KeePosted Info

Directly Speaking
An Update from the Task Force

by Scott A. Meyers, Executive Vice President

The third open meeting (all of them are open by law) of the Collaborative Pharmaceutical Task Force has come and gone and unfortunately, we are still waiting for two of the eight voting members to be appointed. I’m not pointing fingers, Mr. Senate President Cullerton, but if the organized labor groups who concocted HB2392 last year to create this mess in the first place can’t get their stuff together to recommend an appropriate appointee to you for appointment, please appoint Garth Reynolds to represent IPhA and let us move on!

As I have mentioned in the past in other articles in previous issues of KeePosted, each of the four legislative leaders (Senate President, Senate Minority Leader, House Speaker and House Minority Leader) each had two appointments to make for this Task Force. House Minority Leader Jim Durkin, R- Burr Ridge made quick work of his appointments from ISMS (Scott Reimers) and ICHP (me). Senate Minority Leader Bill Brady, R-Bloomington followed the lead quickly and while House Speaker Madigan, D- Chicago, took his time and provided a twist by not appointing the Illinois Retail Merchants Association President, Rob Karr, as expected but got the job done before the second meeting.

The saddest part of this portion of the update is that during the three past meetings, organized labor hasn’t even bothered to send someone to at least sit in the audience and participate from there. The instigators don’t seem to be interested in solving the many identified problems any time soon. Unfortunately, nothing will happen until they get to the table and start participating.

As for the meetings, as reported previously, the first meeting was a review of the Task Force’s charge and initial identification of next steps. The second meeting or first real step was to hear an expert on “whistleblower” law talk about what is and what is not in the Pharmacy Practice Act already. The answer is pretty much nothing.

The March meeting (number 3) brought in staff from NABP to describe laws in other states that may address several of the 16 identified issues the task force is charged to review. There are some promising statutes and rules out there that may be useful but again, no steps can be taken until the task force is at full strength.

At the April Meeting of the task force, experts on e-prescribing will be present to discuss automated refills, e-discontinuation and other technology related topics. The meeting is set for April 10th at 1:30 pm in Chicago and Springfield. It will be open to the public should any interested party wish to participate. The specific locations have not yet been identified but will be posted on the IDFPR website prior to the meeting date.

The task force has had some good discussions and could be ready to tackle some of these issues in the next few meetings if and when the final two appointees are approved. I hope that we have a full task force for the next meeting and that we don’t have to repeat the discussions of the previous two. Garth Reynolds, IPhA Executive Director has been present at all three previous meetings and is expected to be appointed shortly. So we know he is ready to go. Let’s hope that organized labor gets their stuff together quickly so that we can move forward with the undertakings of the task force and improve care for our patients!

President's Message
Elevate Yourself - Keys to Learning New Skills

by Travis Hunerdosse, PharmD, MBA President, ICHP

The profession of pharmacy is ever changing to meet the needs of patients and the health care industry. As professionals, we need to equip ourselves with the knowledge and skills to meet these new demands. Elevating yourself through continuing professional development prepares you to reach your full potential in order to seize new opportunities in healthcare. You are ready for the challenge, but you may ask yourself where do I start?

People who are committed to life long learning are more likely to perform better at their job, find a new job or receive a promotion. Elevating yourself takes a commitment and developing habits to ensure you are always learning new skills. There are 4 habits that can influence your continuing learning of new skills.¹

• Focus on emerging skills. The pharmacy and healthcare landscape is always changing and the requirements of technicians and pharmacists change with it. Learning the latest skills ensures that you stay relevant in your area of practice. Keep up with hot topics in pharmacy and emerging job opportunities. Once you identify a gap, take advantage of the opportunity to learn a new something new or broaden your expertise.

• Get synchronous. Learning on-line or by yourself may cause you to loose motivation and give up on learning. To avoid this, align yourself with others who share the same interest. Forming a study group for technician or pharmacist board certification is one way to stay motivated and ensure your goal is met. This interaction among the group fosters deeper learning and keeps everyone motivated.

• Implement learning immediately. Benefit your patients and your organization by acting on the new skills that you have acquired. This can be achieved by finding opportunities to use your new skills. Volunteer to serve on a task force, committee or lead a project.

• Set a golden benchmark. You need to have a clear goal in mind of what you want to achieve. It helps if you determine what you want to get out of your professional development plan. Developing a professional objective will help you stay focused as you learn. Learning is a life long process and your goals are likely to change over time as you achieve them and determine the next one.

Commit to Continuing Professional Development

Having served as the Director of Educational Affairs Division, I appreciate the importance of Continuing Professional Development for technicians and pharmacists. This can be achieved through various avenues such as on line or live continuing education (CE) activities, attending professional organization meetings like the ICHP Spring and Annual Meetings or ASHP Midyear and Summer Meetings, or obtaining advance certifications through the Pharmacy Technician Certification Board (PTCB) or the Board of Pharmacy Specialties (BPS).

Obtaining continuing education credits is only the first step of continuing professional development. In order to achieve the next level, you need to put new information or skills acquired into practice. In order to get started, focus on one or two educational programs that you enjoyed and learned something new. Perhaps it was a technician-focused session on USP 800 or a guideline update on the management of diabetes. The next step would be to learn more on the topic by finding related CE, journal articles and on-line resources. Once you are armed with the knowledge and skills, it is time to put it into practice by implementing changes or stepping up and volunteering for a committee or project.

Attending professional meetings is a great way to obtain live CE; however there are many more ways to do this. Take advantage of being around colleagues and exchanging new ideas. Some of the best innovations come from talking it through with a colleague who has a similar interest or has already implemented a successful change or program. After attending a particular session you may want to have further discussion with others who attended the same session to gain their insights and share ideas. Many professional meetings are also offering special interest networking sessions such as ambulatory practice, women in leadership, and medication safety just to name a few. This is a great opportunity to meet experts in the field and fosters great discussions.

Board certification is a great avenue for technicians and pharmacists to demonstrate their expertise in a particular area of pharmacy practice. The Pharmacy Technician Certification Board (PTCB) now offers an advanced certification for technicians in sterile compounding. Through this advanced certification technicians can learn new knowledge and skills that demonstrate expertise in safe sterile compounding. A commitment to developing advanced skills and qualifications benefits our health-systems and patients.

Another way to elevate yourself is through mentoring. Mentoring is a great way to keep your skills and knowledge sharp. In order to be an effective preceptor of student technicians and pharmacists, preceptors must keep up with the latest skills, regulations, or treatments in their area of expertise. In addition, students bring new information and ideas throughout the learning experience and push you to learn as well.

Elevating yourself can also come through presenting at a state or national meeting or publishing an article. Volunteering to give a presentation or publish an article pushes you to learn all you can about the subject that you will be presenting or writing about. It requires you to perform additional research and dig deeper into the topic so you are prepared to give it your best and address all potential questions that your audience may pose.

Let’s not forget to take advantage of opportunities outside of pharmacy or healthcare. All of us have interests outside of work such as playing sports or a musical instrument, gardening, or cooking. Enrolling in classes and participating in activities that are outside of the profession gives you a break from the day-to-day and equips you with new skills that you may not obtain otherwise. In addition, there are valuable lessons that can be translated back into your work. Don’t forget to take care of “you”, as this allows you to stay sharp, focused and at your peak so you can provide the very best care for patients.

Elevate yourself by developing habits to be a life long learner and commit to continuing professional development. Learning new skills elevates your practice and enables you to take the very best care of your patients.

Reference:

1. Kehoe, M. 4 Habits of people who are always learning new skills. HBR. https://hbr.org/2018/01/4-habits-of-people-who-are-always-learning-new-skills January 31, 2018. Accessed March 8, 2018.

Board of Pharmacy Update
Highlights of the March Meeting

by Scott A. Meyers, Executive Vice President

The March 13th Board of Pharmacy Meeting was held at the Illinois Department of Financial and Professional Regulation Building at 320 West Washington in Springfield. These are the highlights of that meeting.

New Board Member Introduced – Board Chair, Yash Patel introduced Ryan McCann as a new pharmacist member of the Board of Pharmacy. Ryan will replace Ned Milenkovich who served over 10 years on the Board. Mr. Patel thanked Mr. Milenkovich for his many years of service to the State and its citizens.

NABP Annual Meeting – The National Association of Boards of Pharmacy will conduct its Annual Meeting in Denver on May 5-8, 2018. Yash Patel will serve as the Illinois Delegate to the meeting with Ned Milenkovich as first alternate and Denise Scarpelli as second alternate.

Department Update – Luciene Doler, Board of Pharmacy’s new general counsel replacing Katy Straub, provided news from the Department of Financial and Professional Affairs. The Collaborative Pharmaceutical Task Force has met twice so far with another meeting scheduled for that afternoon in Springfield and Chicago. There are still two task force members to be appointed representing IPhA and organized labor.

The public comments on the draft compounding rules are being reviewed by Department staff and a final draft is expected soon. ICHP will notify members of their details when they are approved and when they will become effective.

Robert Nelson and Janelle Kirby were present and introduced as pharmacy investigators.

Election of the Board Vice Chair– with the departure of Mr. Milenkovich, the Board elected Al Carter as its new Vice Chair. Mr. Carter will become the alternate delegate at the NABP Annual Meeting in May and Ms. Denise Scarpelli will become 2nd alternate.

