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KeePosted
Official News journal of the Illinois Council of Health-System Pharmacists

EDITOR
Jennifer Phillips

ASSISTANT EDITOR
Milena McLaughlin

MANAGING EDITOR
Scott Meyers

ASSISTANT MANAGING EDITOR
Trish Wegner

DESIGN EDITOR
Melissa Dyrdahl

ICHP Staff
EXECUTIVE VICE PRESIDENT
Scott Meyers

VICE PRESIDENT - PROFESSIONAL SERVICES
Trish Wegner

DIRECTOR OF OPERATIONS
Maggie Allen

INFORMATION SPECIALIST
Heidi Sunday

CUSTOMER SERVICE AND
PHARMACY TECH TOPICS™ SPECIALIST
Jo Ann Haley

ACCOUNTANTS
Jan Mark

COMMUNICATIONS MANAGER
Melissa Dyrdahl

LEGISLATIVE CONSULTANT

Jim Owen

ICHP's Mission Statement

Advancing Excellence in Pharmacy

ICHP's Vision Statement

ICHP dedicates itself to achieving a vision of pharmacy practice where:

· Pharmacists are universally recognized as health care professionals and essential providers of health care services.

· Pharmacists use their medication expertise and leadership skills to optimize the medication use process and patient outcomes.

· Pharmacy technicians are trained and PTCB certified to manage the medication distribution process.

ICHP's Goal Statements

· Raising awareness of the critical role pharmacists fulfill in optimizing medication therapy and ensuring medication safety in team-based, patient-centered care.

· Providing high quality educational services through innovative continuing pharmacy education and training programs, and sharing evidence-based best practices.

· Developing and nurturing leaders through mentorship, skill development programs, and leadership opportunities.

· Working with national and state legislators and policymakers to create or revise legislation and regulation critical to pharmacy practice and quality patient care.

· Urging pharmacy technician employers to require successful completion of an accredited pharmacy technician training program and PTCB certification of all pharmacy technicians.

Approved by the ICHP Board of Directors May 30, 2018.

KeePosted Vision
As an integral publication of the Illinois Council of Health-System Pharmacists, the KeePosted newsjournal will reflect its mission and goals. In conjunction with those goals, KeePosted will provide timely information that meets the changing professional and personal needs of Illinois pharmacists and technicians, and maintain high publication standards.

KeePosted is an official publication of, and is copyrighted by, the Illinois Council of Health-System Pharmacists (ICHP). KeePosted is published 10 times a year. ICHP members received KeePosted as a member benefit. All articles published herein represent the opinions of the authors and do not reflect the policy of the ICHP or the authors’ institutions unless specified. Advertising inquiries can be directed to ICHP office at the address listed above. Image disclaimer: The image used in the Pharmacy Tech Topics™ advertisement is the property of © 2017 Thinkstock, a division of Getty Images.

Directly Speaking
There’s More to Life Than Pharmacy

by Scott A. Meyers, Executive Vice President

Pharmacy has been a big part of my life but it is not my life. I got into pharmacy to help people and anyone who says pharmacists don’t help people sit in the corner and think about it. But I have found that I can help people in many other ways than just helping them get better outcomes from their medications. And so can you!

Over the last year and a half, ICHP has tried to guide our members to support specific charitable organizations. This year we’re focused on the American Heart Association (AHA), a great organization with a strong history fighting one of the biggest killers each year - heart disease. We are encouraging members to walk with AHA in Rockford, Oak Brook, and Carterville. Check our website for more details. Members can also sponsor walkers or just donate directly to the AHA.

But there’s more ways to help and we certainly don’t want to dictate which charitable efforts you support. In fact, we encourage each and every one of you to seek out a volunteer opportunity that satisfies your own interest, cause, or concern. And if there is an opportunity to share your experience with others, let us know at the ICHP office and we’ll post the event on our Community Service page of the ICHP website! Did you know we have one? It can be found under the members’ tab on the home page.

So that means if you need sponsors for your marathon run, 5K walk, or local paint-a-thon, let us know in advance and we’ll see if we can’t drum up some support! If you have raw energy and no place to burn it, take a look at the Community Service page and maybe you’ll find a new passion.

For many years, my church held a volunteer event every June (including this year) called Sharefest, which started out painting, cleaning and renovating Rockford Public Schools. I volunteered for a few years, increasing my participation a little each year until I was asked to become a team leader. I learned a lot, met a ton of great people, and had great personal experiences that still generate warm memories. But I also learned to paint fairly well. Something pharmacists don’t learn in school but something we all eventually deal with personally or through someone we hire. The accomplishment of a nicely painted room can also provide a rewarding feeling especially if you never thought you would do it.

During my volunteer experiences I’ve done a lot of things that I never dreamed of doing and learned a lot along the way. But more importantly, I’ve gained great friends, helped others less fortunate, and generated fond memories. If you haven’t got a regular volunteer job that you enjoy regularly, this summer is a great time to look for one.

Volunteering relieves stress by taking your mind off your problems and focusing on the needs of others. Volunteering helps you meet new people, including some who may help you build a professional network. Volunteering gets you out of the house, away from your home computer or cell phone (at least you have to put it down when you’re working) and more often than not gets you some much needed exercise.

Sure, it can cost you a little in travel expenses and supplies (sometimes) but the ROI is amazing! And if you can’t physically participate, you can always donate. And if you are the recipient of sponsorship donations, don’t forget to report back to all those who donated with the results and the highlights of how the event went! It’s great to hear marathon times and exciting moments or see pictures of paint-splattered workers with big smiles and speckled faces.

Take volunteering seriously and you will be surprised what fun you can have! With just over two years until my retirement from ICHP, I’ve already begun thinking of new ways to add to my volunteer resume. I’m sure Sharefest will be a part of it along with the other church related positions I already have but my guess is that I will join my wife on Wednesdays at the local food pantry and maybe find my own gig with the Rockford Park District or a local homeless shelter. It doesn’t take much effort to identify our communities’ needs and only a little more effort to jump in and start meeting them. There is more to life than pharmacy!

President's Message
Start Asking Questions

by Travis Hunerdosse, PharmD, MBA, ICHP President

Have you considered questioning a skill that could be developed? Or how your own answers to questions impact conversation? If you are not asking questions, you may be missing an opportunity to make conversations more productive with your colleagues, boss, trainees, or preceptors. Asking questions, or questioning, fosters learning and idea exchange. Questioning provides energy for innovation, change, and process improvement. Asking the right questions in the right way can also expose breakdowns in systems that put an organization at risk. There are useful techniques that can be used in order to gain more from your questioning and how you answer others.

The act of conversation accomplishes two things; information exchange (learning) and impression management (liking). Asking questions achieves both. Questioning provides a channel for people to get to know one another and also demonstrates a genuine interest in the individual. Believe it or not, people liked to be asked questions. It makes them feel appreciated which in turn leaves a positive impression.

Consider this in context of a job interview. During a traditional interview, the candidate is the one answering most of the questions. They are also taking the opportunity to describe why they are the best candidate for the job, past experience, and qualifications. What leaves a lasting (and good) impression is when the candidate asks questions. Interviewees that ask questions demonstrate competence and an interest in the organization or the interviewer, develop a rapport, and learn key information that ensures that the position and the company are a good match.

In addition to beginning to ask questions, there are other factors that influence the quality of the conversation. These factors are type, tone, sequence, and framing. These can be taken into context when determining the desired outcome of the conversation. Active listening is also crucial. You are asking questions to gain information and learn. Also you want to be able to respond effectively to ensure you are achieving your goals in the conversation.

Consider the following techniques when approaching your next conversation:

Follow up questions. Follow up questions demonstrate to the conversational partner that you are listening to their responses, care about what they have to contribute, and that you are interested in additional information. This type of question establishes a relationship where both parties feel mutually respected and heard. The best part of the follow up question is that it does not take much effort. They do not have to be prepared ahead of time or require complex thinking.
Open ended questions. Use of open-ended questions keeps the conversation going and allow you to get the most information. Keeping questions open-ended sparks thinking and encourages people to open up to provide a wide array of responses. You may get an answer you were not expecting that unlocks a solution to a difficult problem. On the other hand, while your conversational partner does not want to get back into a corner by getting asked yes or no questions, sometimes you need to ask more direct questions to get the response you are looking for. Of course, it is important to keep these framed correctly so folks do not feel threatened.
Sequence. The order in which you ask questions may vary depending on the type of conversation you are having. If your goal is to build relations with your conversational partner, start with less intrusive questions then escalate to more difficult ones to be most effective. However, if the encounter may be tense, it is best to start with the sensitive or tough questions first and then de-escalate. Used in tough situations, this tactic can make people more willing to open up.
Tone. Your conversational partner will be more willing to open up when you ask questions in a casual manner versus a more formal approach. People are also more willing to answer questions when they are given “an out” or know they are able to change their answer based on additional questions. This holds true during brainstorming sessions. If participants are using a white board and are able to erase their answers, people are more willing to freely share ideas and less likely to hold back. Allowing information between individuals without inhibition leads to better learning and innovation.

Use these techniques to strengthen the power and effectiveness of your questioning in order to take the best care of your patients and your teams. Think about your approach to a drug information question. Sure, you could simply answer the question that you were given, but often times that may not be the information the inquirer was looking for. Dig deeper to find the real question to answer by asking a series of questions in order for you to feel confident you are providing a solid answer. Asking questions helps leaders uncover potential risks in the operations. Questions can mitigate medication safety issues, lead to improvements in workflow and process, and increase efficiency. Front line clinicians can use questions to build a rapport with physician and nurse colleagues. When interacting with other health care professionals, it is important to consider the type, tone, sequence and framing because how you ask the question may generate a very different response.

Reference:

Wood Brooks, A., John, L.K. The Surprising Power of Questions. HBR. May-June, 2018. pg 60-67.

Columns

Board of Pharmacy Update
Highlights of the May Meeting

by Scott A. Meyers, Executive Vice President

NABP Annual Meeting – The National Association of Boards of Pharmacy conducted its Annual Meeting in Denver on May 5-8, 2018. Yash Patel served as the Illinois Delegate to the meeting with Al Carter serving as first alternate and Denise Scarpelli as second alternate. Hot topics of discussion and education included the opioid crisis, medical marijuana, technology including the use of social media by Boards of Pharmacy and USP compounding standards.

2018 District IV Meeting – Will be held in Grand Rapids, MI and hosted by Ferris State University College of Pharmacy and the Michigan Board of Pharmacy on November 7-9, 2018.

Department Update – Compounding rules comments are being reviewed for final publication and approval by JCAR. There is no specific date for approval at this time.

The license renewal process is nearly complete for pharmacists and pharmacies with over 90% of both received, however only approximately 69% of pharmacy technician renewals have been completed at the time of the meeting which appears to be low. There was no identified reason yet. Now would be a good time for all Pharmacists-In-Charge (PICs) to check to make sure their technicians have current licenses. Those without one should not be allowed to work, as the PIC will be disciplined also.

