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NAT I O N A L A S S O C I AT I O N O F B O A R D S O F P H A R M A CY
A I D T O G O V E R N M E N T
– T H E
P R O F E S S I O N – T H E
P U B L I C – 1 9 0 4
TO
2 0 0 0
Anderson Presents VIPPS at FIP Congress
As the
at the 60th International
of at least one representative
Verified
Congress of the Federation
from each of FIP’s 60 member
Internet
Internationale Pharmaceutique
nations. Entitled “VIPPS and the
Pharmacy
(FIP), held in Vienna, Austria,
Regulation of Online Pharmacy
Practice
in August. Upon the request of
Practice,” Anderson’s remarks
Sites™
FIP President Peter Kielgast,
outlined the VIPPS program and
(VIPPS™)
and with the assistance of John
illustrated how the program
program
Gans, executive vice president
could translate internationally.
continues
of the American Pharmaceutical
to grow, so does its reputation.
Association (APhA), Anderson
Proof of this is NABP Chairman
addressed the members of the
Dyke F. Anderson’s presentation
FIP Council, which is composed
At a press conference held at
the August meeting, Kielgast
(continued on page 126)
Applications/Database Management Department Launched
NABP has launched a new
organized for research, publi-
applications and submissions
applications and database
cations, and all of NABP’s
next year. NABP’s testing
management department to
programs.”
programs, licensure programs,
better serve the state boards of
pharmacy.
The Application/Database
“Centralizing the data entry
primary function is data entry,
function will create
database manage-
more consistent
ment, and data
procedures, data
analysis. The depart-
definitions, and
ment processes and
database manage-
controls data enter-
ment across
ing the databases
NABP’s programs,”
through multiple
says Carmen A.
media, including
Catizone, NABP
scannable registra-
executive director/
tion and application
secretary. “This will
forms; electronic
allow data collected and
submissions from boards and
processed by the Applications/
testing vendors; manual data
Database Management depart-
entry; and data editing. The
ment to be available to state
department is expected to
boards in real time and
process more than 30,000
127
Survey Finds Nutraceuticals Being Added
to Pharmacy Curriculum
128
Legal Briefs: Why Don’t You Staaay,
Just a Little Bit Longer...
135
138
NABP Accepting Awards Nominations
2000-2001 Committee and
Task Force Members
ION OF BOA
AT
R
CI
DS
PHARM
OF
AC
Y
TIONAL ASS
O
NA
(continued on page 127)
Management department’s
19 0 4
®
VOLUME 29 - NUMBER 9 - OCTOBER/NOVEMBER 2000
in this issue
Anderson Presents VIPPS at FIP Congress (continued from page 125)
announced FIP’s interest in the
safer for consumers around
Anderson’s speech included
VIPPS certification program.
the world.
general and background
There, he noted that the VIPPS
Anglo-Saxon countries. FIP,
headquartered in The Hague, is
the umbrella organization for
pharmacy worldwide.
“The presentation was received
overwhelmingly beyond my
expectations,” says Anderson.
“In the time remaining after the
speech I was able to answer a
number of questions, although
there were more that I could
not get to because of time
constraints. I also received
wonderful comments after the
speech from people who came
to me with questions or wanting additional information.”
He added that throughout
the conference attendees
— Dyke F. Anderson,
NABP chairman
complementing him on the
VIPPS certification program.
Anderson says it is very important to introduce other countries to the VIPPS program. “As
a national association, NABP
can assist state boards in
regulating the pharmacy sites
within the borders of the United
Currently, NABP is helping
Australia and Canada implement the VIPPS certification
program. “If all goes well,” says
NABP President Jerry Moore,
“the VIPPS system will be in
place internationally by the
end of the year.”
States. However, international
An international VIPPS pro-
sites that are prescribing and
gram would be based upon the
selling drugs illegally require
same principles that guide the
cooperation with other coun-
original VIPPS program.
tries throughout the world in
International sites wishing to
order to fully protect consumers.”
be considered for VIPPS certifi-
There is no need to reinvent
cation must be appropriately
the wheel, Anderson adds,
licensed or registered in all
and other pharmacy regula-
jurisdictions in which they
tors realize that VIPPS can be
practice pharmacy, and they
modified to fit their countries’
must meet criteria review and
needs, making pharmacy sites
on-site inspection by a VIPPS
program, as well as information from the NABP Executive
Committee’s May meeting,
when approval to expand the
VIPPS program internationally
was granted.
Anderson will also be giving a
presentation on VIPPS at the
Drug Information Association
Workshop on October 24 in
Washington, DC.
For additional information
about the VIPPS program, please
contact NABP at 847/698-6227,
or visit the Association’s Web
site at www.nabp.net.
ION OF BOA
AT
R
CI
PHARM
OF
AC
Y
know more about VIPPS and
“As a national
association, NABP can
assist state boards in
regulating the pharmacy
sites within the borders of
the United States.
However, international
sites that are prescribing
and selling drugs illegally
require cooperation with
other countries
throughout the world in
order to fully protect
consumers.”
DS
approached him, wanting to
information about the VIPPS
TIONAL ASS
O
NA
program lends itself well to
19 0 4
®
The NABP Newsletter
(ISSN 0027-5700) is published ten times
a year by the National Association of
Boards of Pharmacy (NABP) to educate,
to inform, and to communicate the
objectives and programs of the
Association and its 68 member boards of
pharmacy to the profession and the
public. The opinions and views
expressed in this publication do not
necessarily reflect the official views,
opinions, or policies of NABP or any
board unless expressly so stated. The
subscription rate is $35 per year.
National Association of
Boards of Pharmacy
700 Busse Highway
Park Ridge, Illinois 60068
847/698-6227
www.nabp.net
[email protected]
Carmen A. Catizone
Executive Director/Secretary
Courtney M. Karzen
Editorial Manager
© 2000 National Association of Boards of
Pharmacy. All rights reserved. No part of this
publication may be reproduced in any manner
without the written permission of the Executive
Director/Secretary of the National Association of
Boards of Pharmacy.
accredited team of inspectors.