Legislative Update – As ICHP Executive Vice President, I provided this month’s update. The Spring Session of the General Assembly is well underway and there are a variety of bills impacting pharmacy. Several bills address the opioid crisis by amending the Controlled Substance Act. These and all the bills ICHP is monitoring are discussed in the Government Affairs Report in this issue of KeePosted.

Next Meeting – The next meeting of the Board is set for May 15th to begin at 10:30 am in the James R. Thompson Center at Randolph and LaSalle in downtown Chicago. These meetings are open to the public and pharmacists, pharmacy technicians and pharmacy students are encouraged to attend.

Educational Affairs
New Oncology Drugs of 2017: Novel Intravenous Approvals

by Christopher Campbell, PharmD, BCPS, BCOP, Northwestern Memorial Hospital; Janna Afanasjeva, PharmD, BCPS, Northwestern Memorial Hospital; Chloe Majkowski, PharmD Candidate 2018, University of Illinois Chicago

With major advances in science and technology over the past few decades, the pharmaceutical industry has discovered better drug targets and applied this to drug development. Simultaneously, the Food and Drug Administration (FDA) introduced fast track, breakthrough therapy, and priority review designations, along with accelerated approval pathways, which have allowed new medications for treating serious conditions to reach the market much sooner than ever before. As Figure 1 demonstrates, expedited approvals for fast track, orphan drug, and accelerated approvals have increased to approximately 100, 40, and 10 respective designations or approvals per year.1 In 2017, 12 of 46 (26%) total novel drug approvals were in hematology and oncology alone, including 9 new molecular entities and 7 new monoclonal antibodies.2-4 The year 2017 also saw biologics license applications (BLAs) approved for the first 2 chimeric antigen receptor (CAR) T-Cell therapies, axicabtagene ciloleucel and tisagenlecleucel. These therapies are completely new methods of gene therapy utilizing modified versions of the patient’s own immune system to attack certain cancers in the blood. The purpose of this article is to provide a brief overview of the intravenous drug approvals in oncology for year 2017 that showcase innovation and the great strides being accomplished in treating cancer. Drug reviews include information on indications, special designations, efficacy, safety, and place in guidelines. Table 1 provides additional information on dosage forms, administration, and cost.

Avelumab (Bavencio®)

Indication

Avelumab received accelerated approval for metastatic Merkel cell carcinoma (MCC) in adult and pediatric patients 12 years of age and older and for locally advanced or metastatic urothelial carcinoma (UC) in patients who have progressed on or after a platinum-containing chemotherapy regimen.5 The MCC indication had priority review, breakthrough therapy, and orphan drug status, as avelumab was the first FDA approved treatment for this disease. Urothelial carcinoma, a difficult to treat tumor, was given priority review.6,7 Avelumab inhibits programmed death-ligand 1 (PD-L1) receptor located on tumor cells, blocking the inhibition of T-cells and restoring immune response to tumor cells. Avelumab also engages the innate immune system and induces antibody-dependent cell-mediated cytotoxicity (ADCC).

Efficacy

The accelerated approvals of avelumab were based on 2 clinical trials: JAVELIN Merkel 200 and the UC cohort of the JAVELIN Solid Tumor trial.5 JAVELIN Merkel 200 was an open-label phase 2 study of avelumab monotherapy (10 mg/kg IV every 2 weeks) in 88 patients with metastatic MCC, who had prior chemotherapy.5,8 At the time of publication, the primary endpoint, the objective response rate (ORR), was 31.8% (95% confidence interval [CI], 21.9% to 43.1%) with 8 (9%) complete responses (CR) and 20 (23%) partial responses. Median progression-free survival (PFS) was 2.7 months, and median overall survival (OS) was 11.3 months. Results after 1 year follow-up included an updated ORR of 33%, due to 2 additional patients achieving a CR. The duration of response (DOR) in 29 patients was 86% over 6 months and 45% over 12 months. Responses were independent of PD-L1 tumor expression.

JAVELIN Solid Tumor was an open-label, single-arm, large phase 1b study of avelumab (10 mg/kg IV every 2 weeks) with a pooled analysis of 2 cohorts consisting of 241 patients with metastatic UC, in whom 95.4% had progressed on platinum-based therapy.5,9 At the time of abstract publication, there was a demonstrated primary endpoint ORR of 17.6% (95% CI, 12.0 to 24.6) in 27 out of 153 patients with at least 6 months follow-up. Median PFS was 6.4 weeks (95% CI, 6.1 to 11.4); however, median DOR was not reached. At the time of the FDA approval, ORR response dropped to 13.3%, and a median DOR had still not been reached (range in months of 1.4+ to 17.4+).5

Safety

In the JAVELIN Merkel 200 study, the most common adverse reactions reported were fatigue (50%), muscle pain (32%), diarrhea (23%), nausea (22%), infusion-related reaction (22%), rash (22%), decreased appetite (20%), and peripheral edema (20%).5 Immune-related adverse reactions included treatment-emergent abnormalities such as grade 3 to 4 elevated liver enzymes, increased bilirubin, and creatinine kinase elevation. Anemia was the most common reason for dose interruption. Permanent discontinuation was required for ileus, nephritis, transaminitis, and pericardial effusion. The UC cohort of the JAVELIN Solid Tumor trial also reported common infusion-related reactions (22.8%) and fatigue (12.0%).9 According to the published abstract, Grade 3 to 4 immune-related adverse reactions occurred in 11.6% of patients including 1 treatment-related death due to pneumonitis. However, the package insert describes that 14 patients (6%) from the pooled cohort died due to pneumonitis, respiratory failure, sepsis, cerebrovascular accident, or gastrointestinal adverse events.5

Guidelines

The NCCN Bladder Cancer guideline recommends avelumab in UC as a second-line single agent systemic therapy option for locally advanced or metastatic disease.10 The NCCN MCC guideline recommends avelumab for disseminated clinical M1 disease with or without surgery and/or radiation therapy.11

Axicabtagene ciloleucel (Yescarta™)

Indication

Axicabtagene ciloleucel is approved for use in adults with relapsed or refractory (r/r) B-cell lymphoma, such as diffuse large B-cell lymphoma (DLBCL) and other high grade lymphomas after fludarabine and cyclophosphamide lymphodepleting chemotherapy.12,13 Axicabtagene ciloleucel has not been studied in patients with primary central nervous system lymphoma and is not indicated for this population. The FDA granted priority review and orphan drug status to axicabtagene ciloleucel for this indication. Axicabtagene ciloleucel is the first treatment for B-cell lymphoma that targets CD19-expressing malignant cells with genetically modified autologous T-cells encoded with a CAR. Binding of CAR T-cells to CD19 activates a T-cell signaling cascade leading to the activation, proliferation, secretion of inflammatory cytokines, and ultimately to elimination of CD19 target cells.

Efficacy

Axicabtagene ciloleucel was approved for r/r B-cell lymphoma based on results from the ZUMA-1 trial.12 The ZUMA-1 trial was an open-label, phase 2, multicenter, single-arm trial assessing the safety and efficacy of a single infusion of axicabtagene ciloleucel therapy in 111 patients enrolled (101 treated) with r/r B-cell non-Hodgkin lymphomas (NHLs), primarily DLBCL.14 Patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to1 were included, and 77% of the patients had refractory disease to 2 or more lines of therapy including autologous stem cell transplant.15 The primary endpoint was an investigator-assessed ORR of 82% with ongoing responses in 44% of patients at 8.7 months.14 Tocilizumab and/or steroid use did not impact ORR. The median PFS was 5.9 months (95% CI, 3.4 to 9.8), while median OS was not reached. Manufacturing time for axicabtagene ciloleucel was on average 17 days with a 99% success rate.

Safety

The most common adverse reactions reported in the ZUMA-1 trial include cytokine release syndrome (CRS) (94%), fever (86%), hypotension (57%), encephalopathy (57%), tachycardia (57%), fatigue (46%), headache (45%), decreased appetite (44%), chills (40%), diarrhea (38%), and other very common (≥20%) adverse reactions such as febrile neutropenia, infections-pathogen unspecified, nausea, hypoxia, tremor, cough, vomiting, dizziness, constipation, and cardiac arrhythmias.14 The most common (≥ 10%) Grade 3 or higher reactions include febrile neutropenia, fever, CRS, encephalopathy, infections-pathogen unspecified, hypotension, hypoxia, and lung infections. Nearly all patients (>95%) experienced a Grade ≥3 adverse reaction - most frequently anemia, neutropenia, and febrile neutropenia. Axicabtagene ciloleucel carries a boxed warning for CRS and neurologic events as Grade 3 or higher events were observed in 13% and 31% of patients, respectively.12 Axicabtagene ciloleucel is only available through a Risk Evaluation and Mitigation Strategies (REMS) to mitigate the risks of CRS and neurological toxicities.

Guidelines

The NCCN B-Cell Lymphomas guideline recommends axicabtagene ciloleucel as subsequent therapy after second-line therapy for DLBCL, primary mediastinal large B-cell lymphoma or double hit lymphoma.16 Axicabtagene ciloleucel is also recommended as subsequent therapy for patients with histologic transformation to DLBCL after treatment with ≥2 chemoimmunotherapy regimens, which included at least 1 anthracycline or anthracenedione-based regimen, unless contraindicated.

