This Week in Pharmacy

PBMs Under Fire, the World Pharmacist Challenge & CRUSH COST

October 30, 2026 | Pharmacy Podcast Network

Sponsored by CurifyLabs and Independent Pharmacy Cooperative (IPC)

Pharmacy benefit managers are facing new scrutiny, controversial peptides are making headlines, and two pharmacy leaders are joining Todd Eury for a special edition of This Week in Pharmacy.

This week's episode features the finale of the 31 Day Challenge, an exciting announcement about the upcoming WORLD PHARMACIST CHALLENGE, and an exclusive in-studio interview with the 2025 Pharmacy 50 winner, Dr. Grant Harting, PharmD, founder of CRUSH COST.

TWIRx News: The Vox Top 3

1. PBMs Forced to Open Their Books — and They're Fighting Back

The Department of Labor has finalized new PBM transparency requirements covering fees, rebates, spread-pricing revenue, and compensation arrangements involving employer health plans.

The Pharmaceutical Care Management Association (PCMA) argues that the regulation creates unnecessary burdens, threatens smaller PBMs, and could increase costs.

The big question: If PBMs are already transparent, why is additional financial disclosure such a problem?

Read PCMA's response

2. HHS Opens the Door to Six Controversial Peptides

HHS has announced an interim enforcement-discretion policy involving six peptides: BPC-157, Epitalon, KPV, MOTS-c, Semax, and TB-500.

The policy could create a pathway for qualifying 503A compounding pharmacies under specific conditions, even as significant questions remain about the safety and efficacy of these non-FDA-approved substances.

The big question: Is this progress for personalized medicine or a dangerous leap ahead of clinical evidence?

Read the HHS Federal Register notice

3. Congress Investigates Alleged PBM Retaliation Against Independent Pharmacies

House Oversight Committee Chairman James Comer is investigating whether CVS Caremark, Express Scripts, and Optum Rx targeted independent pharmacies with burdensome audits after those pharmacies publicly supported PBM reform.

One allegation involves a medication costing just 99 cents that reportedly generated hundreds of hours of pharmacy staff work. The investigation is ongoing, and retaliation has not been established.

The big question: Are PBM audits protecting the system, or could they be used to intimidate pharmacies advocating for reform?

Read the congressional announcement

Special Guest: Dr. Jesse McCullough, PharmD

The 31 Day Challenge Finale & WORLD PHARMACIST CHALLENGE Announcement

Leadership starts with action!

Dr. Jesse McCullough, PharmD, CEO of Keystone Pharmacy Insights, returns to TWIRx for the final special feature of the 31 Day Challenge, reflecting on leadership, personal growth, accountability, and the importance of pharmacists stepping beyond their comfort zones.

October 23, 2026
Sponsored by Independent Pharmacy Cooperative and YARAL Pharma

This week on TWIRx: peptide compounding policy, a new hepatitis B treatment, specialty pharmacy growth, a rare-disease breakthrough, and pharmacy workforce pressure — followed by three conversations focused on the future of independent pharmacy.

TWIRx NEWS 1. FDA Moves Peptide Policy to White House Review

The FDA has submitted an Interim Access Policy for Compounding Using Certain Peptides for White House review. No final policy has been announced.

Why it matters: A temporary pathway could move some patients away from gray-market peptide sellers and toward licensed pharmacies, while raising ongoing questions about safety and evidence.

TWIRx angle: Is regulated compounding safer than leaving patients to buy peptides online?

2. FDA Approves GSK’s Hibsago for Chronic Hepatitis B

FDA approved Hibsago, bepirovirsen, for certain adults with chronic hepatitis B.

In Phase III studies, about 19% of eligible treated patients achieved functional cure after therapy stopped.

Why it matters: This could move hepatitis B treatment beyond long-term viral suppression toward sustained disease control for some patients.

3. Carelon Specialty Pharmacy Helps Drive Growth

Elevance Health reported $19.3 billion in quarterly Carelon revenue and about $900 million in operating gain, citing CarelonRx growth and improved specialty-pharmacy profitability.

Why it matters: Specialty pharmacy continues to become a major earnings and strategic growth engine inside vertically integrated healthcare organizations.

4. Positive Phase III Results for Bitopertin

Disc Medicine reported positive Phase III results for bitopertin in rare disorders where exposure to light can cause severe pain.

