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LTC Rx at Home: Logistics & Advocacy | TWIRx · 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.
0:38
Speaker 1: Welcome to t works. It's good to good to feel
0:43
Speaker 1: you out there the vibes, put the vibes out put
0:47
Speaker 1: the old twarks vibes out there. How was your week?
0:53
Speaker 1: I hope it was well. I hope you're doing things
0:55
Speaker 1: that give you passion. I hope you're working some where,
1:00
Speaker 1: doing something that brings you happiness and being part of
1:07
Speaker 1: something bigger than yourself and helping others. Our world, our
1:14
Speaker 1: country seems to be really an emotional hurt right now.
1:20
Speaker 1: And it's my fault. It's my fault for not being understanding.
1:26
Speaker 1: It's not my fault for not listening. It's my fault
1:28
Speaker 1: for not making someone feel cared about and valued. And
1:37
Speaker 1: isn't that the basis of what healthcare is. It's making
1:43
Speaker 1: people helping people, not making people, helping people to make
1:48
Speaker 1: decisions along with you as someone that can guide them
1:53
Speaker 1: in this case in our medication worlds, and making sure
1:58
Speaker 1: that they're cared for, making sure that they're hurt. And
2:01
Speaker 1: that starts with that relationship between physician, patient and pharmacist
2:08
Speaker 1: patient and for them to understand where the strengths are
2:12
Speaker 1: of their physician, where are the strengths of their pharmacists.
2:17
Speaker 1: You know what we have to do. We've got to
2:20
Speaker 1: get the message out there more about what pharmacists are doing.
2:23
Speaker 1: You know, when you look at the Pharmacy fifty Awards list,
2:27
Speaker 1: there are more than six I think I've counted them.
2:32
Speaker 1: Are all social media influencers, A huge into TikTok, huge
2:37
Speaker 1: on Instagram, big on YouTube. This is important and this
2:43
Speaker 1: is what the Pharmacy Podcast Network is all about. For
2:46
Speaker 1: seventeen years, We've been delivering the latest news and what's
2:51
Speaker 1: happening in technology, what's happening at cardinal health, what's happening
2:55
Speaker 1: in maternal health with doctor Daniel Plumber. We had a
2:59
Speaker 1: really special Valentine's Day special with Mark Garafully and Gretchen
3:04
Speaker 1: Gara fully both farm edees. Yeah, if you haven't listened
3:08
Speaker 1: to that, listened to that. And then herbal support for
3:12
Speaker 1: chronic lime disease. This was really super duper interesting. I
3:16
Speaker 1: did not know and just learning more about the dangers
3:20
Speaker 1: of lime disease. We have a lot to talk about
3:25
Speaker 1: today and I'm going to be in Harrisburg today, so
3:32
Speaker 1: be on the lookout for Pharmacy Podcast Network. We're going
3:36
Speaker 1: to be at the Pennsylvania Pharmacists Association meeting the PPA
3:44
Speaker 1: twenty six it's the Super Bowl of Pennsylvania Pharmacy. We're
3:49
Speaker 1: going to be there with a special tribute in coverage
3:56
Speaker 1: of the Pennsylvania Pharmacists Care Network, the Consultant Network. That's
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Speaker 1: a PULL, which is the chapter of the CSPN National
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Speaker 1: Network to do more treatment driving and clinical care and
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Speaker 1: clinical follow up and really making pharmacists plugged deeper into
4:18
Speaker 1: a patient's life. And I'm going to be proud to
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Speaker 1: be there, proud to talk with him, proud to be
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Speaker 1: a Pennsylvanian, and going to the super Bowl. The Super
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Speaker 1: Bowl of Pennsylvania Pharmacy is now happening twenty twenty six,
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Speaker 1: February twenty twenty second in Harrisburg. It's going to be
4:48
Speaker 1: a fun time. Shout out to John James, he's my
4:53
Speaker 1: good friend from Value Drug and their support of twerques
4:59
Speaker 1: as well as their support of the Pharmacy fifty Awards.
5:03
Speaker 1: It's nice to have the support from organizations like that
5:06
Speaker 1: so that we can get more messaging out. And if
5:08
Speaker 1: you're listening and you want to work with us. I
5:10
Speaker 1: tell you what it's fun being the number one podcast
5:13
Speaker 1: and the entire pharmacy profession from a world perspective. How
5:18
Speaker 1: many people just reached out to us. We have several
5:20
Speaker 1: features coming out of London. We have a collaboration coming
5:26
Speaker 1: back out of New Zealand, Australia, Ireland. So we're growing,
5:33
Speaker 1: it's expanding and there are the voices of pharmacists on
5:36
Speaker 1: a global scale. We need to support each other more,
5:40
Speaker 1: talk with each other more and more important, learn more importantly,
5:45
Speaker 1: learn from each other. Today's Twerks February twentieth, twenty twenty
5:51
Speaker 1: sixth is brought to you by and sponsored by our
5:55
Speaker 1: ex four Route. If you've never heard of this platform,
5:58
Speaker 1: you're going to hear from us. We're going to be
6:00
Speaker 1: talking about it a lot, and we're going to be talking.
6:06
Speaker 1: The more important aspect of talking about ARS for Route
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Speaker 1: isn't them necessarily, but more importantly, it is all about
6:15
Speaker 1: the long term care pharmacy services at home that's expanding.
6:21
Speaker 1: In a big part of long term care pharmacy at
6:24
Speaker 1: home and the expansion of independent community pharmacy, the world
6:28
Speaker 1: of the outpatient pharmacy that is involved with our hospital
6:31
Speaker 1: systems and even grocery store chains. You have to get
6:36
Speaker 1: into the delivery and doing it yourself is a lot
6:41
Speaker 1: more expensive than outsourcing it to an organization that's going
6:46
Speaker 1: to be plugging into drivers all across the country. Check
6:50
Speaker 1: out arcs for route and be on the lookout. We're
6:53
Speaker 1: going to be interviewing the ce SO, the Chief sales Officer,
7:00
Speaker 1: my friend Donnie of That interview is coming up. But
7:05
Speaker 1: I do want to do Twerks News. It's probably my
7:08
Speaker 1: favorite part of Twerks and I once again, I'd like
7:11
Speaker 1: to start off start off just saying congratulations to the
7:17
Speaker 1: Pennsylvania Pharmacist Care Network. They're celebrating ten years of being
7:23
Speaker 1: the Pennsylvania Pharmacist Care Network. They couldn't have made it
7:26
Speaker 1: there without the contributions of numerous indispensable partners. But are
7:31
Speaker 1: grateful to our ten over ten partners that have elevated
7:36
Speaker 1: the PPCN to the network it is today. Wow. Once again,
7:42
Speaker 1: this is why I'm so excited about this coming weekend
7:44
Speaker 1: and being out at the Pennsylvania Pharmacist Association Annual event.
7:51
Speaker 1: Like I said, if you're going, let's hang out, let's
7:56
Speaker 1: get together. I'm not sure if you're going to be there,
7:58
Speaker 1: but we'd love to see you to carennect with you.
8:01
Speaker 1: Hey up on towrque's news. You gotta you gotta read this.
8:06
Speaker 1: This is fun. University of Kansas School of Pharmacy has
8:11
Speaker 1: covered this and they have alumni and they've supported the
8:16
Speaker 1: the the advancement of oral testosterone replacement therapy and what
8:22
Speaker 1: this means for patients and what this means for options
8:27
Speaker 1: and being able to cover what they're saying a clinical
8:32
Speaker 1: problem hidden in plain sight, and how testosterone is widely
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Speaker 1: prescribed and and then what issues is is is that
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Speaker 1: only one percent is actually making it to the bloodstream
8:46
Speaker 1: through the oral dosage and how when you when you
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Speaker 1: take oral versus it absorbing into your skin even sedentif
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Speaker 1: getting in your system through now the new strips they're
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Speaker 1: coming out that you put underneath your tongue, and it
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Speaker 1: just gets into your system differently and also gets into
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Speaker 1: your system faster, and then a much larger percentage of
9:13
Speaker 1: the substance is also reaching the bloodstream. Read up on that.
9:17
Speaker 1: This is news from KU dot edu. That's news dot
9:22
Speaker 1: KU for the University of Kansas and it's their School
9:28
Speaker 1: of pharmacy. But check that out. They should be so
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Speaker 1: very proud. All right, we have news coming out of
9:36
Speaker 1: Pharmacy Practice News. I love this organization. I love the paper.
9:41
Speaker 1: We hope to see them at this sembia covering specialty pharmacy.
