sticker to help find relocated products.
Affix “name alert” stickers to areas
where look- or sound-alike products are
stored (available from pharmacy label
manufacturers) or to the actual product
containers.
Employ at least two independent
checks in the dispensing process (one
person interprets and enters the prescription into the computer and another
compares the printed label with the original prescription as well as the manufacturer’s product).
Open the prescription bottle or
package in front of the patient to confirm
the expected appearance of the medication and review the indication.
Caution patients about error potential
when taking a product that has a lookor sound-alike counterpart. Encourage
patients to ask questions if the appearance of their medication changes. Take
time to fully investigate any patient concerns.
Encourage reporting of errors and
potentially hazardous conditions with
look- and sound-alike names to the
ISMP Medication Errors Reporting
Program and use the information to
establish priorities, as listed above, for
error reduction. Maintain an awareness
of problematic product names and errorprevention recommendations provided
by ISMP (www.ismp.org) and FDA
(www.fda.gov). 3
newsletter directly to their inbox. Simply
return this form via fax to (703) 683-3619,
send
us
an
email
at
[email protected]
or
register
online at www.fight4rx.org. 3
Mark Hendrickson
Manager, Public Affairs & Grassroots
National Community Pharmacists Association
NYCPS NEWSLETTER
MARCH 2010 PAGE 15
PAGE 16 MARCH 2010
NYCPS NEWSLETTER
NEWS AROUND THE WORLD:
FROM PAGE
13
never obtained CMS approval for the use of the PA program, “Prior Authorization” and their ST “Step Therapy”
criteria that were used by Fox to wrongly deny drugs to
some Medicare Part D enrollee members. Last year we
were informed of possible payment delays from Fox to the
pharmacy providers in the Fox PDP network. According to
news reports, CMS did a three day on site audit of the Fox
headquarters and shortly thereafter, terminated their participation. Fox is a New York based Part D provider with
Medicare contracts in four CMS regions covering 18
states. Fox was a big player. CMS is also looking at
some other big players. Rumors abound that WellCare
Health Plans and Wellpoint are now also coming under
the CMS microscope.
CMS is focusing on marketing,
enrollment processing and access to critical medications
which can run up the costs of the programs. We are also
hearing that as a result of the construction of the competitive PDP concept, it is more difficult to root out provider
and patient fraud and abuse in the Part D program. The
CMS/HHS Office of Inspector General is troubled by the
lax standard of many of the Part D plans. Part D plans
should be the initial gatekeepers protecting the program.
CMS does require that sponsors have measures to detect
fraud and abuse, but CMS guidelines allow each plan
sponsor to handle the individual specifics on their own of
their individual fraud and abuse programs. In 2008, the
OIG did a report on 86 sponsor’s individual stand alone
PDP programs. This report found 24 of the 86, which represents about 25% of the plans, did not identify ANY
potential fraud and abuse incidents at all! Who is watching the store? CMS plans to introduce new rules and regulations to address these concerns in the next few weeks.
CMS will be conducting more intense audits of the various
Part D PDP groups. In the meantime, fraudulent activity
and abuse of the system is continuing at times
unchecked. Maybe having this competitive type of program is too clumsy and too difficult to manage.
Manufacturers Issues
The world’s largest generic-drug firm Teva, has beaten out Pfizer Inc., the world’s largest research-based
pharmaceutical company, by placing a $5 billion successful bid to take over a German generics manufacturer,
Reuters reported on March 18, 2010.
Teva
Pharmaceutical Industries of Israel announced that it had
agreed to pay $5 billion for the German firm Ratiopharm
in a cash-and-credit deal that followed a bidding war with
Pfizer, for the company. Ratiopharm accepted the offer in
a final round of bidding that closed on March 18, 201. It
appears that besides Pfizer, Iceland’s Actavis Group was
said to be in the running to buy Ratiopharm, Germany’s
second-biggest generics company. Ratiopharm was put
on the sales block, after its company leader Adolf Merckle
committed suicide last year as he faced mounting debts,
after he make a bad call in the stock market. He predicted the total demise of Volkswagen, which did not occur,
but his failure did occur shortly after the bewitching hour.
Mr. Merckel threw himself in front of a train maybe to
escape the financial headaches he was uncovering.