Patients experienced improved light tolerance and fewer phototoxic reactions.

Why it matters: This could meaningfully improve daily life for patients whose disease forces them to avoid sunlight.

5. Pharmacy Technicians Describe Growing Pressure

A widely discussed Reddit thread featured pharmacy technicians describing prescription backlogs, nonstop phones, frustrated patients, and inadequate staffing.

Important disclaimer: These are anonymous accounts and cannot be independently verified.

TWIRx angle: Are pharmacy teams being asked to do more without enough staffing and infrastructure?

FEATURED CONVERSATIONS Mark Kinney — IPC

IPC is expanding its Government Relations team as independent pharmacies face major federal and state issues involving PBM reform, reimbursement, rural access, and patient choice.

Discussion focus: Why IPC is investing more heavily in advocacy and what pharmacy owners should expect heading into 2027.

Shelley Bailey — IPC Rural Health and Independent Pharmacy

Independent pharmacies often serve as critical healthcare access points in rural communities.

Discussion focus:

• Pharmacy closures and rural access
• Chronic disease management
• Pharmacist clinical services
• Reimbursement and provider opportunities
• Why rural pharmacies should be treated as healthcare infrastructure

Kelli Stovall, IPC + Brandon Haag, Tenovi Remote Monitoring Beyond the Pharmacy Counter

IPC and Tenovi are partnering to give independent pharmacies access to RPM and RTM technology, including blood pressure monitors, scales, smart pillboxes, and inhaler sensors.

The goal is to support:

• Medication adherence
• Hypertension and chronic disease management
• Weight management
• Respiratory care
• Cash-pay and reimbursable clinical services

Big question: Can remote monitoring help independent pharmacies improve patient care while creating sustainable new revenue?

Closing

Independent pharmacy’s future increasingly depends on three things:

A stronger voice.
A broader clinical role.
Sustainable new economic models that keep care local.

TWIRx is sponsored by Independent Pharmacy Cooperative and YARAL Pharma. Independent Pharmacy: Power, Policy & Patient Care | TWIRx

Cell and gene therapy has entered a new phase. The science is advancing rapidly, but the harder question is increasingly becoming: How do we actually get these therapies to the right patient, at the right treatment center, with the financing, logistics, clinical support, and follow-up required?

That is the problem McKesson is trying to address through InspiroGene, its dedicated cell-and-gene commercialization business. McKesson built InspiroGene to connect manufacturers, payers, providers, treatment centers and patients across the CGT journey. McKesson

1. McKesson: Building the infrastructure around the therapy

A major area of focus for Joe and McKesson is what happens after a therapy proves clinically viable.

In 2026, Joe DePinto and Biologics by McKesson outlined the need for patient hubs purpose-built specifically for cell and gene therapies. These are more complex than conventional specialty-drug hubs because CGT may involve eligibility screening, treatment-center coordination, benefit investigation, financial assistance, scheduling, logistics, long-term follow-up and caregiver support. McKesson Biologics

McKesson has also developed an interactive map covering qualified treatment centers across 109 U.S. metropolitan regions, addressing another fundamental problem: patients may need to travel significant distances to receive CGT. McKesson

Question for Joe:
“Joe, the scientific breakthrough gets most of the headlines, but is the bigger challenge now building the infrastructure that allows a patient to actually receive the therapy?”

Follow-up:
“Where do you currently see the biggest friction — reimbursement, treatment-center capacity, logistics, patient identification, or ongoing follow-up?”

2. FDA is actively trying to speed cell and gene therapy development

FDA has made a noticeable regulatory shift in 2026.

In June, FDA issued draft guidance allowing gene-therapy developers to rely more heavily on existing platform knowledge and prior scientific information, potentially reducing redundant testing for products using similar genome-editing technologies. FDA has also issued guidance providing more flexibility around chemistry, manufacturing and controls for CGT products. U.S. Food and Drug Administration

FDA says it has now approved close to 50 cell and gene therapies, signaling that CGT is moving well beyond a small experimental category. U.S. Food and Drug Administration

TWIRx takeaway:
The regulatory conversation is shifting from “Can we safely approve these therapies?” toward “How do we safely accelerate an entire therapeutic platform?”

