Pharmacist mentoring Pharmacy Students and making a difference

Waterloo druggist promotes pharmacy ownership


Nov 25, 2018  | By: Pat Kinney For The Courier

WATERLOO — Bob Greenwood says Rabbi Sol Serber was his most constructive critic.

The late longtime leader of Sons of Jacob Synagogue would call the Waterloo pharmacist frequently.

During Greenwood’s years on the Waterloo City Council, Serber would urge Greenwood to improve his posture at televised council meetings so he looked poised and alert. Serber kept little turtle statues around his home, and urged Greenwood to follow their example and “stick his neck out” every once in a while.

Greenwood followed his mentor’s advice. Thirty years ago, Greenwood stuck his neck out when he left the pharmacy he’d been working at for a decade to run his own independent drug store.

Now, Greenwood’s done it again. He’s mentoring aspiring young independent pharmacists — not just the mechanics of filling prescriptions, but the nuts and bolts of running a business.

Over the last 18 months, he’s had pharmacy school graduates perform a one-year residency through the University of Iowa.

Greenwood’s first resident, Wartburg College and University of Iowa pharmacy school graduate Rob Nichols, now helps Greenwood mentor other young pharmacists.

Nichols, an Ottumwa native who played football at Wartburg, is working for Greenwood full-time and hopes to get his own independent pharmacy when the right opportunity presents itself. He also majored in business, and is saving for the day that can happen. With Greenwood, he’s also working with other fifth-year pharmacy and post-graduate students obtaining field experience.

Greenwood is trying to stem a decades-long decline in independent pharmacies by promoting entrepreneurship in the field. Nichols is one of his best examples of that effort.

“He’s surrounded himself with some of the best pharmacists around the state,” Greenwood said. “So he set himself up to be successful through hard work. And just paying attention. He knew who he had to meet. He was active in the student pharmacy programs both and Iowa and at the national level,” even starting a student chapter of the National Community Pharmacy Association in Iowa City.

“I would say in the last 15 years we probably lost 300 stores,” Greenwood said, where 850 independent pharmacies may have existed when he entered the field. He named at least a half-dozen independent pharmacies in Waterloo-Cedar Falls alone that no longer exist.

The University of Iowa started the pharmacy residency program. While Greenwood’s affiliation is a fairly recent development, over time he’s been very supportive. He’s hired about six to 10 graduates of that program.

Nichols said the program encourages talented students from Iowa “to stay in Iowa, and with that education, to understand the importance of giving back to the community.”

“We want to encourage entrepreneurship, ownership,” Greenwood said. “We have to train these (pharmacists) to backfill these rural communities,” Greenwood said. “Dyersville. Cherokee. Rural areas.”

Greenwood told of one instance in which a small-town pharmacist ready to retire searched five years to find a young qualified pharmacist interested in taking over his store.

Nichols said he decided to enter the pharmacy field late during his undergraduate education at Wartburg; He worked at Meyers Pharmacy in Waverly and became active in professional associations.

“I kind of fell in love with the profession,” Nichols said. “At that point I decided to pursue not only just being a pharmacy technician, but I wanted to pursue the path of being a pharmacist.” He worked as a technician during pharmacy school. He graduated from Wartburg in 2011.

Eventually, he was admitted to pharmacy school at Iowa.

“When I got on there I took on some leadership roles, kept me involved within the profession,” he said. He worked at a pharmacy in Denver operated by Greenwood.

Greenwood was president of the National Community Pharmacy Association at the time Nichols started a student chapter at Iowa. Nichols then worked with the university so Greenwood’s business would become an accredited site for the residency program, emphasizing pharmacy ownership.

“In pharmacy school, you learn everything there is to know about the medications. But in residency, you learn how to take care of people,” Nichols said.

He said his business background guided his decision to focus his residency on ownership.

“And having Bob as a mentor, learning the ins and outs of the business of running a pharmacy, managing a pharmacy, was just an added benefit of me being at this site for a residency,” Nichols said.

His residency concluded in June, and Greenwood hired him full time. He’s working with new pharmacists coming into the residency program at Greenwood.

He was one of just three African-Americans in his pharmacy class at Iowa, and pharmacy mentors who are minorities are rarer still, he said.

