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Why the Pharmacy Supply Chain Breaks — and What Leaders Must Do About It | Executive Dose · Pharmacy Podcast Network

• 0:07
  Speaker 1: Thanks for listening to the Pharmacy Podcast Network.
• 0:26
  Speaker 2: Welcome to Executive Dose, the podcast where pharmaceutical leadership meets
• 0:32
  Speaker 2: unfiltered insight. Hosted by Stephen Beckman, CEO of Your All Pharma.
• 0:37
  Speaker 2: Each episode explores the complex forces shaping today's pharmaceutical industry,
• 0:41
  Speaker 2: from global supply chain stress and regulatory shakeups to innovation
• 0:45
  Speaker 2: in branded and generic drug markets. Join us as we
• 0:48
  Speaker 2: engage sea level leaders and decision makers in candid conversations
• 0:52
  Speaker 2: about navigating disruption, driving growth, and preparing for the next
• 0:56
  Speaker 2: era of pharmaceutical transformation. Curiosity leads strategy, She follows, this
• 1:01
  Speaker 2: is the Executive Dose.
• 1:09
  Speaker 3: Hey, we're back with the Executive Dose, and in the
• 1:11
  Speaker 3: studio today I have back the CEO of Your Ral Farm,
• 1:15
  Speaker 3: of my friend, Steven Beckman.
• 1:18
  Speaker 4: Hey, it's a pleasure excited. We're getting into double digit
• 1:22
  Speaker 4: Executive Dose podcast. So that must mean we're doing something right.
• 1:25
  Speaker 5: We are doing something right.
• 1:27
  Speaker 3: Something that we're doing right is having another fellow Pittsburgher
• 1:31
  Speaker 3: in the virtual studio today, Jessica Daily and two out
• 1:35
  Speaker 3: of one against a Browns fan.
• 1:39
  Speaker 5: Nothing wrong with brown and orange.
• 1:41
  Speaker 3: Well still, if this is a black and gold studio,
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  Speaker 3: this is all about.
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  Speaker 5: Yes it is. Yes, it is black and gold everywhere,
• 1:49
  Speaker 5: black and black and gold.
• 1:51
  Speaker 3: Jessica, is so good to see you again.
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  Speaker 6: It's really nice to see you too, Todd. And now
• 1:55
  Speaker 6: I feel very left out that I didn't take the
• 1:57
  Speaker 6: trek down to be in studio with you today. This
• 1:59
  Speaker 6: could have been a blast, still going to be fun
• 2:01
  Speaker 6: that it would have been realized to see you in person.
• 2:04
  Speaker 4: Well, well we'll do another one. We'll get you down there.
• 2:07
  Speaker 4: And you know, I hope that that all the audience
• 2:10
  Speaker 4: out there listening will understand that, you know, brown and
• 2:13
  Speaker 4: orange and kind gold and black or black and gold
• 2:16
  Speaker 4: I should say, can co exist in a positive way
• 2:19
  Speaker 4: without throwing a you know, a beer cup or something.
• 2:23
  Speaker 4: So so, Jessica, I as well want to say thank
• 2:27
  Speaker 4: you for joining us today and we appreciate you coming
• 2:29
  Speaker 4: on and sharing some of your perspective and expertise. You know,
• 2:34
  Speaker 4: the topic really for today's podcast is a supply chain.
• 2:39
  Speaker 4: You know, what's what's happening in supply chain?
• 2:42
  Speaker 5: Now?
• 2:42
  Speaker 4: What are the opportunities, what are the challenges currently? Hopefully
• 2:46
  Speaker 4: we can dig into a little bit of what you
• 2:48
  Speaker 4: see happening in the future. But you know, how do
• 2:51
  Speaker 4: we weave that into what leaders must do. So maybe
• 2:56
  Speaker 4: we'll warm us up. Let's take it from thirty feet
• 2:59
  Speaker 4: thirty thousand feet and take it down. And what are
• 3:01
  Speaker 4: you seeing in supply chain now? And how's that translating
• 3:06
  Speaker 4: to opportunities and challenges and we'll dissect it from there.
• 3:09
  Speaker 7: Yeah.
• 3:09
  Speaker 6: So I would love to say, and I think Todd
• 3:12
  Speaker 6: has heard me say this in the past, I would
• 3:14
  Speaker 6: love to say that after all of the years that
• 3:16
  Speaker 6: I've been in supply chain, at some point we would
• 3:18
  Speaker 6: stop talking about drug shortages. Unfortunately, we haven't done that,
• 3:22
  Speaker 6: so we are still living in a nightmare of drug shortages,
• 3:27
  Speaker 6: where patients are impacted in our healthcare facilities and our
• 3:31
  Speaker 6: pharmacies every day with some type of supply disruption. So
• 3:35
  Speaker 6: I wish that I could say that our supply chain
• 3:37
  Speaker 6: has gotten to a position where we have more stability,
• 3:41
  Speaker 6: we have more security and guarantee and supply.
• 3:44
  Speaker 7: But we haven't. And I think a large part of
• 3:46
  Speaker 7: that is because we've done a.
• 3:47
  Speaker 6: Very good job of outlining the reasons behind we have
• 3:51
  Speaker 6: such an instability in the supply chain, but we haven't
• 3:54
  Speaker 6: really done a lot to change the fundamental reasons for
• 3:59
  Speaker 6: the on going disruptions, so supply chain still tends to
• 4:03
  Speaker 6: kind of exist the way it always has. You know,
• 4:06
  Speaker 6: we've got every group that is participating in the drug
• 4:10
  Speaker 6: supply chain who ultimately is looking for the best deal
• 4:14
  Speaker 6: that they can get, which has created a network of
• 4:18
  Speaker 6: suppliers and manufacturing that sometimes is not is not as
• 4:23
  Speaker 6: efficient or as high quality as we would like it
• 4:26
  Speaker 6: to be. But I think even more than that, it's
• 4:29
  Speaker 6: also created significant compression in the market. And you know,
• 4:33
  Speaker 6: we would joke about this when when I was working
• 4:36
  Speaker 6: in the health system or even with the GPO, that
• 4:39
  Speaker 6: you're chasing a penny, right, if I can get just
• 4:42
  Speaker 6: a little bit shape a little bit off the price
• 4:44
  Speaker 6: of this product, I can report back to my organization
• 4:47
  Speaker 6: that I have delivered savings. And we know and we've
• 4:50
  Speaker 6: seen that those types of behaviors don't create a supply
• 4:55
  Speaker 6: chain that is predictable and manageable and secure and so
• 4:58
  Speaker 6: ye again, unfortunately, I I think we're in the same
• 5:01
  Speaker 6: place we have been for the past several decades and
• 5:04
  Speaker 6: really haven't seen much change, even despite the fact that
• 5:08
  Speaker 6: we know more and more about what are causing the
• 5:10
  Speaker 6: challenges that work experience.
