Daniel Weiss, Senior Editor

A number of speakers at the American Pharmacists Association 2014 Annual Meeting in Orlando emphasized the importance of winning provider status for pharmacists.

The ongoing campaign to win health care provider status for pharmacists was a recurring topic at the American Pharmacists Association (APhA) 2014 Annual Meeting, held in Orlando, Florida, from March 28-31. With a 

bill having been introduced into Congress

 just weeks before that would recognize state-licensed pharmacists as health care providers under Medicare Part B in underserved communities, speakers at the meeting evinced a sense of progress, but emphasized the importance of continuing to pursue provider status on a number of different fronts.

keynote speech during the meeting’s second general session

, on March 30, APhA Executive Vice President and CEO Thomas E. Menighan, BSPharm, MBA, FAPhA, argued that pharmacists are “gaining the momentum” in their pursuit of provider status and urged them to push for recognition on multiple levels: from federal and state programs and from private payers. “None of them is a slam dunk,” he noted. Menighan pointed out that pharmacists (280,000 nationwide) are vastly outnumbered by nurses (3 million) and physicians (1 million), so pharmacists need to be united in order to attain results.

, APhA President-elect Matthew C. Osterhaus, BSPharm, FASCP, FAPhA, urged attendees to focus on why attaining provider status is important for improving patient care. “Every constituent, inside and outside the pharmacy family, needs to know why provider status is so important for our patients,” he said. “We are driven by a purpose, a cause, a belief that we can impact our patients and the health care system by improving outcomes.”

a number of other sessions focused on provider status

, including a “provider status 101” session on March 28, a session on accountable care organizations and patient-centered medical homes on March 29, and one on efforts to win provider status from federal, state, and private payers on March 31.

During the March 28 session, APhA Senior Vice President of Pharmacy Practice and Government Affairs Stacie Maass, PharmD, JD, urged pharmacists to constantly spread the word on the role they play in the health care system to complement the advocacy efforts of pharmacy associations. “Policy makers don’t realize all that pharmacists can do,” she said. “We need to talk about specifics of what do you do with your patients every day.”

During the same session, National Alliance of State Pharmacy Associations Director of Policy and State Relations Krystalyn Weaver, PharmD, noted that winning provider status on the federal level would make it easier to do so on the state level, but that the campaign should nonetheless be pursued on both levels at once. “[I]f we can’t get federal provider status in 2014, in the meantime, we need to get patients access to these services” through state-level efforts, Dr. Weaver argued. “If your patients understand the services you could provide, they can be strong advocates for us.”

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Pharmacist Provider Status in Spotlight at APhA Annual Meeting

Associations representing pharmacists expressed overwhelming support for a bill introduced in the House of Representatives that would define pharmacists as health care providers under Medicare.

A bill recently introduced into the House of Representatives will make pharmacists eligible for reimbursement as health care providers for certain services under Medicare if it becomes law. H.R. 4190, introduced on March 11, 2014, by Reps. Brett Guthrie (R-Ky.), G.K. Butterfield (D-N.C.), and Todd Young (R-Ind.), would amend the Social Security Act of 1935 so pharmacists are recognized as providers under Medicare Part B.

The bill would allow state-licensed pharmacists to provide care for patients in medically underserved communities and to be paid for their services. The services that pharmacists could provide include immunizations, diabetes screenings and self-management education, cardiovascular screenings, and behavioral therapy.

Since the beginning of 2013, a coalition of pharmacy associations has been 

pushing to win provider status for pharmacists

 last year. Representatives of these associations expressed overwhelming support for the House bill:

		“This bill will make a tremendous difference to patients needing additional access to the critical health care services that pharmacists provide,” said American Society of Health-System Pharmacists (ASHP) CEO Paul W. Abramowitz, PharmD, in a 

		“It is heartening to see that our elected officials in Washington appreciate the value pharmacists can bring as patient care providers, and we look forward to seeing this bill get passed and signed into law,” said ASHP President Gerald E. Meyer, PharmD, MBA, in a 

		“The provider status designation will amplify pharmacists’ ability to do what they do best — serve patients and help them on the road to better health,” said National Association of Chain Drug Stores President and CEO Steven C. Anderson, IOM, CAE, in a 

		"Independent community pharmacies often care for underserved patients in rural and urban areas alike,” said National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, RPh, MBA, in a 

. “Most of these providers are located in smaller communities and approximately 1,800 independents are the only pharmacy option in their rural communities. In other areas, independent pharmacies cater to diverse populations for whom English may be a second language. In these scenarios and others, independent community pharmacists are ideally positioned to play a greater role in health care, so NCPA is proud to support this legislation."

