Latest / Pharmacy Podcast Network / Independent Pharmacy: AI, Consolidation & Fighting for Every Dollar | TWIRx

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Independent Pharmacy: AI, Consolidation & Fighting for Every Dollar | TWIRx · Pharmacy Podcast Network

0:02
Speaker 1: Hey everyone, Jesse McCullough here with the 31 Day Challenge.
0:05
Speaker 1: I'd like to start out just by giving thanks to
0:08
Speaker 1: Todd and the whole team at the Pharmacy Podcast Network.
0:10
Speaker 1: I appreciate the opportunity to share some unique challenges with
0:16
Speaker 1: the This Week in Pharmacy audience. For those of you
0:20
Speaker 1: who may not be familiar with the 31 Day Challenge,
0:23
Speaker 1: this is actually our second year to implement the 31-day challenge.
0:29
Speaker 1: This is something that coincides with American Pharmacists Month. And
0:33
Speaker 1: the idea came from, is there something that we can
0:37
Speaker 1: do to encourage and equip and enhance and empower pharmacists
0:41
Speaker 1: throughout American Pharmacists Month, no matter what discipline of pharmacy
0:46
Speaker 1: you find yourself working in, whatever that area of practice
0:50
Speaker 1: may be. And the idea became this 31-day challenge. And
0:55
Speaker 1: what the way it operates is on a daily basis.
0:59
Speaker 1: There's a new video released primarily on LinkedIn. And now
1:02
Speaker 1: this year I'm on YouTube. I got sophisticated. But the
1:07
Speaker 1: challenge features just some little thing that you can do
1:13
Speaker 1: that would make life better for you or your team or,
1:17
Speaker 1: or the people that you serve. So with that, The
1:21
Speaker 1: challenge kicked off on October 1st, yesterday, as of this recording,
1:27
Speaker 1: and I want to invite you to be a part
1:30
Speaker 1: of that. Follow along, you know, find a couple of
1:33
Speaker 1: people to follow along with. I think you'll find it
1:36
Speaker 1: to be well worth your time, and it'll be a
1:38
Speaker 1: fun and encouraging and uplifting time. That said, Todd asked
1:43
Speaker 1: me if I would give a special challenge to the
1:46
Speaker 1: This Week in Pharmacy audience. And that's what I'm here
1:50
Speaker 1: to do today. I'm going to give you a special challenge.
1:53
Speaker 1: This is a very simple thing. It's something that you
1:55
Speaker 1: can actually do right now. Obviously, you find value in
2:01
Speaker 1: the Pharmacy Podcast Network. You find value in this particular
2:06
Speaker 1: episode that you are listening to. And what I want
2:09
Speaker 1: to invite you to do, what I want to challenge
2:10
Speaker 1: you to do, is to share this episode with at
2:14
Speaker 1: least two colleagues. Find at least two colleagues that you
2:18
Speaker 1: can just hit the share button from however it is
2:20
Speaker 1: that you're consuming this content and invite them to be
2:23
Speaker 1: a part of it as well. Now, I also understand
2:27
Speaker 1: that the Pharmacy Podcast Network has a number of different shows,
2:32
Speaker 1: a number of different hosts, and they all deliver tremendous value.
2:36
Speaker 1: What I would also encourage you to do is find
2:39
Speaker 1: one of those shows, find one of those episodes, find
2:41
Speaker 1: one of those hosts, and take one of those podcasts
2:43
Speaker 1: and share that with some colleagues as well. For those
2:47
Speaker 1: of you who say, I don't know which colleagues to
2:49
Speaker 1: send this to, feel free just to share it on
2:52
Speaker 1: social media, on whatever your platform of choice is. But
2:55
Speaker 1: do something to help elevate and get the word out
2:58
Speaker 1: and just give some type of encouragement to our fellow
3:02
Speaker 1: pharmacists that are out and doing the good work that
3:05
Speaker 1: serves our communities so, so well. With that, I'm going
3:09
Speaker 1: to wrap up this particular edition, but I will see
3:12
Speaker 1: you back here next week. With another challenge.
3:16
Speaker 2: Have a great week, everybody.
3:18
Speaker 3: This episode is brought to you by Hendren AI. Specialty
3:22
Speaker 3: pharmacy teams are being asked to do more than ever before.
3:25
Speaker 3: Between patient outreach, refill coordination, prior authorizations, and the endless
3:30
Speaker 3: volume of phone calls, valuable clinical and operational time is
3:34
Speaker 3: often consumed by administrative work. At Hendren AI, we believe
3:38
Speaker 3: the people caring for patients should spend less time managing
3:41
Speaker 3: workflows and more time delivering meaningful outcomes. That's why we
3:45
Speaker 3: build AI-powered solutions designed specifically for specialty and infusion pharmacy organizations.
3:51
Speaker 3: Our platform helps automate repetitive phone-based and administrative processes, streamline operations,
3:57
Speaker 3: and improve the patient experience while fitting into existing workflows.
4:02
Speaker 3: Hendren AI is focused on a simple mission, turning human
4:05
Speaker 3: labor into software so healthcare organizations can scale more efficiently
4:10
Speaker 3: while keeping patients at the center of care. To learn more,
4:13
Speaker 3: visit Hendren.ai and discover how AI can help your team
4:17
Speaker 3: work smarter, not harder.
4:26
Speaker 4: You are listening to the global network of podcasters dedicated
4:29
Speaker 4: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
5:02
Speaker 4: Welcome to Twerks News on This Week in Pharmacy. We
5:05
Speaker 4: head into NCPA 2026 with independent community pharmacy front and center,
5:10
Speaker 4: from artificial intelligence and consolidation to supply chain economics and
5:14
Speaker 4: policy reform. We start with the Twerks rumor mill, behind-the-counter intelligence,
5:19
Speaker 4: looking at three developing stories worth watching. First, another massive
5:23
Speaker 4: pharmacy transaction may be coming. The owner of Walgreens Boots
5:27
Speaker 4: Alliance is reportedly nearing a deal to sell UK pharmacy
5:30
Speaker 4: giant Boots to the Westin family in a transaction valued
5:33
Speaker 4: at roughly $ 9 billion, including debt. The Westin interests already
5:38
Speaker 4: control Loblaw companies and Shoppers Drug Mart in Canada. No
5:41
Speaker 4: final transaction has been announced, so this remains one to watch.
5:45
Speaker 4: Twerk's take, pharmacy consolidation isn't slowing down. As major organizations
5:50
Speaker 4: continue reorganizing, buying, selling, and vertically integrating assets, What does
5:55
Speaker 4: that mean for independent pharmacy and where does scale become
5:59
Speaker 4: too much scale?
6:04
Speaker 5: National Community Pharmacists Association Super Bowl of Independent Community Pharmacy
6:10
Speaker 5: is this week coming up October 3rd, 4th, 5th, 6th
6:15
Speaker 5: or October 4th. I don't know the dates. It's like
6:18
Speaker 5: it's coming up, people. And I'm here this week in pharmacy.
6:23
Speaker 5: with John Booz from Hendren AI. John, you were on
6:28
Speaker 5: Torx on September 18th. It was a great time to
6:31
Speaker 5: kind of find out who was Hendren. What's the background?
6:35
Speaker 5: What's your background? Now we're headed to, like I said,
6:38
Speaker 5: the Super Bowl of independent community pharmacy. Are you excited
6:42
Speaker 5: to be going to Kansas City?
6:43
Speaker 6: Actually my first time, Todd. I've never actually been to
6:45
Speaker 6: Kansas City before. I was born and raised in New York.
