The Georgia Pharmacy Journal: September 2011

*This is not a claims reporting site. You cannot electronically report a claim to us. To report a claim, call 800.247.5930.**Compensated endorsement.Not all products available in every state. The Pharmacists Life is licensed in the District of Columbia and all states except AK, FL, HI, MA, ME, NH, NJ, NY and VT. Check with your representative or the company for details on coverages and carriers.

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The Georgia Pharmacy Journal September 20113

F E A T U R E A R T I C L E S

7 BlueCross BlueShield Insurance Information

13 New GPhA Member Benefit: Be a Mentor, Get a Mentor

12 Athens Student Pharmacist, Kyle Burcher Honored as Future Pharmacist of the Year

14 GPhA Legislative Update

18 2012 Convention Save the Date

24 CPE Opportunity: New Drugs: Halaven, Natroba and Viibryd

C O L U M N S

4 President’s Message

6 Editorial

22Health Mart Healthy Living Tour

Visits Georgia Pharmacies

Departments16 GPhA New Members10 Pharm PAC Contributors15 Pharm PAC Contribution Card30 GPhA Board of Directors

Advertisers2 Pharmacists Mutual Companies5 GPhA Career Center12 Financial Network Associates11 Logix, Inc.11 Melvin Goldstein, P.C.16 Barbara Cole, Attorney at Law17 PACE Alliance19 AIP20 GPhA Workers’ Compensation21 NCPA Convention Information23 Pharmacy Quality Commitment32 UBS

For an up-to-date calendarof events, log ontowww.gpha.org.

P R E S I D E N T ’ S M E S S A G E


Some two months ago while at the executivecommittee retreat in Hartwell I informed theexecutive committee that we were going to

implement two programs for the association. Theseprograms involve two simple steps and planning for abetter year in 2011-12. With the recent trip of the Boardof Directors to Jekyll Island, I believe these programsstarted off with a big step for our association. On Friday,members of the executive committee gave a briefdescription on the staff of GPhA. I believe this was veryimportant for the new members of the board of directors,as they now know how to communicate with staff ofGPhA.

Saturday morning Kelly McLendon gave a presentationabout the GPhA website. She went through the process onhow to navigate through the website. Kelly went intodetail on locating members as well as finding membersbenefits. She also gave insight on how to find the GPhAcalendar on the website. If you are looking for yourrepresentative and your senator it is located on thewebsite as well. I was amazed how much easier it was tonavigate after hearing Kelly’s presentation.

On Saturday afternoon with the guidance of ReneeAdamson, president of the 3rd Region and Pam Marquess,a past president of the 7th region, the region presidentswere introduced to requirements for region president.With involvement from all members there was an openforum for information for each office. Guidelines wereestablished for each member to carry out throughout theyear. From helping with the regions meetings to

communications with region members I believe that thiswill only make the presidency of the regions and academychairs a more productive unit in the involvement in GPhAgrowth.

L. Jack Dunn, Jr., R.Ph.GPhA President

Be Not Afraid of Growing Slowly;Be Afraid of Standing Still

Find the best jobs and highly qualified pharmacists Georgia has to offer.

SUPPORTING PHARMACISTS.ADVANCING CAREERS.

ONLINE CAREER CENTERwww.gpha.org/jobs

While your stocks may have declined in value, yourinvestment in your GPhA membership has grownin value. Maybe congress ought to be talking to

the GPhA leadership.

GPhA has added three significantly enhanced membershipbenefits this membership year.

#1 Blue Cross Blue Shield insurance is now available atGPhA Association group rates as of October 1, 2011

GPhA has long been a resource for quality and cost efficienthealth insurance benefits for its member groups. Nowemployee groups can get that benefit via an agreementbetween GPhA and Blue Cross/Blue Shield which is one ofthe premiere providers of insurance in our state.

See the additional information on pages 7 & 9, or contactRuth Ann McGehee at GPhA for a complete brochure andinformation package. Ruth Ann can be reached directly at404-419-8104 or via email at [email protected].

In today’s uncertain health care insurance market, takingadvantage of this significantly enhanced program providedthrough your GPhA membership can be a very wise movefor all to consider.

#2 Administrative Management of 401ks at GPhA, agroup discounted rate

If you are an employer or your employer provides your teamwith a 401K benefit you can now do so at a cost you maynever have thought was available. After more than a year ofdue diligence research GPhA was able to reduce theadministrative cost of the Association’s 401K by almost 50%and at the same time significantly improve our investmentopportunities for our team. Now you too, as a GPhAmember, can avail yourself of this group discounted rate for401K services.

If you would like some basic information contact Dan

Griggs, GPhA’s Director of Finance and Administration,directly at 404-419-8119 or via email at [email protected] can put you in touch with Harris Gignilliat with UBS totake advantage of these special discounted rates. Save moneyand improve your investment options, not a bad idea for thisyear.

#3 Personal financial planning and investment servicesmembership group rates

If you are like me you know very little about personalfinancial planning. As a member of GPhA you can get aprofessional review or professional assistance in preparingyour personalize financial plan for your future. If you are verysmart and have already done that you are exceptional. Wouldyou like to get a second opinion on your plan at no cost toyou? I did and I learned a lot had changed in the last fewyears and that I was not taking advantage of all that wasavailable to me. As a GPhA member, your membership nowentitles you to a no cost to you comprehensive financial planreview or plan development. You have no obligation to makeany changes and no pressure. UBS does not sell insurance.UBS does not sell stock. UBS sells financial managementservices for a fee not a commission. You can purchaseadvice, not products. Jeff Lurey, Dan Griggs and severalmembers of the GPhA Board have taken advantage of thisgreat membership benefit. See the back page of this Journalfor more information.

Your association has become very selective about newmembership benefits. We want to add value to yourmembership investment, not a bunch of coupons and tickets.We heard your feedback and acted accordingly. We thinkyou will be pleased with these three new benefits ofmembership.

E X E C U T I V E V I C E P R E S I D E N T ’ S E D I T O R I A L

Jim BracewellExecutive Vice President / CEO

6The Georgia Pharmacy Journal September 2011

New Enhanced GPhA MembershipBenefits this Fall

For the January 2012 Open Enrollment period, the Georgia

Pharmacy Services Insurance Agency will be offering

BlueCross BlueShield of Georgia Medical and Dental Benefits.

To find Blue Cross and Blue Shield

of Georgia Medical or Dental

Providers, simply follow these

easy steps:

See other side for a brief description of the medical and dental benefits.

Open Access Point of Service (POS)

1. Go to bcbsga.com

2. Select “Find a Doctor” and choose

“Go”

3. Select the Medical Tab

4. Select (Blue Open Access POS)

and follow the steps outlined on the

screen

Health Savings Account (H.S.A.)

1. Go to anthem.com.


“Go”

3. Select your state

4. Select (Anthem Lumenos Open

Access POS H.S.A)


screen

Dental

1. Go to bcbsga.com


“Go”

3. Select the Dental Tab

4. Select (Dental Complete) and follow

the steps outlined on the screen

Discounts on healthy living

products and services through

Healthy Extensions like Jenny

Craig®, Weight Watchers Online®,

fitness club memberships,

acupuncture, massage therapy and

chiropractic services

Pharmacy programs designed to

educate: Half-Tablet and

GenericSelectSM

Walking programs

Free Women’s Health e-Newsletter

Worksite wellness programs

Latest health care news on

bcbsga.com

Better networks equal lower costs

Our partnerships with Georgia’s

doctors and hospitals saves your

employees money because we’ve

negotiated better fees for the

services they provide.

360° Health program® This brand

new integrated group of health care

services is the industry’s first

comprehensive approach to help

you and your employees achieve

better health. It’s simple; if you’re

healthier, then your health care

costs are lower.

Call monitoring, 100 percent of calls

recorded

Local walk-in customer service in

Atlanta and Columbus

Employer Reference Guide

available 24/7 at bcbsga.com

Download commonly used forms

Review enrollment and billing

guidelines

Tips on using your coverage

Weekly updates to online provider

directories

We do this by giving your employees the

tools and resources they need to take

control. For example:

We want to ensure that you attract and retain

the people needed to carry out your mission

by offering a competitive benefits program.

More than 14,600 POS heath care providers

in Georgia

Largest provider network in the country with

more than 900,000 BlueCard© providers

Worldwide networks with providers in 200

countries and territories

Blue members accepted by 89% of doctors

and territories

24/7 NurseLine (888-724-BLUE)

Preventative benefits in every plan

360o Health® our innovative health services

programs is an integrated group of health

care services designed to help your

employees:

Manage and maintain their health

Make more informed health decisions

Maximize the value of their health care

benefits

Early detection/targeted health screening

reminders

Health education and disease prevention

programs; maternity management, breast

cancer care program & smoking cessation

programs

MyHealth Record: a safe and secure place

to store your personal health information

online (we’ll even help by uploading claims

every week to each member’s personal

record)

Power of the most recognized name in

health care; 1 in 3 Americans carry a Blue

member ID card!

Better networks equal lower costs. Our

partnerships with Georgia’s doctors and

hospitals saves your employees money

because we’ve negotiated better fees for the


Online self-service tools for employers and

members that simplify benefit administration

Multi-lingual capabilities

24hr voice response unit

Ther

e’s m

ore t

han

REASON

TO

CHOOSE

THE

GEORGIA

PHARMACY

SERVICES

INSURANCE

BENEFIT

OFFERS

THROUGH

BCBSGA!