OCTOBER/NOVEMBER 2000
126
Survey Finds Nutraceuticals Being Added to Pharmacy Curriculum
Consumer interest in herbal
herbal or nutraceutical
pharmacists about alternative
products and nutraceuticals
courses; and, of those schools
medicines.
continues to grow. But are
that responded, less than 2%
pharmacy schools equipping
offer no type of herbal or
students with the tools to
nutraceutical course.
effectively counsel patients
Herbal and nutraceutical
product courses cover many
topics, including the role of the
Food and Drug Administration
regarding alternative medi-
(FDA) in regulating drugs versus
cines? NABP surveyed 81 US
dietary supplements, clinical
schools and colleges of phar-
efficacy studies for herbs,
macy to find out if the study of
product standardization issues,
nutraceuticals has reached the
and documented drug interac-
classroom.
tions. Also, many schools cover
Of the 58 schools that re-
the top 10-20 herbal products
sponded to the survey, 41
offered on the market, discuss-
include the teaching of herbal
ing advocated uses, efficacy,
products as either part of
The survey results indicate
ineffectiveness, side effects,
another course (ie, over-the-
there is a definite, growing
known drug interactions, and
counters and therapeutics) or
trend to include the study of
clinical “pearls” for practice.
as a required course solely
herbal products in pharmacy
dedicated to herbal products
curricula. According to the
and/or nutraceuticals. A
survey, many schools currently
further breakdown shows that
changing their curricula to the
nearly 40% of responding
entry-level PharmD degree will
schools have required herbal
be incorporating herbal and
or nutraceutical courses; 31%
nutraceutical information into
have both elective and required
their programs. Colleges and
courses; approximately 28% of
schools of pharmacy recognize
schools offer only elective
the need to educate future
Information about herbals and
nutraceuticals is widely available, but the amount of information from critical studies is
limited. The NABP survey shows
that the academic world
understands the need for
students to become more
knowledgeable about this topic.
Applications/Database Management Department Launched (continued from page 125)
and communications depart-
Foreign Pharmacy Graduate
to NABP’s Web site and the
ment, which were previously
Equivalency Examination™
department has begun process-
®
responsible for entering and
(FPGEE ) applications. The
maintaining their own data,
department receives and
are supported by the new
processes disciplinary informa-
department, which began
tion for the NABP Clearing-
functioning in June.
house and for the Healthcare
Currently, the department
processes NAPLEX® (North
American Pharmacist Licensure Examination™) and
Multistate Pharmacy Jurisprudence Examination™ (MPJE™)
registration forms; NAPLEX
score transfer requests; and
OCTOBER/NOVEMBER 2000
Integrity and Protection Data
Base (HIPDB) program. Verified
Internet Pharmacy Practice
Sites™ (VIPPS™) certified
pharmacy information and
Pharmacist and Pharmacy
Achievement and Discipline®
(PPAD®) information is posted
ing NABP meeting registrations.
Once fully staffed and operational, the department will
assume responsibility for data
analysis and synchronization
of data across all of NABP’s
databases. Also this new
department will soon be
generating standard and ad
hoc reports and supporting
research projects for NABP
programs as well as the state
boards of pharmacy.
127
LegalBriefs
Why Don’t You Staaay, Just a Little Bit Longer …
By Dale J. Atkinson, JD
As has been
headaches, antidepressant
In an unrelated case, and
stressed on numer-
medications, antianxiety
within a few months of the
ous occasions,
agents, and migraine medica-
death of the technician, the
regulatory boards
tion as well as the analgesics
same physician pleaded guilty to
must understand
Stadol and Nubain.
a Class D felony of fraudulently
the parameters
under which they
may operate.
Boards of pharmacy are statutorily created
and empowered through a
legislatively enacted practice
act. It is within this statutory
authority that boards must
carry out their duties and
responsibilities. Actions
outside the scope of authority
will be considered ultra vires
acts, or acts beyond the scope
of authority. The consequences
of acting outside the scope of
authority can be severe,
ranging from the removal or
limitation of the immunity
protections granted to boards
and board members to a
judicial reversal or prohibition
from enforcing important
regulatory board decisions.
Eventually, the technician
transferred to another medical
center for consultation with a
physician regarding her drug
dependence and mental health.
At her own insistence, the
technician was discharged. Her
discharge diagnosis and
analysis included depression;
attempting to obtain Demerol.
Based upon this guilty plea, the
State Board of Registration for
the Healing Arts ordered the
physician to appear for a
hearing. One of the grounds for
discipline for the hearing
included a citation to a specific
statute which stated:
drug seeking behavior; previous
The license of a physician
history of intravenous and
shall be automatically
intramuscular Stadol drug
revoked at such time as the
abuse; psychogenic purpura;
final trial proceedings are
cephalalgia; history of ulcer-
concluded whereby a
ative skin lesions, probably
physician has been adjudi-
self-inflicted; and suspected
cated and found guilty or
history of childhood sexual
has entered a plea of guilty
abuse. The evaluating physi-
or nolo contendere in a
cian notified the prescribing
felony criminal prosecution
physician of the technician’s
under the laws of the State
drug problem. The evaluator
of Missouri, the laws of any
wrote, “Because of her history
other state, or the laws of
of drug seeking behavior and
the United States of
the out-of-hospital use of
America for any offense
Consider the following facts. A
Stadol without a physician’s
reasonably related to the
licensed osteopathic physician
prescription, I think it is very
qualifications, functions or
and surgeon who practiced
important to minimize any
duties of a physician.
family medicine became
narcotics or other dependency
addicted to narcotics and
inducing drugs that this
alcohol. The physician struck
patient could come in contact
up a relationship with a labora-
with.” In spite of this analysis,
tory technician in the hospital
the physician continued to
where the physician was on
prescribe Demerol to the
staff. The technician became his
technician. He also prescribed
patient shortly thereafter. For
70 tablets of a Schedule II drug
several years, the physician
containing hydrocodone and
prescribed and administered
two prescriptions for Stadol.
excessive amounts of Demerol
Shortly thereafter, the techni-
to the technician. He also
cian died of an overdose of
Eighteen months later, the
prescribed medication for severe
morphine.
Board initiated a new disciplin-
OCTOBER/NOVEMBER 2000
Based upon the guilty plea, the
Board revoked the physician’s
license but stayed the revocation and placed his license on
probation with conditions for
five years. The Board also
ordered the physician not to
prescribe or administer any
controlled substances, Stadol,
or Nubain.