Copanlisib (Aliqopa™)

Indication

Copanlisib received accelerated approval for the treatment of relapsed follicular lymphoma (FL) in patients who have received 2 prior systemic therapies.17,18 The FDA granted orphan drug and fast track designation for copanlisib in the harder to treat third-line setting due to efficacy and safety profiles. Copanlisib’s mechanism of action is novel in that it inhibits mainly phosphatidylinositol-3-kinase (PI3K) alpha and delta isoforms expressed in malignant B-cells. This process causes apoptosis and inhibition of proliferation of malignant B-cell lines. Idelalisib, a first generation PI3K inhibitor, only inhibits a single PI3K-delta isoform.19

Efficacy

The results contributing to the efficacy and safety of copanlisib are only available from the manufacturer and have not been published yet. The approval of copanlisib is based on CHRONOS-1 trial, which was a single-arm, multicenter, phase 2 clinical trial.18 The trial enrolled 142 patients, which included 104 patients with follicular B-cell NHL who have received at least 2 therapies before. All patients were treated with at least rituximab and an alkylating agent in the past. The majority of patients (130/142) received 60 mg of copanlisib on days 1, 8, and 15 of a 28-day cycle. The ORR was 59% (95% CI, 49% to 68%). This medication received accelerated approval based on ORR, which is contingent on the results of a confirmatory trial.

Safety

The most common adverse reactions reported with copanlisib were hyperglycemia (54%), diarrhea (36%), decrease in energy and strength (36%), hypertension (35%), leukopenia (36%), neutropenia, thrombocytopenia (22%), nausea (26%), and lower respiratory tract infections (21%).18 Pneumonia (8%), pneumonitis (5%), and hyperglycemia (5%) were the most frequent serious adverse reactions. Side effects may be different from idelalisib as copanlisib is administered intravenously and bypasses the gastrointestinal (GI) tract in an attempt to minimize severe GI side effects such as colitis. Per the prescribing information, caution is advised for GI toxicity, pulmonary toxicity, hyperglycemia, hypertension, dermatologic toxicity, bone marrow suppression, and infection.

Guidelines

Per NCCN guidelines for B-cell lymphomas, copanlisib is listed as a second-line and subsequent therapy in patients with FL who are refractory to at least 2 prior therapies.16

Durvalumab (Imfinzi®)

Indication

Durvalumab received accelerated approval for the use in patients with locally advanced or metastatic UC who have experienced disease progression with platinum-containing chemotherapy.20,21 The FDA granted priority review and breakthrough therapy designations to durvalumab, and the agent was approved only days before the approval of avelumab, which can be also used in UC. Durvalumab is a monoclonal antibody that inhibits the interaction of PD-L1 with PD-1 and CD80. This mechanism differs from PD-1 inhibitors, as it acts at the ligand on tumor cells. This inhibition leads to the activation of T-cells and decrease in tumor size by allowing T-cells to kill tumor cells. Unlike avelumab, durvalumab is engineered to prevent ADCC. The FDA simultaneously approved the VENTANA PD-L1 assay to test for PD-L1 expression, which may predict the likelihood of response to durvalumab.22

Efficacy

The approval of durvalumab was based on a phase 1/2 open label study.21,23 The study enrolled 191 patients with locally advanced or metastatic UC who have progressed on or refused chemotherapy. Patients received durvalumab 10 mg/kg IV every 2 weeks for up to 12 months, until disease progression, or until unacceptable toxicity. The median follow-up time was 5.78 months and ranged from 0.4 to 25.9 months. The primary endpoint, the ORR, was 17.8% (95% CI, 12.7% to 24%). In patients with high PD-L1 expression, the ORR was 27.6% (95% CI, 19% to 37.5%). The ORR was 5.1% (95% CI, 1.4% to 12.5%) in patients with low or no expression of PD-L1. The median PFS was 1.5 months (95% CI, 1.4 to 1.9 months) with 2.1 months (95% CI, 1.4 to 2.8 months) in patients with high PD-L1 expression and 1.4 months (95%CI, 1.3 to 1.5 months) in patients with low or no PD-L1 expression. The median OS was 18.2 months (95% CI, 8.1 months to not estimable) with 20 months (95% CI, 11.6 to not estimable) in patients with high PD-L1 expression and 8.1 months (95% CI, 3.1 to not estimable) in patients with low or no PD-L1 expression.

Safety

In the clinical study for UC, Grade 3/4 adverse events occurred in 6.8% of patients.23 The most common adverse events were fatigue (19.4%), decrease in appetite (9.4%), diarrhea (8.4%), and rash (7.3%). Immune-mediated warnings and concerns apply, such as adrenal insufficiency, rash, type 1 diabetes, colitis, hepatitis, hypophysitis, pneumonitis, nephritis, and others known to be associated with cancer immunotherapy are listed in the prescribing information.

Guidelines

Per NCCN Bladder Cancer guideline, durvalumab is an option as a subsequent systemic therapy for locally advanced or metastatic bladder cancer after first-line therapy.10

Inotuzumab ozogamicin (Besponsa™)

Indication

Inotuzumab ozogamicin is approved for treatment of adult patients with r/r B-cell precursor acute lymphoblastic leukemia (ALL) which is associated with poor prognosis in adults.24,25 The FDA granted priority review, breakthrough therapy and orphan drug status for this indication associated with poor prognosis. Inotuzumab ozogamicin, an antibody-drug conjugate (ADC) for CD22, selectively binds to tumor cells expressing CD22.25 An internalization of ADC-CD22 complex by cells leads to release of N-acetyl-gamma-calicheamicin dimethylhydrazide, which contributes to double-strand DNA breaks, cell cycle arrest, and apoptosis.

Efficacy

The approval of inotuzumab ozogamicin was based on INO-VATE ALL study.25 This was an open-label, multicenter, randomized, phase 3 study of inotuzumab ozogamicin versus standard of care in 326 adult patients with r/r B-cell ALL (CD22-positive, Philadelphia chromosome (Ph)-positive or negative) requiring first or second salvage treatment.26 The administered dose was 0.8 mg/m2 (or 0.5 mg/m2 if CR or CR with incomplete hematologic response (CRi) was achieved after cycle 1) on day 1, 0.5 mg/m2 on day 8 and 15 of 21 to 28-day cycles. The standard of care consisted of fludarabine with cytarabine and granulocyte-colony stimulating factor, mitoxantrone with cytarabine, or high-dose cytarabine. The primary endpoints were CR and OS. The study showed a higher CR rate in 80.7% (95% CI, 72.1 to 87.7) of patients in the inotuzumab ozogamicin group versus 29.4% (95% CI, 21.0 to 38.8) of patients in the standard therapy group (p<0.001). The PFS was greater at 5 months in the inotuzumab ozogamicin group versus 1.8 months in the standard therapy group with a hazard ratio (HR) of 0.45 (97.5% CI, 0.34 to 0.61; p<0.001). The median OS was 7.7 months in the inotuzumab ozogamicin group versus 6.7 months in the standard therapy group (HR, 0.77; 97.5% CI, 0.58 to 1.03; p=0.04).

Safety

According to the INO-VATE ALL study, the most common non-hematologic adverse event in the inotuzumab ozogamicin was a veno-occlusive liver disease (11% in the inotuzumab ozogamicin group versus 1% in the standard therapy group).26 Common treatment emergent adverse events with inotuzumab ozogamicin consisted of nausea (31%), headache (28%), and pyrexia (32%). The boxed warning for the agent mentions veno-occlusive liver disease and a higher non-relapse mortality after hematopoietic stem cell transplant.25

Guidelines

Per the NCCN ALL guideline, inotuzumab ozogamicin is an option for patients with Ph-positive ALL who are refractory or intolerant to tyrosine kinase inhibitors (TKIs).27 This agent is also recommended in patients with r/r Ph-negative ALL. The guideline also states that inotuzumab ozogamicin is associated with hepatic problems and has an increased risk for post-hematopoietic stem cell transplant non-relapse mortality.

Tisagenlecleucel (Kymriah™)

Indication

Tisagenlecleucel was the first-in-class CAR T-cell therapy.28 Tisagenlecleucel is approved for use following fludarabine and cyclophosphamide lymphodepleting chemotherapy in patients up to 25 years of age with r/r B-cell precursor ALL.29 Tisagenlecleucel targets CD19-expressing malignant cells with genetically modified autologous T-cells encoded with a CAR. Binding of CAR T-cells to CD19 promotes T-cell signaling, expansion, activation, and persistence to eliminate target cells.

Efficacy

Tisagenlecleucel was approved for r/r B-cell ALL based on results from the ELIANA trial.29 The ELIANA trial was an open-label, multicenter, single-arm, phase 2 trial assessing the safety and efficacy of at least 1 treatment of tisagenlecleucel therapy (0.2 to 5.0 x 10^6 cells/kg for patients ≤50 kg or 1.0 to 2.5 x 10^8 cells/kg for patients >50 kg) in 88 enrolled (68 treated) pediatric and young adult patients (median age of 12 years) with r/r B-cell ALL.30 The primary endpoint was overall remission rate of 82.5% with duration of remissions in 64% of patients at 9 and 12 months. The relapse-free probability at 6 months remission onset was 75% (95% CI, 57% to 87%) and OS was not reported. Tisagenlecleucel cellular productmanufacturing failures prevented 7 (8.0%) patients from being treated.