Getting back to this acquisition, what does that mean for
the likes of Watson and Mylan? Who knows but they are
worth watching I would think. It is amazing that Pfizer
could be out bid by a generic powerhouse. Pfizer is looking to expand the Greenstone label in all areas of the
pharmaceutical marketplace and this generic acquisition
would have fit Pfizer like a glove, too bad for Pfizer.
Moving from Pfizer let us explore the issues facing Eli Lilly.
This past few weeks have been tough for Eli Lilly and
Company. Somebody (sounds like an insider) worked up
a pretty good plan to rob the Enfield Connecticut manufacturing and storage facility. Nearly 75 million dollars worth
of Zyprexa, Prozac, and Cymablta were stolen from the
facility in an elaborate break in robbery. The thief’s got
away with their intended medication targets - -scot clean.
This is not the first robbery of a pharmaceutical warehouse, but the frequency and listing of products is becoming a frequent and disruptive way to start the pharmacist’s
day. Glaxo Smith Klein also recently announced a multi
million dollar heist from a warehouse, of Advair, the powdered formula inhaler for asthma. In recent months even
generic albuterol solution was robbed in a tractor trailer
hijacking. What is going on in our profession?
Dispensing Errors: Civil or Criminally Punishment”
What happens if you commit a negligent dispensing
error? What happens if that person who receives that
medication in error dies? Should you as the pharmacist
who dispensed that drug go to prison for the error? Is
death from an error enough to justify being charged with
criminally negligent homicide? Putting you in the same
category of a drunk driver who kills a pedestrian is it not?
This question was recently posed by Dr. Daniel Hussar in
his monthly newsletter the Pharmacist Activist. You may
have heard about the Ohio pharmacist who was responsible for the death of young child who died from a Heparin
overdose. According to published reports, the pharmacist
trusted the drug selection and failed to further review the
actions of a pharmacy technician and thus the error went
out without being caught. The death occurred and it
appears that th Ohio Board of Pharmacy hung this pharmacist out to dry and the pharmacist served several
months in prison. Is the error worthy of jail time? What do
you think? Write me either way at [email protected].
Folks enough for one issue. We will discuss the
impact of the health care reform legislation next issue.
Spring is back, thank God! Now just end the rain!! 3
Stay Well,
Jim Schiffer
©2010 James R. Schiffer
NYCPS NEWSLETTER
MARCH 2010 PAGE 17
PAGE 18 MARCH 2010
NYCPS NEWSLETTER
NYCPS NEWSLETTER
MARCH 2010 PAGE 19
2010 LEGAL WAR CHEST UPDATE
For the past five years, The New York City Pharmacists Society has
had a Legal War Chest to fund the local battles that we as community pharmacists fight by ourselves day after day. We have fought various battles
including some with our elected officials, the OMIG, PBM’s, and other foes
of community pharmacy. Back in 2008 we were successful in convincing
HIP of New York that they should not recover payments made to pharmacies based on allegations of overpayments that went back to 2006. That
effort took time and resources of NYCPS. Additionally we have educated
elected officials in Albany and New York City about the shortcomings that
are affecting both patients and pharmacies the way PBM’s make payments
to pharmacies. We are fighting for our survival. This fund is separate from
the existing PSSNY Legal Defense Fund which is being utilized to fund the
ongoing PSSNY Medicaid dispute over their audit practices.
By supporting the NYCPS Legal War Chest, we will be enabled to fight
the fight for survival in this dog eat dog health care environment. Thanks
to the generosity of our members this fund continues to grow.
As we see the outrageous tactics and actions of the PBM in their contracts, their administration of Medicare Part D and also we see the erosion
of our patients due to mandatory mail order contracts and the reduction of
our levels of reimbursement due to the newly formed Medicare Part D
Contracts. At this time more than ever, we truly need a strong professional
voice to fight for our concerns. Please join us in these necessary struggles.
Enclosed we are sharing the Final List for 2009 as well as for 2008.
See if your name and pharmacy are posted. As we start this New Year
2010 we have plenty of problems to deal with, and we need your help. We
will continue to publish past years donations as space permits.—the list is
done alphabetically, not in order of receipt or donation amount. (All new
contributions will have an asterisk *).