For the January 2012 Open Enrollment period, the Georgia

Pharmacy Services Insurance Agency will be offering

BlueCross BlueShield of Georgia Medical and Dental Benefits.

To find Blue Cross and Blue Shield

of Georgia Medical or Dental

Providers, simply follow these

easy steps:

See other side for a brief description of the medical and dental benefits.

Open Access Point of Service (POS)

1. Go to bcbsga.com


“Go”

3. Select the Medical Tab

4. Select (Blue Open Access POS)


screen

Health Savings Account (H.S.A.)

1. Go to anthem.com.


“Go”

3. Select your state

4. Select (Anthem Lumenos Open

Access POS H.S.A)


screen

Dental

1. Go to bcbsga.com


“Go”

3. Select the Dental Tab

4. Select (Dental Complete) and follow

the steps outlined on the screen

Discounts on healthy living

products and services through

Healthy Extensions like Jenny

Craig®, Weight Watchers Online®,

fitness club memberships,

acupuncture, massage therapy and

chiropractic services

Pharmacy programs designed to

educate: Half-Tablet and

GenericSelectSM

Walking programs

Free Women’s Health e-Newsletter

Worksite wellness programs

Latest health care news on

bcbsga.com

Better networks equal lower costs

Our partnerships with Georgia’s

doctors and hospitals saves your

employees money because we’ve

negotiated better fees for the


360° Health program® This brand

new integrated group of health care

services is the industry’s first

comprehensive approach to help

you and your employees achieve

better health. It’s simple; if you’re

healthier, then your health care

costs are lower.

Call monitoring, 100 percent of calls

recorded

Local walk-in customer service in

Atlanta and Columbus

Employer Reference Guide

available 24/7 at bcbsga.com

Download commonly used forms

Review enrollment and billing

guidelines

Tips on using your coverage

Weekly updates to online provider

directories

We do this by giving your employees the

tools and resources they need to take

control. For example:

We want to ensure that you attract and retain

the people needed to carry out your mission

by offering a competitive benefits program.

More than 14,600 POS heath care providers

in Georgia

Largest provider network in the country with

more than 900,000 BlueCard© providers

Worldwide networks with providers in 200

countries and territories

Blue members accepted by 89% of doctors

and territories

24/7 NurseLine (888-724-BLUE)

Preventative benefits in every plan

360o Health® our innovative health services

programs is an integrated group of health

care services designed to help your

employees:

Manage and maintain their health

Make more informed health decisions

Maximize the value of their health care

benefits

Early detection/targeted health screening

reminders

Health education and disease prevention

programs; maternity management, breast

cancer care program & smoking cessation

programs

MyHealth Record: a safe and secure place

to store your personal health information

online (we’ll even help by uploading claims

every week to each member’s personal

record)

Power of the most recognized name in

health care; 1 in 3 Americans carry a Blue

member ID card!

Better networks equal lower costs. Our

partnerships with Georgia’s doctors and

hospitals saves your employees money

because we’ve negotiated better fees for the


Online self-service tools for employers and

members that simplify benefit administration

Multi-lingual capabilities

24hr voice response unit

Ther

e’s m

ore t

han

REASON

TO

CHOOSE

THE

GEORGIA

PHARMACY

SERVICES

INSURANCE

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OFFERS

THROUGH

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Blue Cross and Blue Shield of Georgia Medical PlansYou will have the option to enroll in one of the following four (4) medical plans: Open Access Point of Service (OA POS) – The plan provides benefits both in and out of network. The

plan does not require a referral to see a specialist who participates in the BCBS Open Access network. Health Savings Account (HSA) – This plan provides you with the flexibility to use a health care provider

either in or out of the network without a referral.

Blue Cross and Blue Shield of Georgia Dental Plans

Medical Plan Highlights OA POS OA POS OA POS HSA

Medical deductible – In network

$500 $1,500 $1,000 $3,000 $1,500 $4,500 $2,500 $5,000

Medical deductible – Out of network

$1,000 $3,000 $1,000 $3,000 $1,500 $4,500 $5,000 $10,000

Out-of-pocketmaximum – In network

$1,000 $3,000 $1,000 $3,000 $1,000 $3,000 $5,000 $10,000

Out-of-pocketmaximum – Out of network

$4,000 $12,000 $4,000 $12,000 $4,000 $12,000 $10,000 $20,000

Primary care physician visit

$25 copayDed. waived



40% Ded. waived

$0 Ded.waived

40% after ded.

Specialist visits $35 copayDed. waived



40% Ded. waived

20% Ded.waived

40% after ded.

Coinsurance 20% after deductible

20% after deductible


40% Ded. waived

20% Ded.waived

40% after ded.

Emergency room $100 copayDed. waived




20% Ded.waived

40% after ded.

Generic $15 copay Ded.then 40%

$15 copay Ded.then 40%


Ded.then 20%

Ded.then 40%

Dental coverage

Calendar year deductible

Single $50

Family $150

Deductible applies to Type II and III

Coinsurance

Preventive services (Type I) 100%

Basic Services (Type II) 80%

Major Services (Type III) 50%

Periodontics and Endodontics 80%

Annual maximum $1,000

Out of network usual and customary 90%

GAD\1-hda\ebpg\Clients\GA Pharmacy Association\GA Pharm Assoc NL attachment 2011_2


Do you want more information on the Blue CrossBlue Shield GPhA Plans?Who do I contact for information?

Email Ruth Ann McGehee at [email protected] or call on her direct line at 404-419-8104

“The responses from our currently insured groups have been overwhelmingly positive. This plan in many respects mirrorsthe plan of the Georgia Dental Association that has long been a successful plan for dentists across Georgia. I am proud theleadership of GPhA was able to put together such a quality offering for the pharmacists and pharmacies of our association”said GPhA Executive Vice President Jim Bracewell. “Morgan Kendrick, the president of Blue Cross Blue Shield and I serveon the board of the Georgia Healthcare Information Exchange. Morgan is a leader in healthcare and its future in ourstate.”

Who will administer the plan for us?

Georgia Pharmaceutical Services, GPhA wholly owned subsidiary and insurance agency will provide the administrationfor the plan as they have in the past for The Insurance Trust.

Who are the board members of Georgia Pharmaceutical Services, Inc.?

The board of directors of the GPhS are elected by the GPhA board of directors and the current board is made up of RobertBowles, Dale Coker, Jack Dunn, Robert Hatton, Eddie Madden, Pam Marquess, Bobby Moody, and Sharon Sherrer.Executive Vice President Jim Bracewell serves as the secretary in an ex-officio non-voting position.

New Health Insurance Benefit From GPhA Plan FactsEffective October 1, 2011 Blue Cross & Blue Shield of Georgia will be GPhA’s Plan Adminstrator

Members of the GPhA health care plan will have four plans to choose from

Dental will be included

Guaranteed rates through December 31, 2012

Blue Cross and Blue Shield of Georgia Medical PlansYou will have the option to enroll in one of the following four (4) medical plans:

Open Access Point of Service (OA POS) – The plan provides benefits both in and out of network. The plan does not require a referral to see a specialist who participates in the BCBS Open Access network.Health Savings Account (HSA) – This plan provides you with the flexibility to use a health care provider either in or out of the network without a referral.

Blue Cross and Blue Shield of Georgia Dental Plans

Medical Plan Highlights OA POS OA POS OA POS HSA

Medical deductible – In network

$500 $1,500 $1,000 $3,000 $1,500 $4,500 $2,500 $5,000

Medical deductible – Out of network

$1,000 $3,000 $1,000 $3,000 $1,500 $4,500 $5,000 $10,000

Out-of-pocketmaximum – In network

$1,000 $3,000 $1,000 $3,000 $1,000 $3,000 $5,000 $10,000

Out-of-pocketmaximum – Out of network

$4,000 $12,000 $4,000 $12,000 $4,000 $12,000 $10,000 $20,000

Primary care physician visit




40% Ded. waived

$0 Ded.waived

40% after ded.

Specialist visits $35 copayDed. waived



40% Ded. waived

20% Ded.waived

40% after ded.

Coinsurance 20% after deductible



40% Ded. waived

20% Ded.waived

40% after ded.

Emergency room $100 copayDed. waived




20% Ded.waived

40% after ded.

Generic $15 copay Ded.then 40%



Ded.then 20%

Ded.then 40%

Dental coverage

Calendar year deductible

Single $50

Family $150

Deductible applies to Type II and III

Coinsurance

Preventive services (Type I) 100%

Basic Services (Type II) 80%

Major Services (Type III) 50%

Periodontics and Endodontics 80%

Annual maximum $1,000

Out of network usual and customary 90%

GAD\1-hda\ebpg\Clients\GA Pharmacy Association\GA Pharm Assoc NL attachment 2011_2


Titanium Level($2400 minimum pledge)T.M. Bridges, R.Ph.Michael E. Farmer, R.Ph.David B. Graves, R.Ph.Raymond G Hickman, R.Ph.Robert A. Ledbetter, R.Ph.Jeffrey L. Lurey, R.Ph.Marvin O. McCord, R.Ph.Scott Meeks, R.Ph.Judson Mullican, R.Ph.William A Murray, R.Ph.Mark Parris, Pharm.D.Jeff Sikes, R.Ph.Dean Stone, R.Ph., CDM

Platinum Level($1200 minimum pledge)Barry M. Bilbro, R.Ph.Robert Bowles, Jr., R.Ph., CDM, CftsJim R. BracewellLarry L. Braden, R.Ph.William G. Cagle, R.Ph.Hugh M. Chancy, R.Ph.Keith E. Chapman, R.Ph.Dale M. Coker, R.Ph., FIACPJohn Ashley Dukes, R.Ph.Patrick DunhamJack Dunn, Jr. R.Ph.Neal Florence, R.Ph.Andy FreemanMartin T. Grizzard, R.Ph.John Hansford, R.Ph.Robert M. Hatton, Pharm.D.Ted Hunt, R.Ph.Alan M. Jones, R.Ph.Ira Katz, R.Ph.Hal M. Kemp, Pharm.D.J. Thomas Lindsey, R.Ph.Brandall S. Lovvorn, Pharm.D.Eddie M. Madden, R.Ph.

