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Compounding Advocacy in Heels: 2026 State Legislation Edition | Essential: The Pharmacy Compounding Podcast · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
• 0:25
  Speaker 2: Welcome to essential news and analysis from the Alliance for
• 0:28
  Speaker 2: Pharmacy Compounding. We are the voice for well Pharmacy Compounding.
• 0:33
  Speaker 2: I'm your host, Andrew Canter. We're going to give you
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  Speaker 2: a bit of compounding news before we get to the
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  Speaker 2: main event. We talk a lot about federal laws and
• 0:40
  Speaker 2: FDA regulations, but today we're going to take a deep
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  Speaker 2: dive into state level legislation that's been introduced this year,
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  Speaker 2: specifically the bills that are aimed at, obviously pharmacy compounding
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  Speaker 2: and where they might lead. But first the news. All right,
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  Speaker 2: this is good stuff. Congressman Michael Rouley of Ohio has
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  Speaker 2: introduced the Protecting Equal Access to Thyroid Act, that's PETE
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  Speaker 2: or pet TO. It would rain in the FDA's reclassification
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  Speaker 2: of desiccated thyroid extract as a biologic. We are totally
• 1:16
  Speaker 2: behind that, because well, DT isn't a biologic. The only
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  Speaker 2: thing that's biological is thyrol globulin and that's clinically inactive.
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  Speaker 2: There's no logical reason for the FDA's reclassification, and it
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  Speaker 2: cuts off access to compounded thyroid meds for millions of
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  Speaker 2: patients who rely on it. It's unfortunate that it might
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  Speaker 2: take an Act of Congress to prevent this, but there
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  Speaker 2: you go. We'll keep you updated as it moves along. Well,
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  Speaker 2: it looked like big news, and apparently a bunch of
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  Speaker 2: news outlets thought it was, but a recent FDA announcement
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  Speaker 2: is actually a whole lot of nothing. The FDA said
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  Speaker 2: it's planning to exclude semaglutide, to zeppetide, and lyriglutide from
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  Speaker 2: the five three B bulks List because the agency says
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  Speaker 2: that outside of a shortage, there's really no need for
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  Speaker 2: outsourcing facilities to compound them. And this changes nothing. Current
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  Speaker 2: REGs already prohibit five oh three b's from compounding those
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  Speaker 2: GLP ones unless there's a shortage. Now, if the agency
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  Speaker 2: said it was planning to add those drugs to the
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  Speaker 2: bulks list, well that would be a story. But nope,
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  Speaker 2: all it said was no, we'll stick with the status
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  Speaker 2: quo and keep those drugs off the bulks list. Still,
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  Speaker 2: the we're not changing anything announcement confused at least some
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  Speaker 2: news agencies, and they acted like it was a big deal,
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  Speaker 2: but once again, the FDA just said it wasn't changing
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  Speaker 2: anything about when five oh three b outsourcing facilities can
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  Speaker 2: compound GLP ones.
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  Speaker 3: So really nothing to see here. Move along, citizen, move along.
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  Speaker 2: The good folks that FDA Law blog have posted a
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  Speaker 2: second part to their primer on the pepti compounding landscape.
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  Speaker 2: This time they talk about the long and winding road
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  Speaker 2: to regulated peptide compounding. There's definitely movement, but it's a
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  Speaker 2: process that could take a year or more, even if
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  Speaker 2: the road is pothole free. The next step is a
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  Speaker 2: meeting of the Pharmacy Compounding Advisory Committee, and even if
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  Speaker 2: that committee recommends allowing compounding with peptides, first the FDA
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  Speaker 2: has to agree, and then there's still the whole rulemaking
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  Speaker 2: process to go through. Then there are supply chain issues,
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  Speaker 2: advertising restrictions, and a lot more eyes to dot and
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  Speaker 2: teas to cross. There's a link to the blog post
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  Speaker 2: in the show notes, and it's well worth the read,
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  Speaker 2: if only to get a clearer picture of what's really
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  Speaker 2: happening with peptides and compounding. Side note, stakeholders have until
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  Speaker 2: July ninth to submit written comments to the docket, So
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  Speaker 2: keep that in mind if you want to weigh in.
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  Speaker 2: Oh and there's always the possibility that HHS Secretary RFK
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  Speaker 2: Junior will unilaterally move to place certain peptides the five
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  Speaker 2: O three A bulks list and bypass the entire process.
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  Speaker 2: All right, I know what you're thinking. Yes, that would
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  Speaker 2: still require notice and comment rule making, but it could
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  Speaker 2: be the start of an era of enforcement discretion pending
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  Speaker 2: that rulemaking. Maybe, I guess we'll see, And yes, ABC members,
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  Speaker 2: we will for sure keep you in the loop. One
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  Speaker 2: of the issues that comes up in pharmacy compounding is
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  Speaker 2: that there are a lot of let's call them questionable
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  Speaker 2: websites out there that claim to be selling compounded medications. Actually,
• 4:33
  Speaker 2: we'll call them what they really are. They are bogus sites, fake,
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  Speaker 2: possibly dangerous, and they confuse people than to be fair,
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  Speaker 2: even legislators who lump them in with legitimate compounding pharmacies.
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  Speaker 2: But if you're a patient, how do you tell what's
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  Speaker 2: legit pharmacy and what's a fake pop up store? And
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  Speaker 2: that is where APC comes in. We've got a free
• 4:53
  Speaker 2: tool that will help you check to see if a
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  Speaker 2: pharmacy you're thinking of using is actually licensed.
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  Speaker 3: We call it is it legit? Catch you right?
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  Speaker 2: You choose a state, enter the pharmacy name, and as
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  Speaker 2: long as you spelled it right, you'll find out whether
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  Speaker 2: it's legit or not. Easyps that site. It's a four
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  Speaker 2: PC dot org slash. Is it legit? That's one word.
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  Speaker 2: There's also a link in the show notes to make
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  Speaker 2: it easy. And with that, it's time for our deep dive.
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  Speaker 2: This year, a dozen odd states have introduced legislation that
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  Speaker 2: affects compounding pharmacies, and in some cases those bills have
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  Speaker 2: the fingerprints of Big Pharma all over them. So to
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  Speaker 2: talk about what's going on in which states and how
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  Speaker 2: some of it might spread around the country, we've got
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  Speaker 2: with us today the leading Ladies of Pharmacy compounding Advocacy
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  Speaker 2: to Neil Davis, Katie Johnston, Lauren Paul, and Sarah Witt.
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  Speaker 2: To Neil is, of course, APC's Chief Advocacy Officer. Katie
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  Speaker 2: Johnson is at Revelation Pharma, where she oversees regularly and
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  Speaker 2: legislation all across fifty states and at the federal level.
