MSCP June 2023 Survey

What tools would make you more comfortable in contacting

a legislator regarding an issue (e.g., reimbursement, provider status)

that affects your practice?

MSCP Pharmacist of the Year

Put Your Quasi-Am Care Glasses On

By Charlie Mollien, Pharm.D., J.D., M.Sc., CHC, FMPA;

pharmacy compliance officer, Meijer; past-president, MPA

Our profession has discussed and worked toward a future community pharmacy practice model for decades. Our practice setting continues to slowly expand services into a model widely referred to as enhanced community services (some pharmacies are part of the “Community Pharmacy Enhanced Services Network).” 

These services range from medication therapy management (MTM) and immunizations, to expanded travel vaccine services and test-to-treat offerings – most widely for influenza and strep throat. Some pharmacies take advantage of Michigan’s expansive delegation laws and are prescribing contraceptives. Others have integrated practice sites with prescribers to help better manage medications for hypertension, cholesterol and other conditions under collaborative practice agreements. We’ll continue to see the pharmacist’s scope of practice grow and catch up to our training – slowly. 

To move forward, I see a critical need to implement a consistent solution for medical billing across all pharmacies – including for independent sites – and a need to move some services away from collaborative models to independent authority. This can and will happen if we stay unified. Why? Because the core role a community pharmacist has in the lives of people is critical for safe and effective medication use. These steps strengthen the pharmacist’s role. And we must remain grateful for our unique ability to help people live better by making meaningful connections with patients. 

Our strength is the ease to access our training and expertise. We know it, but the world isn’t always ready; it will come in due time.

Michigan has thought leaders to spend time to understand, write down and articulate where we are going, so we can get there. Then repeat, over and over. It’s a living pathway, not stone. Our past patchwork efforts forward have been successful, but a clear strategy will keep us moving forward to a practice model we choose in 10 or 15 years. Everyone won’t agree on how to get there, but a clear vision better aligns with our profession. 

What do I see? A model different than today – it’s not community pharmacy we know today and it’s not ambulatory care either. It’s somewhere in the middle, bringing the best of both worlds. 

We won’t move forward without letting go of some traditional pharmacist functions and expanding the role pharmacy technicians play in the pharmacy. So much of what we do has advanced and become so safe and simplified that our technicians can do so much more to help us. This is happening in several fields, including medicine, dentistry, nursing and lab services. Everyone is training professionals to simplify, support and delegate aspects of practice that deepen and expand our own capabilities.

What will we call this “quasi-am care” model? I don’t know. It’s too soon to worry about a name. First, let’s strategically align on the work to get where we say we’re going. And we will because I know pharmacists – they’re diligent, determined and detail-oriented. We practice with an artful grace that sharpens our ability to connect with people.

EDITOR'S NOTE: Charlie T. Mollien was named the 2023 Michigan Society of Community Pharmacists (MSCP) Pharmacist of the Year at the Michigan Pharmacists Association (MPA) Annual Convention & Exposition. He earned a Doctor of Pharmacy from Ferris State University, a Master of Science in pharmacy regulation and policy from the University of Florida and a Juris Doctor from Western Michigan University. He is the pharmacy compliance officer for Meijer pharmacies, where he leads the company’s patient safety, regulatory compliance, drug diversion, privacy and accreditation programs. Mollien is a respected expert in Michigan on pharmacy law, a past Distinguished New Pharmacist Practitioner, former MPA President and past chair for the Michigan Board of Pharmacy.

Event Recaps

MSCP President Brooke Roe presents

Charlie Mollien with the MSCP

Pharmacist of the Year award.

Roe honors outgoing board member

Robin Curtis for her service.

Roe speaks at the MSCP Annual Meeting in February

at the Renaissance Center in Detroit.