Safety

The most common adverse reactions in the ELIANA trial include CRS (79%), hypogammaglobulinemia (43%), infections (41%), fever (40%), decreased appetite (37%), headache (37%), encephalopathy (34%), hypotension (31%), bleeding (31%), tachycardia (26%), nausea (26%), diarrhea (26%), vomiting (26%), viral infections (26%), hypoxia (24%), fatigue (22%), acute kidney injury (22%), and delirium (21%).30 Half of all patients with CRS in this trial required tocilizumab. The most common (≥ 10%) Grade 3 or higher reactions include CRS, febrile neutropenia, hypoxia, hypotension, increased liver enzymes, decreased appetite, hypokalemia, cytopenias, and neurological events. Two deaths occurred within 30 days of tisagenlecleucel treatment (one due to ALL progression during CRS and another due to cerebral hemorrhage with resolving CRS). Tisagenlecleucel carries a boxed warning for CRS and neurologic events as 49% and 18% of patients experience Grade 3 to 4 effects, respectively. There is a REMS in effect to mitigate the risks of CRS and neurological toxicities.

Guidelines

The NCCN ALL guidelines recommend tisagenlecleucel as a single-agent therapy for patients under 26 years old with r/r B-cell ALL after 2 or more relapses, and if Ph -positive B-cell ALL then also after failure of 2 TKIs.27

Table 1. Properties of newly approved IV oncology agents in 2017.5,12,18,21,25,29,31

aPricing is based on average wholesale price.

bPricing is based on manufacturer statement.

Abbreviations: CR = complete response; CRi = complete response with incomplete hematologic recovery; IV = intravenous.

Conclusion

This article reviewed 6 novel intravenous or cellular therapies approved in 2017 for at-need patient populations in malignancies such as those with MCC, UC, r/r B-cell lymphoma, ALL, and FL. This represents 33% of all new oncology medications, medication combinations, or biosimilars approved, and 13% of new hematology or oncology indications approved in 2017. As a condition of the accelerated approvals, ongoing clinical trials to confirm clinical benefits of avelumab, copanlisib, and durvalumab are needed. Overall these are much welcomed approvals, but come with significant costs. While exciting breakthroughs in cellular technology such as CAR T-Cell therapy can potentially increase survival, they carry a significant price tag, hospital admissions, and the need for ancillary high cost medications such as tocilizumab. It is yet to be seen how these costs will be weighed against other potential therapies, including stem cell transplants. With combined increases in the complexity of newly approved medications, sky-rocketed price tags, and expedited approval pathways, it has never been more important to advance the conversation that correlates cost with defined value for patients and healthcare systems.

References:

1. Number of fast track designation requests granted. Food and Drug Administration website. https://www.accessdata.fda.gov/scripts/fdatrack/view/track.cfm?program=cder&status=public&id=CDER-RRDS-Number-of-Fast-Track-Designations-granted&fy=2012. Updated September 30, 2017. Accessed January 14, 2018.

2. CY 2017 CDER breakthrough therapy calendar year approvals. Food and Drug Administration website. https://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/
   HowDrugsareDevelopedandApproved/DrugandBiologicApprovalReports/
   NDAandBLAApprovalReports/UCM494010.pdf. Updated December 31, 2017. Accessed January 14, 2018.

3. Drugs@FDA: FDA approved drug products. Food and Drug Administration website. https://www.accessdata.fda.gov/scripts/cder/daf/. Accessed January 14, 2018.

4. Novel drug approvals for 2017. Food and Drug Administration website. https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DrugInnovation/ucm537040.htm. Updated January 12, 2018. Accessed January 15, 2018.

5. Bavencio [package insert]. Rockland, MA: EMD Serono, Inc; 2017.

6. FDA grants accelerated approval to avelumab for urothelial carcinoma. Food and Drug Administration website. https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm557162.htm. Updated May 9, 2017. Accessed January 15, 2018.

7. Avelumab (Bavencio). Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm547965.htm. Updated May 30, 2017. Accessed January 15, 2018.

8. Kaufman HL, Russell J, Hamid O, et al. Avelumab in patients with chemotherapy-refractory metastatic Merkel cell carcinoma: a multicentre, single-group, open-label, phase 2 trial. Lancet Oncol. 2016;17(10):1374-1385.

9. Patel M, Ellerton J, Infante J, et al. Avelumab in patients with metastatic urothelial carcinoma: pooled results from two cohorts of the phase 1b JAVELIN solid tumor trial. Poster presented at ASCO 2017. J Clin Oncol. 35:6; suppl 330.

10. NCCN Clinical Practice Guidelines in Oncology. Bladder Cancer Version 1.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. Published January 8, 2018. Accessed January 8, 2018.

11. NCCN Clinical Practice Guidelines in Oncology. Merkel Cell Carcinoma Version 1.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/mcc.pdf. Published September 18, 2017. Accessed January 8, 2018.

12. Yescarta [package insert]. Santa Monica, CA: Kite Pharma, Inc; 2017.

13. FDA approves axicabtagene ciloleucel for large B-cell lymphoma. Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm581296.htm. Updated October 25, 2017. Accessed January 15, 2018.

14. Locke FL, Neelapu SS, Bartlett NL, et al. Clinical and biological covariates of outcomes in ZUMA-1: a pivotal trial of axicabtagene ciloleucel (Axi-cel; KTE-C19) in patients with refractory aggressive non-Hodgkin lymphoma (r-NHL). Presented at: American Society for Clinical Oncology Annual Meeting; June 2-6, 2017; Chicago, IL.

15. A phase 1-2 multi-center study evaluating axicabtagene ciloleucel in subjects with refractory aggressive non-hodgkin lymphoma (ZUMA-1). Clinicaltrials.gov website. https://clinicaltrials.gov/ct2/show/NCT02348216. Updated December 17, 2017. Accessed February 8, 2018.

16. NCCN Clinical Practice Guidelines in Oncology. B-Cell Lymphomas Version 7.2017. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf. Published December 5, 2017. Accessed January 7, 2017.

17. FDA grants accelerated approval to copanlisib for relapsed follicular lymphoma. Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm576098.htm. Updated September 14, 2017. Accessed January 15, 2018.

18. Aliqopa [package insert]. Whippany, NJ: Bayer; 2017.

19. Zydelig [package insert]. Foster City, CA: Gilead Sciences, Inc.; 2017.

20. Durvalumab (Imfinzi). Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555930.htm. Updated May 1, 2017. Accessed January 15, 2018.

21. Imfinzi [package insert]. Wilmington, DE: AstraZeneca; 2017.

22. Roche receives FDA approval for complementary PD-L1 (SP263) biomarker test in urothelial carcinoma. Ventana website. http://www.ventana.com/roche-receives-fda-approval-complementary-pd-l1-sp263-biomarker-test-urothelial-carcinoma/. Updated May 2, 2017. Accessed February 12, 2018.

23. Powles T, O'Donnell PH, Massard C, et al. Efficacy and safety of durvalumab in locally advanced or metastatic urothelial carcinoma: updated results from a phase 1/2 open-label study. JAMA Oncol. 2017;3(9):e172411.

24. FDA approves inotuzumab ozogamicin for relapsed or refractory B-cell precursor ALL. Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm572133.htm. Updated August 17, 2017. Accessed January 15, 2018.

25. Besponsa [package insert]. Philadelphia, PA: Pfizer; 2017.

26. Kantarjian HM, DeAngelo DJ, Stelljes M, et al. Inotuzumab ozogamicin versus standard therapy for acute lymphoblastic leukemia. N Engl J Med. 2016;375(8):740-753.

27. NCCN Clinical Practice Guidelines in Oncology. Acute Lymphoblastic Leukemia Version 5.2017. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/all.pdf. Published October 27, 2017. Accessed January 8, 2018. In.

28. FDA approves tisagenlecleucel for B-cell ALL and tocilizumab for cytokine release syndrome. Food and Drug Administration website. https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm574154.htm. Updated September 7, 2017. Accessed January 25, 2018.

29. Kymriah [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2017.

30. Buechner J, Grupp S, Maude S, et al. Global registration trial of efficacy and safety of CTL019 in pediatric and young adult patients with relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL): update to the interim analysis. Clin Lymphoma Myeloma Leuk. 17:S263-S264.

31. LexiComp [database]. Hudson, OH: Wolters Kluwer Health; 2018. https://online.lexi.com/lco/action/home. Accessed January 5, 2018.

Educational Affairs Meeting News
ICHP 2018 Spring Meeting - Get the Handouts & the App!

Government Affairs Report
The Fun Has Begun!

by Jim Owen and Scott Meyers

Bill introduction is complete and now the real work begins for ICHP’s Government Affairs Division and the staff. With 3083 new bills this spring and nearly 5800 bills from last year that could be resurrected to sift through, the 2018 Spring Legislative Session is proving to be more excitement than we would like. Especially with the on-going deliberations of the Collaborative Pharmaceutical Task Force we discussed in February well underway!

As you will see from the attached list of proposed legislation, there is no shortage of pharmacy and health care related propositions to monitor! We will discuss a few briefly and then recommend you review the entire list for yourselves to see if one we didn’t mention grabs your personal attention!

SB2524 Amends the Environmental Protection Act to create the Pharmaceutical Disposal Task Force. The task force will be responsible for coordinating a public information campaign on the benefits of properly disposing of unused pharmaceutical products. The bill identifies task force members including one pharmacist and one representative of the retail sector (most likely from the Illinois Retail Merchants Association – IRMA). The sponsor of the bill is Sen. Chapin Rose – Champaign, R.

SB2529 Amends various acts prohibiting Illinois licensing authorities from denying, not renewing, suspending or revoking professional licenses as a result of default on state guaranteed student loans or scholarships. The sponsor of the bill is Sen. Steve Stadelman – Rockford, D.