Legislative Update – The May Board Meeting update was scheduled to be presented by IPhA Executive Director, Garth Reynolds. However, he stayed in Springfield to testify on HB3479, so 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 July 10, 2018 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 Oral Oncolytics of 2017: Key Points for a Counseling Pharmacist

by Janna Afanasjeva, PharmD, BCPSa; Chloe Majkowski, PharmD Candidate 2018a; Christopher Campbell, PharmD, BCPS, BCOPb; Institutional affiliations: aUniversity of Illinois Chicago; bNorthwestern Memorial Hospital

The research in oncology has been increasing over the past few years, and the availability of oral oncolytic agents has also surged.^1,2 Oral formulations comprise about 25% to 35% of oncology medications in the pipeline. For the year 2017, the Food and Drug Administration (FDA) approved 8 oral oncolytics that are new molecular entities.³

As more oral oncolytics become available on the market, more opportunities exist for pharmacists to provide direct patient care to patients with cancer.^2,4 One of the key services that pharmacists can provide is patient education. In fact, patient education is extremely important for oral oncolytics because patients take these medications at home without direct supervision of a treating physician. Oral oncolytics have similar benefits and drawbacks as intravenous medications, and therefore, patients must completely understand proper drug administration, importance of adherence, and possible adverse events. This article reviews new oral oncolytics that have been approved by the FDA in the year 2017. The goal of the article is to briefly introduce and describe new agents and their efficacy and safety data so that practicing pharmacists in a variety of settings can counsel on these agents if the need arises.

This article also mentions the cost of agents (see Table 1). The affordability is a particular concern with oral oncolytics as copays tend to be higher for them compared to intravenous medications that are administered in infusion clinics.⁵ Prescription drug benefits typically cover the cost of oral oncolytics while medical insurance for physician office visits covers intravenous medications resulting in lower costs to patients. Although some states are working on legislation to ensure comparable coverage between oral and intravenous oncolytics, a federal law in this area is lacking. Pharmacists may need to work with patients, oncology providers, and prescription drug benefits to confirm that patients are able to afford and adhere to new oncolytics.

Abemaciclib (Verzenio)

Abemaciclib inhibits cyclin-dependent kinases 4 and 6 (CDK4 and CDK6). These kinases are responsible for phosphorylation of the retinoblastoma protein (Rb), cell cycle progression, and cell proliferation.

Indication

Abemaciclib is approved for use as a monotherapy or in combination with fulvestrant for hormone-receptor (HR)-positive and human epidermal growth factor 2 (HER2)-negative advanced or metastatic breast cancer after patients have progressed on endocrine therapy.⁶ Abemaciclib is also approved as initial therapy in combination with an aromatase inhibitor for postmenopausal women with HR-positive, HER-2 negative advanced or metastatic breast cancer. The monotherapy approval requires prior chemotherapy but is unique that it is the only drug in class to be used as stand-alone therapy.

Efficacy

The approval of abemaciclib was based on 3 clinical trials: MONARCH1, MONARCH2, and MONARCH3.⁶ MONARCH1 was an open-label phase 2 study of abemaciclib monotherapy (200 mg every 12 hours until disease progression or unacceptable toxicity) in 132 women with HR-positive HER2-negative metastatic breast cancer who have progressed on endocrine therapy.⁷ The objective response rate (ORR), which was the primary endpoint, was 19.7% (95% CI, 13.3% to 27.5%). Median progression-free survival (PFS) was 6 months, and overall survival (OS) was 17.7 months.

MONARCH2 was a double-blind, phase 3 study of abemaciclib (150 mg twice daily) with fulvestrant versus fulvestrant alone in 669 women with HR-positive HER2-negative advanced breast cancer, who have progressed on endocrine therapy.⁸ Median PFS, the primary endpoint, was 16.4 months in the combination group versus 9.3 months in the fulvestrant group (hazard ratio, 0.55; 95% confidence interval (CI), 0.45 to 0.68; p<0.001). The ORR was 48.1% (95% CI, 42.6% to 53.6%) in the combination group and 21.3% (95% CI, 15.1% to 27.6%) in the fulvestrant group. At the time of the publication, OS results were not mature.

The approval for abemaciclib in combination with an aromatase inhibitor as initial therapy for postmenopausal women with advanced or metastatic breast cancer was based on results from the MONARCH3 trial.⁹ This was a double-blind, phase 3 study of 493 patients with no prior systemic therapy in the advanced setting. Patients were randomized to receive abemaciclib 150 mg or placebo twice daily in addition to physician’s choice of letrozole (80% of patients) or anastrozole (20% of patients). Median PFS was prolonged in the abemaciclib group with a hazard ratio of 0.54 (95% CI, 0.41 to 0.72; p = 0.000021). The median was not reached in the abemaciclib arm, and the median PFS in the placebo group was 14.7 months. The ORR was 48.2% (95% CI, 42.8% to 53.6%) in the abemaciclib group versus 34.5% (95% CI, 27.3% to 41.8%) in the placebo group.

Safety

In MONARCH 1, the most common grade 3 adverse events with abemaciclib were diarrhea (19.7%), fatigue (12.9%), and nausea (4.5%).⁷ The only grade 4 event in MONARCH1 was decreased neutrophil count (4.6%). Adverse events led to discontinuation of treatment in 7.6% of patients. In MONARCH2, the most common grade 3 or 4 adverse events with abemaciclib were neutropenia (26.5%), diarrhea (13.4%), and leukopenia (8.8%).⁸ The most common grade 3 or 4 adverse events in the MONARCH3 with the abemaciclib group were neutropenia (21.1%), diarrhea (9.5%), and leukopenia (7.6%).⁹ Guidelines

Per National Comprehensive Cancer Network (NCCN) Breast Cancer guidelines, abemaciclib plus an aromatase inhibitor is recommended as a preferred regimen for HR-positive, HER2-negative recurrent or metastatic breast cancer in postmenopausal women and may be considered as a first-line option for patients without previous systemic therapy.¹⁰ Abemaciclib plus fulvestrant is also listed as a preferred regimen for postmenopausal patients with advanced or metastatic HR-positive, HER2-negative breast cancer but is only indicated after progression on prior endocrine therapy. Abemaciclib monotherapy is listed as useful in certain circumstances for this population.

Acalabrutinib (Calquence)

Acalabrutinib inhibits Bruton tyrosine kinase (BTK) more selectively than first-generation BTK inhibitors. These kinases are involved in downstream signaling pathways vital to malignant B-cell proliferation and survival.

Indication

Acalabrutinib received accelerated approval for use as monotherapy for mantle cell lymphoma (MCL) after patients have progressed on at least 1 prior therapy.¹¹

Efficacy

The accelerated approval of acalabrutinib was based on ORR in Trial LY-004, an open-label, phase 2 study.¹¹ Acalabrutinib was administered (100 mg twice daily until disease progression or unacceptable toxicity) in 124 relapsed or refractory (r/r) MCL patients, who had at least 1 prior therapy.¹² The primary endpoint, ORR, was 81 % 80% (95% CI, 73% 72% to 87%). The trial reported a complete response (CR) in 40% of patients and partial response in 41% of patients, with a median time to best response of 1.9 months. After 15.2 months of follow-up, the median duration of response (DOR) had not been reached.

Safety

In Trial LY-004, the most common non-hematologic adverse effects (AEs) of acalabrutinib were headache, diarrhea, fatigue, myalgia, and bruising. Decreased hemoglobin (46%), platelets (44%), and neutrophils (36%) were very common. The most common Grade 3 or greater toxicities were diarrhea, neutropenia, thrombocytopenia, and anemia. Dose reductions or discontinuations due to any AE were reported in 1.6% and 6.5% patients, respectively.¹² Similar to first-generation BTK inhibitor, ibrutinib, the package insert for acalabrutinib carries warnings for hemorrhage, infection, cytopenias, second primary malignancies, and atrial arrhythmias.^11,13 Transient lymphocytosis may also occur with a median time to onset of 1.1 weeks and median duration of 6.7 weeks.

Guidelines

Per NCCN B-Cell Lymphomas guideline, acalabrutinib is recommended as a second-line single-agent therapy for patients with stage I or II disease, aggressive stage II bulky, III, or IV disease, or symptomatic indolent stage II bulky, III, or IV disease to achieve a CR after partial response to induction therapy or for relapsed, refractory, or progressive disease.¹⁴ The NCCN chronic lymphocytic leukemia (CLL) guideline provides a category 2A recommendation for acalabrutinib as a single agent therapy for relapsed or refractory disease with or without del(17p)/TP53 mutation.¹⁵ Of note, acalabrutinib should not be used for ibrutinib-refractory CLL or small lymphocytic lymphoma in patients with BTK C481S mutations.

Brigatinib (Alunbrig)

Brigatinib is a tyrosine kinase inhibitor with broad activity against multiple kinases including ALK, c-ros oncogene 1 (ROS1), insulin-like growth factor-1 receptor (IGF-1R), and fetal liver tyrosine kinase 3 (FLT-3) including epidermal growth factor receptor (EGFR) deletion and point mutations. Brigatinib inhibits ALK and blocks a signaling cascade with downstream effects on proteins STAT3, AKT, ERK1/2, and S6. Brigatinib’s mechanism of action allows for activity despite ALK-inhibitor resistance due to EML4-ALK and 17 other mutant forms, even after progression on crizotinib.

Indication

Brigatinib received accelerated approval for use in non-small cell lung cancer (NSCLC) patients with anaplastic lymphoma kinase (ALK)-positive metastatic disease after crizotinib.¹⁶

Efficacy

The accelerated approval of brigatinib was based on clinically significant and durable ORR in the ALTA trial, an open-label, two-arm, phase 2 study. Brigatinib was administered (either 90 mg once daily or 180 mg once daily with an initial 7-day lead-in of 90 mg daily) in 222 patients with locally advanced or metastatic ALK-positive NSCLC and who were previously treated with crizotinib.¹⁷ The primary endpoint, ORR, was 48 % (95% CI, 39% to 58%) and 53% (95% CI, 43% to 62%) in the 90 mg and 180 mg arms, respectively. Brigatinib showed clinically meaningful improvement in measurable brain metastases in both arms. Most of the intracranial responses were durable for at least 4 months. The trial reported a total of 3.6% or 4.5% CRs and 45% or 48% partial responses, in the 90 mg and 180 arms, respectively. The median DOR was 13.8 months. The PFS was 12.9 months in the 180 mg group and 9.2 months in the 90 mg group.

Safety

In the published abstract of the ALTA trial, the most common AEs in the 90 mg and 180 mg groups were nausea (33% and 40%), diarrhea (19% and 38%), headache (28 and 27%), and cough (18% and 34%), while less than 10% of patients experienced grade 3 events including hypertension, increased blood creatine phosphokinase (CPK), pneumonia, and increased lipase.¹⁷ Notably, pulmonary AEs were more common among patients (6%) in the lead-in phase. The abstract reports no increase in serious pulmonary events after escalation to 180 mg. According to the package insert, brigatinib commonly led to increases in liver and pancreatic enzymes and has a warning for amylase, lipase, CPK, and glucose elevations. Caution is advised regarding the development of hypertension and bradycardia.¹⁶

Guidelines

The NCCN NSCLC guideline recommends brigatinib as monotherapy for ALK-positive recurrent or metastatic disease for patients, who are refractory or intolerant to crizotinib, except in cases of symptomatic systemic disease with an isolated lesion.¹⁸ The NCCN Central Nervous System Cancers recommends brigatinib as a single-agent treatment for recurrent brain metastases in patients with ALK-positive NSCLC.¹⁹

Enasidenib (Idhifa)

Enasidenib works by inhibiting the mutated IDH2 enzyme, leading to decreased 2-hydroxyglutarate levels, reduced blast counts, and increased myeloid differentiation and mature myeloid cells.

