Latest / Pharmacy Podcast Network / Asembia's Specialty Pharmacy Summit 2026 Rewind | Part 4/6

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Asembia's Specialty Pharmacy Summit 2026 Rewind | Part 4/6 · Pharmacy Podcast Network

• 0:08
  Speaker 1: Better patient outcomes start with the right technology partners. JB
• 0:11
  Speaker 1: Consulting helps pharmacies deliver superior clinical care and enhance patient
• 0:15
  Speaker 1: experiences through smart technology solutions. Our products help pharmaceutical manufacturers
• 0:20
  Speaker 1: improve patient access and build stronger pharmacy relationships. JB Consulting.
• 0:25
  Speaker 1: Where pharmaceutical expertise meets cutting edge technology, visit Jbconsulting dot com.
• 0:43
  Speaker 2: You are listening to the global network of podcasters dedicated
• 0:47
  Speaker 2: to the pharmacy profession. Welcome to the Pharmacy podcast Network.
• 1:03
  Speaker 3: Each year, assembia's Specialty Pharmacy Summit is at the epicenter
• 1:07
  Speaker 3: of the pharmacy industry, providing a unique opportunity for stakeholders
• 1:11
  Speaker 3: throughout the industry to understand challenges, generate solutions, and define
• 1:16
  Speaker 3: the future. This is the pharmacy podcast networks Assembia twenty
• 1:20
  Speaker 3: twenty six rewind We're dedicated to bringing you inside coverage
• 1:27
  Speaker 3: of the pharmacy Nation's biggest events with on the street
• 1:30
  Speaker 3: style interviews with keynote speakers, attendees, exhibitors, and recurring guests
• 1:35
  Speaker 3: who make each year special. Stay tuned each week for
• 1:38
  Speaker 3: a new episode of this special six part series on
• 1:41
  Speaker 3: the ASSEMBIA twenty twenty sixth summit held this year in
• 1:44
  Speaker 3: Las Vegas.
• 1:50
  Speaker 4: Hey, Shawn Jensen here from the DV Consulting Group, and
• 1:52
  Speaker 4: you're listening to the Pharmacy Podcast Network.
• 1:57
  Speaker 5: Sean Jensen, How are you. It's nice to see you.
• 2:01
  Speaker 6: Hey Todd, so good to see you too.
• 2:02
  Speaker 5: Why don't we only get to hang out when we
• 2:05
  Speaker 5: come to work? Like you and I never get time
• 2:08
  Speaker 5: to just go get a drink or watch a ball
• 2:11
  Speaker 5: game or something like. We're always working.
• 2:13
  Speaker 4: Yeah, but that's actually going to change.
• 2:15
  Speaker 6: It's gonna change this in May.
• 2:16
  Speaker 4: Actually, I'm coming out to Pittsburgh area for a couple
• 2:20
  Speaker 4: of days for a customer I'm working with us.
• 2:22
  Speaker 5: Yeah, all right, big announcement. I'll be hanging out, hanging
• 2:26
  Speaker 5: out at Pittsburgh freaking News right here. That's right, all right.
• 2:28
  Speaker 5: So I want to know we're really focused on really
• 2:32
  Speaker 5: three core themes during Assembia during the podcast press coverage
• 2:37
  Speaker 5: women's health, selling gene therapy, a shout out to Joe
• 2:41
  Speaker 5: Depinto with mckessony did an amazing job, and AI AI and
• 2:46
  Speaker 5: specialty pharmacy specifically. So that's why I was so excited
• 2:49
  Speaker 5: that you were coming back to the show. You've been
• 2:51
  Speaker 5: a reoccurring guest over the years, always at a SEMBIA,
• 2:54
  Speaker 5: at NASP, even on twerks. But talk to me, talk
• 2:58
  Speaker 5: to me from your perspective, because that's all you guys
• 3:00
  Speaker 5: are really doing right now, is what's your advice to
• 3:03
  Speaker 5: the first time attendees in those like they're wondering the
• 3:08
  Speaker 5: halls here, how to get the most out of Assembia.
• 3:11
  Speaker 4: Yeah, I mean, great question. There's a I'll say in
• 3:14
  Speaker 4: terms of the hall here, this where we're sitting, there's
• 3:16
  Speaker 4: there's so many vendors right now. I think it's probably
• 3:19
  Speaker 4: got to be overwhelming for not even a first time
• 3:22
  Speaker 4: attend to anybody here who's trying to decide, like which
• 3:24
  Speaker 4: of these vendors to partner with, you know, which of
• 3:26
  Speaker 4: these AI companies to go with? Are they going to
• 3:28
  Speaker 4: be in business a year from now, Like there's so
• 3:31
  Speaker 4: many unknowns, and just walking by and reading the signage,
• 3:34
  Speaker 4: it's not totally clear, you know, what some of these
• 3:36
  Speaker 4: companies are even doing here. I could see be really overwhelming.
• 3:40
  Speaker 4: So I would just say, you know, take the time
• 3:45
  Speaker 4: to listen, talk to them, but like find out who
• 3:47
  Speaker 4: they're working with, Talk to the customers, talk to their customers,
• 3:50
  Speaker 4: you know, find out because you know, everyone here is
• 3:52
  Speaker 4: selling the same stories, the same solving the same problems,
• 3:55
  Speaker 4: and a lot of these companies are really new at
• 3:56
  Speaker 4: you're saying time.
• 3:57
  Speaker 7: Yeah, so.
• 4:00
  Speaker 5: The pharmacy management landscape is has been condensing. However, there
• 4:06
  Speaker 5: are still gaps in many of the systems are out
• 4:09
  Speaker 5: there that the pharmacy has needs, either in workflow or
• 4:14
  Speaker 5: something that's communication with the patient or something. So tell
• 4:17
  Speaker 5: us about the pharmacy management system landscape from your perspective
• 4:21
  Speaker 5: and how a JB Consulting fits into that.
• 4:24
  Speaker 4: Yeah, I mean, great question. The really like with the
• 4:27
  Speaker 4: consolidation that you said in the narrowing, Like on the
• 4:29
  Speaker 4: retail side, it's like eighty ninety percent market share now
• 4:33
  Speaker 4: under red sale. There's a couple other you know, large
• 4:36
  Speaker 4: price ticket, you know, other alternatives. No matter what you pick,
• 4:40
  Speaker 4: you're always trying to stitch something together. You're always adding
• 4:43
  Speaker 4: something to customize it. You know, some people feel nickeled
• 4:47
  Speaker 4: and dying when they have to make customizations. Even if
• 4:49
  Speaker 4: you're willing to pay, you're getting a long line a
• 4:51
  Speaker 4: lot of times. So you know, nothing's perfect. And some
• 4:54
  Speaker 4: of the lower end systems, like the price points almost zero,
• 4:57
  Speaker 4: it's like negligible, but like what's what's free? You know,
• 5:00
  Speaker 4: you got to ask yourself like how many how much
• 5:02
  Speaker 4: time is being wasted by your team and how many
• 5:05
  Speaker 4: big workarounds and band ais are you putting on? How
• 5:08
  Speaker 4: much just human labor do you put into solving these problems?
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  Speaker 5: So one thing JB is done.
• 5:14
  Speaker 4: We have built because people it's to buy or build.
• 5:16
  Speaker 4: Everyone always wants to know, like what's what system should
• 5:18
  Speaker 4: I go with? And will help migrate between systems? You know,
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  Speaker 4: we're agnostic whichever platform you're going to or coming from.
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  Speaker 4: You know, we're happy to help manage that integration process.
• 5:27
  Speaker 4: But we've built pharmacy systems. So even some of these
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  Speaker 4: companies that wish they could build their own, they don't
• 5:32
  Speaker 4: know where to start. They know it's going to be
• 5:33
  Speaker 4: millions and millions of dollars, you know, it's not We
• 5:36
  Speaker 4: have like white label solutions that people have bought and
• 5:38
  Speaker 4: they're modular and you know, for the most part, a
• 5:40
  Speaker 4: lot of it's a commodity. Like most of the stuff
• 5:42
  Speaker 4: that goes through that system is they're the same between
• 5:45
  Speaker 4: all of them. And that's what you know, we've already
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  Speaker 4: built that for twenty years, building things like that, but
• 5:50
  Speaker 4: the customization who you integrate with, what partners are integrating with.
• 5:53
  Speaker 4: So that's where having that flexibility really build it yourself
• 5:56
  Speaker 4: and at the end you can own the source code.
• 5:58
  Speaker 4: I mean, it's really an interesting choice, you know, And
• 6:02
  Speaker 4: the camullity came from a demand. People were asking us,
• 6:04
  Speaker 4: you know, we want to build the system, but it's
• 6:06
  Speaker 4: just overwhelming.
• 6:07
  Speaker 7: What are we going to start?
• 6:07
  Speaker 4: And that's something JB's been helping companies do, you know,
• 6:10
  Speaker 4: kind of quietly. And it's white labeled. So if anyone
• 6:13
  Speaker 4: out there is listening they want a pharmacy management system,
• 6:15
  Speaker 4: it's not as big an endeavor as you might think.
• 6:17
  Speaker 4: And you know, take control of your operation, do whatever
• 6:20
  Speaker 4: you want, you know, so you.
• 6:22
  Speaker 5: Reach out and at least just ask questions. Let me
• 6:24
  Speaker 5: get you reach out to JB Consulting Group and just
• 6:27
  Speaker 5: be like, hey, here's what I'm here's what I want
• 6:30
  Speaker 5: to do, here's what I've already invested in, here's the
• 6:33
  Speaker 5: tools I already have. Is their way to build something
• 6:37
  Speaker 5: different for us because we're maybe you're doing long term
• 6:40
  Speaker 5: care at home infusion and a little bit of traditional
• 6:45
  Speaker 5: LTC DM, who knows, but yeah, there might be gaps
• 6:48
  Speaker 5: in your system that you have an opportunity to to
• 6:52
  Speaker 5: solve that problem for them. And that's what you guys
• 6:55
  Speaker 5: have been famous for really over the you said, last
• 6:58
  Speaker 5: twenty years of being in business and developing software. We
• 7:02
  Speaker 5: our theme is AI and specialty pharmacy. So since the
• 7:07
  Speaker 5: last time that we talked, what's come up? What's what's
• 7:10
  Speaker 5: happening or where are we shifting to or what's the
• 7:13
  Speaker 5: success story you can share with us regarding AI and
• 7:16
  Speaker 5: specially I.