• 5:12
  Speaker 4: You know, music to my ears, and it maybe be
• 5:16
  Speaker 4: funny for somebody on the manufacturer side to say that,
• 5:18
  Speaker 4: But the word that you use is that fundamentally hasn't changed,
• 5:22
  Speaker 4: and I could agree with you more. I don't think
• 5:26
  Speaker 4: we have seen any change. And when I talk to
• 5:30
  Speaker 4: customers and we're trying to find ways to create value
• 5:33
  Speaker 4: and improve the interdependency of the value chain all the
• 5:37
  Speaker 4: way down to the patient, is that you use the
• 5:40
  Speaker 4: word trying to find the penny. I always said that
• 5:45
  Speaker 4: we've gotten in the position now where it's all about
• 5:47
  Speaker 4: best price and not right price, and there's a big difference.
• 5:51
  Speaker 4: I know there's a subtlety, but in my perspective, the
• 5:53
  Speaker 4: right price means that we're creating a right price in
• 5:57
  Speaker 4: the marketplace that does what we traditionally wanted to do.
• 6:01
  Speaker 4: We want to improve access, we want to have high
• 6:04
  Speaker 4: quality products, and we need everybody within the system to benefit.
• 6:10
  Speaker 4: The problem is is that it seems to be the
• 6:12
  Speaker 4: front end of the back end that are the ones
• 6:14
  Speaker 4: taken a hit. When I say front end, obviously is manufacturer.
• 6:17
  Speaker 4: Back end is really pharmacy and patient. So we need
• 6:22
  Speaker 4: to evoke some of that fundamental change in supply chain,
• 6:26
  Speaker 4: and it is scary to think that we're in the
• 6:28
  Speaker 4: largest uh supply deficit.
• 6:31
  Speaker 5: That we ever have.
• 6:33
  Speaker 4: You know, I've worked both on the brand and generic site.
• 6:36
  Speaker 4: I currently run a generic company and we have we
• 6:40
  Speaker 4: compete in one channel where there's seventeen suppliers of one
• 6:44
  Speaker 4: or one product and now we've kind of got ahead
• 6:47
  Speaker 4: of our skis and so how do we how do
• 6:50
  Speaker 4: we change that? I mean, I mean, I mean maybe
• 6:53
  Speaker 4: that's the you know, that's going to cost me a
• 6:55
  Speaker 4: lot because I don't know what your consulting fees are, But.
• 6:58
  Speaker 7: That's the million dollar question. Just raised my rates.
• 7:00
  Speaker 5: There, there you go, yeah, there you go.
• 7:03
  Speaker 4: But if we try to break it down, I mean,
• 7:04
  Speaker 4: some of this stuff is pretty obviously, but what's your
• 7:07
  Speaker 4: thoughts on as leaders and that it could be leaders
• 7:11
  Speaker 4: at the manufacturer level? Leaders, uh, you know in down
• 7:16
  Speaker 4: through the process. But where are some of the areas
• 7:18
  Speaker 4: at least we have to get some traction. We've got
• 7:22
  Speaker 4: to start something where where would you think we could
• 7:26
  Speaker 4: have the greatest potential impact to create a.
• 7:32
  Speaker 5: Movement for change in a positive way?
• 7:34
  Speaker 7: Right?
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  Speaker 6: So I think that you know, you talked about the
• 7:38
  Speaker 6: key components of right price. Right, it's not it's not
• 7:42
  Speaker 6: best price, and that's really the metric that a lot
• 7:44
  Speaker 6: of a lot of the components of the supply chain
• 7:47
  Speaker 6: are looking at is best price, and that best price
• 7:50
  Speaker 6: can change from day to day. The real the real
• 7:52
  Speaker 6: goal here is to get to right price, and there's
• 7:57
  Speaker 6: I think a couple of other things that you have
• 7:59
  Speaker 6: to consider when looking at that right price and things
• 8:02
  Speaker 6: that can change and help stabilize the market. We hear
• 8:06
  Speaker 6: a lot of talk about quality and how quality filters
• 8:09
  Speaker 6: into that right price and making sure that when you
• 8:13
  Speaker 6: are purchasing the product, it's the right product in the
• 8:16
  Speaker 6: right channel at the right price, but it has to
• 8:18
  Speaker 6: be of high quality.
• 8:20
  Speaker 7: So we've got to have.
• 8:21
  Speaker 6: Some better visibility, I think, as a supply chain into
• 8:26
  Speaker 6: the quality of the product. And that quality can include
• 8:29
  Speaker 6: everything from the quality of the API, of the manufacturing,
• 8:33
  Speaker 6: the processes that surround the manufacturing and creation of the
• 8:37
  Speaker 6: product as it gets to the market. But I think
• 8:39
  Speaker 6: the quality also talks about the health of the supply
• 8:44
  Speaker 6: chain upstream from the purchase of that product. So where
• 8:47
  Speaker 6: are suppliers manufacturing, where are they getting their components from,
• 8:52
  Speaker 6: what's the makeup of the market, how concentrated is that
• 8:55
  Speaker 6: market in one supplier in one area or region of
• 8:58
  Speaker 6: the world, or even in one source of API. Those
• 9:02
  Speaker 6: are all things that we really don't know a lot about,
• 9:05
  Speaker 6: which is crazy when you think about the US drug
• 9:09
  Speaker 6: supply chain. We are literally keeping patients alive and we
• 9:12
  Speaker 6: don't know where the stuff is coming from. So it's
• 9:15
  Speaker 6: a little crazy, and I think we've got to get
• 9:16
  Speaker 6: better on that quality piece so that we can make
• 9:20
  Speaker 6: the right decisions as the supply chain, which ultimately leads
• 9:23
  Speaker 6: to what I think is the biggest issue that we're
• 9:26
  Speaker 6: facing is just consistency, stability, commitment right of the supply
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  Speaker 6: chain to purchase what they say they're going to purchase.