		“This legislation seeks to fill critical needs and increase access to quality health care in medically underserved communities by enabling pharmacists to practice to the full extent of their education, training and license,” said Vince Ventimiglia, a principal with FaegreBD Consulting and advisor to the Patient Access to Pharmacists’ Care Coalition (PAPCC), in a 

. “The PAPCC is encouraged by this significant step forward to increasing patient access to health care in a cost-effective manner by making pharmacists, as key members of the patient care team, eligible for payment under Medicare Part B, and we look forward to working with our champions and others in Congress to enact this common-sense legislation into law.”

Do you think that the current effort to win provider status for pharmacists will succeed?

Pharmacist Provider Status Bill Introduced in Congress

Pharmacists slip to fifth place from third place in the 

 ranking of the country’s best professions, but continue to place highly thanks to relatively good pay and the promise of job growth due to the changing health care system.

, pharmacist comes in the fifth on the list of best professions in the country. The profession earns its spot based on strong demand despite the tough job market, relatively high pay, and the promise of job growth due to structural changes in the health care system.

“With an aging population of baby boomers, more Americans expected to seek health services due to the Affordable Care Act, and increased demand for prescription medications, industry growth will likely remain high for years to come,” 

a ranking of pharmacists’ top recommendations for more than 1000 OTC products

The median salary for pharmacists in 2012 was $116,670, up from $113,390 in 2011. The 75th percentile of pharmacists in terms of salary made $133,700, while the 25th percentile in terms of salary made $103,350.

 rates upward mobility and stress level above average for pharmacists and flexibility below average. (Stress levels are particularly high when pharmacists must deal with a large number of customers or with difficult customers.) Approximately 40% of pharmacists work in pharmacies or drug stores, but an increasing number are going to work for mail-order or Internet pharmacies or wholesalers.

The professions that ranked higher than pharmacist were, in order, software developer, computer systems analyst, dentist, and nurse practitioner. This marks the first time that the top-ranked profession has not been in health care. Of the two 

 ranked higher than pharmacist, dentists receive a higher median salary than pharmacists (by $46,570), but nurse practitioners receive a lower median salary (by $26,710).

, after dentist and registered nurse. Pharmacists also tend to rank highly in the annual Gallup poll measuring various professions’ reputation for honesty and integrity. In the 

, 70% of respondents said that pharmacists have high or very high honesty and ethical standards. Of the 22 professions included in the poll, pharmacists tied with grade school teachers for the second highest honesty rating, behind only nurses.

’s ranking of pharmacist in fifth place among professions? To vote in our online poll, click 

Pharmacists slip to fifth place from third place in the U.S. News ranking of the country's best professions, but continue to place highly thanks to relatively good pay and the promise of job growth due to the changing health care system.

Pharmacists Place Near Top of U.S. News & World Report Job Rankings

Following the urging of many health care and public health organizations, CVS Caremark will become the first national pharmacy chain to stop selling cigarettes and tobacco products.

CVS Caremark has announced that it will stop selling cigarettes and other tobacco products at its CVS/pharmacy locations by October 1, 2014, making it the first national pharmacy chain to do so.

“Ending the sale of cigarettes and tobacco products at CVS/pharmacy is the right thing for us to do for our customers and our company to help people on their path to better health,” said Larry J. Merlo, president and CEO of CVS Caremark, in a 

.  “Put simply, the sale of tobacco products is inconsistent with our purpose.”

With 7600 locations across the country, CVS Caremark is the nation’s second largest pharmacy chain after Walgreens. Its decision to halt tobacco sales is in accord with positions taken by a range of health care and public health organizations, including the American Medical Association, American Heart Association, American Cancer Society, American Lung Association, and American Pharmacists Association (APhA).

“We welcome CVS Caremark’s commitment to health and wellness and its promise to remove tobacco products from their stores,” said APhA President and community pharmacist Steven T. Simenson, in a 

. “As pharmacists step up to provide care to their patients, we cannot continue to sell known health hazards in our pharmacies.”

, John Colaizzi, RPh, PhD, a professor and former dean at the Ernest Mario School of Pharmacy at Rutgers University who has called for pharmacists to stop selling tobacco products since the 1990s, argued that CVS Caremark’s announcement marked a turning point.

“It is inconsistent with the mission of pharmacy to continue selling cigarettes or tobacco products in pharmacies because today's pharmacy is a part of the health care system,” said Dr. Colaizzi. “Clearly this is a move in the right direction. We will see others, in time, follow in the same direction.”