SB2849 Creates the Prescription Drug Repository Program Act and requires the Department of Public Health to establish a prescription drug repository where citizens may donate unused medications for redistribution to the indigent. Participation in the program by pharmacies is voluntary and pharmacies who do participate in the program may charge a handling fee to fill prescriptions but may not charge for the medications. In addition, civil and criminal liability protection is provided for participants in the program unless harm is caused by willful and wanton behaviors. Sponsor of the bill is Sen. Patrician Van Pelt – Chicago, D.

SB2952 and HB4907 Amends the Controlled Substance Act by allowing the Department of Human Services to adopt rules allowing pharmacists and physicians who have registered to access the PMP to authorize licensed and non-licensed individuals who have been properly trained with regard to HIPAA requirements to access the PMP on their behalf. The bill also adds one dentist to the PMP Advisory Committee’s Peer Review Subcommittee. Sponsors of the bills are Sen. Melinda Bush – Grayslake, D and Rep. Mike McAuliffe – Chicago, R.

SB3431 Amends the Controlled Substance Act to restrict first prescriptions of opiates to a 7-day supply for patients 18 and older and all prescriptions for opiates for patients under 18 to a 7-day supply. There are exceptions for cancer or palliative care patients. The sponsor of the bill is Sen. Sue Rezin – Peru, D.

HB4650 Amends the Controlled Substance Act to allow pharmacists who are employed by Managed Care Organizations and Pharmacy Benefit Managers to access the PMP. Sponsored by Rep. Mike Zalewski – Riverside, D.

HB4707 Creates the Prescription Drug Task Force Act and establishes a 17 member task force to examine the extent of over prescribing of opioids has on patients and to make recommendations for future legislation to address the opioid crisis in Illinois. Sponsor of the bill is Rep. Sue Scherer – Decatur, D.

HB5442 Amends the Controlled Substance Act to require hospitals to transmit all controlled substance doses administered to inpatients to the PMP by the end of the business day. Requires all pharmacies to report by the end of the business day instead of the next business day. Sponsor of the bill is Rep. Jim Durkin – Burr Ridge, R.

HB5747 Amends the Pharmacy Practice Act to allow pharmacists to prescribe and dispense hormonal contraceptives (tablets, patch or ring) after completing approved training. Requires the pharmacist to provide the patient with a self-assessment form that will be reviewed and evaluated by the pharmacist prior to prescribing and dispensing. For patients 18 years of age and older or patients under 18 years of age if they have previously received a prescription for one of these products. Sponsor of the bill is Rep. Michelle Mussman – Schaumburg, D.

Here are all the bills ICHP is currently monitoring. If you have suggestions or an interest in these bills, please contact Scott Meyers at scottm@ichpnet.org.

2018 Illinois General Assembly Bill Summary

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Leadership Profile
Meet Bernice Man, PharmD

My story: Bernice Man, PharmD

Leadership position in ICHP: Chair of New Practitioners Network

Practice site: Practice Coordinator at Northwestern Medicine Specialty Pharmacy

I made a difference:

One my best experiences was with a recent interaction with an ulcerative colitis patient who expressed to me her appreciation for my work and reassurance in helping get her biologic medication covered.

Why pharmacy is for me:

My career path to pharmacy has been different than many other pharmacists as I previously worked in more arts-oriented fields such as acting, graphic design, and independent film. I joined pharmacy at an opportune time when the nature of our profession is in positive flux with the push for provider status and the emphasis on practicing at the top of our license. I truly enjoy having the opportunity to actively participate in making change in our profession through organizations such as ICHP. Through my work as the gastroenterology pharmacist in the specialty pharmacy, I also truly enjoy the opportunity to positively impact patients’ health and quality of life.

ICHP is great because:

ICHP is great because of the plethora of opportunities available to collaborate with like-minded people who actively participate in the progression of our profession.

First time joining ICHP:

I initially joined ICHP because of the SSHP booth at my pharmacy school’s student organization fair. At that time, I worked at a suburban community hospital as an inpatient pharmacy technician and already had in mind that I wanted to complete a residency. I had goals of increasing my involvement in SSHP so I subsequently ran for P1 Liaison. My SSHP leadership and ICHP involvement developed and grew from that point onward.

Special thanks for making me who I am today in my career:

There are a number of exceptional individuals who have inspired and guided me in my career thus far. I’d like to take this opportunity to thank Diana Isaacs, Bryan McCarthy, Katherine Miller, Jennifer Tryon, and Kevin Colgan. All of these individuals had and continue to have a strong impact and positive influence on my growth within pharmacy. I will always be so thankful and appreciative of their support.

Advice for a student:

I would advise student pharmacists to remain open-minded as one never knows where your life will lead, within and outside of pharmacy.

My special interests or hobbies outside of work:

Watching films (would highly recommend Phantom Thread and Loving Vincent) and going to concerts of many different genres, from classical to pop to new wave. I also enjoy playing mahjong with my family and going to baseball games.

Favorite restaurant or food:

I love restaurants and cuisines of all types, which is one of the best benefits of living in Chicago!

New Practitioners Network
Is There a Better Way to do That? From Practitioner to Resident - A Step Back to Look Forward

by Elana Nelson, PharmD, BCPS, PGY2 Drug Information Resident, University of Illinois - Chicago

It was over two years ago that I decided to pursue a non-traditional path in pharmacy. Although I enjoyed what I was doing at the time, I still had some regrets about not following what I loved after my PGY1 residency. I was encouraged when I received some advice from an older, experienced pharmacist. “Follow your passion”, he advised. He stated that he wished he could have done things differently many years ago when he was young and it was early in his career. I learned from him that fear is a huge deterrent. Fear is the main thing that can stop many people from pursuing their dreams. However, when you face your fears head-on, you can do unbelievable things. I decided to face my fears and applied for a PGY2 residency four years after completing my PGY1 residency. I have learned many valuable lessons from taking that step.

It was during the first month of my residency that I quickly realized I was not alone. Although my path in pharmacy is not traditional, there are many others who did not pursue a second year of residency immediately after completing a PGY1. Two of my preceptors completed a PGY2 residency several years after working as clinical pharmacists. These preceptors had a substantial impact on my development. They were there to provide support and inspiration because of their similar experiences.

In addition to these preceptors, I am thankful that I found a good mentor who has guided me through the more challenging aspects of residency training. The importance of having a mentor cannot be overemphasized. Much of my personal and professional success can be attributed to the advice I received from her. She has changed my perspective, helped me stay motivated, and continues to serve as a great resource.

What makes my PGY2 residency worthwhile is that I am doing the work I enjoy. It is true that a residency requires wearing many different hats and acquiring several skills simultaneously, but the bottom line is that I have found my passion. This makes the work not so hard.

Finally, the most important lesson I have learned is that sometimes our careers may lead to new experiences and opportunities that we might not have imagined. Keep yourself prepared for the unexpected experiences that may come your way. A pharmacy career is a journey that offers real opportunities, potential, and variety. It is one thing to be good at something, but to enjoy it and be very passionate about it is quite different.

When you find what you love, follow that passion. You will be more successful and happier if you do.

Professional Affairs
Pharmacist Burnout: A Decline in the Health of Healthcare Professionals

by Jen Phillips, PharmD, BCPS, FCCP, FASHP Associate Professor, Pharmacy Practice, Midwestern University Chicago College of Pharmacy and Jane Lee, PharmD Candidate, Midwestern University, Chicago College of Pharmacy

The Issue

The term “burnout” describes the characteristics of chronic, unrelieved stress that can result in running out of the sustenance necessary to continue functioning at a healthy capacity. Common signs involve emotional exhaustion, amplified depersonalization, and feelings of inadequacy in the workplace.^1,2 Perhaps the most surprising of these three for a healthcare professional, is depersonalization, which involves viewing people as objects rather than human beings.² Exhaustion and inefficacy may be reversible with appropriate rest and refocus, but depersonalization can result in a permanent psychological shift in the way healthcare providers think about their profession. A 2014 study analyzing the prevalence of burnout among practicing physicians (N=35,922) found that more than half (54.4%) exhibited at least one symptom of burnout.² Moreover, these results represented a 10% increase in burnout compared to a similar study performed 3 years earlier in 2011.¹

The Data

The consequences of clinician burnout include detrimental effects on quality, safety, patient satisfaction, and healthcare costs. Specifically, stress levels, burnout, and emotional exhaustion among physicians and nurses has been correlated with increased number of malpractice lawsuits,³ health-care associated infections,⁴ and mortality.⁵ From a patient perspective, depersonalization has been shown to affect patient satisfaction,^6,7,8,9 and patient adherence to medical advice.¹⁰ These consequences substantiate a need for increased awareness of burnout and systematic changes to prevent it from occurring in all healthcare practitioners and trainees.

Most of the published research describing the prevalence of stress, depression, and other detrimental effects of burnout has involved the medical and nursing disciplines. Medical residents and students, in particular, have been found to have worse outcomes than age-similar individuals in different careers.¹¹ Limited data exists for other members of the health care team, but there seems a high likelihood that these results can be extrapolated to other members of the healthcare team, including pharmacists.

One cross-sectional study evaluated the effects of job demands and interpersonal interactions of 566 hospital pharmacists on work-related outcomes, such as organizational and professional commitment, job satisfaction, burnout, and professional identify.¹² The researchers based their objective on the job demands-resources model (JD-R). The JD-R model assumes that pharmacist burnout occurs through exhaustion and job disengagement from lack of resources.¹² The researchers found a correlation between poor work environments (defined as high-demand/unpleasant interactions) and the frequency (r 2 =0.08, p<0.01) and intensity (r2 =0.07, p<0.01) of emotional exhaustion.¹² In addition, there was also a correlation between positive work environments (defined as low-demand/pleasant encounters) and the frequency (r2 =0.11, p<0.001) and intensity (r2 =0.05, p<0.001) of feeling personal accomplishment.¹² The results of this study support the JD-R model and provided an alternative method of looking at the quality of pharmacy practice work environments.