This week on TWIRx, we head into NCPA 2026 with independent community pharmacy front and center — from artificial intelligence and consolidation to supply-chain economics and policy reform.

We start with the TWIRx Rumor Mill — Behind the Counter Intelligence, looking at three developing stories worth watching.

TWIRx RUMOR MILL — TOP 3

1. Another massive pharmacy transaction may be coming.

The owner of Walgreens Boots Alliance is reportedly nearing a deal to sell UK pharmacy giant Boots to the Weston family in a transaction valued at roughly $9 billion, including debt. The Weston interests already control Loblaw Companies and Shoppers Drug Mart in Canada. No final transaction has been announced, so this remains one to watch.

TWIRx Take: Pharmacy consolidation isn't slowing down. As major organizations continue reorganizing, buying, selling, and vertically integrating assets, what does that mean for independent pharmacy — and where does scale become too much scale?

2. Specialty pharmacy keeps getting bigger — and Cigna sees an enormous opportunity.

At its 2026 Investor Day, Cigna identified a specialty pharmacy and care-services market approaching $500 billion, with Accredo and its specialty operations positioned as major growth drivers.

TWIRx Take: Follow the money. Specialty drugs, rare disease, biologics, infusion and complex medication management continue to reshape pharmacy economics. The question for community pharmacy is: How much of this expanding market can independents capture?

3. AI is moving from pharmacy experiment to pharmacy infrastructure.

Just as NCPA prepares to make AI implementation one of the major topics at its 2026 Annual Convention, health-profession regulators are increasingly discussing governance and accountability surrounding AI. NCPA's programming includes real-world AI implementation and operational applications for community pharmacies.

TWIRx Take: The conversation is changing from "Should pharmacy use AI?" to "How do we use it responsibly, profitably and safely?"

And that takes us directly into our first featured conversation.

SEGMENT 1 John Boos, PharmD, MBA — HendrenAI AI Meets Independent Community Pharmacy

Sponsored by HendrenAI and Independent Pharmacy Cooperative

NCPA 2026 officially opens October 3 in Kansas City, with independent pharmacy owners and innovators gathering to focus on practical ways to increase efficiency, expand services and strengthen pharmacy profitability. AI implementation is specifically among this year's featured topics.

In Part One of our conversation with John Boos, PharmD, MBA of HendrenAI, we set the stage for NCPA 2026 and examine what artificial intelligence can realistically do for independent pharmacy.

This isn't AI replacing the pharmacist.

It's AI giving pharmacists and their teams additional capacity.

As margins tighten and workload continues to increase, the pharmacies that intelligently automate routine work may be able to redirect valuable human time toward the things pharmacists do best: patients, clinical care, relationships and growing the business.

SEGMENT 2 Yvonne Dominguez — Independent Pharmacy Cooperative IPC Acquires IntegralRx

Independent Pharmacy Cooperative recently announced its acquisition of IntegralRx, bringing together two organizations serving independent community pharmacies.

IntegralRx has supported thousands of pharmacies through purchasing opportunities, service and pharmacy relationships. IPC says the acquisition will expand access to products, services and resources designed to help pharmacy owners remain competitive and profitable.

We talk with Yvonne Dominguez about:

• Why IPC made the acquisition
• What IntegralRx brings to the cooperative
• What changes — and what stays the same — for IntegralRx pharmacies
• How scale can strengthen independent pharmacy purchasing power
• Why independent pharmacies increasingly need collaboration without surrendering their independence

TWIRx Question: Can cooperatives create enough collective scale to give independent pharmacies some of the economic leverage enjoyed by vertically integrated competitors?

SEGMENT 3 David A. Hargraves — CEO, Pharma Logistics Jessica Daley — Industry Intelligence Pharmacy Supply Chain: Fighting for Every Dollar

Finally, we turn to an issue that doesn't always generate headlines but directly affects pharmacy profitability:

What happens to medication inventory after a pharmacy can no longer use it?

Pharmacies continue to face significant economic pressure, and many of the largest forces affecting reimbursement remain outside the direct control of the pharmacy owner.

But there are areas pharmacies — and policymakers — can change.

One is pharmaceutical return policy.

The Problem

Pharmacy economics are being squeezed from multiple directions.