128
ary action against the same
Following this interpretation,
stay of execution. Conse-
physician. The charges related
the court held that the intent
quently, the court held that,
to the physician’s treatment of
of the general assembly was to
because the portion of the
the technician. After a hearing,
restrict the discretion of the
Board’s order staying the
the Board issued a second
Board. That is, the Board’s
revocation of the physician’s
disciplinary order suspending
only determination was
license and placing it on
the physician’s medical license
whether the physician was
probation was void, the
for a period of 60 days; placing
convicted of a felony that was
physician no longer had a
his license on probation with
reasonably related to the
license as of the entry date of
conditions for a period of 10
qualifications, functions, or
the first disciplinary order. As
years; and restricting him from
duties of a physician, a finding
a result of this revocation, the
prescribing, administering,
affirmed by the Board and not
physician no longer had a
dispensing, ordering, or pos-
valid license and could not be
sessing controlled substances
subjected to the second
and certain other drugs. The
physician appealed the Board’s
second disciplinary order.
On appeal, and before addressing the specific allegations of
error raised by the physician,
the court, on its own volition,
considered whether the Board
The court appears to hold
that the initial revocation
of the physician’s license
divested the board of
jurisdiction to hear a
second disciplinary matter.
disciplinary order. In so
holding, the court held that
the issues on appeal by the
physician for the second
disciplinary order were moot.
The issue of whether a Board
has “jurisdiction” over an
individual or practitioner is
had acted within its jurisdiction
important to note under these
when it stayed the revocation of
circumstances. While not
the physician’s license in the
contested by the physician.
overtly stated in the opinion,
first disciplinary hearing. In its
However, the Board could not
the court appears to hold that
initial assessment, the court
“stay” the statutorily mandated
the initial revocation of the
cited the general rule that if the
revocation. Specifically, the
physician’s license divested the
Board exceeded its jurisdiction
court held that the Board
board of jurisdiction to hear a
to assess the discipline and if
exercised unauthorized discre-
second disciplinary matter, in
the board exceeded and violated
tion in staying its revocation of
spite of the fact that the
its statutory authority, such
the physician’s license and
circumstances giving rise to
acts were void.
placing such license on proba-
this second set of allegations
tion. According to the court,
took place while the physician
the Board had only one option
was duly licensed. It may be
under the circumstances,
important for regulatory
revocation.
boards, under certain circum-
The court considered the
language of the specific statute
which called for the “automatic
revocation” of the license of the
physician if the criminal guilty
The court also cited the general
verdict were reasonably related
rule that when an administra-
to the practice of medicine. The
tive agency usurps its author-
court concluded that the term
ity, its unlawful act is void.
“automatic” meant self-acting
Thus, the physician’s license
and, thus, “a license cannot
was revoked as of the first
revoke itself.”
disciplinary order and was not
subject to a Board-ordered
OCTOBER/NOVEMBER 2000
stances, to initiate an additional disciplinary action
against an already disciplined
licensee to provide further
sanctions to better protect the
public health. This is especially
true in jurisdictions where
(continued on page 134)
129
The
Academic
Perspective
Flexibility through Demonstration Projects
By David B. Brushwood, JD
The pace of change
more, health care has become
cannot be done due to the
in health care is
more evidence-based, and
impossibility of studying an
increasing, and
decisions about authorizing
illegal practice. One of the
the solutions to
changes in practice are not
insidious costs of maintaining
new problems
likely to be made based on
a status quo is that new ideas
require approaches
fuzzy promises in the absence
are not put to the test. This is
that were unan-
of solid supportive data.
probably not always a bad
ticipated as
recently as a
decade ago. In pharmacy,
conscientious practitioners are
considering new ways of doing
things. Pharmacy practice
innovations include central fill,
call centers, unit-of-use
State boards of pharmacy are
charged with the responsibility
to protect the public health,
but increasingly they are
accepting correlative responsibility for public health promotion. State regulation is not
thing. Many ideas are halfbaked and do not warrant even
a test. Testing bad ideas would
expose the public to harm and
betray the public trust that has
been placed in the various
governing bodies.
simply a negative force that
Perhaps one effective option for
prevents bad practices. It can
recognizing the need to be
also be a positive force that
flexible in regulation, and to
enables good practices. Unfor-
also continue a high level of
tunately, state boards of
public health protection, is to
In many states, some or all of
pharmacy are sometimes
legislatively authorize boards of
these approaches to practice
restricted in the positive
pharmacy to approve pilot
violate laws that were enacted
influence they can exert on
studies or demonstration
at a time when innovation was
pharmacy practice by restric-
projects that may include
not so critical for professional
tive enabling legislation
violations of technical legal
survival. In the mid-twentieth
containing rules that may
requirements, but also contain
century, a change in profes-
have lost their usefulness.
oversight mechanisms to
packaging, therapeutic interchange, automated dispensing,
and the expanded use of
supportive personnel.
sional practice could wait for
the deliberate legislative
process to first react to proposals, then consider options, and
finally adjust to the slowly
changing times. Changes in
practice could be thoroughly
reviewed, exhaustively discussed, and then implemented
through regulations in plenty
of time to enable beneficial
improvements in practice.
In addressing this problem, the
quandary legislators will face is
how to accept new ways of
practice, in the absence of data
to support the new practices
and with continued assurance
that the public will not be
unnecessarily placed at risk of
harm. Legislators who ask for
evidence that an innovative
practice is both safe and
effective will be frustrated by
adequately protect the public.
In this way, innovative pharmacists would have the opportunity to at least try out a
seemingly good idea and
produce the compelling data
that should lead to rapid
adoption of productive change.
Formal quality checks would
detect any threats to the public
that might arise during the pilot
study, and a pilot study would
be ended if unacceptable risks
In contemporary practice, the
the scant supportive data they
time it takes to amend state
are likely to receive. A practice
legislation can lead to lost
that has not been legal, and
There is precedent for such an
opportunities for a pharmacy
that the legislature is being
approach in the medication use
profession that is adjusting to
asked to approve, will not be
system. An investigational new
new demands and to increased
supported by data because
drug (IND) exemption is, in
public expectations. Further-
studies that might support it
effect, a formal way for the
OCTOBER/NOVEMBER 2000
to the public became evident.