2023 MSCP Annual Meeting and Luncheon Recap

By Brooke Roe, Pharm.D., BCPS; manager of pharmacy

quality and accreditation, Meijer; president, MSCP

All Michigan Society of Community Pharmacists (MSCP) members were invited back together at the MSCP Annual Meeting during MPA’s Annual Convention & Exposition (ACE) in February. Our annual meeting is a time many members look forward to as we get to reconnect with pharmacists and technicians throughout the state over a delicious meal. The MSCP Board of Directors also provides an update to membership over the past year, which includes an introduction of board members, recognition of outgoing board members and the presentation of our Pharmacist of the Year award.

At the end of 2022, Robin Curtis completed her term with the MSCP Board of Directors. She was thanked for her service and we wished her well in future endeavors.



Charlie Mollien was recognized as the 2023 MSCP Pharmacist of the Year. He is the pharmacy compliance officer for Meijer, where he leads the company’s patient safety, regulatory compliance, drug diversion, privacy and accreditation programs. Also an attorney, he is a highly-respected expert in Michigan on pharmacy law. Congratulations on the recognition of the important contributions you have made and continue to make to the pharmacy profession!

Our last piece of business was to officially vote on the amended bylaws for MSCP. During 2022, for the first time in several years, members of the MSCP board – along with MPA staff – worked to update the bylaws. Most of the changes modernized and clarified the practiced intent. Most notably, the purpose was edited to read “The Society is the state professional organization of community pharmacists, representing pharmacists practicing in Michigan, cooperating to advance public health, increase access to pharmacist services and improve patient care.” The members in attendance unanimously voted to approve the bylaws.

The 2023 Annual Meeting and Luncheon for MSCP was productively fun. We’re already preparing for next year’s MSCP luncheon and looking for ways to get even more of the membership involved!

At left: MCPC members Michael Klepser and Michelle Kelly (FSU); Karen Farris (U-M); Brittany Stewart (WSU) and Farah Jalloul (MPA).

Highlights from a Landmark Event:

The Michigan Community Pharmacy Summit

By Brittany Stewart, RD, Pharm.D. and Hanadi Thomas Salamey, BS Pharm

Ferris State University (FSU), the University of Michigan (U-M), the Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences (WSU) and the Michigan Pharmacists Association (MPA) have collaborated to develop the Michigan Community Pharmacy Coalition (MCPC). The purpose of the MCPC is to identify a roadmap to ensure the growth and sustainability of community pharmacy practice over the next 20 years in Michigan. The coalition members are Michael Klepser and Michelle Kelly (FSU); Karen Farris (U-M); Brittany Stewart (WSU) and Farah Jalloul (MPA).

Some of the key objectives of the coalition are to:

• Identify opportunities to partner with key stakeholders, such as payers, health systems and public health.
• Identify the skills and knowledge that pharmacy graduates must possess to be successful in community pharmacy practice.
• To examine the current state of pharmacy education to identify gaps that should be addressed to better position graduates to practice in future models of community practice.

The coalition decided the most optimal way to meet the objectives and bring stakeholders together to discuss these critical issues was to host a Community Pharmacy Summit. The MCPC met several times during the planning phase and conducted a SWOT (strengths, weaknesses, opportunities and threats) analysis related to community pharmacy practice in Michigan. The coalition then distributed a 10-question Qualtrics survey to attendees one month prior to the summit to collect demographics and SWOT analysis data. The SWOT data was collated and used as a tool to develop engaging breakout discussion sessions for the summit. The SWOT results were presented at the summit and given to all attendees to be able to identify innovative opportunities for growth and formulate action steps.

Event Recap

The Michigan Community Pharmacy Summit was held on June 6, 2023, at the MPA headquarters in Lansing. There were 39 pharmacists and four student pharmacists from across the state that attended representing independent pharmacy, chain pharmacy, the Michigan Board of Pharmacy, academia and MPA. The summit was a significant landmark event that brought together the three Michigan Colleges of Pharmacy (COP), MPA and pharmacy stakeholders from across Michigan. 

To the knowledge of the MCPC, an event of this nature has never been held in Michigan previously. It was history in the making.