6:48
Speaker 6: I've never been to conferences. I usually go to conferences,
6:51
Speaker 6: East Coast, West Coast, Vegas, sometimes in the South, but
6:55
Speaker 6: never to Kansas.
6:57
Speaker 7: All right.
6:57
Speaker 5: Well, if I'm planning a conference for a bunch of
7:00
Speaker 5: pharmacists to meet up, especially our independent community pharmacy pharmacist.
7:05
Speaker 5: I'm not going to Kansas City. I'm going to go
7:07
Speaker 5: to Orlando. I'm going to go to Orlando. I'm just
7:09
Speaker 5: being honest, NCPA. Shout out to NCPA. You guys are awesome.
7:13
Speaker 5: But I'm going to go to Orlando. I'm going to
7:15
Speaker 5: go to Vegas. I'm going to go. I'd like to know,
7:18
Speaker 5: if they're having it at Kansas City, why can't we
7:20
Speaker 5: have a conference in Pittsburgh? Pittsburgh has a huge convention center.
7:24
Speaker 5: We're a tech company. We got MIT and Pitt and
7:31
Speaker 5: Duquesne University School of Pharmacy. But yeah, I'm excited. The
7:35
Speaker 5: reason why I'm all fired up is meeting up with
7:39
Speaker 5: independent community pharmacy owners who are ready to change their
7:43
Speaker 5: lives and ready to change their businesses. I've noticed that
7:48
Speaker 5: when we have pharmacy owners investing in these conferences, because
7:51
Speaker 5: they're so expensive to go to, the flights, the hotels,
7:54
Speaker 5: meeting up places, these people want to make things happen.
7:57
Speaker 5: So when they show up, they want to engage and
8:00
Speaker 5: they want to talk with vendors and people who are
8:03
Speaker 5: just as passionate as they are about their business and
8:06
Speaker 5: really making changes. So I want you to talk with
8:09
Speaker 5: our listeners, especially if they're going, let's talk AI in
8:13
Speaker 5: independent community pharmacy right out of the gate. What's kind
8:16
Speaker 5: of the hot button when it comes to implementation of AI?
8:20
Speaker 5: What's that one part that is like, if you're using AI,
8:24
Speaker 5: you've got to be doing this.
8:27
Speaker 2: Right.
8:28
Speaker 6: So if you've got to use AI, I think the
8:30
Speaker 6: best next step is to use AI agents, numerous AI
8:34
Speaker 6: agents doing things simultaneously. And what I usually tell people,
8:38
Speaker 6: if you have a technician and you have certain productivity
8:41
Speaker 6: that's coming out of that technician on the screen or
8:43
Speaker 6: over the phone, imagine having.
8:46
Speaker 2: a team of.
8:47
Speaker 6: AI agents working simultaneously, calling numerous providers for numerous patients
8:53
Speaker 6: simultaneously without actually having to expand outside.
8:57
Speaker 2: Of your walls.
8:58
Speaker 6: And I typically get this question all the time where
9:00
Speaker 6: they're a corner store pharmacy or they have a small chain.
9:03
Speaker 2: We're trying to grow outside.
9:05
Speaker 6: Of our walls, but we're unable to because of staffing problems,
9:09
Speaker 6: unable to find really talented folks within the market, whether
9:13
Speaker 6: they're pharmacists or technicians that have the know-how.
9:16
Speaker 2: But at the same time, they want.
9:17
Speaker 6: To obviously increase the volume of prescriptions and the patients
9:21
Speaker 6: that are actually coming into the pharmacy.
9:23
Speaker 2: So how do they get that.
9:25
Speaker 6: Bottleneck removed and really clear in a way that they
9:28
Speaker 6: can expand in a proficient manner without really losing quality care?
9:33
Speaker 2: So the voice AI agents are definitely the way to.
9:35
Speaker 6: Do it in terms of being able to have those
9:38
Speaker 6: AI agents' productivity with payers, providers, and at the same
9:42
Speaker 6: time communicating with those patients via voice.
9:44
Speaker 2: Phone and text message.
9:47
Speaker 5: Text message follow-up being able to ask questions pulling that
9:51
Speaker 5: data back to the pharmacy management system and cataloging what
9:55
Speaker 5: was said so that you can follow up on it
9:58
Speaker 5: and then personalizing it because I think if the patient,
10:03
Speaker 5: if there's a follow-up either with a phone call or
10:06
Speaker 5: they're in the physical pharmacy and then the pharmacy technician,
10:14
Speaker 5: the pharmacist are reading through the notes to be able
10:17
Speaker 5: to say, Hey, we reached out to you three days
10:21
Speaker 5: ago and you said that you don't have any refills left.
10:25
Speaker 5: Did you lose the medication? What's going on? That kind
10:29
Speaker 5: of personalization can really make AI much more fluid with
10:36
Speaker 5: caring for that personalized patient experience. And now it's like, wow,
10:42
Speaker 5: these people really pay attention to not only what I texted,
10:45
Speaker 5: but what I'm saying. And if you can merge those
10:47
Speaker 5: two things together, that's why I think once again, I've
10:51
Speaker 5: never operated a pharmacy, but I've, I've been documenting this
10:54
Speaker 5: through podcasting 20 years now. And it's like, boy, if
10:57
Speaker 5: I can, if I can get the best out of it,
11:00
Speaker 5: where my texts, I might text might be doing less
11:02
Speaker 5: now because AI has taken over some of their busy work,
11:06
Speaker 5: put them on customer service and romancing your customer, romancing
11:09
Speaker 5: your patients of getting them.
11:12
Speaker 6: Right now, it's the fall season. Vaccines, you have a
11:14
Speaker 6: better ROI on vaccines than you do actually dispensing.
11:18
Speaker 2: It's interesting that you mentioned that.
11:19
Speaker 6: Todd, and we talk a lot about the patient journey
11:22
Speaker 6: memory and being able to have.
11:24
Speaker 2: The memory of the patient journey from beginning to end.
11:27
Speaker 6: And at the same time, since we walk on both
11:29
Speaker 6: sides of the aisle, so we're able to communicate with
11:32
Speaker 6: the Epic, Cerner, Athena, eClinicalWorks, and at the same time,
11:36
Speaker 6: the pharmacy management softwares that are out there, we're able
11:39
Speaker 6: to have that kind of patient journey memory and prescription
11:42
Speaker 6: journey memory for that patient and be able to basically
11:45
Speaker 6: communicate those kind of things in a HIPAA-compliant manner so
11:48
Speaker 6: that they'll be able to communicate at ease without having
11:51
Speaker 6: to risk that kind of protected health information.
11:55
Speaker 5: All right, so interaction with the patient, whether that's text,
11:59
Speaker 5: whether it's voice, personalizing the experience. What other things? Let's
12:04
Speaker 5: talk about summit administration. What about inventory planning? What about
12:09
Speaker 5: the cash flow side of things?
12:12
Speaker 6: Right, so that's more of like a CRM QuickBooks. We
12:15
Speaker 6: really don't touch those kind of things. What we essentially
12:18
Speaker 6: do is look at administrative and clinical path flows. In
12:23
Speaker 6: terms of inventory modules, that's on the roadmap, not there yet.
12:27
Speaker 6: But in terms of being a CRM system, we are
12:30
Speaker 6: not a CRM system where we're essentially maintaining that kind
12:33
Speaker 6: of inventory of customers. Every PMS system has all those
12:38
Speaker 6: customers there. to begin with, but to have like a
12:41
Speaker 6: CRM system, for example, typically most corner store pharmacies have
12:45
Speaker 6: like a CRM system to reach out to providers, right?
12:49
Speaker 6: And I've been with pharmacies before where we essentially try
12:53
Speaker 6: to market the pharmacy to providers to make sure that
12:56
Speaker 6: these pharmacies are actually getting those prescriptions from those providers.