Reimbursement pressure.
Inventory expense.
Expired medication.
Operational costs.
Supply-chain complexity.

When margins are razor thin, seemingly small inefficiencies become substantial.

The Opportunity

Medication return policies represent an area where pharmacies may have an opportunity to recover value that otherwise disappears from the business.

Virginia's regulations, for example, specifically address circumstances under which drugs can be returned within the supply chain while maintaining appropriate storage conditions, documentation and product integrity.

The Bigger Conversation

With David A. Hargraves, CEO of Pharma Logistics, and Jessica Daley of Industry Intelligence, we examine how smarter pharmaceutical returns and responsible policy reform could improve pharmacy economics.

Closing Thought

As we head into NCPA 2026, the independent pharmacy conversation isn't simply about surviving another difficult year.

It's about finding leverage.

Leverage through AI.

Leverage through cooperative scale.

Leverage through better supply-chain economics.

And leverage through policy change.

Independent pharmacy may not control every economic force affecting the profession — but this week's TWIRx demonstrates that there are still areas where pharmacy owners, innovators and advocates can take action.

We'll see you in Kansas City for NCPA 2026.

In this special episode of This Week in Pharmacy, Todd Eury welcomes Vox, the PPN and RxPR Intelligence Officer, for a timely conversation about the forces reshaping pharmacy.

Together, they examine the reimbursement pressures threatening independent pharmacies, the progress—and unfinished work—of PBM reform, and how artificial intelligence can augment pharmacists, strengthen operations, and create more time for meaningful patient care.

The discussion also looks ahead to NCPA 2026 in Kansas City, emerging innovations from Hendren AI and FDB, YARAL Pharma’s support of community pharmacy, and the upcoming Veterans Pharmacy Care Summit.

The message is clear: pharmacists and pharmacy technicians must engage lawmakers, host pharmacy tours in 2027, and share the patient stories that demonstrate pharmacy’s value.

This is not our platform. This is your platform.

In this IPC-sponsored episode, Todd Eury explores how manufacturer-direct programs, direct-to-consumer channels, cash-pay models, specialty carve-outs, and new reimbursement structures are reshaping medication access and independent pharmacy.

Joining the conversation are Shelley Bailey of Independent Pharmacy Cooperative and Sammy Salem, Principal Owner and COO of Vios Health and an Executive Board Member of the AAPARx.

Manufacturer-direct care is often associated with websites, telehealth, and mail-order fulfillment—but it does not have to exclude community pharmacy. IPC is developing infrastructure that allows patients to receive manufacturer-supported pricing while participating independent pharmacies remain the dispensing location.

The discussion examines IPC’s manufacturer-sponsored GLP-1 opportunities and a broader network covering more than 140 branded medications. Shelley and Sammy explain how these programs can improve patient affordability, create more sustainable pharmacy economics, and help independent pharmacies reconnect with patients lost to online and manufacturer-controlled channels.

Topics include:

• Whether the traditional pharmacy benefit is beginning to fragment
• How manufacturer-direct programs can include independent pharmacy
• The economics behind manufacturer-supported reimbursement
• Finding patients facing denied authorizations, high deductibles, lost coverage, or limited brand access
• Why excellent service must now be paired with digital access and new payment models
• Employer drug carve-outs and the importance of evaluating total benefit economics
• Point-of-sale affordability and acquisition-cost protections
• What manufacturers need to provide for pharmacy participation
• How successful pharmacies can prepare for the next access model

The central message is clear: the industry may not need to create new dollars—it needs to change where existing dollars land.

In partnership with GoodRx, this manufacturer-direct program combines GoodRx’s trusted consumer platform and broad patient reach with IPC’s nationwide network of independent pharmacies. Together, we create a more direct and accessible path from patient engagement to prescription fulfillment—while keeping community pharmacies at the center of care.

IPC GPO members interested in participating should contact their IPC Regional Director. Other IPC members, affiliates, and interested pharmacies can reach IPC Digital Health at digital-health@ipcrx.com.

Host: Todd S. Eury, Pharmacy Podcast Network
Guests: Shelley Bailey, IPC; Sammy Salem, AAPARx and Vios Health
Sponsored by: Independent Pharmacy Cooperative

This week on TWIRx, we’re looking at the expanding role of pharmacists in public health, value-based care, artificial intelligence, medication intelligence, and the technology infrastructure supporting independent community pharmacy.