• 9:34
  Speaker 6: So you're a manufacturer if you believe that you have
• 9:38
  Speaker 6: secured contracts or purchasing for a certain volume of product,
• 9:42
  Speaker 6: and you manufacture to that volume of product, but then
• 9:45
  Speaker 6: the market shifts because someone chases a price or they
• 9:49
  Speaker 6: negotiate a different contract with a different vendor, and your
• 9:53
  Speaker 6: seventeen manufacturer market that can be devastating. So we're dealing
• 9:57
  Speaker 6: with a lot of instability and inconsistent in consistency in
• 10:01
  Speaker 6: the market, not because our manufacturers are not necessarily producing
• 10:05
  Speaker 6: the best quality, not because they're not doing the right
• 10:08
  Speaker 6: things or patients and they're not prepared. It's because we
• 10:11
  Speaker 6: have sort of a whiplash effect in many ways, right,
• 10:14
  Speaker 6: we don't have that consistency. So when you find that
• 10:17
  Speaker 6: supplier that has the right price through the right channel
• 10:20
  Speaker 6: with high quality and stability and transparency, you've got to
• 10:24
  Speaker 6: commit to them, right, You've got to make the decision
• 10:26
  Speaker 6: that this is part of my strategy and I'm going
• 10:29
  Speaker 6: to stick with this company for as long as we've
• 10:32
  Speaker 6: agreed to because it's the right thing to do, and
• 10:34
  Speaker 6: because it provides that stability.
• 10:36
  Speaker 7: We see just so.
• 10:37
  Speaker 6: Much movement across the market that you can't predict and
• 10:41
  Speaker 6: you can't work that into manufacturing, and so until we
• 10:44
  Speaker 6: fix those I think those two things are really paramount
• 10:47
  Speaker 6: in my opinion, into creating a more stable market for
• 10:50
  Speaker 6: the future. Is that transparency and quality of the total
• 10:54
  Speaker 6: life cycle, but then also having commitment and making sure
• 10:58
  Speaker 6: that we follow through on that with our manufacturing partners.
• 11:01
  Speaker 4: Todd, I don't know why you've been hiding her so
• 11:04
  Speaker 4: long for me, because I'm going to I feel like
• 11:08
  Speaker 4: a kindred soul here. You know, you made some amazing
• 11:11
  Speaker 4: comments and points, and I think some of the transparency
• 11:15
  Speaker 4: issues that a lot of people don't think is that
• 11:17
  Speaker 4: in our industry, for the most part, we're judged on
• 11:19
  Speaker 4: three things. We're judged on price, we're judged on service levels,
• 11:24
  Speaker 4: which we'll get to in a minute, and continuity to supply.
• 11:29
  Speaker 4: But the reality is that the system works on the
• 11:32
  Speaker 4: first level the other two don't. They complain in the
• 11:35
  Speaker 4: system when those aren't met. And I don't know if
• 11:37
  Speaker 4: you know this, Todd, we're actually by our direct customers.
• 11:41
  Speaker 4: And it's not that it's a bad goal, but we
• 11:44
  Speaker 4: have a ninety eight percent service level requirements otherwise we
• 11:48
  Speaker 4: can get penalized. And if I'm a distributor, I understand
• 11:52
  Speaker 4: that they want to put that kind of pressure on
• 11:54
  Speaker 4: the system because ultimately they make money to make sure
• 11:58
  Speaker 4: they supply. But you know, sometimes the ability to deliver
• 12:03
  Speaker 4: is challenging because we don't know where some of our
• 12:06
  Speaker 4: products are coming from. And then continuity supply is almost
• 12:10
  Speaker 4: to a certain extent, not even valued it is when
• 12:14
  Speaker 4: it comes because we get so distracted by the first
• 12:16
  Speaker 4: lever with the starts of the p and you know,
• 12:20
  Speaker 4: that's what we do have to change. It kind of
• 12:22
  Speaker 4: goes back to your point that fundamentally there should be value,
• 12:26
  Speaker 4: and we have it in our own business, and we
• 12:27
  Speaker 4: have products now that there's greater demand and supply, and
• 12:33
  Speaker 4: I still have conversations with customers about understanding how do
• 12:37
  Speaker 4: we have equitable value costs those three principles. I think
• 12:42
  Speaker 4: she makes another really really good point about where our
• 12:45
  Speaker 4: product comes.
• 12:45
  Speaker 5: I don't think most people know that. I don't. You
• 12:48
  Speaker 5: might know this number.
• 12:49
  Speaker 4: I might be a little bit off, but I believe
• 12:51
  Speaker 4: it's over ninety percent of all API comes out of
• 12:54
  Speaker 4: Asia Pacific. I think it's like two or three percent
• 12:57
  Speaker 4: of API from the drug manufacturing from US or Europe.
• 13:02
  Speaker 4: So and I'm not dispourging that that region per se,
• 13:07
  Speaker 4: but what I'm saying is you can't have ninety percent
• 13:09
  Speaker 4: of your drug API coming out of one region because
• 13:13
  Speaker 4: it does create for a lot of challenges in some
• 13:17
  Speaker 4: of those markets where you have to question quantity quality
• 13:21
  Speaker 4: and at the end of the day, quality should count,
• 13:22
  Speaker 4: and I think that should be kind of that fourth
• 13:25
  Speaker 4: level or level. And do you think there's an opportunity
• 13:30
  Speaker 4: for that to eventually play out? And if so, what
• 13:33
  Speaker 4: do we have to do in the system to elevate that?
• 13:37
  Speaker 4: As a maybe a fourth pillar here in terms of quality.
• 13:41
  Speaker 4: And if I think we go down that quality route
• 13:43
  Speaker 4: as you suggested, it's going to naturally reset the market, right,
• 13:51
  Speaker 4: and we won't need twenty five suppliers because in the
• 13:53
  Speaker 4: generic business, yeah, for many products and many companies, they're
• 13:57
  Speaker 4: getting roefered every week, and you spend more time worrying about,
• 14:01
  Speaker 4: you know, what price you can you know, absorb to
• 14:05
  Speaker 4: maintain some share. And that's that's a tough way to
• 14:09
  Speaker 4: run business and ensure that that that drugs there. And
• 14:13
  Speaker 4: that's why companies are losing money. I mean, one of
• 14:17
  Speaker 4: my prior employers, ten percent of actually is probably more
• 14:21
  Speaker 4: like twenty percent of their entire portfolio was underwater. So
• 14:24
  Speaker 4: can't justify keeping products that you can't even pay to
• 14:28
  Speaker 4: produce them.
• 14:29
  Speaker 6: No, and we've seen that so much over recent years,
• 14:33
  Speaker 6: manufacturers going through and rationalizing their portfolios.
• 14:36
  Speaker 7: Right.