Jonathan Marquess, Pharm.D., CDE, CPTPam Marquess, Pharm.D.Kenneth A. McCarthey, R.Ph.Drew Miller, R.Ph., CDMLaird Miller, R.Ph.Cynthia K. MoonJay Mosley, R.Ph.Allen Partridge, R.Ph.Houston Lee Rogers, Pharm.D., CDMTim Short, R.Ph.Christoher R. Thurmond, Pharm.D.Danny Toth, R.Ph.

Gold Level($600 minimum pledge)James Bartling, Pharm.D., ADC, CACIILarry Batten, R.Ph.Liza G. Chapman, Pharm.D.Mahlon Davidson, R.Ph., CDMJames Gordon Elrod, R.Ph.Kevin M. Florence, Pharm.D.Robert B. Moody, R.Ph.Sherri S. Moody, Pharm.D.Jeffrey Grady Richardson, R.Ph.Andy Rogers, R.Ph.Daniel C. Royal, Jr., R.Ph.Michael T. TarrantTommy Whitworth, R.Ph., CDM

Silver Level($300 minimum pledge)Renee D. Adamson, Pharm.D.Chandler M. Conner, Pharm.D.Terry Dunn, R.Ph.Marshall L. Frost, Pharm.D.James E. Jordan, Pharm.D.John KalvelageWillie O. Latch, R.Ph.W. Lon Lewis, R.Ph.Kalen Porter Manasco, Pharm.D.Earl Marbut, R.Ph.

Michael L. McGee, R.Ph.William J. McLeer, R.Ph.Albert B. Nichols, R.Ph.Richard Noell, R.Ph.Rose Pinkstaff, R.Ph.William Lee Prather, R.Ph.Sara W. Reece, Pharm.D., BC-ADM, CDEEdward Franklin Reynolds, R.Ph.Sukhmani Kaur Sarao, Pharm.D.David J. Simpson, R.Ph.James N. Thomas, R.Ph.Alex S, Tucker, Pharm.D.Flynn W. Warren, M.S., R.Ph.Walter Alan White, R.Ph.William T. Wolfe, R.Ph.

Bronze Level($150 minimum pledge)Monica M. Ali-Warren, R.Ph.Fred W. Barber, R.Ph.John R. Bowen, R.Ph.Ben Cravey, R.Ph.Michael A. Crooks, Pharm.D.William Crowley, R.Ph.Charles Alan Earnest, R.Ph.Randall W. Ellison, R.Ph.Mary Ashley Faulk, Pharm.D.Amanda R. Gaddy, R.Ph.Amy S. Galloway, R.Ph.Johnathan Wyndell Hamrick, Pharm.D.Ed KalvelageSteve D. KalvelageMarsha C. Kapiloff, R.Ph.Joshua D. Kinsey, Pharm.D.Brenton Lake, R.Ph.William E. Lee, R.Ph.Ashley Sherwood LondonCharles Robert Lott, R.Ph.Max A. Mason, R.Ph.Amanda McCall, Pharm.D.Susan W. McLeer, R.Ph.

Current Pharm PACMembers

If you made a gift or pledge to Pharm PAC in the last 12 months and your name does not appear above, please, contactAndy Freeman at [email protected] or 404-419-8118. Donations made to Pharm PAC are not considered charitabledonations and are not tax deductible.


Pharm PAC Contributors’ List ContinuedMary P. Meredith, R.Ph.Leslie Ernest Ponder, R.Ph.Kristy Lanford Pucylowski, Pharm.D.Leonard Franklin Reynolds, R.Ph.Richard Brian Smith, R.Ph.Charles Storey, III, R.Ph.Archie Thompson, Jr., R.Ph.Marion J. Wainright, R.Ph.Jackie WhiteCarrie-Anne WilsonSteve Wilson, Pharm.D.Sharon B. Zerillo, R.Ph.

Members(no minimum pledge)John J. Anderson, Sr., R.Ph.Mark T. Barnes, R.Ph.Walter A. Clark, R.Ph.Henry Cobb, III, R.Ph., CDMCarleton C. Crabill, R.Ph.Wendy A. Dorminey, Pharm.D., CDMDavid M. Eldridge, Pharm.D.James Fetterman, Jr., Pharm.D.Charles C. Gass, R.Ph.Christina GonzalezChristopher Gurley, Pharm.D.Ann R. Hansford, R.Ph.Joel Andrew Hill, R.Ph.Carey B. Jones, R.Ph.Susan M Kane, R.Ph.Emily KrausCarroll Mack Lowrey, R.Ph.Tracie Lunde, Pharm.D.Roy W. McClendon, R.Ph.Tom E. Menighan, R.Ph., MBA, ScD, FAPhAWilliams Moye, R.Ph.Darby R. Norman, R.Ph.Christoher Brown Painter, R.Ph.Steve Gordon Perry, R.Ph.Whitney B. Pickett, R.Ph.Michael Roland Reagan, R.Ph.James L. Riggs, R.Ph.Laurence Ryan, Pharm.D.Victor Serafy, R.Ph.James E. Stowe, R.Ph.James R. Stirckland, R.Ph.Celia M. Taylor, Pharm.D.Leonard E. Templeton, R.Ph.Heatwole C. Thomas, R.Ph.Erica Lynn Veasley, R.Ph.

William D. Whitaker, R.Ph.Elizabeth Williams, R.Ph.Jonathon Williams, Pharm.D.


M E M B E R S I N T H E N E W S

Kyle Burcher, a student pharmacist at TheUniversity of Georgia College of Pharmacy wasnamed Future Pharmacist of the Year Winner at

the second annual Next-Generation Pharmacist awards, anational event hosted at the John F. Kennedy PresidentialLibrary in Boston, Massachusetts on Aug. 29.

The Next-Generation Pharmacist program was created byParata Systems and Pharmacy Times to salute the futurevision of pharmacy, and those professionals who arehelping define that future by their innovative practices.

The Next-Generation Pharmacist awards honoredpharmacy professionals in 10 additional categories,selected from nearly 350 nominations received from 40states and Guam. The 2011 winners represent a truecross-section of the pharmacy industry – from large chainretailers and independent pharmacies, to institutionalfacilities and long-term care operations.

A panel of esteemed judges, chaired by Pharmacy Times’Editor-in-Chief, Fred M. Eckel, RPh, MS, evaluatedcandidates against the highest standards of the pharmacyprofession including customer service and patient care, aswell as how he or she relates to the specific category. Thejudges also reviewed how each nominee is contributing tothe pharmacy profession as a whole.

“All of the 2011 winners are more than deserving ofrecognition for their dedication and attentiveness topatient care,” said Eckel. “They truly embody the ideals ofthe Next-Generation Pharmacist program.”

Kyle Burcher, along with each category honoree is profiledon Pharmacy Times’ website, www.pharmacytimes.com,and spotlighted in the July and August issues of thepublication.

“Now in its second year, the Next-Generation Pharmacistawards are bringing well-deserved recognition to theoutstanding contributions of our dedicated pharmacy

professionals,” said Tom Rhoads, CEO of Parata Systems.“It was a perfect fit to honor these recipients in aprominent innovation hub like Boston.”

For information about the Next-Generation Pharmacistprogram, please visit www.nextgenerationpharmacist.comand www.pharmacytimes.com, or follow the program onFacebook and Twitter.

Athens Student Pharmacist, Kyle Burcher Honoredas Future Pharmacist of the Year

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G P h A M E M B E R B E N E F I T

Be a MentorAs a Mentor, you will share your knowledge with a pharmacy professional in a similar discipline in your region. In doingso, you will make an impact on the career path of an individual at the beginning of a career or at a crossroads.

Based upon your responses to the questionnaire that follows, we will match you up with a Mentee that fits your needs.

Mentor Criteria:

• Your address

• Your years of experience

• Your field of experience

To be a mentor got to GPhA and click “Be a Mentor, Find a Mentor” at the bottom of the Member Benefits Page.

Get a MentorThe “Be a Mentor, Find a Mentor” program is designed to help pharmacy professionals learn and grow in theirprofession, in addition to helping executives at any level increase their skill set by signing up for a Mentor. As a Mentee,you will be have an opportunity to gain knowledge and experience from pharmacy professionals that help guide yourcareer.

Based upon your responses to the questionnaire that follows, we will match you up with a Mentor that fits your needs.

Mentee Criteria:

• Your address

• Your years of experience

• Your current practice area

• Your desired practice area

To be a mentor or mentee go to www.gpha.org and click “Be a Mentor, Find a Mentor” at the bottom of the MemberBenefits Page.

New GPhA Member Benefit:Be a Mentor, Get a Mentor

M E M B E R N E W S

Things have been busy recently for the GovernmentAffairs team of GPhA. We have been meeting withelected officials to brief them on issues that are of

importance to pharmacy and what can be done in theState or Federal government.