Summit Proceedings

The beginning of the summit featured a brief presentation by the three Michigan schools of pharmacy to present updates about their curriculum landscape and goals related to community pharmacy practice. MPA provided an update on membership and community pharmacy resources. The plan for the summit was to create engaging and productive conversations with the attendees from across the state and to gather feedback from practicing pharmacists, as the MCPC wanted to hear from the valuable pharmacy leaders about critical community pharmacy practice issues.  

The attendees were divided into groups of eight to 12 people who participated in 20-minute breakout discussions on four different topics. MCPC members facilitated the breakout discussions, with the student pharmacists serving as scribes during the sessions. During each breakout session, there were key takeaway points and action items developed. 

Following the breakout discussions, the attendees came back together and were given the opportunity to choose four action items they would like to see the MCPC work on moving forward. Figure 1 highlights some of the top-priority action items that were identified from the breakout discussions.

Figure 1

The summit was a successful, exciting and engaging day full of networking and discussions for moving community pharmacy practice forward in Michigan. All attendees were provided valuable feedback and are motivated to get student pharmacists excited about a career in community pharmacy. This is the beginning of the rejuvenation of community pharmacy practice in Michigan and the MCPC is excited to continue to meet to discuss high-priority action items, develop a plan to move forward with the implementation of the action items and prepare pharmacy graduates to be successful in community pharmacy practice.



Stay tuned! There are plans to host another summit in the next nine to 12 months. Keep an eye out for the comprehensive summit data that will be published at a later date and presented by the MCPC at the 2024 MPA Annual Convention & Exposition (ACE). We hope to see you all there!

More attendees of the MCPC Summit

Legislative Update

MPA Summer Legislative Update

Immunization and CLIA-Waived Testing

The S-4 Substitute of SB 219, which codifies pharmacist authority to independently administer immunizations and CLIA-waived tests, has passed the Michigan Senate and moved on to the House of Representatives. The bill has been referred to the House Health Policy Committee. 

The S-4 version of the bill includes the following provisions:

• Pharmacists may independently order an immunization recommended by ACIP to individuals 3 years of age and up provided they have completed a board-approved training program.
• Requires pharmacists to provide information about the Vaccines for Children Program to individuals younger than 19 years of age.
• Requires pharmacists to report all immunizations they administer into MCIR.
• Pharmacists may independently order and administer a CLIA-waived test for COVID-19, influenza, or other respiratory illness provided they have completed a board-approved training program. This statutory authority does not preempt a pharmacist’s ability to order and administer CLIA-waived tests as otherwise authorized under federal law or pursuant to a collaborative practice agreement.
• Based on the result of a COVID-19 or influenza test, pharmacists may dispense antiviral therapy to a patient without a prescription.

Updates to Pharmacy General Rules

MPA recently submitted comments on the Board of Pharmacy’s proposed changes to the general rules. As listed in the notice for a public hearing, the proposed changes to the rules include:

• Except for disciplinary inspections, inspections at the direction of the department will not involve purchasing data, other than shipment data and the current and historical selling price of the drug, or some research data.
• Applicants will only be able to submit intern hours that are acquired through an educational program, under the personal charge of a preceptor, through a preapproved unconventional internship, or through an educational program outside of the United States.
• Graduates of programs outside of the United States will be able to submit up to 1,400 hours earned in an educational program experience if the hours are not completed through an approved educational program or under the personal charge of a preceptor licensed in this state.
• Preceptors in an educational program will not have to submit annual affidavits of hours.
• Applicants for licensure by endorsement will no longer have to take the MPJE and instead will submit knowledge of the laws and rules affidavit.
• A PIC or facility manager who is unable to fulfill their duties for 120 consecutive days will appoint a new PIC or facility manager.
• An out-of-state pharmacy that will not compound sterile pharmaceutical products in this state may submit an inspection from NABP-VPP or a resident state board of pharmacy.
• An in-state pharmacy that will compound sterile pharmaceutical products will have a two-step inspection process that requires an inspection from the department and, within 6 months, an inspection to assess USP compliance or accreditation.
• Mandates compliance with USP 795 and 797 to versions revised in 2014 and 2008, respectively.
• A pharmacy that dispenses drugs will have a sink with running water, a refrigerator for drugs, and a telephone; a manufacturer will have the option of submitting an inspection from the FDA, the manufacturer’s resident state board of pharmacy, or NABP drug distributor accreditation.
• A pharmacy intern who provides final product verification will record both the initials of the intern and supervising pharmacist.
• A pharmacy may locate an automated device as an extension of a pharmacy in additional locations with limitations.
• A pharmacy may locate a non-dispensing storage and pick-up device on the premises of the pharmacy.
• A pharmacist may dispense an emergency supply of insulin.  

