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Executive Insight

HELEN SAIRANY, BA, PHARMD, MBA, RPH, BCACP EXECUTIVE VICE PRESIDENT & CEO

Educate! Advocate! Engage! Network!

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I hope this piece finds you all well. I am excited to have officially started my role as executive vice president and CEO for the Florida Pharmacy Association. I am thankful to the FPA’s board of directors for entrusting me with this very important role in serving your needs in advancing the profession in the state. I look forward to initiating site visits to meet all of you in person.

I want to let FPA members to know that I am aware of the urgent matters that are impacting the pharmacy profession, including payment reform; attention to workplace conditions; securing our role within the healthcare system; ensuring a diverse, equitable and inclusive culture; as well as practice transformation and expansion through statewide protocols.

I promise to continue working hard to address your concerns, but I cannot do it alone. I need your help and engagement to tackle these issues. I will need you to join me in the arena to fight for the profession and bring pharmacy to every public health discussion at a state as well as national platform.

Some of you might not be fully aware of what our role is as our state pharmacy association. Perhaps the best way to summarize why FPA is here is through four key terms: advocate, engage, network and educate.

Advocate!

We all have the responsibility to advocate for the profession through patient care services. Protecting and advancing the pharmacy profession requires constant vigilance by identifying, monitoring and quickly acting upon current, as well as future, opportunities and threats.

As a former state executive in South Carolina, I have heard from members about how abuses by PBMs are impacting the mental health of our pharmacists and support staff as well as the financial stability of our profession. I am excited to hear about Governor Ron DeSantis’s support for my fellow pharmacists here in Florida through his execu-

tive order to ensure transparency and accountability.

I am also aware of the challenges pertaining to unbearable work conditions. Just like other healthcare providers, pharmacists and their team members are under an immense amount of stress, pressure and demand to serve the needs of their patients.

Throughout the pandemic, overrun hospitals were often referred to as combat zones, and healthcare workers as frontline soldiers. Research shows that those comparisons were probably warranted. As they faced fatigue, death, fear of infection, burnout and watching people ignore public health recommendations, healthcare workers have been experiencing record levels of mental health distress.

The impact of the pandemic on the mental health of healthcare workers, including pharmacists, has been well documented. Every day, we hear about rising reports of exhaustion, burnout and staff turnover in our communities. A recent survey reveals that over 60% of pharmacists report experiencing a high level of burnout in practice. This is one of the highest rates among all healthcare professionals, even higher than surgeons, oncologists and emergency and trauma unit practitioners.

Research shows that members of the healthcare team, pharmacists included, are more prone to making errors when

We all have the responsibility to advocate for the profession through patient care services. Protecting and advancing the pharmacy profession requires constant vigilance by identifying, monitoring and quickly acting upon current, as well as future, opportunities and threats.

Helen Sairany, BA, PharmD, MBA, RPh, BCACP

FPA STAFF

Executive Vice President, CEO Helen Sairany, ext.200 Director of Continuing Education Tian Merren-Owens, ext. 120 Continuing Education Coordinator Stacey Brooks, ext. 210 Coordinator of Membership Ranada Howard, ext. 110

FLORIDA PHARMACY TODAY BOARD

Chair....................David Mackarey, Boynton Beach Vice Chair.................................. Matt Schneller, Tampa Treasurer................................... Eric Jakab, Gainesville Secretary............................. Julie Burger, Pensacola Member .................................. Aiya Almogaber, Tampa Member ........................Michael Finnick, Jacksonville Member....................... Carol Motycka, Jacksonville Member ...........................Teresa Tomerlin, Rockledge Member...................................... Greta Pelegrin, Hialeah Technician Member..........Julie Burger, Pensacola Executive Editor .........Helen Sairany, Tallahassee Managing Editor..................Dave Fiore, Tallahassee Journal Reviewer........................... Dr. Melissa Ruble Journal Reviewer....................................Dr. Angela Hill

This is a peer-reviewed publication. ©2022 FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web address: www.floridapharmacy.org. under a lot of pressure. This is particularly concerning considering that medical errors are the third-leading cause of death in the United States, with cardiovascular disease and cancer being the first and second.