13:00
Speaker 6: And to me, that would be a CRM, essentially, that
13:03
Speaker 6: you would want to find out how you can look
13:06
Speaker 6: at the demographics in the area and making sure those
13:08
Speaker 6: providers are essentially sending those prescriptions at the patients that
13:12
Speaker 6: are visiting your pharmacy, and you'd be able to deliver
13:15
Speaker 6: mail it or essentially any pathway to be able to
13:18
Speaker 6: get that medication to the patient. But yeah, we don't
13:20
Speaker 6: have that in place, a CRM system for the providers
13:24
Speaker 6: or an inventory because most of the systems out there
13:26
Speaker 6: already have an inventory system. So we don't run into
13:30
Speaker 6: that problem.
13:31
Speaker 5: Well, that's good to at least identify what you definitely
13:34
Speaker 5: do versus what you don't. And I think that that
13:37
Speaker 5: helps to bring clarity. We have talked with some other
13:40
Speaker 5: AI developers and and when they talk with pharmacy operators,
13:45
Speaker 5: especially like in the independent community pharmacy space, I've heard
13:49
Speaker 5: back from those owners of saying, it's hard to clarify
13:53
Speaker 5: what it is that they do because they keep saying,
13:55
Speaker 5: oh yeah, we can do that. Or we can do that.
13:57
Speaker 5: And I'm like, yeah, that's true. Like if you're a,
13:59
Speaker 5: if you're a, uh, if you've become an expert in
14:01
Speaker 5: something specific that can build strength. And then at least
14:05
Speaker 5: I know where I stand with an organization. So It's
14:08
Speaker 5: good to know what Hendren is doing. I think you
14:11
Speaker 5: have a special relationship with several pharmacy management system softwares
14:16
Speaker 5: out there that are doing inventory and are doing all
14:19
Speaker 5: the things that we're talking about. One of those is DRX,
14:22
Speaker 5: which you can learn more about them by going to getdrx.com.
14:27
Speaker 5: Once again, that's getdrx.com. Talk to me about DRX. What's
14:31
Speaker 5: going on with that organization and the relationship with Hendren AI?
14:38
Speaker 6: So DRX is the primary platform. So it's a pharmacy
14:41
Speaker 6: management software. I would say probably the one most robust
14:45
Speaker 6: out there because it is a SQL-based. And a lot
14:49
Speaker 6: of them, like the competitors that are out there, are
14:53
Speaker 6: mostly on-premises.
14:54
Speaker 2: So they're not sitting on a cloud.
14:56
Speaker 6: So Dan and I have been in communications for the
14:59
Speaker 6: past couple of months working And we've noticed a great
15:02
Speaker 6: opportunity to be able to work together to essentially leverage
15:05
Speaker 6: our secondary platform on top of its primary platform so
15:09
Speaker 6: that we're the intelligence automation to be able to leverage
15:12
Speaker 6: those AI agents that I mentioned via voice, data entry
15:16
Speaker 6: to be able to get those prescriptions in and scrape
15:19
Speaker 6: them and essentially leverage map them into the pharmacy software,
15:23
Speaker 6: and then looking at some of the opportunities where essentially
15:25
Speaker 6: we can grow together in terms of implementing that kind
15:28
Speaker 6: of technology. So we're very thankful to be working with
15:31
Speaker 6: DRX and having that API and sandbox environment to really work,
15:37
Speaker 6: I would say, in a tailored approach with some of
15:39
Speaker 6: these pharmacies. And I know some pharmacies want that kind
15:42
Speaker 6: of experience. And you can just pick up the phone
15:44
Speaker 6: and call. And we have that kind of experience with us.
15:47
Speaker 6: So you can just pick up the phone and get
15:48
Speaker 6: in touch with Hendren at our 1-800 number. And we'd
15:52
Speaker 6: be able to get in touch with you to try
15:53
Speaker 6: to see if we could build something tailored specifically for
15:56
Speaker 6: your pharmacy.
15:59
Speaker 5: Yeah. And just a shout out to our listeners. If
16:02
Speaker 5: you are going to the NCPA website, in Kansas City,
16:07
Speaker 5: and you want to connect with us, if you want
16:11
Speaker 5: to be part of our interviews, we're going to be
16:15
Speaker 5: at two of the booths. We're going to be at
16:17
Speaker 5: Ural Pharma, probably going to be at DRX Pharmacy Softwares.
16:22
Speaker 5: We'll be confirming that, but stay close to the mic.
16:26
Speaker 5: Text me at my phone number. I'm going to put
16:28
Speaker 5: it in the show notes, 412-585-2251. That's 412-585-2251. Let me
16:38
Speaker 5: know where you guys are at. Hey, if somebody wants
16:41
Speaker 5: to buy me a drink in Kansas City, I'm all
16:44
Speaker 5: for that. By the way, if you're from Kansas City,
16:48
Speaker 5: you got to tell me what kind of food I
16:49
Speaker 5: should be eating. Because if you come to Pittsburgh, I'm
16:52
Speaker 5: going to take you to Primanti's or I'm going to
16:53
Speaker 5: take you to some place up on Mount Washington or something.
16:58
Speaker 5: But I don't know what's good to eat out in
17:00
Speaker 5: Kansas City.
17:01
Speaker 8: Do you?
17:02
Speaker 5: John, see, nobody knows like what's going on in Kansas city.
17:08
Speaker 5: Like let's, let's get something together.
17:10
Speaker 1: All right.
17:10
Speaker 5: Hey, I'm excited to be seeing you, John. We spend
17:14
Speaker 5: a lot of time on zooms and on calls and
17:17
Speaker 5: you know, but, but being in front of you is
17:19
Speaker 5: going to be fun. Really appreciate the work that you
17:22
Speaker 5: guys are doing, the support that you're giving us as,
17:25
Speaker 5: as press coverage for the upcoming NCPA and, And we'll
17:30
Speaker 5: see you in Kansas City. Hopefully you have a safe travel,
17:34
Speaker 5: uneventful travel. That's what we're wishing for.
17:37
Speaker 2: That's all we can wish for, Todd. Thank you so much.
17:40
Speaker 2: Really appreciate it. All right.
17:41
Speaker 5: See you soon. Hey, stay tuned for more twerks.
17:47
Speaker 7: Independent Pharmacy is the heart of community care. At Independent
17:52
Speaker 7: Pharmacy Cooperative, we believe your success strengthens the health and
17:56
Speaker 7: well-being of the communities you serve. As the nation's largest
17:59
Speaker 7: member-owned GPO, IPC helps pharmacies thrive with competitive pricing, profit sharing,
18:05
Speaker 7: and the support of a team who shares your vision.
18:07
Speaker 7: Let's build the future of independent pharmacy together and gain
18:10
Speaker 7: the freedom to farm. Visit IPCRX.com to start the conversation
18:15
Speaker 7: with an IPC representative today.
18:26
Speaker 9: Next up on Twerks News, specialty pharmacy keeps getting bigger
18:30
Speaker 9: and Cigna sees an enormous opportunity. At its 2026 Investor Day,
18:35
Speaker 9: Cigna identified a specialty pharmacy and care services market approaching
18:38
Speaker 9: $ 500 billion, with Acredo and its specialty operations positioned as
18:43
Speaker 9: major growth drivers. Twerks take. Follow the money. Specialty drugs,
18:48
Speaker 9: rare disease, biologics, infusion, and complex medication management continue to
18:52
Speaker 9: reshape pharmacy economics. The question for community pharmacy is, how
18:57
Speaker 9: much of this expanding market can independence capture?