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Speaker 1: But today's article is how to handle live therapeutics despite
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Speaker 1: lack of guiding document how to handle the bio therapeutics
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Speaker 1: and the biosimilars. And they're saying when there's despite the
10:02
Speaker 1: lack of guiding documentation, we do have an interview coming
10:07
Speaker 1: up with a medical writer. I don't want you to
10:11
Speaker 1: miss that. A Kursten is going to be on and
10:15
Speaker 1: I want you to read this. Go to Pharmacy Practice
10:17
Speaker 1: News dot com and read through the issues that they're
10:21
Speaker 1: talking about. Thirty eight percent of those are in vivo
10:26
Speaker 1: mechanisms and about fifty eight of them are in late
10:30
Speaker 1: stage research. And that's the amount of information. That's the
10:36
Speaker 1: amount of research that's going into new therapies, being being
10:43
Speaker 1: researched and being gone through clinical trials and getting them
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Speaker 1: out there. The American Society of Gene and Cell Therapy
10:51
Speaker 1: third quarter of twenty twenty five, more than three thy
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Speaker 1: two hundred gene cell in RNA therapy. Clinical trials are
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Speaker 1: underway worldwide, reflecting the sustained growth across viral sectors of
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Speaker 1: cell based platforms and novel delivery mechanisms. Do you know
11:12
Speaker 1: with the advent of the new world of pharmacy where
11:15
Speaker 1: pharmacists are going to be doing a lot more than
11:19
Speaker 1: dispensing medications and really dialing in, anyone listening is fascinated
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Speaker 1: by biosimilars, reach out to me. I have some connections
11:28
Speaker 1: for you to get you to the people who are
11:30
Speaker 1: helping to actually build that entire sector of pharmacy. But
11:34
Speaker 1: if you're interested in biosimilar so if you're interested in
11:38
Speaker 1: talking about it and what the future is for this
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Speaker 1: and how pharmacists play in as in my opinion, you
11:44
Speaker 1: obviously you should be the experts. Let's talk more about that. Last,
11:52
Speaker 1: but certainly not least, one of my favorite magazines is
11:58
Speaker 1: here and they're talking about pharmacists help importance of Food
12:02
Speaker 1: is Medicine for American Heart Month. I love this story
12:08
Speaker 1: just came out today. Food as medicine differs from general
12:11
Speaker 1: wellness and embedding therapeutic nutrition into clinical pathways via medical
12:17
Speaker 1: tailored meals, medically tailored groceries, and produce prescriptions for conditions
12:23
Speaker 1: like high pretension and diabetes. You know who talked about
12:27
Speaker 1: connecting nutrition with a grocery store tracking system. You know
12:32
Speaker 1: your advantage cards, Like you're in the Pittsburgh area, we
12:35
Speaker 1: have Giant Eagle, they have the Giant Egal advantage card.
12:39
Speaker 1: Can you imagine I've said this at least ten times
12:44
Speaker 1: on the Pharmacy podcast Network, but can you imagine you
12:48
Speaker 1: know exactly what your patients aka consumer is buying because
12:56
Speaker 1: if they use their advantage card, you have all that data.
12:59
Speaker 1: We pull some of that data when applicable, so when
13:03
Speaker 1: the patient now gets on some kind of medication within
13:07
Speaker 1: the pharmacy sign off on all the legal documentation letting
13:11
Speaker 1: you know that you're going to be exchanging data between departments.
13:14
Speaker 1: And now you send the data from all of the
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Speaker 1: produce that they have bought, any of the recommended herbs
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Speaker 1: and spices and substances that has been recommended by nutritionist
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Speaker 1: driven pharmacists, and now you're assuring based on what they're
13:31
Speaker 1: buying that most likely they're also consuming it. You have
13:35
Speaker 1: to assume, and with that you could help to control
13:40
Speaker 1: and supplement medications that the patient's on. I'm not talking
13:44
Speaker 1: about anything that isn't in motion already. I'm sure that
13:47
Speaker 1: these people are thinking that this. But this article really
13:51
Speaker 1: drills down into what is the opportunities for pharmacists. We
13:54
Speaker 1: just got talked or just got done talking about biosimilars.
13:58
Speaker 1: We know there's senior care, pediatric now know nutrition changing
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Speaker 1: people's lives metabolically, physiologically, and pharmacologically to assure that they're
14:10
Speaker 1: in the best shape that they can be and based
14:14
Speaker 1: on decisions once again that they make and then you know,
14:17
Speaker 1: helping them to track that. But this is a really
14:20
Speaker 1: interesting article out of Drug Topics and shout out to
14:27
Speaker 1: the team over Drug Topics once again, it's pharmacist help.
14:31
Speaker 1: Importance of food is medicine for American Heart Month. Good move,
14:37
Speaker 1: good move, I love it. All right. So I'm going
14:44
Speaker 1: to see you in Harrisburg. If you're going to the
14:47
Speaker 1: PPA twenty twenty six. If not, I think we will
14:51
Speaker 1: see you. I don't know what is next for us.
14:53
Speaker 1: I'm boggling my mind, but we know we're going to
14:56
Speaker 1: the Pharmacy Profits Summit. That's all about building profitability and
15:00
Speaker 1: sustainability and thrive ability for independent community pharmacies profits. Some
15:05
Speaker 1: at Live Google that Profit sum at Live twenty twenty
15:09
Speaker 1: six Profits Summit Live. It's going to be in Dallas.
15:13
Speaker 1: Take a look at that. Understand it is a change
15:17
Speaker 1: maker in the business of independent pharmacy because all of
15:22
Speaker 1: these independent community pharmacists show up and everybody throws into
15:27
Speaker 1: the pots when they're networking. What are you doing to
15:30
Speaker 1: make money? What are you doing to make money? How
15:32
Speaker 1: are you doing it to make money? How are you
15:35
Speaker 1: providing value to the community while making money? You have
15:38
Speaker 1: to make money, and this place is absolutely what it
15:41
Speaker 1: says it is. It drills down into the profits of pharmacy.
15:46
Speaker 1: So hope to see you there. We are excited about today.
15:51
Speaker 1: Like I said, I want you to take this. Take
15:54
Speaker 1: a listen to my friend Donnie with our for route,
16:02
Speaker 1: we will be right back.
16:07
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16:53
Speaker 1: Hey, welcome to this weekend Pharmacy. Todd Uri here. I
16:57
Speaker 1: hope you've had a good week. It's been a fast
17:00
Speaker 1: week for us. We are headed to the Pennsylvania Pharmacists
17:04
Speaker 1: Association today and we'll be there tonight to celebrate the
17:09
Speaker 1: ten year anniversary of the PPCN. So what is the PPCEND, Todd,
17:14
Speaker 1: I'm glad you asked the PPCN. It's the Pennsylvania Pharmacist
17:19
Speaker 1: Care Network and they are basically taking what CPESN are
17:25
Speaker 1: National Enhanced Services Pharmacy Network is doing. CPESN look at
17:32
Speaker 1: all this alphabet soup, and they are working in teaching
17:38
Speaker 1: and coaching and supporting each of the states. And some
17:42
Speaker 1: states do a better job based on their aggressiveness for
17:47
Speaker 1: the program through the Pharmacy State Associations, and then there's
17:52
Speaker 1: other ones that are maybe wrapped up in something else
17:55
Speaker 1: that they just don't have time to push it to
17:57
Speaker 1: the state. Pennsylvania very proud to say this as I
18:02
Speaker 1: am from the great state, the Commonwealth of Pennsylvania, but
18:09
Speaker 1: our state is one of the best at leveraging the
18:12
Speaker 1: CPESN strategies, care plans, saving money to the plans, building
18:19
Speaker 1: partnerships with the healthcare plans. That's exciting. So we're going
18:23
Speaker 1: to be talking a lot about that at the event.
18:26
Speaker 1: So even if you're not from Pennsylvania, even if you're
18:29
Speaker 1: not going to that national event, I'm giving a shout
18:31
Speaker 1: out to the PPCN. It's their tenth anniversary since building
18:36
Speaker 1: this network of pharmacists digging into clinical, digging into treatment
18:41
Speaker 1: in the state of Pennsylvania. Bravo to you. But we
18:45
Speaker 1: will have a multi part series talking with some of
18:49
Speaker 1: the experts in Pennsylvania. So you're not going to want
18:51
Speaker 1: to miss this series coming out. But today on twerks,
18:55
Speaker 1: we're going to be talking about one of my most
18:58
Speaker 1: favorite subjects because I want to see more of this
19:01
Speaker 1: taking place. And what is that, Well, that's long term
19:04
Speaker 1: care pharmacy services at home. Long term care pharmacy at home,
19:09
Speaker 1: I guess they're calling it. Used to be called combo shop,
19:12
Speaker 1: but now we're really becoming much more grandular about getting
19:16
Speaker 1: paid for the services that you provide as a community pharmacy,
19:19
Speaker 1: as an independent community pharmacy, as a health system outpatient
19:23
Speaker 1: pharmacy that they're getting into this taking the patient from
19:26
Speaker 1: the emergency room to the ward of recovery in the hospital,
19:32
Speaker 1: making up the medication list, transferring that medication list out
19:36
Speaker 1: to an independent pharmacy, a consultant pharmacy, a long term
19:40
Speaker 1: care pharmacy, who knows it might even be specialty depending
19:44
Speaker 1: on the patient. But part of that ecosystem. The focus
19:48
Speaker 1: of today's twerks is inviting back an expert and a
19:52
Speaker 1: friend of mine who I'm excited to bring back, Donnie
19:56
Speaker 1: Sator SOTV. What's the last name, Donnie Sota is Sutur.