Final List of Donations for 2008
Dominic Amendolara, Salzman Chemists . . . . . . . . . . . . . . . . . .$1,000
Curt Constable, Medicine Cabinet Pharmacy . . . . . . . . . . . . . . ..$300
John Demetriades, Farmacon Pharmacy . . . . . . . . . . . . . . . . . . . .$250
James Detura, Melrose Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$5,000
K. Dinesh, Ozone Park NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Roy Eisner, The Charles Pharmacy . . . . . . . . . . . . . . . . . . . . . . . .$300
Howard Feder, Myrtle Ave. Pharmacy . . . . . . . . . . . . . . . . . . . . . .$150
Steve Kabakoff, Sol’s Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Peter Lau, Confucius Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Jeff Liberman, Howard Beach Apothecary . . . . . . . . . . . . . . . . .$1,000
Sal Lombardo, Corona Heights Pharmacy . . . . . . . . . . . . . . . . . .$350
LONG ISLAND PHARMACITS SOCIETY (LIPS) . . . . . . . . . . .$1,000
Boris Mantell, Health Care Pharmacy . . . . . . . . . . . . . . . . . . . .$1,500
Michael Morrelli, Arrow Pharmacy . . . . . . . . . . . . . . . . . . . . . .$1,000
Syed Muzaffar, Longwood Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$300
Robert Newman, Theresa Pharmacy . . . . . . . . . . . . . . . . . . . . . . ..$250
Tom Pelizza, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Stewart Rahr, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,000
Michael Rothstein, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Joann Santarelli, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Bill Scheer, Scheer Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
James Schiffer, Jim & Phil Family Pharmacy . . . . . . . . . . . . . . . .$700
Jeff Smith, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Alan Solman, Kings Tribeca Pharmacy . . . . . . . . . . . . . . . . . . . . .$100
Frank Wong, RX Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,000
Viva Pharmacy New York, New York . . . . . . . . . . . . . . . . . . . . . . .$150
Our war chest total for 2008 . . . . . . . . . . . . . . . . . . . . . . . .$22,000.00
Final List of Donations for 2009
Rao Alturi, Atluri/Laconia Pharmacy Inc . . . . . . . . . . . . . . . . . . .$500.
Khalid Amin, Audobon Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . .$300
Robert Annicharico, Delco Drugs & Specialty Pharmacy . . . . . .$250
Chris Aprile, Thriftway 10th Ave. Drug Corp. . . . . . . . . . . . . . . . .$350
Samsul Bakar, Kings Bronx Inc . . . . . . . . . . . . . . . . . . . . . . . . . . .$200
Robert J. Baker, SBC RX/Thriftway Pharmacy . . . . . . . . . . . . . . .$350
Robert J. Baker, Thriftway-Kings Highway Pharmacy . . . . . . . . .$350
Charles Catalano, C&D Drug Corp. . . . . . . . . . . . . . . . . . . . . .$2,500
Joseph M. Ciol, J&C Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . .$350
James Detura, Melrose Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$5,000
Ray & Dana Eisner, The Charles Pharmacy . . . . . . . . . . . . . . . . .$300
John Kranjac, Marama Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$1,000
Steven Gelwan, Hosp Rx, Thriftway Pharmacy . . . . . . . . . . . . . . .$350
Jagdeesh Gummella, Loisaida Rx Inc. . . . . . . . . . . . . . . . . . . . . . .$500
Martin Katz, Scarpa Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Dominic Lettieri, Drug Mart Pharmacy Corp. . . . . . . . . . . . . . . .$500
Joseph Locastro, Clinton Apothecary . . . . . . . . . . . . . . . . . . . . . .$200
Long Island Pharmacists Society (LIPS) . . . . . . . . . . . . . . . . . .$3,000
Suni Mandalapu, New Amsterdam Drug Mart . . . . . . . . . . . . . . .$300
Murugan Naidu, Rite Choice Pharmacy . . . . . . . . . . . . . . . . . . . .$500
The Paganelli Family, Mt. Carmel Pharmacy . . . . . . . . . . . . . . .$1,500
Alex Perchuk, STM RX/Thriftway Pharmacy . . . . . . . . . . . . . . . . .$350
Alex Perchuk, STJ RX/Thriftway Pharmacy . . . . . . . . . . . . . . . . . .$350
Wendy & John Rossi, Rossi Pharmacy . . . . . . . . . . . . . . . . . . . . . .$200
Adam Siegel, Parkway Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Bill Scheer, Scheer Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
James Schiffer, Jim & Phil‘s Family Pharmacy . . . . . . . . . . . . . . .$100
Russell Sherman, Esco Drug Co,* . . . . . . . . . . . . . . . . . . . . . . . .$1000
Nadira Singh, Thriftway Church Ave. Drug Corp . . . . . . . . . . . . .$350
Michael Somma, Artis Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Robert Spivack, employee of Pathmark Pharmacy . . . . . . . . . . . .$100
Lesly Thelemaque, Vanderveer/Thriftway Pharmacy . . . . . . . . . . .$350
Yan Vilensky, Thriftway Flatbush Ave. Drug Corp . . . . . . . . . . . . .$350
Alex Zatsepilo, Thriftway Foster Ave. Drug Corp. . . . . . . . . . . . . .$350
Gilbert Zuckerman, Kenby Pharmacy . . . . . . . . . . . . . . . . . . . . . .$300
Our war chest total for 2009 . . . . . . . . . . . . . . . . . . . . . . . . . .$23,650
Donations for 2010
Khalid Amin, Audobon Pharmacy* . . . . . . . . . . . . . . . . . . . . . . . .$350.