130
Food and Drug Administration
a modern health care system.
plan of study could include
(FDA) to permit a technical
They suggest that regulators
background information
violation of the law to occur
reflect on how their activities
regarding the proposed activity
under very controlled circum-
might impede constructive
and its expected value, as well
stances. According to the Food,
innovation in the design and
as identification of individuals
Drug, and Cosmetic Act, it is
provision of health care ser-
involved with the activity and
illegal to place into interstate
plans for the protection of
commerce an unapproved new
human subjects. In fact, a
drug. However, the Act permits
the FDA to allow unapproved
new drugs into interstate
commerce under an IND
exemption because there
otherwise would be no drug
studies and no innovation in
drug therapy. There is a risk to
the public from the use of
unapproved new drugs under
an IND, but it is a necessary
risk and it is a controlled risk.
In a similar fashion, state
State boards of pharmacy
could consider permitting
unapproved new drug
use activities that would
otherwise be illegal, on
the condition that the
activities be done within
a study that bears the
characteristics of a
controlled clinical trial.
new drug use activities that
would otherwise be illegal, on
the condition that the activities
be done within a study that
bears the characteristics of a
controlled clinical trial. It is
necessary for state legislatures
to permit these studies to occur,
just as the Congress has
permitted unapproved new drugs
to be used in limited ways.
In their landmark book, New
Rules: Regulation, Markets, and
the Quality of American Health
Care, authors Troyen Brennan
and Donald Berwick argue for
the establishment of “safe
havens” for major innovation
in health care. They note that
regulation has historically
tended to undervalue innovation as an essential feature of
OCTOBER/NOVEMBER 2000
require that all such projects
be approved by an Institutional Review Board familiar
with the necessaries for
protecting human subjects in
experimentation.
The pharmacy profession is
serious about meeting expanded responsibilities, but
some regulations currently
hinder innovation necessary to
meet expanded responsibilities.
Boards of pharmacy can be
boards of pharmacy could
consider permitting unapproved
board of pharmacy could
vices. Anticipating that some
regulators will be concerned
about the risks of innovation,
Brennan and Berwick state:
“Some will fear that forces of
irresponsibility might be unleashed, but to them we reply
that risks can come from two
types of imbalance: too much
innovation and too little.”
empowered to authorize the
“safe havens” for innovation
the profession wants and
needs. But this will require
legislation that the profession
will have to propose and
support. Pilot studies and
demonstration projects may be
the best way to provide immediate opportunities for innovation and lasting legislation
State boards of pharmacy can
that incorporates into wide-
be trusted to permit studies of
spread practice new knowledge
promising new approaches to
from isolated successes by a
medication use, and to not
few pioneers.
permit poorly conceived studies, under authority they might
Attorney David Brushwood is a
be given to allow demonstra-
professor at the University of
tion projects. Just as the FDA
Florida College of Pharmacy. He
requires a protocol for an IND
holds degrees from the Univer-
exemption, the boards could
sity of Kansas, Schools of
require a plan of study for a
Pharmacy and Law.
demonstration project. The
131
Compliance News
Maine Board Urges
Caution with OxyContin
Prescriptions
The Maine Board of Pharmacy
reported in its September
Newsletter that the Maine
Department of Professional
larly OxyContin. “Make sure
stances, including
you verify all information with
OxyContin, that cannot
the prescribing physician,”
be copied;
n
advises Cameron.
use numbers followed by
The Maine Board of Pharmacy
words to describe the
made the following recommen-
quantity and strength of
dations.
medication;
n
and Financial
n
Regulation1 has
patient and
the name of the pharmacy
urged pharmacists
diagnosis; ask
selected by the patient for
and physicians to
questions,
controlled substance
use extreme caution
especially of
prescriptions as well as for
when prescribing or
first-time
the patient’s insurance
filling prescriptions
patients;
plan; and
for narcotic drugs,
n
especially
controlled
tion to the selected phar-
OxyContin. According
substances
macy, when feasible, for
to the Board, alter-
prescriptions
authentication.
ation and forgery of
written for
prescriptions for
large quanti-
Watch for
n
specify on the prescription
fax a copy of the prescrip-
1
OxyContin are at an
ties; evaluate
all time high in the
state.
Know your
the ordered dosage;
n
Always verify telephoned and
The Department of Professional and
Financial Regulation is the umbrella
state agency for numerous licensing
boards including the Board of Pharmacy.
The Board of Licensure in Medicine and
the Board of Osteopathic Licensure are
affiliated with the Department.
OxyContin, prescribed by
faxed prescriptions by
physicians primarily for
comparing them with hard
chronic pain management,
copies provided by the
Searching for Compliance
Officer Correspondents
has replaced hydrocodone as
patient; and
NABP is searching for Compli-
Inspect the quality of
ance Officer correspondents
among drug dealers. The
prescription paper presented
from all districts for the
Newsletter reported that
for alterations or forgeries.
“Compliance News” column
the street drug of choice
n
during the past two months,
four deaths caused by
The Maine Board of Licensure
OxyContin overdoses have
in Medicine has also made
been reported in Maine.
recommendations to their
physicians to address the
that runs every other month in
the NABP Newsletter. Articles
feature topics such as drug
diversion scams, prescription
forgery problems, and inspector
Greg Cameron, senior phar-
possible conflict between
macy inspector for the Maine
adequate prescribing for pain
Board of Pharmacy, has asked
and diversion of drugs for illicit
If you would like to serve as a
pharmacies and licensed
use. The Medical Board recom-
correspondent, contact Lara
pharmacists to follow certain
mended that physicians:
Jackson, editor, at NABP
guidelines for filling prescrip-
n
headquarters, 847/698-6227.
tions for any narcotic or
controlled substance, particu-
OCTOBER/NOVEMBER 2000
use special prescription
training programs.