20:01
Speaker 1: So I have to have a little accent in the right,
20:07
Speaker 1: the Russian accent exactly. So welcome back to the show.
20:11
Speaker 1: It's good to.
20:11
Speaker 4: See you, Thank you, thank you.
20:14
Speaker 1: All Right, So I know you guys, you guys aren't
20:17
Speaker 1: able to make the Pennsylvania one, right, You're not coming
20:19
Speaker 1: this weekend.
20:20
Speaker 4: Unfortunately, we are busy with the NCPA conference.
20:24
Speaker 1: Yeah location a multi site. Yeah. Shout out to everybody
20:28
Speaker 1: going to the NCPA multi site. What a special event
20:32
Speaker 1: where they're really focusing on strategies for these organizations that
20:36
Speaker 1: have five, ten, twenty becoming like these small regional chains
20:40
Speaker 1: and empowering them. I love that conference. That conference for me,
20:44
Speaker 1: The reason why we don't concentrate on going is I
20:47
Speaker 1: don't get enough exhibit time to network and to be
20:50
Speaker 1: able to really build content because their exhibit space there
20:54
Speaker 1: seems to be such a shorter span of time than
20:57
Speaker 1: other places. But then I think they do networking at
21:01
Speaker 1: different I don't know. I don't even I haven't been
21:04
Speaker 1: there since twenty eighteen, So you tell me.
21:06
Speaker 4: I know, I know. This one is more about quality
21:09
Speaker 4: than quantity. You do have a couple I'd say it's
21:15
Speaker 4: a couple hours at most to exhibit per day, that's
21:18
Speaker 4: if you're lucky. But the quality of the pharmacies, the
21:23
Speaker 4: people in there, it's not mixed with the crowd, it's
21:25
Speaker 4: not mixed with the students. It's just exactly what we
21:28
Speaker 4: need for us.
21:29
Speaker 1: That's funny because it's kind of it is like the
21:31
Speaker 1: cream of the business crop. These people don't have any
21:35
Speaker 1: time to mess around, so they're sing for solutions and
21:38
Speaker 1: they're ready to make deals, and so I see what
21:41
Speaker 1: you mean. Hey, today we are talking about long term
21:45
Speaker 1: care pharmacy at home, and there are different components of that.
21:50
Speaker 1: And you know this, Donny, because you're soaking in it.
21:52
Speaker 1: But we have regulatory compliance, we have workflow changes, formulaary
21:59
Speaker 1: put changes, medication regimen controls, and different things that have
22:05
Speaker 1: to happen. An emergency tackle box. You have to have
22:07
Speaker 1: a tackle box of emergency meds, the ability to get
22:11
Speaker 1: twenty four hour emergency assistants. And then the key today
22:16
Speaker 1: of what we're really dialing into is how important delivery
22:21
Speaker 1: is to this ecosystem of what is long term care
22:24
Speaker 1: pharmacy at home. And here's the deal. And I don't
22:27
Speaker 1: know if the listeners you might not realize this, but
22:30
Speaker 1: seniors are lacking transportation and they're often facing really significant
22:36
Speaker 1: boundaries accessing medications. Lots of pharmacies, Donnie, have been closed.
22:42
Speaker 1: Over eight thousand pharmacies are not here that we're here
22:45
Speaker 1: two and three years ago. Transportation issues are causing thirty
22:49
Speaker 1: percent increase in medication non adherents, and that's infecting three
22:55
Speaker 1: point six million Americans. The three point six million Americans
23:00
Speaker 1: are missing out on doses of medication that they need,
23:04
Speaker 1: which is tied back to Ding Ding ding Ding Ding Transportation.
23:10
Speaker 1: So talk to us about how your organization is coming
23:15
Speaker 1: at this from a very strategic perspective where you're not
23:18
Speaker 1: just trying to sell a delivery service. You are trying
23:21
Speaker 1: to integrate this system into workflow, into pharmacy systems, into
23:26
Speaker 1: the whole business model so that you can help those
23:29
Speaker 1: pharmacies be more profitable. So talk to us about this absolutely.
23:33
Speaker 4: So we are setting off.
23:35
Speaker 1: We worked.
23:36
Speaker 4: We started as a just a software company for managing
23:41
Speaker 4: your deliveries, right, we worked very closely with multiple pharmacies.
23:46
Speaker 4: Specifically once the long term care at home became so popular,
23:51
Speaker 4: we optimized our system into making sure it helps you
23:55
Speaker 4: to finish the chain at the end, right, making sure
24:00
Speaker 4: that all the refills, all the thirty day, all the
24:05
Speaker 4: cycles are on there within those patients in the RX
24:09
Speaker 4: route livery system. So not only it helps your drivers
24:13
Speaker 4: to make to stay compliant, to deliver everything on time,
24:17
Speaker 4: to reduce the errors, but as weall, as it helps
24:20
Speaker 4: your pharmacy to stay and be more profitable, stay on
24:23
Speaker 4: top of every medication use in.
24:24
Speaker 1: That you know, I used to wrap business development sell
24:33
Speaker 1: pharmacy management software framework HEALTC really and yeah, that's how
24:38
Speaker 1: I started in the pharmacy industry. This is back and
24:40
Speaker 1: this is going to you might not have been born.
24:43
Speaker 1: I'm scared because you're so young. Two thousand and four
24:46
Speaker 1: is when I entered pharmacy, and I was brought in
24:53
Speaker 1: because I had a workflow background. I set up well,
24:58
Speaker 1: I set up frame relay network in the telecom space,
25:01
Speaker 1: and I would sell frame relay and manage networks. And
25:05
Speaker 1: that type of concept back in two thousand and four
25:08
Speaker 1: was so novel. Nobody was talking about workflow. So when
25:12
Speaker 1: Framework came out with their pharmacy management system, it was
25:15
Speaker 1: based on SQL. It allowed for the integration and pulling
25:20
Speaker 1: and pushing of data in and out of the system.
25:22
Speaker 1: It wasn't necessarily the primary software because back in that day, Donnie,
25:27
Speaker 1: every one of the freaking softwares back then were closed.
25:30
Speaker 1: They were like you could put in information just in
25:33
Speaker 1: the system. You could get a label out. That was it.
25:36
Speaker 1: You couldn't attract, you couldn't put in. So what I
25:40
Speaker 1: think is interesting is now we're at the age where
25:43
Speaker 1: it's the community pharmacy and independent pharmacy and local chain
25:48
Speaker 1: pharmacies like even grocery store that when they start dialing
25:52
Speaker 1: into long term care pharmacy at home. It opens up
25:56
Speaker 1: a whole new profit center and revenue opportunity for them.
26:00
Speaker 1: But they have to talk about it. They have to
26:02
Speaker 1: let the community know what they're offering. They have to
26:07
Speaker 1: advertise that they have a current courier service, delivery service,
26:11
Speaker 1: logistics service, timing application, handheld app like engaging the public
26:18
Speaker 1: like it's not just about the tech, and it's not
26:20
Speaker 1: about you know, putting it in place. It's really about
26:24
Speaker 1: making it part of your whole business. Every day you're
26:27
Speaker 1: talking about No, absolutely, do you have stories about the integrations.
26:37
Speaker 1: This is so important for listeners. They're like, Hey, yeah,
26:39
Speaker 1: I want to move forward with long term care pharmacy
26:41
Speaker 1: at home. I've brought up my policy and procedures, I
26:45
Speaker 1: got my pharmacy software ready at the workflow. Talk to
26:48
Speaker 1: me about working with other pharmacy software systems.
26:52
Speaker 4: Sure so, rx rout integrates with all major pharmacy management systems,
26:57
Speaker 4: and it's a two way integration that we have. Not
27:00
Speaker 4: only nowadays we can retrieve the data from a pharmacy
27:03
Speaker 4: management system, we can also send it back with the
27:07
Speaker 4: information that we collect. Especially for the past couple of years,
27:11
Speaker 4: we've made some edits and works that is now fully
27:14
Speaker 4: optimized or specifically for long term care at home pharmacies,
27:18
Speaker 4: combo shops quote unquote, where not only the patient's information
27:23
Speaker 4: is retrieved, but as well as the next filling date,
27:26
Speaker 4: next cycle dates, and within our system. The reason why
27:31
Speaker 4: it's so differentiates between us and any other delivery system
27:35
Speaker 4: that you might have come across is that we're so
27:38
Speaker 4: optimized within the cycles where our system tells you what
27:44
Speaker 4: is the best profitable, efficient way to schedule your deliveries
27:48
Speaker 4: knowing all the information regarding the cycles.
27:53
Speaker 1: That's so cool. Yeah, because as a long term care pharmacy,
27:57
Speaker 1: there are these I don't think they do seven day anymore,
28:00
Speaker 1: but like fourteen day, twenty eight day, thirty day maintenance meds.