19:04
Speaker 5: Hey, it's This Week in Pharmacy. I'm your host, Todd Urie,
19:08
Speaker 5: founder of the Pharmacy Podcast Network. Hey, there is news
19:12
Speaker 5: happening this week in pharmacy. Excited about this. And not
19:15
Speaker 5: sure if you heard, but Independent Pharmacy Cooperative, who's been
19:19
Speaker 5: a huge supporter of the Pharmacy Podcast Network, they acquired
19:24
Speaker 5: a company called Integral Rx. And I've heard of Integral.
19:29
Speaker 5: I knew that they were associated with Smith drug and
19:32
Speaker 5: didn't really understand exactly what they did. But that inclusion
19:37
Speaker 5: into the independent pharmacy cooperative is very important. And a
19:42
Speaker 5: leader of the organization who has roots in the pharmaceutical
19:46
Speaker 5: manufacturing as well as distribution and pharmacy care. is with
19:51
Speaker 5: us today, Yvonne Dominguez. It's so good to have you
19:55
Speaker 5: here on Twerks.
19:57
Speaker 8: Thank you so much for having me.
19:59
Speaker 5: I'm not going to make you Twerks, but sometimes I've tried.
20:02
Speaker 5: My butt is too. It's too skinny, so I can't twerk.
20:07
Speaker 5: But I've asked other people to do it, and we've tried,
20:10
Speaker 5: and it doesn't work. So nobody can see it. Most
20:12
Speaker 5: of the people that are listening are just listening on
20:16
Speaker 5: audio anyway, so they can't hear the thumping of the twerking.
20:22
Speaker 8: We can fake it, yeah.
20:24
Speaker 5: All right, so a big weekend for me. I'm in
20:28
Speaker 5: Los Angeles for the USC School of Pharmacy panel that
20:32
Speaker 5: are going to be talking about the future of business
20:34
Speaker 5: in pharmacy and how pharmacists are changing. I'm headed to
20:38
Speaker 5: the NCPA in Kansas City, where it's the Super Bowl
20:43
Speaker 5: of independent community pharmacy. Obviously, independent pharmacy cooperative will be there,
20:49
Speaker 5: always there. Supporting independence, this kind of goes back to
20:54
Speaker 5: the very beginnings of my career in independently owned long-term
21:00
Speaker 5: care pharmacies and their focus on seniors. But you also
21:05
Speaker 5: have a rich background. I want you to share it
21:10
Speaker 5: with our listeners. Introduce yourself and let us know how
21:14
Speaker 5: you got involved in the pharmacy industry.
21:18
Speaker 8: Excellent, thank you so much.
21:19
Speaker 10: So yes, I started in this industry at Goldline Laboratories,
21:23
Speaker 10: who is a private label company. At the time in
21:26
Speaker 10: our business, I believe the perception was that generic drugs
21:30
Speaker 10: were made out of someone's garage. The brands were considered
21:34
Speaker 10: the boutique and the high.
21:38
Speaker 8: End of the industry.
21:40
Speaker 10: And consumers were a little skeptical and afraid to take
21:44
Speaker 10: generics as a copy. I would like to think that
21:47
Speaker 10: Goldline as a private labeler who bought directly from manufacturers
21:51
Speaker 10: helped change and shape that. Michael Orlov owned it at
21:55
Speaker 10: the time. And I was lucky enough to spend five
21:58
Speaker 10: years with them, learned a lot about the industry in
22:02
Speaker 10: a variety of capacities there from sales to collections to chargebacks.
22:09
Speaker 10: And that kind of projected me into a retail independent
22:14
Speaker 10: sales capacity. From there, I was lucky enough to be
22:20
Speaker 10: the first person the first inside salesperson who sold the
22:25
Speaker 10: generic source program for Cardinal Health and was with them
22:30
Speaker 10: for nine years through all of their acquisitions. I was
22:34
Speaker 10: with them when they were just one facility. And we,
22:37
Speaker 10: in turn, after nine years and a lot of growth
22:42
Speaker 10: with Whitmire and the different distribution centers, a change came
22:45
Speaker 10: up that allowed me to go to the Northeast and
22:49
Speaker 10: work for H.D.
22:50
Speaker 7: Smith.
22:51
Speaker 8: H.D. Smith at the time had just purchased J.J. Ballin.
22:55
Speaker 10: They were interested in posturing themselves as a primary in
23:00
Speaker 10: the Northeast up against some of the big ones in
23:03
Speaker 10: an area that was very populated with the retail independent pharmacies.
23:09
Speaker 10: So I was with the inside sales team there. And
23:14
Speaker 10: over time, was actually having the opportunity to work with
23:18
Speaker 10: the field team as well.
23:19
Speaker 8: So inside, outside.
23:21
Speaker 10: And continued on to Anda Pharmaceuticals, who I had chased
23:27
Speaker 10: around my entire professional career in the generic drug business.
23:30
Speaker 10: They were amazing. Was with them for five years. And
23:33
Speaker 10: then was with Smith. I got to work for both
23:36
Speaker 10: Smith families, taking on the Integral Program, Integral Rx, was
23:43
Speaker 10: a or is a generic secondary program that was under
23:50
Speaker 10: the Smith Drug umbrella.
23:51
Speaker 5: So the Acquisition Independent Pharmacy Cooperative acquires Integral. We put
23:58
Speaker 5: this press release out. We were excited to announce it.
24:01
Speaker 5: I was also really excited to have you come on
24:06
Speaker 5: Twerks and just give us an overview of this. What
24:08
Speaker 5: does this mean? How does this benefit the independent pharmacy community?
24:14
Speaker 10: Well, it was really important that this program be acquired
24:19
Speaker 10: and taken over versus having Smith Drug just kind of
24:26
Speaker 10: sail into the sunset and remove us from the industry.
24:28
Speaker 10: The independents are consistently behind the eight ball in chasing profits,
24:36
Speaker 10: chasing margins, and trying to strengthen their stance in the business.
24:43
Speaker 10: The generic drug industry is very competitive, as are the
24:51
Speaker 10: independents constantly competing with the big box stores. There are
24:56
Speaker 10: so many areas in the country that don't have support
25:00
Speaker 10: of pharmacies. And so if we don't continue to strengthen
25:04
Speaker 10: this category in our business, you know, that is going
25:08
Speaker 10: to continue to erode over time.
25:10
Speaker 8: Needing....
25:15
Speaker 10: Being able to source generic drugs from credible manufacturers and
25:23
Speaker 10: supply them at a rate that allows a store to
25:26
Speaker 10: gain more margins is incredibly important. It helps offset the
25:31
Speaker 10: expense of brands that stores are experiencing.
25:36
Speaker 8: You know, this category is the most important.
25:40
Speaker 10: It is everybody knows that the brands are basically sold
25:45
Speaker 10: at whack minus. And having a competitive generic price that
25:51
Speaker 10: allows them to offset those, in some cases, negative margins
25:57
Speaker 10: is incredibly important. So we were grateful that this program
26:01
Speaker 10: can continue.
26:02
Speaker 5: Yvonne, I want to go back to something you said.
26:05
Speaker 5: I'm going to read a quote from the press release.
26:09
Speaker 5: And this is from the CEO of IPC, Marcus Senza.
26:14
Speaker 5: And it says, at its core, this acquisition is about
26:19
Speaker 5: preserving and strengthening the relationships that Integral built with independent pharmacies.