• 14:37
  Speaker 6: In the past, we liked to play with loss leaders
• 14:39
  Speaker 6: because we could use the terrible word bundle, right, We
• 14:43
  Speaker 6: could bundle a grouping of products and create a price
• 14:46
  Speaker 6: that was compelling, but you always had those loss leaders.
• 14:50
  Speaker 6: We can't function like that anymore when the margins, especially
• 14:53
  Speaker 6: in generics, are so thin to begin with, right, if
• 14:56
  Speaker 6: you give up a lot on one and you try
• 14:59
  Speaker 6: to make it up with another, there's just not enough
• 15:01
  Speaker 6: in there. There's there's We could have a whole nother
• 15:03
  Speaker 6: discussion about the about the financing of generics in this
• 15:09
  Speaker 6: country and where the money's going, and how insane that
• 15:12
  Speaker 6: entire market is.
• 15:13
  Speaker 7: But let's talk first.
• 15:15
  Speaker 6: We're, you know, focusing on manufacturing and getting API from
• 15:20
  Speaker 6: outside of the US.
• 15:22
  Speaker 7: And you know, when you think about it, all of the.
• 15:25
  Speaker 6: All of the things that have happened in this market
• 15:28
  Speaker 6: to bring us to where we are. The constant look
• 15:31
  Speaker 6: at price, the constant look at trying to sort of
• 15:35
  Speaker 6: cut some of that that price out of the system
• 15:38
  Speaker 6: has has driven.
• 15:39
  Speaker 7: Us to where we are today.
• 15:41
  Speaker 6: With sourcing of API and even in many cases finished
• 15:45
  Speaker 6: goods from outside of the US. It is incredibly expensive
• 15:50
  Speaker 6: to manufacture products here in the United States.
• 15:54
  Speaker 5: That is true.
• 15:55
  Speaker 6: It is expensive, right, and and we have not created
• 15:59
  Speaker 6: a system that rewards investment in manufacturing here. And there's
• 16:03
  Speaker 6: I mean, there's a lot of reasons, right. Manufacturing of
• 16:06
  Speaker 6: pharmaceuticals in general is just an expensive proposition because of
• 16:10
  Speaker 6: all the regulation that goes into it. Correct, But we've
• 16:13
  Speaker 6: found and right, any system is going to look to
• 16:17
  Speaker 6: find the most.
• 16:18
  Speaker 7: Efficient way, the most cost efficient way.
• 16:20
  Speaker 6: To manufacture products to maintain their position in the market.
• 16:23
  Speaker 6: And this is why you see so many of these
• 16:26
  Speaker 6: products being manufactured outside of the United States, like you said,
• 16:29
  Speaker 6: in China and India in particular, because the cost of
• 16:33
  Speaker 6: manufacturing there is much lower, the cost of labor is
• 16:37
  Speaker 6: much lower, and some of and you know, people don't
• 16:39
  Speaker 6: always like to talk about this, but some of the
• 16:41
  Speaker 6: environmental regulations are also less strict than what we have
• 16:46
  Speaker 6: here in the United States to manage the environmental impact.
• 16:49
  Speaker 6: Of the cost of managing environmental impact, it is prohibitive
• 16:55
  Speaker 6: to the market that we have established. So I think
• 16:58
  Speaker 6: even beyond quality, because you could absolutely argue there are
• 17:02
  Speaker 6: manufacturers in China and India that manufacture products to the
• 17:06
  Speaker 6: highest quality have total confidence.
• 17:08
  Speaker 7: In what they're producing.
• 17:10
  Speaker 5: That is true.
• 17:10
  Speaker 7: So there is that, right, but there.
• 17:13
  Speaker 6: Is also a very different level of scrutiny that is
• 17:16
  Speaker 6: placed on manufacturing facilities in those locations. Right, FDA surprise
• 17:21
  Speaker 6: inspections happen in the United States with relative frequency. We
• 17:25
  Speaker 6: saw during the COVID pandemic that surprise inspections, inspections at
• 17:28
  Speaker 6: all were relatively infrequent outside of the United States, and
• 17:33
  Speaker 6: many times for announce So if you know that your
• 17:36
  Speaker 6: FDA inspector is coming, you've got some time to kind
• 17:39
  Speaker 6: of exactly does the shelves you run the vacuum looks
• 17:44
  Speaker 6: pretty good in here all the exactly. So it's just
• 17:50
  Speaker 6: a different, I think, level of scrutiny that you see
• 17:54
  Speaker 6: with products that are manufactured in the United States versus elsewhere.
• 17:58
  Speaker 6: And I really think think that there's there's been this.
• 18:02
  Speaker 6: You know, there's there's people in the market that are
• 18:05
  Speaker 6: really toying with the idea of do we need to
• 18:07
  Speaker 6: quality score? Does every manufacturer, every product need to have
• 18:11
  Speaker 6: a quality score in a grade for the products that
• 18:14
  Speaker 6: they're producing. I will tell you my my gut reaction
• 18:18
  Speaker 6: to that is concern.
• 18:20
  Speaker 7: Right, We've got interesting. So here's why, and I'll explain why.
• 18:24
  Speaker 4: Yeah, because I would have thought you would be pro
• 18:27
  Speaker 4: because technically, to come full circle, I am pro some
• 18:32
  Speaker 4: kind of mechanism only because it goes back to my
• 18:36
  Speaker 4: earlier comment.
• 18:37
  Speaker 5: That we we we.
• 18:41
  Speaker 4: You can have a really great idea and you can
• 18:44
  Speaker 4: achieve it, but then you can go too far, which
• 18:46
  Speaker 4: is I think has happened to the generic industry to
• 18:48
  Speaker 4: a little extent, So how do we find mechanisms? And
• 18:51
  Speaker 4: I thought, and I agree, you know, first of all,
• 18:54
  Speaker 4: we got to always look at quality, but quality could
• 18:56
  Speaker 4: be a mechanism that would help us controlled in a
• 18:59
  Speaker 4: po so that we're still looking at the business side
• 19:04
  Speaker 4: as well as the outcome side for patients.
• 19:06
  Speaker 6: Absolutely, and so and my argument and here's where here's
• 19:10
  Speaker 6: where my head is at on quality scoring, yeap. My
• 19:15
  Speaker 6: perspective is that if we provide and let's just save
• 19:21
  Speaker 6: letter grades. Right, there's an A rated manufacturer, there's B there, c,
• 19:25
  Speaker 6: there's however you want to rate this.
• 19:27
  Speaker 7: What will happen in our.