For his efforts, Greenwood and his business are receiving an Iowa Trailblazer award from the Coalition to Build a Better Community in Iowa, an organization created by local automobile executive Jeff Zaputil to recognize innovation and initiative in local entrepreneurship.

Greenwood “inspires others to take charge of their own destiny,” Zaputil said.

New Enhancements to Trading Platform

TRxADE GROUP, INC. Launches New Enhancements to Trading Platform

TRxADE GROUP, INC. Launches New Enhancements to Trading Platform

SOURCE: Trxade Health, Inc.

Press Release | 10/02/2018

TAMPA, FL / ACCESSWIRE / October 2, 2018 / Trxade Health, Inc., (OTCQB: TRXD) a web-based market platform with 9,300 registered independent pharmacy customers that enables its customers to quickly source and purchase pharmaceuticals, accessories and services from a wide range of manufacturers and drug distributors today announced new enhancements to the trading platform.

Jariel Morales, Executive Vice President of Trxade Health said, “As we continue on our path of being a premier healthcare solutions provider, our team has focused on the voice of the customer and expanding our portfolio to provide additional services to our members that increase their bottom line revenue, increase the number of patients they see each month, and provide alternative health solutions to their patient base. By focusing on the voice of the customer and their direct needs, we experienced record-breaking figures this quarter where we experienced a record-breaking number of buyers, orders per day, and line items/products sold per day. We look forward to meeting the demands of our members and continuing to see the growth we are experiencing through the 4th quarter.”

Launched Trxade Release Version 1.17 on our Nova platform.

  • New and advanced filters allowing members to select ADD, ADD Pending, or Non-ADD Suppliers and filter their favorite products by Brand or Generic.
  • We continuously focus on making it easier to find significant savings on products for our Pharmacy members and this release helps meet that goal. We launched recommended products at the shopping cart level to help our Pharmacy members meet the minimum per order required via data analytics. This feature informs them of products their peers are procuring through the platform by each supplier including auto selecting the preferred method of shipping.
  • We are proud to announce that this release also features our updated dashboard displaying additional product lines trending including Vials, Test Strips, Alcohol Pads, Syringes, and other categories our members report significant savings versus their primary wholesalers. The new updated Dashboard also focuses on Trending items tied to an algorithm which features artificial intelligence to provide the best priced products to each member based on buying patterns yielding a maximum significant time and cost savings.
  • “Do Not Contact” feature has been implemented allowing our Pharmacies to request marketing “opt-out” from up to 45 wholesalers with just one click.
  • We have also incorporated Orange Book ratings for Rx products, as well as Unit of Measure on each package size.
  • New updated Dashboard that focuses on Trending items tied to an algorithm featuring artificial intelligence providing best priced products to each member based off buying patterns yielding a significant time and cost savings.

About Trxade Health, Inc.

Headquartered in Tampa, Florida, Trxade Health, Inc. (OTCQB: TRXD) is a web-based market platform that enables trade among healthcare buyers and sellers of pharmaceuticals, accessories and services. Founded in 2010, Trxade Health currently operates the trading platform with 9,300 registered members. For additional information please visit us at

Forward-Looking Statements

The information contained herein includes forward-looking statements. These statements relate to future events or to our future financial performance, and involve known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. You should not place undue reliance on forward-looking statements since they involve known and unknown risks, uncertainties and other factors which are, in some cases, beyond our control and which could, and likely will, materially affect actual results, levels of activity, performance or achievements. Any forward-looking statement reflects our current views with respect to future events and is subject to these and other risks, uncertainties and assumptions relating to our operations, results of operations, growth strategy and liquidity. Except as may be required by applicable law, we assume no obligation to publicly update or revise these forward-looking statements for any reason, or to update the reasons actual results could differ materially from those anticipated in these forward-looking statements, even if new information becomes available in the future. The company undertakes no duty to update forward-looking statements.

Investor Relations Contact:

Christi Justi

How Pharmacists Can Stay at the Forefront of Patient Care in an Evolving Market

How Pharmacists Can Stay at the Forefront of Patient Care in an Evolving Market


July 25, 2018 | By: Rebecca W. Chater, RPh, MPH, FAPhA

Amazon recently announced its entry into pharmacy through the acquisition of PillPack, a service that delivers medications, presorted in adherence packaging, to a patient’s home. The announcement has the pharmacy profession and the pharmaceutical industry debating several questions around the deal’s impact on local pharmacies and the role of the pharmacist in this process. At last estimate, the burden of nonadherence on our healthcare system exceeded $300 billion in direct and indirect costs, with approximately 50% of patients not taking their medications as prescribed, indicating a clear opportunity to mitigate related barriers to improved adherence.