Due to the demand and the stress they are under, pharmacists are more likely to suffer more from PTSD than the general population. It’s easy to understand why. Pharmacists bear witness to their patients’ suffering, and many lack complete control over their work conditions and their ability to maintain personal safety. New demands created by COVID-19 are fueling these stress responses— further raising the risk of PTSD.

Engage!

Engagement is the central pillar of what we do here at FPA. The only way we can tackle and resolve big agenda items is by having engaged members. I want to hear from you and learn about your needs and concerns. It is only through your engagement that we can protect and advance the profession.

Network!

Coming out of the pandemic and social isolation, I can’t emphasize enough the importance of social connection. I am working diligently with my staff to firm up some of our upcoming events. I hope you are able to join us in one of our future live events so I can meet you in person.

Educate!

Here at FPA we strive to provide cutting-edge educational content to help you stay up-to-date, fulfill your professional development needs and practice at the top of your license. Please check our calendar of events at floridapharmacy.org for our upcoming educational events.

Lastly, I would like to leave you with a challenge. I challenge you to increase your level of engagement with FPA 2022-2023. Attend one of our live events. Renew your membership at a higher level. Donate. Volunteer for a committee. Run for an elected position. As you can tell, the opportunities are endless and the need is great.

I look forward to serving along side you this year.

Florida Pharmacy Association Unit Association Recognition Award

Joy Wright, B.Sc.Phm., Pharm.D., CPh, BCPS, TTS, CFMS

To highlight the efforts of local unit associations, the FPA has recognition awards in several categories that are presented during the annual meeting. We wanted to take a moment and share a 2021-2022 submission from the Alachua County Association of Pharmacists (ACAP). Over the next few issues, we will continue to share submissions from different categories to encourage other members and local units to share their efforts in the Journal.

The Alachua County Association of Pharmacists supported FPA through attendance at conferences, volunteering on councils, assisting with Legislative Days and promoting and participating in the leadership conference. During the past year, ACAP provided approximately 20 free FPA memberships to pharmacy students across the state.

Association members serving as officers, council chairs, council/committee members or delegates for the Florida Pharmacy Association include: n William Garst, Florida Pharmacist Political Committee,

Legislative Days n Joy Wright, FPA Board Member, District 1; Chair, Professional Affairs Council, participated in Legislative Days n Edwin (Charlie) Brown, Student Affairs Council, SAOT,

Legislative Days Student Affairs Committee FPPC, GAC n Yania Aguero-Martinez and Emmaleigh Munn, Student

Affairs Council, SAOT, Legislative Days n Tim Rogers, William Garst, Paul Ackerman, Charlie

Brown, Jeff Consaul and Joy Wright, House of Delegates (July)

Corresponding secretary, Charlie Brown and newsletter editor, William Garst either highlighted issues or forwarded STAT news to members as needed throughout the year. Michael Jackson was asked to speak not only at each meeting of this year but presented a two-hour CE on legislative updates to our members which also encouraged them to contribute to the PAC.

ACAP is very visible at Legislative Days, providing packets to legislators on the issues. This year, our Student Engagement Fund (special treasury account for student activities) awarded FPA memberships to students throughout the state who participated in Legislative Days. Also, each fall when the P-1’s are starting at UF, ACAP is involved with tabling events and finding other ways to be visible with the students, often encouraging FPA membership alongside ACAP membership to all UF students. In addition to assembling welcome packets for incoming students, ACAP extends free membership to ACAP and FPA to many of the event participants. ACAP also supports the students by providing speakers for events planned at the college.

The Unit Association Recognition Award is designed to recognize a local unit association with respect to association involvement. Recognition may be warranted based upon the unit association’s service to the Florida Pharmacy Association.

University of Florida College of Pharmacy Profile

As the University of Florida College of Pharmacy approaches its centennial year in 2023, it’s important to reflect upon the rich history of educating Florida pharmacists while boldly planning for the next 100 years. From its humble beginnings in UF’s Science Hall, the UF College of Pharmacy has emerged to become a national leader in pharmacy education, research and patient care. The Pharm.D. program recently received a perfect accreditation score, and for the sixth time in seven years, the college led the nation in the number of students placed into residency programs. Annual research funding reached a record $32.3 million, and for the first time, the college ranked in the top three nationally in all the American Association of Colleges of Pharmacy’s major funding categories (NIH, federal and total grant funding). New and innovative approaches to patient care have allowed the college to expand its clinical footprint in Florida, including a new alliance with Shell Point Retirement Community in Fort Myers. These achievements and more are highlighted in this edition of Florida Pharmacy Today. It’s a great time to be a Gator pharmacist, and the college is well-positioned to make an even greater impact on the pharmacy profession during our second century.

