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Access Against the Odds: How Pharmacists Navigate Shortages and Unmet Need | Love Your Pharmacist Awards presented by Clinigen · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession.
• 0:10
  Speaker 2: Welcome to the Pharmacy Podcast Network.
• 0:23
  Speaker 1: Welcome to the Pharmacy Podcast Network. In partnership with Love
• 0:27
  Speaker 1: Your Pharmacist Awards by Clinigen, a global program celebrating hospital
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  Speaker 1: pharmacists whose dedication, innovation, and leadership are transforming patient care
• 0:36
  Speaker 1: around the world. In this episode, we're exploring a challenge
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  Speaker 1: that touches every healthcare system, ensuring patients receive the medicines
• 0:43
  Speaker 1: they need when the usual route isn't available. We'll discuss
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  Speaker 1: how pharmacists in the United States and Europe are navigating
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  Speaker 1: these challenges. What happens when a medicine isn't available through
• 0:53
  Speaker 1: conventional channels? and how healthcare systems are adapting to an
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  Speaker 1: increasingly complex supply landscape.
• 0:58
  Speaker 3: Podcast listeners, we are delighted to be joined by this
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  Speaker 3: year's Love Your Pharmacist Awards Lifetime Achievement Award winner, Alfred Latrelli,
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  Speaker 3: Chief Pharmacy Officer.
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  Speaker 4: Alfred, welcome to the show.
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  Speaker 2: Thanks, it's great to be here. My name's Alfred Latrelli.
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  Speaker 2: I'm a pharmacist currently at Memorial Medical Center in Las Cruces,
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  Speaker 2: New Mexico, where I serve as the Chief Pharmacy Officer
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  Speaker 2: for our health system.
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  Speaker 3: Also, you have a distinguished career spanning nearly three decades,
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  Speaker 3: and you have been groundbreaking initiatives that have improved access
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  Speaker 3: to care, enhanced medication safety, and expanded pharmacy services for
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  Speaker 3: those undeserved communities throughout the country. I also want to
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  Speaker 3: note that you are a podcaster. I know that you
• 1:45
  Speaker 3: don't necessarily host your own show, but you know how
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  Speaker 3: to podcast.
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  Speaker 4: You've been doing it for a while.
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  Speaker 2: I've done a few. Yeah.
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  Speaker 3: Also joining is Louise Moorshead, a pharmacist and portfolio director
• 1:58
  Speaker 3: from Clinogen.
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  Speaker 4: Louise, welcome.
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  Speaker 5: Hi, I'm Louise Moorshead.
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  Speaker 6: I'm a pharmacist by background and I'm portfolio director for
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  Speaker 6: Clinogen in the global access division.
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  Speaker 4: Very good.
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  Speaker 3: You know, I just returned from the National Association of
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  Speaker 3: Chain Pharmacists. drugstores, as well as the NASP and specialty pharmacy.
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  Speaker 3: And we have been talking about drug shortages and how
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  Speaker 3: access to medication can be a major issue in treatment.
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  Speaker 3: Today's episode is Access Against the Odds, How Pharmacists Navigate
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  Speaker 3: Shortages and Unmet Needs.
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  Speaker 4: Excited to have both of you here.
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  Speaker 3: The insights that you'll bring is going to be an
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  Speaker 3: impact to our listeners as we round out this three-part series.
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  Speaker 3: A thank you to Clinigen for your sponsorship of this.
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  Speaker 3: So Al, first of all, congratulations on receiving this year's
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  Speaker 3: Love Your Pharmacist Awards Lifetime Achievement Award. It was amazing
• 3:03
  Speaker 3: to hear this. We always want pharmacists to get recognition.
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  Speaker 3: In my opinion, you don't get enough recognition. So this
• 3:11
  Speaker 3: is why the Love Your Pharmacist Awards is is so
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  Speaker 3: special to us at the Pharmacy Podcast Network. Throughout your career,
• 3:18
  Speaker 3: you've been a pioneer in services that have improved access
• 3:22
  Speaker 3: to care and medication safety and patient outcomes. As you
• 3:26
  Speaker 3: reflect on that journey, what achievements best capture the impact
• 3:32
  Speaker 3: that you've hoped to make as a pharmacy leader?
• 3:35
  Speaker 2: Thank you. I'm definitely honored to receive this award.
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  Speaker 4: It's exciting.
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  Speaker 2: And like you said, a lot of times, uh, pharmacists
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  Speaker 2: don't get the recognition that I feel like they deserve either.
• 3:45
  Speaker 2: So I appreciate that these types of awards exist. And again,
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  Speaker 2: I'm honored to receive it. Then whenever you say nearly
• 3:51
  Speaker 2: three decades in pharmacy, I feel kind of old, and
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  Speaker 2: I can't believe that it's been three decades. But it has,
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  Speaker 2: maybe more like 27 years, give myself that extra 10%.