28:05
Speaker 1: Like there's all these things that are in place for
28:09
Speaker 1: our long term care facilities, our assisted living centers, even
28:13
Speaker 1: some just simple care. But now when we're starting to
28:16
Speaker 1: bring this to the home, that's a lot of complexity,
28:21
Speaker 1: you know, from a delivery perspective. So knowing that you
28:24
Speaker 1: have thirty homes, that might be a low number, but
28:29
Speaker 1: let's say you have like thirty forty homes in a
28:32
Speaker 1: five mile radius, each of them need their updates on
28:37
Speaker 1: their basic DME supplies, durable medical equipment supplies, but then
28:43
Speaker 1: their medications go out just slightly differently in a schedule.
28:46
Speaker 1: So what you're telling me is you're you're really dialing
28:49
Speaker 1: into that in coming up with the most efficient way
28:52
Speaker 1: of getting those deliveries done.
28:54
Speaker 4: Absolutely, and it's a good thing you mentioned Dourbal medical
28:58
Speaker 4: equipment supplies as well.
29:00
Speaker 1: Is that.
29:02
Speaker 4: Now we integrate with almost all DME management systems.
29:09
Speaker 1: What about there's been I remember back in the day
29:13
Speaker 1: when I remember the expansion of people getting services at home.
29:18
Speaker 1: A matter of fact, my grandfather was in a surgical
29:21
Speaker 1: bed or one of those real hospital professional beds for
29:25
Speaker 1: a while in his home with the oxygen and everything
29:29
Speaker 1: that was necessary. So what level of delivery of services
29:34
Speaker 1: can can you do? Like, for example, obviously medications DMY equipment,
29:40
Speaker 1: obviously you can do that. Is it like, do you
29:43
Speaker 1: have to have a special license for oxygen for example?
29:48
Speaker 4: For oxygen? I don't think so, but I know with
29:51
Speaker 4: some of the needles and some of the control substances,
29:55
Speaker 4: that's where you have to really be careful. I do
29:58
Speaker 4: know that right. No, now we're in process of getting
30:02
Speaker 4: the nuclear license, so that's going to be a big
30:07
Speaker 4: one for us. I think that's going to open a
30:08
Speaker 4: lot of doors, and I think that's where the money
30:12
Speaker 4: is as well.
30:14
Speaker 1: All Right, now that you've been in this a while,
30:17
Speaker 1: you and your team have several advantages. One of those
30:21
Speaker 1: advantages is the fact that your team understands pharmacy internal operations.
30:27
Speaker 1: Because you have another sister organization that helps to offload
30:34
Speaker 1: tedious tasks in data entry and some of the things
30:37
Speaker 1: you guys are doing. That's a huge education to the organization.
30:41
Speaker 1: Talk to me about what you've seen from a perspective
30:46
Speaker 1: of revenue, of talking with pharmacy owners who are implementing
30:51
Speaker 1: this and how it's making an impact.
30:53
Speaker 5: On their business.
30:54
Speaker 4: Absolutely, I've come across a lots of pharmacy that switched
31:01
Speaker 4: to RX or route from majority of different different pharmacy
31:07
Speaker 4: management for a majority of different delivery systems, and the
31:11
Speaker 4: feedback that I've been getting from them is that the
31:14
Speaker 4: software RX fraud is literally pays for itself. I've seen
31:19
Speaker 4: pharmacies reduce the amount of in house employees because everything
31:23
Speaker 4: is so automated. And the way you could put it
31:27
Speaker 4: and think is us calculating something manually, Let's say, it's
31:31
Speaker 4: just the numbers, right, you have fourteen day cycles, twenty
31:33
Speaker 4: day cycles, twenty day cycles. Doing everything manually, what's finding
31:37
Speaker 4: what's sufficient compared to doing everything to a calculator, to
31:41
Speaker 4: the computer where everything is just calculated for you. It's
31:44
Speaker 4: it's unmatchable. I've had some feedback from one of the
31:48
Speaker 4: pharmacies actually that if, for instance, there if for instance,
31:55
Speaker 4: their pharmacy management system decides to switch to a different
32:00
Speaker 4: every system, that they will rather switch a pharmacy management
32:03
Speaker 4: system than spit than than switch their delivery.
32:06
Speaker 1: System, which is our x RA rout.
32:07
Speaker 4: I think that's one of the best feedbacks I've I've
32:09
Speaker 4: received so far.
32:11
Speaker 1: That's awesome. That Andre. If you're if you're watching us
32:15
Speaker 1: on YouTube, watching us streaming live on LinkedIn, you'll see
32:19
Speaker 1: kind of like this graphic. It shows kind of how
32:23
Speaker 1: things are working to bring this to two operations to workflow.
32:30
Speaker 1: Talk to me about the delivery of the medication. You
32:33
Speaker 1: have some kind of app, you know, app that you're
32:38
Speaker 1: using to get the patient to either sign off on something,
32:41
Speaker 1: but talk to us about that a little bit.
32:43
Speaker 4: Absolutely all drivers will have an access of the mobile
32:46
Speaker 4: app that is available on the app store. Google Play Market.
32:50
Speaker 4: You have to downloaded from any of the third party
32:52
Speaker 4: shady websites or anything like that. Everything is official, very
32:55
Speaker 4: fighted by Google Apple. That app is fully hip a
32:59
Speaker 4: compliant and it's fully sucked to certified. With this app,
33:03
Speaker 4: the drivers are able to collect the signatures, look at
33:07
Speaker 4: all the delivery information, take pictures of the delivery, mark
33:11
Speaker 4: deliveries us completed, complete it to the nurse with any
33:14
Speaker 4: special instructions, nurse names anything you would want to see
33:18
Speaker 4: in there, and everything is the real time. That's another
33:21
Speaker 4: best thing regarding our ex FO route. You don't have
33:23
Speaker 4: to wait for anything to be uploaded. You don't have
33:25
Speaker 4: to come back to the pharmacy to upload the signatures
33:28
Speaker 4: or anything in that way. And even if there's no
33:30
Speaker 4: connection our system, our mobile app will still work. Once
33:34
Speaker 4: it's connected to any network, the signatures and the pictures
33:37
Speaker 4: of the delivery along with the data stamp will automatically
33:39
Speaker 4: go back to your pharmacy management systems. It's not two
33:43
Speaker 4: thousand and four anymore. Most of the pharmacy's management are open,
33:46
Speaker 4: so we are able to receive and extract any data alongside.
33:53
Speaker 6: All.
33:53
Speaker 1: Right, so let's talk about temperature. We hear horror stories
33:59
Speaker 1: about mail order pharmacy dropping a ninety day supply or
34:04
Speaker 1: whatever into the mailbox and then it just cooks, cooks
34:08
Speaker 1: the medication and no one really it's just it's a
34:11
Speaker 1: commodity environment. I hate it. I think that they should
34:15
Speaker 1: do away with the majority of our mail order pharmacies
34:22
Speaker 1: and move more to the independence or actually I used
34:26
Speaker 1: a term probably ten years ago called mail service pharmacies,
34:30
Speaker 1: and I think that independence could become mal service pharmacies,
34:35
Speaker 1: where it's concentrating more on the holisticness of the patient
34:39
Speaker 1: in engaging them in mail. But I think moving them
34:45
Speaker 1: to an RX for route relationship is going to be
34:48
Speaker 1: better for the profitability of the individual account because of
34:53
Speaker 1: vitamin therapies, because of suggested therapies, for other things that
34:58
Speaker 1: you could deliver. So talk to us up temperature, talk
35:01
Speaker 1: to us about like getting the patient to know that
35:04
Speaker 1: their medication is delivered and is there.
35:08
Speaker 4: Absolutely so for any of the for any of the medical,
35:14
Speaker 4: for any of the medical, for any of the refrigerated items. Uh.
35:18
Speaker 4: There is a special procedure that comes alongside within the app,
35:22
Speaker 4: and how it works is we get that information directly
35:25
Speaker 4: from the pharmacy management system. You don't have to imput
35:27
Speaker 4: anything manually. So as long as your pharmacy management system
35:31
Speaker 4: knows this is a medication that needs to be kept
35:34
Speaker 4: in the refrigerator, we get that information and we pass
35:37
Speaker 4: it along to your drivers right and during the transportation
35:41
Speaker 4: until that package is delivered, the driver will have to
35:44
Speaker 4: take a picture of this medication being located on the coolbox,
35:49
Speaker 4: alongside with the picture of the thermometer and same thing
35:52
Speaker 4: at the time of the delivery as well, making sure
35:54
Speaker 4: that he proves to you that the patient that throughout
35:58
Speaker 4: the whole time the medication was and fridge. Here's the
36:01
Speaker 4: pictures for every two hours with the correct with the
36:03
Speaker 4: correct time stamps, as well as on the delivery, this
36:06
Speaker 4: was a temperature. This is how it looks like with
36:09
Speaker 4: the patient's picture on the background. Everything is nice and
36:12
Speaker 4: neat as it should be. I like it.
36:16
Speaker 1: I like it. I like the assurance. I think it's
36:18
Speaker 1: a marketing opportunity. I think make sure pharmacy look ten
36:21
Speaker 1: times more professional when it's like using this the same format,
36:26
Speaker 1: the technology of the app, people get used to using it,
36:29
Speaker 1: and then the communication back to the patient through texting,
36:32
Speaker 1: through pictures, through you know, whatever else is tied into it.