While convenient access to medications certainly aids adherence, and could be facilitated by the PillPack acquisition, the deal stands to disrupt direct pharmacist-to-patient contact and the essential role of the community-based pharmacist within the healthcare continuum. Convenience of medication delivery is not a panacea for resolution of nonadherence and falls woefully short in addressing other critical aspects of addressing medication-related problems including unanticipated medication interactions, gaps in care, cost challenges, lack of patient education, lifestyle incompatibilities, and others.

Rather than focusing on the PillPack acquisition by Amazon as a threat, pharmacists should consider this as an opportunity to reassess the value that they bring—the existing patient care services, tools, and technology that equip them to deliver patient-centric, personalized care. Whether employing data analytics to more efficiently identify needed interventions, adherence packaging, or medication therapy management, pharmacies can enhance their service offerings to differentiate their practices and keep patients at the center of care.

Leveraging Adherence Tools

Pharmacists have long differentiated themselves with patients by stepping up to help with the confusion around managing multiple medications, and monitoring health issues. By using technology to streamline patient communications, and offering adherence tools, such as multimed blister cards, that can be customized to each patient, pharmacists can ensure they are not edged out by the online retailer.

This is especially true when patients experience care transitions. From one care setting to the next, they need the pharmacist as a local resource to help ensure smooth transition, and guide them on their path to better health outcomes. Research has shown that pharmacists are specially qualified to fulfill this role, helping to address concerns, and reduce medication errors that might not always be evident. The one-size-fits-all approach that Amazon is developing circumvents the role of the local pharmacist, and is not designed to meet the individualized needs of patients with unique health concerns.

Enhancing Pharmacy Care for Better Results

As our nation’s most accessible healthcare professionals, pharmacists serve as touchstones of care in communities all across the country, offering patient-centered, personalized, and coordinated care. Emerging data-driven solutions provide pharmacists with tools they need to increase their value through targeted clinical engagement, enabling them to further improve health outcomes, reduce healthcare costs, while offering a level of patient convenience that rivals Amazon-PillPack.

Centralized, actionable data specific to managing patient engagement is essential to improving care while reducing costs across the care continuum. For this reason, healthcare needs a system that not only provides convenience related to medication access—as this Amazon acquisition aims to do—but also keeps the pharmacist regularly connected to the patient to evaluate medication-related health needs on an ongoing basis, communicating as needed with patient and prescriber regarding medication adherence, potential medication changes or dosage adjustments, side effects, drug interactions, needed vaccinations, and more.

The coming months will reveal changes that result from the Amazon-PillPack deal. In the meantime, pharmacists should take this as an opportunity to amplify their value to further differentiate their practices, ensuring that their role will not be diminished by this new venture. By staying connected to their patients and implementing tools that help to expand their service offerings and improve patient care, today’s pharmacists will reinforce their own essential role in the care continuum, now and in the future.

PBM Transparency: PBM’s made $223 Million from Ohio Medicaid

PBMs made $223.7M from Ohio Medicaid in 2017


July 12, 2018 | BY Kaitlin Schroeder

For the first time, the state of Ohio on Friday released data showing how private companies manage $2.5 billion in public money for pharmacy benefits for Ohioans on Medicaid.

The middlemen, called pharmacy benefits managers, are under scrutiny for how transparent they are in how the public money gets spent. The new report shows the companies retained $223.7 million last year of the money they billed Medicaid.

Operators of small pharmacies have contended that the benefits managers take too much of the money and give pharmacists reimbursements that are too small. Some in the industry claim the low payments have forced small pharmacies out of business.

CVS Caremark, with the same parent company as CVS retail pharmacies, manages pharmacy benefits for four of the five Medicaid managed care companies. Last year it kept 8.7 percent or the payments it received, or $197.3 million. OptumRx does work for the other insurer and kept 9.4 percent, or $26.4 million.