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  Speaker 2: Lauren Paul is a licensed pharmacist in multiple states, and
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  Speaker 2: she's currently the director of State Government Affairs for Hymns
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  Speaker 2: and Hers, and Sarah Witt is the advocacy lead for
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  Speaker 2: Strive Compounding Pharmacy, where she manages its federal and state
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  Speaker 2: advocacy efforts. They've all been heavily involved in tracking and
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  Speaker 2: responding to the kind of state level legislation that impacts
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  Speaker 2: compounding pharmacies, and you know, doing their part to educate
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  Speaker 2: people and even organize grass roofs engagement efforts. Now that
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  Speaker 2: you know are experts, it's time to talk about that
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  Speaker 2: state level legislation, what's happened, what's pending, and where it's
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  Speaker 2: all going to Neil take it away.
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  Speaker 4: Thanks Andrew.
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  Speaker 5: I'm really pleased today to welcome Sarah and Katie and
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  Speaker 5: Lauren to our podcast. We are the Ladies of Advocacy,
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  Speaker 5: and I was going to start out by having each
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  Speaker 5: one of them give a little bit of background into
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  Speaker 5: how they got into advocacy work. Most of us here
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  Speaker 5: are pharmacist by trade, and advocacy doesn't really lend itself
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  Speaker 5: to our scientific background. So what was the path that
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  Speaker 5: led you into the advocacy role that you hold now
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  Speaker 5: at your job?
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  Speaker 4: And I'm going to start with Lauren Hi.
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  Speaker 6: Thanks to Neil.
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  Speaker 7: Great to be here.
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  Speaker 6: I started as a community pharmacist in one of our
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  Speaker 6: larger retail pharmacies and sort of worked my way throughout
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  Speaker 6: the organization into different roles and was plucked into the
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  Speaker 6: advocacy role over a decade ago. Really enjoy the advocacy side,
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  Speaker 6: being able to shape the practice of pharmacy and moving
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  Speaker 6: pharmacy practice forward within the profession.
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  Speaker 8: Awesome.
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  Speaker 4: How about Sarah?
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  Speaker 9: Yeah, thank you Toanil so really got my advocacy first
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  Speaker 9: introduced to me. And during my APPY rotation my fourth
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  Speaker 9: year pharmacy school, I had a pharmacy Advocacy and leadership
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  Speaker 9: rotation and I was on rotation with a Utah State
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  Speaker 9: senator here who's also a pharmacist. He kind of handed
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  Speaker 9: me a bill the first day and told me to
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  Speaker 9: run with it. And that was the beginning. And once
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  Speaker 9: I joined Strive, I really had the opportunity to attend
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  Speaker 9: CCH back in twenty twenty four and really realized the
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  Speaker 9: need for it within Strive, and so ever since then,
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  Speaker 9: I've kind of been running with it, learning on the
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  Speaker 9: fly and loving every minute of it.
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  Speaker 5: For those of you who don't know, Sarah's referring to
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  Speaker 5: Compounders on Capitol Hill, which is APC's yearly fly into Washington,
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  Speaker 5: d C, where pharmacy professionals in the compounding space fly
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  Speaker 5: over all into Washington, DC and visit with their members
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  Speaker 5: of Congress, educating them on issues of compounding. I'll moved
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  Speaker 5: to our non pharmacist, but no less amazing Katie Johnston's
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  Speaker 5: to Neil.
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  Speaker 7: Hello, everyone.
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  Speaker 10: Yes, I am not a pharmacist, but I have a
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  Speaker 10: background that's actually focused in government affairs and policy. Coming
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  Speaker 10: out of high school and going to college, I always
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  Speaker 10: had a super strong interest in American government and policy,
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  Speaker 10: but also healthcare.
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  Speaker 7: At the same time. Biology was always my favorite subject,
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  Speaker 7: but kind of.
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  Speaker 10: Always assumed I did not have the skills and ability
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  Speaker 10: to be a doctor or a pharmacist or anything that's
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  Speaker 10: actually on the ground in the field. So I kind
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  Speaker 10: of thought, you know, policy and healthcare, I can marry
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  Speaker 10: the two together going down this route. So my undergraduate
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  Speaker 10: degrees in political science and then I got my masters
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  Speaker 10: in public administration with a specialty in health care policy.
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  Speaker 10: And since then my career has been you know, pretty
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  Speaker 10: much all governor affairs roles.
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  Speaker 7: I've I've done a position with a pharmaceutical company.
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  Speaker 10: I've worked with NIH for a little bit, so I've
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  Speaker 10: gotten some experience on the local, state, and federal level.
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  Speaker 10: I joined Revelation about two and a half years ago,
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  Speaker 10: and learning the compounding space has definitely been a challenge,
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  Speaker 10: but it's been amazing. It's a great, great industry to
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  Speaker 10: be in, and despite the challenges we're facing, it's been.
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  Speaker 7: A wonderful opportunity. So I'm happy to be here.
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  Speaker 8: Well, I appreciate you being here so much.
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  Speaker 5: We're going to talk about state level legislation to because
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  Speaker 5: I know most of our advocacy work has either been
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  Speaker 5: in the federal space with FDA USP or it's been
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  Speaker 5: in the state space with the state boards of pharmacy.
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  Speaker 5: But there's not very often that we, as advocacy ladies
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  Speaker 5: in the compounding space get.
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  Speaker 4: Involved with state level legislation.
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  Speaker 5: So I'm going to start out this wave of legislation
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  Speaker 5: that's been introduced. It really started the first bills were
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  Speaker 5: introduced in December, if I remember in Florida, and we've
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  Speaker 5: had quite a few cents then, so let's let's start
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  Speaker 5: out by talking about kind of the bills that were
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  Speaker 5: introduced in Florida and kind of how it started the
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  Speaker 5: ball rolling to have legislation come along in about a
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  Speaker 5: dozen other states.
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  Speaker 4: So I'll start with Katie.
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  Speaker 5: Katie, will you talk a little bit about the two
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  Speaker 5: bills that were introduced in Florida in December and kind
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  Speaker 5: of what those bills look like and how, you know,
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  Speaker 5: kind of set the stage for the rest of the country.
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  Speaker 4: Yeah.
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  Speaker 10: Absolutely, I think you know, going into the end of
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  Speaker 10: the year, we are all caught off guard by this sudden.
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  Speaker 7: Wave of leeds.
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  Speaker 4: Florida.
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  Speaker 10: I think we felt good about going into it because
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  Speaker 10: of existing relationships we had there, but then we started
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  Speaker 10: getting our hands on some of the language that was
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  Speaker 10: included in these bills, and that's where the concern really
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  Speaker 10: came to be. And I know, at first there was
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  Speaker 10: legislation that would touch any compounding, not even just GLP one.
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  Speaker 7: Specifically, and that was super alarming.
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  Speaker 10: And you know, fortunately as we went through the past
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  Speaker 10: couple of months, it definitely refined down to being more
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  Speaker 10: focused on GLP ones. But you know, again, I think
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  Speaker 10: the biggest thing going into the end of year, though,
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  Speaker 10: was we were all just so unprepared for what was coming.