Indication

Enasidenib is approved for the treatment of relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation.²⁰

Efficacy

Results from study AG221-C-001, a phase 1/2, open-label, single-arm trial, led to the approval of enasidenib for AML.²⁰ Enasidenib 100 mg daily was selected for the expansion phase of the study, which assessed efficacy in 199 patients response rate was 40.3%, and median DOR was 5.8 months. Median OS was 9.3 months (95% CI, 8.2 to 10.9 months), and 19.3% of patients attained a CR with a median overall survival of 19.7 months (95% CI, 11.6 months to not reached).

Safety

The most common adverse events seen with enasidenib in the AG221-C-001 study were hyperbilirubinemia and nausea.²¹ Hyperbilirubinemia, IDH differentiation syndrome, hematologic events, and infections were the most common grade 3 or 4 events.

Guidelines

The NCCN AML guideline recommends enasidenib for patients with relapsed or refractory AML with IDH2 mutation that are not candidates for intensive remission induction therapy.²² Patients with a response to therapy, which may take 3 to 5 months, should continue enasidenib therapy until progression occurs. The guideline also warns about the increased risk of IDH differentiation syndrome and hyperleukocytosis that may require treatment with hydroxyurea and steroids during treatment with enasidenib.

Midostaurin (Rydapt)

Midostaurin inhibits several receptor tyrosine kinases such as FLT3 mutant kinases, KIT, PDGFRα/β, VEGFR2, and PKC.²³ The inhibition of FLT3 promotes apoptosis of leukemic cells expressing FLT3 mutant kinases such as internal tandem duplication (ITD) and tyrosine kinase domain (TKD) and leukemic cells overexpressing wild type FLT3 and platelet-derived growth factor (PDGF) receptors.

Indication

Midostaurin is indicated for newly diagnosed AML in patients who are positive for FLT3 mutation.²³ The medication is administered in combination with cytarabine and daunorubicin induction and cytarabine consolidation. Midostaurin is also approved for aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN), or mast cell leukemia.

Efficacy

Midostaurin was studied in a phase 3 trial that enrolled 717 patients with newly diagnosed AML and FLT3 mutation.²⁴ Patients received induction therapy with daunorubicin and cytarabine, consolidation therapy with high-dose cytarabine, and midostaurin or placebo. From enrolled patients, 214 had high ITD mutation, 341 low ITD mutation, and 162 point mutations in TKD. Median OS, the primary endpoint, was prolonged in the midostaurin (74.7 months) group versus in the placebo (25.6 months) group (hazard ratio for death, 0.78; 95% CI, 0.63 to 0.96; p=0.009).

Midostaurin was also studied in an open-label study in 116 patients, who had ASM, SM-AHN, or mast cell leukemia.²⁵ Patients received midostaurin 100 mg twice daily. The median OS was 28.7 months, and the median PFS was 14.1 months.

Safety

In the trial exploring midostaurin versus placebo use in patients with newly diagnosed AML and FLT3 mutation, both groups displayed similar adverse events except for higher rate of anemia and rash in the midostaurin group and higher rate of nausea in the placebo group.²⁴ From the trial of midostaurin in patients with ASM, SM-AHN, or mast cell leukemia, the most common adverse events were nausea, vomiting, and diarrhea.²⁵ About 24% of patients developed grade 3 or 4 neutropenia, 41% grade 3 or 4 anemia, and 29% grade 3 or 4 thrombocytopenia.

Guidelines

Per the NCCN AML guideline, midostaurin is recommended as induction therapy for FLT3 mutation-positive disease in combination with standard dose cytarabine and daunorubicin as induction therapy. It is also recommended as post-induction therapy or post-remission therapy in combination with cytarabine.²² The US guidelines are lacking for treatment of systemic mastocytosis.

Niraparib (Zejula)

Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor.²⁶ PARP-1 and PARP-2 are enzymes involved in DNA repair. Inhibition of PARP 1/2 increases formation of PARP-DNA complexes, leading to DNA damage, apoptosis, and cell death.

Indication

Niraparib is approved as maintenance therapy for adults with primary peritoneal cancer, recurrent epithelial ovarian cancer, or fallopian tube cancer who have experienced CR or partial response to platinum-based chemotherapy.²⁶

Efficacy

Niraparib was approved based on the phase 3 NOVA trial.²⁶ NOVA was a randomized, double-blind trial comparing niraparib 300 mg daily versus placebo in 553 patients with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer.²⁷ All patients had previously received at least 2 platinum-based regimens and had shown sensitivity to platinum-based treatment. Study treatment was started within 8 weeks after the last dose of platinum-based therapy and was continued until disease progression. Patients were categorized based on the presence or absence of a germline BRCA mutation (gBRCA cohort and non-gBRCA cohort). In the gBRCA cohort, median PFS was 21.0 months in the niraparib group versus 5.5 months in the placebo group (hazard ratio, 0.27 0.26; 95% CI, 0.17 to 0.41). The non-gBRCA cohort had a median PFS of 9.3 months with niraparib versus 3.9 months with placebo (hazard ratio, 0.45; 95% CI, 0.34 to 0.61).

Safety

The most common grade 3 or 4 adverse events reported in the NOVA trial for patients taking niraparib were thrombocytopenia (33.8%), anemia (25.3%), and neutropenia (19.6%).²⁷ Treatment discontinuation due to an adverse event of any grade occurred in 14.7% of the niraparib group compared to only 2.2% of the placebo group.

Guidelines

The NCCN Ovarian Cancer guideline recommends niraparib as maintenance therapy for patients with epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who had previously received 2 or more platinum-based regimens and demonstrated a CR or partial response.²⁸

Neratinib (Nerlynx)

Neratinib inhibits EGFR and HER2, demonstrating antitumor activity in cell lines expressing these kinases.

Indication

Neratinib is approved for use as extended adjuvant treatment following trastuzumab-based therapy in patients with early-stage HER2-positive breast cancer.²⁹

Efficacy

Neratinib was approved for HER2-positive breast cancer based on results from the ExteNET trial.²⁹ ExteNET was a randomized, double-blind, phase 3 study assessing the safety and efficacy of neratinib therapy versus placebo over 1 year in 2,840 women who previously completed trastuzumab-based adjuvant therapy for early-stage HER2-positive breast cancer.³⁰ The invasive disease-free survival rate was 93.9% 94.2% in the neratinib group versus 91.6% 91.9% in the placebo group at 2 years after randomization, with 5% of neratinib patients experiencing invasive disease recurrence or death versus 8% of patients in the placebo group (hazard ratio, 0.67 0.66; 95% CI, 0.50 0.49 to 0.91 0.90, p=0.0091 p=0.008).

Safety

The most common grade 3 and 4 adverse events with neratinib in the ExteNET trial were diarrhea, nausea, and vomiting.³⁰ Rates of QT prolongation were similar in the neratinib group (3%) and placebo group (7%), and decreases in left ventricular ejection fraction occurred in only 1% of each group. Four deaths occurred in the neratinib group and 3 in the placebo group after study drug discontinuation, none of which were attributed to study treatment.

Guidelines

The NCCN breast cancer guideline recommends neratinib as extended adjuvant therapy for HER2-positive patients after completion of adjuvant trastuzumab-based therapy when there is a high risk of recurrence.¹⁰

Ribociclib (Kisqali)

Ribociclib is a CDK4 and CDK6 inhibitor.³¹ Enzymes CDK4 and 6 phosphorylate Rb leading to cell cycle progression and cell proliferation. Ribociclib decreases phosphorylation of the Rb and results in cell cycle arrest in the G1 phase.

Indication

Ribociclib is indicated in postmenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer as initial endocrine-based therapy in combination with an aromatase inhibitor.³¹

Efficacy

Ribociclib gained approval based on the results of the MONALEESA-2 trial.³¹ MONALEESA-2 was a phase 3, double-blind, placebo-controlled trial.³² A total of 668 patients with HR-positive, HER2-negative advanced breast cancer who had not received any previous systemic therapy were enrolled in the trial. Patients were randomized to receive either ribociclib 600 mg daily for 21 days on and 7 days off plus letrozole 2.5 mg daily continuously, or placebo plus letrozole. Median PFS was not reached in the ribociclib plus letrozole group, as compared to 14.7 months in the placebo plus letrozole group. At 18 months, the estimated PFS was 63.0% (95% CI, 54.6 to 70.3) in the ribociclib group versus 42.2% (95% CI, 34.8 to 49.5) in the placebo group.

Safety

The most common grade 3 or 4 adverse events in the MONALEESA-2 trial were neutropenia (59.3% in the ribociclib group versus 0.9% in the placebo group), leukopenia (21% versus 0.6%), and hypertension (9.9% versus 10.9%).³² Discontinuation of study drug due to adverse events occurred in 7.5% of the ribociclib group versus 2.1% of the placebo group.

Guidelines

The NCCN Breast Cancer guideline recommends a CDK4/6 inhibitor (ribociclib or palbociclib) in combination with an aromatase inhibitor as first-line treatment option for postmenopausal patients with HR-positive, HER2-negative metastatic breast cancer.¹⁰ Ribociclib in addition to tamoxifen is another recommended therapy for this population.

Table 1. Key properties of newly approved oral oncology agents in 2017.^{6,11,16,20,23,26,29,31,33}

Drug name (Brand)

Dosage form,

strength(s)

Dosing

Cost^a

Abemaciclib

(Verzenio™)

Tablet; 50 mg, 100 mg, 150 mg, 200 mg

200 mg twice daily as monotherapy; 150 mg twice daily in combination with fulvestrant 500 mg on Days 1, 15, 29, and then once monthly

$3,284

(14 tablets)

Acalabrutinib (Calquence™)

Capsule; 100 mg

100 mg twice daily

$16,877

(60 capsules)

Brigatinib

(Alunbrig™)

Tablet; 30 mg, 90 mg, 180 mg

90 mg daily for 7 days, and then 180 mg daily if tolerated

$1,995

(21 tablets)

Enasidenib

(Idhifa™)

Tablet; 50 mg, 100 mg

100 mg daily

$29,846

(30 tablets)

Midostaurin

(Rydapt™)

Capsule; 25 mg

50 mg twice daily for AML; 100 mg twice daily for ASM, SM-AHN, or mast cell leukemia

$4,497

(28 capsules)

Niraparib

(Zejula™)

Capsule; 100 mg

300 mg daily

$17,700

(90 capsules)

Neratinib

(Nerlynx™)

Tablet; 40 mg

240 mg daily

$12,600

(180 tablets)

Ribociclib

(Kisqali™)

Tablet; 200 mg

600 mg daily for 21 days, followed by 7 days off in combination with continuous letrozole

$13,140

(63 tablets)

^aPricing is based on average wholesale price.