The impact of stress and burnout among trainees has also been evaluated. One study investigated stress levels in pharmacy residents.¹³ This cross-sectional study assessed stress reported by PGY-1 and PGY-2 residents through survey questionnaires sent to program directors from 2011 to 2012.¹³ To measure stress and negative affect levels, the 10-item Perceived Stress Scale (PSS10) and the Multiple Affect Adjective Checklist-Revised (MAACL-R) were utilized. Both are validated or widely used psychological tools. Age and program year did not result in significantly different PSS10 scores.¹³ However, MAACL-R scores for hostility were higher for PGY2 residents compared to PGY1 residents (50.83 vs. 48.62, respectively, p=0.017).¹³ Working more than 60 hours per week correlated with higher stress levels on the PSS10 (r=0.143, p=0.001) and higher scores on the MAACL-R hostility subscale (r=0.0088, p<0.05), depression subscale (r=0.118, p<0.05), and dysphoria subscale (r=0.119, p<0.05) for the entire sample¹³ This is important to note, as the data suggests that even with the American Society of Health-System Pharmacists’ (ASHP) current residency duty hour limitation set at a maximum of 80 hours per week, residents may still be experiencing inappropriate amounts of stress.

Strategies to Address the Issue

As a response to the data that continues to emerge on the consequences of healthcare worker burnout, many organizations have begun studying the issues further. The National Academy of Medicine (NAM) issued an Action Collaborative on Clinical Well-Being and Resilience in 2017.¹⁴ The collaborative consists of over 50 sponsoring organizations that have committed to addressing the issue of clinician burnout. The NAM document separates factors affecting healthcare professional well-being into individual and external categories.¹⁴ Sub-factors such as the healthcare role, relationships and social support, learned skills and abilities, and personal elements, are grouped into the individual category.¹⁴ The external category is composed of the work environment, regulatory environment, organizational elements, and society itself.¹⁴ Some factors – such as organizational element, learned skills and abilities, and relationships/social support - may require less time and resources for improvement. All of these elements have communication-based cores. Improving communication can assist with these three factors. Other factors, including the work or regulatory environment, may take more time and resources to change.

In an article published by the Annals of Family Medicine, the authors present reasons to expand the “Triple Aim” to the “Quadruple Aim”.¹⁵ The Triple Aim was a framework developed by the Institute for Healthcare Improvement (IHI), as an initiative to “enhance patient experience, improve population health, and reduce costs”.¹⁵ Improving the lives of “health care providers, including clinicians and staff” was the goal of the fourth addendum.¹⁵ Even though the data presented supporting this addendum was on nurse and physician burnout, the authors summarized that “those who deliver care” are the focus of the fourth aim.

To respond to the issue of clinician burnout, pharmacy and other healthcare organizations have begun developing and implementing policies advocating clinician well-being and resilience in the workplace. The American Medical Association (AMA) recognizes burnout in students, residents, and physicians, and has policies in place supporting collaboration with other groups to maintain continued awareness of this topic. They also encourage research, monitoring of the issue, and mindfulness education. For nurses, the American Nursing Association (ANA) has a separate policy regarding fatigue, safety, and health, to be upheld by both nurses and employers. The American Pharmacists Association (APhA) encourages employers to provide tools for stress and conflict management. Regarding working conditions on public safety, APhA opposes having a quota for prescriptions that need to be dispensed during a certain time period. ASHP has policies addressing several topics related to clinician burnout, including: workplace violence, intimidating or disruptive behaviors, support for second victims, and the relationship between staff fatigue and medication errors. In addition, ASHP is one of the sponsors of the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience and is actively working toward developing policies and strategies to address the issue of clinician burnout.

Conclusion

The issue of healthcare professional burnout must be addressed for the sake of the patients, who deserve safe, high-quality care and for the health and well-being of the healthcare workers. Strategies to improve resilience must be developed and shared with all healthcare professionals.

Many healthcare employers offer physical and mental well-being programs at their workplace, however, few offer programs specifically address issues such as burnout. As more research becomes available, institutions should use this data to expand the support and outreach programs available to employees. Managers should ensure that their healthcare workers are aware of the resources that are available to them. In addition, those who are involved in the training of pharmacy students, residents, or fellows should be aware of the potentially deleterious effects of stress on performance and well-being and should refer them to appropriate resources at the college/institution to assist them.

Pharmacists and technicians who are ASHP members may be interested in joining the Clinician Well Being and Resilience community on ASHP connect to join the conversation on this issue and potentially share tips, advice, resources, and support. Finally, academicians and clinicians involved in research can assist by conducting more research in this area so that we can understand the issue more thoroughly and devise evidence-based solutions to help curb this epidemic.

The issue of healthcare professional burnout is an important one that deserves attention and action. Improving visibility of this issue at the organizational, state, and local levels is the first step in addressing this problem.

References:

1) Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012; 172:1377-85.

2) Shanafelt TD, Hasan O, Dyrbye L, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proc. 2015; 90:1600-13.

3) Jones JW, Barge BN, Steffy BD, et al. Stress and medical malpractice: Organizational risk assessment and intervention. J Appl Psychol. 1988;73:727-35.

4) Cimiotti JP, Aiken LH, Sloane DM, et al. Nurse staffing, burnout, and health care-associated infections. [Erratum appears in Am J Infect Control. 2012 Sep;40(7):680]. Am J Infect Control. 2012;40:486.

5) Welp A, Meier LL, Manser T. Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol. 2015;5:1-13.

6) Halbesleben JRB, Rathert C. Linking physician burnout and patient ouccomes: Exploring the dyadic relationship between physicians and patients. Health Care Manage Rev. 2008;33:29-39.

7) McHugh MD, Kutney-Lee A, Cimiotti JP, et al. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff. 2011;30:202-10.

8) Leiter MP, Harvie P, Frizell C. The correspondence of patient satisfaction and nurse burnout. Soc Sci Med. 1998;47:1611-7.

9) Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction. Med Care. 2004;42:1157-66.

10) DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians’ characteristics influence patients’ adherence to medical treatment: Results from the medical outcomes study. Health Pyshcol. 1993;12:93-102.

11) Waldman VS, Cruz Lopez Diez J, Arazi CH, et al. Burnout, perceived stress, and depression among cardiology residents in Argentina. Acad Psychiatr. 2009;33:296-301.

12) Gaither CA, Nadkarni A. Interpersonal interactions, job demands and work-related outcomes in pharmacy. Int J Pharm Pract. 2012, 20, pp. 80-89.

13) Le HM, Young SD. Evaluation of stress experienced by pharmacy residents. Am J Health-Syst Pharm. 2017; 74:599-604.

14) National Academy of Sciences. National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience. Available at: https://nam.edu/initiatives/clinician-resilience-and-well-being/. Accessed 2018 Feb 22.

15) Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014; 12: 573-576.

Professional Affairs - Call for Entries
Best Practice Award!

Call for Nominations
Lead, Follow or Get out of the Way! How Would You Like to Run for an ICHP Office?

Feature Article

by Scott A. Meyers, Executive Vice President

Have you ever observed a group with a purpose? Every effective group has a leader or two, a bunch of people ready to do whatever is needed and a few people who stand around and watch what happens. Every year, ICHP elects new members to its Board of Directors – the Leaders. Those are the folks we will begin searching for over the next couple of months.

Don’t get me wrong, we need a lot of those group members who are ready to do whatever the group has as a goal and in ICHP’s case that goal or mission is “Advancing Excellence in Pharmacy!” We recruit these folks all year long! We’ll call them Followers. Oh, and the Watchers, most often eventually become the Followers, ready to work on the goals and well, you can see where I’m headed.

So, every year the ICHP Committee on Nominations sifts through the Followers searching for new Leaders to step up to carry on the business of the Council and who are already dedicated to “Advancing Excellence in Pharmacy!”

This year is no exception. With Charlene Hope completing her term as Immediate Past President, ICHP will need someone to enter the top leader rotation as President-elect, which leads to President and eventually Immediate Past President over three years. In addition, Board Members Kathryn Schultz, Chris Crank, Mary Lee, Karin Terry, Elise Wozniak, and Amy Boblitt have a year left on their current terms and can run for another term for their respective offices if they choose. And even if they do decide to run again, the Committee on Nominations will be seeking a second candidate to make the ballot complete. Lynn Fromm will complete her second term as Southern Region Director next year so we will need both candidates for that position. And every year we need two energetic New Practitioners to step up and run for the New Practitioners Network Chair-elect. By the way, since 2003 when we formed the New Practitioners Network, several of the NPN Chairs have gone on to serve in a variety of offices within ICHP and other state societies!

Below is the complete list of the offices open for election in the fall of 2018. All the elected candidates will take office at the 2019 Annual Meeting in September with the exception of the President-elect, who assumes office immediately. So each new leader will have almost a year to train for their new jobs and be coached by our current Board Members. You don’t have to start leading right away!