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  Speaker 4: Mean, I think it's interesting. You're seeing adoption, You're seeing
• 7:21
  Speaker 4: people automating the level tasks. Obviously you see a lot
• 7:24
  Speaker 4: of vendors here helping to do that where you're interestingly,
• 7:28
  Speaker 4: you're not seeing the decline in headcount. So it's not like, hey,
• 7:32
  Speaker 4: we were able to automate fifty hours, so now we
• 7:34
  Speaker 4: don't have text anymore. Now we don't have you know,
• 7:37
  Speaker 4: we got rid of two of our best pharmacists and
• 7:38
  Speaker 4: you don't see any of that anywhere. So people are
• 7:40
  Speaker 4: still trying to figure out, like, all right, they're saving time,
• 7:43
  Speaker 4: are they like using that to reinvest that time?
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  Speaker 7: Which is what the hope always was.
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  Speaker 4: I don't want robots replacing pharmacists replacing people if it
• 7:51
  Speaker 4: can take some of the job away and make.
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  Speaker 7: Other parts better.
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  Speaker 4: Sure, unlike someone like as a society, like the you know,
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  Speaker 4: the larger things.
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  Speaker 7: Not to get too deep, but like the.
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  Speaker 4: There are concerns that AI that are obviously telling you
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  Speaker 4: put glue on a pizza to keep this cheese on.
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  Speaker 4: Some of the scary dark stuff that's coming out. That's
• 8:08
  Speaker 4: where like to me, I like the the automation, like, hey,
• 8:12
  Speaker 4: read this hundred page document and tell me what it is.
• 8:14
  Speaker 4: Like I got a weird credit card statement thing that
• 8:16
  Speaker 4: was eight pages long. I just took a picture and
• 8:18
  Speaker 4: was like, is there anything I need to know about this?
• 8:20
  Speaker 4: Just out of curiosity. He was like, no, not really.
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  Speaker 4: So sure AI is good for that, but making decisions
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  Speaker 4: advising people like I don't know, that's where it gets
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  Speaker 4: scary in any industry, and like especially with healthcare, So
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  Speaker 4: we got to be really careful where we're treading with it.
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  Speaker 4: I'm not a doomsday guy or anything like that by
• 8:35
  Speaker 4: any means, but that's you know, I think once we
• 8:39
  Speaker 4: crossed that area into advice and guidance, you know, that's
• 8:43
  Speaker 4: where things are going to get go off the guard. Rails,
• 8:46
  Speaker 4: at least initially, and we'll see what Happenan what do
• 8:48
  Speaker 4: you think?
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  Speaker 7: What?
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  Speaker 6: Well?
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  Speaker 5: I know that AI is impacting humanity in general already
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  Speaker 5: where there was a study I can't remember who did it,
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  Speaker 5: but the uh generational study of intelligence. It's the first
• 9:02
  Speaker 5: time that the latest of generations are less intelligent based
• 9:07
  Speaker 5: on a measurement than the last generation. And they're all
• 9:11
  Speaker 5: tying this back to people, students, children skipping steps because
• 9:18
  Speaker 5: of the accessibility of information. And not to sound like
• 9:22
  Speaker 5: I'm the old guy in the room, but really, when
• 9:25
  Speaker 5: I had to do a book report, when I had
• 9:28
  Speaker 5: to do a research project, I had to physically go
• 9:32
  Speaker 5: to the library, go to the Dewey decimal system, for
• 9:36
  Speaker 5: god's sakes, look up the book. Go find the book,
• 9:40
  Speaker 5: sit down, read, read, read, take notes, take notes, and
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  Speaker 5: develop my report. That taught me something about research, that
• 9:48
  Speaker 5: taught me something about information. We have lost that component
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  Speaker 5: of learning, and I think quick to everything is not
• 9:57
  Speaker 5: good in all sense, In all senses, I think when
• 10:00
  Speaker 5: and you remember the old movie The Karate Kid, right,
• 10:04
  Speaker 5: and Daniel LaRusso right, he had to do the same
• 10:08
  Speaker 5: action where he was paint the fence, paint the fence up,
• 10:11
  Speaker 5: paint the fence down, paint defence up. And he had
• 10:13
  Speaker 5: to do it in a specific way. He wasn't allowed
• 10:16
  Speaker 5: to just do it however he wanted, and he didn't
• 10:18
  Speaker 5: understand why do I have to do this over and
• 10:20
  Speaker 5: over and over again. Then all of a sudden it
• 10:22
  Speaker 5: was put into action, and he's like, holy cow, I
• 10:25
  Speaker 5: just blocked. It was like a crane style block. Like,
• 10:28
  Speaker 5: I understand now why that was necessary. Throw AI into that,
• 10:33
  Speaker 5: I mean, even into martial arts, and you're going to
• 10:36
  Speaker 5: get your ass kicked because you've shortened the process of
• 10:41
  Speaker 5: getting to a conclusion. And I think that AI, while
• 10:45
  Speaker 5: it's fascinating, it's less dangerous to you and I in
• 10:49
  Speaker 5: our psyches as fifty plus year old men that have
• 10:54
  Speaker 5: already gone through what we had to go through to
• 10:56
  Speaker 5: get here. We didn't have cell phones, we didn't have
• 10:59
  Speaker 5: you know, video games. We don't like like that there
• 11:01
  Speaker 5: is today. So that's my issue is I think that
• 11:04
  Speaker 5: it's deteriorating components of humanity because of the quickness and
• 11:09
  Speaker 5: the access of information.
• 11:10
  Speaker 7: Yeah, no, it's really well put.
• 11:13
  Speaker 4: I mean I think kids today they're using spell check
• 11:15
  Speaker 4: and they don't even know what to pick because they
• 11:17
  Speaker 4: don't know how to spell anyway. They're just picking the
• 11:19
  Speaker 4: first choice that comes up, and it's like changing what
• 11:21
  Speaker 4: they're writing into nonsense. It's like they don't true, they're
• 11:24
  Speaker 4: not learning any of the fundamentals.
• 11:25
  Speaker 5: But is there anything that you can give out or
• 11:29
  Speaker 5: talk to our listeners about. Listening to the show that
• 11:32
  Speaker 5: JB Consulting is doing it, you think is pretty exciting
• 11:35
  Speaker 5: coming up.
• 11:37
  Speaker 4: I think we're always doing something exciting because I'm a
• 11:39
  Speaker 4: big nerd.
• 11:40
  Speaker 5: I love this stuff. But no, I mean absolutely, I.
• 11:43
  Speaker 4: Think that we're reaching the wheels of the where data
• 11:48
  Speaker 4: flows and goes between both you know, the pharmacies sending it,
• 11:51
  Speaker 4: but also the companies who are receiving it behind the scenes.
• 11:54
  Speaker 4: We've always just been helping increase those wheels and making
• 11:57
  Speaker 4: that better, but we're seeing more to can seeing really
• 12:01
  Speaker 4: connection between the entities through the data share Sosig'm as
• 12:03
  Speaker 4: much like data and telling a story, but see if
• 12:06
  Speaker 4: we can't use that to technology to really connect pharmacy
• 12:10
  Speaker 4: to pharma, you know, to the health plan to the
• 12:13
  Speaker 4: provider and really seeing like that ecosystem be built that
• 12:16
  Speaker 4: you know, interoperability promised us for the last few decades.
• 12:20
  Speaker 4: It's kind of like behind the scenes on the data
• 12:22
  Speaker 4: share side, I'm seeing companies coming to us for the
• 12:25
  Speaker 4: first time. They don't just want the data, they want
• 12:27
  Speaker 4: to know how to use that to establish the relationship
• 12:30
  Speaker 4: and create that bridge and that like plumbing that'll really
• 12:33
  Speaker 4: connect this like ecosystem, and there's companies trying to build
• 12:35
  Speaker 4: the whole ecosystem and being go on forever about that.
• 12:38
  Speaker 4: But now that's an interesting thing. I think, you know,
• 12:40
  Speaker 4: connection is coming out of the interoperability, and that's what
• 12:43
  Speaker 4: we're kind of seeing people coming to us for. So
• 12:45
  Speaker 4: stay tuned.
• 12:46
  Speaker 5: It'll be cool to see what happens. All right, JB
• 12:48
  Speaker 5: Consulting Group, Sean Jensen, thanks for being on the Assembia
• 12:53
  Speaker 5: twenty twenty sixth show. Yeah, thank you for having me time.
• 12:55
  Speaker 4: Pleasure is always say.
• 12:59
  Speaker 1: Hi.
• 13:00
  Speaker 8: This is Lindsay Greenleaf with ADVI Health and you are
• 13:02
  Speaker 8: listening to the Pharmacy Podcast.
• 13:06
  Speaker 5: Lindsay, Welcome to ASSEMBIA twenty twenty six post podcast press
• 13:10
  Speaker 5: coverage show. We're so excited to have you here.
• 13:13
  Speaker 9: Thanks for having me.
• 13:14
  Speaker 5: All right, So you've been extremely busy here at ACEMBIA.
• 13:17
  Speaker 5: You were on a panel discussion on a subject that
• 13:20
  Speaker 5: we have not tackled yet on this show. So we're
• 13:23
  Speaker 5: so excited that you're here. I area Inflation Reduction Act
• 13:30
  Speaker 5: and the Most Favored Nation and Trump OREX and blah
• 13:35
  Speaker 5: blah blah. I mean, if you don't have the right
• 13:37
  Speaker 5: people talking about these things, it kind of gets lost
• 13:40
  Speaker 5: in the weeds. So talk to us about this from
• 13:43
  Speaker 5: your perspective, your experience, but also this panel discussion, talk
• 13:48
  Speaker 5: to us about how this went.
• 13:49
  Speaker 8: Yes, it's a lot of acronyms in our world and
• 13:52
  Speaker 8: the policy market access world at ADVI, but on our panel,
• 13:55
  Speaker 8: we talked about the biggest policy issues facing manufacturers. Most
• 14:00
  Speaker 8: notably started off with MFN most Favored Nation drug pricing
• 14:04
  Speaker 8: developments coming out of the Trump administration. Talked about the
• 14:07
  Speaker 8: latest status with we now have seventeen companies that have
• 14:10
  Speaker 8: these voluntary deals with the White House. They're volunteering to
• 14:13
  Speaker 8: give most Favored Nation pricing to most of not all
• 14:16
  Speaker 8: of their drugs.
• 14:17
  Speaker 9: In Medicaid and for new launches.
• 14:19
  Speaker 8: We talked a lot about that the implications that's going
• 14:21
  Speaker 8: to have for xus launches or the lack thereof. Also
• 14:26
  Speaker 8: talked a lot about, as you said, the IRA, the
• 14:28
  Speaker 8: Inflation Reduction Acts, government negotiation policy. This is the law
• 14:33
  Speaker 8: that passed in twenty twenty two under the Biden administration
• 14:37
  Speaker 8: to impose what folks will often refer to as Medicare.