Conclusion

In 2017, the FDA approved 8 new oral oncolytics with indications for AML, MCL, ASM, SM-AHN, mast cell leukemia, NSCLC, breast cancer, peritoneal cancer, epithelial ovarian cancer, or fallopian tube cancer. Pharmacists must be familiar with the efficacy and safety data for these agents as a comprehensive counseling is imperative for patients taking oral oncolytics. Patients may inquire about the costs of these newly approved agents because higher copays are more typical with oral oncolytics compared to intravenous oncology medications.

References:

Heymach J, Krilov L, Alberg A, et al. Clinical cancer advances 2018: annual report on progress against cancer from the American Society of Clinical Oncology. J Clin Oncol. 2018;36(10):1020-1044.
McCullough S, Newton R. Pharmacy's changing role as care transitions from infused to oral therapies. Am J Manag Care. 2017;23(12 Spec No.):sp468.
Hematology/oncology (cancer) approvals & safety notifications. The Food and Drug Administration website. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm279174.htm. Updated March 22, 2018. Accessed March 26, 2018.
Bailey R, Newton R. PBMs: their role, the problems, and how practices can work with PBMs. Am J Manag Care. 2017;23(12 Spec No.):Sp497-sp498.
The state of cancer care in America, 2017: a report by the American Society of Clinical Oncology. J Oncol Pract. 2017;13(4):e353-e394.
Verzenio [package insert]. Indianapolis, IN: Eli Lilly and Company; 2018.
Dickler MN, Tolaney SM, Rugo HS, et al. MONARCH 1, a phase II study of abemaciclib, a CDK4 and CDK6 Inhibitor, as a single agent, in patients with refractory HR(+)/HER2(-) metastatic breast cancer. Clin Cancer Res. 2017;23(17):5218-5224.
Sledge GW, Jr., Toi M, Neven P, et al. MONARCH 2: abemaciclib in combination with fulvestrant in women with HR+/HER2- advanced breast cancer who had progressed while receiving endocrine therapy. J Clin Oncol. 2017;35(25):2875-2884.
Goetz MP, Toi M, Campone M, et al. MONARCH 3: Abemaciclib as initial therapy for advanced breast cancer. J Clin Oncol. 2017;35(32):3638-3646.
NCCN Clinical Practice Guidelines in Oncology. Breast Cancer Version 1.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Published March 20, 2018. Accessed March 26, 2018.
Calquence [package insert]. Los Angeles, CA: Puma Biotechnology, Inc; 2017.
Wang M, Rule S, Zinzani P, et al. Abstract 155: Efficacy and safety of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma in the phase 2 ACE-LY-004 study. 2017 ASH Meeting. Available at: http://www.bloodjournal.org/content/130/Suppl_1/155. Accessed May 29, 2018.
Imbruvica [package insert]. Sunnyvale, CA: Pharmacyclics LLC; 2017.
NCCN Clinical Practice Guidelines in Oncology. B-Cell Lymphomas Version 2.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf. Published February 26, 2018. Accessed March 26, 2018.
NCCN Clinical Practice Guidelines in Oncology. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Version 5.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/cll.pdf. Published March 26, 2018. Accessed April 11, 2018.
Alunbrig [package insert]. Cambridge, MA: Ariad Pharmaceuticals, Inc; 2018.
Camidge DR, Tiseo M, Ahn MJ, et al. Brigatinib in crizotinib-refractory ALK+ NSCLC: central assessment and updates from ALTA, a pivotal randomized phase 2 trial. J Thorac Oncol. 2016;12(1 suppl) [abstract P3.02a-013].
NCCN Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer Version 3.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Published February 21, 2018. Accessed March 26, 2018.
NCCN Clinical Practice Guidelines in Oncology. Central Nervous System Cancers Version 1.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Published March 20, 2018. Accessed April 11, 2018.
Idhifa [package insert]. Summit, NJ: Celgene Corporation; 2017.
Stein EM, DiNardo CD, Pollyea DA, et al. Enasidenib in mutant IDH2 relapsed or refractory acute myeloid leukemia. Blood. 2017;130(6):722-731.
NCCN Clinical Practice Guidelines in Oncology. Acute Myeloid Leukemia Version 1.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/aml.pdf. Published February 7, 2018. Accessed March 26, 2018.
Rydapt [package insert]. East Hanover, NJ: Novartis; 2017.
Stone RM, Mandrekar SJ, Sanford BL, et al. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 mutation. N Engl J Med. 2017;377(5):454-464.
Gotlib J, Kluin-Nelemans HC, George TI, et al. Efficacy and safety of midostaurin in advanced systemic mastocytosis. N Engl J Med. 2016;374(26):2530-2541.
Zejula [package insert]. Waltham, MA: Tesaro, Inc.; 2018.
Mirza MR, Monk BJ, Herrstedt J, et al. Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med. 2016;375(22):2154-2164.
NCCN Clinical Practice Guidelines in Oncology. Ovarian Cancer Version 2.2018. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf. Published March 9, 2018. Accessed March 26, 2018.
Nerlynx [package insert]. Los Angeles, CA: Puma Biotechnology, Inc; 2017.
Chan A, Delaloge S, Holmes FA, et al. Neratinib after trastuzumab-based adjuvant therapy in patients with HER2-positive breast cancer (ExteNET): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2016;17(3):367-377.
Kisqali [package insert]. East Hanover, NJ: Novartis; 2017.
Hortobagyi GN, Stemmer SM, Burris HA, et al. Ribociclib as first-line therapy for HR-positive, advanced breast cancer. N Engl J Med. 2016;375(18):1738-1748.
LexiComp [database]. Hudson, OH: Wolters Kluwer Health; 2018. https://online.lexi.com/lco/action/home. Accessed March 26, 2018

Leadership Profile
Meet Karin Terry, PharmD

Leadership position in ICHP

Director of Professional Affairs

Tell us about your position and practice site.

Medication Safety Pharmacist for OSF HealthCare. I am based in Peoria, but we have practice sites all over Central and Northern Illinois!

Tell us about a time you made a difference.

I will always remember this situation, because I was a new pharmacist and still in orientation at OSF-Saint Franice Medical Group. Xigris® had been approved the month before (I know, that dates me…), and our P&T had decided to add it to formulary just the day before. It was a Saturday in December, and I answered a call from an ICU attending who wanted Xigris® for a young septic patient. It was peak Christmas season, so I had a hard time finding someone who could help us order it. I ended up coordinating a drop shipment flight to get the drug there within 12 hours, doing “just in time” education with pharmacy and nursing staff, and keeping in touch with the attending all day. We got the patient the drug, and I got a personal “Thank You” note from the attending (whom I later learned was a very hard person to impress!). Now, I realize that Xigris® was later pulled from the market and may not have actually helped the patient…but the entire situation gave me so much confidence in my ability to handle a situation that seemed “above my paygrade”.

How did you know that pharmacy was for you?

I decided in 6^th grade that I wanted to be a pharmacist. My brother had a “Careers” magazine that he brought home from high school. I looked up my favorite subjects, math and science, and one of the options was pharmacy. I boldly declared that I was going to be a pharmacist when I grew up. Stubbornly, I stuck to that declaration all through high school! Luckily for me, I ended up choosing a career that was a great fit for me. I love all the different places a pharmacy career can take you! Over the last almost 20 years, I have had some great experiences and met some amazing people.

Fill in the blank: ICHP is _____ because…

ICHP is vital, because it gives all of us an outlet to be able to see outside of ourselves and our current role. I have learned so much about what pharmacy can be by meeting pharmacists and techs from across the state in hospitals and clinics big and small. I also see ICHP’s role in advocacy as vital to our profession, and I love that it gives me easy access to get involved.

Tell us about when you first joined ICHP.

I have always been involved in pharmacy organizations since my time at Drake University. I knew that I wanted to be a member of ICHP once I started working at Saint Francis. Working at a facility with multiple pharmacists who were not just members but involved in committee and leadership positions definitely helped me stay engaged! It was easy to say that I was “too busy” with work and family to get involved in committees, but seeing my co-workers make it all happen and benefit from the relationships made me decide it was time to jump in!

Special thanks to so many people who have made me who I am today. My mom was a bedside nurse for 40 years. She always kept her passion for her care of her patients, and she showed me that you don’t have to have a title to earn respect. I had some amazing professors at Drake who made me look at pharmacy in a way I didn’t even know I could. There were a few specific preceptors during rotations and residency who greatly influenced how I saw myself as a pharmacist. I have had some very intelligent and motivated co-workers who keep me on my toes and push me to do more. And, of course, my family. I want my girls to know that I am working hard to help people.

What advice do you have for students?

Never exclude an area of pharmacy as a career option. I never would’ve thought I would be a Medication Safety Pharmacist. As a new grad, I would never have found my current role to be exciting enough. I wanted ICU or transplant or cardiology. But every little project I did that related to medication safety made me realize that I would really enjoy Medication Safety as a career. There are more areas in pharmacy than you realize, so keep your options open!

Any special interests or hobbies outside of work?

You will often find me in my “Mom uniform” at one of my daughters’ sporting events. Whether it is soccer, basketball, volleyball, or cross country, I love watching my girls do their thing!

For “me” time, I enjoy playing slow pitch softball with both my co-workers and my church league teams. I also enjoy running and training for the St Jude Run every August.

What is your favorite place to vacation?

We try to check out different places, but our favorite would have to be Park City, Utah. We were there for the bobsledding World Cup the year before the Salt Lake City Olympics, and we really enjoyed ourselves. Then we went back for the Winter Olympics the next year and we really fell in love with the place! They have great snow for snowboarding in the winter and great trails to hike, bike, and horseback in the summer.

Government Affairs Report
The List Gets A Little Shorter

by Jim Owen and Scott Meyers

As we enter the final month (May) of the spring session of the Illinois General Assembly, the list of active bills begins to shrink. Some of the losses are good but unfortunately, a few bills that have died would have been positive for pharmacy. One in particular, HB0274 would have allowed pharmacists with special training to prescribe hormonal contraceptives for their patients. Reluctantly, the sponsor will most assuredly bring this effort back next spring with the 101^st General Assembly.

HB3479 is still breathing at the time of writing and would require managed care providers for Illinois’ Medicaid patients to reimburse pharmacies at the same rate as the fee-for-service Medicaid population. Currently community and outpatient pharmacies frequently receive less than the actual acquisition cost of the medication for payment and cannot refuse to fill those prescriptions or they will lose access to all Medicaid prescriptions. Losses have ranged from a few dollars to hundreds of dollars per prescription. If you’re wondering why we (ICHP) is concerned with this issue, it is two-fold. The first is that many of our members’ hospitals have outpatient pharmacies and are suffering and the second is to support the overall regulation and oversight of PBMs that currently have none in the State of Illinois.

While limitedly related to pharmacy in general, the budget battle wages on this year as it has in the past. It appears that Governor Rauner is not as steadfast on his reform platform with the hope of achieving a budget compromise before the end of May. It is unclear which solution will be acceptable, but it is fairly certain that Illinois’ long-term money woes will not be solved this session.

For a complete list of the bills that still have life at the time of this writing, they are provided below with a brief summary. We encourage you to visit the Illinois General Assembly website to get more information on any bill that draws your interest.