26:26
Speaker 5: Integral Rx earned the trust of its customers by delivering value,
26:31
Speaker 5: personalized support, and genuine commitment to independent pharmacy. Those same
26:37
Speaker 5: principles have guided IPC for decades. We believe this combination
26:41
Speaker 5: creates the best possible outcome for pharmacies preserving what made
26:46
Speaker 5: Integral Rx successful while expanding the opportunities available to its customers. Now,
26:53
Speaker 5: when I mix that statement with what you just said
26:55
Speaker 5: about the importance of generics and the profitability of independent
27:01
Speaker 5: community pharmacy, it's two sides of a coin of doing business.
27:06
Speaker 5: It's one side that has to be, we have to
27:10
Speaker 5: make money. You have to make money to stay in business.
27:13
Speaker 5: There's nothing wrong with making money. There's nothing wrong with
27:15
Speaker 5: making profit. But the other side of the coin is
27:19
Speaker 5: a sense of service. It's a sense of trust. It's
27:23
Speaker 5: a sense of preservation and respect for things that have
27:29
Speaker 5: proven successful for independent community pharmacies. And your reputation and
27:35
Speaker 5: your participation, you specifically, is part of that. So the
27:40
Speaker 5: reason why I love working with IPC is when the
27:47
Speaker 5: announcement was made that Smith Drug was closing, the attitude
27:51
Speaker 5: of the IPC team was, how do we help independent
27:55
Speaker 5: community pharmacies that relied on Smith Drug and had trust
28:01
Speaker 5: in Smith Drug to treat them like a business partner
28:05
Speaker 5: and like friends and like people you can trust. And
28:09
Speaker 5: Mark made a statement in an email that was an
28:11
Speaker 5: internal email that basically said to the whole IPC team,
28:16
Speaker 5: we are here to serve these people and to assure
28:20
Speaker 5: that they feel stabilized and that they feel insured. And
28:23
Speaker 5: he even made a statement about if they don't choose IPC,
28:28
Speaker 5: help them find someone else. Help them find somebody else.
28:31
Speaker 5: that they're comfortable with and that they can work with.
28:35
Speaker 5: And that's what I love about the owners of this
28:40
Speaker 5: organization are independent community pharmacy owners. And that spills through
28:47
Speaker 5: the entire organization. It's almost, it's that practice what you preach,
28:51
Speaker 5: walk the walk that you talk in order to ensure
28:55
Speaker 5: that our independent community pharmacies stay in business and stay successful.
29:00
Speaker 5: because that spills over into the communities that they're part of.
29:03
Speaker 5: And the health of those communities is literally on the line.
29:08
Speaker 5: Because when you shut down an independent versus shutting down
29:12
Speaker 5: a chain, those are two very bad things. You don't
29:16
Speaker 5: want to see the chains go out of business. I
29:18
Speaker 5: don't want to see independent community pharmacies go out of business.
29:21
Speaker 5: But when the independent closes because of whatever reason, financial pressures, PBMs,
29:28
Speaker 5: the change of a major vein of wholesale in this case,
29:32
Speaker 5: it cripples the health of that community in so many ways.
29:36
Speaker 5: and so many ways that sometimes the chain doesn't because
29:40
Speaker 5: there's more of an intimate relationship between the independent and
29:44
Speaker 5: their community.
29:45
Speaker 8: There really is.
29:47
Speaker 10: I'm so glad that you said that because what Mark
29:52
Speaker 10: says cascades through the whole organization. And how could you
29:56
Speaker 10: not be motivated and want to continue that when you
30:00
Speaker 10: get to work with a team that cares?
30:05
Speaker 8: I am super grateful. We're excited at what this.
30:08
Speaker 10: Means is giving customers and staff a soft landing in
30:13
Speaker 10: a time when, you know.
30:15
Speaker 8: This is disruptive.
30:16
Speaker 10: We had a variety of people that reached out in
30:19
Speaker 10: the industry that were very caring, asking, you know, are
30:22
Speaker 10: you okay?
30:23
Speaker 8: Is it okay?
30:24
Speaker 10: Ironically enough, today is Smith's last day. where I have
30:30
Speaker 10: the person that I work with was there 27 years
30:33
Speaker 10: would pick orders off the line. And today is his
30:36
Speaker 10: last day going into that building. So, you know, it's
30:41
Speaker 10: really important that, and if you look at IPC's model,
30:45
Speaker 10: they meet the pharmacies where we need them to be.
30:48
Speaker 10: If they're interested in a buying group opportunity, if they're
30:51
Speaker 10: interested in distribution, they have an incredible robust group of
30:56
Speaker 10: resources like yourself that will provide the information, provide the
31:00
Speaker 10: marketing tools. It's really exciting to be part of this
31:04
Speaker 10: next steps and getting to continue on serving an industry
31:10
Speaker 10: that we love.
31:12
Speaker 5: A benefit also is I got to link up with
31:15
Speaker 5: you and didn't get to meet you before this. This
31:18
Speaker 5: was like our first chance of meetings. This is awesome.
31:23
Speaker 5: This has been This Week in Pharmacy. Yvonne Dominguez with Integral,
31:28
Speaker 5: now part of IPC. Yvonne, where would you like listeners
31:34
Speaker 5: to connect with you? What's the best place to do that?
31:37
Speaker 5: Is it email? Is it LinkedIn?
31:38
Speaker 1: LinkedIn.
31:39
Speaker 10: It's both, actually. Yvonne Dominguez at LinkedIn. Yvonne.Dominguez at IPCRX.com.
31:47
Speaker 8: And I'll see you at NCPA.
31:49
Speaker 5: Yes, NCPA. We're coming to Kansas City to celebrate independent
31:54
Speaker 5: community pharmacy. We're so excited. Before we go, there is
31:58
Speaker 5: another big announcement from IPC on This Week in Pharmacy.
32:04
Speaker 5: IPC and Tenovi collaborate. to Advanced Patient Care and Clinical
32:08
Speaker 5: Services in Independent Pharmacies. This is about to know these
32:12
Speaker 5: remote patient monitoring and remote therapeutic monitoring technology. And just
32:19
Speaker 5: like Yvonne said, if you are a pharmacy that is
32:24
Speaker 5: looking at increasing revenue, remote patient services is huge. And
32:29
Speaker 5: there's reimbursements coming from different Medicaid systems, Medicare systems, please
32:35
Speaker 5: talk to IPC about how Tenovi and remote patient monitoring
32:39
Speaker 5: can impact your business and how there are people out
32:42
Speaker 5: there who need these connections. They need to have the
32:46
Speaker 5: monitoring happening so that you can catch things early and
32:50
Speaker 5: be more preventative. Yvonne, this has been terrific. This has
32:54
Speaker 5: been fun. Thank you for being on Twerks.
32:56
Speaker 8: Thank you.
33:01
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34:17
Speaker 12: Last up on Twerk's news, AI is moving from pharmacy
34:20
Speaker 12: experiment to pharmacy infrastructure. Just as NCPA prepares to make
34:25
Speaker 12: AI implementation one of the major topics at its 2026
34:29
Speaker 12: annual convention, health profession regulators are increasingly discussing governance and
34:33
Speaker 12: accountability surrounding AI. NCPA's programming includes real-world AI implementation and
34:39
Speaker 12: operational applications for community pharmacies.
34:42
Speaker 9: Twerk's take.
34:43
Speaker 12: The conversation is changing from should pharmacy use AI to
34:46
Speaker 12: how do we use it responsibly, profitably, and safely?