President-elect

Treasurer-elect

Director-elect of Division of Government Affairs

Director-elect of the Division of Organizational Affairs

Director-elect of Division of Professional Affairs

Northern Region Director-elect

Central Region Director-elect

Southern Region Director-elect

NPN Chair-elect

If you are interested in running for an office or you would like to know more about an office before committing to run, you may contact Committee on Nominations Chair, Charlene Hope at chope@macneal.com or Scott Meyers at scottm@ichpnet.org. We hope you are ready to become an ICHP and Pharmacy Leader!

Meet Xing Jin

Feature Article

by Xing Jin, Doctor of Pharmacy Candidate 2018, UIC - Rockford

You Want Me to Talk to a Legislator???

Feature Article

by Kathryn Schultz, PharmD, BCPS, BCOP, ICHP Treasurer and member of Division of Government Affairs; Michaela Murphy, PharmD Candidate 2020, Rush University Medical center, Pharmacy Technician Intern; Katie Dalton, PharmD Candidate 2019, Rush University Medical Center, Pharmacy Technician Intern

On Wednesday, March 7, 2018, about 400 pharmacists, pharmacy students, and pharmacy technicians visited Springfield, IL for “Illinois Pharmacy Legislative Day: Under the Dome” during the 100th Illinois General Assembly to speak with legislators regarding important pharmacy issues. While visiting the Capitol, we not only met with our legislators but we also listened to the House of Representatives while they were in session. It was interesting to observe the operations of our legislative process first hand and very rewarding to be able to personally educate our legislators on the impact these bills would have on our profession. The four bills of focus for 2018 are summarized below along with recommendations for your legislator on how to vote on these issues.

1) HB5442: Clogging the PMP with Unnecessary Information. This bill amends the Controlled Substance Act to require hospitals to report all controlled substances ordered and administered to patients to the Prescription Monitoring Program (PMP).

a. However, this reporting is likely unnecessary and takes away from the purpose of the PMP, which is to monitor for patients who are “provider shopping” and potentially abusing controlled substances. Patients are not able to “provider shop” within the hospital and are closely monitored by multiple disciplines (including pharmacy) for appropriate usage.

b. Adding all these inpatient orders would clog up the PMP! Recommend to your legislator to VOTE NO!

2) HB3285/SB1844: Extending Pharmacy Rights by Instituting Audit Protections. This bill amends the Illinois Insurance Code to provide fair guidelines on pharmacy audits by Pharmacy Benefit Managers (PBMs).

a. In the state of llinois, one has to undergo the rigorous process of registering as a PBM and pay $49 to start auditing pharmacies and “recouping” payment for insurance companies.

b. The purpose of a PBM should be to audit for fraud, waste, and abuse of insurance payments. However, PBMs in their current state, are completely unregulated and can charge-back payments for computer or clerical errors that had no negative impact on the patient.

c. Recommend to your legislator to VOTE YES and extend pharmacy rights by instituting audit protections.

3) HB3479/SB1888: Preserving Pharmacies in Our Communities and for Our Patients. This bill amends the Illinois Public Aid code to provide fair reimbursement within the Managed Care Organization (MCO) contracts with the state of Illinois for Medicaid.

a. Previously, Medicaid reimbursed based on a Fee-For-Services methodology. In 2016, a pilot program was started that attempts to improve health outcomes while controlling health care costs. This new program utilized contracts with MCOs to provide insurance coverage to the ~25% of the residents of Illinois who are on Medicaid.

b. Analysis of the pilot program has shown a significant reduction in the reimbursement of prescriptions dispensed and pharmacist-provided patient care services are well below acquisition costs (how much it costs the pharmacy to purchase the drug).

c. This bill provides guidance for fair reimbursement so that it is not below the acquisition cost and a fair and reasonable professional fee to be established for pharmacist-provided patient care services.

d. It also requires improved documentation of dollars handled by the MCOs (who paid who and how much) as there is currently a report that $7.1 billion dollars is unaccounted for in 2016 alone.

e. Please VOTE YES to mandate that MCOs contract with the Illinois Department of Healthcare and Family Services (HFS) to establish, maintain, and provide a fair and reasonable reimbursement rate to pharmacy providers for prescriptions dispensed and pharmacist-provided patient care services.

4) HB5747: Improving Women’s Access to Hormonal Contraception. This bill amends the Pharmacy Practice Act to allow pharmacists to provide patients with increased access to hormonal contraceptives.

a. Pharmacists with specialized training will be able to provide hormonal contraceptive patches, vaginal rings, and self-administered oral hormonal contraceptives after a patient’s medical history is screened. Access to contraceptives is crucial in reducing unintended pregnancies.

b. The contraceptives would continue to be covered by insurance.

c. Currently Oregon, California, Colorado, New Mexico, Maryland, and Hawaii all have programs that allow pharmacists to prescribe contraception. It is estimated that having pharmacists in this role could decrease the number of unintended pregnancies by 7-25%.

d. Please VOTE YES to expand women’s access to hormonal contraceptives!

So Now What?

We cannot solely rely on one day in Springfield to advocate for our profession! If you don’t know who your legislator is, look them up here:

http://www.elections.illinois.gov/DistrictLocator/DistrictOfficialSearchByAddress.aspx

Become an advocate for our profession – legislators want to hear from you! Contact them and educate them on the impact these bills will have on our profession and our patients. Most of them do not understand what a hospital pharmacist does, so invite them to see what hospital pharmacy is all about! In November 2017, we invited Representative Sonya Harper to come to Rush University Medical Center for a short visit. This was a great experience for everyone!

How Can You Set up a Visit?

First, get approval from your director of pharmacy and determine who else at the institution needs to approve the visit before arranging it. For our institution, we needed the approval of the Vice-President of the health system. We also reached out to public affairs to confirm whether they needed to be notified and we were asked to have a visitor HIPAA confidentiality form signed by the representative. We emailed the representative and worked with her local assistant to set up the time and location and relay the need for the HIPAA form to be signed.

Be patient with setting up these appointments! The representative may need to cancel and reschedule their visit, since their schedules are ever changing. We had to reschedule 3 times, but we were understanding of her need to reschedule and it finally worked out! Keep the visit SHORT! There are so many people wanting the ear of these legislators. We kept our visit to 1 hour. During that visit we showed her what interdisciplinary patient care rounds are about and how the pharmacist can have a role in these. Be sure to prep your physicians that they may encounter the legislator. We were fortunate to have a very strong advocate for pharmacists with the physician leading rounds so he even had a direct conversation with Representative Harper about the value he sees in having a pharmacist on rounds! We then took her on a tour to a pharmacy satellite and to the central pharmacy. We described how we incorporate technology into our work, our work with pharmacy technicians, and how important the technician’s role is for hospital pharmacy. Finally, we had her observe our daily huddle—essentially a 10-15 minute sign-out from day shift to evening shift of any issues and updates on drug shortages.

What’s next? Invite more legislators to see what hospital pharmacy is all about! Representative Harper commented on how her eyes had been opened to a whole new aspect of pharmacy. We were then able to meet with her again in Springfield for Legislative Day. She recognized us and we were able to have a great conversation with her about the current bills.

We encourage you to reach out to your legislators and invite them to visit your hospital so that we can continue to educate them on the practice of hospital pharmacy. This better understanding of what pharmacists and pharmacy technicians do will be of value in the near future when there are bills that impact our practice and especially as we work to propose changes to the Pharmacy Practice Act before it sunsets.

If you are looking to become even more involved, you can also consider joining the ICHP Division of Government Affairs to be a proponent of the change for our profession!

Midwestern University Chicago College of Pharmacy
Reflections of a Student Pharmacist

College Connection

by Ziad Dabbagh, PS-2, ICHP Historian

Will Assibey, Jr. is a PharmD candidate who is studying at Midwestern University Chicago College of Pharmacy. Through his reflections on his past experiences, I learned about his involvement on campus and how his activities relate to where he wants to take is pharmacy career. Beginning pharmacy school in the Fall of 2015, Will has had a variety of experiences which he was willing to reflect on during our interview in hopes that they will aid other students who may be interested in becoming more involved with organizations during pharmacy school.

Our interview began with an explanation of past experiences as they related to his first year as a pharmacy student. “I wasn’t very sure where I wanted to go in my career, like many students, so I decided to join organizations,” explained Will. During his first year, he was a member of many organizations. Will explained that it was easy to become overwhelmed with the amount of information and the multitude of directions that each organization could take a person. Through various campus activities which encouraged involvement and self-discovery, Will was able to whittle down his interests to four organizations in which to immerse himself. Will chose to become involved in Phi Delta Chi (PDC; to foster camaraderie with other students), the American Pharmacists Association – Academy of Student Pharmacists (APhA-ASP; due to his interest in pharmacy as a profession), the American Association of Pharmaceutical Scientists (AAPS; to gain some insight into the pharmaceutical industry), and the Illinois Council of Health System Pharmacists (ICHP; to gain a better understanding of pharmacy and how it is practiced in Illinois). Will spent the “majority of [his] first year getting to know others and picking their minds regarding school.”

Progressing to a second-year pharmacy student and with more refined interests, Will continued his involvement with all of the same organizations, except now taking on more responsibility as an elected board member for APhA-ASP and PDC. One particular project Will enjoyed was being a volunteer for the Medication Therapy Management / Collaborative Healthcare Advocacy Team (MTM/CHAT) in Bolingbrook, Illinois. MTM/CHAT is a collaborative effort at a healthcare center in Bolingbrook which enables students to give back to the community by practicing medication therapy management services and gaining experience by counseling patients about diabetes. Asked to comment on his second-year, Will had to say that aside from studying his “roles have taken a better portion of [his] time which has limited [him] from being involved with other organizations.” Recalling the time spent being involved with APhA-ASP and ICHP during his second-year, Will enjoyed when these organizations brought in professionals to share their insight on different areas of pharmacy; he also shared with me that it is his goal to one day speak about his experiences in pharmacy.