John G. Gums, Pharm.D., FCCP

Interim Dean, Associate Dean for Clinical and Administrative Affairs UF College of Pharmacy Julie Johnson Bids Farewell as Dean After nine years of leading the University of Florida College of Pharmacy, Julie Johnson, Pharm.D., stepped down as dean on Aug. 14. As a visionary leader, Johnson helped the college reach new heights, including its firstever top-five finish in the U.S. News & World Report Best Pharmacy Colleges rankings. Julie Johnson, Pharm.D During Johnson’s tenure, the college made significant strides to improve its education, research and clinical areas. She led the recruitment of many world-renowned clinicians and researchers, as the faculty nearly doubled in nine years from 72 to 135. The college also completely overhauled its Pharm.D. curriculum by adopting an innovative and contemporary teaching approach that the Accreditation Council for Pharmacy Education self-study team described as “the model for 21st-century pharmacy education.” Johnson also oversaw tremendous growth in the college’s research program with annual research funding increasing from $8.5 million in 2013 to a record $32.3 million in 2021.

Johnson was the first female dean of the college and the first to hold a Doctor of Pharmacy degree. She will return to the faculty after a year-long sabbatical. A national search is underway to identify her replacement. Carol Motycka Sworn in as FPA President Carol Motycka, Pharm.D., a clinical professor and assistant dean for the UF College of Pharmacy’s Jacksonville campus, was sworn in as president of the Florida Pharmacy Association during the organization’s annual meeting in July. She was elected by a vote among FPA’s members in spring 2021 and served the past year as president-elect of the organization. As president, Motycka will lead the largest and oldest statewide organization representing the profession of pharmacy in Florida. Her presidential responsibilities will include setting the organization’s annual goals, appointing

Carol Motycka, Pharm.D., CHSE

committee chairs and members, presiding over meetings at the annual conventions and representing FPA at state and national pharmacy events, among many other duties.

UF College of Pharmacy No. 1 in the Nation Again for Pharmacy Residency Placements

The University of Florida College of Pharmacy finds itself in a familiar position atop the national pharmacy match rankings after a record 153 fourth-year students and graduates secured residency positions in the American Society of Health-System Pharmacists, or ASHP, match in 2022.

It’s the sixth time in seven years that the UF College of Pharmacy led the nation in total residency placements.

ASHP’s match program pairs thousands of student pharmacists across the country with a variety of pharmacy practice settings, including hospitals and community pharmacies. Nearly 5,800 postgraduate year one, or PGY1, and postgraduate year two, or PGY2, residency positions were available this year. UF’s 153 residency matches included 113 PGY1 and 40 PGY2 placements.

Residency programs from coast to coast will welcome Gator pharmacy students and graduates this summer. UF’s matches featured programs in 22 states and Washington, D.C. Most pharmacy students and graduates will continue their training in Florida, with 105 matching in the Sunshine State.

White Coat Moment Finally Arrives

On April 2, second- and third-year pharmacy students joined their peers from the first-year class in walking across the stage to ceremoniously receive their white coats. The coating ceremonies were the first hosted by the UF College of Pharmacy since April 2019, as the COVID-19 pandemic forced the postponement of the 2020 and 2021 events.

More than 600 students participated across the three classes, with the first-year students being coated in the morning, followed by afternoon ceremonies for the second- and third-year students at the Stephen C. O’Connell Center in Gainesville.

In acknowledging the unusual circumstances surrounding the delayed white coat ceremonies, then Dean Julie Johnson, Pharm.D., applauded all the students who persisted

UF College of Pharmacy gradution ceremony

through difficult times to finally enjoy their moment on the stage.

“Making the transition into pharmacy school and navigating through the curriculum is challenging under the best of circumstances, but these students have worked incredibly hard and persevered through exceptionally challenging times,” Johnson said. “The white coat is symbolic of the highest ideals of the practice of pharmacy, and it was especially meaningful to finally present white coats to our students.”