forms for scheduled sub-
132
Health Law Officers Conference Program
November 12-14, 2000
Beau Rivage Hotel
Biloxi, Mississippi
Sunday, November 12
9 - 10:30 AM
3 - 3:30 PM
Magnolia Ballroom E-G
Magnolia Ballroom E-G
Understanding the PBM
Operation
Refreshment Break
11AM - 7 PM
Magnolia Foyer
Registration/Information
Desk Open
1 - 1:15 PM
Magnolia Ballroom E-G
Welcoming Remarks
Carmen A. Catizone,
Executive Director/Secretary,
NABP
1:15 - 2 PM
0.15 CEUs – 1.5 contact hours
Program #: 205-000-00-012-L04
Sponsored by: Merck-Medco
Manged Care, LLC
Moderator:
Donna M. Horn, Member,
NABP Executive Committee
Presenter:
Kim Caldwell, Member, Texas
State Board of Pharmacy
Tuesday, November 14
8:30
AM - Noon
Magnolia Foyer
Registration/Information
Desk Open
8:30 - 9 AM
Magnolia Foyer
Continental Breakfast
9 AM - Noon
Magnolia Ballroom E-G
10:30 - 10:45
Keynote Address
Alan J. Parisse, motivational
and inspirational futurist
Magnolia Foyer
Magnolia Ballroom E-G
Refreshment Break
Workshop: Inspecting for
Pharmaceutical Care Outcomes
AM
10:45 AM - 12:15
2 - 5 PM
PM
Magnolia Ballroom E-G
Magnolia Ballroom E-G
Legislative Update
Street Drug Update
0.15 CEUs – 1.5 contact hours
Program #: 205-000-00-013-L03
Sponsored by: Eli Lilly & Co
0.3 CEUs – 3.0 contact hours
Program #: 205-000-00-011-L01
Sponsored by: Walgreen Co
Moderator:
Richard “Mick” Markuson,
President-elect, NABP
Presenter:
Harold L. Crossley, Associate
Professor of Pharmacology,
University of Maryland
Dental School
Moderator:
B. Belaire Bourg, Jr, Member,
NABP Executive Committee
Presenter:
John F. Atkinson, Counsel,
NABP Legal Counsel
12:30 - 2 PM
Camellia B
Magnolia Ballroom E-G
HLOC Award Luncheon
Presiding: Dyke F. Anderson,
Chairman, NABP
Refreshment Break
2 - 5 PM
6:30 - 8 PM
Magnolia Ballroom E-G
Pavillion/Special Event Area
Workshop: Investigating
Internet Pharmacies
3:30 - 3:45
PM
Welcoming Reception
(Casual Attire – shorts, jeans,
slacks, dresses.)
Monday, November 13
8:30 AM - 5 PM
Magnolia Foyer
Registration/Information
Desk Open
8:30 - 9 AM
Magnolia Foyer
Continental Breakfast
OCTOBER/NOVEMBER 2000
0.3 CEUs – 3.0 contact hours
Program #: 205-000-00-014-L03
Sponsored by: Pfizer Pharmaceuticals Group
Moderator:
John A. Fiacco, Treasurer,
NABP
Presenters:
Timothy J. Benedict, Assistant
Executive Director, Ohio State
Board of Pharmacy
Carla J. Stovall, Attorney
General, Kansas
0.3 CEUs – 3.0 contact hours
Program #: 205-000-00-015-L03
Sponsored by: PDX-NHIN, Inc
Moderator:
Vicki Schmidt, Member, NABP
Executive Committee
Panelists:
Carol E. Fisher, Director of
Enforcement, Investigation,
and Compliance, Texas State
Board of Pharmacy
Llyn A. Lloyd, Executive
Director, Arizona State Board
of Pharmacy
David Nau, Assistant Professor
of Pharmaceutical Systems and
Policy, West Virginia University
School of Pharmacy
John D. Taylor, Executive
Director, Florida Board
of Pharmacy
Charles R. Young, Executive
Director, Massachusetts Board
of Registration in Pharmacy
10 - 10:30
AM
Magnolia Ballroom E-G
Refreshment Break
Noon
Magnolia Ballroom E-G
Closing Remarks
Jerry Moore, President, NABP
133
Around theAssociation
Tennessee Board
Awarded Survey
Luncheon Gift Certificate
The Tennessee Board of
Pharmacy was selected as the
owner of the Rexall Drug in
n
Larry J. Lantier, Jr, RPh
Plentywood.
n
Richard J. Oubre, RPh
Arizona Board Moves to
New Office
Retirements
Leonard Eugene Herberlee
The Arizona State Board of
retired in July from the
Pharmacy office has moved. The
Nevada State Board of
Board’s new address is 4425 W
Pharmacy after 26 years of
Olive Ave, Suite 140, Glendale,
affiliation. During his time
AZ 85302-3844. The phone
with the Board, he served as a
numbers have also changed: the
member for three terms. He
main office number is 623/463-
first became associated with
2727 (ASBP) and the new fax
the Board in 1974 as a part-
number is 623/934-0583. The
time inspector. In 1992, after
Montana Board Names
New Executive Director,
Member
Board’s home page address has
closing his pharmacy and
not changed and is accessible at
retiring as a Board member,
www.pharmacy.state.az.us.
Herberlee became a full-time
Check the Web site for Board
inspector until his retirement.
The Montana Professional
meeting minutes, state phar-
Licensing Division hired
macy practice act, existing
After 30 years of governmen-
Rebecca Deschamps, RPh, as
Board administrative regula-
tal service to the District of
the executive director for the
tions, and proposed regulations.
Columbia, Barbara Hagans,
Montana Board of Pharmacy.
Deschamps, a graduate of the
New Board Members
University of Montana School
Louisiana recently appointed
of Pharmacy, assumed her
several new Board members,
position as the new executive
who are listed below.
director on October 9.
n
Joseph L. Adams, RPh
representative is Toylanda
n
Brian A. Bond, RPh
Brown and can be reached by
recently appointed to the
Montana Board. Mann is co-
n
Lois R. Anderson, RPh
2000 winner of the annual
drawing for the Survey of
Pharmacy Law luncheon.
State board offices that
returned their updated
Surveys to the NABP office by
the deadline were eligible for
the drawing.
Robert Mann, RPh, was
licensing specialist and
contact representative with
the District of Columbia
Board of Pharmacy, has
retired from her position as
of August 31, 2000. The new
calling 202/442-4778.
LegalBriefs (continued from page 129)
revoked licensees can apply for
placed in that order to ensure
reinstatement after a specified
compliance by the disciplined
period of time.
practitioner as well as to
This, of course, raises an
additional important issue for
regulatory boards to consider.
provide a basis for future board
Notice: This opinion has not been
released for publication in the
permanent law reports. It may be
subject to a motion for re-hearing
or transfer. It may be modified,
superseded, or withdrawn.
members to consider any such
re-application for licensure.
Attorney Dale J. Atkinson is a
partner in the law firm of
When drafting final orders, it is
Cantrell v. State Board of Registra-
Atkinson & Atkinson, counsel for
imperative that reinstatement
tion for the Healing Arts, 2000 WL
NABP.
rights (or the lack thereof) be
864987 (Mo. App. W.D.)