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  Speaker 10: I don't think we realized the scale of it. And
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  Speaker 10: on top of that, you know, I think APC, the
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  Speaker 10: industry as a whole, hasn't faced an effort like an
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  Speaker 10: issue like this before, where it was you know, multiple
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  Speaker 10: states at the same time, you're working with a limited timeframe.
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  Speaker 10: You have some states who are in session for only
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  Speaker 10: two months and then some who go all year long,
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  Speaker 10: along with you know, limited resources. We haven't had to
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  Speaker 10: organize something like this before, so it was kind of
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  Speaker 10: a mad dash to how we're going to go about this,
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  Speaker 10: the approach we're going to take. But I think all
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  Speaker 10: things considered, we did pretty pretty dark good. But yeah,
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  Speaker 10: I think that was probably the most concerning part. It
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  Speaker 10: was just how caught off guard we were.
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  Speaker 8: Yeah, we were absolutely caught off guard. And especially in Florida.
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  Speaker 5: We had a bill introduced kind of simultaneously in the
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  Speaker 5: Florida House and in the Florida Senate. Like you said,
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  Speaker 5: one of those bills would have restricted all of compounding,
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  Speaker 5: and one of them was a little bit more limited
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  Speaker 5: in that it applied only to weight loss drugs without
• 12:29
  Speaker 5: defining what weight loss drugs were. So we were trying
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  Speaker 5: to analyze this new legislation and figure out what it meant,
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  Speaker 5: would it apply to met foreman, would it apply to
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  Speaker 5: loto smell truck zone. I mean, there's so many things
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  Speaker 5: that could be used off label for weight loss. So
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  Speaker 5: we talked about bills that were introduced in Florida and
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  Speaker 5: how that kind of.
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  Speaker 8: Threw us off.
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  Speaker 4: But let's talk now.
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  Speaker 5: About how they set the stage and they shared DNA
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  Speaker 5: with the legislation that was going to end up being
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  Speaker 5: filed in about a dozen states around the country. Can
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  Speaker 5: you kind of share some common themes in the legislation
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  Speaker 5: that ended up getting filed.
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  Speaker 7: Yeah.
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  Speaker 4: Sure.
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  Speaker 6: I think what we saw across the country was requirements
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  Speaker 6: that were very similar in all the bills. Some of
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  Speaker 6: them effectively would limit all the compounding for GLP ones.
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  Speaker 7: We did see a few that.
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  Speaker 6: Started off as prohibition of all compounding, and then through
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  Speaker 6: very early committee meetings, they were moved more into a
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  Speaker 6: prohibition on GLP one compounding. Some of the requirements we
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  Speaker 6: saw or that compounding pharmacies needed to buy API directly
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  Speaker 6: from the drug makers themselves. This was language that you
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  Speaker 6: really had to understand because it wasn't an outright saying
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  Speaker 6: that you had to buy from the drug makers. It
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  Speaker 6: was the way that it was worded and it took
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  Speaker 6: a couple readings, I think to identify that. I think
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  Speaker 6: what we also saw is API testing requirements and then
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  Speaker 6: also more testing of finished compounded preparations that's above and
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  Speaker 6: beyond what FDA and USP standards and would effectively put
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  Speaker 6: the compounds out of reach for patients. We also saw
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  Speaker 6: limits on sourcing from FDA registered suppliers or manufacturers. They
• 14:20
  Speaker 6: required that the API be sourced from FDA registered suppliers
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  Speaker 6: that had been inspected within the last two years receiving
• 14:32
  Speaker 6: either a no action indicated or voluntary action indicated, which
• 14:36
  Speaker 6: is a requirement not placed on any other FDA registered
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  Speaker 6: manufacturers and is not how the FDA inspection process works,
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  Speaker 6: as it's a risk based inspection.
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  Speaker 3: I think.
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  Speaker 6: Finally, also we saw some certificate of analysis requirements which
• 14:50
  Speaker 6: were above and beyond what is already required by the FDA.
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  Speaker 5: Yeah, a lot of these bills had language that was
• 14:59
  Speaker 5: surprisingly similar.
• 15:00
  Speaker 4: So it definitely.
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  Speaker 5: Appeared that there was someone behind all of these bills,
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  Speaker 5: and I think that we know who that is, and
• 15:09
  Speaker 5: you know, we're not going to name names or anything,
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  Speaker 5: but there's some big drug.
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  Speaker 8: Makers that were pushing this legislation in.
• 15:15
  Speaker 5: Order to protect their market share, and a lot of
• 15:18
  Speaker 5: the talking points that they used and that they had
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  Speaker 5: the lawmakers use when introducing these bills was around patient safety.
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  Speaker 4: That these were a bill, a bill to protect patient.
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  Speaker 5: Safety, talking about counterfeit drugs and illicit medications, even though
• 15:33
  Speaker 5: these bills really would target legitimate compounding and pharmacies. Haiti,
• 15:37
  Speaker 5: can you talk a little bit about the way that
• 15:39
  Speaker 5: these bills were framed versus what these bills actually.
• 15:43
  Speaker 4: Would do if they were passed as introduced?
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  Speaker 10: Yes, absolutely, I think that was honestly, probably the biggest
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  Speaker 10: problem we face was the narrative that was being created
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  Speaker 10: around compounding.
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  Speaker 7: Compounding plays a very.
• 15:56
  Speaker 10: Important and valuable rule in the healthcare space, and a
• 15:59
  Speaker 10: lot of the dialogue that was being used round being
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  Speaker 10: dangerous and unsafe was super concerning, you know, even outside
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  Speaker 10: of GLP ones. In addition to that, I know some
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  Speaker 10: of the bills, you know, they include language on deceptive advertising,
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  Speaker 10: and you know, I think it's okay to explain that,
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  Speaker 10: you know, a compounded drug is not FDA approved, They're
• 16:19
  Speaker 10: not supposed.
• 16:19
  Speaker 7: To be FDA approved. But including language.
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  Speaker 10: Such as it's unsafe does just as a detriment to
• 16:26
  Speaker 10: compounding as a whole and that ultimate heart patient access.
• 16:29
  Speaker 7: If you create this narrative that it's so dangerous.
• 16:31
  Speaker 10: That legislators are going to be encouraged to want to
• 16:33
  Speaker 10: restrict access to it. So for us, we had a
• 16:37
  Speaker 10: big hurdle to face in terms of education and awareness
• 16:40
  Speaker 10: on compounding and why it does exist. And you know,
• 16:43
  Speaker 10: for many legislators, compounding is such a very complex and
• 16:48
  Speaker 10: specific issue. So going in and meeting with them, you've
• 16:50
  Speaker 10: not only had to address the hurdle of what is compounding,
• 16:53
  Speaker 10: but also what is it in the context of these
• 16:55
  Speaker 10: bills and what these bills are trying to do. So
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  Speaker 10: I think that was a big part of our efforts
• 17:00
  Speaker 10: and the planning coordination that went around it.