We begin with a special conversation featuring Alex J. Adams, PharmD, MPH, Assistant Secretary for the Administration for Children and Families (ACF), and Pennsylvania pharmacy leader Robert “Rob” Maher, PharmD, President and Chief Operating Officer of the Pennsylvania Pharmacists Care Network (PPCN).

Dr. Adams brings a pharmacist’s perspective to federal health and human services leadership, while Maher leads a statewide clinically integrated pharmacy network focused on measurable patient outcomes. Together, we discuss how pharmacists are becoming increasingly involved in public health initiatives and how organizations such as PPCN are helping demonstrate the value of pharmacist-provided care through value-based models in Pennsylvania.

Next, we continue our countdown to NASP inSPire 2026 with one of PPN’s Podcast Press Sponsors, Hendren AI.

John Boos, PharmD, MBA, Founder and CEO of Hendren AI, joins us to examine the growing role of artificial intelligence in specialty pharmacy and rare disease management. We discuss how AI-enabled tools can support pharmacists by processing complex information, improving workflow efficiency, automating administrative processes, and helping pharmacy teams devote more time to clinical care and patient engagement.

Our 3rd segement on today’s TWIRx, we catch up with Vince Costanzo of RxBLU for an important discussion about the rapidly changing pharmacy technology landscape.

Pharmacy software today is about far more than features and functionality. For an independent pharmacy, its technology platform can sit at the center of dispensing, claims, inventory, patient communication, workflow, and business continuity.

We discuss why pharmacies should evaluate not only the technology they purchase, but also the stability, accessibility, support structure, and long-term strategy of the company behind it. As consolidation continues throughout healthcare technology, independent pharmacy owners need to understand what a potential acquisition, ownership change, or shift in corporate priorities could mean for the software platforms their operations depend upon.

Our featured Podcast Press Sponsor is First Databank — FDB.

David Delaney, MD, President of FDB, joins TWIRx to discuss the company's newly announced FDB Script Agent™, an AI-powered prescribing agent designed to move ambient listening beyond clinical documentation.

FDB Script Agent converts patient-clinician dialogue into structured prescriptions ready for clinician review, using FDB medication intelligence to provide clinical grounding and codification rather than relying on simple natural-language processing alone. We explore what this next generation of ambient AI could mean for prescribing workflows, medication safety, clinicians, and ultimately the pharmacies receiving those prescriptions.

It’s another packed edition of This Week in Pharmacy — connecting pharmacy leadership, public health, specialty pharmacy, artificial intelligence and the technology shaping the future of the profession.

This is TWIRx — This Week in Pharmacy, from the Pharmacy Podcast Network.

Specialty Pharmacy Access, Innovation & Independent Pharmacy Growth

This Week in Pharmacy, we explore specialty pharmacy, pharmacy innovation, emerging career opportunities, and new business models for independent community pharmacy.

Today’s episode is sponsored by Clearway Health, Value Drug Company, and FDB (First Databank, Inc.)

First, Allison Arant of Clearway Health joins us to discuss the next phase of specialty pharmacy within hospitals and health systems.

As rare disease and specialty therapies become more complex, health systems are looking for better ways to improve medication access, strengthen continuity of care, and keep patients connected to trusted clinical teams.

Todd and Allison discuss how health-system specialty pharmacy can expand community access and improve management of complex and rare disease treatments.

Learn more:

https://www.clearwayhealth.com/

National Association of Specialty Pharmacy (NASP) #inSPire2026

Next, we preview inSPire 2026, taking place September 22–25, 2026, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.

The specialty pharmacy community will come together to discuss medication access, emerging therapies, technology, patient services, clinical care, and the continued evolution of specialty pharmacy.

The Next Dose Summit

Then we welcome Jordan Smith, PharmD, AAHIVP, CPGx, and Melinda Fowler, RPh, ABAAHP, FAAFM to preview The Next Dose Summit, happening October 14–15, 2026.

RxPR and the Pharmacy Podcast Network are proud press and media partners.

The event focuses on innovation, entrepreneurship, leadership, emerging career pathways, and new opportunities for pharmacists looking beyond traditional roles.