• 14:40
  Speaker 6: Negotiation or government negotiation.
• 14:42
  Speaker 9: Of drug pricing.
• 14:43
  Speaker 8: I like to refer to it as government price setting.
• 14:46
  Speaker 8: It's not much of a negotiation process. But what we
• 14:48
  Speaker 8: talked about today is the status of the negotiation program.
• 14:53
  Speaker 8: As of today, there are ten drugs, ten pharmacy benefit
• 14:57
  Speaker 8: drugs and Medicare partty subject to a government set negotiated price.
• 15:01
  Speaker 8: What's going on with them, how's the part D effectuation going,
• 15:06
  Speaker 8: the effectuation for the pharmacies themselves, and what's going on
• 15:11
  Speaker 8: with the other negotiations for I Pay what we call
• 15:14
  Speaker 8: ipay twenty twenty seven and I Pay twenty twenty eight.
• 15:17
  Speaker 8: These are additional drugs that will be subject to a
• 15:20
  Speaker 8: negotiated price darting next year in twenty twenty.
• 15:21
  Speaker 6: Eight on more So spoke to our panelists about all
• 15:25
  Speaker 6: of that.
• 15:26
  Speaker 8: One thing that was interesting that we got to talk
• 15:28
  Speaker 8: about is the patient perspective of the inflation reduction acts
• 15:33
  Speaker 8: and what's going on with these drugs subject to a negotiated.
• 15:35
  Speaker 9: Price right now? Our team at adv We have a data.
• 15:39
  Speaker 8: Analytics team ADVSAVES that has access to one hundred percent
• 15:43
  Speaker 8: Medicare Medicaid claims data. They did a quick analysis for
• 15:47
  Speaker 8: us before we came out here to Assembia, looking at
• 15:50
  Speaker 8: average out of pocket costs for patients taking the ten
• 15:53
  Speaker 8: drugs that are subject to a negotiated price right now.
• 15:56
  Speaker 8: They looked at their costs for Q one and twenty
• 15:58
  Speaker 8: twenty six compared to Q one of last year. It
• 16:01
  Speaker 8: was interesting, on average, patient out of pocket costs are
• 16:05
  Speaker 8: only about six percent lower across all ten drugs. You
• 16:09
  Speaker 8: go through this whole negotiation process, the manufacturers are taking
• 16:12
  Speaker 8: a big hit financially, and you're getting six percent on
• 16:16
  Speaker 8: average of out of pocket savings. That was an average.
• 16:20
  Speaker 8: That's an average number I'm giving you in Bruvca. I
• 16:23
  Speaker 8: would note patients taking in Bruvica are worse off under
• 16:28
  Speaker 8: this scheme. They on average, they're out of pocket costs
• 16:30
  Speaker 8: for Q one of twenty six were twelve percent higher
• 16:33
  Speaker 8: than they were in twenty twenty five.
• 16:36
  Speaker 9: So the Panels reacted to that.
• 16:38
  Speaker 8: They had gone through the negotiation process themselves and working
• 16:40
  Speaker 8: for manufacturers, and sadly they weren't too surprised. Some of
• 16:45
  Speaker 8: this we knew would be coming. Plans PBMs. They're kind
• 16:49
  Speaker 8: of you know, shifting bitefit design, having a fewer drugs,
• 16:53
  Speaker 8: be on a cope model, hav them switched to a
• 16:55
  Speaker 8: co insurance model. Everybody's kind of squeezing the balloon from
• 16:58
  Speaker 8: different directions. But I think of all the things we
• 17:01
  Speaker 8: talked about on our panel today, that was just one
• 17:03
  Speaker 8: interesting data point that the idea that patients are not
• 17:06
  Speaker 8: all that better off and some are worse off in
• 17:09
  Speaker 8: twenty twenty six.
• 17:10
  Speaker 5: All right, so this is not good news. So we
• 17:13
  Speaker 5: really appreciate you depressing us on the podcast. Now I'm
• 17:16
  Speaker 5: just but what, okay, you have the data, you have
• 17:20
  Speaker 5: this information when you look at everything, is they're a
• 17:26
  Speaker 5: red flag somewhere to say, here's the issue that's keeping
• 17:31
  Speaker 5: us from not driving pricing down, Like, what's the what's
• 17:36
  Speaker 5: the what's the issue, what's the barrier?
• 17:39
  Speaker 8: Oh gosh, Well, we talk a lot about need for
• 17:44
  Speaker 8: more PBM reforms and President Trump's talks all the time
• 17:48
  Speaker 8: about cutting out the middleman. And you see what's going
• 17:50
  Speaker 8: on with Trump r X and the focus on these
• 17:53
  Speaker 8: direct to patient programs and cash pay generally and how
• 17:57
  Speaker 8: GLP ones are changing things, so I think, you know,
• 18:00
  Speaker 8: generally there is this theme of taking close a look
• 18:03
  Speaker 8: at the role played by middleman quite frankly and PBMs.
• 18:07
  Speaker 8: Not everything is appropriate for direct to patient program Not
• 18:10
  Speaker 8: everything's for cash pay obviously.
• 18:12
  Speaker 9: So what else can we do here?
• 18:15
  Speaker 8: We need more substantive reforms on the PBM front. Congress
• 18:21
  Speaker 8: enacted some reforms in February of this year, things that
• 18:25
  Speaker 8: we refer to as de linking D linking PBM compensation
• 18:29
  Speaker 8: from rebates and medicare part D, then mandating rebate passed
• 18:35
  Speaker 8: through for commercial plans.
• 18:36
  Speaker 9: And also some transparency requirements.
• 18:39
  Speaker 8: That's notable, yes, But as we talked to our panelists
• 18:42
  Speaker 8: about today and the folks that we work with are
• 18:45
  Speaker 8: telling us, is it really going to change all that much?
• 18:48
  Speaker 9: Maybe? Probably not.
• 18:49
  Speaker 8: It's really hard to have significant, notable change that's going
• 18:52
  Speaker 8: to take down drug costs while also helping patient access.
• 18:55
  Speaker 9: When you have three PBMs.
• 18:58
  Speaker 8: Controlling more than eighty percent of the market, no one
• 19:01
  Speaker 8: has enough leverage to really go up against these guys.
• 19:03
  Speaker 8: So I think unless and until we really address that consolidation,
• 19:07
  Speaker 8: and it's not just with the pharmacy benefit managers, it's
• 19:10
  Speaker 8: the fact that they're also owned by the health plans.
• 19:12
  Speaker 9: Who are who also in a lot of pharmacies.
• 19:16
  Speaker 8: It's a real squeeze on manufacturer's patients. And I know
• 19:19
  Speaker 8: a lot of the independent pharmacies that you work with.
• 19:22
  Speaker 8: So to me, consolidation is the piece that has to
• 19:25
  Speaker 8: be addressed.
• 19:26
  Speaker 9: For any of this to change.
• 19:27
  Speaker 5: So are you a lawyer too? I am? I see
• 19:30
  Speaker 5: that's nice. That's the right answer. That's what I wanted,
• 19:32
  Speaker 5: all right. So when I look at this, I've been
• 19:36
  Speaker 5: observing the pharmacy care market for twenty two years. Fifteen
• 19:42
  Speaker 5: of the twenty two years, I finally understood kind of
• 19:45
  Speaker 5: what a PBM is. Now. It's ultra focused because we
• 19:49
  Speaker 5: have data and Antonio Chuccha and his crazy band of
• 19:53
  Speaker 5: merry men from Access three Advisors, three Access Advisors, and
• 19:58
  Speaker 5: now Congress is Jake Auchincloss from the great State of
• 20:02
  Speaker 5: Connecticut is a rock star and he's beaten the crab
• 20:04
  Speaker 5: out of them. Then we have states like Arkansas and
• 20:08
  Speaker 5: Tennessee who are saying you cannot own pharmacies and be
• 20:13
  Speaker 5: the insurance company governing that. All right, When I look
• 20:16
  Speaker 5: at all of the marbles swirling around in the world
• 20:20
  Speaker 5: of PBM reform. The most evident one at the CMS
• 20:26
  Speaker 5: level is to say you cannot be an insurance company
• 20:31
  Speaker 5: and govern pharmacy distribution and care through pharmacies that you own.
• 20:35
  Speaker 5: That's completely what's stark law, that's whatever like that doesn't
• 20:41
  Speaker 5: make any sense. That you are the insurance provider, the
• 20:45
  Speaker 5: person that's controlling the money, and you're the outlet of services.
• 20:49
  Speaker 5: And by the way, you're favored, you're favoring even with
• 20:53
  Speaker 5: favoring their own pharmacies at CVS Health and the whatever.
• 20:57
  Speaker 5: Even some CVS pharmacies are getting close down because their
• 21:02
  Speaker 5: own model sucks so bad that they can't even keep
• 21:05
  Speaker 5: their own pharmacies open, let alone right Aid collapsing, let
• 21:08
  Speaker 5: alone Walgreens collapsing, let alone independent pharmacies collapsing. Why, in
• 21:14
  Speaker 5: your opinion, isn't it happening at the CMS level where
• 21:18
  Speaker 5: they're like, dudes, if you own an insurance company, you
• 21:22
  Speaker 5: cannot operate, you cannot own the pharmacy too.
• 21:27
  Speaker 9: It's a great question.
• 21:29
  Speaker 8: I am going to look into this.
• 21:32
  Speaker 9: I do not have a good answer for you. I
• 21:34
  Speaker 9: would imagine.
• 21:37
  Speaker 8: CMS may or may not have an authority on that. I'm
• 21:39
  Speaker 8: trying to think under what authority they could regulate that Is.
• 21:43
  Speaker 5: It under FTC?
• 21:44
  Speaker 8: Maybe yeah, maybe the FTC, but thin of CMS though,
• 21:47
  Speaker 8: maybe it is network adequacy requirements. Maybe there's something there
• 21:50
  Speaker 8: and I haven't. I haven't thought about like that. There
• 21:53
  Speaker 8: is the FTC. The FTC has been active.
• 21:57
  Speaker 9: We had been waiting for a very long time to get.
• 22:01
  Speaker 8: A response on what's going off these lawsuits, the insulin
• 22:04
  Speaker 8: lawsuits against the Big three. We have this FTC settlement
• 22:07
  Speaker 8: with express Scripts that came out just It came out
• 22:10
  Speaker 8: the day after Congress happened to enact some reforms on PBM,
• 22:14
  Speaker 8: so it was a very big week for US consultants
• 22:16
  Speaker 8: on PBM reforms. The express Script settlement with the FTC
• 22:19
  Speaker 8: is notable. It requires express Scripts to do a number
• 22:23
  Speaker 8: of things that would be helpful and that folks want.