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  Speaker 2: But there really isn't one award or program or title
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  Speaker 2: or anything like that that stands out as an achievement.
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  Speaker 2: It's more about impact for me. I've always hoped to
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  Speaker 2: make a difference, like helping create pathways, create care where
• 4:14
  Speaker 2: none existed, or if there's some sort of a barrier
• 4:17
  Speaker 2: or delay, figuring out how to remove it. that's always
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  Speaker 2: been something that intrinsically motivated me. So, you know, throughout
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  Speaker 2: my career, I've really had the privilege of leading initiatives
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  Speaker 2: that brought different types of pharmacy services, special pharmacy services,
• 4:32
  Speaker 2: even to rural communities, expanding beyond the walls of the
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  Speaker 2: hospital and helping patients receive life-changing treatments that, you know,
• 4:40
  Speaker 2: weren't previously available in whatever, you know, region they were
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  Speaker 2: in before. So whether it's a transplant type of telepharmacy
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  Speaker 2: that I've done in the past, building different care models
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  Speaker 2: so that we're providing pharmacist care in the home, helping
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  Speaker 2: navigate those changes that we saw during the pandemic, whether
• 5:00
  Speaker 2: it's for vaccination, or the MABS or just general cardiac care,
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  Speaker 2: you know, those, those types of things, um, you know,
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  Speaker 2: all really are about making healthcare more accessible, more equitable,
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  Speaker 2: you know, more human. And of course, you know, leveraging
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  Speaker 2: the value of pharmacists because, uh, pharmacists can do a
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  Speaker 2: lot more than we've, uh, kind of done in, in
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  Speaker 2: recent history. So, um, yeah, I mean, I think it's
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  Speaker 2: just about more than the medications. It's about the possibility.
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  Speaker 2: It's about standing between the patient and whatever barrier it
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  Speaker 2: is and figuring out how to remove it. And those
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  Speaker 2: types of things are what, you know, I view as
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  Speaker 2: really achievements.
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  Speaker 3: Well, thank you so much for that. Just understanding the
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  Speaker 3: lives that are saved every day by pharmacists catching errors
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  Speaker 3: as a key person, the right wing to our physicians
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  Speaker 3: and and other healthcare providers.
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  Speaker 4: It's really amazing.
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  Speaker 3: And what really stands out is listening to you and
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  Speaker 3: that sheer scale of impact that pharmacists make, not only
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  Speaker 3: for our patients, but the entire healthcare system. Some pharmacists
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  Speaker 3: are dedicated to higher authorization or more of the financial
• 6:09
  Speaker 3: side and saving our healthcare systems thousands, billions of billions
• 6:14
  Speaker 3: of dollars a year. Louise, Clinigen's judging panel reviewed hundreds
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  Speaker 3: of nominations this year through the Love Your Pharmacist Awards.
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  Speaker 4: What themes stood out to you?
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  Speaker 6: Yeah, so without a doubt, it was the breadth of
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  Speaker 6: the contribution pharmacists are having across healthcare, and.
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  Speaker 5: They really were an inspiring read.
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  Speaker 6: When we reviewed the nominations, we weren't just reading stories
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  Speaker 6: about the medication and supply. It was stories about leadership, innovation,
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  Speaker 6: patient advocacy, and ultimately people finding the practical solutions to
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  Speaker 6: really complex challenges. The most common thread running through the
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  Speaker 6: nominations was that determination to improve patient access to the
• 7:02
  Speaker 6: care that they need and look at And that took
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  Speaker 6: a different form in each example. So for some, it
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  Speaker 6: meant helping patients access treatments when the first, second, conventional
• 7:17
  Speaker 6: options had all been exhausted. Then we had examples of
• 7:21
  Speaker 6: the pioneers creating new services aimed at safety, supporting clinical
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  Speaker 6: decision-making and finding ways to bring care closer to the
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  Speaker 6: patients and.
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  Speaker 5: The communities, which was fantastic. Yeah, very much showcased in
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  Speaker 5: what Al was saying.
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  Speaker 6: I was also struck about how collaborative modern pharmacy has
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  Speaker 6: become in the hospitals. And I've been at the clinical
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  Speaker 6: setting for some time now. So to see so many
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  Speaker 6: of the nominees were working across the multidisciplinary teams, influencing
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  Speaker 6: clinical pathways and supporting research programmes, and helping to introduce
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  Speaker 6: new technologies and creating the systems to benefit.
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  Speaker 5: Patients longer term.
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  Speaker 6: When some of the new shiny projects are complete, these
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  Speaker 6: are long-term changes that they're influencing. So if you look
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  Speaker 6: at the, this year's winners, you can see the themes
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  Speaker 6: very clearly, Al, your work has transformed pharmacy services and
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  Speaker 6: expanded access to care across so many settings.
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  Speaker 5: And as I've already said, it's really, truly inspiring.
