Magazine article Drug Topics

Bottom Line Improves, but APhA Uneasy over Industry

Magazine article Drug Topics

Bottom Line Improves, but APhA Uneasy over Industry

Article excerpt

On the eve of his third convention as executive v.p. of the American Pharmaceutical Association, John A. Gans should be a happy man. Membership is "about where it was last year, which is amazing, considering the recession and that we had the largest dues increase in the history of the association," Gans pointed out. "For the first time in five or six years," he added, "we're slightly in the black."

But the burly, tight-end-sized ex-pharmacy dean is uneasy as APhA's 139th annual meeting and exposition opens March 14 in San Diego. The Pharmaceutical Manufacturers Association is upset with Gans and APhA for supporting proposed legislation that would financially rap drugmakers whose price increases exceeded the annual inflation rate. PMA has hinted that its member companies might try to exact revenge on APhA.

Adding to his unease is the fact that APhA is the only pharmacy association supporting the bill, which also contains provisions for demonstration projects that would pay pharmacists for cognitive services. For reasons they have never explained to Gans, the other associations are publicly neutral on S. 2000, sponsored by Sen. David Pryor (D, Ark.) and eight other Senators.

In an interview in his office across from the State Department, Gans discussed with Drug Topics the state of affairs at APhA, where he was named CEO in May 1989. Here are some of the issues covered:

COMPOUNDING: Gans believes there is more compounding going on today and that it will continue to rise. APhA is keeping a wary eye on the Food & Drug Administration, which is trying to develop a policy statement that would define compounding and differentiate between it and manufacturing.

Gans does not believe there is a "major problem" with compounding but conceded, "There really is a lack of knowledge on the part of some pharmacists who are doing compounding. It is really the art of pharmacy. To be good at art, you've got to do it over and over and over again. I would say that many pharmacists today don't do sufficient compounding to be professionally competent at it."

Part of the reason is that many pharmacy schools have dropped compounding in favor of clinical courses. Gans said APhA is looking at developing certificate courses and training on proper compounding techniques. "I can almost see a potential specialty area of pharmacy evolving in the area of compounding simply because you need to have specific tools and training," he noted further. "It is a unique aspect of the profession, and I see it growing."

PATIENT PACKAGE INSERTS: "It didn't work before for a lot of reasons," Gans said of FDA's effort to get pharmacists to voluntarily include computer-generated patient package inserts along with Rxs. In 1979 FDA proposed and then abandoned mandatory PPIs. "The answer is not a piece of paper being given to patients. They are being given out now," and a lot of them are being thrown away before the patient even leaves the store.

"Our answer is that pharmacists need to be paid to manage the drug therapy plan," he continued. "Provide the drug product. Get a reimbursement for distributing the product, controlling, etc., and a fee to mange a patient's drug therapy....That," he said, "is our highest legislative priority."

Counseling is the key to compliance--the way to optimize the therapeutic outcomes that are in the best interests of everyone, Gans observed.

"I think the commissioner (FDA chief David A. Kessler) should work to put pressure on the profession of pharmacy to educate patients better," Gans added. …

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