CVS Caremark also announced that it will launch a smoking cessation program this spring that will offer information and treatment through its pharmacies, its 800 MinuteClinic locations, and through online resources. It will also offer smoking cessation programs to members of the CVS Caremark pharmacy benefit management plan.

, Health and Human Services Secretary Kathleen Sebelius called the decision “an unprecedented step in the retail industry.” A recent report from the Centers for Disease Control and Prevention found that each year smoking kills 480,000 Americans and costs the country $289 billion. In addition, each day 3200 youths under 18 try their first cigarette and more than 700 under 18 become daily smokers. Based on current smoking rates, a projected 5.6 million children alive today will die due to smoking.

“Today’s CVS Caremark announcement helps bring our country closer to achieving a tobacco-free generation,” Secretary Sebelius said in the statement. “I hope others will follow their lead in this important new step to curtail tobacco use.”

President Obama, who has publicly struggled with a smoking habit, also applauded CVS Caremark’s announcement, as did First Lady Michelle Obama, who 

: “Now we can all breathe a little easier, and our families can live healthier.”

Editor's note: Dr. Colaizzi was one of Dr. Page's professors at the Ernest Mario School of Pharmacy at Rutgers University.

What is your reaction to CVS Caremark’s decision to stop carrying cigarettes and other tobacco products in its pharmacies?

Let us know by taking part in our online poll at 

Following the urging of many health care and public health organizations, CVS Caremark will become the first national pharmacy chain to stop selling cigarettes and tobacco products. 

CVS Caremark to Kick Tobacco Habit

 that it would recommend tighter restrictions on commonly prescribed painkillers that include hydrocodone in combination with other drugs such as acetaminophen or aspirin. The announcement called for reclassifying hydrocodone combination products such as Vicodin and Lortab as Schedule II drugs from their status as Schedule III drugs.

American Society of Health-System Pharmacists (ASHP) 2013 Midyear Clinical Meeting

 in Orlando included a debate on whether hydrocodone combination products should be rescheduled. Mary Lynn McPherson, PharmD, professor and vice chair at the University of Maryland School of Pharmacy, argued in favor of rescheduling, and Jeff Fudin, PharmD, FCCP, adjunct associate professor at the Albany College of Pharmacy and adjunct assistant professor at the UCONN School of Pharmacy, argued against it. (Drs. McPherson and Fudin were assigned to take these positions, and their arguments do not necessarily reflect their personal positions on the issue.)

At the ASHP Midyear Clinical Meeting, we interviewed Drs. McPherson and Fudin about the key points of their respective arguments. Here are all 12 of the video clips from these interviews.

Will making hydrocodone combination products Schedule II drugs improve patient safety or limit access to those who need them? Take part in our online poll by clicking 

Dr. McPherson discusses the dramatic increase in use of opioids in the United States.

Evidence for Rescheduling Hydrocodone Combination Products?

Dr. Fudin argues that there is no evidence to support categorizing hydrocodone combination products as Schedule II drugs rather than Schedule III drugs.

Potential for Abuse of Hydrocodone Combination Products

Dr. McPherson discusses the appeal of hydrocodone combination products to drug abusers.

Will Rescheduling Hydrocodone Combination Products Actually Reduce Abuse?

Dr. Fudin argues that categorizing hydrocodone combination products as Schedule II drugs is unlikely to reduce abuse of the medications.

Rationale for Categorizing Hydrocodone Combination Products as Schedule III

Dr. McPherson discusses why hydrocodone combination products were categorized as Schedule III drugs in the first place.

Abuse Liability of Hydrocodone Combination Products

Dr. Fudin argues that studies comparing the abuse liability of hydrocodone combination products with that of other opioids have produced conflicting results.

How Rescheduling Hydrocodone Combination Products Will Reduce Abuse

Dr. McPherson explains how rescheduling hydrocodone combination products as Schedule II drugs will help reduce levels of abuse.

Codeine and Rescheduling Hydrocodone Combination Products

Dr. Fudin argues that categorizing hydrocodone combination products as Schedule II drugs could lead to increased prescription of codeine, a much “sloppier” drug that could create problems for patients.

Rescheduling Hydrocodone Combination Products Will Lead to More Responsible Use

Dr. McPherson argues that rescheduling hydrocodone combination products as Schedule II drugs will introduce limitations that will lead to more responsible prescribing of the drugs and monitoring of their use.