36:37
Speaker 1: But this is exciting. So multi site level, multi site
36:42
Speaker 1: conference and CPA that's going to be in Naples, so
36:46
Speaker 1: you have to drive. How far away is that? It's
36:48
Speaker 1: only like a tests.
36:49
Speaker 4: Right, that's four, that's three and a half four. But
36:52
Speaker 4: the rights should be nice.
36:55
Speaker 1: I mean, get out of here with with your Florida
36:58
Speaker 1: weather and it's money and it's cold and I don't
37:03
Speaker 1: like it. And from you guys went from where to wear,
37:06
Speaker 1: New Jersey to Florida.
37:08
Speaker 4: From New Jersey to Florida.
37:09
Speaker 1: Yes, that's part's a big stretch. Are you guys in now?
37:12
Speaker 4: We're in Fort Lyldale now and that's nice. I'm sure
37:17
Speaker 4: you could see the weather. It's sunny outside almost every day.
37:20
Speaker 1: Hey listen, if you are a pharmacy owner in the
37:24
Speaker 1: tri state from from Florida, it might be a quad state,
37:28
Speaker 1: actually might be four states that attach it. Make a
37:31
Speaker 1: trip down to their offices, make a time to spend
37:34
Speaker 1: some time with him, ask lots of questions. It kind
37:37
Speaker 1: of could develop kind of a work lab for you
37:39
Speaker 1: for a day down there to really go through the system.
37:41
Speaker 1: How it's going to impact your pharmacy. Do some demos
37:44
Speaker 1: do some some rollout of the marketing of the system,
37:47
Speaker 1: because if you market this the right way, it's going
37:49
Speaker 1: to make your pharmacy look like a freaking champion and
37:53
Speaker 1: really take advantage of our technology and engagement. But I think, Donnie,
37:58
Speaker 1: this is more about the relationship between the pharmacy and
38:01
Speaker 1: the patient at home, making them feel like, listen, you're
38:04
Speaker 1: not able to get out. We got your back, we
38:07
Speaker 1: got your emergency services, we got your vitamins, we got
38:11
Speaker 1: other things that are coming from our stores. I think
38:13
Speaker 1: it's a big opportunity. No, absolutely, all right, Well, we
38:19
Speaker 1: are excited to see you at upcoming conferences and spending
38:23
Speaker 1: some time with you and your your team. Love going
38:26
Speaker 1: to dinners with you. You guys are are wild. I love it.
38:29
Speaker 1: Love hanging out with of course you are upcoming conference.
38:34
Speaker 4: Yep, work hard, party hard.
38:36
Speaker 1: That's right. I like that motto. Hey, we'll be right
38:38
Speaker 1: back with more torques.
38:48
Speaker 7: This episode is sponsored by Independent Pharmacy Cooperative, widely known
38:52
Speaker 7: as IPC. Established in nineteen eighty three, IPC is the
38:56
Speaker 7: nation's largest group purchasing organization owned by Independent farm with
39:00
Speaker 7: a mission of maximizing the success of community pharmacists. IPC
39:04
Speaker 7: works to provide members with access to effective programs and
39:08
Speaker 7: services designed to enhance profitability for independent pharmacy. Read more
39:12
Speaker 7: about our mission by checking out our website at ipcrx
39:16
Speaker 7: dot com. That's ipcrx dot com.
39:32
Speaker 1: Hey, welcome back to twerks. We're here on Friday.
39:36
Speaker 5: It's so good to be Frida.
39:38
Speaker 1: It's good to be Friday. I actually am working over
39:41
Speaker 1: the weekend, Kristen. I don't know if you're having any
39:45
Speaker 1: big plans this weekend or not, but I'm working.
39:49
Speaker 8: Yes, I don't have to do any yet. We'll see
39:51
Speaker 8: what the weather brings.
39:54
Speaker 1: So I'm going to be going to the Pennsylvania Pharmacists
39:57
Speaker 1: Association Annual Conference and it starts today later tonight, and
40:01
Speaker 1: then we'll go through Saturday and it'll just be the
40:05
Speaker 1: gathering of I call it the super Bowl of Pennsylvania Pharmacy,
40:08
Speaker 1: and it'll be a good time to I like the
40:12
Speaker 1: smaller conferences sometimes than the gargantuan ones because sometimes it's
40:16
Speaker 1: better communication.
40:19
Speaker 8: I agree.
40:20
Speaker 5: Yeah, So.
40:22
Speaker 1: You are the guests today on twit's excited to have you.
40:25
Speaker 1: Christin Hutchison tell our listeners out of the gate, like,
40:29
Speaker 1: what do you do?
40:31
Speaker 5: How are you tying?
40:31
Speaker 1: Back to patient advocacy and policy and clinical research and
40:36
Speaker 1: just give us a little of your back ground.
40:39
Speaker 8: Yeah, well great, Well it's nice to be on the podcast. Yeah.
40:44
Speaker 6: My name is Kristin Hudgson. I live over in Minneapolis.
40:47
Speaker 6: I recently completed a master's in health policy and law,
40:51
Speaker 6: and I come from a background of medical writing and research.
40:55
Speaker 6: I've done a lot of my own consulting work in
40:59
Speaker 6: clinic medicine, especially on the side of systematic literature reviews
41:05
Speaker 6: in looking at patient outcomes based on different devices and
41:08
Speaker 6: pharma agents. And I also have a background on patient
41:11
Speaker 6: advocacy side, working in a lot of different chronic illness
41:16
Speaker 6: spaces and organizations, doing federal lobbying and some state lobbying
41:21
Speaker 6: as well.
41:22
Speaker 1: Yeah, the changes that are happening right now in PPM
41:28
Speaker 1: reform is accelerated. We were talking about it. We launched
41:33
Speaker 1: the PBM Reform podcast in twenty nineteen, and it was
41:36
Speaker 1: slow go like it was, I mean staging and trying
41:40
Speaker 1: to get something done in staging and more staging and
41:43
Speaker 1: more meetings, and it was just like there's lots of
41:46
Speaker 1: people pharmacy owners and people like Pharmacies United for Truth
41:51
Speaker 1: and Transparency and all these organizations were like, we were
41:54
Speaker 1: really getting exhausted. And now over the last eighteen months,
42:00
Speaker 1: things have really accelerated, and people like State Representative Auchincloss,
42:06
Speaker 1: who bring so much attention to he's very good at
42:12
Speaker 1: articulating in a way that a twelfth grade high school
42:16
Speaker 1: graduate would be able to understand and being able to
42:21
Speaker 1: break it into pieces, because that was some of the
42:25
Speaker 1: tricks of the Big three PBMs is let's keep changing
42:30
Speaker 1: rebate and formula a role and let's change this in
42:33
Speaker 1: this and it was so confusing. Now we're starting to
42:36
Speaker 1: break it into categories and it's starting to.
42:38
Speaker 5: Become much more.
42:41
Speaker 1: Attackable. That's not even a word, but being able to
42:44
Speaker 1: attack the issue. And you and I kind of before
42:48
Speaker 1: we started talking, was like, okay, so what's next. And
42:52
Speaker 1: the big, the big next thing that's going to be
42:55
Speaker 1: happening we'd like your insights on is the bipartisan breakup
42:58
Speaker 1: of Big Medicine, the Big Big Medicine Act. It targets
43:03
Speaker 1: vertical integration and healthcare. And you know, Doug Hoyt, the
43:08
Speaker 1: c the CEO of the National Community of Pharmacists Association,
43:12
Speaker 1: he testified and he's like to have a physician working
43:17
Speaker 1: for a health system that overrides what the physician has
43:23
Speaker 1: prescribed just because they're making more money on it is ludicrous.
43:30
Speaker 1: Insurance companies should not be making decisions for our our
43:36
Speaker 1: livelihood and our health. I want I want my physician
43:39
Speaker 1: and I want my pharmacists talking to each other and
43:42
Speaker 1: whatever they decide, that's what I want to go with,
43:45
Speaker 1: and and that's who I want to trust, not not
43:47
Speaker 1: pencil pushers.
43:49
Speaker 8: HM. Right. And I think a big part that.
43:53
Speaker 6: We don't talk about too much is that when patients
43:56
Speaker 6: go into the pharmacy counter, they will get, you know,
43:59
Speaker 6: the price to on their medication, and they think, oh,
44:01
Speaker 6: this is the pharmacist's fault, when in reality, as you're saying,
44:04
Speaker 6: there's a lot happening behind the scenes that is taking
44:09
Speaker 6: down the autonomy of pharmacists and physicians, money, and healthcare
44:13
Speaker 6: providers in general. And so we're kind of trying to
44:16
Speaker 6: look higher up on the ladder on like where are
44:19
Speaker 6: these prices coming from? And it's really not the provider's fault.
44:22
Speaker 6: So I think that's important.
44:26
Speaker 1: It is it's to know we have technicians who get
44:31
Speaker 1: screamed at, we have pharmacists who get screamed at and
44:35
Speaker 1: people shouldn't be acting that way anyhow, regardless of what's
44:38
Speaker 1: going on. But the patient is under the impression this
44:42
Speaker 1: is this individual with that computer system and they're just
44:46
Speaker 1: trying to gouge me or make more money or my
44:48
Speaker 1: copay change.