In early August Congressman Paul Broun stopped byHodgson’s Pharmacy in Athens, to talk with GPhAmember and Region 10 President Chris Thurmond,Pharm. D. Chris made Congressman Broun aware offederal efforts we support to curb some of the abuses ofPBMs. More visits are being planned right now for everyGeorgia congressmen to visit Georgia pharmacies over thenext few months.

First Vice-President Pam Marquess recently testified at ahearing of the House Health and Human ServicesCommittee. She spoke about the problems of mail orderand specialty drugs. Legislators listened intently to hertestimony and asked how they could address the concernsshe raised.

We have also handed out campaign contributions thanksto the generous members of PharmPAC and began the

process of educating legislative leaders on our issues forthe 2012 legislative session. Recently LieutenantGovernor Casey Cagle stopped by the GPhA offices andthe executive committee also had a meeting with SpeakerDavid Ralston at the Capitol.

GPhA Legislative Update


By Andy FreemanGPhA Government Affairs Director

GPhA Executive Committee meet with Speaker David Ralston over issuesthat are of importance to GPhA members

GPhA 1st Vice President Pam Marquess poses at podium at the capitaol

Region Region 10 President Chris Thurmond welcomes Congressman PaulBroun to his pharmacy


President Jack Dunn and PharmPACChairman Eddie Madden meet withLieutenant Governor Casey Cagle

Circle the Level in which you would like to participate with a monthly contribution:

Titanium ($200/month) Platinum ($100/month) Gold ($50/month)

Silver ($25/month) Bronze ($12.50/month)or

If you wish to make a one time contribution write the amount you wish tocontribute here: ______________________________________

If you are making a monthly contribution you will be contacted for additional information to set up your monthlycontribution. If you are making a one time payment pleas mail your check in with your form

Join Pharm PAC Today!Pharm PAC is GPhA's Political Action Committee, providingthe resources for the association to lobby and advocate onbehalf pharmacy. GPhA leads the way in influencing pharmacy-related legislation in Georgia. There are two ways in which tobecome a member. Once you have completed this form pleasemail it to Pharm PAC, 50 Lenox Pointe, NE, Atlanta, GA30324.

Name: __________________________________________________Address: _________________________________________________Phone#: _________________________________________________Email Address: ____________________________________________

Individual Pharmacist Members

Amy C. Grimsley, Pharm.D., AtlantaRobert Haynes, Pharm.D., AtlantaCarmen Zayas-Aiken, Pharm.D.,

LawrencevilleJonathan Canterbury, Pharm.D., Kathleen

Erin Steinberg, Pharm.D., AtlantaMegan B. Jacobs, Pharm.D., Warner Robins

Eric Lee Mullins, Pharm.D., GainesvilleSamantha Yawn Berry, Pharm.D., Hoschton

Samuel W. Lokey, R.Ph., AshburnBryan Hazelton, R.Ph., Fayetteville

Robert George Probst, Pharm.D., Acworth

Pharmacy School StudentMembers

William Brown, DuluthLinda Im, Augusta

New Graduate PharmacistMembers

Daniel B. Purvis, Pharm.D., AdelAlecia R. Chatman, Pharm.D., AtlantaMegan C. Potts, Pharm.D., Oxford

Amanda R. Paisley, Pharm.D., AtlantaBrittany N. McLeod, Pharm.D., HawkinsvilleCheryl Neely Bursmith, Pharm.D., Waleska


G P h A M E M B E R N E W S

Welcome to GPhA!The following is a list of new members who have joined Georgia’s premier

professional pharmacy association! If you or someone you know would like to joinGPhA go to www.gpha.org and click “Join” under the GPhA logo.

Don’t be content to watch from the sidelines.

Pace Alliance offers you the chance to make your pharmacy a prosperous business, one that stays ahead of the game.

We know what it takes to survive. After all, we have been running ahead of the bulls for 22 years.

Plus, teaming up with Pace benefits Pharmacy all across Georgia.

So stop watching from the sidelines. Join the group of your peers who

want to control the destiny of their businesses in order to prosper.

This is your chance to take the bull by the horns.

Contact Pace Alliance today.

Run with the bulls.

1-888-200-0998 • www.pacealliance.com

Run with the bulls.BARBARA COLE

ATTORNEY AT LAW, LLC539 Green Street, NWGainesville, GA 30501

678-971-9088email [email protected]

All Aspects of Representation of Health CareProfessionalsLicensure MedicareAdministrative MedicaidCriminalBankruptcyCompliance

State Bar Health Law SectionFormer Chief Magistrate Judge

Don’t be content to watch from the sidelines.

Pace Alliance offers you the chance to make your pharmacy a prosperous business, one that stays ahead of the game.

We know what it takes to survive. After all, we have been running ahead of the bulls for 22 years.

Plus, teaming up with Pace benefits Pharmacy all across Georgia.

So stop watching from the sidelines. Join the group of your peers who

want to control the destiny of their businesses in order to prosper.

This is your chance to take the bull by the horns.

Contact Pace Alliance today.

Run with the bulls.

1-888-200-0998 • www.pacealliance.com

Run with the bulls.


Please save the date for our 137th AnnualConvention!Georgia Pharmacy Association137th Annual ConventionHilton Head Marriott Resort & SpaHilton Head Island, SCJuly 7-11, 2012

ARE YOU COMING?

LEARN TO IMPROVE YOUR BUSINE$$

1. 3 hour CE course on Pharmacy Law for Certified Technicians and Registered Technicians (pharmacists may also attend for CE credit) 2. Multiple programs on business management A. How to evaluate your Pharmacy B. How to generate additional revenue outside the prescription department C. Financial planning and retirement plans 3. Afternoon business meeting (includes an update from the PBM Task Force and the GPhA Governmental Affairs team) BRING YOUR STAFF AND NETWORK WITH YOUR COLLEAGUES

1. Come meet and network with fellow independent pharmacists 2. Bring your staff to network with other technicians and get CE 3. Join us for a continental breakfast and lunch 4. Visit with our AIP partners during breaks and lunch

SHOW YOUR SUPPORT ATTEND THIS

AIP Fall Meeting Sunday, October 23, 2011

Macon Marriott & Centreplex Macon, GA


As the owner of a community pharmacy you make important decisions daily regarding the

health of your patients and your business, the well being of your staff and a host of issues

that come from your involvement in the community. There comes a time when you are

faced with another important decision – how and when to sell the business you have

nurtured and grown.

This program is designed to help you with that process:

Financial planning and preparation for retirement

Normalizing Your Books

Sellers Checklist – The details of sale

Contracts and the legalities

Accounting Guidelines for Sale

The Bankers perspective - Valuation

Should I do this myself or rely on a broker – Tools for Decision

Ask the Experts Panel

All registrants receive a copy of “Selling A Pharmacy: A How To Guide” ($90 value!)

The first 50 registrants will receive a 25% discount on a listing on the NCPA site,

www.pharmacymatching.com, linking independent pharmacy owners preparing to sell,

existing owners looking to buy additional stores, and entrepreneurs searching for the right

opportunity to become a pharmacy owner.

Registration fee: NCPA members: $225 Non-Members: $325

Register today at http://www.ncpanet.org/index.php/events/2011-convention

For more information, contact the NCPA Convention Department at 1.800.544.7447

Selling a Pharmacy: The Community Pharmacist’s Roadmap toSuccessful Transition

Saturda , October 8, 1 6:30 .m. Se arate re istration fee

As the owner of a community pharmacy you make important decisions daily regarding the

health of your patients and your business, the well being of your staff and a host of issues

that come from your involvement in the community. There comes a time when you are

faced with another important decision – how and when to sell the business you have

nurtured and grown.

This program is designed to help you with that process:

Financial planning and preparation for retirement

Normalizing Your Books

Sellers Checklist – The details of sale

Contracts and the legalities

Accounting Guidelines for Sale

The Bankers perspective - Valuation

Should I do this myself or rely on a broker – Tools for Decision

Ask the Experts Panel

All registrants receive a copy of “Selling A Pharmacy: A How To Guide” ($90 value!)

The first 50 registrants will receive a 25% discount on a listing on the NCPA site,

www.pharmacymatching.com, linking independent pharmacy owners preparing to sell,

existing owners looking to buy additional stores, and entrepreneurs searching for the right

opportunity to become a pharmacy owner.

Registration fee: NCPA members: $225 Non-Members: $325

Register today at http://www.ncpanet.org/index.php/events/2011-convention

For more information, contact the NCPA Convention Department at 1.800.544.7447

Selling a Pharmacy: The Community Pharmacist’s Roadmap toSuccessful Transition

Saturda , October 8, 1 6:30 .m. Se arate re istration fee

Get Ready to Meet. Learn. Succeed. Registration is Now Open!Meeting friends, learning from experts, and succeeding back home with new ideas and knowledge.These are the top reasons pharmacists tell us why they attend NCPA's Annual Convention and TradeExposition. Join us October 8-12 this year in Nashville and we're sure you'll agree.

Welcome to NashvilleIn the heart of Nashville, the Gaylord Opryland Resort and Convention Center is located on the banksof the Cumberland River. Centrally located and close to everything, this resort won the 2010 Toast ofMusic City, The Tennessean award, and many more. You'll find everything you need inside theOpryland complex and nearby. Featured attractions right outside the complex include the Grand OleOpry (celebrating 86 years October 7-8) and the General Jackson Showboat cruise. Twelve miles fromGaylord Opryland, the Country Music Hall of Fame and Museum offers a visceral experience.Preserving the evolving history and traditions of country music to educating its audiences, thisinternational arts organization serves fans, students, scholars, and the music industry. The collection ismanaged from this location, as it travels the 8,000 museums nationwide. Elvis, Hank Williams, andGene Autry are among the many inductees. A must see!