Jim Detura, Melrose Pharmacy* . . . . . . . . . . . . . . . . . . . . . . . .$5,000.
Roy and Dana Eisner, The Charles Pharmacy and Surgical* . . .$300.
Jagdeesh Gummella, Loisaida Rx Inc.* . . . . . . . . . . . . . . . . . . . .$500.
Total as of March 21, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,150.
2010 LEGAL WAR CHEST COUPON
The NYCPS Board of Directors appreciates the vote of confidence from our colleagues who have been making these contributions. Thanks you for this support! Can we count on you to
join us in this fight to survive in 2010? If you have not already
done so, please send in your contribution with the coupon
below.
Yes, count me in; I want to contribute to the New York City Legal War Chest!
Name __________________________________________________________________________________
Pharmacy ___________________________________________________Donation Amount _____________
Address ________________________________________________________________________________
City, State _______________________________________________________________________________
Please send to: NYCPS Legal War Chest c\o Mr. William Scheer • 77 Louis Drive • Farmingdale, NY 11735
PAGE 20 MARCH 2010
NYCPS NEWSLETTER
NYCPS NEWSLETTER
MARCH 2010 PAGE 21
program, why not allow us to do a
free, no-obligation savings analysis? We’re typically able to save
FROM PAGE 8
businesses money on this expense
Merchant Services Department at
and no other processor offers the
(800) 442-3589 if you are interestadded protection of a quarterly
ed in checking your account online;
review of statements like the Retail
they will get you registered for this
Council
does
through
our
service. Michele and Nicholl would
Watchdog Program.
also be happy to answer any quesFor a nominal dues payment,
tions about your credit card proyour membership in the Retail
cessing statements or terminal
Council is a great complement to the
reprogramming.
continuing education and other servIf you haven’t considered joinices you receive through NYCPS
ing the Retail Council’s processing
and PSSNY. In addition to our com-
Retail Council:
petitive credit card processing service, the Council also has a great
workers’ compensation program,
which can save pharmacies up to 50
percent or more on this mandatory
insurance. More than 170 independent pharmacies in New York State
are already participants because the
savings is difficult to beat!
You can learn more about the
Retail Council and its programs by
visiting www.retailcouncilnys.com or
by calling us at (800) 442-3589. 3
prescription medication take back
programs for disposal. The Drug
From Page 9 Enforcement Administraion however
currently has specific regulations
medicines out of the system.”
restricting the return of controlled
Bob Stressman of Manning
substances without the direct
Pharmacy and President of the Iowa
involvement of law enforcement.
Pharmacy Association opined,
The most common feedback we
“Patient reaction has been extremereceived from State Boards of
ly favorable. I highly recommend
Pharmacy was: NO controlled subthis service. The TakeAway prostances should be returned.
gram is the complete package that
The pharmacist should be
helps remove discontinued medicadirectly involved to ensure that contions from the home AND provides
trolled substances are not being
another patient contact opportunity
placed into the return
to ensure continued therapy complibox.
ance.”
The medication
The
Sharps
TAKEAWAY
take back box should
Environmental Return System is a
not be freely accessafe, easy way to dispose of unused
sible to the public.
medications either in postage preOnce the box is
paid envelopes for patients to mail
full, return immedithemselves or in the form of 10- or
ately via UPS or the
20-gallon pharmacy collection
US Postal Service
boxes.
for disposal.
