PFOA logo

"To Preserve, Protect and Promote

the Interests of Pharmacy Owners."

December 2018
In This Issue
Welcome New
PFOA Members
Magnolia Pharmacy
Burbank, CA
Woodland Hills Rx Pharmacy
Woodland Hills, CA
Medicap 8427
Garden Valley ID
Healthrx Pharmacy
Gilbert, AZ
D-Rex Pharmacy of Yadkinville
Yadkinville, NC
Glenvista Pharmacy
Glendale, CA
Buckhead Pharmacy
Cleveland, OH

Bara Pharmacy
Annandale, VA

Gladbrook Family Pharmacy
Gladbrook, IA
 PFOA Holiday Schedule
The PFOA offices will be closed on Tuesday, December 25th and Tuesday, January 1st.

We wish all of our members Happy Holidays and healthy and successful 2019!
 PFOA Membership Survey
In mid November, PFOA distributed a short questionnaire via email to our membership to aid in our re-engineering process. We intend to use the responses to better serve the PFOA members.

If you have not completed the survey, we urge you to do so. If you need an additional copy, please contact our office at 888-406-7467.

Thank you for your contributions.
 Wes Drake Jr. to Retire
Wes Drake Jr. has announced his plans to retire from PFOA at the end of 2018. Wes has contributed to our association over the last few years, adding new members and offering his expertise to our existing membership.

Wes will be spending more time on the golf course as well as travelling with his wife, Rita and visiting his grandchildren.

We want to thank Wes for being a large part of PFOA's success. 
 New Additions 
to PFOA Staff
PFOA is pleased to announce the addition of two new members to our staff.
Rochelle "Shelly" Gritz has joined PFOA in an administrative capacity. She will be working in our Coral Springs office.
Shelly comes to us from drug wholesaler, H. D. Smith where she worked for seven years as an Executive Assistant and Sales Administrator.
You may reach Shelly at 954-340-5944 ext 138 or
Patrick Kittoe will be serving the Association as our South East Sales Representative, meeting with current members and prospecting in the region. His territory will cover Florida, Georgia, Eastern Tennessee, North Carolina, South Carolina and Virginia.
Patrick  has extensive experience in the wholesale drug industry. He was employed with AmerisourceBergen for almost thirty years. Located in Rockledge, Florida, Patrick traveled the country in his position of Director of Field Advertising.
If you are located in his sales territory, Patrick will be getting in touch with you soon. His contact information is listed below:
Patrick Kittoe
We look forward to both Shelly's and Patrick's contributions to PFOA
PFOA logo
Board of Directors
Todd Pendergraft

Vice President:
 Doug Coyle
    Larry McIntosh

Phil Rigsby

  Board Members: 

Gabriel Guijarro

 Eric Pusey

  Ron Robichaux

Ty Stout
John Zuzack

Non-Voting Board Members:

Dirk Andrepont

Gaye Moseman

Board of Directors
Dirk Andrepont
John Zuzack
David Cole

Phil Rigsby
Board of Directors

Eric Pusey
Vice President:
Devin Trone
Bobbie Barbrey

PFOA Staff
Contact Information 
David Mayper
Executive Director
Nancy Coibion
Administrative Assistant
Mailing Address
  10944-B Gravois Industrial Court 
  St. Louis, MO 63128
Wesley Behar
West Region Sales

Wes Drake
Florida Sales

Karen Godbold
Executive Administrator

Shelly Gritz
Administrative Assistant
954-340-5944 x138

Ronda Hubbard  
Generics Specialist/Sales
Fax: 270-632-4206

Patrick Kittoe
Southeast Sales
Al Schuster
Northeast Sales
Bob Sutton
Vendor Programs/Mid-West Sales
Nancy Tataronis
Vendor Relations/Marketing
  Jamie Wilbanks
Inside Sales/Service
Toll Free: 888-406-7467

Get Linked In!  