44:50
Speaker 5: The consumer has zero idea.
44:54
Speaker 1: Talking about PBM or form in twenty nineteen, I would
44:58
Speaker 1: admit it took me probably three years to really understand
45:04
Speaker 1: the parts of the engine that was a PBM. And
45:08
Speaker 1: then by the time I learned it, new elements came
45:12
Speaker 1: out of how they were keeping more of the rebate
45:15
Speaker 1: or negotiating with pharma or going to the TPA to
45:20
Speaker 1: kind of negotiate it at different levels. And then they
45:24
Speaker 1: gave specialty pharmacy a bad rap because now politicians who
45:29
Speaker 1: don't understand that there truly is a difference between a
45:33
Speaker 1: specialty medication therapy regimen, not necessarily the actual medication right,
45:40
Speaker 1: not the necessarily the science. But if you're on a
45:43
Speaker 1: certain medication and you have to be checked on day ten,
45:48
Speaker 1: day twenty, you know what's happening at you at day
45:51
Speaker 1: thirty five. I mean, there are therapies that it's physician
45:56
Speaker 1: and pharmacists that are like, listen, this is such a
45:58
Speaker 1: delicate situation that this person's in with cancer or some
46:02
Speaker 1: kind of tiation from one drug to the next drug. Like,
46:05
Speaker 1: specialty is real, it's a real part of And everybody's like, oh,
46:09
Speaker 1: let's throw that into the bucket of that's just a
46:12
Speaker 1: PBM tactic.
46:13
Speaker 5: Well guess what.
46:13
Speaker 1: PBMs did use specialty pharmacy as a way of gutting
46:17
Speaker 1: the system of more revenue. And you know, shame on
46:20
Speaker 1: them for messing up a whole sector, given a whole
46:25
Speaker 1: sector of pharmacy a bad rap.
46:28
Speaker 6: Right, Yeah, I think I could share a more patient
46:31
Speaker 6: story on that, on specialty pharmacy. So yeah, I personally
46:35
Speaker 6: have all sort of Yes, so I have all sort
46:38
Speaker 6: of clitis. I've had it since two thousand and nine,
46:41
Speaker 6: I would say now it is the hardest I've ever
46:45
Speaker 6: worked to stay on a medication that will keep me
46:47
Speaker 6: in remission. So I speak about this with a lot
46:50
Speaker 6: of different patient advocates. We if you're on you know,
46:53
Speaker 6: one of these higher retail price drugs to Lara Humera,
46:57
Speaker 6: you know one of these kind of blockbusters essentially for
46:59
Speaker 6: the PM they're they're kind of throwing you off and
47:03
Speaker 6: making you try a biosimilar, which has a lot of
47:07
Speaker 6: ramifications for patients who you know, have a condition that
47:11
Speaker 6: will flare if you switch medication and doesn't work as well,
47:14
Speaker 6: there are a lot of potential side effects things like this,
47:18
Speaker 6: and so for patients to speak with specialty pharmacists in
47:22
Speaker 6: these appeal processes, I think that's what's something that's important
47:27
Speaker 6: to put a spotlight on, because these pharmacists are essentially
47:30
Speaker 6: writing prior authorizations, they're writing the appeal letters, the work,
47:35
Speaker 6: the bulk work that they're doing is speaking with the
47:38
Speaker 6: patients and fighting on behalf of patients. And every time
47:41
Speaker 6: I speak to another pharmacist, I think, did you go
47:43
Speaker 6: to pharmacy school to write pas?
47:46
Speaker 8: You know?
47:47
Speaker 6: And so it's it's really unfortunate, and I'm sure you
47:50
Speaker 6: talk to a lot of pharmacists on that side. But
47:53
Speaker 6: the patient perspective, I think is like, you know, we've
47:56
Speaker 6: never had to work so hard just to be stabilized.
48:00
Speaker 6: And the work that I did in my master's program
48:05
Speaker 6: on my capstone research was about PA legislation at the
48:09
Speaker 6: state level, because as we know, ARISA is much harder
48:12
Speaker 6: to kind of get in and work around at the
48:15
Speaker 6: federal level. So I was looking at Minnesota's state level
48:17
Speaker 6: and looking at you know, turnaround times, how quickly the
48:21
Speaker 6: PA needs to be turned around. And there are a
48:24
Speaker 6: lot of different legal loopholes that you know, health insurance
48:28
Speaker 6: and PBMs are getting into. But I think the kind
48:33
Speaker 6: of humanizing factor of these prior authorizations, all of the
48:37
Speaker 6: administrative work that's happening on the specialty pharmacy side plus
48:40
Speaker 6: the patient side.
48:42
Speaker 8: I mean, these are hours and hours.
48:43
Speaker 6: These are full teams of people that have been hired
48:46
Speaker 6: just to do PAS and do appeal letters. And so
48:50
Speaker 6: what's happening kind of consequently is there's an entire market
48:53
Speaker 6: now with companies like Claimable, Counterforce Health, a lot of
48:58
Speaker 6: other free options that are helping patients write these appeal letters.
49:02
Speaker 6: And so I just as a patient and a health
49:06
Speaker 6: policy researcher, I've never seen such work go into keeping
49:10
Speaker 6: patients stabilized and essentially reducing medical care, because if patients
49:15
Speaker 6: are not stabilized with their medication, they will require more
49:19
Speaker 6: medical care, which produces more costs. So we're trying to
49:24
Speaker 6: do some type of preventative medicine here and keep patients stable,
49:27
Speaker 6: which will save costs in the long run.
49:30
Speaker 8: Which I don't think is really spoken about that much.
49:33
Speaker 1: So we know several things are taking place this week
49:38
Speaker 1: in pharmacy. Buchanan Ingersoll published a blog that said, sweeping
49:44
Speaker 1: PBM reforms arrive. What the twenty twenty six federal legislation
49:48
Speaker 1: means for pharmacies patients in employers, And they do touch
49:53
Speaker 1: on House Bill seven to one for eight and a
49:59
Speaker 1: large I don't why when they always say sweeping or
50:04
Speaker 1: like large, like I like things to be as as
50:08
Speaker 1: definitive and definition driven as specific so that the PBMs
50:12
Speaker 1: can't get away with being too obscure in certain you know, subjects.
50:17
Speaker 1: But what have you kind of read on this and
50:20
Speaker 1: where this could lead or what dominoes fall next?
50:25
Speaker 6: Yeah, I think this is a really prominent time in
50:28
Speaker 6: PBM reform. I agree with you that, you know, the
50:31
Speaker 6: past few years, I've seen a lot of bills go
50:35
Speaker 6: into circulation and die on the hill, especially like the
50:38
Speaker 6: Safe Step Act. We've been trying to get that past
50:41
Speaker 6: for years and it's kind of gone nowhere. Personally speaking,
50:44
Speaker 6: I think the Vertical Integration Act that was just presented
50:49
Speaker 6: is kind of a reflection of the hearing that happened
50:53
Speaker 6: on I believe January twenty second with the health insurance executives,
50:58
Speaker 6: the six different insurance CEO. But I do think that
51:02
Speaker 6: that hearing was very pivotal. However, there have been multiple
51:06
Speaker 6: hearings in Congress last year. I know, July twenty twenty four,
51:10
Speaker 6: there was a third part of the series that was
51:12
Speaker 6: talking about PBM transparency and we talked about spread pricing,
51:18
Speaker 6: and all three of the panelists committed perjury. They got
51:21
Speaker 6: a letter from Homer, you know, threatening them with jail time.
51:25
Speaker 8: But that part wasn't talked about too much.
51:28
Speaker 6: So I think that personally, as a patient advocate and
51:31
Speaker 6: policy researcher, I've seen PBM reform.
51:35
Speaker 8: Even at the federal level.
51:37
Speaker 6: Two years ago, I was there with Infusion Access Foundation
51:41
Speaker 6: and I spoke to quite a few aids and they said,
51:43
Speaker 6: you know, PBR reform comes in these packages.
51:45
Speaker 8: As you're saying sweeping PBM.
51:47
Speaker 6: Reform will get put into a package and then all
51:50
Speaker 6: of a sudden it disappeared, you know, in that package
51:53
Speaker 6: it was removed.
51:54
Speaker 8: And I have a lot of feelings of why that happens.
51:57
Speaker 6: But I think that you know, it's been kind of transparency, uh,
52:03
Speaker 6: kind of glamorize word of oh, we just need transparency
52:06
Speaker 6: and that will solve everything. So I do think that
52:09
Speaker 6: this push on, you know, this recent testimony a few
52:14
Speaker 6: weeks ago, has led to this awareness of, oh, this
52:18
Speaker 6: vertical integration, as you're saying, you know, specialty pharmacy is
52:21
Speaker 6: feeding on the other part of supply chain.
52:24
Speaker 8: You know, it's such a closed.
52:25
Speaker 6: Loop where their profit seeking behaviors on every step.
52:29
Speaker 8: If we break down you know, one of.