Each ceremony featured a keynote speaker and remarks from a senior UF College of Pharmacy student. Michael Jackson, B.Pharm., executive vice president and chief executive officer of the Florida Pharmacy Association, spoke to the first- and second-year cohorts, while Theresa Tolle, B.Pharm., FAPhA, a 1988 graduate of the UF College of Pharmacy and president of the American Pharmacists Association delivered the keynote remarks to the third-year students.

UF College of Pharmacy Students Take Home Multiple Honors at APhA Annual Meeting

The American Pharmacists Association Annual Meeting and Exposition was held in person for the first time in three years and students from the University of Florida College of Pharmacy made their presence known by winning multiple national awards in San Antonio, March 18-21. n The 2020-21 UF American Pharmacist Association –

Academy of Student Pharmacists, or APhA-ASP, chapter won the National Chapter Achievement Award for Division A. The Chapter Achievement Awards Program recognizes outstanding activities of APhA-ASP chapters at colleges of pharmacy in the United States and Puerto

Rico. n Shirly Ly, a fourth-year student pharmacist and president of the UF APhA-ASP chapter, was one of four national recipients of the 2022 APhA-ASP Student Leadership Award. n Ronald Levinson, a fourth-year student pharmacist, was elected as the APhA-ASP National Speaker of the House.

As speaker, he will guide student pharmacists through the policy process and work with national, regional and chapter officers to ensure student pharmacists are prepared to write effective resolutions and policies. n Megan Backus, a fourth-year student pharmacist, finished second runner-up in the APhA-ASP National Patient Counseling Competition, which encourages student pharmacists to become better patient educators. n Theresa Tolle, a 1988 graduate of the UF College of Phar-

UF College of Pharmacy Students Take Home Multiple Honors at APhA Annual Meeting

macy, was sworn in as president of APhA. The owner of Bay Street Pharmacy in Sebastian, Florida, will serve a one-year term leading the largest association of pharmacists in the U.S.

UF College of Pharmacy Receives Insight into Diversity 2021 Health Professions Higher Education Excellence in Diversity Award

The University of Florida College of Pharmacy received the 2021 Health Professions Higher Education Excellence in Diversity, or HEED, Award from INSIGHT Into Diversity magazine. It marks the first time the college has received the award, which is presented annually by the oldest and largest diversity-focused publication in higher education.

As a recipient of the Health Professions HEED Award — a national honor recognizing U.S. health colleges and universities that demonstrate an outstanding commitment to diversity and inclusion — the UF College of Pharmacy was featured, along with 50 other recipients, in the December 2021 issue of INSIGHT Into Diversity Magazine. The UF College of Pharmacy is one of only three pharmacy colleges nationally to receive the honor and joins the UF College of Dentistry as a recipient of this year’s award.

UF College of Pharmacy Moves into Top 3 of National Research Rankings

The University of Florida College of Pharmacy moved up two places to No. 3 in the nation for total research funding in the latest American Association of Colleges of Pharmacy, or AACP, report released June 23. The No. 3 ranking is the highest ever achieved by the college when compared to peer institutions.

The AACP compiles research data from more than 140 colleges of pharmacy around the country. For the first time, the UF College of Pharmacy ranked No. 3 in all three major categories where research funding is reported: NIH funding ($22.1 million), federal funding ($25.9 million) and total funding ($32.3 million).

UF College of Pharmacy Moves into Top 3 of National Research Rankings

The $32.3 million is a new record for annual research funding in the college and represents a nearly fourfold increase since 2013 when the college secured $8.5 million.

“To achieve these record-setting results takes a tremendous amount of hard work and dedication by our faculty and the research teams who support them,” said Julie Johnson, Pharm.D., former dean and distinguished professor in the UF College of Pharmacy. “Scientific discovery is a neverending pursuit, and our faculty have demonstrated an unwavering commitment to improving the health and welfare of others through their pharmaceutical research.”

The UF College of Pharmacy increased the number of grant-funded faculty from 53 to 57 during AACP’s reporting period from October 2020 to September 2021. AACP’s report also indicated that 92.5 percent of the college’s tenure-track research faculty were grant-funded. Both numbers reflect new statistical highs for the college.