It is designed for pharmacists, students, entrepreneurs, and healthcare leaders asking one important question:

What’s next for pharmacy — and what’s next for me?

Register here:

https://www.jscommunitycare.org/store/p/2026-the-next-dose-summit-registration

Expanding Independent Pharmacy

Finally, Rick Seipp, PharmD, President and CEO of Value Drug Company, returns to discuss creative strategies for expanding independent community pharmacy.

Todd and Rick explore cash-based pharmacy, transparent pricing, clinical services, new revenue streams, and other non-PBM-dependent models that can help independent pharmacies diversify and grow.

The conversation focuses on how community pharmacies can strengthen their businesses while continuing to serve as trusted healthcare destinations.

Learn more:

https://www.valuedrugco.com/

Sponsored By

Clearway Health

https://www.clearwayhealth.com/

Value Drug Company

https://www.valuedrugco.com/

First Databank — FDB

https://www.fdbhealth.com/

TWIRx — This Week in Pharmacy is hosted by Todd S. Eury and produced by the Pharmacy Podcast Network — Amplifying the Voice of Pharmacists & Our Profession.

TWIRx NEWS 1. Medicare Part D Paid Nearly $588 Million for Ineligible OTC Drugs

A federal audit found that Medicare Part D sponsors made approximately $587.7 million in ineligible payments from 2021 through 2023 for medications that had effectively transitioned from prescription to over-the-counter status.

The HHS Office of Inspector General cited outdated FDA information and the lack of a clear CMS rejection timeline as major contributors.

Why it matters: This exposes a serious coordination problem across FDA data, manufacturers, CMS, health plans and pharmacy claims systems.

Pharmacists may see the rejection or payment issue at the counter, but the failure often begins far upstream.

Read the Fierce Healthcare report
Read the HHS-OIG audit

2. FDA Responds to Estradiol Patch Supply Pressure

The FDA is working with six manufacturers to improve access to estradiol transdermal patches amid increased demand.

While FDA has not declared a national shortage, availability varies by product, strength and geographic area. Manufacturers are increasing production through larger batches, added shifts and expanded capacity.

Why it matters: Pharmacists are again serving as the front line of a supply-chain challenge—helping patients locate medication, coordinating with prescribers and identifying alternatives.

Read the Reuters report
Read the FDA update

3. New RSV and COVID-19 Guidance Released

The American Academy of Pediatrics and American College of Obstetricians and Gynecologists have issued updated recommendations for RSV and COVID-19 protection during the 2026–2027 respiratory season.

Why it matters: Pharmacists may face conflicting recommendations, patient confusion and questions about eligibility.

Clear counseling and coordination with pediatric and obstetric providers will be critical.

Read the Pharmacy Times report

SPECIAL ANNOUNCEMENT FROM OUTCOMES

A special update from Megan Urban and Outcomes.

Outcomes is highlighting new enhancements to its Rx30 pharmacy management platform, including a refreshed user experience, automated data-entry capabilities and support from a dedicated Client Success Team.

The program will explore how these updates can streamline pharmacy workflows, save time and support greater focus on patient care.

Presented by: Dalia Rios and Kaley Lester
September 9, 2026 — 1:30 p.m. ET

Register here

FEATURED CONVERSATION Building a Bridge to GLP-1 Access

Our featured guest is HaVy Ngo-Hamilton, PharmD, RPh, Senior Pharmacy Director at Buzz Health.

HaVy works at the intersection of pharmacy, healthcare technology, medication affordability and prescription access.

Buzz Health operates platforms including BuzzRx, RxCompare and RxAffect, with a focus on helping connect patients, pharmacies, prescribers and prescription pricing information.

That makes today’s discussion particularly timely.

THE MEDICARE GLP-1 BRIDGE

CMS launched the Medicare GLP-1 Bridge on July 1, 2026, to provide eligible Medicare Part D beneficiaries access to selected GLP-1 medications for weight management.

The demonstration runs through December 31, 2027.

Eligible beneficiaries pay $50 for a monthly supply, while the program operates outside the traditional Part D payment flow through centralized prior authorization, claims adjudication and pharmacy payment.

Eligible therapies currently include:

Foundayo®
Wegovy®
Zepbound®

The bigger issue is not simply GLP-1 coverage.