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  Speaker 5: So, like I said, these bills have been introduced in
• 17:07
  Speaker 5: about a dozen states. Sarah, can you talk a little
• 17:11
  Speaker 5: bit about what we've done as an industry to fight
• 17:14
  Speaker 5: some of this legislation, how APC has helped lead the
• 17:19
  Speaker 5: charge in the States to get pharmacists to come testify.
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  Speaker 4: We talk a little bit about what the strategy.
• 17:24
  Speaker 5: Has been in protecting compounding pharmacies in the States from
• 17:29
  Speaker 5: this legislation getting further along.
• 17:32
  Speaker 9: Yeah, Denil, So a lot of what we've had to
• 17:34
  Speaker 9: do as an industry is really correct the record on
• 17:37
  Speaker 9: what compounding is, what compounding isn't, and really just take
• 17:43
  Speaker 9: the time to educate these lawmakers on what we do
• 17:47
  Speaker 9: on a day to day basis, how we fit into
• 17:49
  Speaker 9: the healthcare ecosystem, how we support the pharmaceutical supply chain.
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  Speaker 9: We have a very unique role, and a lot of
• 17:57
  Speaker 9: people don't know what that is. So it was a
• 18:01
  Speaker 9: lot harder because we had to dig ourselves out of
• 18:03
  Speaker 9: a hole of misconceptions. But I think we got there eventually,
• 18:08
  Speaker 9: and we know that fight isn't over. So that's our
• 18:11
  Speaker 9: main strategy is really letting them know what compounding is.
• 18:15
  Speaker 9: Then another strategy is just conveying to them what the
• 18:19
  Speaker 9: effects of the bill would actually be to patients. You
• 18:23
  Speaker 9: can see all of the legislation and the good intentions
• 18:28
  Speaker 9: and what we would love to do to regulate the
• 18:32
  Speaker 9: bad actors that operate outside of current regulations, but it's
• 18:36
  Speaker 9: going to bleed over into compounding pharmacies who are licensed
• 18:41
  Speaker 9: and operate under federal and state regulations. So really just
• 18:45
  Speaker 9: putting a face to it and saying there are patients
• 18:48
  Speaker 9: out here who rely on compounding medications because they can't
• 18:52
  Speaker 9: take a commercially available option, and when they do, notice
• 18:56
  Speaker 9: that it is going to impact a lot more patients
• 18:58
  Speaker 9: than they think and a lot more business than they
• 19:00
  Speaker 9: realize in taking away access and provider discretion. I think
• 19:06
  Speaker 9: that's where they truly realized that this bill had unintended
• 19:09
  Speaker 9: consequences and we really needed to work on the legislation.
• 19:13
  Speaker 10: And if I could just add to that, Neil, I
• 19:16
  Speaker 10: think overall, with all the legislation, my biggest concern was
• 19:19
  Speaker 10: the president it was going to set for.
• 19:21
  Speaker 7: You know, obviously glp ones.
• 19:22
  Speaker 10: Were a blockbuster drug, something we've never dealt with before,
• 19:26
  Speaker 10: and so that's not to say there's going to be
• 19:28
  Speaker 10: another drug like that ten years from now, twenty years
• 19:30
  Speaker 10: from now, and so we don't want to set this
• 19:32
  Speaker 10: president of putting pharmaceutical manufacturing like standards onto compounding pharmacies,
• 19:38
  Speaker 10: because that is not why compounding pharmacies exist.
• 19:41
  Speaker 7: Compounding pharmacies exist to.
• 19:42
  Speaker 10: Meet an individual patient need, and the requirements and processes
• 19:46
  Speaker 10: that you know, pharmaceutical manufacturers have to go to cannot
• 19:49
  Speaker 10: be met by a small compounding pharmacy.
• 19:51
  Speaker 7: That is not what they are built and created to do.
• 19:54
  Speaker 10: And so I think any of this legislation passing passing
• 19:57
  Speaker 10: would just again set you know, a very bad example
• 19:59
  Speaker 10: for future drugs that will be similar to the craze
• 20:02
  Speaker 10: of DLP ones and how we treat compound pharmacies when
• 20:05
  Speaker 10: it comes to that space, not including the fact that
• 20:08
  Speaker 10: you know, we played a critical role in meeting the
• 20:09
  Speaker 10: gaps when these drugs were on shortage. So again, all
• 20:12
  Speaker 10: that is just something I think that needs to be
• 20:14
  Speaker 10: taken in consideration as we move.
• 20:15
  Speaker 9: Forward, Exactly, Katie, Like, if they can target one class
• 20:20
  Speaker 9: of medications, what's to say that they can't target HRT
• 20:24
  Speaker 9: in the future, which is one of the biggest classes
• 20:28
  Speaker 9: of medications that we compound for our patients. That has
• 20:31
  Speaker 9: a huge impact for our patients in the industry.
• 20:36
  Speaker 6: And if I could add to this also, I think
• 20:39
  Speaker 6: one thing APC has done a really nice job at
• 20:42
  Speaker 6: is really unwinding the narrative and the conflation between illicit
• 20:47
  Speaker 6: and counterfeit drugs with compounding. We know that that has
• 20:51
  Speaker 6: been a message that has been out there by some groups,
• 20:55
  Speaker 6: and really needing to unwind that and explain the difference
• 20:58
  Speaker 6: between the two has been a key in the education
• 21:01
  Speaker 6: that APC has done during this legislative session.
• 21:05
  Speaker 5: One of the things that APC learned as these bills
• 21:07
  Speaker 5: were introduced around the country. You know, we hadn't had
• 21:09
  Speaker 5: a whole lot of experience dealing with state level legislation
• 21:12
  Speaker 5: in the past, is kind of what the steps are
• 21:15
  Speaker 5: needed to take when you're talking about defeating state legislation
• 21:19
  Speaker 5: or changing state legislation. So we had to, you know,
• 21:24
  Speaker 5: say a bill was introduced in a particular state, we
• 21:26
  Speaker 5: would run reports of all the pharmacies and pharmacists that
• 21:29
  Speaker 5: were in that state to gather a group of, uh,
• 21:32
  Speaker 5: you know, people that would be actively involved in helping
• 21:35
  Speaker 5: with getting the legislation stopped.
• 21:37
  Speaker 4: So the kind of people that would.
• 21:39
  Speaker 5: Go in make these visits, you know, to their legislators
• 21:43
  Speaker 5: either in their offices or invite them to their pharmacies.
• 21:46
  Speaker 5: We hired lobbyists around the country. In most states we
• 21:49
  Speaker 5: ended up hiring a lobbyist. This was the first time
• 21:51
  Speaker 5: that we really ever hired these state level lobbyists to
• 21:54
  Speaker 5: deal with state legislative issues.