Pharmacy Franchisees and Owners Assn
(FPN) Federation of Pharmacy Networks
       (NCPDP) National Council for Prescription Drug Programs  
        (NCPA)  National Community Pharmacists Association 

(NABP) National Association of
Boards of Pharmacy

(NASPA) National Alliance of State Pharmacy Associations

  Pharmacist E-Link   

Dave Mayper
PFOA closed the month of November with a Board webcast where we reviewed the initial information received on our reengineering survey.  While we will make efforts to get more of a sample set and have more than doubled the response so far, the Board was able to begin to derive some conclusions.
We continue to smooth out the new dual agreement with American Pharmacies.  They are now handling the majority of rebate distribution which will allow us more efficiencies after everything is adjusted.  IPC has already converted.  API should begin with rebates next month.  We are waiting on commitment from AAP. 
As Wesley Drake III is no longer with the organization, I will be naming an interim solution shortly with more permanent solution to be discussed and finalized in January.  I have begun leading bi-weekly sales staff meetings to keep coordination and communications going. I have visited part of Wesley Drake III's territory and members have been contacted via email, phone and webcast. 
On December 3rd, we started two new associates.  Patrick Kittoe will be covering the southeast territory for PFOA.  He comes with an excellent background, most recently with AmerisourceBergen where he last held a national position.  Patrick  is well known and highly thought of by a number of our members.  Rochelle "Shelly" Gritz will be administrative help located in the Coral Springs office.  Shelly has spent the last seven years with HD Smith in an Executive Administrative Sales position. We welcome the both aboard. 
Wes Drake Jr. has confirmed his plans to retire at the end of 2018.  Wes has contributed mightily to PFOA's success over the past few years.  I want to thank Wes for his contributions and for being a good friend.  I'm sure we all wish him the best and will encourage him not to be a stranger.
I have been involved in conversations with a number of our vendors.  New York has implemented a very tough tax on sales of opiate products and are trying to collect this retroactively.  While this is being challenged in the courts, we can expect change in availability of these items.  Similar legislation is being brought in other states.  This will likely create issues in 2019 in a number of areas.  There are going to be other changes and we will try to provide information as it becomes available.  Change in our industry is the only guarantee. Those that accept it, adjust and embrace it will continue to be successful. 
Happy Holidays and a healthy New Year to all. I thank you for the opportunity to be your executive director.  

Yours Truly,
David Mayper
Annual Pharmacy Forecast Predicts Industry Developments for 2019

As the health care landscape continues to evolve, pharmacy leaders must anticipate changes in the industry to plan for what's ahead. 

In a session held at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting and Exhibition, the ASHP Foundation's annual Pharmacy Forecast was presented, highlighting some trends in pharmacy to keep an eye out for in 2019. 
The 2019 Forecast predicts changes in the education and work dynamic of pharmacists, enhancements in medication delivery for patients, innovations in technology that change the way pharmacists will interact with patients, and a more enhanced role of the patient in their own care, among other areas.

Education and Workforce
Pharmacist burnout was a top concern among those surveyed. The majority of those surveyed felt it is 'very likely' (21%) or 'somewhat likely' (40%) that burnout and the growing complexity of health care will increase the annual turnover rate for front-line pharmacists to at least 15%


If the majority of those surveyed are correct, at least 25% of health systems will give community pharmacists outside their organization access to patient information from their electronic health records. This information could include laboratory test results and clinical notes, and would enable community pharmacists to perform patient care services.

Health Care Delivery, Financing

Many survey respondents said they believe the introduction of biosimiliars will reduce national expenditures on biologics by 25%. Forty-five percent said it is 'somewhat likely.'

The Opioid Crisis 

Many pharmacists polled believe more health systems will provide structured educational programs to improve the pain management. The Forecast authors stress the important role that pharmacists play in opioid stewardship programs, and emphasize the importance of shared decision-making with patients on the best way to address their pain. 