Greg Moody, the director of the Ohio Department of Health Transformation, which oversees Ohio Medicaid, said Ohio needs more information before it determines what is a fair share for the pharmacy benefit managers.

“At this stage we’re not saying that’s too high or too low,” Moody said. “What we’re saying is this is information we’ve never had before. And now the state, the managed care plans, the pharmacies have more information to make their argument and determine if that number is too high or too low or what should happen next.”

The report shows the system saves the state money, Moody said. Medicaid saved $145 million under the privatized system compared to the former system where the state insurance program for the poor directly paid fees for services.

Ohio Association of Health Plans, which lobbies on behalf of the Medicaid managed care companies, said the new report confirms that the current system saves the state money. Attention should instead be focused on the pharmaceutical companies and their prices, according to Miranda C. Motter, president and CEO of Ohio Association of Health Plans.

“Further, this report proves that independent pharmacies are not underpaid and confirms that the real problem is the prices drug companies charge for prescriptions drugs are kept secret and that pricing is unsustainable for Ohio’s purchasers of health care,” Motter stated.

In 2017, the Dayton Daily News reported more than 90 pharmacies in Ohio closed their doors and others at the time said they may have to do the same because of a dramatic decrease in reimbursements from Medicaid managed care plans.

Since CVS Caremark also has the same parent company as CVS retail pharmacies, independent pharmacists have claimed their lowered reimbursements are an attempt to drive them out of business and give more Medicaid business to CVS. CVS has more than 9,000 locations nationwide.

From the state’s standpoint, Moody said his department wants its Medicaid enrollees to have access to the benefits they need and that they are getting a good price for tax payers.

Since their enrollees could access pharmacy services and the state was saving money, Moody said there wasn’t an initial need to have the type of data released in the report. The impetus for the report was to get enough information on whether these middlemen were engaging in fair business practices.

“From the state’s stand point there was no reason to ask this question except — and this is important — we don’t want to get a deal if it is at the price of anti-competitive behavior somewhere in the system,” he said.

The state had a third party, HealthPlan Data Solutions, create the report on prescription benefit data following recent criticism of pharmacy benefit managers. The report used claims data provided by the Medicaid managed care companies and matched it to Ohio Medicaid data.

Pharmacy benefit managers
New data shows the difference between what pharmacy benefit managers (PBMs) billed to Medicaid plans verses what they paid to pharmacies.
Managed Care Plan Price PBM Paid to Pharmacies Price PBM billed to Medicaid managed care plan Money PBM kept Percent PBM kept
Buckeye $268,014,861 $300,953,989 $32,939,128 10.94%
Caresource $1,289,174,707 $1,403,459,575 $114,284,868 8.14%
Molina $286,966,691 $313,813,700 $2,033,837 8.70%
Paramount $228,400,715 $250,914,832 $1,494,203 9.14%
UnitedHealthcare $253,372,283 $277,516,774 $2,765,797 9.41%
Source: HealthPlan Data Solutions   

From July 1, the state will be able to do the analysis themselves because of how it changed its contract with the Medicaid managed care companies.

CVS said in a statement that report’s finding show that CVS Caremark pays independent pharmacies a higher rate than CVS pharmacies — 3.6 more for brand prescriptions and 3.4 more for generics.

The company said this confirms it “does not provide preferential pricing to CVS Pharmacy that would create an anti-competitive advantage over independent pharmacies.”

CVS said some of the the money it keeps also pays for clinical services and other benefit management services provided to clients.

But Antonio Ciaccia, lobbyist with the Ohio Pharmacists Association, said “paying $224 million to essentially process claims is frankly remarkable.”

He said the report doesn’t disprove concerns that the middlemen companies are squeezing pharmacists. The data also doesn’t dig into whether the middlemen are paying too little given the cost of the drugs or pocketing too much for their services.

“What’s reasonable? It’s very hard to tell because we don’t have a competitive and transparent marketplace,” he said.

Moody said the pharmacy benefit manager debate is part of a broader issue that starts with frustration over how drug makers aren’t transparent on drug costs.

“Manufacturers go out of their way to keep prices secret and then everything that happens after that is in a sense distorted. Because I think everyone assumes someone else is getting a better deal and there’s a lot of distrust in the system,” he said.