Rescheduling Hydrocodone Combination Products: Lessons from New York State

Dr. Fudin discusses the effect of making hydrocodone combination products Schedule II drugs in New York State on prescription of other opioids, including oxycodone.

Why Should Hydrocodone Combination Products Be Categorized as CII Drugs?

Dr. McPherson explains why hydrocodone combination products should no longer be categorized as Schedule III drugs.

Hydrocodone Combination Product Rescheduling: The Bigger Picture

Dr. Fudin argues that categorizing hydrocodone combination products as Schedule II drugs will not make the medications safer for patients. Instead, he argues, there should be more education for those who prescribe the medications and pharmacists who dispense them.

An expert debate on whether hydrocodone combination products should be made Schedule II drugs, as the FDA has recommended.

The Great Hydrocodone Rescheduling Debate

Our review of the year’s most popular and important stories in pharmacy—from the push for pharmacist provider status to the ongoing fight against prescription drug abuse.

From a push to attain pharmacist provider status to ongoing efforts to combat prescription drug abuse, 2013 was yet another year filled with pharmacy news. Other major topics ncluded the launch of health insurance exchanges under the Affordable Care Act, further findings that pharmacists can help improve patients’ health while saving the health care system money, and new guidelines for determining whether patients should be prescribed statins.

Here are the news stories that have been most popular among 

 over the past year, organized loosely by category:

At the beginning of 2013, a coalition of pharmacy associations announced that they were banding together to push for a change in the Social Security Act designating pharmacists as patient-care providers eligible for reimbursement under Medicare. The movement hasn’t succeeded yet, but it shows no signs of diminishing.

Unprecedented Coalition Supporting Pharmacist Provider Status

Pharmacists Make Progress Toward Attaining Provider Status

Studies, surveys, and algorithms continued to find that pharmacists are widely respected, have among the best jobs in the country, and help improve patient outcomes while saving money.

The Role of Hospital Pharmacists in Transitions of Care

Physician-Pharmacist Team Improves Hospital Care

Pharmacists Rank Among Most Trusted Professionals

Increased Medication Adherence Reduces Health Care Costs

Rates of overdose and death due to abuse of prescription drugs—in particular opioids&mdash;continued to rise, and the FDA continued to grapple with how to help prevent this abuse.

FDA Backs New Restrictions on Hydrocodone Painkillers

CVS Caremark Targets Inappropriate Prescribers to Cut Prescription Drug Abuse

FDA Refuses to Remove Generic Opana From Market

Illicit Use of Prescription Drugs Widespread Among College Students

Opioid Overdose and Death Rates Skyrocket in Women

Launch of insurance exchanges under the Affordable Care Act:

The federal insurance exchange website may not have been ready for primetime, but pharmacies across the country had spent months preparing to help patients make the most of the opportunities offered under health care reform.

Health Insurance Marketplaces Open for Business

Pharmacies Plan to Promote Benefits of Affordable Care Act

Bill Clinton Praises Health Care Reform, Pharmacists

New guidelines for determining who should take statins proved quite controversial, and there was a steady stream of newsworthy studies on treatment of heart conditions as well as the effects of medications on cardiovascular health.

The New Lipid Guidelines: An In-Depth Look

Statins Linked to Increased Diabetes Risk

Blood Pressure Guidelines: Is Change Coming?

Calcium Supplements Can Spell Heart Trouble for Women

Bedtime Aspirin May Be More Beneficial for Heart Patients

Niacin Fails to Reduce Cardiovascular Events

In a year in which the CDC found that antibiotic-resistant infections kill tens of thousands of Americans each year, antibiotics were frequently in the news.

CDC: Antibiotic-Resistant Infections Kill 23,000 Each Year

Antibiotics Recommended for All Toddlers with Ear Infections

FDA Issues Warning on Antibiotic and Fatal Heart Rhythms

Pharmacists play an important and growing role in providing vaccinations, which are key to warding off potentially deadly infectious diseases.

Pneumococcal Vaccine Recommendations Updated

Yet Another Study Finds No Vaccine-Autism Link

FDA Approves New, More Quickly Produced Flu Vaccine

Vaccines Have Prevented Millions of Disease Cases

A number of our most popular stories defied categorization.

“Fiscal Cliff” Deal Has Consequences for Pharmacies

Keeping an Eye on Medical Marijuana for Glaucoma

New Diabetes Guidelines Take Comprehensive Approach

Hillary Clinton Addresses NACDS Total Store Expo

Our review of the year's most popular and important stories in pharmacy-from the push for pharmacist provider status to the ongoing fight against prescription drug abuse.