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  Speaker 6: Um, Natalia de Amorizzo-Chichero, our Pharmacist of the Year winner,
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  Speaker 6: was recognized for helping patients access targeted treatments through expanded
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  Speaker 6: access programs.
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  Speaker 5: We call them managed access programs here at Clinogen, when
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  Speaker 5: all the other options were limited.
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  Speaker 6: Then we had an aseptic services team in Australia demonstrating
• 8:52
  Speaker 6: the impact that teamwork and service innovation can have. And
• 8:58
  Speaker 6: then for this year's new category, Pharmacy Technician of the Year.
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  Speaker 6: And I think you had some, Al, examples of you
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  Speaker 6: really utilising the strength of the technicians. So we really
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  Speaker 6: wanted to recognise that this year. So we had Gemma
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  Speaker 6: Cryer being recognised for helping vulnerable patients access medicines and
• 9:17
  Speaker 6: also mentoring the next generation of pharmacy professionals. So it's
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  Speaker 6: great to see and encouraging that the nominations showcase that
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  Speaker 6: hospital pharmacy profession continues to evolve well beyond its traditional boundaries.
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  Speaker 6: There's so many pharmacists and technicians that are shaping services.
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  Speaker 6: They're advancing patient safety, supporting research, developing future talent, and
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  Speaker 6: very much present in helping healthcare systems serve increasingly complex challenges.
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  Speaker 6: And that's what made judging so inspiring and honestly difficult
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  Speaker 6: and often felt.
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  Speaker 5: I wasn't worthy to be judging these nominees. So Well
• 9:58
  Speaker 5: done to everyone.
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  Speaker 3: Louise I feel the same way when I'm among pharmacists
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  Speaker 3: who are saving lives and I'm I'm a podcaster and
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  Speaker 3: I'm like come on there's just like I try to
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  Speaker 3: give as much exposure to these amazing people and their
• 10:15
  Speaker 3: voices every day It's my mission. And I keep hearing
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  Speaker 3: from both of you, I want to come back to
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  Speaker 3: that special word, access, and the challenges that take so
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  Speaker 3: many forms from workforce pressures and healthcare inequalities to the medications,
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  Speaker 3: the shortages and supply disruptions. And while those challenges are
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  Speaker 3: often experienced by pharmacists worldwide, the ways healthcare systems respond
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  Speaker 3: to can be very different from country to country and
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  Speaker 3: even in the United.
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  Speaker 4: States from state to state.
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  Speaker 3: So Louise, turning to you from a European perspective, how
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  Speaker 3: significant a challenge are medication shortages today? And has the
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  Speaker 3: situation changed since the disruption we saw during COVID-19?
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  Speaker 6: Yeah, so here in Europe, shortages are still very much
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  Speaker 6: a reality, but thankfully, not to the same extent that
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  Speaker 6: we saw in COVID-19 and the immediate aftermath. And that
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  Speaker 6: was compounded here, especially in the UK from the fallout
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  Speaker 6: from Brexit as well. So it was the perfect storm
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  Speaker 6: at that time. So disruptions were far more widespread and
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  Speaker 6: we were dealing with a much higher volume of shortages
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  Speaker 6: across the board. But I'd say now, more recently, there
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  Speaker 6: are signs that the supply chains have become more resilient.
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  Speaker 6: There's a huge amount of work across industry manufacturers regulators
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  Speaker 6: health care boards um to strengthen that continuity of supply
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  Speaker 6: and build some of that resilience back into the system
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  Speaker 6: but you know resilience as a word is something that
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  Speaker 6: kind of masks the grit and determination like we band
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  Speaker 6: it around such a lot but there's an awful lot
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  Speaker 6: of work goes into building that resilience it's yeah more
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  Speaker 6: than just a word but saying that we can't rest
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  Speaker 6: on our laurels uh the challenge certainly hasn't disappeared shortages
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  Speaker 6: do still occur regularly and pharmacists and their procurement teams
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  Speaker 6: are still required to invest significant time and effort into
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  Speaker 6: managing them and finding the alternative solution for the patient's treatment.
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  Speaker 6: So the thing is with shortages, they're difficult to solve
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  Speaker 6: as a wholesale concept because there isn't just a single
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  Speaker 6: root cause. So we're looking at manufacturing issues, quality concerns,
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  Speaker 6: shortages of API, when often many of these generics are
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  Speaker 6: manufactured from a single source API, forecasting challenges, we all
• 12:51
  Speaker 6: have those, and product technical transfers when products move between
• 12:56
  Speaker 6: ownership and things like that. There's a whole range of
• 12:59
  Speaker 6: supply chain disruptions that are contributing to the problem, but
• 13:05
  Speaker 6: they are a serious issue because of their impact on patients, ultimately,
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  Speaker 6: as well as the overstretched healthcare teams trying to solve
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  Speaker 6: them Every supply disruption has the potential to delay treatment
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  Speaker 6: and increase the administrative burden and create uncertainty for clinicians
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  Speaker 6: trying to deliver the best possible care in often difficult circumstances.