• 22:27
  Speaker 8: A couple things like not preferring a high whack price
• 22:31
  Speaker 8: drug over the same the.
• 22:33
  Speaker 9: Generic by similar that has a lower whack.
• 22:35
  Speaker 8: Price, new transparency requirements, things around passing through debates, et cetera,
• 22:40
  Speaker 8: et cetera. There were notable things in there, but the
• 22:42
  Speaker 8: big catch is they mandate that express Scripts make this
• 22:46
  Speaker 8: part of their standard offering and then employers and health
• 22:50
  Speaker 8: plans have the choice of do they pick it or
• 22:52
  Speaker 8: go with some other custom model that they're already doing. So,
• 22:57
  Speaker 8: whether you're pointing the finger at the PBMs or the
• 22:59
  Speaker 8: employers in the health plans who keep demanding to keep
• 23:02
  Speaker 8: the old model in place, it's kind of who are
• 23:05
  Speaker 8: we pointing your finger at?
• 23:06
  Speaker 9: It's helpful. I'm just I'm kind of a simpleton on
• 23:09
  Speaker 9: these things.
• 23:10
  Speaker 8: I just want someone to wave their want and say,
• 23:12
  Speaker 8: we can't have a company that's this big. I mean,
• 23:13
  Speaker 8: to your point, make it as simple as you can't
• 23:15
  Speaker 8: own the pharmacy and also be the insurer. It seems
• 23:18
  Speaker 8: so simple to me. The f TOC is active, they're
• 23:20
  Speaker 8: doing things. It's just they're not addressing that what you
• 23:23
  Speaker 8: and I are talking about. I wish they would go big,
• 23:25
  Speaker 8: and I wish they could, and maybe they need more
• 23:28
  Speaker 8: direction from Congress in order to do all of these
• 23:30
  Speaker 8: big things and getting Congress to do things. It takes
• 23:33
  Speaker 8: next Congress. I know, yeah, but I do. I really
• 23:37
  Speaker 8: think it all comes back down to these consolidation issues,
• 23:39
  Speaker 8: because otherwise we're just we're just chipping away at bits
• 23:44
  Speaker 8: and pieces of this and meaningful reform.
• 23:46
  Speaker 5: It's just not going to happen, so ADVI is extremely
• 23:49
  Speaker 5: involved in all of this data analysis. Do me a favor.
• 23:52
  Speaker 5: Promise to come back funny, either of the This Week
• 23:55
  Speaker 5: in Pharmacy, which is our weekly show, or maybe the
• 23:58
  Speaker 5: NASP podcast with Sheila ar Keed as our host, but
• 24:02
  Speaker 5: promise to come back and talk more to us, more
• 24:04
  Speaker 5: to us from the ad VP perspective, because I find
• 24:06
  Speaker 5: it fascinating.
• 24:07
  Speaker 9: I would love to please hep you back.
• 24:09
  Speaker 5: All right, thank you, Lindsay, thank you to take care.
• 24:15
  Speaker 10: Magnerfielu with Open Pharmacy Innovations.
• 24:18
  Speaker 5: You're listening to the Pharmacy podcast, Magnar. It's great to
• 24:24
  Speaker 5: talk to you again here at Visembia's show. How are you?
• 24:26
  Speaker 7: I am well and you how's it going?
• 24:28
  Speaker 5: Very good? This has been a busy show, one of
• 24:30
  Speaker 5: the busiest that we've ever been at. But it's exciting
• 24:33
  Speaker 5: time and I can see how so many things are changing.
• 24:37
  Speaker 5: Selling gene therapy, attention one hundred and eighty different medications
• 24:42
  Speaker 5: that may be coming out over the next twelve to
• 24:44
  Speaker 5: eighteen months, AI and pharmacy women's health. Like, there's so
• 24:49
  Speaker 5: much happening. Justin's specialty. Share with us what's been going
• 24:53
  Speaker 5: on in your neck of the woods.
• 24:55
  Speaker 10: Well, thank you that this show has always is a
• 24:58
  Speaker 10: great show ature you.
• 25:01
  Speaker 7: Can see what's actually happening.
• 25:03
  Speaker 10: Historically we've done pharmacy builds, improvements, turnaround times, payer clinical issues,
• 25:12
  Speaker 10: and recently I've just expanded it's h o R and
• 25:17
  Speaker 10: got some activity going there and it's been a great
• 25:22
  Speaker 10: year and just coming here just to see what's going on.
• 25:25
  Speaker 10: And to your point, there's a lot going on.
• 25:28
  Speaker 7: Here very much, very much.
• 25:31
  Speaker 5: So talk to us about some of the projects and
• 25:33
  Speaker 5: some of the things that you've been working on and
• 25:36
  Speaker 5: how it impacts the future of specialty pharmacy.
• 25:39
  Speaker 10: Well, I think that it's everything old is new again.
• 25:44
  Speaker 10: It's all about getting the patient on board. What is
• 25:46
  Speaker 10: the experience with the getting a patient on board? We
• 25:51
  Speaker 10: have the list that is perpetually their PA, turnaround time,
• 25:56
  Speaker 10: friction within the system, access to a work access. But
• 26:02
  Speaker 10: when you just break it down and compartmentalize and stratify
• 26:05
  Speaker 10: the patient, stratify your payers, and really plan your work
• 26:08
  Speaker 10: and work the plan, that's where that's where there's game changes.
• 26:12
  Speaker 5: That's incredible. How are you using artificial intelligence in your
• 26:16
  Speaker 5: operations and how has that impacting the most important person
• 26:22
  Speaker 5: in healthcare, which is our patients.
• 26:24
  Speaker 10: Yeah, and not only using it as a user, but
• 26:27
  Speaker 10: here at the show, we've got a lot of vendors
• 26:29
  Speaker 10: here utilizing AI. And what we're really seeing now is
• 26:33
  Speaker 10: AI is stretching from in the EMR with the prescriber,
• 26:37
  Speaker 10: through the hub, through the specialty pharmacy, and it is
• 26:42
  Speaker 10: just bundling information reading PDF reading non data reading the
• 26:46
  Speaker 10: PDF creating the data. And it's just amazing now on
• 26:50
  Speaker 10: a personal level, Yes, you can use these AI tools,
• 26:53
  Speaker 10: and every pharmacist listening should be using, you know, to
• 26:56
  Speaker 10: you pick the open chapt claud any of them.
• 27:00
  Speaker 7: And it's just amazing what you can do.
• 27:02
  Speaker 10: Anecdotally, last week I had to get some data the
• 27:06
  Speaker 10: Unfortunately I couldn't get an export from the platform. I
• 27:09
  Speaker 10: have three years of data, monthly data, thirty six individual
• 27:14
  Speaker 10: PDFs and just ask Claude, can you pull this out?
• 27:18
  Speaker 10: I want this, I want it sorted in this way
• 27:20
  Speaker 10: in an Excel and out at pop.
• 27:23
  Speaker 7: Took a few minutes to prompt.
• 27:24
  Speaker 5: There are a few minutes to come back, but it would.
• 27:26
  Speaker 7: Have been two three out.
• 27:27
  Speaker 10: You know, it could have been a day or two wasteed,
• 27:29
  Speaker 10: just with manual data entry. So it's a game changer.
• 27:34
  Speaker 10: But the platforms I think are really going to make
• 27:36
  Speaker 10: a difference where you're getting the entire information on the patient.
• 27:42
  Speaker 10: Is this a naive patient or an experienced patient here,
• 27:45
  Speaker 10: those are two different patients.
• 27:48
  Speaker 5: I really appreciate the fact that AI is in specialty
• 27:54
  Speaker 5: and in healthcare is being held to specific standards too,
• 27:57
  Speaker 5: where they're starting to develop standards to old things in checks,
• 28:00
  Speaker 5: so there's guardrails. We don't want obstacles. We want a
• 28:04
  Speaker 5: guard weill in place to assure that it's just not
• 28:08
  Speaker 5: run a muck and that your AI is adhering to
• 28:13
  Speaker 5: some kind of standard.
• 28:15
  Speaker 10: Absolutely, absolutely, And the exciting thing is here. There's a
• 28:19
  Speaker 10: lot of AI companies here at Assembia, at various parts
• 28:25
  Speaker 10: in their experience, at a few years old, others longer.
• 28:29
  Speaker 10: But the nice thing is here you can sit talk
• 28:32
  Speaker 10: with them and then just watch and see who's who
• 28:35
  Speaker 10: the winner is going to be, which is the exciting thing.
• 28:38
  Speaker 5: Magnar, We appreciate you being part of the Assembia twenty
• 28:40
  Speaker 5: twenty six post show and we hope to have you
• 28:43
  Speaker 5: back next year.
• 28:44
  Speaker 7: Fantastic always a pleasure thought.
• 28:46
  Speaker 5: Thank you do such a great job.
• 28:47
  Speaker 7: Thank you.
• 28:52
  Speaker 6: The podcast.
• 28:53
  Speaker 11: Press coverage of the ASSEMBIA twenty twenty sixth Summit is
• 28:56
  Speaker 11: brought to you by Paragon Pharmacy three sixty, powered by
• 29:01
  Speaker 11: the innovative Modesto Health platform. Where specialty pharmacy meets real
• 29:06
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• 29:10
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• 29:14
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  Speaker 11: a clinical intelligence platform that works for both the care
• 29:20
  Speaker 11: team and the patient simultaneously. On the clinical side, pharmacists
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  Speaker 11: get a unified patient record, auto generated care plans, and
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  Speaker 11: real time insights that automatically surface at risk patients before
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• 29:59
  Speaker 11: across specialty and chronic conditions. But what truly sets Paragon
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• 30:42
  Speaker 12: Hi, this is Marina Allen with our ex Access partners,
• 30:45
  Speaker 12: and you're listening to the Pharmacy Podcast.
• 30:50
  Speaker 5: Marina, Welcome to the ASSEMBIA twenty twenty six post show
• 30:54
  Speaker 5: here at the podcast press booth. I kind of just
• 30:57
  Speaker 5: named the podcast press booth because nobody else has press
• 31:00
  Speaker 5: here as podcast.
• 31:01
  Speaker 6: I know, I love it. Thanks for having me. Great.
• 31:05
  Speaker 5: So you've been to ASSEMBIA a bunch, So why do
• 31:08
  Speaker 5: you invest in coming to this conference. What is it
• 31:10
  Speaker 5: about the SEMBIA that you like?
• 31:12
  Speaker 12: Wow, I've been coming to a SMBIA for about ten years.