NCPA has talked with dozens of
Should you have
Boards of Pharmacy about guidespecific questions,
lines for a pharmacy’s participation
check directly with
in a drug take back / disposal proyour
Board
of
gram in their state. Among Boards of
Pharmacy to ensure
Pharmacy and other numerous
that you are in full
pharmacy groups, there is tremencompliance with your
dous support for voluntary programs
respective
state
to help remove unused / expired
pharmacy reguladrugs from the supply chain in a
tions.
safe and environmentally friendly
Whether
you
manner. Most state pharmacy prachave your own inditice acts do not specifically address
vidual program, are
planning to create one or use the
Sharps TAKEAWAY Environmental
Return System, please get involved.
It’s certainly a worthy cause and
could benefit your business, too.
These are benefits exclusive to
NCPA members, so contact us at
703-683-8200 or e-mail [email protected] if you would like to
learn more. 3
NCPA Report
By Bruce T. Roberts, RPh, NCPA
Executive Vice President and CEO
PAGE 22 MARCH 2010
Rx and the Law:
NYCPS NEWSLETTER
from page 10
missed in this case, the case should serve as a wakeup call to pharmacists. The dissent made some strong
arguments, and even the majority hinted that the
answer might be different under today’s laws. The
court here said that the pharmacies did not have a duty
to act upon information received from the task force, so
they never provided guidance as to what a pharmacy
should do if it were required to act. This issue is very
likely to come up again and the next court could find
that the pharmacy was required to act. Prescription
drug monitoring programs work by providing information that a single pharmacy or prescriber is unlikely to
obtain on their own. In the past, a single pharmacy was
usually unaware of all of a patient’s activities in acquiring controlled substances and didn’t have enough infor-
THE PRESIDENT’S REPORT:
FROM PAGE
1
munity pharmacy derives over 90% of its revenue from prescription sales.
All the legislative members that were visited on March
3rd expressed concern with the possible demise of the community pharmacy. They stated that they wanted to help however the huge budget deficit in the State may prevent any
changes. Everyone was aware of the lower pharmacy reimbursements as the result of the First Data Bank/ Medispan
lawsuit. We explained that the cost of implementing the differential for the independents would be 28 million dollars,
and that this money was already budgeted for in the last
budget. The problem has resulted when the DOB booked a
savings of 57 million dollars, state share for the 2010-2011
New York State budget.
THANK YOU TO THE 70 NYC INDEPENT PHARMACY
OWNERS AND STAFF FOR TAKING THE TIME TO VISIT
THEIR LEGISLATURES ON MARCH 3RD. I requested via
e-mail that all NYCPS members that could not join us, that
they call their legislatures in the district where their pharmacy is located.
What we need to do is to continuously follow up with
these legislatures until the budget is finalized. NYCPS has
always encouraged its members to contribute to the PSSNYPAC, if you do so then thank you, if not then now is the time
to contribute.
NYCPS along with PSSNY will be hosting fundraisers for
Speaker Silver, Senate Majority Leader Sampson and
Senator Adams. Your participation in these events is vital.
We need to support those that we seek to have support our
needs.
This is what we need to do NOW. I know some members
have expressed dissatisfaction with the legislature for allowing these cuts to happen, but please remember that the
September 26th cut was the result of a federal court ruling.
mation to take any action. In the present case, the
pharmacies were notified that the patient was getting
prescriptions filled at 12 other pharmacies around town.
It is very possible that this additional information might
provide the basis for a court or legislature to make a
major change in the law of negligence.
© Don McGuire, R.Ph., J.D., is a Professional Liability
Claims Attorney at Pharmacists Mutual Insurance
Company.
This article discusses general principles of law and
risk management. It is not intended as legal advice.
Pharmacists should consult their own attorneys and
insurance companies for specific advice. Pharmacists
should be familiar with the policies and procedures of
their employers and insurance companies, and act
accordingly. 3
By Don McGuire, R.Ph., J.D.
We are seeking to have our State legislatures help us
NOW.
The dates of these fundraisers will be announced once
the funds have been secured, therefore check your e-mails
from NYCPS, if you have not received e-mails from NYCPS
please call our lobbyist firm, Malkin & Ross and have them
update your information. The Malkin & Ross phone number
is 518-449-3359.