Local Association Spotlight

Kent County Pharmacists Association

By Courtney Biehl, Pharm.D., KCPA secretary

When was your local formed?: Kent County Pharmacists Association (KCPA) was founded many years ago and welcomes pharmacists, students and pharmacy technicians. KCPA has supported our profession in Kent County and was excited to have Ionia, Mecosta and Montcalm counties join our association in 2021!

How did you learn about your local association?: I learned about our local association through colleagues who were involved and who enjoyed participating in KCPA.

Where and when does your local hold meetings?: We hold a mixture of in-person and virtual meetings once per month from September through May. KCPA does not meet June through August.

Why do you feel it is valuable to support and join a local association? How has it benefitted you?: Becoming involved in your local association is a great way to collaborate with others who work in all aspects of our pharmacy profession and who are meeting the needs of our shared communities. Participating in your local pharmacy association is a wonderful way to serve your neighbors through advocacy, education, as well as partnering with other pharmacists, students and pharmacy technicians to improve and impact our profession in a meaningful way.

Do you have a favorite event or memory related to your local?: I love being involved with KCPA community service events, most recently KCPA had an opportunity to volunteer at Kids Food Basket in Grand Rapids, where we were able to package food for nutritious meals to be distributed to children throughout western Michigan. 

Upcoming events: KCPA just concluded our service year in May and will re-convene in September.

Who is a good contact at your Local for further information and questions?: President Brooke Roe or Secretary Courtney Biehl.

KCPA board members volunteer at Kids Food Basket in Grand Rapids to package meals

for area students.

The 2023 KCPA Holiday Party

New Drug Update

New Drug Update: Veozah™

By Katie Wenstrom, Pharm.D., CSP

Vasomotor symptoms (VMS) are a common symptom of menopause, affecting up to 80 percent of women.¹ They are caused by the constriction and dilation of blood vessels, with symptoms such as hot flashes, night sweats, heart palpitations and changes in blood pressure.² The frequency of vasomotor symptoms varies, with the average being four to five hot flashes per day. In the United States, menopause typically begins between the ages of 45 and 58. Most women enter menopause 12 months after their last period.²

VMS may cause a significant impact on a patient’s quality of life. The goal of treatment is to provide relief from VMS and increase the quality of life while minimizing side effects.^1,3 The mainstay of treatment for VMS is hormone replacement therapy with estrogen and progestin products.¹ However, these products carry numerous risks and many patients are not candidates for therapy due to the increased risk of ovarian and breast cancer, thromboembolic events and liver dysfunction. 

On May 12, 2023, fezolinetant (Veozah™) was approved for the treatment of moderate to severe VMS due to menopause. It is the first neurokinin 3 (NK3) receptor antagonist approved by the U.S. Food and Drug Administration (FDA). Fezolinetant works by binding to and blocking the activities of the NK3 receptor, which plays a role in the brain’s regulation of body temperature.⁴  

As a non-hormonal therapy, it represents another effective treatment option for women who are not candidates for hormone therapy. In clinical trials, fezolinetant showed a statistically significant and clinically meaningful decrease in VMS compared to placebo at weeks four and 12. Data from each trial also demonstrated a statistically significant reduction from baseline in the severity of moderate to severe VMS over 24 hours at weeks four and 12 compared to a placebo.  