By Kristen Coppock, MA, Editor Published in Pharmacy Times (edited)
Study Analyzes Trends Across Adulterated Dietary Supplements
Potentially harmful active pharmaceuticals continue to be identified in over-the-counter dietary supplements, according to a study that analyzed trends across adulterated dietary supplements associated with a warning released by FDA. These FDA warnings have not been comprehensively analyzed for recent years, indicate the authors of the article published October 12, 2018, in JAMA Network Open. Using data from FDA's Tainted Supplements database, from 2007 through 2016, the results show the following:
  • 776 adulterated dietary supplements were identified by FDA and 146 different dietary supplement companies were implicated.
  • Most of these products were marketed for sexual enhancement (353), weight loss (317), or muscle building (92), with 157 adulterated products containing more than one unapproved ingredient.
  • The most common adulterants were sildenafil for sexual enhancement supplements (166 of 353), sibutramine for weight loss supplements (269 of 317), and synthetic steroids or steroid-like ingredients for muscle building supplements (82 of 92).
The active pharmaceutical ingredients identified in dietary supplements are present at unknown concentrations and have not been characterized as safe and effective by FDA, making them unapproved drugs. These products have the potential to cause severe adverse health effects related to accidental misuse, overuse, interaction with other medications, underlying health conditions, or other drugs within the same dietary supplement. While FDA has focused efforts on screening of international mail shipments and online sampling in recent years, the authors state that other studies have reported tainted supplements for sale at US retail locations as well.
From NABP enews
Walgreens, FedEx Partner on Next-Day Rx Delivery Nationwide
Walgreens and FedEx are teaming up to deliver on convenience for patients. The companies have launched Walgreens Express, a service that will provide next-day delivery nationwide, as well as same-day delivery in select markets.
Patients who are enrolled in Walgreens text alerts will get a text message notification when their qualifying prescriptions are ready. They can then follow a process to choose to have their prescription delivered the next day for a $4.99 fee. To be eligible, prescriptions must be received by 4 p.m. Monday through Friday. Though Walgreens said most prescription orders are available to be delivered by the next business day, it noted some prescription benefit plans and insurance plans do not allow home delivery, encouraging patients to talk to a pharmacist with any questions.
Walgreens Express allows patients to preview their cost, prepay for prescriptions that can be delivered and choose between delivery or in-store pickup. If they choose to pick the prescription up in-store, they can use a dedicated Walgreens Express pickup checkout line in the store.
Currently, patients in Dallas; Chicago; New York City; Miami; Gainseville, Fla.; Tampa, Fla.; and Fort Lauderdale, Fla., can choose same-day delivery, with Walgreens planning to expand the offering in 2019.
By David Salazar Published in Drug Store News (edited)
CMS' Proposed DIR Fee Reform Garners Industry Support
  The latest effort from the Centers for Medicare and Medicaid Services is garnering industry attention. CMS unveiled a proposed rule, titled "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses," which includes provisions focused on direct and indirect remuneration, or DIR, fee reform.
The proposed rule is interested, among other things, in transparently pricing drugs, and seeks to redefine what constitutes "negotiated prices" under Medicare Part D to mean "the lowest amount a pharmacy could receive as reimbursement" for Part D drugs through its contract with the plan sponsor or intermediary. This would require PBMs and plan sponsors to include the lowest possible reimbursement in their claims processing systems.
It also would add a definition for "price concession" in Part D to include "all forms of discounts and direct or indirect subsidies or rebates that serve to reduce the costs incurred under Part D plans by Part D sponsors."
The National Association of Chain Drug Stores, the National Community Pharmacists Association and the National Association of Specialty Pharmacy jointly praised the proposed rule, noting that it includes many changes related to direct and indirect remuneration, or DIR, fee reform that they have advocated for in the past.
CMS noted in the proposed rule that it also is considering developing a standard set of metrics upon which pharmacies and plans could base their contracts, and is seeking feedback on whether they could be designed to offer pharmacies more predictability regarding reimbursements while still letting plans negotiate terms.
CMS said that the changes in the proposed rule could happen as soon as 2020 - a timeline industry organizations said they would welcome.
By David Salazar, Published in Drug Store News (edited)
Complete Your 2018 Fraud, Waste and Abuse Attestation by December 31st
It's that time of year! Please take a moment to complete your 2018 FWA Attestation-all attestation must be completed before the end of the year to remain in compliance with CMS and contracted PBMs.
How to Complete the Attestation
CMS has developed a standardized FWA training education module, available on their 
Medicare Learning Network . You will need to create a CMS account to access the training.