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  Speaker 6: But pharmacists, I feel, are so well equipped to use
• 13:32
  Speaker 6: the access mechanisms to navigate the challenges, minimise disruption where
• 13:37
  Speaker 6: possible and help ensure patients continue to receive.
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  Speaker 5: The medicines that they need.
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  Speaker 4: Alfred, what about the United States? What about the shortages
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  Speaker 4: that you're experiencing?
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  Speaker 2: Sure. In the United States, medication shortages still remain a
• 13:51
  Speaker 2: significant concern. They continue to affect hospitals, health systems, pharmacies,
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  Speaker 2: physician offices, everywhere. So it's not even just a pharmacist
• 14:02
  Speaker 2: problem or just a hospital or pharmacy related impact. Although,
• 14:08
  Speaker 2: you know, I think a lot of the acute supply
• 14:11
  Speaker 2: disruptions that we saw during that COVID error stabilized, there's
• 14:15
  Speaker 2: still shortages that occur regularly that kind of make it
• 14:18
  Speaker 2: the new norm of how we have to operate. And
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  Speaker 2: they impact everything anywhere from, you know, critical care medications,
• 14:24
  Speaker 2: injectable drugs, oncology medications, chronic disease management, So you know
• 14:30
  Speaker 2: what you're experiencing today, but you don't know what's necessarily
• 14:32
  Speaker 2: coming up tomorrow. We put a lot of time in
• 14:36
  Speaker 2: trying to kind of forecast that, stay ahead of back orders,
• 14:40
  Speaker 2: identify what the FDA and ASHP list as possible drug
• 14:46
  Speaker 2: supply shortages or any other kind of supply impact so
• 14:50
  Speaker 2: that we're planning ahead. And just like in Europe, the
• 14:54
  Speaker 2: causes are super complex, right? We've got the interruptions to manufacturing.
• 14:58
  Speaker 2: We've got shutdowns for quality-related issues, limited production capacity, supply
• 15:05
  Speaker 2: chain issues with weather, just the logistics of moving things around,
• 15:10
  Speaker 2: increased demand, all of these types of things. So a
• 15:14
  Speaker 2: single issue at one manufacturing point has all these downstream
• 15:19
  Speaker 2: effects whenever you have all of these problems. different pieces
• 15:23
  Speaker 2: of the supply chain impacted. I think that we're much
• 15:27
  Speaker 2: more resilient and collaborative, like Louise was saying, you know,
• 15:32
  Speaker 2: definitely with manufacturers, regulators, providers, distributors, you know, we're talking more,
• 15:37
  Speaker 2: we're figuring out things more, we're trying to be on
• 15:40
  Speaker 2: top of it, because we realize the impact it has
• 15:42
  Speaker 2: on on patients. You know, one area I think that
• 15:46
  Speaker 2: the pharmacist makes the most impact on is just being
• 15:51
  Speaker 2: close to the real-world impact of those shortages. We live it.
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  Speaker 2: We're frontline. We see the patient. We see the provider.
• 15:58
  Speaker 2: You know, we get that whole picture, you know, really firsthand.
• 16:03
  Speaker 2: And working with the clinicians to look at different therapeutic alternatives,
• 16:07
  Speaker 2: you know, talking through maybe like some new data, evidence-based practices.
• 16:11
  Speaker 2: All of those types of things are stuff that, you know,
• 16:14
  Speaker 2: we're the experts of medications. You know, we're happy to
• 16:16
  Speaker 2: have those conversations and work through, you know, what we
• 16:20
  Speaker 2: need to so we can make sure that the patient
• 16:22
  Speaker 2: receives the treatment that they need when they need it,
• 16:24
  Speaker 2: despite any of the challenges that are occurring in the
• 16:26
  Speaker 2: supply chain.
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  Speaker 3: Louise, I think of compounding, specialty, rare disease, long-term care, seniors, geez,
• 16:35
  Speaker 3: mental health. There's so much that pharmacists have to be
• 16:38
  Speaker 3: concerned with. which medications cause the greatest concern when shortages occur?
• 16:43
  Speaker 6: Yeah, I mean, any medicine shortage has the potential to
• 16:48
  Speaker 6: create a challenge and anxiety.
• 16:52
  Speaker 5: With the patients that are taking the medicine.
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  Speaker 6: But I think the ones that tend to cause the
• 16:56
  Speaker 6: greatest concern, I think Al's already mentioned, but where there's
• 17:00
  Speaker 6: limited flexibility for the clinicians and the patients, these are
• 17:05
  Speaker 6: medicines that sit usually in established treatment pathways where changing
• 17:10
  Speaker 6: therapy isn't straightforward and delays can have significant.
• 17:14
  Speaker 5: You know, life or death consequences.