It is how healthcare connects eligibility, affordability, prior authorization, pharmacy workflow and patient access.

The central question for today’s discussion:

Can we create a medication-access system where patients know whether they can obtain and afford their therapy before they reach the pharmacy counter? CLOSING THOUGHT

The Medicare GLP-1 Bridge is more than another federal drug program.

It is a real-world test of how healthcare can better connect coverage, affordability, prior authorization and pharmacy fulfillment around high-demand therapies.

Pharmacists remain at the center of that process.

The opportunity is to use technology to move more complexity upstream—allowing pharmacists to spend less time troubleshooting prescriptions and more time caring for patients.

Our thanks to HaVy Ngo-Hamilton, PharmD, RPh, Senior Pharmacy Director at Buzz Health, for joining us on This Week in Pharmacy.

Learn more about the CMS Medicare GLP-1 Bridge

Learn more about Buzz Health

TWIRx — This Week in Pharmacy
Pharmacy Podcast Network

Amplifying the Voice of Pharmacy.

Y8mIl2V5tNxFiC3PBxmn

Today’s episode of This Week in Pharmacy — #TWIRx is sponsored by Value Drug Company and explores two major forces reshaping pharmacy: the evolution of the community pharmacy business model and the expanding role of artificial intelligence in medication optimization and value-based care.

PART ONE: The Impact of the Cash-based Community Pharmacy

Special Guest: Rick Seipp, PharmD President, Value Drug Company

Community pharmacy is entering a new era.

In Part One, Todd Eury sits down with Rick Seipp, PharmD, President of Value Drug Company, to discuss the continued evolution and expansion of independent community pharmacy and the many different business models emerging across the profession.

Independent pharmacy owners are increasingly evaluating new ways to build sustainable businesses while creating greater professional freedom for pharmacists. One of the most interesting developments is the growth of cash-based and cost-plus pharmacy models that reduce or eliminate dependence on traditional insurance reimbursement and PBM-controlled prescription economics.

These models can give pharmacy owners greater control over pricing, patient relationships, clinical services and the overall direction of their businesses — while allowing pharmacists to practice with significantly less interference from insurance companies and pharmacy benefit managers.

Two pharmacies in the Pittsburgh region are demonstrating how powerful this model can become:

Blueberry Pharmacy — Kyle McCormick, PharmD has built Blueberry Pharmacy around a transparent, cash-based model designed to simplify prescription pricing and create a more direct relationship between the pharmacist and patient.

Forward Rx Pharmacy — Brandon Antinopoulos, PharmD is another emerging example of how pharmacists can create innovative pharmacy businesses built around transparency, accessibility and freedom from many of the traditional constraints of third-party reimbursement.

Todd and Rick discuss what these models mean for the broader independent pharmacy marketplace and why community pharmacy may be moving toward a much more diversified future.

Sponsored by Value Drug Company, a pharmacist-led wholesale distribution partner committed to supporting the continued growth and independence of community pharmacy.
https://lnkd.in/ehf76qUs

PART TWO: AI-Powered Medication Optimization

Special Guests:

Yoona Kim, PharmD, PhD
Co-Founder & CEO, Arine

Jenny Behan, PharmD
Lead Clinical Pharmacist, Arine

In Part Two, #TWIRx shifts from pharmacy business innovation to one of the most important developments occurring in clinical pharmacy: the use of artificial intelligence to optimize medication therapy at scale.

Arine is an AI-powered medication optimization platform designed to improve patient outcomes and reduce healthcare costs by helping ensure patients receive the most effective and appropriate medications.

Listen to This Week in Pharmacy — TWIRx on the Pharmacy Podcast Network across Apple Podcasts, Spotify, Amazon Music, iHeartRadio, YouTube and all major podcast platforms.

Pharmacy Podcast Network — Amplifying the Voice of Pharmacy.

Y8mIl2V5tNxFiC3PBxmn

Pharmacists and Advocacy for Patients in Pain

Friday, August 21, 2026

What happens when patients living with chronic pain, their advocates, and the pharmacists responsible for dispensing opioid medications view the same healthcare system from very different perspectives?

This special episode of This Week in Pharmacy brings together the Doctor Patient Forum’s founders, Claudia A. Merandi and Bev C. Schechtman, with pharmacist and nationally recognized pharmacy advocate Dr. Shane Jerominski, PharmD—better known as “The Accidental Pharmacist.”