34:52
Speaker 5: Hey, welcome back to Twerks This Week in Pharmacy. Big Friday,
34:57
Speaker 5: getting ready for the NCPA, National Community Pharmacists Association, the
35:02
Speaker 5: Super Bowl of Independent Community Pharmacy. The reason why I'm
35:07
Speaker 5: so excited about this is I feel like I don't
35:09
Speaker 5: feel I know. We're preparing for 2027, and there's never
35:14
Speaker 5: been a time in pharmacy in general, not just our
35:19
Speaker 5: independence and community, where we have a bunch of initiatives
35:24
Speaker 5: that have been percolating and have been preparing for a
35:29
Speaker 5: year that's going to be filled with additional services that
35:32
Speaker 5: weren't traditional to our pharmacy operators and our pharmacists, like
35:37
Speaker 5: they are going to be very value-based, very clinical tracking,
35:41
Speaker 5: rare disease. We just got back from the NESP and
35:44
Speaker 5: talking about how artificial intelligence is going to now push
35:47
Speaker 5: data into the EHR and exchanging it with the pharmacy
35:50
Speaker 5: management system to really drill down on specific conditions. So
35:56
Speaker 5: this is the time, and this is why NCPA probably
35:59
Speaker 5: puts their event towards the end of the year. It's
36:03
Speaker 5: the preparation for what you are setting up as a
36:07
Speaker 5: strategist in your long-term care pharmacy, in your specialty pharmacy,
36:12
Speaker 5: into your community pharmacy to get ready and make 2027
36:17
Speaker 5: the most profitable year of your operation because that's good
36:21
Speaker 5: for your patients, because that means you get to expand
36:23
Speaker 5: and you get to invest in your company and You
36:26
Speaker 5: know what? This Week in Pharmacy has been so blessed
36:30
Speaker 5: to be able to connect with, it's our number one
36:33
Speaker 5: podcast on the network. And the reason is because we
36:36
Speaker 5: bring in some of the most brilliant minds in pharmacy.
36:40
Speaker 5: A reoccurring correspondent to us is Jessica Daly, a fellow Pittsburgher.
36:45
Speaker 5: Go Steelers. We need all the Steeler wishes that we
36:49
Speaker 5: need right now. But Jessica, welcome back to Twerks.
36:53
Speaker 13: Thanks, Todd. I think we're going to have some overload
36:55
Speaker 13: here because all of us, all three of us now, you, me,
36:58
Speaker 13: and David, all Pittsburghers. So we've overloaded the twerk stream
37:04
Speaker 13: with Steelers.
37:05
Speaker 5: Heck yeah. You introduced our guest today, special guest, David.
37:09
Speaker 5: Thank you for being here. Introduce him and let's get going.
37:12
Speaker 13: All right, sounds good. Yeah, thank you so much. Again, Todd,
37:14
Speaker 13: thanks for having me on the call. And I love
37:18
Speaker 13: that you say you bring the brightest minds onto the
37:20
Speaker 13: podcast because that makes me feel good today on this
37:22
Speaker 13: lovely Friday as you're getting into NCPA. One of the
37:26
Speaker 13: things that you bring me in to talk to your audience,
37:29
Speaker 13: usually about things and challenges that your audience is facing.
37:33
Speaker 13: We talk a lot about drug shortages, about the financial
37:35
Speaker 13: pressures that your listeners are facing. And I'm really excited
37:39
Speaker 13: today to have David Hargraves with us because, yes, we
37:43
Speaker 13: are going to talk about a challenge. But I think
37:45
Speaker 13: the spin that we're going to put on this today, again,
37:47
Speaker 13: as your listeners are getting ready for NCPA and for.
37:51
Speaker 13: all of the great things that are coming in 2027
37:53
Speaker 13: is that there is some positive movement. So one of
37:56
Speaker 13: those challenges that you face, there's actually a bright light
37:59
Speaker 13: on the horizon. So with that, David Hargraves is here
38:02
Speaker 13: to join us today, and we're going to talk about
38:05
Speaker 13: reverse distribution, pharmaceutical reverse distribution. David is the CEO of
38:10
Speaker 13: Pharma Logistics and has been in the pharmacy and in
38:15
Speaker 13: the supply chain organization and for many many years and
38:20
Speaker 13: we've worked together and I've been fortunate to work with
38:23
Speaker 13: David so let's go right here David why don't you
38:27
Speaker 13: tell us a little bit about yourself and about pharma
38:29
Speaker 13: logistics to get us kicked off And I.
38:32
Speaker 14: Will, but for the listeners in here, Jessica and Todd,
38:35
Speaker 14: thanks for having us on today.
38:36
Speaker 15: And Jessica, it's always great to see you. I'd say
38:39
Speaker 15: one thing.
38:39
Speaker 14: I don't really want to talk about pharmaceutical reverse distribution today,
38:43
Speaker 14: but rather I want to talk about some remarkable work
38:45
Speaker 14: that pharmacists themselves had done. Some of them might actually
38:48
Speaker 14: be at NCPA next week. But the work that they
38:52
Speaker 14: did does impact my industry and the pharmaceutical distribution. So
38:57
Speaker 14: it's not about me, not about pharma logistics. It's all
39:00
Speaker 14: about the pharmacist. We'll try to tie that together for
39:03
Speaker 14: you here. Just quickly from a credentialing standpoint, as Jessica mentioned,
39:07
Speaker 14: I'm old. I've been doing healthcare supply chain at least
39:10
Speaker 14: the last 25 years. Used to run clinical supply chain
39:13
Speaker 14: for UPMC, a large healthcare provider, Western Pennsylvania. Spent nine
39:17
Speaker 14: years at Premier leading their supply chain businesses, including their
39:20
Speaker 14: national GPO.
39:22
Speaker 15: And now the last two and a half.
39:23
Speaker 14: Years as CEO of Pharma Logistics, who is the number
39:27
Speaker 14: one market share reverse distributor for independent retail pharmacists and
39:31
Speaker 14: also very large in hospitals and health systems. So the
39:35
Speaker 14: part of that that I want to make sure that
39:37
Speaker 14: the listeners get across is the thread that ties those
39:41
Speaker 14: all together, acute care, hospitals, working for a large national GPO,
39:45
Speaker 14: and then the work here in reverse distribution is this.
39:48
Speaker 14: The question that's been driving me and the passion is,
39:51
Speaker 14: how do I help our healthcare providers? How do I
39:55
Speaker 14: help them keep more of what they earn? How do
39:57
Speaker 14: I help them improve profitability? How can I make it
40:00
Speaker 14: such that they are sustainable and that they can do
40:04
Speaker 14: what they're supposed to do, which is taking care of patients?
40:06
Speaker 15: So that's really the thread all across it today, Jessica.
40:09
Speaker 14: And as I alluded to, some of the work that's
40:12
Speaker 14: been done recently by pharmacists is fantastic because it's 100%
40:14
Speaker 14: aligned with that.
40:18
Speaker 13: No, I love it, David. Anytime that we can promote
40:22
Speaker 13: and show pharmacists how they have power and strength and influence,
40:26
Speaker 13: it's such an important topic. So let's just pause for
40:30
Speaker 13: a second. I think most of the audience will know this,
40:32
Speaker 13: but how about give us a little bit of an
40:35
Speaker 13: idea of what reverse distribution really is. What does it
40:39
Speaker 13: mean so that we can level set for anyone who
40:41
Speaker 13: doesn't maybe deal with that part of the pharmaceutical supply chain?
40:45
Speaker 15: Absolutely. Good point.
40:47
Speaker 14: In this particular audience of listeners, I think we'll be
40:49
Speaker 14: in good shape. This is a really tough one to
40:51
Speaker 14: explain sometimes when you're out in the world in general.
40:54
Speaker 14: But for folks to understand here, when we look at
40:56
Speaker 14: pharmaceutical reverse distribution, here's the core of it. Whether it's
41:00
Speaker 14: an independent retail pharmacy down the street, whether it's a
41:03
Speaker 14: hospital outpatient pharmacy, all dispensing pharmacies end up with some
41:08
Speaker 14: type of excess unsaleable inventory. Typically, it's when the drugs
41:14
Speaker 14: reach its expiration date prior to being dispensed to a patient.