Building Trust Through Telehealth

When the COVID-19 pandemic emerged in spring 2020, clinical pharmacists in the University of Florida College of Pharmacy pivoted to telehealth to help patients manage their medications. With physician practices and clinics shuttered and many people staying home, video conferencing became a lifeline between pharmacists and their patients. The service model proved so effective that the college began exploring new ways to deliver pharmaceutical services through telehealth.

In September 2021, the college formalized an alliance with the Shell Point Retirement Community in Fort Myers, Florida, to launch the first telehealth anticoagulation consultation service. Three mornings a week, a clinical pharmacist from the UF College of Pharmacy’s Orlando campus provides medication consultations with Shell Point residents nearly 200 miles away. The pharmacist has access to the patient’s medical records and can record notes in realtime. They also work closely with the four physicians and five nurse practitioners providing on-site care at the retirement community.

“Anticoagulation medications require careful and constant management, and this new collaboration with Shell Point allows our UF pharmacists to share their expertise and provide a high-quality service to the Shell Point community,” said John Gums, Pharm.D., FCCP, associate dean for clinical and administrative affairs and a professor of pharmacotherapy and translational research in the UF College of Pharmacy.

The anticoagulation clinic is the first to launch at Shell Point, and the college has added a polypharmacy service which began in June 2022. This telehealth offering is helping patients who are taking multiple medications to reduce their side effects, costs and the likelihood of a drug-induced emergency room visit or hospital admission.

UF’s First Black Ph.D. Graduate Honored with Distinguished Alumnus Award Ira C. Robinson Sr., ’66, had a career nothing short of distinguished. He overcame racial tension and adversity to become the University of Florida’s first Black Ph.D. graduate — earning a degree in industrial pharmacy. He was the first Black Ph.D. senior research scientist at Pfizer, and at the age of 28, he became the nation’s youngest pharmacy college dean at his undergraduate alma maIra C. Robinson Sr., ter, Florida A&M University. Later in his career, he served as dean of the Howard University College of Pharmacy.

Robinson recently added to his list of accomplishments as the recipient of UF’s Distinguished Alumnus Award. The honor is the highest bestowed upon a UF doctoral graduate and only about 300 individuals have ever received the award. UF recognized Robinson during the university’s Doctoral Recognition Ceremony on April 28.

“Throughout his career, Dr. Robinson has demonstrated being a trailblazer and pioneer in the profession of pharmacy,” said John Allen, Pharm.D., associate dean of diversity, inclusion and health equity in the UF College of Pharmacy. “His exemplary career in the pharmaceutical industry and pharmacy education was grounded in knowledge, skills, and attitudes obtained at the University of Florida, and were instrumental in his success. Being UF’s first Black Ph.D. graduate took great endurance and courage, and his greatest legacy may be found in the generations of Black students who have followed in his footsteps and sought a more equitable education.”

Robinson used his industrial pharmacy education to establish his own international pharmaceutical health care consulting business. He advised the U.S. government and Ministries of Health around the world on drug supply logistics as well as the importation, manufacturing and storage of

medications. His devotion to advancing Blacks in pharmacy was evident through his service to the profession. He founded and served as executive director for the National Pharmaceutical Foundation for 17 years and was instrumental in the establishment of the Student National Pharmaceutical Association, which is dedicated to the pharmacy profession and serving the underserved. Editor’s Note: Dr. Robinson passed away on April 28, 2022, after a long illness. Our thoughts and prayers are with the Robinson family during this difficult time.

UF College of Pharmacy and APhA Offering Test and Treat Certificate Program

The University of Florida College of Pharmacy and the American Pharmacists Association, or APhA, announced a new partnership in April that will allow pharmacists to test patients for several non-emergency health issues.

The two organizations will leverage their expertise to offer one of the first national pharmacy-based test-and-treat certificate programs. APhA is the largest association of pharmacists in the United States, while the UF College of Pharmacy ranks among the nation’s top five pharmacy colleges according to U.S. News & World Report.

The training will expand a pharmacist’s ability to provide on-the-spot testing services at their local pharmacy. Pharmacists will be able to test and initiate therapy for influenza, strep throat, urinary tract infections and other minor, noncomplicated health conditions in accordance with their state practice. This expansion of pharmacy-led services will significantly improve a patient’s access to care.