• 21:56
  Speaker 4: You know, we've had a federal lobbyist for years, but
• 21:58
  Speaker 4: these are this is new.
• 21:59
  Speaker 5: So I was dealing with hiring and developing contracts with
• 22:03
  Speaker 5: lobbyists all around the country and directing their activities saying
• 22:07
  Speaker 5: this is what we need to do to get these
• 22:09
  Speaker 5: bills stopped.
• 22:11
  Speaker 4: So the.
• 22:13
  Speaker 5: First state that really had anything that actually went through
• 22:16
  Speaker 5: that ended up crossing the finish line and actually the
• 22:18
  Speaker 5: only state, and we're going to cross our fingers and
• 22:20
  Speaker 5: say the only state.
• 22:21
  Speaker 4: This year with Indiana, and Indiana is a.
• 22:25
  Speaker 5: Little bit different than some of the other states in
• 22:27
  Speaker 5: the legislation that ended.
• 22:28
  Speaker 4: Up getting passed.
• 22:29
  Speaker 5: And Katie, do you want to talk a little bit
• 22:33
  Speaker 5: about Indiana and how it was different than the kind
• 22:35
  Speaker 5: of the other state legislation which shared a lot of
• 22:38
  Speaker 5: the same DNA.
• 22:40
  Speaker 4: Yes.
• 22:40
  Speaker 10: So for Indiana, that was kind of our first trial
• 22:43
  Speaker 10: run in terms of how to actually treat the bill,
• 22:45
  Speaker 10: how to triage it, how to get amendments, in how
• 22:47
  Speaker 10: to work with legislators, and how to testify. And at
• 22:51
  Speaker 10: the end of the day, you know, pharmacists, pharmacy owners,
• 22:54
  Speaker 10: those are who are altoly going to be affected by
• 22:56
  Speaker 10: these bills, and so that's who we want in their testifying.
• 22:59
  Speaker 10: Except for most pharmacists, that's not something they're doing on
• 23:02
  Speaker 10: a regular basis. So you not only had the issue
• 23:05
  Speaker 10: of having to recruit people quickly, but also get them
• 23:08
  Speaker 10: up to speed on what the building, which is how
• 23:10
  Speaker 10: it'll affect them, and you know how to you know,
• 23:12
  Speaker 10: successfully testify before you're the members of your legislature. And
• 23:16
  Speaker 10: so fortunately with Indiana, it went through multiple, multiple rounds
• 23:21
  Speaker 10: of amendments where we ultimately got it to where essentially
• 23:25
  Speaker 10: aligns with federal law, which I think we can all
• 23:27
  Speaker 10: agree totally makes sense and we are happy with the
• 23:29
  Speaker 10: outcome there, especially with that being the only bill, as
• 23:33
  Speaker 10: you said fingers Cross, hopefully the only bill that has passed.
• 23:36
  Speaker 7: So I think Indiana was definitely our practice round.
• 23:40
  Speaker 10: I think there was room for improvement as we were
• 23:42
  Speaker 10: all kind of learning as we want the best way
• 23:44
  Speaker 10: to go about it, but ultimately I think we came
• 23:46
  Speaker 10: out with a win there.
• 23:48
  Speaker 5: The Indiana build, like like Katie said, did essentially just
• 23:52
  Speaker 5: require compounding and pharmacies to adhere to federal law section
• 23:56
  Speaker 5: five to three A of the Food Dragging Cosmetic deckt
• 23:59
  Speaker 5: But it also created a registration system for medspas, which
• 24:02
  Speaker 5: is different than much of the other legislation that's been
• 24:05
  Speaker 5: introduced that kind of shares the same DNA we're talking about,
• 24:09
  Speaker 5: Sarah or Lauren, does one of you want to talk
• 24:11
  Speaker 5: about that, that MEDSPA legislation and you know kind of
• 24:16
  Speaker 5: where we think that the industry might go there.
• 24:19
  Speaker 6: What we saw in Indiana was a requirement for registration
• 24:25
  Speaker 6: for medspas which had not been in the statute prior.
• 24:31
  Speaker 6: There is some enforcement that will happen by the Board
• 24:36
  Speaker 6: of Pharmacy, but the registration will happen for the medspas.
• 24:42
  Speaker 6: This was something we did see the first time the
• 24:45
  Speaker 6: American MEDSPA Association come into the conversation. So there are
• 24:51
  Speaker 6: some other requirements within that language, but really one of
• 24:55
  Speaker 6: the only bills that addressed the MEDSPA aspect of the
• 25:01
  Speaker 6: GLP one compounding or i would say more of the
• 25:06
  Speaker 6: lifestyle treatment therapies that we see.
• 25:11
  Speaker 5: There was one other bill that was introduced that with
• 25:14
  Speaker 5: a quite a bit of fanfare. Actually, there was a
• 25:16
  Speaker 5: press conference that was done that included a patient that
• 25:20
  Speaker 5: had taken a compounded JLP one and unfortunately had to
• 25:24
  Speaker 5: have a liver transplant.
• 25:27
  Speaker 8: And you know, this press conference was.
• 25:29
  Speaker 5: With the executive director of the Board of Pharmacy in Kentucky,
• 25:33
  Speaker 5: the patient, and.
• 25:34
  Speaker 4: The legislator that introduced it.
• 25:36
  Speaker 5: And you know, this press conference made it seem like
• 25:39
  Speaker 5: the bill that was coming in Kentucky was going to
• 25:41
  Speaker 5: be very similar to the bill that the bills that
• 25:43
  Speaker 5: had been introduced around the country, but it actually ended
• 25:46
  Speaker 5: up being really different. Katie, can you speak to the
• 25:50
  Speaker 5: Kentucky bill at all.
• 25:52
  Speaker 7: Yeah, the Kentucky bill totally caused my surprise.
• 25:55
  Speaker 10: I think when we found out about it, we had
• 25:56
  Speaker 10: learned that it was connected to a patient and also
• 25:59
  Speaker 10: the fact that the boarder pharmacy helped drive some of
• 26:02
  Speaker 10: the language.
• 26:02
  Speaker 7: That was included.
• 26:04
  Speaker 10: And I think the Kentucky bill was a step in
• 26:07
  Speaker 10: the right direction. You know, we definitely had some concerns
• 26:10
  Speaker 10: with it in certain areas, but the overall goal of
• 26:12
  Speaker 10: the bill was aligned with what we agree would be
• 26:14
  Speaker 10: best done to control some of.
• 26:16
  Speaker 7: These bad actors that are out there.
• 26:18
  Speaker 10: And you know, I think when you compare the Kentucky
• 26:20
  Speaker 10: bill to the legislation that we saw in other states,
• 26:24
  Speaker 10: it's addressing the wide range of bad actors and focusing
• 26:27
  Speaker 10: on unlicensed facilities, which where we believe.