• 19:31
  Speaker 6: Semi well, I shouldn't say semi and our litigious society
• 19:34
  Speaker 6: is that every player will then try to purchase only
• 19:39
  Speaker 6: A rated products or no. And so we could end
• 19:43
  Speaker 6: up then with a market that I think again, one
• 19:47
  Speaker 6: of those other areas where we start to see issues
• 19:49
  Speaker 6: is where we are too heavily concentrated in one area.
• 19:52
  Speaker 7: And I know sometimes manufacturers don't want to hear this.
• 19:54
  Speaker 6: Right, you want to be the market leader, you want
• 19:55
  Speaker 6: them win the business, you want to own that market.
• 19:58
  Speaker 6: And sometimes that can be good as long as and
• 20:01
  Speaker 6: this goes back to the transparency side.
• 20:04
  Speaker 7: As long as.
• 20:05
  Speaker 6: We know that there is sufficient redundancy in your supply
• 20:08
  Speaker 6: chain to support any potential issues, whether it's geopolitical, you know,
• 20:13
  Speaker 6: whether quality related. Something happens and you you lose a
• 20:18
  Speaker 6: portion of that manufacturing capability. If you're the only manufacturer
• 20:22
  Speaker 6: in that market, the whole market goes under right, So
• 20:25
  Speaker 6: that's what.
• 20:26
  Speaker 5: I hear with that. I agree with it.
• 20:28
  Speaker 4: I look at I'm actually as a manufacturer, I believe
• 20:31
  Speaker 4: there should be a certain level of competition and there
• 20:34
  Speaker 4: should be a level of redundancy because our goal is
• 20:37
  Speaker 4: to make sure that the drug product we're not selling widgets,
• 20:40
  Speaker 4: we're selling drugs, and we we we have to be
• 20:43
  Speaker 4: in a dynamic that we understand the common good as
• 20:47
  Speaker 4: well as the business good. And the common good is
• 20:49
  Speaker 4: is that patient needs the product. They need a product.
• 20:52
  Speaker 4: So yeah, so I think it's a matter of having
• 20:53
  Speaker 4: the right the right number of them to create the
• 20:56
  Speaker 4: right dynamic.
• 20:57
  Speaker 5: And maybe.
• 21:00
  Speaker 4: Maybe the way to think about is not a grade
• 21:03
  Speaker 4: or score, but is there another approach to create a
• 21:07
  Speaker 4: quality that.
• 21:07
  Speaker 5: Will help us find some value in that process.
• 21:11
  Speaker 6: So and this is where and again this is my
• 21:14
  Speaker 6: hesitancy with the scoring unless everybody is a scored and
• 21:19
  Speaker 6: you don't have that kind of pull to consolidate purchases
• 21:24
  Speaker 6: with a small number or only one vendor because of
• 21:26
  Speaker 6: their quality score.
• 21:28
  Speaker 7: What would be even better is if the FDA.
• 21:31
  Speaker 6: Approval meant that you have a rated quality so we
• 21:36
  Speaker 6: have then consistency. The FDA is doing surprise inspections in
• 21:40
  Speaker 6: every facility. We've got a level of the minimum level
• 21:44
  Speaker 6: of quality standard that is required to even have your
• 21:47
  Speaker 6: FDA approval. That to me means' that's your quality stamp.
• 21:52
  Speaker 6: If you can satisfy a very high level of scrutiny
• 21:56
  Speaker 6: from the FDA and you can be approved, you've got
• 21:59
  Speaker 6: that high high level of quality. So I think quality
• 22:01
  Speaker 6: needs to be a very important part of the FDA
• 22:04
  Speaker 6: approval process that we can ensure and then you're not
• 22:08
  Speaker 6: worrying about well, am I buying from the A rated
• 22:11
  Speaker 6: supplier or the B rated supplier. I am buying from
• 22:13
  Speaker 6: a supplier that satisfied those intense that intense level of
• 22:18
  Speaker 6: scrutiny to even become a supplier.
• 22:20
  Speaker 5: In my market.
• 22:21
  Speaker 4: I agree with you, I think in practicality and the
• 22:25
  Speaker 4: way it should be, the FDA should have that ability
• 22:27
  Speaker 4: to grow that they should be the ones responsible for that.
• 22:30
  Speaker 4: So the question is how can you execute it right?
• 22:33
  Speaker 4: So you're not going to get the FDA to be
• 22:35
  Speaker 4: able to go everywhere. So there almost has to be
• 22:37
  Speaker 4: a process maybe where the manufacturer has to be able
• 22:42
  Speaker 4: to provide and present enough information that suggests that they
• 22:47
  Speaker 4: would be an a in order to get that visit
• 22:51
  Speaker 4: and validation, and then thus everybody that is selling into
• 22:54
  Speaker 4: a market would have it.
• 22:56
  Speaker 5: And maybe I'm not an expert in this area, but
• 22:59
  Speaker 5: I do.
• 22:59
  Speaker 4: I do leave you know, because of the level of
• 23:03
  Speaker 4: interdependency we all have in this outcome, which is, you know, patients,
• 23:08
  Speaker 4: we all should be in this business first and foremost
• 23:10
  Speaker 4: because we're trying to improve patient outcome and health.
• 23:15
  Speaker 5: Then we all have to have a hand in.
• 23:16
  Speaker 4: Trying to figure out where the right trade offs are
• 23:18
  Speaker 4: and that would be a big one. But you talked
• 23:21
  Speaker 4: about the FDA. Do you see the FDA having other
• 23:25
  Speaker 4: issues on supply chain from a regulatory standpoint that creates
• 23:29
  Speaker 4: bottlenecks or anything else that are also having Since we
• 23:33
  Speaker 4: kind of talked on FDA, I'd be interested in your
• 23:35
  Speaker 4: perspective on a broader basis. Where the FDA has been
• 23:38
  Speaker 4: a help or hindrance so far well, and I.
• 23:41
  Speaker 6: Think this is one of those areas where again, I,
• 23:44
  Speaker 6: just like you, I am not an expert on FDA
• 23:48
  Speaker 6: law and regulation, and I've gotten into some situations where
• 23:51
  Speaker 6: I've said, why this should this is the purview of
• 23:53
  Speaker 6: the FDA, right, and then you find out, well, no,
• 23:56
  Speaker 6: they don't actually have the authority to do some of
• 23:59
  Speaker 6: the things that I think we would really like them
• 24:01
  Speaker 6: to be able to do, nor do they have the
• 24:02
  Speaker 6: funding or the scope of you know, of reach to
• 24:07
  Speaker 6: be able to do some of these things that said,
• 24:10
  Speaker 6: you know, there's we see this especially in drug shortages, right,
• 24:15
  Speaker 6: what does the pathway look like to to bringing product
• 24:19
  Speaker 6: into the United States if we have a shortage? Are
• 24:22
  Speaker 6: we going to is the FDA going to allow importation?