Fezolinetant is available in 45-milligram tablets. The recommended dose is one tablet daily, with or without food. Use of fezolinetant is contraindicated in patients with known cirrhosis, severe renal impairment, end-stage renal disease or concomitant use of CYP1A2 inhibitors. Before beginning fezolinetant, patients should undergo baseline bloodwork to evaluate for hepatic function and injury, with follow-up bloodwork at three, six and nine months after initiation. 

Additional bloodwork should be conducted if the patient experiences symptoms indicative of liver injury, such as nausea, vomiting or yellowing of the skin or eyes. The most common side effects were abdominal pain, diarrhea, insomnia, back pain, hot flush and elevated hepatic transaminases.⁵

References

1. Dang DK, Wheeler KE, Chen JT. Hormone Therapy in Women. In: DiPiro JT, Yee GC, Posey L, Haines ST, Nolin TD, Ellingrod V. eds. Pharmacotherapy: A Pathophysiologic Approach, 11e. McGraw Hill; 2020. Accessed June 07, 2023. https://accesspharmacy-mhmedical-com.ferris.idm.oclc.org/content.aspx?bookid=2577§ionid=228344524
2. Healthline. What Are the Vasomotor Symptoms of Menopause? 2022 Oct 12. Available from: https://www.healthline.com/health/menopause/vasomotor-symptoms-of-menopause
3. Medscape. Menopause. 2023 May 16. Available from: https://emedicine.medscape.com/article/264088-overview
4. Food and Drug Administration. FDA Approves Novel Drug to Treat Moderate to Severe Hot Flashes Caused by Menopause. 2023 May 12. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause
5. Veozah [package insert]. Northbrook, IL: Astellas Pharma US, Inc.; 2023.

Events and Announcements

MPF Golf Classic

There's still time to register for the Michigan Pharmacy Foundation Golf Classic, June 21, 2023, at Eldorado Golf Course in Mason.

Don't miss this excellent opportunity to enjoy a day on the links, while also supporting the Foundation's mission "To Foster the Future of Pharmacy." There will also be a chance to win a $25,000 grand prize during the Hole-in-One contest!

Click the buttons below to sign up for this amazing event!

MPA News

Michigan Pharmacist Journal Published

The April/May/June 2023 edition of the Michigan Pharmacist Journal is now available online! Click the cover image to the right to read about the following topics:

• MPA Members Stack Up Awards: At home and nationally, MPA members bring home hardware.
• President's Platform: MPA President Hope Broxterman looks at opportunities ahead for pharmacists.
• From the Foundation: Don't take a mulligan on the annual MPF Golf Classic June 21.
• Advocacy Update: Read up on how you can promote pharmacy priorities at the state and federal levels.
• MSCP Focus: MSCP President Brooke Roe gives pharmacists some phrases to live by, while Thomas Burns looks at how pharmacists can help women have greater access to hormonal contraception.
• New program: Wayne State professors and students give a glimpse of the school's new ambulatory care concentration.

Please note: The Michigan Pharmacist will be available in digital format only. Printed copies may be requested via email at MPA@MichiganPharmacists.org.

Promote With the MPA Social Media Request Form

Have something you want MPA to share on its social media channels? The MPA social media request form might be right for you!

This valuable tool can now be found on the MPA website here. This form can be used to promote events or resources, recognize member accomplishments, or share other messages and information. Submitting this form does not guarantee your content will be shared, but you will be contacted if MPA is unable to post your content.

You must be logged in to your MPA account in order to view and complete the form.

Contact MPA Communications Manager Ryan Weiss with any questions.

Upcoming CE Programs

APhA Pharmacy-Based

Immunization Training

9-11 a.m. July 19

Implicit Bias 2.0:

Education, Practice and Teams

10 a.m.-noon Aug. 25

Implicit Bias 2.0:

Education, Practice and Teams

4-6 p.m. Oct. 24