We also encourage you to find out who will be running for office this fall in your district. All State representative districts and 39 of the 59 State senate districts are up for election in the fall of 2018 so chances are you will have to make a decision or two this fall. Find out what the candidates’ stances are on health care and pharmacy so you are informed and ready to vote intelligently. In many districts, as is the case always in Illinois, you may not have a chance because your candidates are unopposed, but get to know them anyway. They will be representing you and the citizens of your district. Summer is a great time for that too with local fund raisers abounding. Bar-B-Ques, golf outings, corn boils and many other events will bring the candidates out to shake hands, kiss babies and raise re-election funds. Let us know if you attend a fund-raiser and what you learn from the candidate, it’s helpful intel.

Finally, if you’ve decided that it’s time to truly get into the advocacy game, this summer is a great time to make a contribution to the ICHP Pharmacy Action Fund, ICHP’s PAC, to support those legislators that listen to our concerns and see the real value of the pharmacist as a member of the health care team. Later this summer the PAC will be making contributions to help our friends in the General Assembly get re-elected so they can keep our voice heard and our message clear.

2018 Illinois General Assembly Bill Summary

Bill Number	Sponsor	Summary	Location	ICHP Position
SB0336 Sam001	Harmon - Oak Park, D	Amends SB336 by replacing everything after the enacting clause with the following: “Section 1. This Act may be referred to as the Alternatives to Opioids Act of 2018. Section 5. the Compassionate Use of Medical Cannabis Pilot Program Act is amended by changing sections 5, 10, 60, and 160 as follows…” Sam001 supporting cannabis as MAT for opioid use disorder	Assigned to Executive Comm in the House 5/8/2018
SB1888 & HB3479	McCann- Jacksonville, R Feigenholtz – Chicago, D	Amends the Medical Assistance Article of the Illinois Public Aid Code. In addition to other specified actions required under the Code, requires a managed care community network that contracts with the Department of Healthcare and Family Services to establish, maintain, and provide a fair and reasonable reimbursement rate to pharmacy providers for pharmaceutical services, prescription drugs and drug products, and pharmacy or pharmacist-provided services. Provides that the reimbursement methodology shall not be less than the current reimbursement rate utilized by the Department for prescription and pharmacy or pharmacist-provided services and shall not be below the actual acquisition cost of the pharmacy provider. Requires a managed care community network to ensure that the pharmacy formulary used by the managed care community network and its contract providers is no more restrictive than the Department's pharmaceutical program. Effective July 1, 2018.	Assignments in Senate 5/5/2017 House Bill postponed in the Senate Human Services Comm. 5/2/2018
SB2226	Nybo - Lombard, R	Amends the State Police Act. Provides that a physician, physician's assistant with prescriptive authority, or advanced practice registered nurse with prescriptive authority who provides a standing order or prescription for epinephrine auto-injectors in the name of the Department of State Police shall incur no civil or professional liability, except for willful and wanton conduct, as a result of any injury or death arising from the use of an epinephrine auto-injector. Amends the Illinois Police Training Act. Provides that a physician, physician's assistant with prescriptive authority, or advanced practice registered nurse with prescriptive authority who provides a standing order or prescription for epinephrine auto-injectors in the name of a local governmental agency shall incur no civil or professional liability, except for willful and wanton conduct, as a result of any injury or death arising from the use of an epinephrine auto-injector. Makes conforming changes to the Medical Practice Act of 1987 and the Public Health Standing Orders Act. Effective immediately.	Judiciary – Civil Procedure Subccommittee in the House 5/9/2018
SB2524 SAM002	Rose - Champaign, R	Sen. Amendment 1: Amends the Environmental Protection Act by creating the Pharmaceutical Disposal Task Force. The task force will coordinate a statewide public information campaign to highlight the benefits and opportunities of properly disposing of pharmaceutical products. Identifies the members of the task force and responsibilities. Sen. Amendment 2: Added representatives of physician, coroner and pharmaceutical manufacturer to the task force.	Passed in the Senate 2^nd Reading. in the House 5/9/2018	Neutral
SB2834	Syverson – Rockford, R	Amends the Alcoholism and Other Drug Abuse and Dependency Act. Changes the short title of the Act to the Substance Use Disorder Act. Removes the terms "addict", "addiction", "alcoholic", "alcoholism", and "substance abuse" and their corresponding definitions. Requires the Department of Human Services to reduce the incidence of substance use disorders (rather than reduce the incidence and consequences of the abuse of alcohol and other drugs). Defines "substance use disorder". Requires the Department to design, coordinate, and fund prevention, early intervention, treatment, and other recovery support services for substance use disorders that are accessible and address the needs of at-risk individuals and their families. Requires the Department to develop a comprehensive plan on the provision of such services; assist other State agencies in developing and establishing substance use disorder services for the agencies' clients; adopt medical and clinical standards on how to determine a substance use disorder diagnosis; and other matters. Contains provisions concerning the licensing of substance use disorder treatment providers; licensure categories and services; the identification of individuals who need substance use disorder treatment using "SBIRT"; patients' rights; services for pregnant women, mothers, and criminal justice clients; and other matters. Repeals a provision of the Act establishing the Committee on Women's Alcohol and Substance Abuse Treatment. Repeals a provision of the Act setting forth the powers and duties of the Medical Advisory Committee. Makes conforming changes concerning the Substance Use Disorder Act to several Acts including the Department of Human Services Act, the Children and Family Services Act, and the Mental Health and Developmental Disabilities Administrative Act. Effective January 1, 2019.	Rules Comm. in the House 4/27/2018
SB2889	Rose – Champaign, R	Creates the Epinephrine Administration Act. Provides that a health care practitioner may prescribe epinephrine pre-filled syringes in the name of an authorized entity where allergens capable of causing anaphylaxis may be present. Provides that an authorized entity may acquire and stock a supply of undesignated epinephrine pre-filled syringes provided the undesignated epinephrine pre-filled syringes are stored in a specified location. Requires each employee, agent, or other individual of the authorized entity to complete a specified training program before using a pre-filled syringe to administer epinephrine. Provides that a trained employee, agent, or other individual of the authorized entity may either provide or administer an epinephrine pre-filled syringe to a person whom the employee, agent, or other individual believes in good faith is experiencing anaphylaxis. Provides that training under the Act shall be valid for 2 years. Requires the Department of Public Health to approve training programs, to list the approved programs on the Department's website, and to include links to training providers' websites on the Department's website. Contains provisions concerning costs, limitations, and rulemaking. Defines terms. Amends the School Code. In provisions concerning epinephrine administration, provides that epinephrine may be administered with a pre-filled syringe. Makes conforming changes. Senate Amendment 1: Changed “auto-injectors” to “injectors” Senate Amendment 2: Removes provision creating Epinephrine Administration Act.	Human Services Comm. in the House 5/7/2018
SB2951 HB4950	Bush - Grayslake, D	Creates the Early Mental Health and Addictions Treatment Act. Requires the Department of Healthcare and Family Services, and other specified agencies and entities, to develop a pilot program under which a qualifying adolescent or young adult may receive community-based mental health treatment from a youth-focused community support team for early treatment that is specifically tailored to the needs of youth and young adults in the early stages of a serious emotional disturbance or serious mental illness. Requires the Department to apply, no later than September 30, 2019, for any necessary federal waiver or State Plan amendment to implement the pilot program. Requires the Department to implement the pilot program no later than December 31, 2019 if federal approval is not necessary. Contains provisions concerning the creation of a community-based treatment model under the pilot program; the development of a pay-for-performance payment model; Department rules to implement the pilot program; and analytics and outcomes report. Requires the Department to develop an Assertive Engagement and Community-Based Clinical Treatment Pilot Program for individuals with opioid and other drug addictions. Contains provisions on in-office, in-home, and in-community services provided under the pilot program; application for a federal waiver or State Plan amendment to implement the pilot program; development of a pay-for-performance payment model; Department rules to implement the pilot program; and analytics and outcomes report. Effective immediately.	Mental Health Comm. in the House 5/7/2018
SB2952 HB4907	Bush – Grayslake, D	Amends the Illinois Controlled Substances Act. Provides that the Department of Human Services, in consultation with the Advisory Committee, shall adopt rules allowing licensed prescribers or pharmacists who have registered to access the Prescription Monitoring Program to authorize a licensed or non-licensed designee (rather than any designee) employed in that licensed prescriber's office or licensed pharmacist's pharmacy and who has received training in the federal Health Insurance Portability and Accountability Act to consult the Prescription Monitoring Program on their behalf. Requires the Clinical Director of the Prescription Monitoring Program to select 6 members (rather than 5 members), 3 physicians, 2 pharmacists, and one dentist, of the Prescription Monitoring Program Advisory Committee to serve as members of the peer review subcommittee. Effective immediately	Human Services Comm. in the House 05/08/2018
SB3015	Koehler - Peoria, D	Amends the School Code. With regard to the self-administration and self-carry of asthma medication, provides that a school district, public school, charter school, or nonpublic school may authorize a school nurse or trained personnel to (i) provide undesignated asthma medication to a student for self-administration only or to any personnel authorized under a student's Individual Health Care Action Plan or asthma action plan, plan pursuant to Section 504 of the federal Rehabilitation Act of 1973, or individualized education program plan to administer to the student that meets the student's prescription on file, (ii) administer an undesignated asthma medication that meets the prescription on file to any student who has an Individual Health Care Action Plan or asthma action plan, plan pursuant to Section 504 of the federal Rehabilitation Act of 1973, or individualized education program plan that authorizes the use of asthma medication; and (iii) administer an undesignated asthma medication to any person that the school nurse or trained personnel believes in good faith is having respiratory distress; defines "undesignated asthma medication" and "respiratory distress". Changes the definition of "asthma medication" to mean quick-relief asthma medication that is approved by the United States Food and Drug Administration for the treatment of respiratory distress. Provides that a school nurse or trained personnel may administer undesignated asthma medication to any person whom the school nurse or trained personnel in good faith believes to be experiencing respiratory distress (i) while in school, (ii) while at a school-sponsored activity, (iii) while under the supervision of school personnel, or (iv) before or after normal school activities. Provides that a school district, public school, charter school, or nonpublic school may maintain a supply of an asthma medication in any secure location where a person is most at risk. Provides that a training curriculum to recognize and respond to respiratory distress may be conducted online or in person. Specifies training requirements. Makes other changes. Effective immediately. Senate Amendment 1: Added must notify the child’s health care provider AND school nurse within 24 hours after the administration of an undesignated asthma medication.	Elementary & Secondary Education, School Curriculum & Policies Comm. in the House 5/7/2018
SB3116	Hunter – Chicago, D	Amends the Nurse Practice Act. In provisions concerning written collaborative agreements, restores the ability of podiatric physicians to collaborate with advanced practice registered nurses. Makes other changes. Effective immediately.	Health Care Licenses Comm. in the House 5/7/2018