• 31:15
  Speaker 12: I'd say I was on the pharma side for many years.
• 31:19
  Speaker 12: I started in pharma in two thousand and feel old
• 31:22
  Speaker 12: yet I'm starting to become an ASSEMBIA vet from back
• 31:27
  Speaker 12: in the days when.
• 31:29
  Speaker 5: You hear when it was called our Mada Health, our
• 31:31
  Speaker 5: MADA Health Yeata.
• 31:32
  Speaker 12: Health currently and they used to even pay people to
• 31:34
  Speaker 12: come to these events versus you know now we pay
• 31:37
  Speaker 12: big bucks here exactly.
• 31:39
  Speaker 5: That's wild, all right, Talk to us about our ex
• 31:42
  Speaker 5: access partners. Talk to us about what you do and
• 31:45
  Speaker 5: why you're focused on specialty pharmacy.
• 31:48
  Speaker 12: Well, we are at a market access and patient services
• 31:52
  Speaker 12: consulting firm and marketing agency. We're not your traditional market
• 31:56
  Speaker 12: access consulting firm or agency. We actually do a little
• 32:01
  Speaker 12: bit more, I would say, in the realm of what differentiates.
• 32:04
  Speaker 6: Us as patient services.
• 32:06
  Speaker 12: We do all your traditional market access consulting, strategy, market research,
• 32:11
  Speaker 12: payer ad boards, all of that. We also do the
• 32:14
  Speaker 12: marketing as well, so we can build all their high decks,
• 32:18
  Speaker 12: PvP decks, anything of that nature.
• 32:21
  Speaker 6: And then when we move over into.
• 32:23
  Speaker 12: The patient services realm, we can really from RFP through design,
• 32:28
  Speaker 12: build implementation. We have a team that can help design, build,
• 32:32
  Speaker 12: implement patient support programs. Our senior led I would say,
• 32:37
  Speaker 12: everyone's twenty plus years in the industry, so.
• 32:41
  Speaker 6: It's not that typical.
• 32:42
  Speaker 12: You know, you've got the seniors as maybe the client leads,
• 32:45
  Speaker 12: but then you've got the juniors doing the work that've
• 32:47
  Speaker 12: never done it before, So we truly are senior led
• 32:50
  Speaker 12: where everybody's been in the shoes of either the manufacturers
• 32:54
  Speaker 12: or life science clients as well as you know, really
• 32:58
  Speaker 12: working in the industry for long time in many different facets.
• 33:01
  Speaker 12: I feel like it's been putting together a very large
• 33:04
  Speaker 12: puzzle together. There's twenty plus of us nationally. We have
• 33:08
  Speaker 12: a whole creative department too, that can do all the
• 33:10
  Speaker 12: access marketing to But each person's a different piece to
• 33:14
  Speaker 12: the puzzle that has very unique expertise.
• 33:17
  Speaker 5: I would say, now, do you pick specific disease states
• 33:22
  Speaker 5: or conditions that you've had success on or is it
• 33:25
  Speaker 5: that really doesn't matter, Just it's up to the scenario,
• 33:28
  Speaker 5: really doesn't matter.
• 33:29
  Speaker 12: Everybody, you know, all of our consultants have all different
• 33:33
  Speaker 12: breaths of experience, right, Rare disease, oncology, specialty, pharmacy, benefits, right, We've.
• 33:41
  Speaker 6: Had all of it.
• 33:42
  Speaker 12: So it just really depends on what client comes to us.
• 33:46
  Speaker 12: You know, anything with access related. A lot of it
• 33:49
  Speaker 12: just comes to the process in which we need to
• 33:53
  Speaker 12: look at it.
• 33:54
  Speaker 6: But no, we really can. Each one of us has.
• 33:58
  Speaker 12: A specialty we like, you know, rare disease, there's a
• 34:02
  Speaker 12: few folks that really like to specialize in rare disease oncology.
• 34:05
  Speaker 6: We have a breadth of experience in oncology as.
• 34:07
  Speaker 12: Well, selling gene therapy, immunology, you know, any of the
• 34:12
  Speaker 12: complex specialty products with those, we've done a lot of
• 34:16
  Speaker 12: work in because you know, when you work in both
• 34:20
  Speaker 12: market access and patient services and really building those patient
• 34:23
  Speaker 12: support programs that have those more complex patient journeys, there's
• 34:26
  Speaker 12: a lot more that you have to do in that world.
• 34:29
  Speaker 5: So what if what challenges are in place that you
• 34:33
  Speaker 5: recognize in your consultancy space that you're like, this is
• 34:37
  Speaker 5: really impeding access, This is really impeding and creating issues
• 34:43
  Speaker 5: for the patient. Like what component of the ecosystem of
• 34:47
  Speaker 5: specialty is still the bane? Like, is still the issue? Well?
• 34:53
  Speaker 12: Getting coverage for those patients, right, I mean the prior
• 34:57
  Speaker 12: authorization process and what the payers put in front of
• 35:01
  Speaker 12: the provider's offices and everything that you got to do
• 35:04
  Speaker 12: for that. I would say that's one of the biggest
• 35:08
  Speaker 12: and making sure that they're recouping reimbursement as well. A
• 35:11
  Speaker 12: lot of these specialty drugs, the offices or providers have
• 35:15
  Speaker 12: to pay for the drug upfront and they're barely reimbursed
• 35:18
  Speaker 12: for what they're paying for the drugs. So the margin
• 35:21
  Speaker 12: is so small and the errors can be so big
• 35:24
  Speaker 12: right where they're not getting that reimbursement. So from on
• 35:27
  Speaker 12: the front end getting it covered and getting that authorization,
• 35:30
  Speaker 12: and on the back end making sure they're getting paid
• 35:32
  Speaker 12: for when they did get the authorization paid covered.
• 35:38
  Speaker 5: Absolutely, it's the ability to get the barriers out of
• 35:44
  Speaker 5: the way, to get them on the medication and get
• 35:47
  Speaker 5: it approved through the prior authorization all everything, and then
• 35:51
  Speaker 5: keeping them on the medication because if there's an insurance
• 35:54
  Speaker 5: change or there's a formulay change, there's so many things
• 35:58
  Speaker 5: that could happen to prevent care from continuing and treatment
• 36:02
  Speaker 5: to continuing. And that's where I think organizations like yours
• 36:06
  Speaker 5: are coming in to kind of say, listen, we've seen
• 36:08
  Speaker 5: this one hundred times, let's look out for these pitfalls.
• 36:12
  Speaker 12: Absolutely, yeah, And how do you decrease the time to therapy?
• 36:17
  Speaker 10: Right?
• 36:17
  Speaker 6: I mean, some of these patients are.
• 36:19
  Speaker 12: Very very ill and waiting two weeks for a prior
• 36:22
  Speaker 12: authorization is just not very doable.
• 36:25
  Speaker 6: So how do we help.
• 36:26
  Speaker 12: Those processes become more efficient by educating not only the manufacturers,
• 36:31
  Speaker 12: the providers and from X all the way to execution
• 36:35
  Speaker 12: in the field where they're able to educate the patients
• 36:38
  Speaker 12: and the providers.
• 36:39
  Speaker 5: Marina, I really appreciate you taking time to be part
• 36:42
  Speaker 5: of the Assembia podcast Press Coverage twenty twenty six. I
• 36:47
  Speaker 5: hope to have you back next year.
• 36:48
  Speaker 6: Absolutely, I'd love to be back.
• 36:50
  Speaker 5: Thank you, Thank you. Hi.
• 36:55
  Speaker 13: This is Matt Hare, vice president of network Growth at
• 36:57
  Speaker 13: Cover my Meds, and you are listening to the Pharmacy Podcast.
• 37:02
  Speaker 5: Matt Hare, Welcome to the Assembia post show covering Access
• 37:06
  Speaker 5: to Pharmacy twenty twenty six.
• 37:08
  Speaker 7: How are you doing great? How are you Todd?
• 37:10
  Speaker 5: I'm great, So good to see your name show up
• 37:13
  Speaker 5: on our interview list Cover my Meds. I have watched
• 37:17
  Speaker 5: this company go through so many different transitions and joining forces,
• 37:22
  Speaker 5: and it's been all focused around pharmacy care. So let's
• 37:27
  Speaker 5: talk specialty. We're going to shift the gear. We're gonna
• 37:29
  Speaker 5: I want to dive in. This is really what I'm
• 37:32
  Speaker 5: curious about. How digital health and artificial intelligence, how's that
• 37:36
  Speaker 5: shaping the future of specialty workflows and care delivery? Kind
• 37:41
  Speaker 5: of give our listeners an overview.
• 37:42
  Speaker 13: Then yeah, absolutely, if you think about specialty workflows in
• 37:45
  Speaker 13: general are very complex. The patient cases are very complex,
• 37:50
  Speaker 13: a lot of questions obviously about their care, and so
• 37:53
  Speaker 13: as clinicians spend time with their patients and they develop
• 37:56
  Speaker 13: a care plan, they also have to think about how
• 37:58
  Speaker 13: do I get my patients on medication, how do I
• 38:00
  Speaker 13: keep them on that medication that's going to make them healthy?
• 38:03
  Speaker 13: And so really the tools that are available have evolved
• 38:06
  Speaker 13: to your point so rapidly, and so as clinicians think
• 38:10
  Speaker 13: of need to get this patient on therapy, but also
• 38:13
  Speaker 13: start to think about other things that are happening with
• 38:16
  Speaker 13: the patient, Leveraging tools like automation and AI.
• 38:19
  Speaker 7: Is something that's critical.
• 38:21
  Speaker 13: The other thing is, I think a lot of patients
• 38:23
  Speaker 13: feel at times that potentially their clinician will have their
• 38:26
  Speaker 13: back to them or are doing work while the patients
• 38:30
  Speaker 13: in the office, and so being able to leverage these
• 38:32
  Speaker 13: tools also lets them bring some of that humanity back
• 38:34
  Speaker 13: to care. And so that's something that we hear a
• 38:37
  Speaker 13: lot about, is how do I spend more time with
• 38:39
  Speaker 13: my patients and leverage the tools that are available, And
• 38:41
  Speaker 13: so it's very exciting. I think there's a lot happening
• 38:44
  Speaker 13: right now, and so I think what we hear from
• 38:47
  Speaker 13: a lot of our clients is what's really going on
• 38:49
  Speaker 13: with some of these tools and how do we leverage
• 38:51
  Speaker 13: those appropriately.