OCTOBER/NOVEMBER 2000
134
NABP Accepting Awards Nominations
Nominations for
please consider the following
their endeavors, best exemplify
NABP’s 2001-02
criteria.
the objectives of NABP, regard-
Honorary Presi-
less of their affiliation with the
dent, the Lester
Honorary President
E. Hosto Distin-
Nominees for Honorary Presi-
guished Service
dent should have served on
Award, and the
one or more of NABP’s com-
Presented by NABP’s past
Fred T. Mahaffey
mittees or task forces and have
presidents and named in honor
Award must be received by
participated in district and
of NABP’s executive director
Carmen A. Catizone, NABP’s
annual meetings. In general,
emeritus, the Fred T. Mahaffey
executive director/secretary at
nominees must have demon-
Award recognizes a member
Association headquarters no
strated a strong commitment
board of pharmacy that has
later than December 31, 2000.
to NABP, the mission of the
made significant contributions
The awards will be presented
Association, and the profes-
to the profession during the
during NABP’s 97th Annual
sion of pharmacy.
past year. Specifically, the
Meeting in Seattle, Wash, May
Lester E. Hosto
Distinguished Service
Award
5-9, 2001.
The letters of nomination,
along with a brief biography or
current curriculum vitae of the
The Distinguished Service
nominee, must be accom-
Award (DSA), named in
panied by a narrative explain-
memory of NABP’s 1990-91
ing why the nominee should be
President Lester E. Hosto, is
considered for an award.
the highest honor bestowed by
When nominating a colleague
or state board of pharmacy,
Association.
Fred T. Mahaffey Award
nominated board’s efforts must
have contributed to the protection of the public health and
welfare through the enforcement of state and federal laws
and regulations and the
advancement of NABP’s goals
and objectives as specified in
the Constitution and Bylaws.
the Association. The DSA
Nominations will be reviewed
plaque and pin are awarded to
by the NABP Executive Com-
those individuals who, through
mittee, which will select the
Honorary President and award
recipients.
NABP Seeks ACE Volunteers
The 2001-02 Honorary Presi-
NABP is seeking volunteers
Mokhiber, Bryan H. Potter,
the 97th Annual Meeting’s Third
to serve on its Advisory
and Donald H. Williams
Business Session on Tuesday
Committee on Examinations
expire May 31, 2001. All
afternoon, May 8. Later that
(ACE), which oversees the
three members are eligible
evening, during NABP’s annual
development and administra-
for reappointment. Appoint-
Awards Dinner, the Lester E.
tion of all the Association’s
ments will become effective
Hosto Distinguished Service
examination programs. The
June 1, 2001.
Award and the Fred T.
Interested individuals should
Mahaffey Award presentations
submit a written statement of
will be made. NABP’s 2000-01
interest and a current resume
Honorary President, H. Lee
or curriculum vitae to NABP
Gladstein, will also be honored
Executive Director/Secretary
at that time.
Carmen A. Catizone at NABP
For more information regarding
The terms of current ACE
headquarters no later than
the nominating process or the
members Lawrence H.
December 29, 2000.
awards, please call NABP
Committee also considers
policy matters, develops longrange planning strategies, and
recommends appropriate
action on issues specific to
NABP’s Executive Committee.
dent will be announced during
headquarters at 847/698-6227.
OCTOBER/NOVEMBER 2000
135
AGuidance
Dose
of
Humor
for the New Graduates (and Not So New Graduates)
By Phil D. Script
My trusty pharmacy intern Al
as photocopied prescriptions,
have to be careful, though, that
Buterol had done such a terrific
different colored inks on the
you do not refuse outright to fill
job over the last few years I
same prescription, lack of
these prescriptions because they
simply had to give him more
required prescription informa-
may be for patients who have
than just a passing grade so he
tion, etc. It is the tricky
terminal illnesses or are in
could finish his P-7 year and
techniques used to dupe
chronic pain. Talk to the
finally graduate. Because there
unwitting pharmacists for
patient or caregiver. Find out
are very few things that I savor
which you have to be vigilant.”
what is afflicting the patient
more than pontificating, I
dragged out my worn soapbox so
I could give, as a gift to Al,
lustrous pearls of wisdom that
every new graduate should heed.
“For instance, beware of the
patient who lives very far from
your pharmacy and is seeking
to have you fill her prescription. Engage her in conversa-
and what other non-controlled
medications the patient has
tried for treating his or her
condition. When in doubt, verify
the suspect prescription with
the prescriber.”
My many years with the
tion and find out what the
organization allowed me to
medication is for and where
“On the other hand, you must
interact with the boards of
she works. It is possible that
also be on the watch for
pharmacy and review many
she works nearby and is filling
prescribers who are writing
disciplinary orders against
the prescription on her way to
illegitimate controlled sub-
pharmacists. I saw recurring
or from work. On the other
stance prescriptions. If you see
themes in these orders and in
hand, she may have had these
that one particular prescriber
the misconduct that gave
controlled substance prescrip-
writes many of the controlled
pharmacists the opportunity to
tions filled at many different
substance prescriptions that
meet their board members on a
pharmacies all over the area,
you fill on a daily, weekly or
personal level.
and you are her latest target.
monthly basis, call the pre-
Also, if she is paying cash, be
scriber to determine his or her
even more cautious. In all
areas of practice. But here is
cases where you suspect the
where it gets difficult. Calling
prescription may not be
an illegally practicing pre-
legitimate, call to verify the
scriber to verify one of his
prescription with the pre-
prescriptions will probably be
scriber. Consider calling other
fruitless. Use your best judg-
local pharmacists to determine
ment in filling his prescriptions
“Go ahead, Mr Script,” urged
whether they have filled similar
based upon information you
Al, “I am hanging on your every
prescriptions for her. You will
obtain about the patient’s
word.” Filled with pride and a
be surprised by what you find if
condition, medication history,
bit of hubris, I began to
you do a little investigating.”
and other treatments, pharma-
“Al,” I said, “you pay attention
to what I am going to say and
follow my advice, and your
pharmacist license should
remain blemish-free until the
day you quit practicing
pharmacy.”
dispense to my soon-to-bedeparted protégé some kernels
of wisdom.
Al squealed, “I like the idea of
playing ‘detective’; what else
should I look for when I fill
ceutical and non-pharmaceutical, that the patient is receiving
to address his condition.”