52:31
Speaker 6: Those and really illustrate it, for example, step therapy, if
52:35
Speaker 6: we're looking at reducing the forced switching, you know, non
52:39
Speaker 6: medical switching that's happening, I think that's one great area
52:44
Speaker 6: that we can really improve patient care. I think we
52:47
Speaker 6: can improve provider care and reduce administrative burden. But you know,
52:52
Speaker 6: those need to be played out specifically in the bill
52:55
Speaker 6: appropriately to actually make an impact and not to have
53:00
Speaker 6: kind of these fancy words of oh, just increased transparency.
53:04
Speaker 5: Right, yeah, exactly. It's it's so.
53:12
Speaker 1: It's so frustrating when you see independent community pharmacies going
53:17
Speaker 1: out of business because.
53:22
Speaker 5: Of them not even being able to.
53:24
Speaker 1: Make you know, payroll, or being able to pay their
53:26
Speaker 1: bills or and then so many people go without pharmacy
53:34
Speaker 1: care because of those policy or because of the way
53:38
Speaker 1: that a business runs because of and it really has
53:41
Speaker 1: very little to do with it has extreme so much
53:48
Speaker 1: of it is just tied to to profit. It's just
53:50
Speaker 1: about the profit. And non medical switching is a prime example.
53:56
Speaker 1: It's one piece of PBM reform, but it's the one
53:59
Speaker 1: piece that is glaring to me. I know Bill Schmidtnick,
54:04
Speaker 1: I've met him, I've spent time with him. I've heard
54:06
Speaker 1: his story about Cole passing away. This was because of
54:10
Speaker 1: medical non medical switching. This was changing this boy's inhaler,
54:16
Speaker 1: this man's in hailer from one product to the next,
54:20
Speaker 1: just because of the PBM being able to make more money.
54:24
Speaker 1: And this is finally coming to light that this is
54:28
Speaker 1: because of it was.
54:29
Speaker 5: That adverre Like he's showing on the screen.
54:32
Speaker 1: So it's like, okay, he was going to pay sixty
54:36
Speaker 1: six dollars, great, that's what he budgeted. No, it was
54:39
Speaker 1: five hundred and thirty nine dollars. And he's like, I
54:42
Speaker 1: either have to pay my rent this month or I
54:44
Speaker 1: have to buy my adverre. I don't even have the
54:47
Speaker 1: money in my bank account. Therefore I have to leave
54:49
Speaker 1: the pharmacy without my adver and he went home not
54:53
Speaker 1: knowing that he was going to have a massive attack.
54:56
Speaker 1: He has an attack, they take him the hospital because
54:59
Speaker 1: the MBA was called, and he passes away, And I'm like,
55:02
Speaker 1: that was completely avoidable if you would have left it
55:06
Speaker 1: in place the way that it was supposed to be
55:09
Speaker 1: notified the physician or notified the pharmacist. If it was
55:13
Speaker 1: like an emergency thing that's like, hey, this guy needs this,
55:16
Speaker 1: let's give it to him and we'll decide on Monday,
55:19
Speaker 1: or we'll decide, you know, in the next week what
55:21
Speaker 1: to do with the pricing. Well that's what that's what
55:24
Speaker 1: that's what would have happened if Cole went to an
55:26
Speaker 1: independent community pharmacy. By the way, just as a little
55:29
Speaker 1: plug for our independence out there, if if he would
55:31
Speaker 1: have went to an independent it would have been like
55:34
Speaker 1: independence has been like, dude, like take your take your
55:37
Speaker 1: freaking medicine. Take it home. We'll get your we'll get
55:40
Speaker 1: the bills, we'll get this all figured out. Because they
55:44
Speaker 1: the independence. They know because it's their livelihood. It's not
55:47
Speaker 1: the pharmacists just at a CVS that standing behind the
55:50
Speaker 1: counter that gets their paycheck. No matter what, these independent
55:54
Speaker 1: community pharmacies are pretty freaking zavvy about going after their
55:58
Speaker 1: money and getting things done, and that's sad. I mean,
56:01
Speaker 1: that's a perfect example of non medical switching.
56:06
Speaker 6: I agree, and I met Bill. I think it was
56:09
Speaker 6: last June when we were in DC with patients rising.
56:13
Speaker 6: I spoke to him for quite a few hours because
56:16
Speaker 6: I mean, I don't think the human cost is seen
56:21
Speaker 6: enough when we're talking about policy. And I do know
56:24
Speaker 6: that Buddy Carter down in Georgia, he will highlight a
56:28
Speaker 6: patient story when he speaks, you know, during these hearings
56:33
Speaker 6: when we're talking about PBM reform, and unfortunately, I've gotten
56:36
Speaker 6: jaded to the point where I think, you know, these
56:39
Speaker 6: lives are being lost and things are not changing. So personally,
56:46
Speaker 6: you know, there's another case I know of a friend
56:48
Speaker 6: of mine. He's an attorney and his son was taken
56:51
Speaker 6: off of remicade for his Crohn's disease. Remickaid was keeping
56:55
Speaker 6: him in remission and he was completely stable. And you know,
56:59
Speaker 6: there's a lot of legality behind this if we're looking
57:02
Speaker 6: at a corporate practice of medicine, and I think that
57:05
Speaker 6: that is also a part that needs to be discussed more.
57:09
Speaker 6: As you're talking about you know, physicians and pharmacists are
57:12
Speaker 6: getting less and less autonomy, and these corporations are doing
57:15
Speaker 6: these quote unquote peer to peers with you know, maybe
57:18
Speaker 6: a physical therapist, someone that has no idea, you know,
57:22
Speaker 6: what the training is like to be able to prescribe
57:24
Speaker 6: these meds. And so I think just generally the humanization
57:29
Speaker 6: of patients and providers is really key when we're looking
57:33
Speaker 6: at policy reform, and getting those stories out is part
57:37
Speaker 6: of our goal.
57:38
Speaker 8: Michael, at least.
57:41
Speaker 1: I tell you what I've heard of Patients Rising. That
57:45
Speaker 1: was a group I mean that's been around for a
57:47
Speaker 1: little while now, and their advocacy to get patients' voices
57:52
Speaker 1: out is pretty powerful. Are you part of a specific
57:57
Speaker 1: chapter of Patients Rising.
58:00
Speaker 8: Yeah, so I've gone to DC with them twice to
58:03
Speaker 8: do a day on the Hill.
58:04
Speaker 6: We go in June, and I'm part of the Patient Senate,
58:09
Speaker 6: which is an organization that's looking to increase their impact
58:13
Speaker 6: essentially at the state level.
58:15
Speaker 8: So right now we have the fly ins.
58:18
Speaker 6: We do a little bit of work on the back
58:21
Speaker 6: end through local and state level legislation. I know build
58:25
Speaker 6: does a lot in Wisconsin, for example, but we mainly
58:30
Speaker 6: go and last year we talked about the Copey Accumulators Act,
58:35
Speaker 6: we talked about the Safe Step Act. I decided to
58:38
Speaker 6: bring up the Upcoding No Upcoding Act because I felt
58:42
Speaker 6: like that was an important part if we're discussing or fraud,
58:46
Speaker 6: waste and abuse, you know, the upcoding that's happening in
58:49
Speaker 6: medicare advantage. Like you said, though, I mean, there are
58:52
Speaker 6: so many areas to look at in PBM reform that
58:57
Speaker 6: staying specific I think is important too.
59:01
Speaker 1: So when you think of this from different lenses, and
59:10
Speaker 1: sometimes you have to, so I look at things from
59:14
Speaker 1: the health system perspective, the hospitals that are out there
59:17
Speaker 1: that are serving their communities, the independent community pharmacies, the
59:21
Speaker 1: pharmacies that are more like publics or Giant Eagle here
59:24
Speaker 1: in Pittsburgh, which is more of the grocery store chain environment.
59:30
Speaker 1: It's so interesting. I've been doing this now for seventeen years,
59:35
Speaker 1: documenting the entire profession through podcasting, and I've noticed that
59:39
Speaker 1: patients get treated differently in each of these you know, elements,
59:45
Speaker 1: different sectors, and it's like the white glove approach. Is
59:50
Speaker 1: this specially pharmacy environment where they're getting a counselor a
59:55
Speaker 1: pharmacy tech to help you with your account management, a
59:58
Speaker 1: chief pharmacist. It's dialing into the actual treatment, follow up,
1:00:04
Speaker 1: patient assistance programs that are given to you and told
1:00:07
Speaker 1: you counseling and together with your family, and now you're
1:00:12
Speaker 1: coming on a zoom or you're going in person and
1:00:15
Speaker 1: like this. It's like, wow, this is this is the
1:00:18
Speaker 1: way that we wish we could all do be treated
1:00:20
Speaker 1: like this in pharmacy. And then you go down to
1:00:23
Speaker 1: fast food out of the CBS, down on the you know,
1:00:27
Speaker 1: on the corner of expensive and pre authorization, and it's
1:00:32
Speaker 1: like you're treated like a fast food burger. Let's just
1:00:36
Speaker 1: turn out as many burgers, as many prescriptions as we
1:00:40
Speaker 1: can because we have to to stay in business because
1:00:44
Speaker 1: of the way that this system works. And I'm just like, no,
1:00:48
Speaker 1: like there's there's a balance between those two environments and
1:00:52
Speaker 1: people treating people number one with dignity and knowing that
1:00:56
Speaker 1: this is we're talking about healthcare. We're not talking about burgers.