• 38:53
  Speaker 5: I'm starting to feel like the old guy in the
• 38:54
  Speaker 5: room I've been around now. We've been doing podcasting for
• 38:58
  Speaker 5: seventeen and a half years. We've covered this event when
• 39:02
  Speaker 5: it was called Armada Health way back in the day
• 39:05
  Speaker 5: and AI. When we first started hearing about this seven
• 39:08
  Speaker 5: years ago in pharmacy, it was kind of like you'd
• 39:12
  Speaker 5: say AI and you didn't really sure what you really meant.
• 39:16
  Speaker 5: Now it's the real deal. Now it's literally embedded into everything.
• 39:20
  Speaker 5: So let's talk about this AI in becoming more practical
• 39:24
  Speaker 5: and specialty pharmacy. Rather than focusing on AI as a
• 39:27
  Speaker 5: broad trend, the discussions turning into intelligent automation. Tell our
• 39:34
  Speaker 5: listeners what that means through cover my meds.
• 39:36
  Speaker 13: Yeah, absolutely, So we believe that whatever tool you have,
• 39:40
  Speaker 13: So think about an EHR, there's a lot of information
• 39:43
  Speaker 13: in that EHR and being able to harness that but
• 39:45
  Speaker 13: also not having the care team have to comb through
• 39:48
  Speaker 13: the chart while they're trying to get a.
• 39:50
  Speaker 7: Patient on medication.
• 39:51
  Speaker 13: And so what we see is you can leverage AI,
• 39:54
  Speaker 13: and to your point, it is here and being able
• 39:57
  Speaker 13: to use that to start to pool information and service
• 40:00
  Speaker 13: up potential recommended solutions or answers to questions for prior
• 40:05
  Speaker 13: authorizations through the chart and so rather than staff having
• 40:10
  Speaker 13: to go through and combe that information, it can populate
• 40:13
  Speaker 13: some of the potential answers for some of those questions.
• 40:15
  Speaker 13: And so that's something that we're hearing a lot about
• 40:18
  Speaker 13: is it's saving me so much time. And that's the
• 40:21
  Speaker 13: one thing and kind of going back to my earlier
• 40:23
  Speaker 13: point about spending time with the patient is really important.
• 40:26
  Speaker 13: These are very critical cases in many instances, and so
• 40:30
  Speaker 13: being able to pull some of that information to the
• 40:33
  Speaker 13: forefront gives them peace of mind that, yes, I'm still
• 40:36
  Speaker 13: being able to spend time with my patient.
• 40:38
  Speaker 7: I'm a clinical.
• 40:38
  Speaker 13: Expert, but I also have these tools that are helping
• 40:41
  Speaker 13: me surface that information.
• 40:42
  Speaker 7: And so it is very very cool.
• 40:45
  Speaker 5: So part of the richness and the secret sauce of
• 40:50
  Speaker 5: Cover my Meds is pulling multiple things together for our providers,
• 40:54
  Speaker 5: for our pharmacists to not have to spend time on
• 40:58
  Speaker 5: those tedious tasks and doing what so digital health is
• 41:02
  Speaker 5: helping speak to the broader shift towards more connected care delivery.
• 41:07
  Speaker 5: Where does that technology support coordination across we're talking providers, pharmacies,
• 41:14
  Speaker 5: health systems, your partners talk to us about the connection.
• 41:17
  Speaker 13: Yeah, absolutely, I think that is the critical piece of
• 41:19
  Speaker 13: being able to have all of these stakeholders that come
• 41:23
  Speaker 13: together in patient care. Right now, in many instances, our
• 41:28
  Speaker 13: users are having to go to disparate points of contact,
• 41:33
  Speaker 13: and you know, whether they're going out to an outside
• 41:35
  Speaker 13: portal or they're going.
• 41:36
  Speaker 7: Out to another website.
• 41:38
  Speaker 13: Really bringing that into a single solution as critical. And
• 41:41
  Speaker 13: to your point, if you're seeing a dozen patients a day,
• 41:45
  Speaker 13: one might go to a different pharmacy than another, they
• 41:47
  Speaker 13: might go to a different clinic, and so how do
• 41:49
  Speaker 13: you bring tooling that will connect all of those stakeholders
• 41:53
  Speaker 13: is absolutely critical And ultimately, at the end of the day,
• 41:57
  Speaker 13: this is about getting patients on therapy quickly and give
• 42:00
  Speaker 13: them the peace of mind that they have that and
• 42:02
  Speaker 13: so that connecting this is absolutely critical to doing that.
• 42:06
  Speaker 5: So one of the biggest obstacles in specialty pharmacy, and
• 42:11
  Speaker 5: the reason why specialty pharmacy is so special, is the
• 42:15
  Speaker 5: workflow also includes the prior authorization can which can always
• 42:20
  Speaker 5: be a barrier, especially if insurances are changing. Bin numbers changing,
• 42:23
  Speaker 5: something changing. It all comes back to that, I want
• 42:27
  Speaker 5: to say, the poor pharmacist has to put up with
• 42:29
  Speaker 5: all that. Absolutely, so Cover my Meds really helps to
• 42:34
  Speaker 5: get rid of those barriers. So talk to us about
• 42:37
  Speaker 5: access affordability solutions, bringing together the capabilities across areas such
• 42:42
  Speaker 5: as benefit investigation and in prior authorization.
• 42:46
  Speaker 13: Yeah, absolutely so Cover my Meds and you kind of
• 42:48
  Speaker 13: hit on it at the beginning. I've been here ten
• 42:50
  Speaker 13: years and so seeing the evolution of the business.
• 42:52
  Speaker 5: Are you an old guy?
• 42:53
  Speaker 13: I pretty much aim at this point. Yeah, and so
• 42:57
  Speaker 13: I'm really starting with pharmacy benefit and we were able
• 42:59
  Speaker 13: to solve them that problem.
• 43:00
  Speaker 7: To your point of bringing all that information together.
• 43:03
  Speaker 13: Into a single solution, one of the things we've been
• 43:05
  Speaker 13: asked from our clients is what about medical benefit prior authorization?
• 43:09
  Speaker 7: What about enrollment capabilities?
• 43:10
  Speaker 13: And so with our specialty affordability and access solution, we
• 43:14
  Speaker 13: are bringing what we did in the pharmacy benefit space
• 43:18
  Speaker 13: and now having pharmacy benefit prior authorization, medical benefit prior authorization,
• 43:23
  Speaker 13: and enrollment capabilities and really the intent.
• 43:25
  Speaker 7: There is whatever barrier there is.
• 43:28
  Speaker 13: And preventing a patient getting on medication, trying to solve
• 43:32
  Speaker 13: that in a single instance.
• 43:33
  Speaker 7: One of the things we've.
• 43:34
  Speaker 13: Heard from a medical benefit standpoint is I'm going to
• 43:37
  Speaker 13: ten different websites and manually entering information, and so it's
• 43:42
  Speaker 13: not acceptable, and so being able to find a way
• 43:44
  Speaker 13: to solve that is something that we think is one
• 43:46
  Speaker 13: of the most important challenges in healthcare.
• 43:49
  Speaker 5: All right, let's talk about the future. I love that word.
• 43:53
  Speaker 5: I've been a science fiction buff my entire life, but
• 43:57
  Speaker 5: I like when it becomes reality instead of it just
• 44:00
  Speaker 5: being science fiction. We don't want science fiction in medicine.
• 44:03
  Speaker 5: We want the real deal. So with that connection, a
• 44:07
  Speaker 5: strong area of specialty pharmacy that looks like digital health
• 44:11
  Speaker 5: and AI could become more embedded and more connected to
• 44:14
  Speaker 5: the patient. Expand on that for us, tell us what
• 44:17
  Speaker 5: that means for using in being partnered with cover MYMTS.
• 44:20
  Speaker 7: Yeah, absolutely.
• 44:21
  Speaker 13: I think there is going to be an expectation of everyone,
• 44:25
  Speaker 13: patient included that there is going to be technology that's
• 44:28
  Speaker 13: going to help facilitate all of these barriers and challenges.
• 44:32
  Speaker 13: And so I think you're going to continue to see
• 44:34
  Speaker 13: more connecting this and leveraging technology to accelerate patients getting
• 44:38
  Speaker 13: on therapy. And so I'm very excited about it. I
• 44:42
  Speaker 13: think one thing that is just really important to keep
• 44:44
  Speaker 13: in mind.
• 44:45
  Speaker 7: The intent is not to displace the clinician.
• 44:48
  Speaker 13: They are the expert and making sure that they have
• 44:50
  Speaker 13: the tools that are in place to help them do that.
• 44:53
  Speaker 13: You're going to continue to see that, and I'm very
• 44:54
  Speaker 13: excited about it.
• 44:56
  Speaker 5: So the typewriter did not displace the pharmacist, the compute
• 45:00
  Speaker 5: did not displace the pharmacist, the data warehousing did not.
• 45:03
  Speaker 5: I could just keep going. AI will not displace the provider,
• 45:07
  Speaker 5: the pharmacist, the person that's signing off on that care.
• 45:10
  Speaker 5: It's a tool. It's not to replace, it's to enhance.
• 45:14
  Speaker 5: It's to make that pharmacist more connected to resources and
• 45:19
  Speaker 5: to information to expedite care. Because that's the important thing
• 45:23
  Speaker 5: is get these patients on their medications and let's keep
• 45:27
  Speaker 5: them on their medications. Matt, thank you so much for
• 45:29
  Speaker 5: being part of the Access to Pharmacy twenty twenty six.
• 45:32
  Speaker 5: Here to SEMBIA. This has been wonderful.
• 45:34
  Speaker 7: Thank you so much, Todd. I really appreciate it.
• 45:41
  Speaker 5: Richard Brooke becoming a regular at the ASSEMBIA podcast coverage
• 45:47
  Speaker 5: here this is the twenty twenty six I can't believe Richard.
• 45:49
  Speaker 5: Here we are again.
• 45:50
  Speaker 14: It's an honor to be here. Todd, thank you so
• 45:52
  Speaker 14: much for sharing all the things that we do with
• 45:55
  Speaker 14: our community.
• 45:56
  Speaker 5: Absolutely, I take great pride in getting this information out.
• 45:59
  Speaker 5: But I like talking with the innovators. I like talking
• 46:01
  Speaker 5: to smart people, and that's why I like having you back.
• 46:05
  Speaker 5: Better Health Worldwide is an organization you started? How many
• 46:09
  Speaker 5: years ago has it been now?
• 46:10
  Speaker 14: So we've actually been in business for this is our
• 46:12
  Speaker 14: twenty sixty year Oh my goodness. Although we for many
• 46:14
  Speaker 14: years worked under the radar with other people. You know,
• 46:19
  Speaker 14: a lot of times we work for pharma device manufacturers,
• 46:22
  Speaker 14: and it's really about promoting their work to the patients
• 46:25
  Speaker 14: and the insurers, not necessarily our work.