Sneak Peek at Educational Programming•The PBM Landscape: A Critical Update •In-Depth PBM Briefing: Generics First and MAC Prices and Reimbursement •340B Opportunity Knocks—Should You Answer? •Opportunities in Diabetes: The Pharmacist's Guide to Insulin Pumps and Training Your Patients•Opportunities in Long-Term Care •A Critical Guide to Audit Survival for the Community Pharmacy •Closing the Image Gap: Merchandising With a Critical Difference •Mastering Your Message: Crystal Communication of Your Pharmacy's Value •A Lesson in 5-Star Leadership: 7 Principles to Fully Engage Your Pharmacy Staff


G P h A M E M B E R N E W S

Health Mart Healthy Living Tour celebratedcommunity pharmacists in Georgia and featurefree health screenings for all patients at the

pharmacies they visited on August 13, 2011.

The Health Mart Healthy Living Tour was on the road tocelebrate and recognize community pharmacists for theimportant role they play as trusted health care providers intheir communities—helping to educate and counselpeople managing diabetes.Aboard the Health MartHealthy Living Tour’s 40-footmobile screening unit, tour staffwill offer FREE healthscreenings that include bloodpressure, cholesterol, bloodglucose and hemoglobin A1Ctests.

Co-sponsored by BayerDiabetes Care and NovoNordisk, the Health MartHealthy Living Tour is aimingto raise awareness of the

growing diabetes epidemic—the disease affectsapproximately 25.8 million Americans. A 2009 report bythe Georgia Department of Community Health estimatesthat one in seven Georgia adults are living with diabetes.

Tour screeners will identify people at risk and encouragethose with diabetes to manage their condition with helpfrom Health Mart pharmacists, who advise on ways toreduce medication spending and better understand drug

regimens and complications.

For Health Mart pharmacists,the events are indicative ofHealth Mart's effort to helpindependent pharmacies attractnew customers and maximizethe value of existing customersthrough marketing support.

Health Mart Healthy Living Bus Visits East MariettaPharmacy

The tour visited East Marietta Drugs Health MartPharmacy, Mableton Health Mart Pharmacy, Moye's HealthMart Pharmacy, and Chip's Health Mart Pharmacy.


Pharmacy Quality Commitment® (PQC) is what you need!

PQC is a continuous quality improvement (CQI) program that supports you inresponding to issues with provider network contracts, Medicare Part D requirements

under federal law, and mandates for CQI programs under state law.

When PQC is implemented in your pharmacy, you will immediately improve your abilityto assure quality and increase patient safety. Do you have a CQI program in place?

Call toll free (866) 365-7472 or go to www.pqc.net for more information.

PQC is brought to you by your state pharmacy association.

“We implemented PQC in our pharmacy fourmonths ago – it was easy. I have noticed an

enhanced effort from the staff to work together to avoid and eliminate quality-related events.”


Thomas A. Gossel, R.Ph., Ph.D., Professor Emeritus, Ohio Northern University, Ada, Ohio andJ. Richard Wuest, R.Ph., PharmD, Professor Emeritus, University of Cincinnati, Cincinnati, Ohio

continuing educat ion for pharmacists

New Drugs: Halaven, Natroba and ViibrydVolume XXIX, No. 7

Dr. Thomas A. Gossel and Dr. J. Richard -

ships to disclose.

Goal. The goal of this lesson is to provide information on eribulin (Halaven™), spinosad (Natroba™), and vilazodone (Viibryd™).

Objectives. At the conclusion of this lesson, successful participants should be able to:

1. identify the new drugs by generic name, trade name and chemical name when relevant;

2. select the indication(s), pharmacologic action(s) and clinical applications for each drug;

3. recognize important thera-peutic uses for the drugs and their

-gies; and

4. demonstrate an understand-ing of adverse effects and toxicity,

and patient counseling information for these drugs.

Drugs discussed within this les-son are new molecular entity compounds (Table 1) indicated for treatment of a variety of patholo-gies. The lesson provides an intro-duction to the new drugs and is not intended to extend beyond a brief overview of the topic. The reader is, therefore, urged to consult each product’s Prescribing Informa-

Medication Guide, and other references for detailed descriptions including outcomes

of comparative clinical trials with similar drugs.

Halaven (Eribulin Mesylate) Eribulin mesylate is a non-taxane

synthetic analogue of halichondrin B, isolated from the rare marine sponge Halichondria okadai, and subsequently from several un-related sponges belonging to the

Axinella family. Early experiments revealed potent anticancer activity in cell-based and animal models, but further work was limited by non-availability of the natural product. The U.S. National Can-cer Institute provided funding to trawl-harvest one metric ton of the deepwater sponge that yielded 310 mg of halichondrin B to continue drug development. At approxi-mately the same time, a synthetic chemistry laboratory succeeded in the total synthesis of halichondrin B following a process involving 90 chemical steps.

Indications and Use. Ha-laven (HAL-ih-ven) is indicated for treatment of patients with metastatic breast cancer who have previously received at least two chemotherapeutic regimens for the treatment of metastatic disease.

Table 1 Selected new drugs in 2011

Generic Applicant/ Indication Dosage Form(Proprietary Sponsor/ Name) Distributor

Eribulin Eisai Inc Microtubule inhibitor Vials: 1 mg/2 mL (Halaven) for treatment of meta- for IV injection static breast cancer

Spinosad ParaPRO and/ Pediculocide for treat- Suspension: 0.9% (Natroba) or Pernix Thera- ment of head lice for topical

peutics, Inc infestation application

Vilazodone Forest Pharmaceu- Antidepressant for Tablets:10, 20, (Viibryd) ticals LLC treatment of major 40 mg depressive disorder


Prior therapy should have included an anthracycline (Adriamycin, and others) and a taxane (Taxol, and others) in either the adjuvant or metastatic setting.

Metastatic Breast Cancer. Breast cancer is the most com-monly diagnosed cancer and the second leading cause of cancer-re-lated death in women in the United States. It is estimated that 207,090 women were diagnosed with breast cancer, and 39,840 women in this country died of breast cancer in 2010.

Approximately 20 percent of patients with breast cancer will

years of their initial diagnosis. Despite recent improvements in the treatment of metastatic breast cancer, there is still no absolute standard of care for patients who have experienced failure of their initial therapy. Thus, the progno-sis for patients with metastatic breast cancer remains poor, with

26 percent in the United States. Death from breast cancer is usually a result of chemotherapy-resistant metastatic disease. Many patients become refractory to the standard agents and therefore fail to re-spond. Moreover, because anthra-cyclines and taxanes are increas-ingly used as adjuvant therapy, the number of patients previously exposed to these agents when they develop metastatic disease is in-creasing.

The term metastatic describes a cancer that has spread from its original tumor site to distant organs. Metastatic breast cancer is the most advanced stage (Stage IV) of breast cancer. Cancer cells have spread beyond the breast and axillary (underarm) lymph nodes to other areas of the body where they continue to grow and multiply, thereby competing with healthy cells in these areas. Breast can-cer has the potential to spread to almost any region of the body; the most common region being bone, followed by lung and liver. Treat-ment of metastatic breast cancer generally focuses on relieving a

woman’s symptoms and extending her life.

A primary diagnosis of Stage IV breast cancer may indicate rapid disease progression or that the cancer was present but not de-tected in the breast for some time. To help detect breast cancer in ear-lier stages when it is most curable, women should follow the guidelines for early detection established by the American Cancer Society, which include breast self-exami-nations, and annual clinical breast exams and mammography (the lat-ter beginning at age 40 years).

Mechanism of Action. In highly complex cells containing a nucleus (eukaryotic cells), micro-tubules are crucial for maintaining cell shape and function. They are also involved in movement of chro-mosomes during cellular division and the subsequent segregation of chromosomes into the two daughter cells. The crucial role for microtu-bules in cell division makes them an extremely suitable target for the development of chemotherapeutic drugs against the rapidly dividing tumor cells.

Eribulin inhibits microtubule dynamics via a novel mechanism of action, which is thought to involve binding to a unique site on tubulin (a protein component of micro-tubules). This blocks the growth phase of microtubules without affecting the shortening phase, and sequesters tubulin into non-productive aggregates. The drug causes irreversible mitotic block, which leads to cell cycle arrest, and ultimately, apoptosis (natural, or programmed death of normal cells) following prolonged mitotic blockage. Cancer cells are deadly because they are immortal, that is, they do not undergo apoptosis. They eventually kill the patient by depriving normal cells of their nutrition and space. Preclinical studies demonstrated eribulin activity in cell lines that are taxane resistant as a result of beta-tubulin mutations. In one study involving 508 patients who received the test drug and 254 the control, median survival with the test drug was

13.1 months versus 10.6 months for the control treatment.

Adverse Effects. The most common adverse reactions (inci-

-penia, anemia, asthenia (loss of strength)/fatigue, alopecia, pe-ripheral neuropathy, nausea and constipation. The most common serious adverse reactions were febrile neutropenia (4 percent) and neutropenia (2 percent). The most common adverse reaction resulting in discontinuation of the drug was peripheral neuropathy (5 percent).

Warnings, Precautions and Contraindications. The following warnings and precautions are listed:

Neutropenia. Peripheral blood cell counts should be monitored and the dose adjusted as appropri-ate.