• 24:25
  Speaker 6: Are they going to allow for extended dating?
• 24:28
  Speaker 7: Those those.
• 24:30
  Speaker 6: Those things take time, and that has typically been a
• 24:34
  Speaker 6: point of bottleneck in working with the FDA when there's
• 24:37
  Speaker 6: an acute and severe nationwide shortage getting products approved into
• 24:43
  Speaker 6: the market. The regulatory pathway for approval not I mean
• 24:46
  Speaker 6: not taking you know, NDAs out of the discussion, because
• 24:50
  Speaker 6: we know that that is a massive approval pathway, but
• 24:53
  Speaker 6: even an DA's and going through the process of getting
• 24:55
  Speaker 6: drugs approved for an A and DA is very expensive,
• 24:58
  Speaker 6: time consuming, lib work.
• 25:02
  Speaker 7: You know, I've I've.
• 25:03
  Speaker 6: Heard some recent news about someone suggesting that we can
• 25:08
  Speaker 6: have micro manufacturing of pharmaceutical products even at each hospital
• 25:13
  Speaker 6: site across the country.
• 25:14
  Speaker 7: And wouldn't that be lovely and wonderful?
• 25:16
  Speaker 6: And when you think about all of the things that
• 25:18
  Speaker 6: go into FDA approval for manufacturing of a product and
• 25:21
  Speaker 6: how difficult it is to to kind of meet those
• 25:25
  Speaker 6: needs and regulations to produce something that can be used
• 25:28
  Speaker 6: for patients, the idea of micro manufacturing is it's a
• 25:34
  Speaker 6: very interesting idea. But given the structure and the regulation
• 25:39
  Speaker 6: that we have around the you know, the FDA's demands
• 25:43
  Speaker 6: for manufacturing stringency and protocol and regulation, those are all
• 25:48
  Speaker 6: things that I think would be very very difficult to
• 25:51
  Speaker 6: bring to the market.
• 25:52
  Speaker 5: So I would think they'd be impossible.
• 25:54
  Speaker 4: I mean, I love the creative I love the creative thinking,
• 25:57
  Speaker 4: and we kind of have that in our in our
• 25:59
  Speaker 4: system now it's called i'm bounding, but that's obviously for
• 26:02
  Speaker 4: products that are not currently approved, so it's not an
• 26:05
  Speaker 4: apple to apple. Yeah, look, at I it's going to
• 26:09
  Speaker 4: take creative change. It's interesting, you know, when you think
• 26:12
  Speaker 4: about it, we just that idea is a very creative idea.
• 26:15
  Speaker 4: How can we change it? But then I go back
• 26:18
  Speaker 4: to the simple thing is to do some of your
• 26:20
  Speaker 4: early remarks, which I agree with, and is is the
• 26:24
  Speaker 4: solutions out there based on a need to come up
• 26:28
  Speaker 4: with something creative and new. And in some areas I
• 26:32
  Speaker 4: would say yes, like we had a podcast that we
• 26:35
  Speaker 4: just completed on independent pharmacy and the idea of how
• 26:39
  Speaker 4: independent pharmacy is bringing in telehealth at the point of
• 26:44
  Speaker 4: care in the pharmacy. To me, that's creative and that's
• 26:48
  Speaker 4: probably going to have a really cool outcome. But what
• 26:51
  Speaker 4: we're talking about supply chain is creativity. Might be everybody
• 26:55
  Speaker 4: gets excited because it's a shiny new object, but the
• 26:57
  Speaker 4: fact of the matter is the problems with supply chain
• 27:00
  Speaker 4: or fundamental and it's fixing the fundamentals could to take
• 27:04
  Speaker 4: us a lot longer, a lot farther than us coming
• 27:08
  Speaker 4: up with a creative idea. And I think that's you know,
• 27:12
  Speaker 4: I always applied creativity because I think that's really important.
• 27:15
  Speaker 4: But you know, also you have to have some practicality,
• 27:18
  Speaker 4: and I understand where the real problem is in listening
• 27:22
  Speaker 4: to you. The problem is not that we're lacking innovation
• 27:25
  Speaker 4: or we're lacking ideas as we're we're not. We don't
• 27:29
  Speaker 4: have supply chain in the pharmaceutical industry in a way
• 27:32
  Speaker 4: that is being managed more fundamentally better, and if we
• 27:36
  Speaker 4: just change a few things there, we could probably see
• 27:38
  Speaker 4: a big improvement.
• 27:39
  Speaker 6: Right now, I think you're absolutely right. We are absolutely
• 27:42
  Speaker 6: not lacking in creativity. The FDA is working very hard
• 27:46
  Speaker 6: right There's certainly some things we wish we could do.
• 27:48
  Speaker 7: Faster or maybe more.
• 27:52
  Speaker 6: In better ways with the FDA, But fundamentally, the issue is,
• 27:56
  Speaker 6: and you see this with every market, you get what
• 27:58
  Speaker 6: you pay for. Meaning what is incentivized in the generic
• 28:04
  Speaker 6: market is not quality, is not stability of supply, it's
• 28:08
  Speaker 6: not consistency, it's not commitment. What is incentivized and what
• 28:11
  Speaker 6: is paid for in the generic market is at pump price.
• 28:16
  Speaker 6: How can we deliver the cheapest price that we possibly
• 28:21
  Speaker 6: can to get these medications in the hands of our
• 28:24
  Speaker 6: positions and patients and health systems. That, ultimately, I think
• 28:28
  Speaker 6: is the biggest issue that we have to learn how
• 28:31
  Speaker 6: to deal with you get what you pay for. And
• 28:33
  Speaker 6: if we can take the system that we have and
• 28:36
  Speaker 6: start to reward quality and stability and pay for quality
• 28:40
  Speaker 6: and stability, then we will start to see a change
• 28:44
  Speaker 6: in the way that the market behaves.
• 28:46
  Speaker 5: Yeah.
• 28:46
  Speaker 4: And so if we layer up to the next part
• 28:49
  Speaker 4: of this conversation in that regard, that means we have
• 28:52
  Speaker 4: to make fundamental change in our industry and the delivery.