• 17:17
  Speaker 6: Um, but in particular shortages affecting oncology, hematology, um, are
• 17:23
  Speaker 6: especially challenging in many cases, the established treatment is following
• 17:28
  Speaker 6: carefully designed treatment protocols that have been built around specific medicines,
• 17:33
  Speaker 6: how they work together and, um, to specific schedules. So
• 17:38
  Speaker 6: if one component of that protocol become becomes unavailable, um,
• 17:43
  Speaker 6: it's not a simply a case of swapping out and
• 17:45
  Speaker 6: substituting for another medicine, you know, clinical teams, um, need
• 17:50
  Speaker 6: to review the treatment plans, consider alternative approaches and assess.
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  Speaker 5: The impact on patient care.
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  Speaker 6: I mean, if you're facing, you know, life dependent treatment
• 18:00
  Speaker 6: and you find your first line treatments not.
• 18:03
  Speaker 5: Available, it's, it's, It's a serious issue.
• 18:07
  Speaker 6: And likewise, we have shortages in emergency medicines, which is
• 18:12
  Speaker 6: another area of concern because, you know, by definition, there
• 18:15
  Speaker 6: isn't often very much time available to identify the alternatives.
• 18:22
  Speaker 6: And again, clinical teams working to establish routine for the
• 18:28
  Speaker 6: emergencies to minimize risk.
• 18:30
  Speaker 5: So they want the regular medicine to avoid risk. errors,
• 18:35
  Speaker 5: all of that. So there's, yeah, so.
• 18:38
  Speaker 6: Oncology, emergency meds, and then antimicrobials also present significant challenges.
• 18:44
  Speaker 6: These medicines play an important role in treating serious life-threatening infections.
• 18:50
  Speaker 6: So particularly vulnerable patient populations. So, you know, continuity of
• 18:56
  Speaker 6: supplies is extremely important.
• 18:59
  Speaker 5: So it's hard to narrow it down to one specific because, yeah,
• 19:02
  Speaker 5: there's so many.
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  Speaker 3: I can imagine the stress that puts on the pharmacist,
• 19:10
  Speaker 3: the system, and of course our patients, and even the
• 19:13
  Speaker 3: physician that's worried when their patient's going to stay on
• 19:17
  Speaker 3: a medication, stay on a medication. Alfred, when a critical
• 19:22
  Speaker 3: medicine becomes unavailable, how do you navigate the system?
• 19:26
  Speaker 2: Yeah, I mean, so I would definitely say that's not
• 19:29
  Speaker 2: one of the most fun things that we do as pharmacists,
• 19:32
  Speaker 2: but at times we do have... things that kind of
• 19:36
  Speaker 2: we can rely on to help us through the process.
• 19:38
  Speaker 2: The first thing to navigate is really understanding the scope
• 19:42
  Speaker 2: of the shortage. Sometimes it's a temporary thing. Sometimes it's
• 19:45
  Speaker 2: much broader. Sometimes it's slow moving. Sometimes it's like an immediate,
• 19:49
  Speaker 2: you know, you're out. So working closely with the manufacturers,
• 19:53
  Speaker 2: working closely with the wholesalers, and then of course, all
• 19:56
  Speaker 2: of the clinical teams and all of the provider teams,
• 19:59
  Speaker 2: you know, to understand and scope it early is key.
• 20:05
  Speaker 2: You know, from there, it's, you know, weighing clinical and
• 20:08
  Speaker 2: operational considerations because we want to see what other options exist.
• 20:13
  Speaker 2: Are those going to become shortages or secondary shortages because
• 20:17
  Speaker 2: of this primary one that we're experiencing? How can we
• 20:21
  Speaker 2: conserve some of the medications for the patients that would
• 20:24
  Speaker 2: benefit from them the most? Is there any evidence that
• 20:27
  Speaker 2: even says that patients could benefit from another medication that
• 20:30
  Speaker 2: we might want to bring on that would be even
• 20:33
  Speaker 2: better for them? So it's a great time to look
• 20:36
  Speaker 2: at all of that clinical All of the clinical activities
• 20:40
  Speaker 2: that are going on and making sure that they align
• 20:42
  Speaker 2: so that the medication is going to who needs it
• 20:45
  Speaker 2: and benefits from it the most. And then we're considering
• 20:48
  Speaker 2: all of the alternatives and what impact there might be
• 20:50
  Speaker 2: to the alternatives. On the automation side, you know, it's definitely,
• 20:56
  Speaker 2: you know, coordination across, you know, different logistics with the manufacturer,
• 20:59
  Speaker 2: so on and so forth. And for that, you know,
• 21:02
  Speaker 2: or actually for both of those, communication is super important.
• 21:06
  Speaker 2: We need timely, accurate information because we want to make
• 21:10
  Speaker 2: informed treatment decisions. We want to have transparency and reassurance
• 21:15
  Speaker 2: into the information that we're getting so that if we're
• 21:19
  Speaker 2: making changes in therapies, changes to our formularies, changing the
• 21:24
  Speaker 2: approach to how we treat patients, We're not starting that
• 21:26
  Speaker 2: one approach and then immediately changing it a couple days later.