Peripheral neuropathy. Patients should be monitored for signs of neuropathy ( numbness, tingling and burning sensation in the hands and feet) and managed with dose delay and adjustment.

Use in pregnancy. Fetal harm can occur when Halaven is admin-istered to a pregnant woman.

QT prolongation. Patients should be monitored for prolonged QT intervals in the presence of con-gestive heart failure, bradyarrhyth-mias, drugs known to prolong the QT interval, and electrolyte abnor-malities. The new drug should be avoided in patients with congenital long QT syndrome.

No contraindications are listed.

Drug Interactions. Eribulin does not inhibit CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1 or CYP3A4 enzymes, so is not expect-ed to alter the plasma concentra-tion of drugs that are substrates of these enzymes. Likewise, no inter-action is expected with permeabil-ity glycoprotein (P-gp) inhibitors.

Dosage and Availability. The recommended dose in patients without hepatic or renal impair-ment is 1.4 mg/m2 administered

-utes on Days 1 and 8 of a 21-day cycle. Doses should be reduced in


hepatic or renal impairment. The drug is supplied in single-

use vials containing 1 mg/2 mL. Vials should be stored at 25° C (77° F), with excursions permitted to 15° to 30° C (59° to 86° F).

Patient Information. Ex-cerpts of FDA-approved Patient Information are shown in Table 2.

Natroba (Spinosad)Spinosad is a relatively new insec-ticide derived from fermentation of a soil actinomycete bacterium, Saccharopolyspora spinosa, discov-ered in 1982 from soil in an aban-doned rum distillery. Spinosad is a mixture of spinosyn A and spinosyn D in a ratio of approximately 5 to 1 (spinosyn A to spinosyn D). The in-

secticide has been used on outdoor ornamentals, lawns, vegetables and fruit trees to control most insect pests. Spinosad is not acutely toxic to mammals and is nonhazardous by oral, dermal, ocular, and inhala-tional routes. In long-term mam-malian studies, it did not cause tumors, neurotoxicity, embryotoxic-ity, or teratogenicity.

Indications and Use. Natro-ba (Nah-TRO-buh) is a pediculocide indicated for topical treatment of head lice infestations in patients four years of age and older. Safety in pediatric patients below the age of four years has not been estab-lished. Caution should be exercised when the drug is used on a nurs-ing mother. The product should be used in the context of an overall lice management program that includes washing or dry cleaning all recently worn clothing, towels and bed linens, and washing all personal care items such as hair brushes and combs. It is an effec-tive, easy-to-use product, resolv-ing most head lice infestations in about 10 minutes with just one application and no nit combing. If live head lice are seen one week

-tion, Natroba should be used again.

remove dead lice and nits from the hair and scalp, but combing is usu-ally not required.

Head Lice Infestation. Head lice are ectoparasitic (live on the surface of the host’s body) insects (Pediculus humanus capitis) that live in the hair of the scalp and neck. They are not usually found elsewhere on the body. Head lice infestation is common in the U.S. among children three to 12 years of age. The insect feeds on the blood of the host by piercing the skin of the scalp. A typical infestation may involve around 30 insects, but the range is wide.

The full-grown insect is dark and small, 2 to 3 mm in length, about the size of a sesame seed. Lice cling to hair shafts with their claws. After mating, the female lays about six to eight eggs a day until death at around 30 days.

The eggs are yellow-white and are attached onto the hair shaft close to the scalp by a secretion from an adult louse, most often behind the ears and back of the neck since the skin there is a rich source of blood. The eggs typically take around seven to 10 days to hatch, with the empty egg shell (“nit”) remaining attached to the hair. Development of the newly hatched louse (nymph) into an adult takes six to 14 days.

Head lice can neither hop nor

that combing dry hair can build

physically eject an adult louse from an infested scalp. Transmission in most cases occurs by direct contact with the head of an infested indi-vidual; however, indirect spread through contact with personal belongings (e.g., combs, brushes, hats) of an infested individual is much less likely but may occur rarely. Lice removed with regular combs are likely to be injured or dead. A healthy louse is not likely to leave a healthy head unless there is a heavy infestation.

Head lice infestation rarely leads to complications other than itching. Rarely, secondary infec-tion of the scalp, including impe-tigo, may occur due to scratching the area. Some people experience a great deal of embarrassment, anxiety and distress due to their, or their children’s, infestation.

Direct costs for various treat-ments and clinic visits are consid-erable. Indirect costs associated with time spent by school nurses and administrators, absenteeism from school and/or work, and lost wages and productivity of caregiv-ers are also considerable as well. The annual combined direct and indirect costs of head lice in the United States is estimated to be $1 billion.

One problem with insecticide lotions is development of resistance among lice, reported to be up to 82 percent for permethrin and 64 per-cent for malathion. These products may also be unacceptable to some people because of the risk of po-tential unwanted effects (e.g., skin

Table 2Counseling points for

Halaven (eribulin)*

This medicine is used to treat breast cancer that has spread to other parts of the body.

you start taking Halaven and each

-if you have liver, kidney or heart problems. -if you have any signs of infection such as: fever (above 100.5° F), chills, cough, burning or pain when you urinate. -if you have numbness, tingling or burning in your hands or feet. -about all other prescription and nonprescription (OTC) medicines, vi-tamin/mineral supplements, natural products and herbal remedies you are taking.

-tant with this medicine. Be sure to make all testing appointments.

become or intend to become pregnant, or breastfeed a child.

vein, in cycles of treatment, with the cycle lasting 21 days. You will receive an injection once a week for 2 weeks in a row with no injection the third week of each treatment cycle.

*Excerpted from the FDA-approved Patient Information.


hepatic or renal impairment. The drug is supplied in single-

use vials containing 1 mg/2 mL. Vials should be stored at 25° C (77° F), with excursions permitted to 15° to 30° C (59° to 86° F).


Natroba (Spinosad)Spinosad is a relatively new insec-ticide derived from fermentation of a soil actinomycete bacterium, Saccharopolyspora spinosa, discov-ered in 1982 from soil in an aban-doned rum distillery. Spinosad is a mixture of spinosyn A and spinosyn D in a ratio of approximately 5 to 1 (spinosyn A to spinosyn D). The in-

secticide has been used on outdoor ornamentals, lawns, vegetables and fruit trees to control most insect pests. Spinosad is not acutely toxic to mammals and is nonhazardous by oral, dermal, ocular, and inhala-tional routes. In long-term mam-malian studies, it did not cause tumors, neurotoxicity, embryotoxic-ity, or teratogenicity.

Indications and Use. Natro-ba (Nah-TRO-buh) is a pediculocide indicated for topical treatment of head lice infestations in patients four years of age and older. Safety in pediatric patients below the age of four years has not been estab-lished. Caution should be exercised when the drug is used on a nurs-ing mother. The product should be used in the context of an overall lice management program that includes washing or dry cleaning all recently worn clothing, towels and bed linens, and washing all personal care items such as hair brushes and combs. It is an effec-tive, easy-to-use product, resolv-ing most head lice infestations in about 10 minutes with just one application and no nit combing. If live head lice are seen one week

-tion, Natroba should be used again.

remove dead lice and nits from the hair and scalp, but combing is usu-ally not required.

Head Lice Infestation. Head lice are ectoparasitic (live on the surface of the host’s body) insects (Pediculus humanus capitis) that live in the hair of the scalp and neck. They are not usually found elsewhere on the body. Head lice infestation is common in the U.S. among children three to 12 years of age. The insect feeds on the blood of the host by piercing the skin of the scalp. A typical infestation may involve around 30 insects, but the range is wide.

The full-grown insect is dark and small, 2 to 3 mm in length, about the size of a sesame seed. Lice cling to hair shafts with their claws. After mating, the female lays about six to eight eggs a day until death at around 30 days.

The eggs are yellow-white and are attached onto the hair shaft close to the scalp by a secretion from an adult louse, most often behind the ears and back of the neck since the skin there is a rich source of blood. The eggs typically take around seven to 10 days to hatch, with the empty egg shell (“nit”) remaining attached to the hair. Development of the newly hatched louse (nymph) into an adult takes six to 14 days.

Head lice can neither hop nor

that combing dry hair can build

physically eject an adult louse from an infested scalp. Transmission in most cases occurs by direct contact with the head of an infested indi-vidual; however, indirect spread through contact with personal belongings (e.g., combs, brushes, hats) of an infested individual is much less likely but may occur rarely. Lice removed with regular combs are likely to be injured or dead. A healthy louse is not likely to leave a healthy head unless there is a heavy infestation.

Head lice infestation rarely leads to complications other than itching. Rarely, secondary infec-tion of the scalp, including impe-tigo, may occur due to scratching the area. Some people experience a great deal of embarrassment, anxiety and distress due to their, or their children’s, infestation.

Direct costs for various treat-ments and clinic visits are consid-erable. Indirect costs associated with time spent by school nurses and administrators, absenteeism from school and/or work, and lost wages and productivity of caregiv-ers are also considerable as well. The annual combined direct and indirect costs of head lice in the United States is estimated to be $1 billion.

One problem with insecticide lotions is development of resistance among lice, reported to be up to 82 percent for permethrin and 64 per-cent for malathion. These products may also be unacceptable to some people because of the risk of po-tential unwanted effects (e.g., skin

Table 2Counseling points for

Halaven (eribulin)*

This medicine is used to treat breast cancer that has spread to other parts of the body.

you start taking Halaven and each

-if you have liver, kidney or heart problems. -if you have any signs of infection such as: fever (above 100.5° F), chills, cough, burning or pain when you urinate. -if you have numbness, tingling or burning in your hands or feet. -about all other prescription and nonprescription (OTC) medicines, vi-tamin/mineral supplements, natural products and herbal remedies you are taking.