• 28:56
  Speaker 4: Because we can do that on the front end, we
• 28:59
  Speaker 4: continue I don't. I believe in my heart that most
• 29:03
  Speaker 4: manufacturers that I work with and know they're they are committed.
• 29:07
  Speaker 4: You know, they're they're they're manufacturing under g M P,
• 29:10
  Speaker 4: They're they're sourcing a P I correctly, their facilities are
• 29:18
  Speaker 4: are are in good condition. Uh. Not everyone, but but
• 29:22
  Speaker 4: I would say for the most. But the problem is
• 29:25
  Speaker 4: is that we continue to invest in that that can't
• 29:28
  Speaker 4: translate down to what we're talking about yet, because there
• 29:32
  Speaker 4: has to be changes, uh, and it has to be rewarded.
• 29:35
  Speaker 4: So we have to go back to fundamentals. If we're
• 29:37
  Speaker 4: only going to be valued on P and we're not
• 29:42
  Speaker 4: going to be valued on other ones. We can put
• 29:45
  Speaker 4: these in places, but it's it's not going to materialize enough.
• 29:48
  Speaker 4: So the reality is that we need a lot of changes.
• 29:51
  Speaker 4: And when we have a lot of changes, you know,
• 29:54
  Speaker 4: I work for one of the largest generic companies that
• 29:57
  Speaker 4: is based in Pittsburgh and had the largest manufacturing facility
• 30:02
  Speaker 4: in the United States in West Virginia, and that that
• 30:04
  Speaker 4: facility is now closed. So we we have to find
• 30:09
  Speaker 4: a way that it's not look at we all want
• 30:15
  Speaker 4: to make money, and you have to make money to
• 30:16
  Speaker 4: make the wheels turn to continue to do the things
• 30:18
  Speaker 4: that we want to do innovation, but we we we
• 30:22
  Speaker 4: have to be able to ensure that there's some uh,
• 30:25
  Speaker 4: some level of confidence in that. And a big point
• 30:30
  Speaker 4: you made, which is a reality which a lot of
• 30:32
  Speaker 4: people might not know downstream, is especially when you look
• 30:36
  Speaker 4: at the generic side, there is no commitments on volumes.
• 30:40
  Speaker 4: Manufacturers continue to take a lot of that risk and
• 30:43
  Speaker 4: they might have a certain position and that position can
• 30:47
  Speaker 4: go away in a in a matter of a week,
• 30:52
  Speaker 4: matter of days, and and all of a sudden, then
• 30:54
  Speaker 4: you you're working on the working capital impact of that,
• 30:58
  Speaker 4: or profitability impact on that and so forth. So you know,
• 31:02
  Speaker 4: the margins are are brittle, they're they're they're small, Uh,
• 31:06
  Speaker 4: they're not as big as people want them to be
• 31:10
  Speaker 4: and if we can fix some of the fundamentals, then
• 31:14
  Speaker 4: then I think it will resolve a lot of themselves.
• 31:16
  Speaker 4: But that would mean level at the change at the
• 31:20
  Speaker 4: federal level, or it's going to have to start at
• 31:22
  Speaker 4: the state level, which is an interesting dynamic because a
• 31:25
  Speaker 4: lot of states are starting to push for whether it
• 31:30
  Speaker 4: be p b M transparency or other issues that will
• 31:35
  Speaker 4: will allow for some of this to to be adjusted.
• 31:40
  Speaker 4: Look at I'm not I'm not going to point fingers.
• 31:43
  Speaker 4: We could all sit here and want to point figures
• 31:45
  Speaker 4: depending on where we are in.
• 31:46
  Speaker 5: The value chain.
• 31:48
  Speaker 4: But I think what we need to do is get
• 31:50
  Speaker 4: the value chain as a whole to look at each
• 31:53
  Speaker 4: other and and come up with a better playbook. And
• 31:56
  Speaker 4: if we could do that, then we will achieve a
• 31:59
  Speaker 4: lot of things that you're talking talking about. I know
• 32:01
  Speaker 4: we're running Todd probably close to our time, but I
• 32:04
  Speaker 4: could probably talk with this young lady all day long, Jessica.
• 32:09
  Speaker 4: As we kind of close down, we always like to
• 32:12
  Speaker 4: turn it back to our guests and then to Todd
• 32:14
  Speaker 4: to share a few things as you close out this
• 32:17
  Speaker 4: this podcast. If there's something you want to kind of
• 32:21
  Speaker 4: say to the community, just listen to us. What's your
• 32:25
  Speaker 4: final words or you know something that's top of mind
• 32:28
  Speaker 4: that you would like to share as we close out today.
• 32:30
  Speaker 6: Okay, so what's running through my head is a million cliches,
• 32:34
  Speaker 6: right as every time you point the finger, there's three
• 32:37
  Speaker 6: fingers pointing back at you.
• 32:38
  Speaker 5: That's right, right.
• 32:40
  Speaker 6: I think the the ultimate thing that everybody needs to
• 32:43
  Speaker 6: start to think about is we all have a steak
• 32:48
  Speaker 6: in fishing this market.
• 32:50
  Speaker 7: We have to be honest in.
• 32:53
  Speaker 6: Looking at how our behaviors and our actions are contributing
• 32:57
  Speaker 6: to the market that we're in. Now, that's it. It
• 33:00
  Speaker 6: becomes very hard to change that unless there is systemic change.
• 33:04
  Speaker 6: So I think the big thing for me is I
• 33:06
  Speaker 6: would just encourage everyone to really allow for breaking down
• 33:10
  Speaker 6: of walls, talking with your own organizations about how you
• 33:14
  Speaker 6: can perform differently. And to your point, maybe we do
• 33:18
  Speaker 6: need to look at more of a governmental change. I
• 33:22
  Speaker 6: hate to say it because it adding government in always
• 33:25
  Speaker 6: creates complexity and downstream changes that you don't necessarily anticipate.
• 33:31
  Speaker 6: But maybe there is a place for the government to
• 33:33
  Speaker 6: really put a stake in the ground and say these
• 33:36
  Speaker 6: are the expectations, minimum expectations on transparency on cost, on
• 33:40
  Speaker 6: how this market has to function. But again everybody needs
• 33:45
  Speaker 6: to look at themselves and start to realize that again
• 33:49
  Speaker 6: you get what you pay for, and if what you
• 33:51
  Speaker 6: want is a stable, healthy market, start paying for a
• 33:56
  Speaker 6: stable healthy market.
• 33:58
  Speaker 5: That really well said.