SB3170	Stadelman - Rockford, D	Amends the Pharmacy Practice Act and the Illinois Food, Drug and Cosmetic Act. Provides that a prescription for medication other than controlled substances shall be valid for up to 15 months from the date issued for the purpose of refills, unless the prescription states otherwise.	Health Care Licenses Comm. in the House 5/2/2018
HB3479 SB1888	Feigenholtz – Chicago, D	Amends the Medical Assistance Article of the Illinois Public Aid Code. In addition to other specified actions required under the Code, requires a managed care community network that contracts with the Department of Healthcare and Family Services to establish, maintain, and provide a fair and reasonable reimbursement rate to pharmacy providers for pharmaceutical services, prescription drugs and drug products, and pharmacy or pharmacist-provided services. Provides that the reimbursement methodology shall not be less than the current reimbursement rate utilized by the Department for prescription and pharmacy or pharmacist-provided services and shall not be below the actual acquisition cost of the pharmacy provider. Requires a managed care community network to ensure that the pharmacy formulary used by the managed care community network and its contract providers is no more restrictive than the Department's pharmaceutical program. Effective July 1, 2018.	Postponed in Human Services Comm. in the Senate 5/2/2018	Support
HB4096	Harris – Chicago, D	Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall require each Medicaid Managed Care Organization to list as preferred on the Medicaid Managed Care Organization's preferred drug list every pharmaceutical that is listed as preferred on the Department's preferred drug list. Provides that the Department shall not prohibit, or adopt any rules or policies that prohibit, a Medicaid Managed Care Organization from: (i) covering additional pharmaceuticals that are not listed on the Department's preferred drug list; or (ii) removing from the Medicaid Managed Care Organization's preferred drug list any prior approval requirements applicable under the Department's preferred drug list. Provides that the Department shall not require a Medicaid Managed Care Organization to utilize a single, statewide preferred drug list and shall not prohibit a plan from negotiating drug pricing concessions or rebates on any drug with pharmaceutical companies, unless otherwise required by federal law. Provides that no later than July 1, 2018, the Department shall develop a standardized format for all Medicaid Managed Care Organization preferred drug lists in cooperation with Medicaid Managed Care Organizations and stakeholders, including, but not limited to, community-based organizations, providers, and individuals or entities with expertise in drug formulary development. Requires each Medicaid Managed Care Organization to post its preferred drug list on its website without restricting access to enrolled members and to update the preferred drug list posted on its website within 2 business days of making any changes to the preferred drug list, including, but not limited to, any and all changes to requirements for prior approval. Effective immediately.	2^nd Reading in the Senate 5/10/2018
HB4146	Fine – Glenview, D	House Amendment 1 : n language providing that a health care plan is not prohibited from requiring a pharmacist to effect substitutions of prescription drugs, provides that the health care plan is not prohibited from requiring a pharmacist to effect substitutions consistent with provisions from the Pharmacy Practice Act that allow a pharmacist to substitute an interchangeable biologic for a prescribed biologic product and select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act.	Postponed Special Comm. on Oversight of Medicaid Managed Care in the Senate 5/2/2018
HB4331	Conner – Romeoville, D	Amends the Counties Code. Provides that in every case in which an opioid overdose is determined to be a contributing factor in a death, the coroner shall report the death and the age, gender, race, and county of residence, if known, of the decedent to the Department of Public Health. Amends the University of Illinois Hospital Act and the Hospital Licensing Act. Requires every hospital to report the age, gender, race, and county of residence, if known, of each patient diagnosed as having an opioid overdose to the Department within 48 hours of the diagnosis. Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department to adopt rules to implement the reporting requirements. Requires the Department to annually report to the General Assembly the data collected.	2^nd Reading in the Senate 5/9/2018
HB4440	Gabel - Evanston, D	Amends the Nursing Home Care Act. Provides that the Department of Public Health shall provide facilities with educational information on all vaccines recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, including, but not limited to, the risks associated with shingles and how to protect oneself against the varicella-zoster virus. Requires a facility to distribute the information to each resident who requests the information and each newly admitted resident. Allows the facility to distribute the information to residents electronically. Effective January 1, 2019.	Placed on 3^rd Reading in the Senate 5/2/2018
HB4643	Burke - Chicago, D	Amends the Illinois Physical Therapy Act. Provides that the limitation on determining a differential diagnosis shall not in any manner limit a physical therapist from establishing a relevant diagnosis. In the definition of "documented current and relevant diagnosis" and in provisions concerning disciplinary actions, removes language requiring a diagnosis to be substantiated by a physician, dentist, advanced practice registered nurse, physician assistant, or podiatric physician. Effective immediately.	2^nd reading in the Senate 5/10/2018
HB4650	Zalewski - Riverside, D	Amends the Illinois Controlled Substance Act. In a provision allowing pharmacists to authorize a designee to consult the Prescription Monitoring Program on their behalf, defines "pharmacist" to include, but be not limited to, a pharmacist associated with a health maintenance organization or a Medicaid managed care entity providing services under the Illinois Public Aid Code. Effective immediately.	2^nd reading in the Senate 5/10/2018	Oppose
HB4707 House Amendment 001	Scherer - Decatur, D	House Amendment 003: Creates the Prescription Drug Task Force Act and a Prescription drug task Force with 18 members, one member from ICHP that will study the extent of over prescribing of opioids to patients and to make recommendations for future legislation to address the issue.	3^rd reading in the Senate 5/10/2018	Neutral
HB4795	Demmer – Rochelle, R	Amends the Alcoholism and Other Drug Abuse and Dependency Act. Changes the short title of the Act to the Substance Use Disorder Act. Removes the terms "addict", "addiction", "alcoholic", "alcoholism", and "substance abuse" and their corresponding definitions. Requires the Department of Human Services to reduce the incidence of substance use disorders (rather than reduce the incidence and consequences of the abuse of alcohol and other drugs). Defines "substance use disorder". Requires the Department to design, coordinate, and fund prevention, early intervention, treatment, and other recovery support services for substance use disorders that are accessible and address the needs of at-risk individuals and their families. Requires the Department to develop a comprehensive plan on the provision of such services; assist other State agencies in developing and establishing substance use disorder services for the agencies' clients; adopt medical and clinical standards on how to determine a substance use disorder diagnosis; and other matters. Contains provisions concerning the licensing of substance use disorder treatment providers; licensure categories and services; the identification of individuals who need substance use disorder treatment using "SBIRT"; patients' rights; services for pregnant women, mothers, and criminal justice clients; and other matters. Repeals a provision of the Act establishing the Committee on Women's Alcohol and Substance Abuse Treatment. Repeals a provision of the Act setting forth the powers and duties of the Medical Advisory Committee. Makes conforming changes concerning the Substance Use Disorder Act to several Acts including the Department of Human Services Act, the Children and Family Services Act, and the Mental Health and Developmental Disabilities Administrative Act. Effective January 1, 2019.	Placed on 3rd Reading in the Senate 5/8/2018
HB4900	Guzzardi - Chicago, D	Creates the Illinois Generic Drug Pricing Fairness Act. Provides that a manufacturer or wholesale drug distributor shall not engage in price gouging in the sale of an essential off-patent or generic drug. Provides that the Director of Healthcare and Family Services or Director of Central Management Services may notify the Attorney General of any increase in the price of any essential off-patent or generic drug under the Medical Assistance Program under the Illinois Public Aid Code or a State health plan, respectively, that amounts to price gouging. Provides that whenever the Attorney General has reason to believe that a manufacturer or wholesale drug distributor of an essential off-patent or generic drug has violated the Act, the Attorney General shall send a notice to the manufacturer or wholesale drug distributor requesting a specified statement. Provides that within 45 days after receipt of the request, the manufacturer or wholesale drug distributor shall submit the statement to the Attorney General. Provides that to accomplish the objectives and carry out the duties prescribed in the Act, the Attorney General may issue subpoenas or examine under oath any person to determine whether a manufacturer or wholesale drug distributor has violated the Act. Provides that upon petition of the Attorney General, a circuit court may issue specified orders against violations of the Act. Contains provisions concerning the disclosure of financial information provided by a manufacturer or wholesale drug distributor to the Attorney General. Effective January 1, 2019.	Passed in the House, in Assignments in the Senate 4/23/2018
HB4907 SB2952	McAuliffe - Chicago, R	Amends the Illinois Controlled Substances Act. Provides that the Department of Human Services, in consultation with the Advisory Committee, shall adopt rules allowing licensed prescribers or pharmacists who have registered to access the Prescription Monitoring Program to authorize a licensed or non-licensed designee (rather than any designee) employed in that licensed prescriber's office or licensed pharmacist's pharmacy and who has received training in the federal Health Insurance Portability and Accountability Act to consult the Prescription Monitoring Program on their behalf. House Amendment 1 now requires the designee in the pharmacy must be a licensed individual. Requires the Clinical Director of the Prescription Monitoring Program to select 6 members (rather than 5 members), 3 physicians, 2 pharmacists, and one dentist, of the Prescription Monitoring Program Advisory Committee to serve as members of the peer review subcommittee. Effective immediately	Postponed in Public Health Comm. in the Senate 5/9/2018
HB5070	Bellock – Westmont, R	Amends the Telehealth Act. Includes clinicians licensed to provide medical services under Illinois law in the definition of "health care professional". Amendment 001: Added pharmacists and other licensed practitioners under the definition of “health care professional”.	Placed on 2^nd Reading in the Senate 05/03/2018
HB5442	Durkin - Burr Ridge, R	Amends the Open Meetings Act. Provides that, for the purposes of the Act, "public body" does not include a Metropolitan Enforcement Group (MEG) Policy Board or drug task force composed or created by any combination of local law enforcement agencies. Amends the Criminal Code of 2012. Provides that a person commits drug-induced homicide when he or she violates delivery of a controlled substance or methamphetamine or a similar law of another jurisdiction, by unlawfully delivering a controlled substance to another, and the injection, inhalation, absorption, or ingestion of any amount of that controlled substance is a contributing cause of the person's death. Amends the Illinois Controlled Substances Act. Provides that controlled substances which are lawfully administered in hospitals or institutions licensed under the Hospital Licensing Act shall be reported under (rather than, exempt from) specified reporting provisions under the Act, and the prescription for the controlled substances ordered and the quantity actually administered (rather than, the reporting requirement only applies for more than a 72-hour supply of a discharge medication to be consumed outside of the hospital or institution). Provides that the information required to be transmitted under the prescription monitoring program must be transmitted not later than the end of the business day on which a controlled substance is dispensed, or at such other time as may be required by the Department of Human Services by administrative rule (rather than, at the end of the next business day on which the controlled substance is dispensed).	Tabled 04/12/2018	Neutral