• 21:30
  Speaker 2: We want to make sure that we're doing what's best
• 21:32
  Speaker 2: for patients, and that really requires that extra transparency and
• 21:36
  Speaker 2: really collaboration. And Louise has been pointing that out. No
• 21:41
  Speaker 2: one can solve this on their own. It requires a
• 21:44
  Speaker 2: lot of interaction. It requires a lot of work with others,
• 21:48
  Speaker 2: trust in others. and having those types of partnerships. Because
• 21:52
  Speaker 2: our goal in the pharmacy, as we provide the medications,
• 21:56
  Speaker 2: is to make the shortage invisible to the patients and
• 21:59
  Speaker 2: as invisible as possible to the nurses and the physicians
• 22:03
  Speaker 2: so that it's a seamless, okay, we're using drug A today,
• 22:06
  Speaker 2: drug B is equivalent, we're using that for this period
• 22:08
  Speaker 2: of time, and then we kind of move back and
• 22:11
  Speaker 2: the patient never knows and their care is never compromised
• 22:14
  Speaker 2: and in some cases it's enhanced. So using a shortage
• 22:17
  Speaker 2: to enhance care is the ultimate goal, not always achievable,
• 22:22
  Speaker 2: but why not take that opportunity?
• 22:24
  Speaker 3: Then listening to you both speak on this issue, and
• 22:30
  Speaker 3: it just brings a lot of other conversations back to
• 22:36
  Speaker 3: memory in the specialty space and in community and in
• 22:42
  Speaker 3: hospital systems. And whether it's a shortage or an urgent
• 22:45
  Speaker 3: patient need for a treatment that's not readily available, pharmacists
• 22:50
  Speaker 3: are finding themselves spending a significant amount of time trying
• 22:54
  Speaker 3: to identify and secure the right medications for their patient,
• 22:58
  Speaker 3: get it to their patient as soon as possible. Louise,
• 23:01
  Speaker 3: you've mentioned previously the administrative burdens this can create for
• 23:07
  Speaker 3: hospital system pharmacists. How much time can be spent sourcing
• 23:11
  Speaker 3: rare or difficult-to-source medications, and what are some of the
• 23:15
  Speaker 3: ways technology is helping to simplify that process?
• 23:19
  Speaker 5: Yeah, so one of.
• 23:20
  Speaker 6: The things we hear consistently from hospital pharmacists is, We've
• 23:26
  Speaker 6: got Al here to describe how it's not one of
• 23:28
  Speaker 6: the things he likes to do, but it's incredibly time consuming.
• 23:32
  Speaker 6: In Europe, it can take pharmacy teams up to five
• 23:35
  Speaker 6: hours to chase down single prescriptions, depending on the complexity
• 23:39
  Speaker 6: of the request. It can involve contacting multiple suppliers, checking availability,
• 23:44
  Speaker 6: reviewing documentation, and then coordinating that delivery. So all alongside
• 23:50
  Speaker 6: their clinical responsibilities. And that's really the challenge. Pharmacists are
• 23:55
  Speaker 6: highly trained clinical professionals, yet a significant amount of their
• 23:59
  Speaker 6: time can be spent navigating a fragmented sourcing pathway rather
• 24:03
  Speaker 6: than supporting patients in the healthcare teams. We've seen growing
• 24:09
  Speaker 6: interest in digital tools that improve the visibility and simplify
• 24:13
  Speaker 6: the process. The goal isn't to replace the pharmacist's expertise,
• 24:17
  Speaker 6: but it's there to make it easier to identify those
• 24:21
  Speaker 6: available access options and make informed decisions more quickly.
• 24:25
  Speaker 5: So one example, shameless plug.
• 24:28
  Speaker 6: But Clinigine Direct that we use here in Europe, we
• 24:32
  Speaker 6: developed it to help pharmacists identify medicines availability and access
• 24:38
  Speaker 6: routes through a single trusted platform. So reducing some of
• 24:42
  Speaker 6: that administrative burden involved in sourcing hard to find medicines.
• 24:47
  Speaker 6: We have it in the United States as well. The
• 24:50
  Speaker 6: use case is slightly different, but Clinogen Direct is focused
• 24:53
  Speaker 6: on supporting managed access programs or early access programs, as
• 24:57
  Speaker 6: they're also known, helping healthcare professionals and manufacturers navigate those
• 25:03
  Speaker 6: access pathways for investigational and pre-approval therapies where appropriate. So
• 25:10
  Speaker 6: although the routes are different, the objective is the same.
• 25:13
  Speaker 6: It's helping patients gain access to the treatments and reducing
• 25:17
  Speaker 6: the complexity for the healthcare team.
• 25:19
  Speaker 3: This discussion is bringing to light just how complex medicines
• 25:25
  Speaker 3: and the access to those medications can be. Louise, most
• 25:30
  Speaker 3: people only see the medicine once it arrives at the hospital.