-tant with this medicine. Be sure to make all testing appointments.

become or intend to become pregnant, or breastfeed a child.

vein, in cycles of treatment, with the cycle lasting 21 days. You will receive an injection once a week for 2 weeks in a row with no injection the third week of each treatment cycle.


irritation, exacerbation of asthma).Mechanism of Action. The

mode of insecticidal action is as-sociated with stimulation of the insect’s nervous system. Spinosad alters the function of nicotinic acid and GABA-gated ion chan-nels in a manner consistent with the observed neuronal excitation. Spinosad does not interact with known binding sites for other nico-tinic or GABAergic insecticides. These data indicate that spinosad acts through a unique insecticidal mechanism. After a period of hy-perexcitation, lice become para-lyzed and die within one to two days after ingesting the substance.

Adverse Effects. The most common adverse events (>1 per-cent) in premarketing clinical trials were application site erythema (redness) and ocular erythema. Spinosad is not systemically ab-sorbed; however, its benzyl alcohol content may be.

Warnings, Precautions and

Contraindications. The following warnings and precautions are listed:

Benzyl alcohol toxicity. Na-troba should not be used on infants below the age of 6 months be-cause of its potential for increased systemic absorption with serious adverse reactions and death.

No contraindications or drug interactions are listed for the product.

Dosage and Availability. The product should be applied to the dry scalp and hair using only the amount needed to cover the scalp and hair, up to 120 mL (one bottle). It should be rinsed off with warm water after 10 minutes; treatment may be repeated seven days after

seen. The product should not be taken orally or be used on areas of the body other than the scalp or hair.

Natroba is supplied as a topical suspension containing 9 mg spinosad per gram. The product should be stored at 25° C (77° F), with excursions to 15° to 30° C (59° to 86° F) permitted.


Viibryd (Vilazodone)Limitations of current antidepres-sant medications include exten-sive inter-individual variability in response, delayed onset of effect,

safety concerns and intolerable side effects. Intolerable adverse events are the primary reason for premature discontinuation of antidepressant medication in one-third of patients, especially early in treatment. The results from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study established that different antidepressants exhibit similar

population of depressed patients, -

ferences in tolerability. This study also demonstrated that augmenta-tion with a second drug is a useful adjunct to treatment. Thus, there

is great need today for alternative treatment regimens that provide improved predictability of response and better tolerability, includ-ing less sexual dysfunction, than existing agents. Drugs active at the 5-HT1A receptor, such as vilazodone to be discussed subsequently, are approved for treatment of anxiety, have been shown to exert antide-pressant activity, and may be use-ful for augmenting the response to other antidepressants. On the basis of its mechanism of action, vila-zodone has the potential to provide a more rapid antidepressant effect.

characterized by good tolerability and lower risk of adverse events.

Indications and Use. Viibryd

of antidepressants, the indolal-kylamines, indicated for treat-ment of adult patients with major depressive disorder (MDD), also

was established in two eight-week, placebo-controlled trials in adult patients with MDD.

Major Depressive Disorder. Depression is a leading cause of disability, lost productivity, and health care expenditure. MDD is a chronic, often debilitating illness that contributes to functional im-pairment and increased morbidity and mortality. It is characterized by symptoms that interfere with an individual’s ability to work, sleep, study, eat and enjoy once-pleasur-able activities. Episodes of major depression often recur throughout a person’s lifetime, although some may experience only a single occur-rence.

The National Comorbidity Survey Replication (2003) estab-lished that the 12-month preva-lence of MDD in the United States was 6.7 percent, with 80 percent of respondents categorized as having moderate or severe depression. The incidence reported in another study for older adults reached 9 percent. Despite the burden of MDD, many patients remain untreated or are inadequately treated following diagnosis. In fact, there is little evi-dence available to guide the initial

Table 3 Counseling points for Natroba (spinosad)*

This medicine is used to get rid of lice in scalp hair of children and adults.

you start using Natroba.

skin conditions or allergies.

become or intend to become pregnant or are breastfeeding a child.

applying Natroba.

use.

the Patient Information carefully.

get in the eyes.

room temperature.

expiration date on the label. Properly discard unused medicine.



choice of therapy, and discontinu-ation and switching prescriptions are common.

Mechanism of Action. The mechanism of antidepressant effect of vilazodone is not fully under-stood, but is believed to be related to its enhancement of central sero-tonergic activity through selective inhibition of serotonin reuptake. Vilazodone is also a partial agonist at serotonergic 5-HT1A receptors; however, the net result of this ac-tion on serotonergic transmission and its role in the drug’s antide-pressant action are unknown.

Adverse Effects. The most common adverse reactions (inci-

the rate of placebo) are: diarrhea, nausea, vomiting and insomnia. In premarketing clinical trials, there was no single adverse reaction leading to discontinuation in >1 percent of the patients.

Warnings, Precautions and Contraindications. The follow-ings warnings and precautions are listed:

Clinical worsening/suicide risk. Patients should be monitored for clinical worsening and suicidal thinking or behavior (suicidal-ity), especially during the initial few months of therapy or at times of dose changes. It is not known whether the suicidality risk ex-tends to longer-term use, i.e., beyond several months. However, there is substantial evidence from placebo-controlled maintenance studies in adults with depression that the use of antidepressants can delay the recurrence of depression.

Serotonin syndrome or neuro-leptic malignant syndrome (NMS)-like reactions. If NMS occurs with treatment, the drug should be discontinued and supportive treat-ment initiated.

Seizures. Seizures can occur with treatment, so the new drug should be used with caution in pa-tients with a seizure disorder.

Abnormal bleeding. Treat-ment can increase the risk of bleed-ing. Caution is advised when used in association with nonsteroidal

including aspirin, or other drugs that affect coagulation.

Activation of mania/hypo-mania. Activation can occur with treatment. Patients should be screened for bipolar disorder.

Discontinuation of Viibryd therapy. A gradual reduction in dose is recommended rather than an abrupt cessation.

Hyponatremia. This can occur in association with the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

The new drug is contraindi-cated in patients taking monoam-ine oxidase inhibitors (MAOIs), so it should not be used concurrently with an MAOI or within 14 days of stopping or starting an MAOI.

Drug Interactions. Viibryd should not be used concomitantly or within 14 days of stopping or starting an MAOI. Based on its potential for serotonin toxicity, also known as the serotonin syndrome, caution is advised when the new drug is taken concurrently with other drugs that may affect the serotonergic neurotransmitter sys-tem (e.g., MAOIs, SSRIs, SNRIs, triptans, buspirone, tramadol and tryptophan products, etc.) .

The Viibryd dose should be reduced to 20 mg when co-adminis-tered with strong CYP3A4 inhibi-tors. Concomitant use of Viibryd with CYP3A4 inducers can result in inadequate drug concentrations and may diminish effectiveness. The effect of CYP3A4 inducers on systemic exposure to vilazodone has not been evaluated.

The risk of using Viibryd in combination with other CNS-active drugs has not been systematically evaluated. Consequently, Viibryd should be used with caution in combination with other CNS-active drugs. Since the new drug is highly bound to plasma protein (96 to 99 percent), its administration with other drugs that are highly protein bound may cause increased free concentrations of the other drug.

Dosage and Availability. The recommended dose is 40 mg once daily. The drug should be titrated to this dose starting with initial ad-

ministration of 10 mg once daily for seven days, followed by 20 mg once daily for an additional seven days, and then increased to 40 mg once daily. The tablets should be taken with food. Administration without

Table 4Counseling points for Viibryd (vilazodone)*

This medicine is used to treat pa-tients with major depressive dis-order.

Medication Guide before you start taking Viibryd and each

-if you are taking an MAO inhibi-tor (medicine for depression or Par-kinsonism). The Medication Guide that comes with Viibryd contains a list of other medicines that should not be taken with it. -if you have any thoughts of com-mitting suicide or manic episodes. -if you develop agitation, halluci-nations, coma or other changes in mental status; coordination prob-lems, fast heartbeat; sweating or fever; nausea, vomiting or diarrhea;muscle stiffness or tightness. -if you have seizures or convul-sions. -if you have any side effect that bothers you or that does not go away. -about all other prescription and nonprescription (OTC) medicines, vi-tamin/mineral supplements, natural products and herbal remedies you are taking.

become or intend to become pregnant or breastfeed a child.

-ous machinery until you know how Viibryd affects you. Alcoholic bever-ages and other sedating medicines can increase the drowsiness caused by Viibryd.

container or blister pack at room temperature. Do not use after the expiration date on the label. Properly discard unused medicine.

*Excerpted from the FDA-approved Medication Guide.


Program 0129-0000-11-007-H01-PRelease date: 7-15-11

Expiration date: 7-15-14CE Hours: 1.5 (0.15 CEU)

The authors, the Ohio Pharmacists Founda-tion and the Ohio Pharmacists Association disclaim any liability to you or your patients resulting from reliance solely upon the infor-mation contained herein. Bibliography for additional reading and inquiry is available upon request.

This lesson is a knowledge-based CE activity and is targeted to pharmacists in all practice settings.

The Ohio Pharmacists Foundation Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

food can result in inadequate drug concentrations and may diminish

-ing treatment, the dose should be

has not been systematically studied beyond eight weeks. It is generally agreed that acute episodes of MDD require several months or longer of sustained pharmacologic therapy. Patients should be reassessed periodically to determine the need for maintenance treatment and the appropriate dose for treatment.