“First and foremost,” I ex-
controlled substance
“Are there any other golden
plained, “quickly learn what to
prescriptions?”
nuggets regarding controlled
look for to determine whether a
controlled substance prescription is legitimate. Some things
will tip you off right away such
OCTOBER/NOVEMBER 2000
“Obviously,” I said, “unusually
high doses and prescriptions
substance prescriptions?” Al
eagerly asked.
written for large numbers of
“Last but not least, my young
tablets are always suspect. You
budding pharmacist, be on the
136
lookout for prescribers, such as
employees you supervise, even
is accepted. For instance, many
dentists, podiatrists, or optom-
when you are not around,
states will only accept American
etrists who prescribe medica-
engages in conduct that
Council on Pharmaceutical
tions that are outside the
violates the state’s practice act.
Education (ACPE)-approved CE;
scope of their practice. For
If you choose to become a PIC
some states require a certain
example, dentists, optom-
and you understand and
number of CE hours be completed in particular areas of
etrists, and podiatrists have no
legitimate reason to prescribe
weight loss medications,
whether for themselves or for
others. If a person describing
herself as a doctor self-prescribes sibutramine (Meridia),
find out what kind of “doctor”
she is. If the medication is
outside the reasonable scope of
her practice, not only should
you not fill the prescription but
also you should report her to
the professional board that
issued her license and regu-
“Pharmacists should make
sure they understand the
CE requirements of every
state in which they are
licensed: the total number
of CE hours they must
obtain, the time frame in
which they must complete
the CE hours, and the type
of CE that is accepted.
pharmacy practice such as
pharmacy law; and, some states
only allow a certain number of
CE hours to be completed as
part of a home study program.
The balance of CE hours may
have to be completed in-person
in the form of ‘live’ seminars
and lectures. It is imperative
that pharmacists contact all
applicable boards of pharmacy
to determine each state’s CE
requirements and coordinate
these obligations with their
calendars so they do not have
lates her practice.”
too few hours or the wrong type
Al was scribbling furiously and,
accept any additional legal
without even looking up from
responsibilities you have, then
his notepad, pleaded for more
make sure your employer
“Is there any other insight you
advice and guidance.
adequately compensates you
can give me, Mr Script? I want
for your increased accountabil-
to have a squeaky clean
ity under the law.”
record!” Al beamed.
offered a position as the
“Finally, Al, continuing educa-
“Al, make duplicate copies of
pharmacy manager or the
tion, or CE, is an easily
your CE credits, and keep the
pharmacist-in-charge (PIC),
overlooked requirement that
extra copy in a safe place away
before you accept, find out
many pharmacists neglect.”
from your hungry dog, out of
“Two more points I would like
to make. First, when you are
what legal responsibilities you
have under the pharmacy
practice act in your state and
decide whether you are able to
“But that is not an onerous
duty, and it is a pretty easy
obligation to meet.” Al seemed
confused.
assume and carry out these
additional responsibilities. In
“Pharmacists should make sure
some states, PICs may be
they understand the CE require-
responsible for the activities of
ments of every state in which
their employees as they relate
they are licensed: the total
to the practice of pharmacy.
number of CE hours they must
This is a very broad responsi-
obtain, the time frame in which
bility, and your license could
they must complete the CE
be disciplined if one of the
hours, and the type of CE that
OCTOBER/NOVEMBER 2000
of CE hours.”
your flood-prone basement,
and away from your ornery
employer who could fire you
and refuse to give you your CE
certificates.”
And with that, I confidently
stepped off my soapbox,
congratulated Al on completing
pharmacy school in only nine
years, and gingerly slid the
rickety box under my desk to
await my next preaching
engagement.
137
2000-2001 Committee and Task Force Members
NABP President Jerry Moore has appointed the following individuals to serve as members of the
Association’s 2000-2001 committees and task forces. Every effort has been made to accommodate individual requests to serve on a committee or task force and to assure uniform representation from all
regional districts.
Executive Committee
Honorary President ................... H. Lee Gladstein,
New Jersey State Board of Pharmacy
Chairman ................................ Dyke F. Anderson,
Nebraska Board of Pharmacy
President .......................................... Jerry Moore,
Alabama State Board of Pharmacy
President-elect ............. Richard “Mick” Markuson,
Idaho Board of Pharmacy
Treasurer ..................................... John A. Fiacco,
New York Board of Pharmacy
Member ................................ B. Belaire Bourg, Jr,
Louisiana Board of Pharmacy
Member ...................................... Paula L. Castor,
Pennsylvania State Board of Pharmacy
Member ...................................... Donna M. Horn,
Massachusetts Board of Regulation in Pharmacy
Member ..................... S. Patricia “Tris” McSherry,
New Mexico Board of Pharmacy
Member ........................................ Vicki Schmidt,
Kansas State Board of Pharmacy
Member ....................................... Donna S. Wall,
Indiana Board of Pharmacy
Committee on Constitution and Bylaws
Chair ........................................ Michael A. Moné,
Kentucky Board of Pharmacy
Member ...................................... Wayne A. Camp,
Louisiana Board of Pharmacy
Member ............................................. Karen Ryle,
Massachusetts Board of Registration in Pharmacy
Member ................................ Charles Curtis Barr,
Nebraska Board of Pharmacy
Member ................................ Robert P. Giacalone,
Ohio State Board of Pharmacy
Alternate ................................. Kendall M. Lynch,
Tennessee Board of Pharmacy
Alternate ........................... Eugene “Gene” Drake,
Arizona State Board of Pharmacy
EC Liaison ........................... B. Belaire Bourg, Jr,
Louisiana Board of Pharmacy
Committee on Law Enforcement/Legislation
Chair .................................... Richard A. Palombo,
New Jersey State Board of Pharmacy
Member .............................. Dennis K. McAllister,
Arizona State Board of Pharmacy
Member ........................ Jeanne Gilligan Furman,
Maryland Board of Pharmacy
Member ........................... Clayton Oxford Wilson,
Alabama State Board of Pharmacy
Member ..................................... Catherine Polley,
Michigan Board of Pharmacy