• 46:28
  Speaker 5: So you attended a session I wasn't able to attend
• 46:31
  Speaker 5: because they've been stuck in the podcast booth all day
• 46:35
  Speaker 5: with the coverage. But something really interesting is how employers
• 46:39
  Speaker 5: have an opportunity to protect their employees and the benefits
• 46:43
  Speaker 5: that they're providing. Would you expand around that session and
• 46:47
  Speaker 5: kind of like from your own insights about that?
• 46:49
  Speaker 7: Sure?
• 46:49
  Speaker 14: Well, I don't want to take other people's thunder and
• 46:51
  Speaker 14: talk about what they talked about. I actually want to
• 46:54
  Speaker 14: talk about what they didn't really talk about. In twenty
• 46:57
  Speaker 14: twenty one, there was a LEGISLATIONA two two one which
• 47:04
  Speaker 14: put a fiduciary responsibility on employers to not harm their
• 47:08
  Speaker 14: employees and do the right things with their insurance. And
• 47:11
  Speaker 14: I think we oftentimes run into a difference between what
• 47:15
  Speaker 14: an employer would like to see and what an insurer
• 47:18
  Speaker 14: would like to pay for. And we think this goes
• 47:22
  Speaker 14: in many facets. We're always interested in making sure of
• 47:26
  Speaker 14: treating our employees so they can get to work, so
• 47:29
  Speaker 14: that their family members don't keep them from working. If
• 47:32
  Speaker 14: they're a caregiver, you know, God forbid your spouse or
• 47:36
  Speaker 14: child has a disease and you have to take time off.
• 47:39
  Speaker 7: We have family.
• 47:40
  Speaker 14: Medical leaves and other things for that. I think we're
• 47:43
  Speaker 14: the only company that actually tracks family medical leaves across
• 47:45
  Speaker 14: a number of industries. Today's session that was very interesting
• 47:49
  Speaker 14: to me because their big focus was on net to
• 47:52
  Speaker 14: zero rebates. Now, granted, we are at a meeting for
• 47:55
  Speaker 14: specialty pharmacy and we were talking about specialty pharmacy drugs
• 47:59
  Speaker 14: and net to zero rebase. The importance of outcomes came up,
• 48:03
  Speaker 14: but certain outcomes just don't come up like absenteeism, caregiver impact.
• 48:09
  Speaker 14: You know, again, if your spouse is sick, can you
• 48:12
  Speaker 14: take time off to go to work or do you
• 48:16
  Speaker 14: have to do other things with your life? You know,
• 48:19
  Speaker 14: family is important, and one of the things we're always
• 48:22
  Speaker 14: looking at are some of those medicines that will improve
• 48:26
  Speaker 14: to somebody's life, allow them to function, not have to
• 48:30
  Speaker 14: have a caregiver drive them somewhere. These are things that
• 48:33
  Speaker 14: we that are important to us, but they're actually a
• 48:35
  Speaker 14: cost to the system.
• 48:37
  Speaker 5: And it's interesting to me.
• 48:39
  Speaker 14: That employers actually we always hear that Medicare, Medicaid and
• 48:44
  Speaker 14: the government or the biggest payers for health care, but
• 48:47
  Speaker 14: if you do the math, it's actually all funded out
• 48:50
  Speaker 14: of employer payroll taxes. So while our employers are actually
• 48:53
  Speaker 14: paying the insurers and other people to do things, the
• 48:56
  Speaker 14: payroll tax is that they pay fund Medicare, they fund Medicaid, they.
• 49:01
  Speaker 7: Fund a lot of these other.
• 49:02
  Speaker 14: Programs, and it's sometimes a shame that we're not getting
• 49:05
  Speaker 14: the right care we would have. You know, well, not
• 49:09
  Speaker 14: a full specialty product, but there's been products over the
• 49:12
  Speaker 14: years to treat influenza, and the cost of that product
• 49:17
  Speaker 14: might be prohibitive, but the data showed that if you
• 49:20
  Speaker 14: took this drug when you had the flu, you could
• 49:25
  Speaker 14: actually go back to work without getting everybody sick. And
• 49:29
  Speaker 14: a lot of insurers said, well, we don't want to
• 49:30
  Speaker 14: pay for that because now we have to pay for
• 49:32
  Speaker 14: a medicine. And the downside to the insurer is not
• 49:37
  Speaker 14: paying for the medicine is well they're not going to work. Well,
• 49:40
  Speaker 14: they don't pay for that, and in you know, one
• 49:43
  Speaker 14: to two percent of the patients they would actually land
• 49:45
  Speaker 14: in the hospital where they did pay. But I think
• 49:48
  Speaker 14: a lot of the insurers were willing to roll the
• 49:50
  Speaker 14: dice there, roll the dice. Hey, I guess we're in Vegas,
• 49:53
  Speaker 14: so you know, I think it's really important that we
• 49:57
  Speaker 14: really focus on keeping people healthy, getting them able to work,
• 50:02
  Speaker 14: making sure if they're in that caregiver role for their
• 50:04
  Speaker 14: family member or even for not a family member, but
• 50:08
  Speaker 14: that they're able to do what they need to do
• 50:10
  Speaker 14: and feel comfortable in that situation.
• 50:13
  Speaker 7: Does that make sense?
• 50:13
  Speaker 5: It does? It does. So when you come out of
• 50:16
  Speaker 5: that session and you start adding in some of your
• 50:18
  Speaker 5: own thoughts, how does that tie back to specially pharmacies
• 50:23
  Speaker 5: executing some policies in place to keep that patient at
• 50:27
  Speaker 5: the center so that we're not once again getting pulled
• 50:31
  Speaker 5: back into the profit over people. You know that we
• 50:37
  Speaker 5: all know that that's real. We're not naive enough to
• 50:39
  Speaker 5: think that that's not happening. You know, in a lot
• 50:41
  Speaker 5: of places.
• 50:42
  Speaker 14: We're all in business, whether you're especially pharmacy, a patient
• 50:45
  Speaker 14: assistant group, the pharmacy podcast, or even our research organization.
• 50:50
  Speaker 7: The goal really though, is.
• 50:52
  Speaker 14: To make sure that you know, we get the people
• 50:54
  Speaker 14: the right medicines for the right patient at the right time.
• 50:58
  Speaker 14: Which makes me think of one of the other things
• 51:00
  Speaker 14: we keep hearing about is how GLP ones or the
• 51:03
  Speaker 14: biggest growth area that we see. And we just published
• 51:07
  Speaker 14: an obesity paper in the American journal Managed Care this
• 51:10
  Speaker 14: month's issue, and employers have been one of the few
• 51:14
  Speaker 14: groups that have traditionally covered obesity medicines.
• 51:17
  Speaker 7: Now we see some movement in the medicare space there.
• 51:20
  Speaker 14: And what's really interesting to me is with this new
• 51:23
  Speaker 14: trend in to direct to patient sales, the way the
• 51:26
  Speaker 14: process is going to work is you're going to call in,
• 51:29
  Speaker 14: They're going to give you a prescription, which then they're
• 51:32
  Speaker 14: going to fill and ship to you. But that prescription
• 51:35
  Speaker 14: that goes through their phone systems through their doctors or
• 51:38
  Speaker 14: their physician assistants, probably is not going to be recorded
• 51:41
  Speaker 14: on your medical record the purchase of the medicine because
• 51:44
  Speaker 14: there's now no medical claims that Health Insured is not
• 51:46
  Speaker 14: paying for it, probably is not going to show up
• 51:48
  Speaker 14: on your medical claims. So when I do a study
• 51:50
  Speaker 14: looking at a control group of people who could have
• 51:55
  Speaker 14: obesity meds versus people who did have obesity meds, my
• 51:58
  Speaker 14: control group needs to really be thought about because now
• 52:02
  Speaker 14: they might actually be taking obesity meds through that direct
• 52:05
  Speaker 14: patient channel. So we're starting to build processes to check
• 52:09
  Speaker 14: for that. We haven't figured out how to break the
• 52:12
  Speaker 14: coin here or how to identify every one of those patients,
• 52:16
  Speaker 14: but I think it's something as an industry, we have
• 52:18
  Speaker 14: to go with this new model because it's not just
• 52:20
  Speaker 14: going to be obesity drugs. We heard people talking throughout
• 52:23
  Speaker 14: the meeting about other classes of drugs that are going
• 52:25
  Speaker 14: to be right for this direct to patient model. And
• 52:28
  Speaker 14: what we really need to figure out is if that's happening,
• 52:31
  Speaker 14: how do we track it. Especially if an employer says,
• 52:34
  Speaker 14: use your deductible to pay for that medicine, Well, what
• 52:37
  Speaker 14: does that do to the rest of the things in
• 52:39
  Speaker 14: the health insurance benefit right exactly.
• 52:42
  Speaker 5: That's a really good point. What about assembia has been
• 52:47
  Speaker 5: has been either surprising or has been inspiring or has
• 52:52
  Speaker 5: been interesting to you? What technology something in AI? What
• 52:56
  Speaker 5: has really stood out to you that you think brings
• 52:59
  Speaker 5: a lot of positive future? Look at the industry.
• 53:04
  Speaker 14: Well, I don't think you can go to a session
• 53:06
  Speaker 14: at Assembia now and not see AI somewhere, whether it
• 53:09
  Speaker 14: was AI curated my slides or AI wrote my slides.
• 53:13
  Speaker 14: I saw somebody present the other day. I think the
• 53:16
  Speaker 14: big challenge is needing to keep the human factor in there.
• 53:20
  Speaker 14: Just because AI came out with this answer doesn't mean
• 53:23
  Speaker 14: it's right. And how do we make sure that it's
• 53:25
  Speaker 14: going to be correct for our particular purposes? So AI
• 53:30
  Speaker 14: can help us get to a destination, but did it
• 53:32
  Speaker 14: get us to the right destination?
• 53:35
  Speaker 5: I like that, Richard Brooke. I appreciate you and your
• 53:38
  Speaker 5: insights here on the ASEMBIA twenty twenty six post show.
• 53:42
  Speaker 5: I can't wait to have you back. I want you
• 53:43
  Speaker 5: on This Week in Pharmacy, So I'll be following up
• 53:45
  Speaker 5: with you to do a special segment of This Week
• 53:47
  Speaker 5: in Pharmacy.
• 53:48
  Speaker 7: We'd love to work with you guys. Todd, thank you
• 53:50
  Speaker 7: so much.
• 53:50
  Speaker 5: Thank you.