• 26:30
  Speaker 7: Was most of the the concern is at, whereas.
• 26:34
  Speaker 10: The legislation and the other states was focused on solely
• 26:36
  Speaker 10: on compounding pharmacies, which you know, if there's a compounding
• 26:39
  Speaker 10: pharmacy who's acting bad out there. There's already existing regulation
• 26:42
  Speaker 10: to acknowledge that and address that. So if the other
• 26:45
  Speaker 10: legislation passed, it would do nothing to address those outside
• 26:48
  Speaker 10: bad actors, whereas the Kentucky bill would focus more on
• 26:51
  Speaker 10: those and give the Boarder of Pharmacy the ability to step.
• 26:54
  Speaker 7: In when there was cause for concern.
• 26:57
  Speaker 9: I think the Kentucky bill was a really interesting example
• 27:00
  Speaker 9: of where we kind of want this legislation to lead
• 27:04
  Speaker 9: in the process that we need to have bringing more
• 27:07
  Speaker 9: stakeholders to the table. If we're all trying to combat
• 27:10
  Speaker 9: these bad actors and unlicensed entities entering the pharmacy space,
• 27:15
  Speaker 9: we all need to work together on that because we
• 27:17
  Speaker 9: all have different perspectives and we all come from different
• 27:20
  Speaker 9: backgrounds to be able to make this what it needs
• 27:23
  Speaker 9: to be. So the Kentucky Bill, I.
• 27:24
  Speaker 7: Think is going to be interesting to see.
• 27:29
  Speaker 5: Okay, so we've talked about some of the outliers like
• 27:31
  Speaker 5: Indiana and Kentucky.
• 27:32
  Speaker 4: So let's talk about the rest of them, because we
• 27:34
  Speaker 4: can kind of.
• 27:35
  Speaker 5: Take the rest of the bills as a whole because
• 27:37
  Speaker 5: they are so similar, whether they applied to all compounded medications,
• 27:42
  Speaker 5: which was the case in Washington, which is one of
• 27:45
  Speaker 5: the reasons that that one was really, you know, relatively
• 27:47
  Speaker 5: easy to defeat versus got limited only to compounded JLP
• 27:52
  Speaker 5: ones for weight loss like Colorado, that was relatively difficult
• 27:56
  Speaker 5: to get that one postponed indefinitely, which is the status
• 28:01
  Speaker 5: is it's at. Now let's talk about those ones kind
• 28:04
  Speaker 5: of as a group. All of those have either been
• 28:07
  Speaker 5: killed in committee, timed out on calendar, or postponed indefinitely.
• 28:13
  Speaker 5: So all around the country those bills didn't advance, which
• 28:16
  Speaker 5: tells us a lot about them because the legislators in
• 28:19
  Speaker 5: those states really came to understand that these bills were
• 28:23
  Speaker 5: bad for patient access to compounded medications. And I think
• 28:27
  Speaker 5: that the legislators took some time to understand federal and
• 28:31
  Speaker 5: state law and what already is required versus not required. Lauren,
• 28:36
  Speaker 5: do you think that the legislators before the education by
• 28:39
  Speaker 5: the pharmacists actually understood how compounding works under federal and
• 28:43
  Speaker 5: state law.
• 28:46
  Speaker 4: Todail.
• 28:46
  Speaker 6: It's a great question, and I think doing some of
• 28:49
  Speaker 6: the visits myself and having some conversations, it's clear that
• 28:54
  Speaker 6: there was a lack of understanding of how the legal
• 28:57
  Speaker 6: and regulatory framework works that. You know, pharmacies are very
• 29:03
  Speaker 6: highly regulated by the FDA, but also they are state
• 29:06
  Speaker 6: regulated by already the legislatures. So there are state statutes
• 29:13
  Speaker 6: and pharmacy acts that have specific language that regulate the
• 29:17
  Speaker 6: state licensed pharmacies, but also the state boards of pharmacy
• 29:21
  Speaker 6: that also highly regulate these pharmacies.
• 29:23
  Speaker 7: So it was clear.
• 29:24
  Speaker 6: That it was an education gap that was not given
• 29:29
  Speaker 6: to them prior. And many of the legislatures aren't pharmacists.
• 29:32
  Speaker 6: They don't understand that. We're very lucky to have a
• 29:35
  Speaker 6: few that are and that understand and are advocates and allies.
• 29:40
  Speaker 6: But unfortunately the education was not there, but we got
• 29:44
  Speaker 6: there through the session with all of the meetings and
• 29:47
  Speaker 6: the education that we were all able to provide.
• 29:50
  Speaker 5: Yeah, I've had the pleasure of flying out to many
• 29:53
  Speaker 5: of these states to pay legislators some visits and do
• 29:57
  Speaker 5: a little compound in one on one and talk about
• 30:00
  Speaker 5: these bills and how they would prevent patient access. And
• 30:03
  Speaker 5: you know, we've had pharmacists within these states that have
• 30:05
  Speaker 5: gone on these visits as well. Sarah and I are
• 30:08
  Speaker 5: actually just in Sacramento. I feel like that was last
• 30:10
  Speaker 5: week to do visits and I'm setting up another time
• 30:15
  Speaker 5: to go back. But Sarah, can you talk about the
• 30:17
  Speaker 5: visits that we've had with state legislators and what those
• 30:21
  Speaker 5: look like.
• 30:22
  Speaker 9: Yeah, so those meetings really look like sitting down and
• 30:26
  Speaker 9: getting into what the consequences of that bill is going
• 30:30
  Speaker 9: to be. The bill in California was really framed as
• 30:36
  Speaker 9: protecting people online from being targeted with ads, so there
• 30:43
  Speaker 9: was a lot of misconceptions about what the bill really was.
• 30:48
  Speaker 7: So we spent a lot.
• 30:49
  Speaker 9: Of time really getting down into the weeds with this
• 30:52
  Speaker 9: bill and letting them know exactly what this is going
• 30:55
  Speaker 9: to do. It's going to take away patient access. It's
• 30:58
  Speaker 9: going to severely limit what patients can and can't do
• 31:03
  Speaker 9: with their health in the state of California, and so
• 31:06
  Speaker 9: we spent a lot of time. I think we had
• 31:09
  Speaker 9: eleven meetings in that one day, so it was a
• 31:13
  Speaker 9: marathon of a day, but we were really able to
• 31:16
  Speaker 9: connect with these lawmakers and tell them the direct impact
• 31:21
  Speaker 9: it would have on their constituents and the people of California,
• 31:24
  Speaker 9: and it's really important to protect these people's health. And
• 31:27
  Speaker 9: we were out there. We had I think it was
• 31:29
  Speaker 9: a whole group of pharmacists. We were all pharmacists out there,
• 31:32
  Speaker 9: so we were really able to speak to what the
• 31:36
  Speaker 9: consequences of this bill would be.