Member .......................................... Linda Labenz,
Nebraska Board of Pharmacy
Member ....................................... Larry L. Pinson,
Nevada State Board of Pharmacy
Alternate ............................. Timothy J. Benedict,
Ohio State Board of Pharmacy
Alternate .................................. Charles A. Young,
Massachusetts Board of Registration in Pharmacy
EC Liaison .............................. Dyke F. Anderson,
Nebraska Board of Pharmacy
Task Force on Expanded Use of the Internet
in Pharmacy Practice and Regulation
Chair .............................................. Ann D. Abele,
Ohio State Board of Pharmacy
Member ...................... William L. “Buck” Stevens,
Mississippi State Board of Pharmacy
Member ...................................... Audrey H. Neely,
Illinois Department of Professional Regulation
Member ............................................ Helen Fong,
Florida Board of Pharmacy
Member ................................... Richard R. Smiga,
Pennsylvania State Board of Pharmacy
Member ............................................. Lydia Main,
West Virginia Board of Pharmacy
Member ..................................... Sam M. Costello,
Alabama State Board of Pharmacy
Alternate ................................ Patricia F. Donato,
New York Board of Pharmacy
EC Liaison ................ S. Patricia “Tris” McSherry,
New Mexico Board of Pharmacy
Task Force on Model Guidelines
for Formulary Development
Chair ..................................... William T. Winsley,
Ohio State Board of Pharmacy
Member ............................. Edith G. Goodmaster,
Connecticut Commission of Pharmacy
Member .................................... Stephen R. Statz,
South Dakota State Board of Pharmacy
Member ................................... John P. Bohlman,
Wisconsin Pharmacy Examining Board
Member ....................... Anthony W. Alexander, Jr,
New Jersey State Board of Pharmacy
Member ................................... Davis C. Hook, Jr,
South Carolina Board of Pharmacy
Member ...................................... Carl O. Benson,
Minnesota Board of Pharmacy
Alternate ................................ Thomas F. Dudley,
Oklahoma State Board of Pharmacy
EC Liaison ................................. Donna M. Horn,
Massachusetts Board of Regulation in Pharmacy
(continued on next page)
OCTOBER/NOVEMBER 2000
138
VIPPS-Certified Online Pharmacies Total 13
With the addition of www.accuratepharmacy.com
clinical services to manage medication compliance
and www.eMD.com, there are now a total of 13
associated primarily with chronic disease states.
online pharmacy sites that have earned Verified
The online pharmacy is licensed in 46 states and
Internet Pharmacy Practice Sites™ (VIPPS™)
has 80 managed care contracts associated with
certification.
more than 170 million patients. The
site’s password-protected medication
Accurate Medical Equipment &
management and charting applica-
Supply Co, Inc, a privately
tion includes electronic prescribing,
owned pharmacy and durable
online medical charting, drug fulfill-
medical equipment (DME)
ment by the patient’s chosen phar-
company, launched
macy, and clinical care services such
www.accuratepharmacy.com in
as monitoring chronic disease
June 2000. The full-service site
patients for prescription compliance.
offers pharmaceuticals (specializing in unit dose bronchodilators and TPN
As VIPPS-certified sites, accuratepharmacy.com
therapy), oxygen and respiratory therapy prod-
and eMD.com may display the VIPPS hyperlink
ucts, DME, an on-staff respiratory therapist to
seal of approval on their Web sites. By clicking on
answer questions on respiratory care, and
the VIPPS seal, consumers will be able to find the
diabetic supplies.
verified information they need to make informed
Also VIPPS certified, eMD.com, a business-tobusiness Internet health care subsidiary of
BioShield Technologies, Inc, offers consumers
online prescription fulfillment and provides
decisions regarding their choice of online pharmacies. Consumers may also access the VIPPS
database directly via NABP’s Web site at
www.nabp.net.
2000-2001 Committee and Task Force Members (continued from previous page)
Task Force on Drug Diversion through
Institutional Outlets
Chair .................................... Byron “Tom” Alford,
Alabama State Board of Pharmacy
Member ........................................ Susan Ksiazek,
New York Board of Pharmacy
Member .................................. Wallace E. Nelson,
North Carolina Board of Pharmacy
Member ..................................... David Flashover,
New York Board of Pharmacy
Member ................................... Donald P. Gibson,
Minnesota Board of Pharmacy
Member ....................................... John D. Taylor,
Florida Board of Pharmacy
Member .................................... Dennis M. Jones,
South Dakota State Board of Pharmacy
Alternate .................................. L. Stan Haywood,
North Carolina Board of Pharmacy
Alternate ...................................... Wiki Erickson,
Texas State Board of Pharmacy
EC Liaison ................................... Donna S. Wall,
Indiana Board of Pharmacy
Member ....................................... John D. Taylor,
Florida Board of Pharmacy
Member ............................... Charles S. Campbell,
Arkansas State Board of Pharmacy
Member ...................................... Lloyd K. Jessen,
Iowa Board of Pharmacy Examiners
Member ................................... Gary A. Schnabel,
Oregon State Board of Pharmacy
Errata
In the September 2000 issue of the NABP
Newsletter, Dennis McAllister was said to
Focus Group to Regulate Patient Outcomes
have been the executive director of Arizona
Member ................................... Charles R. Young,
Massachusetts Board of Registration in Pharmacy
Member .................................... David D. Dryden,
Delaware State Board of Pharmacy
State Board of Pharmacy, in fact, he once
OCTOBER/NOVEMBER 2000
served as president of that Board.
139
NABP Meeting Dates
Friday-Sunday, November 10-12, 2000
District IV Meeting,
Radisson Hotel & Suites, Chicago, Ill
Friday, May 5, 2001
Pre-convention Executive Committee Meeting
The Sheraton Seattle Hotel, Seattle, Wash
Saturday-Sunday, November 11-12, 2000
Executive Committee Meeting,
Beau Rivage Hotel, Biloxi, Miss
Saturday-Wednesday, May 5-9, 2001
97th Annual Meeting,
The Sheraton Seattle Hotel, Seattle, Wash
Sunday-Tuesday, November 12-14, 2000
Health Law Officers Conference,
Beau Rivage Hotel, Biloxi, Miss
ION OF BOA
AT
R
CI
DS
PHARM
OF
AC
Y
TIONAL ASS
O
NA
Friday-Sunday, February 2-4, 2001
Executive Committee Meeting
Location to be Announced
19 0 4
®
newsletter
National Association of Boards of Pharmacy
700 Busse Highway
Park Ridge, Illinois 60068
OCTOBER/NOVEMBER 2000
140