• 25:34
  Speaker 3: They don't see everything that has happened beforehand. Can you
• 25:37
  Speaker 3: give us a sense of what sits behind a complex
• 25:40
  Speaker 3: sourcing request?
• 25:42
  Speaker 5: Yeah, so this is.
• 25:43
  Speaker 6: The invisibility that Al's mentioning. So yeah, behind every sourcing
• 25:48
  Speaker 6: request for a hard-to-find medicine, you know, it involves those
• 25:51
  Speaker 6: multiple teams working together behind the scenes. So it often
• 25:55
  Speaker 6: starts with understanding exactly what's needed. So we have anything
• 25:59
  Speaker 6: from one pack to thousands of packs. So understanding the
• 26:02
  Speaker 6: quantities and the urgency behind the request is From there,
• 26:07
  Speaker 6: it may involve searching a global network of assured supplies
• 26:12
  Speaker 6: to identify potential source, verifying the intended supply chain, and
• 26:17
  Speaker 6: then reviewing documentation and navigating those regulatory requirements and coordinating
• 26:22
  Speaker 6: the logistics. So every request is different, and some medicines
• 26:28
  Speaker 6: might already have a fairly established supply route, while others
• 26:33
  Speaker 6: require a much more bespoke approach. So in some cases,
• 26:36
  Speaker 6: you're effectively building.
• 26:37
  Speaker 5: That pathway from scratch. You know, with the.
• 26:42
  Speaker 6: Advancement of cell and gene therapy or ATMPs, identifying where
• 26:49
  Speaker 6: supply exists, then ensuring that it meets the necessary quality standards,
• 26:54
  Speaker 6: confirming that it can actually be moved legally and safely,
• 26:57
  Speaker 6: and then coordinating delivery within required timeframes because that's There's
• 27:03
  Speaker 6: all sorts of scheduling that's happening in the hospital to
• 27:05
  Speaker 6: get the treatment to the patient. So a lot of
• 27:08
  Speaker 6: collaboration and communication. So it goes without saying a huge
• 27:13
  Speaker 6: amount of work also goes into that quality and compliance aspect.
• 27:16
  Speaker 6: We're not simply flying in. suppliers who have stock available
• 27:21
  Speaker 6: there has to be confidence in the supply chain and
• 27:23
  Speaker 6: confidence in the documentation and confidence that everything has been
• 27:27
  Speaker 6: handled appropriately before ever reaches a healthcare professional and ultimately
• 27:31
  Speaker 6: the patient um there are plenty of practical considerations so
• 27:36
  Speaker 6: depending on the product um you'd be managing temperature controlled
• 27:41
  Speaker 6: transportation import requirements customs um the documentation backing all that
• 27:48
  Speaker 6: up and then coordination of the multiple stakeholders across different
• 27:52
  Speaker 6: countries and time zones um so it's certainly not a
• 27:56
  Speaker 6: one-woman job and there's a whole team behind it um
• 28:01
  Speaker 6: so yeah it is fascinating that every pack has has
• 28:05
  Speaker 6: its own story um so behind what might appear to
• 28:07
  Speaker 6: be a simple delivery there can be days of problem
• 28:10
  Speaker 6: solving collaboration for and specialist expertise focused on a single objective,
• 28:16
  Speaker 6: so making sure the patient receives the medicine they need
• 28:20
  Speaker 6: when they need it.
• 28:21
  Speaker 3: Alfred, Louise has described the work happening on the supply side.
• 28:27
  Speaker 3: From the hospital perspective, what matters most when your team
• 28:31
  Speaker 3: is trying to secure a difficult-to-source medicine for a patient?
• 28:36
  Speaker 2: So I already discussed about the visibility, the partnership, the communication,
• 28:41
  Speaker 2: and the clinical support aspects. You know, a lot of
• 28:45
  Speaker 2: different things that need to come together need some sort
• 28:48
  Speaker 2: of a source to do that. And here, you know,
• 28:52
  Speaker 2: we've relied on different technology to help free us up.