Senate Deadlines

Bill Introduction: February 16, 2018

Senate bills out of Committee: April 13, 2018

Third Reading for Senate Bills: April 27, 2018

House Bills out of Committee: May 11, 2018

Third Reading House Bills: May 25, 2018

Adjournment: May 31, 2018

House Deadlines

Bill Introduction: February 16, 2018

House Bills out of Committee: April 13, 2018

Third Reading House Bills: April 27, 2018

Senate Bills out of Committee: May 18, 2018

Third Reading Senate Bills: May 25, 2018

Adjournment: May 31, 2018

New Practitioners Network
Ask For Advice

by Mary Lacy, PharmD, PGY-2 Health-System Pharmacy Administration Resident, University of Illinois at Chicago

“Asking people for advice makes you appear more competent, not less.”

An experienced pharmacy director explained this to me at the most recent ASHP Conference for Pharmacy Leaders. The annual conference is designed to attract current and future pharmacy leaders in all practice settings. The conference focuses on different areas of leadership and practice management, such as organizational alignment, achieving service excellence, and effective communication. What I enjoyed most about the conference was the opportunity to network with and learn from pharmacy leaders from across the country. By the end of the conference, I realized that even seasoned pharmacists seek mentorship.

I took away three key lessons from the conference:

1. Don’t be afraid to ask for help.

Many times you find yourself challenged by responsibilities and tasks for which you feel unprepared. As a student you are naturally guided through these challenges by a number of mentors, including professors, advisors, and bosses. As you transition from student to new practitioner, it can be difficult to determine when you should or should not ask for advice. We often avoid asking for advice for a number of reasons. Often it is because we fear to seem incompetent or because we do not want to take up someone else’s time. However, asking for advice does not decrease your credibility. In fact, people are flattered when you seek their advice, and they are typically more than willing to help you succeed.

One of the biggest oversights of new practitioners is the failure to recognize the importance of seeking out mentorship. Mentorship is the opportunity to learn from someone else’s successes as well as their mistakes. A good mentor can make the difference between learning lessons the hard way or easily sidestepping mistakes throughout your career. Not only can mentors help you think through complicated problems, but they can also help you identify your goals and introduce you to potential key players in your future career.

2. Having multiple mentors can be beneficial.

Many new practitioners do not think about having more than one mentor. Mentors come in all different forms, and they serve different purposes. You should have at least three mentors at any given time: (1) a more experienced professional who can give you big picture career advice, (2) a colleague or peer mentor who can relate to your current situation, and (3) someone who can provide insight on how a career move might affect your personal life. Depending on the situation at hand, you may seek advice from only one of your mentors, or it may be beneficial to seek advice from each of your mentors to gain their individual perspectives.

3. Mentorship doesn’t have to be formal.

Another misconception among new practitioners is that only experienced pharmacists can serve as mentors. All pharmacists have leadership responsibilities, whether they hold official leadership positions or not. As Sara White discusses in her “Leadership: Successful alchemy” article, there are two types of leaders – “big L” and “little L” leaders.¹ “Big L” leaders are those in formal leadership positions, such as pharmacy directors, managers, and supervisors. Yet every pharmacist is a “little L”, guiding pharmacy technicians, pharmacy students, and even fellow pharmacists.

You may already act as a mentor without even realizing it. Mentorship does not need to exist solely in a formal setting. Each time you provide guidance or feedback to a colleague, you are adopting a mentor’s role. As you progress throughout your career, your role as a mentor will naturally grow and expand. Reflect on how the mentors in your life impart their wisdom and determine how you can provide the best guidance to others as you progress through your career. Think about the things you wish you would have known as a student starting rotation, a new resident, or a new practitioner, and pass them along to others seeking your advice.

Mentorship is key to career success, and you will never outgrow the benefits gained while being a mentee. No matter how long you have been practicing, there will always be uncharted territories and challenges that arise. The key is to have the foresight and humility to ask for guidance. Lastly, remember that your mentors’ time is just as valuable as yours. Take it upon yourself to add value for your mentors by trying to teach them something new. After all, preceptors and mentors love to learn from their students and mentees. In doing so, you will ensure that you get the most out of the mentorship and find success in your career.

References

1. White SJ. Leadership: successful alchemy. Am J Health Syst Pharm. 2006 Aug 15;63(16):1497-503.

ICHPeople
Our members have a lot to celebrate!

Congratulations to ICHP member Dan Majerczyk who was awarded

Roosevelt University College of Pharmacy's "Preceptor of the Year!"

Congratulations to our members from Midwestern University Chicago

College of Pharmacy on their promotions and achievements!

Promotion to Professor: Jen D’Souza (with Tenure)

Promotion to Associate Professor: Milena McLaughlin (with Tenure)

Promotion to Adjunct Associate Professor: Amy Lullo

2017-2018 Golden Apple Award: Carrie Sincak

2017-2018 Preceptor of the Year Award: Milena McLaughlin

2017-2018 New Preceptor Excellence Award: Andrew Merker

2017-2018 Preceptor of the Year Award for Adjunct Faculty: William Budris

Professional Affairs - Call for Entries

Past winners include:

2017
Sandra M. Salverson, Pharm.D., BCPS and Jerry Storm, RPh
Implementation of Integrated Telepharmacy Services Achieve a Health-System Standard of Pharmacy Care

2016
Maya Beganovic, PharmD and Sarah M. Wieczorkiewicz, PharmD, BCPS
"MALDI-TOF alone versus MALDI-TOF combined with real-time antimicrobial stewardship interventions on time to optimal therapy in patients with positive blood cultures"

2015
Kuntal Patel, Pharm.D., Pavel Prusakov, and Heather Vaule
"Osteopenia of Prematurity (aka Better Bones for Babies)"

2014
Arti Phatak, Pharm.D.; Brooke Ward, Pharm.D., BCPS; Rachael Prusi, Pharm.D.; Elizabeth Vetter, Pharm.D.; Michael Postelnick, BS Pharm, BCPS (AQ Infectious Diseases); and Noelle Chapman, Pharm.D., BCPS
"Impact of Pharmacist Involvement in the Transitional Care of High-Risk Patients through Medication Reconciliation, Medication Education, and Post-Discharge Callbacks"

View 2008 - 2013 Winners at ichpnet.org

Online entry form: http://www.ichpnet.org/professional_practice/best_practices/
Submission deadline: July 1, 2018

The objective of the Best Practice Award program is to encourage the development of innovative or creative pharmacy practice programs or innovative approaches to existing pharmacy practice challenges in health systems within the state of Illinois.

Applicants will be judged on their descriptions of programs and practices employed in their health system based on the following criteria:

Innovativeness / originality
Contribution to improving patient care
Contribution to institution and pharmacy practice
Scope of project
Quality of submission

Eligibility
Applicants must be a member of ICHP for a minimum of 90 days prior to the submission deadline and practice in a health system setting. More than one program can be submitted by a health system for consideration.

Instructions for preparing manuscript
Each entry for the Best Practice Award must include a manuscript prepared as a Word document, double-spaced using Times New Roman 12-pitch type. A header with the paper title and page number should appear on each page. The manuscript should not exceed 2000 words in length (not counting references), plus no more than a total of 6 supplemental graphics (tables, graphs, pictures, etc.) that are relevant to the program. Each picture, graph, figure, and table should be mentioned in the text and prepared as a separate document clearly labeled.

The manuscript should be organized as a descriptive report using the following headings:

Introduction, Purpose, and Goals of the program
Description of the program
Experience with and outcomes of the program
Discussion of innovative aspects of programs and achievement of goals
Conclusion

Format
Submissions will only be accepted via online submission form. The manuscript will be forwarded to a pre-defined set of reviewers. Please do not include the names of the authors or affiliations in the manuscript to preserve anonymity.

All applicants will be notified of their status within three weeks of the submission deadline. Should your program be chosen as the winner:

The program will be featured at the ICHP Annual Meeting. You will need to prepare a poster to present your program and/or give a verbal presentation. Guidelines will be sent to the winner.
You will be asked to electronically submit your manuscript to the ICHP KeePosted for publishing. This program will be accredited for CPE and will require that you complete material for ACPE accreditation.
You will receive a complimentary registration to the ICHP Annual Meeting, recognition at the meeting and a monetary award of $1,000 distributed to your institution.

Non-winning submissions may also be considered for publication in the ICHP KeePosted, but your permission will be obtained beforehand.

If you have any questions related to the program please contact Trish Wegner at trishw@ichpnet.org.

Thank you to PharMEDium, Division of AmerisourceBergen for providing a grant for this year's Best Practice Award!

The 2016 & 2017 Best Practice Winners Available for CPE!

MALDI-TOF alone versus MALDI-TOF combined with real-time antimicrobial stewardship interventions on time to optimal therapy in patients with positive blood cultures
Authors: Maya Beganovic, PharmD and Sarah M. Wieczorkiewicz, PharmD, BCPS
Advocate Lutheran General Hospital, Park Ridge, Illinois

Implementation of Integrated Telepharmacy Services Achieve a Health-System Standard of Pharmacy Care
Authors: Sandra M. Salverson, PharmD, BCPS and Jerry Storm, RPh
OSF Healthcare System, Peoria, Illinois

Click here to learn how ICHP members can obtain free CPE credit.

Features

2018 Annual Meeting
Taking Pharmacy to New Heights

Elevate! ICHP President, Travis Hunerdosse, calls on us to elevate ourselves, elevate our teams and elevate our profession! The 2018 ICHP Annual Meeting provides a variety of opportunities for engaging in professional development, networking and social events with fellow pharmacists, pharmacy technicians, pharmacy students, and pharmacy industry – all with the purpose of elevating pharmacy professionals and advancing excellence in the pharmacy profession.

In response to the overwhelming positive experiences of attendees to our 2016 Annual Meeting, we are once again collaborating with the Pharmacy Learning Network (PLN) – part of the North American Center for Continuing Medical Education (NACCME). Their mission is to develop and disseminate live, print and web-based CME/CE activities to provide an education forum through which healthcare practitioners may examine current medical issues, therapies, and technologies. PLN will provide Thursday’s programming as a combination of their Chicago 1-Day Regional Meeting and the ICHP Annual Meeting.

In addition, Thursday evening will include an ICHP networking session and reception with specific groups discussing issues pertinent to technicians, new practitioners, medication safety, leadership/ management, ambulatory care, pharmacy practice and academia.

This year’s education sessions will include leadership and clinical skills, as well as technician, management, technology and ambulatory care specific sessions and student initiatives to assist with advancement and professional development. Attendees will have an opportunity to share relevant challenges and solutions during the Town Hall Lunch, share in the fun of award recognition during the Awards Luncheon, and learn about the latest advances from industry representatives during the Exhibit sessions.

Please join us at the ICHP 2018 Annual Meeting! Participate in taking your profession to new heights through professional development and networking opportunities!

Registration is now open! Check out our web brochure for more details!

College Connection

Midwestern University Chicago College of Pharmacy
Legislative Day: Advocating Together

College Connection

by Kelly Moran, PS-2, ICHP Member

Getting caught up in the deadlines, assignments, and stress of pharmacy school is extremely easy and can leave students feeling like they are drowning. On top of this, students are frantically trying to find spare time to work, volunteer, and stay involved in school. When the topic of advocacy arises, most students are intimidated because we associate it with politicians, government, policies, and topics in which we do not have much personal experience. But in reality, most of us are advocating every day. We advocate for the wellbeing and health of our patients on our rotations, at work, and through volunteering. Educating a patient on the safe and effective use of a medication compared to educating our representatives on the practice of pharmacy is not entirely different.

Attending the 12th Annual Pharmacy Legislative Day “Under the Dome” this March was not my first experience advocating for the pharmacy profession. I had the opportunity this past summer to meet with Illinois senators, representatives, and their staff on Capitol Hill. I remember feeling terrified in my white coat standing in front of the U.S. Capitol building about to meet with these powerful individuals. I felt so small. I then took a look around to see the other hundreds of student pharmacists standing alongside me and I felt how strong we were together. As I sat in the auditorium at Legislative Day this year, I had that same feeling of relief. As students, we have the power to make a difference whether it be through making phone calls, letter writing, attending events such as Legislative Day, or even just educating each other.