• 33:59
  Speaker 4: I couldn't agree, and I think you know, the reality
• 34:02
  Speaker 4: is is that we if we can come together and
• 34:04
  Speaker 4: have the conversation and ascertain, you know, little problems can
• 34:08
  Speaker 4: be fixed. Big problems need that systemic change. So the
• 34:13
  Speaker 4: first question that we have and you said very very well,
• 34:16
  Speaker 4: but we've got to get some honesty into this conversation
• 34:20
  Speaker 4: and complete transparency. And that's really what the spirit of
• 34:24
  Speaker 4: this whole podcast has been about is.
• 34:27
  Speaker 5: And then I mean, the answer is the answer. It's
• 34:29
  Speaker 5: black and white.
• 34:30
  Speaker 4: We're not it doesn't have to be pointing fingers, it's
• 34:32
  Speaker 4: just here the facts and the facts are if we're
• 34:34
  Speaker 4: going to make the change that we need, it's it
• 34:37
  Speaker 4: can be done at an individual company or individual segment
• 34:41
  Speaker 4: within the supply chain, or or does it need that
• 34:45
  Speaker 4: extra push you know, do we need the village you
• 34:48
  Speaker 4: know versus just And that's what I think we need
• 34:52
  Speaker 4: to have the conversation, because what we shouldn't be talking about,
• 34:55
  Speaker 4: especially in the US, is that patients can't get their
• 34:58
  Speaker 4: product now on many forms.
• 35:01
  Speaker 5: One, they can't get the products.
• 35:02
  Speaker 4: It can't afford it can't get the pro becaus it
• 35:05
  Speaker 4: it's not available. These things should not have to be
• 35:08
  Speaker 4: in part of our dialogue. So if it is today,
• 35:11
  Speaker 4: which it is, then we know that there's a there's
• 35:13
  Speaker 4: a problem that could be fixed, or a you know,
• 35:16
  Speaker 4: a challenge that we need to overcome.
• 35:18
  Speaker 5: So Todd, what are your thoughts? You've been really quiet today.
• 35:21
  Speaker 3: Oh, I enjoy listening to the people that know a
• 35:24
  Speaker 3: lot more than I do. I'm just the I bring
• 35:27
  Speaker 3: people together, and oh, you're much more than that, bring
• 35:30
  Speaker 3: the minds together to really give our listeners some deep
• 35:34
  Speaker 3: dive into in this case, you know, how we improving
• 35:38
  Speaker 3: supply chain and understanding intricacies and details that nobody really
• 35:43
  Speaker 3: talks about much. That's why I really like executive dose.
• 35:46
  Speaker 3: But I like being able to reach out to the
• 35:49
  Speaker 3: experts that do it all the time every day. Have
• 35:52
  Speaker 3: been soaking in it for years. Not to make Jessica
• 35:55
  Speaker 3: sound old, but Jessica Daily, CEO of Daily Consulting Services,
• 36:00
  Speaker 3: really been intimately involved in this for quite some time.
• 36:04
  Speaker 3: And very proud of your work, Jessica, and thank you
• 36:07
  Speaker 3: so much for being on The Executive Dose today.
• 36:09
  Speaker 7: No, thank you both for having me.
• 36:11
  Speaker 6: This is a very fun conversation and I think we
• 36:13
  Speaker 6: could probably go in a million directions.
• 36:15
  Speaker 7: So happy to come back and join you.
• 36:18
  Speaker 4: I think I'm already thinking of a couple extra executives, Todd,
• 36:21
  Speaker 4: I think it should be going to be repeat guest.
• 36:24
  Speaker 5: Yes, I think so.
• 36:25
  Speaker 4: So I'd like to say the same thanks to all
• 36:27
  Speaker 4: the listeners for out out there listening to The Executive Dose.
• 36:31
  Speaker 4: I hope the spirit of what we're bringing is a
• 36:34
  Speaker 4: positive one and it creates an opportunity to think a
• 36:38
  Speaker 4: little bit, to dialogue a little bit, and maybe hopefully
• 36:41
  Speaker 4: that will translate into into some action. But it's gonna
• 36:45
  Speaker 4: it's gonna take all of us to make a difference.
• 36:47
  Speaker 4: And and uh, the final the final shout out goes
• 36:50
  Speaker 4: to PPN. So you know, Todd, you might downplay your
• 36:54
  Speaker 4: role in this whole process, but I have to say
• 36:57
  Speaker 4: that I know Jessica wouldn't be on this, on this podcast,
• 37:01
  Speaker 4: and I wouldn't be hosting it if we didn't feel
• 37:03
  Speaker 4: that PPN and the platform that's been created with your
• 37:06
  Speaker 4: leadership is not making a difference, and we'll continue to
• 37:10
  Speaker 4: make a difference, especially within the pharmacy channel, and that's
• 37:15
  Speaker 4: where we think a lot of the change to come
• 37:17
  Speaker 4: is important. And the topics like supply chain are extremely
• 37:21
  Speaker 4: relevant to to the to these pharmacists in terms of
• 37:25
  Speaker 4: access to products at a at a good price. We
• 37:29
  Speaker 4: didn't even get into things like on time, inventory and
• 37:34
  Speaker 4: working capital and all the other stuff we could get into,
• 37:37
  Speaker 4: which I think we should, because I think maybe what
• 37:40
  Speaker 4: we should do is bring a pharmacist into this conversation
• 37:43
  Speaker 4: about supply chain. But Jessica, thank you so much, and
• 37:46
  Speaker 4: have a great day and go Browns. All right, we'll
• 37:53
  Speaker 4: give some Steelers some love.
• 37:54
  Speaker 5: Sense.
• 37:54
  Speaker 4: The draft is in Pittsburgh for the next couple of days,
• 37:56
  Speaker 4: so go Stealers. But you'll never catch me away your
• 38:00
  Speaker 4: terrible time.
• 38:00
  Speaker 3: Okay, Hey, thanks so much for listening to the executive.
• 38:05
  Speaker 3: Does share this with a fellow pharmacy professional, somebody that
• 38:09
  Speaker 3: you know that it would mean to mean something to
• 38:12
  Speaker 3: them and subscribe to the Pharmacy Podcast Network for forty
• 38:15
  Speaker 3: plus podcasts access to one RSS feed. We very much
• 38:20
  Speaker 3: appreciate you out there, pharmacist technicians working in the trenches
• 38:24
  Speaker 3: and that's it. We'll hear you next time on the
• 38:27
  Speaker 3: executive does sounds great