• 53:55
  Speaker 15: Hi, this is Colin Bannons with Doctor First and you're
• 53:57
  Speaker 15: listening to the Pharmacy podcast.
• 54:01
  Speaker 5: Colin, this has become a tradition where we show up
• 54:03
  Speaker 5: together and meet up at Assembia for the Assembia post show.
• 54:07
  Speaker 5: This is terrific. How are you good?
• 54:08
  Speaker 7: Good? Thanks for having me.
• 54:10
  Speaker 5: Hey, you brought a colleague with you, Valerie Mondeli pharmacist,
• 54:14
  Speaker 5: which you're my favorite provider by the way, Valerie probably
• 54:17
  Speaker 5: didn't know that.
• 54:17
  Speaker 6: Thank you, Todd.
• 54:18
  Speaker 16: Well, we're accessible and certainly we love our patients, so
• 54:23
  Speaker 16: appreciate you having.
• 54:24
  Speaker 5: Us the most accessible. I also know that with pharmacy deserts,
• 54:30
  Speaker 5: enclosures and complexities, it's making everything that much harder. So
• 54:34
  Speaker 5: data is so important now, and specially medications have that
• 54:39
  Speaker 5: high risk abandonment situation with people may not even start
• 54:44
  Speaker 5: the prescription, they might stop it. It just wrecks everything
• 54:48
  Speaker 5: and within the therapy. I'm going to start with you, Colin.
• 54:51
  Speaker 5: What keeps patients from filling their prescriptions and how does
• 54:54
  Speaker 5: Doctor First help?
• 54:55
  Speaker 15: Yeah, well, the prescription that adherence is multifactorial, as you
• 54:59
  Speaker 15: would expect, but I tend to put it into sort
• 55:02
  Speaker 15: of big buckets of when I'm categorizing, I'd say one
• 55:06
  Speaker 15: of them is the education bucket. So patients often don't
• 55:08
  Speaker 15: understand how important the met is, or what to expect,
• 55:11
  Speaker 15: or what sorts of side effects there might be, and
• 55:13
  Speaker 15: so you can never over prepare or over educate your patients.
• 55:17
  Speaker 15: I think the second one is probably the most sensitive,
• 55:20
  Speaker 15: and that's the price bucket, the out of pocket bucket.
• 55:23
  Speaker 15: And there's a lot of problems in the current system
• 55:25
  Speaker 15: today in terms of the transparency of the whole process,
• 55:28
  Speaker 15: and so the patients often don't know what to expect,
• 55:32
  Speaker 15: go to the pharmacy and then get hit with sticker shock,
• 55:34
  Speaker 15: and so how can we help them overcome that barrier?
• 55:37
  Speaker 15: And then the third one is often patients just forget
• 55:41
  Speaker 15: life gets in the way. Pharmacists know this just as
• 55:45
  Speaker 15: well when they have to reshelve something because it's been
• 55:47
  Speaker 15: sitting there for two weeks. So how can we give
• 55:49
  Speaker 15: our patients gentle nudges to help overcome all three of
• 55:52
  Speaker 15: those barriers.
• 55:53
  Speaker 5: So Valerie, as a pharmacist, someone who's in the midst
• 55:56
  Speaker 5: of all this, you're like the hub of everything. You're
• 55:59
  Speaker 5: caring for the patient, You're following up. Sometimes the patient's
• 56:02
  Speaker 5: family has questions. Obviously the physician talk to us about
• 56:06
  Speaker 5: the network importance and how doctor First fits into this
• 56:10
  Speaker 5: and how it actually helps to keep this whole process flowing.
• 56:12
  Speaker 6: I love that question.
• 56:14
  Speaker 16: First of all, I don't practice anymore, but I certainly
• 56:17
  Speaker 16: was behind the pharmacy and the counter and when I
• 56:20
  Speaker 16: would help patients try to start their therapy, it left
• 56:24
  Speaker 16: quite the impression on me with what they go through
• 56:27
  Speaker 16: and the friction that sometimes they experience. And so what
• 56:31
  Speaker 16: Doctor First has been able to do in our platform
• 56:34
  Speaker 16: is really be a prescription engagement for both the provider
• 56:40
  Speaker 16: as well as the patient and the pharmacists to kind
• 56:42
  Speaker 16: of bridge the gap once they leave the doctor's office.
• 56:46
  Speaker 6: It's intimidating.
• 56:47
  Speaker 16: They've just experienced maybe something they've been diagnosed with diabetes
• 56:52
  Speaker 16: and they now have to inject themselves, and how do
• 56:54
  Speaker 16: you educate them, but also how do you get them
• 56:57
  Speaker 16: to the pharmacists to pick up their therapy, to to
• 57:00
  Speaker 16: start and stay on it without being fearful. And part
• 57:04
  Speaker 16: of that is education, but also part of it is
• 57:06
  Speaker 16: the financial assistance that Colin referenced. I think a lot
• 57:10
  Speaker 16: of times patients think that they can't afford therapy, so
• 57:13
  Speaker 16: why would I even bother go go and pick it up.
• 57:16
  Speaker 6: It's just an intimidating process all the way around.
• 57:20
  Speaker 16: So what we try to do is bridge the gap
• 57:21
  Speaker 16: from the prescriber to the pharmacy for the patient so
• 57:26
  Speaker 16: that they have a coordinated experience between the two then
• 57:30
  Speaker 16: that they're not alone. And I think it really makes
• 57:33
  Speaker 16: a difference just that those nudges, but also the education
• 57:37
  Speaker 16: and the financial options that we really display to them
• 57:41
  Speaker 16: before they even get to the pharmacy.
• 57:43
  Speaker 5: That's awesome. I appreciate that from the pharmacist perspective because
• 57:48
  Speaker 5: you see it from the patient's perspective. You see it
• 57:50
  Speaker 5: through the patient's eyes exactly. The bane of specially pharmacy,
• 57:54
  Speaker 5: in my opinion, Colin, is the prior authorization. How is
• 57:57
  Speaker 5: doctor first implemented into this ecosystem to loosen that up?
• 58:02
  Speaker 15: Yeah, doctor versus in a very unique position after twenty
• 58:05
  Speaker 15: six years in the industry having relationships with the prescribers.
• 58:09
  Speaker 15: The patients's vow was just talking about the pharmacies themselves
• 58:13
  Speaker 15: and even PBMs and pharma pharmaceutical companies. And so because
• 58:17
  Speaker 15: the specialty prescribing an adherence process is so complex, and
• 58:20
  Speaker 15: there's so many different players with so many different sets
• 58:24
  Speaker 15: of rules for lack of a better term. How though,
• 58:27
  Speaker 15: what doctor first does is sit at the very point
• 58:30
  Speaker 15: of the prescriptions inception and understands all of those key
• 58:34
  Speaker 15: players and all of those key rules so that we
• 58:37
  Speaker 15: can influence and guide and assist the prescriber to get
• 58:41
  Speaker 15: what I call a clean script out the door of
• 58:43
  Speaker 15: the first time. And when I say clean script, I
• 58:45
  Speaker 15: don't mean it abides by the NCPDP standards and it
• 58:49
  Speaker 15: makes it from point A to point B. A clean
• 58:51
  Speaker 15: script is one that doesn't come back to me, that
• 58:54
  Speaker 15: doesn't get a phone call, that doesn't get a fax.
• 58:56
  Speaker 15: A clean script is one that vowel and the specialty
• 58:59
  Speaker 15: pharmacy can fill without additional effort. And the way to
• 59:03
  Speaker 15: do that is upstream, where the prescriber sits understanding all
• 59:07
  Speaker 15: of those rules and then packing that data into the
• 59:10
  Speaker 15: script itself. So sometimes it's as simple as an ICD
• 59:13
  Speaker 15: ten code. Sometimes it's answering three simple questions that the
• 59:17
  Speaker 15: doctor can just bang out right there, and we use
• 59:20
  Speaker 15: AI to predict those sorts of things so that we
• 59:21
  Speaker 15: can create that clean script. Because the best PA is
• 59:24
  Speaker 15: a PA that I don't have to do, and probably
• 59:27
  Speaker 15: the pharmacy doesn't want to do it either, So absolutely,
• 59:30
  Speaker 15: let's move the whole thing upstream and just get it
• 59:32
  Speaker 15: right from jump.
• 59:33
  Speaker 5: All right, Valerie, Now downstream doctor first is closer to
• 59:38
  Speaker 5: the patient than ever before with some of the new
• 59:41
  Speaker 5: communications tools. Tell our listeners about some of those tools
• 59:44
  Speaker 5: you guys have in place.
• 59:45
  Speaker 16: Yes, when they leave, as Colin was describing, after the
• 59:48
  Speaker 16: script is clean, I can fill it.
• 59:51
  Speaker 6: I can the pharmacists can fill it.
• 59:53
  Speaker 16: They can focus in on really what they love to do,
• 59:57
  Speaker 16: which is clinical services, right to really try and spend
• 1:00:00
  Speaker 16: their time not having to do all of the work
• 1:00:03
  Speaker 16: on the insurance part of it, fixing the prayer off,
• 1:00:06
  Speaker 16: calling the doctor back, having all that work to do,
• 1:00:09
  Speaker 16: Let's focus on getting a patient started on their therapy
• 1:00:12
  Speaker 16: in the right way, and they can spend their time
• 1:00:14
  Speaker 16: on clinical services, teaching the patient how to inject, making
• 1:00:18
  Speaker 16: sure that they have their vaccinations, that they're up to
• 1:00:22
  Speaker 16: date on all of their medications, that they have the
• 1:00:24
  Speaker 16: time to really answer the questions and help the patient
• 1:00:28
  Speaker 16: to have a better healthy outcome. That's really what we're
• 1:00:31
  Speaker 16: trying to do is take all of the administrative work
• 1:00:35
  Speaker 16: out of the process so that it's clean and it's
• 1:00:37
  Speaker 16: a win win for everyone.
• 1:00:40
  Speaker 5: Colin and Valerie, I want to thank you for sitting
• 1:00:43
  Speaker 5: down with me for the post show. It's always a
• 1:00:45
  Speaker 5: pleasure catching up with you. Colin. I've watched your career
• 1:00:48
  Speaker 5: for over twelve years now. It's just amazing to watch
• 1:00:52
  Speaker 5: how far Doctor First has come too and the technology
• 1:00:56
  Speaker 5: in place. We need more and more of this to
• 1:00:58
  Speaker 5: make things easier to add access medications, to get on medications,
• 1:01:01
  Speaker 5: to stay on medications. Thank you. In a shout out
• 1:01:04
  Speaker 5: to doctor First and your team for being part of
• 1:01:06
  Speaker 5: the show. Thank you, thanks for having us