• 28:56
  Speaker 2: The amount of time that it takes to do all
• 28:58
  Speaker 2: of these things, you know, is a drain on limited resources. So,
• 29:03
  Speaker 2: you know, what we're trying to achieve is a more
• 29:05
  Speaker 2: resilient and transparent supply chain. If we can have technology
• 29:09
  Speaker 2: and we use different types, that can help us ensure
• 29:13
  Speaker 2: that we have the information that we need. We can
• 29:16
  Speaker 2: make informed decisions. We can get the right medication to
• 29:19
  Speaker 2: the right patient at the right time because our success
• 29:22
  Speaker 2: is ultimately measured in did they receive the therapy that
• 29:25
  Speaker 2: they need without unnecessary delay. And that takes some of
• 29:30
  Speaker 2: the burden off of us and some of the time
• 29:31
  Speaker 2: investment that we put into doing those things manually. I
• 29:36
  Speaker 2: would say at the end of the day, technology really
• 29:39
  Speaker 2: isn't the goal itself. It is a big enabler that
• 29:42
  Speaker 2: helps us as healthcare professionals maintain access to care and
• 29:46
  Speaker 2: keep the focus on the patient. That's where we want
• 29:49
  Speaker 2: to be. That's what we want to be doing. So
• 29:52
  Speaker 2: if we're participating in those conversations, if any of that
• 29:55
  Speaker 2: background work or there's assistance that can be provided, That's
• 29:59
  Speaker 2: very helpful to us. You know, we want to rely
• 30:01
  Speaker 2: on technology. We don't want technology to replace us. But
• 30:04
  Speaker 2: we know that there's certain things that, you know, bring
• 30:07
  Speaker 2: extra value from having the pharmacist involved with. And that's
• 30:10
  Speaker 2: the direct conversations with the providers and the conversations with
• 30:12
  Speaker 2: the patients when they're needed. So the other stuff where
• 30:15
  Speaker 2: technology can help us. We're happy to have it.
• 30:18
  Speaker 3: This has been a great conversation. So appreciative of you, Louise,
• 30:23
  Speaker 3: and your insights, Alfred. We've heard today that pharmacists are
• 30:26
  Speaker 3: increasingly acting not only as medication experts, but as problem solvers.
• 30:32
  Speaker 3: You're the advocate for the patient in so many different ways.
• 30:36
  Speaker 3: You're the navigators of increasingly complex healthcare systems today. And
• 30:41
  Speaker 3: to close, what is one change each of you would
• 30:45
  Speaker 3: most like to see that would make it easier for
• 30:48
  Speaker 3: pharmacists to protect continuity of care?
• 30:51
  Speaker 4: Louise?
• 30:54
  Speaker 6: For me, it's all about giving pharmacists time to be pharmacists.
• 30:59
  Speaker 5: We've talked a lot about shortages.
• 31:02
  Speaker 6: Access challenges and the complexity of sourcing medicines. But pharmacy's
• 31:08
  Speaker 6: expertise is most valuable when it's focused on patients, the
• 31:12
  Speaker 6: clinical decision-making and improving care from a very human aspect.
• 31:19
  Speaker 5: If we can make those access pathways more transparent and
• 31:23
  Speaker 5: reduce some of the administered burden, we can help pharmacists
• 31:26
  Speaker 5: spend less time navigating systems and more time doing what
• 31:31
  Speaker 5: they do best, you know, supporting patients and the healthcare teams?
• 31:35
  Speaker 2: I mean, I would say, you know, ultimately the continuity
• 31:38
  Speaker 2: of care depends on continuity of information. There's a lot
• 31:42
  Speaker 2: of different sources out there. There's the, you know, medical record, There's,
• 31:46
  Speaker 2: you know, the pharmacy system. There's, you know, what's happening
• 31:49
  Speaker 2: in the retail space. And you could go on and
• 31:51
  Speaker 2: on and on. We're trying to pull all of that
• 31:53
  Speaker 2: information together from all of these disparate systems, from all
• 31:57
  Speaker 2: of these different sources. If we could improve the way
• 32:00
  Speaker 2: the healthcare system interacts with all of these different data sets,
• 32:04
  Speaker 2: all of these sources of information and pulls the pharmacists,
• 32:07
  Speaker 2: you know, providers, manufacturers, everybody together in a way that
• 32:12
  Speaker 2: can coordinate it more effectively, that would really free up
• 32:16
  Speaker 2: our time as pharmacists to do the things that we
• 32:19
  Speaker 2: became pharmacists to do. And that is to focus on
• 32:23
  Speaker 2: what the patient needs, to have the person-on-person interactions that
• 32:28
  Speaker 2: technology can't do. The opportunity is really to get people
• 32:36
  Speaker 2: The opportunity is really to coordinate care more effectively and
• 32:39
  Speaker 2: ensure patients receive what they need without the delays using
• 32:43
  Speaker 2: technology so that pharmacists can practice at the highest level
• 32:46
  Speaker 2: of their scope.
• 32:47
  Speaker 4: Thank you.
• 32:47
  Speaker 3: Thank you so much, Louise and Alfred, for your insights today.
• 32:51
  Speaker 3: A shout out to the Clinigen team for supporting our pharmacists,
• 32:57
  Speaker 3: my favorite providers, and the Love Your Pharmacist Awards program.
• 33:01
  Speaker 4: This has been exceptional work.
• 33:03
  Speaker 3: The Pharmacy Podcast Network is proud to support this initiative
• 33:07
  Speaker 3: to bring more attention and more recognition of the work
• 33:13
  Speaker 3: that our pharmacists are doing on a global scale. Thank you, listeners,
• 33:17
  Speaker 3: for listening to this three-part series sponsored by Clinogen.