• 31:38
  Speaker 5: So you started, but we have to talk about California.
• 31:42
  Speaker 5: Why has California been so uniquely challenging?
• 31:45
  Speaker 4: Do you think, Katie?
• 31:46
  Speaker 10: The California Border of Pharmacy recently upgraded their USP standards
• 31:50
  Speaker 10: and actually did more than what was required in USP,
• 31:53
  Speaker 10: and so that's kind of been a challenge adapting to
• 31:56
  Speaker 10: those additional requirements. And now on top of that, we
• 31:58
  Speaker 10: were facing what is our arguably the most challenging legislative
• 32:02
  Speaker 10: language that we've seen of all the bills in every state.
• 32:06
  Speaker 10: You know, California, it's such a hub of healthcare and
• 32:09
  Speaker 10: technology and innovation, and they have a very involved legislature,
• 32:13
  Speaker 10: and so it's just been a much different culture and
• 32:15
  Speaker 10: effort compared to what we've done in some of the
• 32:17
  Speaker 10: other states.
• 32:19
  Speaker 5: Yeah, the bill in California was introduced in the Assembly
• 32:23
  Speaker 5: and it was triple referred, so it actually had hearings
• 32:25
  Speaker 5: in three different committees. And our drug makers that are
• 32:29
  Speaker 5: pushing these bills have learned along the way.
• 32:31
  Speaker 4: Of course, we all learn from trial.
• 32:33
  Speaker 5: And error, and they found a tactic in California that
• 32:36
  Speaker 5: really has resonated with California lawmakers and in the committee
• 32:40
  Speaker 5: hearing for Privacy and Consumer Protection, it was quite an
• 32:43
  Speaker 5: effective display for the people that were proponents of this
• 32:47
  Speaker 5: bill and the assemblymen who introduced this bill. Sarah, can
• 32:52
  Speaker 5: you talk about the consumer protection angle that they're calling
• 32:54
  Speaker 5: out in California.
• 32:56
  Speaker 9: So the consumer protection angle was really viewing this through
• 33:01
  Speaker 9: a lens of targeted social media advertising, which, like Tinyel said,
• 33:07
  Speaker 9: was very effective. We don't want people to be targeted
• 33:12
  Speaker 9: with ads to make them feel ashamed of who they
• 33:15
  Speaker 9: are or how they look, or what their bodies look like.
• 33:21
  Speaker 9: And so that's really what they framed it as. And
• 33:23
  Speaker 9: that's stuck, and it stuck hard. It was really hard
• 33:27
  Speaker 9: to get away from. And I think that people still
• 33:31
  Speaker 9: think that that's what the bill is intended to do,
• 33:33
  Speaker 9: is to limit those targeted social media advertisements.
• 33:38
  Speaker 5: Yeah, in California, it's been a little bit different because,
• 33:41
  Speaker 5: unlike in other states where we really just opposed the legislation,
• 33:45
  Speaker 5: in California, we authored and offered a complete set of
• 33:50
  Speaker 5: amendments to the assemblymen who introduced the bill. The amendments,
• 33:55
  Speaker 5: you know, had advertising restrictions built into them, such as
• 33:59
  Speaker 5: disclosures that compounded drugs or not. FDA approved a complete
• 34:03
  Speaker 5: prohibition on advertising that aimed at people under the age
• 34:06
  Speaker 5: of eighteen.
• 34:07
  Speaker 4: But we also.
• 34:07
  Speaker 5: Included an entire news section in the bill that didn't
• 34:10
  Speaker 5: exist before, surrounding the essentially a copy.
• 34:13
  Speaker 8: Provisions in California.
• 34:15
  Speaker 5: As you know, was recently mentioned, California updated its compounding
• 34:19
  Speaker 5: regulations and right now has the kind of.
• 34:22
  Speaker 8: Most tight guardrails around compounding.
• 34:24
  Speaker 5: What is deemed you know, quote unquote essentially a copy
• 34:27
  Speaker 5: of an FDA proved medication. Where most states follow the
• 34:31
  Speaker 5: federal guidance which requires a significant difference between FDA approved
• 34:37
  Speaker 5: and a compounded product to be documented by the pharmacy,
• 34:40
  Speaker 5: but in California there has to be a clinically significant difference.
• 34:45
  Speaker 5: So this news section that we added into the bill
• 34:48
  Speaker 5: actually defined clinically significant difference in a way that isn't
• 34:52
  Speaker 5: in the California Border Pharmacy regulations.
• 34:54
  Speaker 4: In an attempt to.
• 34:55
  Speaker 5: Make it easier for pharmacies to understand what documentation is
• 34:59
  Speaker 5: enough what is not enough to kind of curtail any
• 35:03
  Speaker 5: sort of you know, widespread compounding under the guise of personalization,
• 35:08
  Speaker 5: we did offer a complete set of amendments to the
• 35:10
  Speaker 5: bill's author that they have.
• 35:12
  Speaker 4: Not been accepted yet. We did have a meeting with.
• 35:14
  Speaker 5: The author to talk about these amendments, so we are
• 35:18
  Speaker 5: hopeful that something will get will get accepted.
• 35:21
  Speaker 4: You know, we would like something to.
• 35:23
  Speaker 5: Pass in California that defines what essentially a copy is
• 35:27
  Speaker 5: and that limits advertising to populations that shouldn't be advertised
• 35:30
  Speaker 5: to and you know, includes appropriate disclosures that compounded medications.
• 35:34
  Speaker 4: Are not FD approved.
• 35:37
  Speaker 5: But because of the way the bill has been framed
• 35:39
  Speaker 5: in California and the way that California Assembly is focusing
• 35:44
  Speaker 5: on this like consumer safety patient safety portion of the bill,
• 35:49
  Speaker 5: which the majority of the bill is not about, and
• 35:52
  Speaker 5: we don't really have a problem with that part of
• 35:54
  Speaker 5: the bill. It's going to go to the Full Assembly
• 35:56
  Speaker 5: this this coming week, and if it passes through the Fullestssembly,
• 36:00
  Speaker 5: it'll move over to the Senate and we'll start the
• 36:03
  Speaker 5: process in the Senate over again. So California continues to
• 36:07
  Speaker 5: be a challenge and we continue to need support in California.
• 36:11
  Speaker 5: So if you have patients in California, we have a
• 36:16
  Speaker 5: grassroots initiative where you can send them to compounding dot Com.
• 36:19
  Speaker 5: It'll send a message to their state assemblyman or legislator
• 36:24
  Speaker 5: explaining about the bill and what the problems.
• 36:26
  Speaker 4: With the bill are. If you have the ability to.
• 36:28
  Speaker 5: Come with us to California, to Sacramento to meet with
• 36:31
  Speaker 5: these senators next that would be helpful. So any way
• 36:35
  Speaker 5: to get involved in this advocacy effort if you've got
• 36:38
  Speaker 5: patients in California is appreciated. But looking forward, but we're
• 36:43
  Speaker 5: going to you know, it's yet to be seeing what's
• 36:45
  Speaker 5: going to end up happening in California.