Viibryd is available in tablets containing 10 mg, 20 mg and 40 mg of vilazodone. It is also available in a starter blister pack containing 30 tablets, seven each 10 and 20 mg, and 16 tablets 40 mg.

Patient Information. Ex-cerpts from the FDA-approved Medication Guide are shown in Table 4.

Overview and Summary The new drugs discussed in this lesson were approved to treat a wide variety of conditions. They should offer renewed hope for the patients they are intended to treat.

The Georgia Pharmacy Journal September 2011 30

The Georgia Pharmacy JournalEditor: Jim Bracewell

[email protected]

Managing Editor & Designer: Kelly [email protected]

The Georgia Pharmacy Journal® (GPJ) is the official publication of theGeorgia Pharmacy Association, Inc. (GPhA). Copyright © 2011, GeorgiaPharmacy Association, Inc. All rights reserved. No part of this publicationmay be reproduced or transmitted in any form or by any means, electronicor mechanical including by photocopy, recording or information storageretrieval systems, without prior written permission from the publisher andmanaging editor.

All views expressed in bylined articles are the opinions of the author anddo not necessarily express the views or policies of the editors, officers ormembers of the Georgia Pharmacy Association.

ARTICLES AND ARTWORKThose who are interested in writing for this publication are encouraged torequest the official GPJ Guidelines for Writers. Artists or photographerswishing to submit artwork for use on the cover should call, write or e-mailthe editorial offices as listed above.

SUBSCRIPTIONS AND CHANGE OF ADDRESSThe Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is distributed asa regular membership service, paid for through allocation of membershipdues. Subscription rate for non-members is $50.00 per year domestic and$10.00 per single copy; international rates $65.00 per year and $20.00single copy. Subscriptions are not available for non-GPhA memberpharmacists licensed and practicing in Georgia.

The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is publishedmonthly by the GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324.Periodicals postage paid at Atlanta, GA and additional offices.POSTMASTER: Send address changes to The Georgia PharmacyJournal®, 50 Lenox Pointe, NE, Atlanta, GA 30324.

ADVERTISINGAdvertising copy deadline and rates are available at www.gpha.org uponrequest. All advertising and production orders should be sent to the GPhAheadquarters as listed above.

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Print: Star Printing - 770.974.6195

2011 - 2012 GPhA BOARD OF DIRECTORS

Name PositionDale Coker Chairman of the BoardJack Dunn PresidentRobert Hatton President-ElectPam Marquess First Vice PresidentBobby Moody Second Vice PresidentRobert Bowles State At LargeHugh Chancy State At LargeKeith Herist State At LargeEddie Madden State At LargeJonathan Marquess State At LargeTim Short State At LargeRichard Smith State At LargeChristine Somers 1st Region PresidentFred Sharpe 2nd Region PresidentRenee Adamson 3rd Region PresidentAmanda Gaddy 4th Region PresidentJulie Bierster 5th Region PresidentAshley Faulk 6th Region PresidentAmanda McCall 7th Region PresidentLarry Batten 8th Region PresidentKristy Pucylowski 9th Region President Christopher Thurmond 10th Region PresidentAshley London 11th Region President Ken Eiland 12th Region PresidentThomas Jeter ACP ChairmanJosh Kinsey AEP RepresentativeSonny Rader AHP ChairmanIra Katz AIP ChairmanGail Lowney APT ChairmanChristina Gonzalez ASA ChairmanJohn T. Sherrer Foundation ChairmanMichael Farmer Insurance Trust ChairmanSteve Wilson Georgia State Board of Pharmacy

RepresentativePatricia Knowles Georgia Society of Health Systems

PharmacistsAmy Grimsley Mercer Faculty RepresentativeRusty Fetterman South Faculty RepresentativeSukh Sarao UGA Faculty Rep.Negin Sovaidi ASP Mercer University Rep.Annie Tran ASP South University Rep.David Bray ASP UGA Rep.Jim Bracewell Executive Vice President

31The Georgia Pharmacy Journal September 201131 july 2011

continuing educat ion quiz New Drugs: Halaven, Natroba and Viibryd

Program 0129-0000-11-007-H01-P0.15 CEUPlease print.

Name________________________________________________

Address_____________________________________________

City, State, Zip______________________________________

Email_______________________________________________

Return quiz and payment (check or money order) to Correspondence Course, OPA,

2674 Federated Blvd, Columbus, OH 43235-4990

To receive CE credit, your quiz must be postmarked no later than July 15, 2014. A passing grade of 80% must be attained. CE state-ments of credit are mailed February, April, June, August, October, and December. Send inquiries to [email protected].

your answer.1. [a] [b] [c] [d] 6. [a] [b] [c] [d] 11. [a] [b] [c] [d]2. [a] [b] [c] 7. [a] [b] [c] [d] 12. [a] [b] [c] [d] 3. [a] [b] [c] [d] 8. [a] [b] [c] 13. [a] [b] [c] [d] 4. [a] [b] [c] [d] 9. [a] [b] [c] 14. [a] [b] 5. [a] [b] [c] 10. [a] [b] [c] [d] 15. [a] [b] [c] [d]

I am enclosing $5 for this month’s quiz made payable to: Ohio Pharmacists Association.

2. Did it meet each of its objectives? yes no If no, list any unmet_______________________________3. Was the content balanced and without commercial bias? yes no4. Did the program meet your educational/practice needs? yes no5. How long did it take you to read this lesson and complete the quiz? ________________ 6. Comments/future topics welcome.

1. Eribulin is isolated from a: a. marine sponge. c. Yerba species. b. medicinal plant. d. Yew tree. 2. The most common region for breast cancer to spread is the: a. lung. c. bone. b. liver.

3. The guidelines of the American Cancer Society sug-gest that yearly mammography begin at age: a. 35 years. c. 45 years. b. 40 years. d. 50 years. 4. In eukaryotic cells, microtubules are crucial for main-taining: a. synthesis of lipoproteins. b. respiration and secretion. c. macrophage differentiation. d. cell shape and function.

5. Numbness, tingling and burning sensation in the hands and feet are signs of: a. allergic reaction. c. peripheral neuropathy. b. myocardial infarction.

6. Spinosad was discovered in the soil of an abandoned: a. coal mine. c. gravel pit. b. soybean farm. d. rum distillery.

7. Natroba resolves most head lice infestations in about: a. 10 minutes. c. 60 minutes. b. 30 minutes. d. 90 minutes.

8. In a head lice infestation, the term nit refers to the: a. newly hatched louse. c. engorged adult. b. empty egg shell.

9. Which of the following products should be shaken well right before use? a. Halaven c. Viibryd b. Natroba

10. The action of spinosad brings paralysis and death to lice after a period of:

b. hypersensitivity. d. hyperhydrosis. 11. Vilazodone is active at which of the following sub-types of 5-HT receptor? a. 1A c. 1C b. 1B d. 1D

12. Drugs that are agonists to 5-HT receptors are: a. adrenergic. c. dopaminergic. b. cholinergic. d. serotonergic.

13. The most common adverse effects of Viibryd include all of the following EXCEPT: a. diarrhea. c. nausea. b. drowsiness. d. vomiting.

14. Viibryd should be taken: a. with food. b. on an empty stomach.

15. The recommended daily dose for Viibryd is: a. 15 mg. c. 40 mg. b. 25 mg. d. 50 mg.

Introducing the GPhA/UBS Wealth Management Program

UBS has agreed to provide all members of the Georgia Pharmacy Association with exclusive access

been recognized as one of Barron’sGroup is the endorsed wealth management provider for the Georgia Dental Association and also

Harris Gignilliat, CRPS®

Vice President–Investments

ubs.com/team/wile

exclusively for GPhA members at a group discount rate

discount rate

income replacement system

– Lending capabilities with competitive interest rates

Chartered Retirement Plans SpecialistSM and CRPS® are registered service marks of the College for Financial Planning®.

UBS Financial Services Inc. is a subsidiary of UBS AG. Financial Services Inc. All rights reserved. Member SIPC.

UBS has agreed to provide

Introducing the GPhA/UBS

members of the Georgia Pharmacy Association all UBS has agreed to provide

Introducing the GPhA/UBS

members of the Georgia Pharmacy Association

Wealth Management ProgramIntroducing the GPhA/UBS

access exclusive with members of the Georgia Pharmacy Association

Wealth Management Program

access

Wealth Management Program

is the endorsed wealth management provider Group been recognized

is the endorsed wealth management provider sBarron’Barron’sof as one been recognized

ice VHarris

for the Georgia Dental Association is the endorsed wealth management provider

President–Investmentsice

®CRPSGignilliat, Harris

and for the Georgia Dental Association

also

Lending capabilities with competitive interest rates–


discount rate


Lending capabilities with competitive interest rates


discount rate


Lending capabilities with competitive interest rates


ubs.com/team/wile

ice V

ubs.com/team/wile

President–Investmentsice

eserved. Member SIPC. Financial Services Inc. All rights r

and CRPSSMement Plans Specialisted RetirCharter

eserved. Member SIPC.

ed service marks of the College for Financial Planningegistere r ar® and CRPS

.®ed service marks of the College for Financial Planning

UBS Financial Services Inc. is a subsidiary of UBS AG.

UBS Financial Services Inc. is a subsidiary of UBS AG.

Georgia Pharmacy Association50 Lenox Pointe, NEAtlanta, GA 30324

Documents

The Georgia Pharmacy Journal: September 2011