41:17
Speaker 14: But one of the things I want to make real clear,
41:19
Speaker 14: because sometimes people misinterpret it, it's not bad management.
41:23
Speaker 15: This happens.
41:24
Speaker 14: Prescribing patterns can change. A patient can switch their therapy.
41:28
Speaker 14: A shortage can cause you to maybe stock up in
41:31
Speaker 14: advance of it. Or maybe you've got or you break
41:34
Speaker 14: the pack of it. You've dispensed 90 out of a
41:36
Speaker 14: bottle of 100 and you have those left over. The
41:39
Speaker 14: fact is there is always some excess inventory for every
41:43
Speaker 14: pharmacy every year. But what is lesser known is that
41:46
Speaker 14: that excess inventory often can still have value.
41:49
Speaker 15: You can still take that. and extract value from the manufacturers.
41:53
Speaker 14: And when I say value, I mean cash, money that
41:56
Speaker 14: goes back to the dispensing pharmacy to help them with
41:58
Speaker 14: their operations for it. But getting it back is complicated.
42:03
Speaker 14: And that's where the pharmaceutical reverse distribution comes in. Every
42:07
Speaker 14: manufacturer has a different return policy. Some have none. They're
42:11
Speaker 14: sold non-returnable. Controlled substances need DEA paperwork. And then everything
42:16
Speaker 14: has to be destroyed, ultimately, in a compliant fashion and documented.
42:21
Speaker 14: So that's, if you say, what's reverse distribution? It's end-of-life
42:24
Speaker 14: supply chain, specifically for pharmaceuticals. It is nearing expiration date
42:31
Speaker 14: and expired drugs that otherwise are being wasted. The reverse
42:36
Speaker 14: distributor inserts themselves and then adjudicates those drugs to and
42:41
Speaker 14: seeks to go get value for the dispensing pharmacy, returns
42:45
Speaker 14: that in the form of cash back to them. So
42:48
Speaker 14: it's sort of like a pharmacy's collection department for expired inventory,
42:52
Speaker 14: if you will. So the pharmacist can focus on the patient.
42:55
Speaker 14: They can send the drugs to us. We will do
42:57
Speaker 14: all the work we can to get them the maximum
42:59
Speaker 14: amount and then return that value back to them. And
43:02
Speaker 14: in the end, The better they do managing inventory, the
43:05
Speaker 14: better we do getting them value recovered from those expired drugs,
43:09
Speaker 14: then the more profitable they are and they can continue
43:11
Speaker 14: their mission to the point we made earlier.
43:13
Speaker 6: Yeah.
43:14
Speaker 13: So let's talk then. Because there was a very important,
43:17
Speaker 13: in my opinion, I think you'll agree, a very important
43:21
Speaker 13: op-ed that was released in Health Affairs. And you are
43:24
Speaker 13: one of the authors of that op-ed. So you and
43:27
Speaker 13: another former colleague of ours, Shomi Saha, PharmDJD, wrote specifically
43:32
Speaker 13: about some recent changes to state law regarding reverse distribution.
43:39
Speaker 13: So let's talk a little bit about why you wrote
43:42
Speaker 13: that article and why that's so important for this audience
43:45
Speaker 13: and their ability to manufacture value.
43:48
Speaker 10: Fantastic.
43:49
Speaker 15: I love it. You're right.
43:50
Speaker 14: That was really the genesis for why Todd thought it
43:52
Speaker 14: might be good for his listeners here. So for folks,
43:55
Speaker 14: if you want to bookmark this or find it, the
43:57
Speaker 14: article is called To Protect Patient Access, States Must Modernize
44:03
Speaker 14: Drug Return Laws. And so that is, if you search
44:06
Speaker 14: on that, you'll go and find it. It is published
44:09
Speaker 14: in Health Affairs.
44:09
Speaker 15: It's not behind a pay firewall, so you can read
44:11
Speaker 15: it freely.
44:12
Speaker 14: And what we were doing with that article and the
44:15
Speaker 14: reason we published it is when I learned about the
44:19
Speaker 14: news and we learned about it because we have to
44:21
Speaker 14: adjust our content. to adjust to these now updated state
44:25
Speaker 14: laws in a couple of states. So let me explain
44:28
Speaker 14: to readers what this is, why it's important to them.
44:31
Speaker 14: So you have a couple of states, Virginia and Mississippi,
44:36
Speaker 14: where the pharmacists got together and it's so appropriate here
44:40
Speaker 14: with NCPA coming up, they got together and they worked
44:44
Speaker 14: through their state legislature and they passed new laws. And
44:48
Speaker 14: the new laws that they passed, and we can go
44:51
Speaker 14: into it in some more detail, essentially change and override Trump,
44:55
Speaker 14: the manufacturer's return policies for certain classes of drugs. And
45:00
Speaker 14: when I saw that, I went, well, look, there's so
45:03
Speaker 14: much that's outside of the dispensing pharmacies' control. They can't
45:08
Speaker 14: control reimbursement. They have trouble controlling labor costs and labor availability.
45:12
Speaker 14: PBMs are part of it. But for expired inventory, that
45:16
Speaker 14: is actually something that they can control. But the way
45:20
Speaker 14: that Virginia and Mississippi controlled it was amazing. So fundamentally,
45:24
Speaker 14: we wrote the article because I wanted to shine a
45:27
Speaker 14: light on pharmacists and lawmakers in those states who working together,
45:34
Speaker 14: what they accomplished, and mostly to encourage other people to
45:38
Speaker 14: build on it. It's really a tremendous accomplishment that they did.
45:43
Speaker 14: And so I got with Shomi Saha, Dr. Shomi Saha,
45:46
Speaker 14: another PharmD like Jessica. And she used to run the
45:50
Speaker 14: Washington lobbying office for us at Premier. And so she
45:53
Speaker 14: and Jessica and I did a lot of great work
45:55
Speaker 14: on the Hill with legislation in the past, for the
45:58
Speaker 14: benefit of our healthcare providers. I saw this and I
46:01
Speaker 14: was like, hey, show me. First off, help me understand
46:03
Speaker 14: it because of her background, what they did. And then
46:06
Speaker 14: we decided to publish out that article again, just to
46:09
Speaker 14: shine the light on some pharmacists and the great work
46:11
Speaker 14: they did to really change their situation as it relates
46:15
Speaker 14: to drug expiration and manufacturer return policies.
46:20
Speaker 13: So what is it that Virginia and Mississippi actually did?
46:24
Speaker 13: Because it sounds like, and I know that I'm sort
46:27
Speaker 13: of leading the witness a little here, right? It sounds
46:29
Speaker 13: like there's a lot of variability. So what have Mississippi
46:32
Speaker 13: and Virginia done that is so groundbreaking?
46:35
Speaker 15: Sure.
46:36
Speaker 14: Well, let's say, I'd say at the highest level, they
46:39
Speaker 14: did locally what has never been done federally. So if
46:42
Speaker 14: we put that frame first, I think it's important for
46:45
Speaker 14: the listeners to understand that return policies are specific by manufacturer.
46:52
Speaker 14: And even in any given manufacturer, they can be different
46:55
Speaker 14: by drug or by the date of sale. So there's
46:59
Speaker 14: a lot of complexity into how manufacturers return policies work.
47:03
Speaker 14: And some manufacturers effectively have, you know, they're sold non-returnable.