This year at Legislative Day we discussed the stance that we want to take as pharmacists on certain bills. A bill discussed that we were not supporting was HB5442 regarding the requirement of hospitals to report all controlled substances prescribed and administered to the Prescription Monitoring Program (PMP). The original purpose of the PMP is to identify patients “shopping” for controlled substances and obtaining large amounts of controlled substances. Based on my volunteer experience in a hospital, implementing this would be extremely difficult and a burden on hospital pharmacists. Also, it would be a burden for community pharmacists to have to search through unnecessary information in the PMP reported by inpatient pharmacists. A bill discussed of which we were supportive was HB5747 regarding the addition of prescribing and dispensing of hormonal contraceptives in the scope of pharmacy practice in Illinois. It is exciting to see this potential advancement for our profession. This bill is a perfect example of where pharmacy in Illinois is headed in the future.

For the moment, advocating does not always feel worthwhile because there is no automatic reward, outcome, or change in the profession. It takes years for certain bills to pass and for our profession and to see a change in our own day to day practice. It is not easy, but by attending these events and coming together we have a voice and we are heard.

Roosevelt University College of Pharmacy
My Reflection as President of RUCOP-SSHP

College Connection

by Kimberly Zaleski, PS3, President Roosevelt University College of Pharmacy

As we transition our SSHP e-board positions to the Class of 2020, I wanted to take this opportunity to reflect on the great strides taken to successfully promote our organization at RUCOP. When I was elected President of our student chapter, I did not realize the opportunities of professional growth that would be available. Each event that we planned for this past school year was planned with professional growth in mind. Not only did our e-board members benefit from our events, but the presence of SSHP on campus has significantly grown. It was a very humbling experience to offer journal clubs and see other students learning from an article that was presented. After each journal club, it was easy to see that the students were becoming more comfortable with statistics and were able to interpret the results and conclusions of a study to make clinical recommendations.

In addition to journal clubs, we hosted multiple events so students could learn more about the residency process. Early in Fall term, we offered Residency 101 which gave a brief overview of what residency is and what the path to obtaining a residency looks like. Recently, we held the annual Residency Roundtable event. There was a great turnout of students and pharmacy residents from Northwestern Memorial Hospital and Advocate Christ Medical Center. During the event, there was plenty of thoughtful conversation and great questions. One of our major goals this year was to promote residency focused events so that our students can ultimately make the best decision for their future careers. We presented a poster at the Midyear clinical meeting on what P1 and P3 students knew about post-graduate opportunities. Our results indicated that some students knew what a residency was but the majority of students were unsure about post-graduate opportunities. Although we have not yet followed up with the Class of 2019 and 2020 with a new survey to see what they know now, my hope is based on the events hosted that more students have a better idea of what a residency has to offer.

In addition to these two events, we offered a CV workshop and brought in guest speakers to talk about initiatives and projects that they have completed during residency. It was a great opportunity to hear what the residents have done and how it has impacted their line of work. We also hosted events to also give back to our community including a blood drive through LifeSource on campus. We were able to help save 45 lives thanks to our blood donors. Members of SSHP and our student government organization also volunteered at a local food pantry to pack food for families that were in need.

Looking back on my year as the RUCOP student chapter SSHP President, I could not have asked for a better e-board to bring ideas to life. I am also beyond grateful for our faculty advisors that supported us throughout the year. I am excited to use what I have learned as an SSHP member to help me succeed during my APPE rotations and during my career as a pharmacist. Opportunities that were presented from ASHP and ICHP helped shape me as a leader and I hope that I can continue being involved in leadership positions throughout my career.

Rosalind Franklin University
ICHP P1 Liaison Reflection

College Connection

by Brit Der, PS-1 ICHP Liaison, Rosalind Franklin University of Medicine and Science, School of Pharmacy

Pharmacy school is difficult and requires a great deal of studying. Yet, I learned that earning the title of Doctor of Pharmacy is more than just studying. It also pertains to the various experiences and opportunities that you encounter. Adapting to my first year in pharmacy school was challenging. I also had the privilege of being appointed as the first year pharmacy student liaison for ICHP. Balancing this officer role made it quite an interesting year.

My role was to act as a communication resource between the chapter, the Dean, and the first year class. The opportunity to attend e-board meetings allowed me to observe the different responsibilities of each role, and the teamwork it required to prepare different events as well as meetings. As the communication resource, I was aware of all the different events that were held by the organization such as the Diabetes Expo and Legislative Day. All the events that I attended provided me with more insight in the clinical field of pharmacy and were great learning experiences. Personally, I am deciding upon the field of pharmacy which I want to pursue, but serving in ICHP has influenced me tremendously to consider the clinical setting.

In addition, serving as the P1 Liaison provided a positive outlet from the constant studying. The liaison position provided me with something different and exciting. The opportunity to connect with others was also an aspect that I did not expect to receive from the position. I had the opportunity to meet many upperclassmen and faculty in our school of pharmacy as well as even alumni that attended some of the events. I was able to slowly learn how to network and gradually come out of my comfort zone. I believe that this was one of the most important aspects that I learned. Mainly because knowing that the pharmacy network is fairly small, any individual in the field that I met was a potential important connection for my future. Overall, the P1 Liaison position was a rewarding experience. I learned a great deal about the clinical field of pharmacy, connected with many future colleagues, and ultimately learned how to manage an officer position with the workload of pharmacy school. I believe that this is a great officer role for incoming first year students that provides a great way to get involved as well as learn more about the clinical field of pharmacy. Studying is essential, but the learning experiences are what shape you as you earn the prestigious title Doctor of Pharmacy.

Welcome New Members!

New Member	Recruiter
William Clafshenkel	Vicelle Sibal
Meagan Conrath
Lucas Dyer
Tina Dyer
Derek Holycross	Jerry Storm
Satoru Ito
Tara Jebrael	Claudia Muldoon
Linhong Amy Long
Jennifer Mayer
Nicholas Moffett	Vicelle Sibal
Noha Mohamed
Mogboluwaga Oginni
Ravikumar Patel	Vicelle Sibal
Tatjana Petrova
Zachary Ress
Yvonne Rodriguez
Danielle Sanchez
Amanda Sek
Karen Serafini

Upcoming Events

AHA Heart Walk

Rockford Walk - 6/16/18
http://www2.heart.org/site/TR…

Oakbrook (Chicago) Walk - 9/22/18
http://www2.heart.org/site/TR…

Carterville Walk - 10/6/18
http://www2.heart.org/site/TR…

Champions Webinar

Thursday, July 12, 2018 - NOON
Safe Management of Drug Shortages

Natasha Nicol, PharmD, FASHP
Champions LIVE Webinar

Accredited for pharmacists and pharmacy technicians | 0.5 contact hour (.05 CEU)

Student Leadership Retreat

When: Saturday, August 25th, 2018
All day
Description: ICHP Student Leadership Retreat
Invitation Only
Location TBA

ICHP Annual Meeting

When: September 13-15th, 2018
All day
Description: 2018 ICHP Annual Meeting
at Drury Lane Theatre and Conference Center,
Oakbrook Terrace, IL

ICHP Pharmacy Action Fund (PAC)

Officers and Board of Directors

Executive Officers

Travis Hunerdosse
President
(312) 926-6124

thunerdo@nm.org

Charlene Hope
Immediate Past President
(708) 783-5933
chope@macneal.com

Noelle Chapman
President-Elect

Kathryn Schultz
Treasurer
(312) 926-6961
kathryn_schultz@rush.edu

Jennifer Arnoldi
Secretary

jearnol@gmail.com

Scott Meyers
Executive Vice President

ICHP Office
(815) 227-9292

scottm@ichpnet.org

Regional Directors

Amy Boblitt
Regional Director Central
(217) 788-3015
boblitt.amy@mhsil.com

Elise Wozniak
Regional Director Northern
elise.m.wozniak@gmail.com

Lynn Fromm
Regional Director

Southern
(618) 391-5539
fromml@andersonhospital.org

Division Directors

Mary Lee
Organizational Affairs Director
(630) 515-7311
mleexx@midwestern.edu

Karin Terry
Professional Affairs Director
(309) 655-3390
Karin.l.terry@osfhealthcare.org

Lara Ellinger
Educational Affairs Director
(312) 926-3571
laelling@nm.org

Carrie Vogler
Marketing Affairs Director
(217) 545-5394
cvogler@siue.edu

Christopher Crank
Government Affairs Director
(630) 978-4853
ccrank@gmail.com

Technician Representative

Clara Gary
Technician Representative
(312) 996-8525
cgary1@uic.edu

Network and Committee Chairs - non-voting

Bernice Man
Chairman, New Practitioners Network
(773) 702-9641
bernice.man.pharmd@gmail.com

Abby Kahaleh
Ambulatory Care Network Chair

akahaleh@roosevelt.edu

David Tjhio
Chairman, Committee on
Technology
(816) 885-4649
davidtjhio@cerner.com

Jennifer Phillips
Editor & Chairman KeePosted
Committee Chair,
Nominations Committee
(630) 515-7167
jphillips@midwestern.edu

Milena McLaughlin
Assistant Editor, KeePosted News Journal
(630) 515-7293
mmclau@midwestern.edu

Student Chapter Presidents

Ashley Shinnick - Chicago State University College of Pharmacy
Ashinnic@csu.edu

Shivek Kashyap - Midwestern University Chicago College of Pharmacy
skashyap28@midwestern.edu

Sara Koehnke - Roosevelt University College of Pharmacy
skoehnke@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

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

West Central Society of Health-System Pharmacists (WSHP)
Ed Rainville
President
ed.c.rainville@osfhealthcare.org

Metro East Society (MESHP)
Jared Sheley
President
jpsheley@gmail.com

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

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

Print Entire Issue

November 2021

KeePosted Info

Directly Speaking There’s More to Life Than Pharmacy

President's Message Start Asking Questions

Columns

Board of Pharmacy Update Highlights of the May Meeting

Educational Affairs New Oral Oncolytics of 2017: Key Points for a Counseling Pharmacist

Leadership Profile Meet Karin Terry, PharmD

Government Affairs Report The List Gets A Little Shorter

New Practitioners Network Ask For Advice

ICHPeople Our members have a lot to celebrate!

Professional Affairs - Call for Entries

Features

2018 Annual Meeting Taking Pharmacy to New Heights

College Connection

Midwestern University Chicago College of Pharmacy Legislative Day: Advocating Together

Roosevelt University College of Pharmacy My Reflection as President of RUCOP-SSHP

Rosalind Franklin University ICHP P1 Liaison Reflection

More

Welcome New Members!

Upcoming Events

ICHP Pharmacy Action Fund (PAC)

Officers and Board of Directors

Directly Speaking
There’s More to Life Than Pharmacy

President's Message
Start Asking Questions

Board of Pharmacy Update
Highlights of the May Meeting

Educational Affairs
New Oral Oncolytics of 2017: Key Points for a Counseling Pharmacist

Leadership Profile
Meet Karin Terry, PharmD

Government Affairs Report
The List Gets A Little Shorter

New Practitioners Network
Ask For Advice

ICHPeople
Our members have a lot to celebrate!

2018 Annual Meeting
Taking Pharmacy to New Heights

Midwestern University Chicago College of Pharmacy
Legislative Day: Advocating Together

Roosevelt University College of Pharmacy
My Reflection as President of RUCOP-SSHP

Rosalind Franklin University
ICHP P1 Liaison Reflection