Although this is now Will’s third year in pharmacy school, he recollects his memories about things he has experienced thus far for the purpose of sharing his perspective. This year, Will has “learned how to taken charge of projects while aiding in the improvement” of organizations in which he is involved. Organizations such as PDC, of which he is currently the president, along with APhA-ASP where he serves as the Membership Chair. Recently, he was involved in the promotion of an event for APhA-ASP which brought students and residency directors together to discuss residencies and answer any questions students may have regarding post-graduate education.

While only time will tell what happens in Will’s future, he hopes to stay involved and muses over what a fourth year pharmacy student’s life may be like and the things that he may learn. Hoping that “rotations will give more insight on what the real world is like,” he realizes that so far, he seems to have a strong interest in clinical pharmacy and plans on pursuing this route as a long-term career path. Until then, it is Will’s goal to apply for a residency in this area and stay up-to-date with the profession.

Roosevelt University College of Pharmacy
New Updates and Upcoming E-board Elections

College Connection

by Anna Majerczak, PS3, SSHP Webmaster and Membership Chair & Hayden Hagemann, PS-3, Treasurer

Our SSHP chapter at Roosevelt University has been quite busy these past few weeks and has a lot of events planned for our coming term! We have recently added a PAI subcommittee to our organization and welcomed two new members to our Executive Board. We have also worked in conjunction with other student organizations within our College of Pharmacy to promote student involvement, professional development, and raise money for charity.

We hosted our spring journal club on the article, “Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis”. There was a great turn-out with 21 attendees, including three clinical faculty members, and lively discussions that had the whole room involved. To close out our spring term, we have a CV workshop set up that will include several of the clinical faculty at Roosevelt. Members will have the opportunity to send their CV in to our Executive Board, and we will then evenly distribute them out for faculty review. This event is very timely as our P3 students are moving closer to APPE rotations and career/residency applications.

Dr. Matt Dandino, PharmD, BCPS, from Mount Sinai Hospital in Chicago, IL is coming to speak to our organization about a process he worked on to streamline a transitions of care service line. This is a great opportunity for students to learn more about a topic in which pharmacists can play a huge role. We are also gearing up for our annual residency round table event by reaching out to Northwestern Memorial Hospital, Rush University Medical Center, Advocate Christ Hospital, and Mount Sinai Hospital to invite current pharmacy residents to RUCOP to answer questions regarding their path to residency. Our last residency round table event was extremely successful and we are hoping this one will be the same.

The SSHP worked concurrently with our student government to sponsor a hot chocolate bar during a finals week De-Stress Fest. De-Stress Fest was created to help fellow students relax and take a break during the most stressful time of the term. We are currently working with Kappa Psi to fundraise for St. Baldrick’s Foundation to raise money and promote awareness for childhood cancer. We made a “pot of gold” basket to raffle off at a trivia night hosted by our student government. Finally, we are also giving back to the community by volunteering at Feed My Starving Children. We are looking forward to volunteering and helping those in need with other classmates and our faculty.

Looking to the next academic year, we are in the process of holding Executive Board elections. We are running elections earlier than in the past to allow the new Executive Board more time to shadow and train under our wing. We hope by electing our new Executive Board early it will allow them to be better prepared to take over next year. We are extremely excited to get our new Executive Board training and hear their ideas for next years’ events.

Rosalind Franklin University
Giving Back at RFU

College Connection

by Joseph DeSantis College of Pharmacy Class of 2019, ICHP Treasurer

At Rosalind Franklin University, our ICHP chapter puts great emphasis on patient advocacy and community outreach. During the Winter quarter, we wanted to extend our patient outreach to a population we thought could use more attention. We contacted a local elementary school in Waukegan, IL, and participated in the “Kicking Asthma” event sponsored by the American Lung Association. The goal of this event was to educate children on how to manage asthma and prevent asthma exacerbations. It is important for children of this age to learn about asthma, not only because it might affect them personally, but they might also have friends or family who are affected as well. Most students that attended were referred by the school nurses that are diagnosed with asthma but students without an asthma diagnosis were in attendance.

The event was divided into 4 different sessions, each with their own learning objectives. In the first session, we introduced and reviewed the basics of asthma and provided general information about how asthma exacerbations affect the lungs. In addition, we emphasized recognizing common signs and symptoms of an asthma attack. Lastly, we asked participants to identify personal goals that can help them to maintain control of their asthma.

The second session focused on preventing asthma exacerbations and identifying asthma triggers and warning signs. This session allowed participants to identify their own specific triggers and signs that an asthma attack is imminent to help them either avoid or prevent an asthma exacerbation. During this session we emphasized the importance of regular doctor visits for follow-up and medication review.

The third session focused on medications to control asthma. We discussed how each medication works for treating asthma and preventing exacerbations. Proper technique for specific inhalers was demonstrated for each inhaler and we discussed proper storage requirements. We stressed the importance of medication adherence, as this can help prevent asthma symptoms and exacerbations.

The fourth and final session focused on tying everything together. We taught the participants what to do in emergency situations and helped them find solutions to problems if something in their asthma plan did not go exactly as expected.

This event was a great way for us to build a relationship with our community while being able to help future generations. The children who we interacted with were all very excited and happy to attend each session. A lot of healthcare professionals do not have the opportunity to interact with the pediatric population. I would recommend this to everyone because children are not only a joy to be around but they are our future as well.

Officers and Board of Directors

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Student Chapter Presidents

Ashley Shinnick - Chicago State University College of Pharmacy

Ashinnic@csu.edu

Maggie Lau - Midwestern University Chicago College of Pharmacy

wlau17@midwestern.edu

Kimberly Zaleski - Roosevelt University College of Pharmacy

kzaleski@mail.roosevelt.edu

Aprille Banchoencharoensuk - Rosalind Franklin University 
College of Pharmacy

aprille.banchoencharoensuk@my.rfums.org

Kaylee Poole - Southern Illinois University Edwardsville School of Pharmacy

kapoole@siue.edu

David Silva - University of Illinois at Chicago College of Pharmacy

dsilva8@uic.edu

HyeRim Whang Kong - University of Illinois at Chicago - Rockford Campus College of Pharmacy

hwhang2@uic.edu

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ICHP Affiliates

Northern Illinois Society (NISHP)

Erika Hellenbart
President

ehellen@uic.edu

Denise Kolanczyk
President-elect

Antoine Jenkins
Immediate Past President

(773) 821-2592 

at-jenkins@csu.edu

David Martin
Treasurer

dwmartin0713@gmail.com

Milena McLaughin
Secretary

(630) 515-7293 

mmclau@midwestern.edu

Vera Kalin
Technician Representative

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West Central Society of Health-System Pharmacists (WSHP

Ed Rainville
President

ed.c.rainville@osfhealthcare.org

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Metro East Society (MESHP)

Jared Sheley
President

jpsheley@gmail.com

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Sangamiss Society of Heath-System Pharmacists

Julie Downen
President

217) 788-3953

downen.julie@mhsil.com

Billee Samples
President-elect

Katelyn Conklen
Immediate Past President

Conklen.Katelyn@mhsil.com

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Vacant Roles at Affiliates; President, Rock Valley Society; Southern IL Society; Sugar Creek Society

Follow us! Find us here:

    

Upcoming Events

Visit the ICHP Calendar for the most up-to-date events!             

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Monday, April 9, 2018

NPN Social Event

Sunda

110 W. Illinois St., Chicago, IL

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April 13 - 14, 2018

ICHP Spring Meeting

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Tuesday, May 1, 2018  
Current Pharmacy Law Cases

Edward Rickert, BS Pharm, JD, Partner, Quarles & Brady

Champions LIVE Webinar

Save the Date! Watch for more information in upcoming news briefs.  

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Tuesday, May 8, 2018  - 6:00 PM
NISHP Double Feature 
WildFire Chicago
159 W. Erie St., Chicago, IL
Presentation #1:
New Treatment Options for Distributive Shock
Scott Benken, PharmD, BCPS-AQ Cardiology
Clinical Assistant Professor, University of Illinois at Chicago College of Pharmacy
Clinical Pharmacist, Medical and Cardiothoracic Surgery Intensive Care
University of Illinois Hospital and Health Sciences System
(Presentation #1 is Sponsored by La Jolla Pharmaceutical Company)

Presentation #2:
Women's and Men's Health Updates: Focus on Hormonal Therapy
Brooke Griffin, PharmD, BCACP
Professor of Pharmacy Practice and Vice Chair for Clinical Services
Midwestern University Chicago College of Pharmacy

and

Drew Halbur, PharmD
Comprehensive Pharmacy Services
Clinical Specialist, Ambulatory Care

(Accredited for pharmacists and pharmacy technicians | 1.0 contact hour (0.1 CEU)

(Presentation #2 is Sponsored by ICHP)

Program seating is limited with only 10 slots available for students. 

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ICHP Pharmacy Action Fund (PAC) Contributors

ichp_pharmacy_action_fund/donation_form/ichp_pharmacy_action.php  to make a contribution!

 

The above represents lifetime contributions of those ICHP members who have contributed to the ICHP Pharmacy Action Fund in the last 12-months.

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