PSSNY is hosting a pharmacy lobby day on April 13th, if
you were unable to attend on March 3rd then this day will
provide you an opportunity to meet with your legislative
members. You must make your own appointment for April
13th if you are going to Albany if you need some talking
points you can call our lobbyist, Tracy Tress at her office in
Albany.
Pharmacy may have obtained some relief from the burden of going through the accreditation process to service
Medicare Part-B beneficiaries in the recently passed H.R.
4213, the American Workers, State and Business Relief Act
of 2010.
Pharmacies that have DME sales less than 5% will not
have to be accredited, however what has not been explained
is that where does that put the pharmacies that have not
been accredited in the upcoming bidding process for DME
supplies.
The US Senate passed the legislation however the
House is still debating the bill. NYCPS will keep you updated on this potentially significant change.
PSSNY and NYCPS recently meet with the OMIG
regarding the card swiping issues. Many concerns where
expressed and we were told responses to our questions will
be addressed.
NYCPS is always seeking input and volunteers for CE
programs, please help in anyway you can. 3
Charles R. Catalano
NYCPS President
NYCPS NEWSLETTER
MARCH 2010 PAGE 23
In Memoriam:
From Page 4
Myers, Florida where he had lived for many years.
Dr. Zupko was 93 years old at the time of his
death.
Dr. Zupko served as dean of the Brooklyn
College of Pharmacy from 1956-1975, and as
president of the College from 1975 until his retirement in 1979. On his retirement, Dr. Zupko was
appointed President Emeritus. From 1976-1979
he also held the Zupko/Schwartz Endowed
Professorship in Pharmacology.
Dr. Zupko was instrumental in the Brooklyn
College of Pharmacy merger with Long Island
University and for the construction of the pharmacy building when the College moved to the Long
Island University Brooklyn Campus. In 1976, the
building was dedicated to him. After his retirement, Dr. Zupko remained a generous contributor
to the College and the University, particularly in
providing support for faculty development and for
encouraging research in gerontology.
Dr. Zupko was the recipient of the prestigious
Hugo Schaefer Award from the American
Pharmaceutical Association for “contributions to
public health.” He received an honorary doctorate
from the University in 1979.
Dr. Zupko was a graduate of the University of
Florida School of Pharmacy and received his M.S.
and Ph.D. from Purdue University.
Dr. Zupko is survived by his son, Arthur M.
Zupko, a graduate of the Southampton campus.
A private funeral service was held in Florida. In
lieu of flowers, memorial gifts may be sent in his
memory to the Florida Rep Children’s Education
Fund, PO Drawer 2483, Fort Myers, FL 339022483. Friends may sign the online guest book for
the family at www.horizoncremation.com. 3
Expressions of condolence can also be sent to
Dr. Zupko’s son:
Mr. Arthur M. Zupko
9067 Alena Court
North Fort Myers, FL 33903
MEMBERSHIP APPLICATION—NEW YORK CITY PHARMACISTS SOCIETY
41 E. 11th Street, 11th Fl., New York, NY 10003
NAME
JOI
NOW
N
2010FOR
DATE OF BIRTH
HOME ADDRESS
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CHECK ONE:
______ ACTIVE OWNER MEMBER (MUST HAVE A DEGREE IN PHARMACY)................$375.00
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______ ASSOCIATE MEMBER (NON-PHARMACIST).............................................$225.00
______ RETIREES..........................................................................................................$237.50
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I WOULD LIKE TO ADD______ (at least $50.00) TO THE POLITICAL ACTION COMMITTEE.
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DUES ______________
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MAKE CHECKS PAYABLE TO NYCPS/PSSNY And Mail to: 41 E. 11th Street, 11th Fl., New York, NY 10003
DUES AUTOMATICALLY INCLUDES MEMBERSHIP IN THE PHARMACISTS SOCIETY OF THE STATE OF NEW YORK
This newsletter is published by the NYC Pharmacists Society as an exclusive service to its membership. The annual newsletter subscription
rate is $100.00. Unless specifically indicated as such, the views expressed in this publication do not necessarily constitute official positions
of the New York City Pharmacists Society, nor do they necessarily represent the views of all the NYC Pharmacists members.
© Copyright 2010 New York City Pharmacists Society. Under license from our collective authors. All rights reserved.
PAGE 24 MARCH 2010
NYCPS NEWSLETTER