1:01:00
Speaker 1: We're not talking about a car sell, we're not even
1:01:02
Speaker 1: talking about the biggest purchase that most of us will
1:01:06
Speaker 1: ever buy is a house. It's not even it's not
1:01:09
Speaker 1: even a house transaction. This is like our living. This
1:01:12
Speaker 1: is the way that we function as human beings for
1:01:15
Speaker 1: longevity and happiness and healthiness. And it's just like, come on,
1:01:20
Speaker 1: Like the radicalization of healthcare couldn't happen at a better time.
1:01:25
Speaker 1: People like you, people like the running we the patients,
1:01:30
Speaker 1: and Matthew Zachary and Mark Cuban's influence. You know that
1:01:35
Speaker 1: all of that is finally, Jake Auchenclaus, We're finally getting
1:01:40
Speaker 1: to a position in my twenty two years in healthcare
1:01:44
Speaker 1: where I am seeing faster changes and I'm seeing impact
1:01:48
Speaker 1: and I'm seeing things happen.
1:01:49
Speaker 5: However, we have.
1:01:52
Speaker 1: To stay vigilant and creative to stay ahead of the
1:01:58
Speaker 1: next big insurearents company building a new model where they're
1:02:02
Speaker 1: going to stay compliant and they're going to these new
1:02:05
Speaker 1: federal PBM laws are going to come out. They're going
1:02:08
Speaker 1: to break up the vertical integration, and then these big
1:02:11
Speaker 1: organizations are just going to rise again in some other
1:02:14
Speaker 1: element to take control of the money. And I'm just like, so,
1:02:17
Speaker 1: how do we keep that from happening? Like how don't
1:02:20
Speaker 1: we always bring it back to the to the physician,
1:02:23
Speaker 1: pharmacist and patient to keep that triangle, you know, tight
1:02:29
Speaker 1: as tight as possible, And I don't know what the
1:02:31
Speaker 1: answer that is.
1:02:33
Speaker 8: Yeah, I agree with you.
1:02:34
Speaker 6: I think when I was in VC last we worked
1:02:38
Speaker 6: with Heart Health Strategies, which is a lobbying organization, and
1:02:43
Speaker 6: all these patients showed up, and you know, we're out
1:02:47
Speaker 6: there at the federal level talking about our stories and
1:02:50
Speaker 6: sharing all of these very emotional things with aids, legislative aids,
1:02:55
Speaker 6: you know. And I truly think that this reform pbm
1:02:59
Speaker 6: OR is the most bipartisan area of legislation that seems
1:03:05
Speaker 6: to you know, have agreement on both sides. And I
1:03:09
Speaker 6: think that that is something that gives me hope definitely
1:03:11
Speaker 6: to be able to see I think it was a
1:03:14
Speaker 6: Republican congressman saying that his medication was denied eight times
1:03:19
Speaker 6: after he had brain surgery.
1:03:22
Speaker 5: Yeah, I remember that and when I.
1:03:24
Speaker 6: Yeah, when I heard that testimony, I thought, wow, you know,
1:03:28
Speaker 6: how much further are.
1:03:30
Speaker 8: We gonna let this one go?
1:03:31
Speaker 6: Because that is something that patients you know that are
1:03:35
Speaker 6: not in Congress have been dealing with their whole lives
1:03:37
Speaker 6: and a lot of lives have been lost, and so
1:03:40
Speaker 6: hearing that, you know, it's like we something needs to change,
1:03:44
Speaker 6: and I think that the further you know things are going,
1:03:49
Speaker 6: the more I guess more big of a change we
1:03:53
Speaker 6: need to have. But then I agree with you on
1:03:55
Speaker 6: the side of these organizations are so big. You know,
1:03:59
Speaker 6: for example, the g that are happening you know abroad
1:04:03
Speaker 6: that people are just kind of learning more about, and
1:04:06
Speaker 6: how these companies are kind of shell companies just to
1:04:09
Speaker 6: make more money. I mean, it's like all of the
1:04:12
Speaker 6: industry is kind of insidious on itself.
1:04:15
Speaker 8: But I do think there are a lot more of
1:04:17
Speaker 8: us that are.
1:04:18
Speaker 6: Kind of saying, hey, you know, this isn't working for
1:04:21
Speaker 6: people and the human lives that are being risked and
1:04:26
Speaker 6: put into danger because of these industry of quote unquote standards.
1:04:32
Speaker 6: I think there are a lot more of us that
1:04:34
Speaker 6: are kind of speaking out, and I think that's really important.
1:04:37
Speaker 1: Bravo. Absolutely and writing, reporting, dissecting, digging into the details.
1:04:45
Speaker 1: That's how we're going to make changes, because if we
1:04:47
Speaker 1: can use the data and the reporting and the information
1:04:51
Speaker 1: against the beast that is the macro economics of healthcare,
1:04:56
Speaker 1: then we can really refine and really, like you were
1:05:00
Speaker 1: saying at the beginning, is speceissivity is pretty important in
1:05:04
Speaker 1: this stuff because the big giants don't want to lose
1:05:10
Speaker 1: that revenue. And if it means inventing a whole new beast,
1:05:15
Speaker 1: I'm already seeing it happen. We're already seeing talk about
1:05:19
Speaker 1: personalized medicine and blah. And I'm just like, please, like,
1:05:24
Speaker 1: where were you guys ten years ago when we were
1:05:27
Speaker 1: talking about don't give this drug?
1:05:30
Speaker 6: That is.
1:05:32
Speaker 1: It's a black box warning on the on the FDA's
1:05:35
Speaker 1: site where it says pharmacogenomics. It's like, these top two
1:05:38
Speaker 1: hundred drugs don't even work the way they're supposed to
1:05:41
Speaker 1: fifty percent of the time. You better get a PGX
1:05:45
Speaker 1: test to even figure out if you're going to metabolize
1:05:47
Speaker 1: it the right way, because there's a fifty percent chance
1:05:51
Speaker 1: that this medication will not work for you. Well, why
1:05:55
Speaker 1: isn't that taking into consideration to start saying to the
1:06:00
Speaker 1: drug manufacturers, Hey, you now have to manufacture three different
1:06:06
Speaker 1: types of the same exact medication in order to help
1:06:11
Speaker 1: people ingest and you know, the efficacy to be as
1:06:15
Speaker 1: you as you.
1:06:16
Speaker 5: Hope it is.
1:06:17
Speaker 1: And I would think that would be a pro for
1:06:20
Speaker 1: pharma because then they can keep the patents long longer.
1:06:23
Speaker 8: Right, right, exactly.
1:06:26
Speaker 1: All right, Well, this Week in Pharmacy has been fun
1:06:30
Speaker 1: talking with Kristen Hutchison. How do you like people to
1:06:34
Speaker 1: reach out to you? Are you a big LinkedIn user?
1:06:37
Speaker 8: Yeah?
1:06:38
Speaker 6: Yeah, I'm on LinkedIn quite often. I also will do
1:06:41
Speaker 6: a full substack analysis of the Vertical Integration Act, so
1:06:46
Speaker 6: I will put that there very soon so we can
1:06:49
Speaker 6: kind of dig into that specificity and see what's being presented.
1:06:54
Speaker 6: So a substack or LinkedIn would be great. I'd love
1:06:57
Speaker 6: to talk with other folks in this field, you know.
1:07:01
Speaker 1: Yeah, Well, Kristen's link to LinkedIn will be in the
1:07:05
Speaker 1: show notes to take a look.
1:07:07
Speaker 5: Kristin.
1:07:08
Speaker 1: Make sure that this is not the last time that
1:07:09
Speaker 1: you're going to show up on This Week in Pharmacy.
1:07:12
Speaker 8: Yeah, great, Thank you Todd. It's been really great.
1:07:16
Speaker 1: Hey, this has been a wonderful day to share with
1:07:19
Speaker 1: you listeners. Thanks so much for listening. If you're listening
1:07:21
Speaker 1: on Apples, Spotify, if you're watching us live on LinkedIn
1:07:25
Speaker 1: or YouTube, it will really help if you share an
1:07:29
Speaker 1: episode that means something to another provider, to another a
1:07:33
Speaker 1: nurse that you work with, a pharmacist, you work with
1:07:35
Speaker 1: a pharmacy technician, to let them know that things are
1:07:38
Speaker 1: not sitting still.
1:07:39
Speaker 5: And if you're on the sidelines and you're.
1:07:41
Speaker 1: Frustrated, we're frustrated too, right along with you, and people
1:07:45
Speaker 1: like Kristin are documenting and helping to helping to refine
1:07:49
Speaker 1: and helping to bring more focus to it.
1:07:51
Speaker 5: So thank you so much.
1:07:53
Speaker 1: Thanks all right, we will talk to you next time
1:07:57
Speaker 1: on This Week in Pharmacy,