• 36:47
  Speaker 4: But we do have next year to look forward to
• 36:49
  Speaker 4: as well.
• 36:49
  Speaker 5: Katie, can you talk to what we expect to see
• 36:52
  Speaker 5: next legislative session?
• 36:54
  Speaker 10: Yes, absolutely, I think next legislative session, I would argue,
• 36:58
  Speaker 10: could potentially be even more of about battle in states
• 37:01
  Speaker 10: where we didn't see anything passed, so basically all of
• 37:04
  Speaker 10: them except for Indiana right now, I think we'll probably
• 37:08
  Speaker 10: see I think we'll see Pharma cut back a little
• 37:11
  Speaker 10: bit on the language that they're using.
• 37:13
  Speaker 7: I think after you know, the.
• 37:14
  Speaker 10: Multiple states that they have failure in this year, they're
• 37:17
  Speaker 10: gonna probably pivot their approach in terms of what they
• 37:20
  Speaker 10: include language wise. But I know for sure Virginia we're
• 37:23
  Speaker 10: guaranteed to see it build next year.
• 37:25
  Speaker 7: I'm hearing rumors of Connecticut, Kentucky.
• 37:29
  Speaker 10: We know we'll be coming back since it did not
• 37:30
  Speaker 10: make it through in this session. So definitely rumors and
• 37:34
  Speaker 10: all the states that we had legislation this year, along
• 37:36
  Speaker 10: with some new ones that we never dealt with. In
• 37:39
  Speaker 10: addition to that, I know we've kind of been hearing
• 37:41
  Speaker 10: of Pennsylvania and North Carolina on the side for a
• 37:44
  Speaker 10: while to be introduced, but have not seen anything there.
• 37:46
  Speaker 10: So if we don't get any movement out of those
• 37:48
  Speaker 10: two states, I would go ahead and assume that they're
• 37:50
  Speaker 10: going to be back next year as well. So I
• 37:53
  Speaker 10: will say while we're anticipating all of that, we as
• 37:58
  Speaker 10: an industry are working on a more proactive approach as
• 38:00
  Speaker 10: we go into next year. Again, this year it was
• 38:03
  Speaker 10: very much panic mode. We were caught off guard. We
• 38:06
  Speaker 10: did the best we could with the limited time and
• 38:08
  Speaker 10: resources we had. So hopefully, given everything we've learned over
• 38:12
  Speaker 10: the past four months, we're going to be going in
• 38:14
  Speaker 10: much stronger next year, prepared to have some of these conversations.
• 38:18
  Speaker 10: And in addition to that, in the states where we've
• 38:20
  Speaker 10: already had legislation we've had we've already initiated some of
• 38:23
  Speaker 10: those conversations, so hopefully, you know, we have some of
• 38:25
  Speaker 10: those relationships going where we've covered some of the basic
• 38:28
  Speaker 10: education aspect of it and can focus more on strategy
• 38:31
  Speaker 10: and amending the bills to get them into a position
• 38:33
  Speaker 10: where both sides are happy.
• 38:36
  Speaker 5: Yeah, Katie, APC is working on a proactive approach, so
• 38:40
  Speaker 5: rather than playing defense like we got to do this year,
• 38:43
  Speaker 5: We've got a group of you know, APC members that
• 38:47
  Speaker 5: we have got together. They're coming up with potential model
• 38:50
  Speaker 5: legislation visits with state legislators, you know, talking with attorney generals,
• 38:56
  Speaker 5: just making a plan for how to go forward to
• 38:59
  Speaker 5: prevent this kind of legislation from ever getting introduced in
• 39:02
  Speaker 5: the first place, because there's enough education, you know, in
• 39:06
  Speaker 5: in these lawmakers offices that they know that this legislation
• 39:12
  Speaker 5: is not good for patient access. So looking forward, we're
• 39:15
  Speaker 5: gonna we're going to have a long road ahead of
• 39:18
  Speaker 5: us of work still to do before the before next year,
• 39:22
  Speaker 5: and a lot of this work also takes money. Lobbyists
• 39:25
  Speaker 5: take money, So if you haven't given to the Compounding
• 39:28
  Speaker 5: Defense Fund, please consider giving to this fight. This fight
• 39:33
  Speaker 5: is coming back next year. If you have given, Please.
• 39:36
  Speaker 4: Consider giving again. The fight is not over just because.
• 39:39
  Speaker 5: We got through twenty twenty six mostly on skates, you know,
• 39:42
  Speaker 5: crossing our fingers about California.
• 39:45
  Speaker 4: I think that's about.
• 39:46
  Speaker 5: It for our state legislative fight on our podcast today.
• 39:50
  Speaker 5: Unless there's anything that anyone wants to add, I think
• 39:53
  Speaker 5: that that is about it. If you have questions or
• 39:57
  Speaker 5: comments or want to reach out to help, please reach
• 39:59
  Speaker 5: out to me to Neil. I'm leading the advocacy effort
• 40:02
  Speaker 5: for APC. My email is my name Tanil T E
• 40:05
  Speaker 5: N I L L E A four PC dot org.
• 40:08
  Speaker 4: And we'll put that in the show notes and I'll
• 40:10
  Speaker 4: give it back to you Andrew.
• 40:12
  Speaker 3: All Right, thank you to Neil. Thank you ladies.
• 40:15
  Speaker 2: That was exactly the kind of perspective we really need
• 40:18
  Speaker 2: these days when it comes to those bills and the
• 40:21
  Speaker 2: thought process behind some of this legislation. People don't always
• 40:26
  Speaker 2: realize what's happening in their state legislatures, especially when you've got,
• 40:31
  Speaker 2: let's say, some organizations deliberately trying to muddy the waters.
• 40:37
  Speaker 2: All right, that is all for this episode of Essential
• 40:41
  Speaker 2: But before we play that outro music, something I always
• 40:44
  Speaker 2: point out, if you are a compounding pharmacist or technician,
• 40:48
  Speaker 2: or if you prescribe compounded meds, APC is almost certainly
• 40:52
  Speaker 2: helping you and helping your patients. I'm not going to
• 40:55
  Speaker 2: go through everything APC does, but i will say that
• 40:58
  Speaker 2: it is the biggest and in a way the loudest
• 41:01
  Speaker 2: trade association for the whole compounding profession. If you're not
• 41:05
  Speaker 2: a member of APC, really ought to be. We are
• 41:07
  Speaker 2: working for you. We'd love to have you on board.
• 41:10
  Speaker 2: Just head over to a four PC dot org check
• 41:14
  Speaker 2: us out. All right, Brady, now you can play that
• 41:17
  Speaker 2: ultro music. Thank you for listening to everyone.