47:07
Speaker 14: They effectively don't have a return policy for it. So
47:11
Speaker 14: what happened in these two states is is they went
47:15
Speaker 14: and said, hey, listen, I think in my state, if
47:19
Speaker 14: you want to be part of my state drug assistance
47:22
Speaker 14: program— this would be the Mississippi example— they said, then you're going
47:26
Speaker 14: to have to have a return policy in order to
47:28
Speaker 14: do so. And so they tied the benefit of that
47:31
Speaker 14: state drug assistance program to the need for having— a
47:36
Speaker 14: return policy inside it. So said another way, they said, hey, listen,
47:39
Speaker 14: as a pharmacy, I shouldn't have to eat the cost
47:41
Speaker 14: of the expired drugs all by myself, me, the pharmacist.
47:45
Speaker 14: So what it says is that starting in 2025, manufacturers
47:48
Speaker 14: have to accept returns of outdated drugs, full bottles, and partials.
47:54
Speaker 14: That was one of the material differences for up to
47:56
Speaker 14: six months after the expiration date for either full credit
48:00
Speaker 14: or for replacement. And that part where they went from
48:03
Speaker 14: full bottles to partials, That's huge because that's actually the
48:07
Speaker 14: biggest material change, a change folks will notice because many
48:11
Speaker 14: of them did not allow credits for partials. The other
48:14
Speaker 14: thing is because like the Mississippi law actually had a
48:17
Speaker 14: version going back to 27-2007. But in this modern one
48:22
Speaker 14: in 2025, they added some teeth to it. And that
48:25
Speaker 14: was the part that I mentioned. So in Virginia, if
48:27
Speaker 14: a manufacturer doesn't comply, its product can't be used for
48:31
Speaker 14: therapeutic substitution in the state. So a pharmacist can't dispense
48:36
Speaker 14: it as an equivalent generic. And then in Mississippi, as
48:38
Speaker 14: I mentioned before, a noncompliant manufacturer can get shut out
48:42
Speaker 14: of those state drug assistance programs. So two states, both
48:46
Speaker 14: improving their situation, do pharmacist activism with their state legislator,
48:53
Speaker 14: changing those rules and putting some teeth behind them. to
48:56
Speaker 14: ensure and really just better their situation. That's the core
48:59
Speaker 14: of it. You can read all the detail, incredibly well
49:02
Speaker 14: written by Shomi, who also happens to have a JD.
49:06
Speaker 14: So she did a great job inside there writing it.
49:09
Speaker 14: And that's the part where I want to highlight for
49:10
Speaker 14: the listeners.
49:12
Speaker 13: So I know we're getting up on time here, but
49:15
Speaker 13: I do have two more questions for you, David, just
49:17
Speaker 13: kind of rapid fire for you here right now. So
49:20
Speaker 13: we're talking about states making changes, but why not the
49:23
Speaker 13: federal government? Why are we looking to the states?
49:26
Speaker 15: Yeah, there's two views, and I just can go quickly.
49:30
Speaker 14: The federal government has largely been silent on this, this
49:33
Speaker 14: issue of manufacturer return policies outside of controlled substance. It's
49:37
Speaker 14: important for listeners to know there is no federal requirement
49:40
Speaker 14: that a manufacturer take back expired product from a pharmacy.
49:44
Speaker 14: Every one of those is a commercial decision by each manufacturer.
49:48
Speaker 14: And like I said, there's a lot of variability. I
49:51
Speaker 14: don't know that that's a bad thing, right? Because you're
49:53
Speaker 14: letting the manufacturers commercially do it, and there's increased competition
49:57
Speaker 14: and decision points. But could Congress fix it someday? Sure
50:02
Speaker 14: they could. Here's the thing, though. But today, pharmacies are closing. Actually,
50:07
Speaker 14: NCPA themselves, if you take a look, they published a
50:10
Speaker 14: stat out there And the status, it's pretty significantly. I
50:15
Speaker 14: want to say that at NCPA, they said roughly 450
50:19
Speaker 14: communities in a given year lose their pharmacy. That can
50:23
Speaker 14: lead to pharmacy deserts. That can lead to decreased patient access.
50:27
Speaker 14: And so it's a bad thing for us. So could
50:29
Speaker 14: the federal government fix it?
50:30
Speaker 15: Sure.
50:31
Speaker 14: What I like about it, though, is there's pharmacies that
50:33
Speaker 14: are closing now. And states have the ability to act.
50:37
Speaker 14: So act now. You don't have to wait for Washington.
50:41
Speaker 14: A state legislation can do it in a single session.
50:44
Speaker 14: And now you've got two states out there that have
50:45
Speaker 14: already have a model, maybe so that some other pharmacists
50:48
Speaker 14: and their association will want to follow. All right.
50:51
Speaker 13: So I think that really brings me right to that
50:53
Speaker 13: last question in the next 30 seconds, David, right? You've
50:56
Speaker 13: got the audience here listening. They're learning about what's happening
50:59
Speaker 13: in the states that they might practice in. What would
51:02
Speaker 13: you tell those pharmacists that they could do today or
51:05
Speaker 13: tomorrow to move this forward?
51:07
Speaker 14: What I would say to them is they probably don't
51:11
Speaker 14: understand the power that they have. When pharmacists can unite,
51:15
Speaker 14: typically through state associations or national associations, like the one
51:19
Speaker 14: that Todd is going to, their voices amplified, can be heard,
51:24
Speaker 14: and absolutely can make change that in turn benefits them,
51:29
Speaker 14: which in turn benefits the patients. So there's no reason
51:32
Speaker 14: not to act. I'd encourage everyone to take a look
51:34
Speaker 14: at this article, understand the models before it.
51:37
Speaker 15: And listen, we all have challenges in our industry.
51:40
Speaker 14: This is just a great example of people choosing to
51:44
Speaker 14: act to make their situation better and ultimately to improve
51:47
Speaker 14: patient access. And that just, again, as I've mentioned at
51:50
Speaker 14: the beginning, it's what I've been doing the last 25 years.
51:52
Speaker 15: I love it.
51:53
Speaker 14: It's inspiring and it's actionable. There's work that can be
51:56
Speaker 14: done today. That was the whole reason for it to
51:59
Speaker 14: put it out here. And I appreciate Todd having Jessica
52:02
Speaker 14: to have the opportunity to talk about it here today.
52:05
Speaker 5: This is awesome.
52:06
Speaker 15: Thank you, David.
52:06
Speaker 5: This is awesome. Thank you, Jessica, for such a A
52:09
Speaker 5: great guest, David. We have to have you back. Probably
52:13
Speaker 5: I'd like to have you come into the studio and
52:15
Speaker 5: be able to chill out together instead of always being
52:19
Speaker 5: on a Zoom.
52:20
Speaker 15: Yeah, absolutely. I would love the opportunity, Todd. Thank you
52:23
Speaker 15: so much.
52:24
Speaker 5: All right. If you're headed to NCPA, make sure that
52:27
Speaker 5: you connect with me. I will be around the entire
52:31
Speaker 5: exhibit floor both days. The first day, we're going to
52:34
Speaker 5: be at your RAL Pharma's booth, and we'll be ready
52:38
Speaker 5: to talk about clinical discussions as well as some of
52:41
Speaker 5: your business discussions. Reach out to me. You can find
52:45
Speaker 5: me on LinkedIn. If you want to email me, Yuri,
52:48
Speaker 5: that's E-U-R-Y at pharmacypodcast.com. We will have a connection to
52:53
Speaker 5: Jessica and David's LinkedIn in the show notes. Take a
52:58
Speaker 5: look at that. And thank you for listening to This
53:00
Speaker 5: Week in Pharmacy.
53:24
Speaker 12: Thank you.