Attestation must be completed on the NCPDP website ( ), and directly with Caremark.

Why FWA Attestation Matters
CMS provides guidance and specific requirements to participate in Medicare Part D. Provider Network and NCPDP worked together to create the FWA Attestation to satisfy those CMS obligations under agreements that we sign on your behalf with PBMs and Payers. In order to continue to participate in Medicare Part D Plans and service Medicare patients, all Provider personnel must complete training each calendar year. 

While you are logged in to NCPDP don't forget to complete your Expanded Profile!

From Elevate Provider Network e-Newsletter (edited)
5 Tips For Independent Pharmacy Owners To Grow Profits Using No-Cost to Low-Cost Marketing
If you're doing any advertising at all, perhaps you're seeing little-to-no results. There's a reason for that: your messages are not memorable.

If you're using discount coupons, severe markdowns, even for a day or two, they, too, may be falling on deaf ears. Again, there's a reason. You're not informing and educating your patients so that the discount becomes meaningful.In other words, your readers and viewers need to fully well recognize the real value of whatever you're offering. You need to answer the question "what's in it for me?"

If the above causes you to throw up your hands in frustration, despair not. Big results from no-cost marketing is available.

The entire premise here is that it is 5 times easier and 5 times less expensive to get your current patients to spend another dollar, than it is to get a newcomer to spend money.

Both are needed; however, your current patients will make you richer faster, because they admire-even adore you-for what you do for them already.

Here are the 5 tips that can most easily and quickly send your profits soaring:
  • Become an expert in chronic diseases. Then very aptly market that fact in ways that show each reader benefits of what offer from his or her viewpoint. Cause them to come running to your pharmacy to purchase specific products because each product will alleviate a certain ache, pain, or other discomfort that the individual has.
  • Capture the name, address, etc. of each patient purchasing a new nutraceutical.
  • Phone each new patient and ask about how that product is performing, and whether he or she is in protocol. In addition to making certain that each patient is in compliance, this call puts a WOW factor into the relationship. Such phone calls result in patients initiating more word-of-mouth advertising about you, especially at social events. When handled properly, you remain within HIPPA regulations.
  • Send a monthly Wellness Newsletter. Make certain it informs and educates in beneficial ways. Include prices.
  • Add some vigor to keeping in touch with your most profitable patients. Email or phone the top 20% most profitable patients an extra time each month re: her particular malady. Phone or email your top 2% weekly pertaining to whatever ails them. 
It all starts with your having the right business model. It's also based on the fact that you can make good money without a big marketing budget. You simply have to apply some sweat-equity to make it work really well.
By Lester Nathan, MS Published In Pharmacy Times
Study Presented at AAP Conference Finds Alarming Percentage of Parents Divert Antibiotics to Others
Nearly three-quarters of parents in a national sample reported sharing or borrowing antibiotics, a practice called prescription diversion, both within and outside of the family, according to a study abstract presented at the American Academy of Pediatrics (AAP) National Conference and Exhibition on November 5, 2018. The purpose of the study was to determine the prevalence of antibiotic diversion among parents, the common recipients of the antibiotics, and how parents estimate the dosage of antibiotics to administer.

An anonymous online questionnaire was distributed to a national sample of 496 parents. Nearly half (48.2%) of the parents reported that they kept leftover antibiotics rather than properly disposing them. Of those, 73% subsequently diverted them to siblings, unrelated children, and unrelated adults. Overall, 16% of participants stated that they had given their child adult medications.
Unused or expired antibiotics can be safely disposed at an approved collection site. These disposal sites can be found using NABP's Drug Disposal Locator Tool, which includes locations for more than 6,000 permanent disposal boxes nationwide. New locations are continuously added to provide consumers with a safe way to dispose of medications and help prevent misuse and abuse of prescription medication. Visit to use the Drug Disposal Locator Tool and to learn about prescription drug safety.