Pharmacists seeking to enroll in the test-and-treat certificate training program will complete 20 hours of self-study and live training. The comprehensive curriculum was designed to meet the credentialing requirements in every state — allowing pharmacists from coast to coast an opportunity to earn the certificate.

To register for the program, visit pharmacy.ufl.edu/testand-treat.

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Gout & Economics- What's the Connection?

By William Garst

William Garst, Pharm.D. Consultant Pharmacist

Gout is an inflammatory condition caused by the deposit of uric acid crystals in the joints, and in 50% of the cases the joint of the big toe. This is caused when levels of uric acid in the blood become too high and the uric acid comes out of solution in the blood as crystals. The treatment of gout includes medications for an acute episode and long-term prevention. The medications used for acute episodes include non-steroid anti-inflammatory drugs such as ibuprofen, naproxen and steroid drugs (prednisone), but for centuries colchicine was used and still used today for acute attacks.

Colchicine is obtained from the plant Colchicum autumnale. The extract from this plant has been referenced for inflammatory conditions as far back as the Ebers Papyrus 1500 B.C. and additional references from the first century A.D. and 550 A.D. However, it was not until 1820 that French chemists P.S. Pelletier and J.B. Caventau isolated colchicine, and in 1833 it was purified and named colchicine by P.L. Geiger. It is interesting to note that Benjamin Franklin, who suffered from gout, brought the Colchicum autumnale plants back to America, having become acquainted with this remedy while Ambassador to France.

In 2006, the FDA started a program called the Unapproved Drug Initiative. The purpose of this program was to remove unapproved drugs from the market and obtain more rigorous testing for safety and effectiveness for drugs like colchicine and other “unapproved drugs” that have been used for a long time.

A small Philadelphia company, URL Pharma (eventually acquired by the Japanese drug maker Takeda) applied to the FDA to do the testing on colchicine and was granted rights for the drug. URL Pharma did 17 studies investing $100 million, of which $45 million went to the FDA for the application fee. This gave URL Pharma monopoly power over the drug and it sued to have other colchicine products removed from the market. Until then colchicine tablets were sold as a generic drug by many generic drug-makers for as little as $0.09 per tablet. URL Pharma quickly raised the price for their colchicine (naming the product Colcrys and selling it as capsules) to $4.85 per capsule, almost 54 times increase in price.

Currently, a colchicine product by another manufacturer is on the market but it still costs around $2.50 per tablet and Colcrys now sells for $4.15 per capsule. This price increase for colchicine has resulted in state Medicaid programs costs for the drug rising from $1 million to an estimated $50 million. Also, Medicare costs have been significantly impacted by this situation. It has been argued that the government and insurers could have done the testing themselves and saved a considerable amount of money.

The FDA program, Unapproved Drug Initiative, had the unintended consequences of making an old inexpensive generic drug into a branded product with market exclusivity. This same situation occurred in the case of other drugs such as thalidomide and pyrimethamine. Pyrimethamine is the famous drug that once the manufacturer had market exclusivity the price was raised from $13.50 to $750 per tablet.

Proving safety and effectiveness of a medicine by clinical trials is an expensive undertaking and important to public safety. The rewards of a successful marketing of a drug are great, however, it is the competition between manufacturers that controls prices for the public good in the end.

Stay informed and stay healthy.

GOUT IS AN INFLAMMATORY CONDITION CAUSED BY THE DEPOSIT OF URIC ACID CRYSTALS IN THE JOINTS, AND IN 50% OF THE CASES THE JOINT OF THE BIG TOE.

William Garst is a consultant pharmacist who resides in Alachua, Florida. He received his bachelor’s degree in pharmacy from Auburn University in 1975. He earned a master’s degree in pharmacy from the University of Florida in 2001. In 2007, he received his doctor of pharmacy from the University of Colorado. Dr. Garst is a member of many national professional associations as well as the local Alachua County Association of Pharmacists. He serves on the Alachua County Health Care Advisory Board. He works part-time at the UF Health Psychiatric Hospital and retired from the VA in 2016. Dr. Garst enjoys golf, reading (especially history) and family. He writes a blog called The Pharmacy Newsletter (https://thepharmacynewsletter. com).He can be contacted at communitypharmacynewsletter@gmail.com.

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