The discussion follows a wave of social-media debate surrounding Claudia’s use of the term “Harmacists,” which prompted responses from hundreds of pharmacists who felt the label misrepresented their professional responsibilities and the legal restrictions under which they practice.

Rather than allow that controversy to deepen the divide, TWIRx created an opportunity for direct, respectful conversation. The purpose of this episode is to help pain-patient advocates better understand the limits pharmacists face when dispensing opioids—and to identify opportunities for pharmacists and patient organizations to advocate together for safe, compassionate and uninterrupted pain care.

Five Legal and Supply-Chain Realities Affecting Opioid Dispensing

• Pharmacists have a federal “corresponding responsibility.”
Under 21 CFR §1306.04, a controlled-substance prescription must be issued for a legitimate medical purpose. Pharmacists share legal responsibility with prescribers for determining whether a prescription is valid. Knowingly filling an illegitimate prescription may expose the pharmacist to federal penalties and professional discipline. Review the federal regulation.
• Schedule II prescriptions must satisfy strict requirements.
Federal law generally requires a valid written or compliant electronic prescription before a Schedule II opioid may be dispensed. Emergency oral prescriptions are permitted only under limited conditions and require prescriber follow-up documentation.
• Schedule II opioid prescriptions cannot be refilled.
Under federal law, every additional dispensing generally requires a new prescription. Partial fills are allowed only under specific circumstances, documentation requirements and time limits. Pharmacists cannot simply extend or refill opioid therapy when a patient or prescriber requests it.
• State laws add another layer of requirements.
Depending on the state, pharmacists may have to verify prescriber authority, review prescription-monitoring information, validate electronic or security-form requirements, confirm identification, document partial fills, or comply with state-specific dispensing limitations. For example, California requires controlled-substance prescriptions to meet defined security and validity standards. California Board of Pharmacy guidance.
• Wholesaler monitoring can restrict a pharmacy’s opioid supply.
DEA-registered distributors must identify and report suspicious controlled-substance orders under 21 CFR §1301.74. National wholesalers therefore operate monitoring programs that may delay, limit or suspend shipments based on ordering patterns, geography, drug mix and internal thresholds. These controls are imposed upstream and can leave a pharmacy unable to obtain medication—even when the pharmacist believes a prescription is clinically and legally appropriate. Review the federal distributor requirements.

These examples are not exhaustive. Pharmacists must navigate overlapping federal law, DEA requirements, state pharmacy and controlled-substance laws, prescription-monitoring systems, employer policies, payer rules, wholesaler restrictions and professional standards. Requirements also vary by state and by the circumstances surrounding an individual prescription.

The Central Question

How can pain-patient advocates and pharmacists move beyond blame and work together to address the policies, supply restrictions, staffing conditions and regulatory pressures that can interfere with appropriate care?

This conversation explores:

• Why patients may interpret a refusal or delay as judgment, discrimination or abandonment
• Why pharmacists cannot treat a valid prescriber signature as automatic authorization to dispense
• How PDMP and risk-scoring information can influence clinical decisions
• The effect of corporate policies and wholesaler ordering controls
• The difference between professional judgment and stigma
• The communication failures that damage trust between patients, prescribers and pharmacists
• How advocacy organizations and pharmacists can pursue policy reform together
• Why patients deserve clear explanations, respectful treatment and continuity-of-care planning
• How pharmacists can remain vigilant without losing empathy for people living with pain

About the Doctor Patient Forum

The Doctor Patient Forum, founded by Claudia A. Merandi and Bev C. Schechtman, combines healthcare education, research, digital influence and patient advocacy to address the consequences of opioid-reduction policies and barriers to individualized pain care.

Claudia A. Merandi is an advocate and educator whose work contributed to a Rhode Island law protecting access to pain management. Since 2016, she has built a growing national audience while documenting systemic harms experienced by patients and healthcare professionals.

Bev C. Schechtman is a researcher, advocate and educator who examines opioid-reduction policies, prescription drug monitoring programs and surveillance technologies such as NarxCare. Her work helps patients understand and navigate an increasingly complex healthcare system.

Learn more: The Doctor Patient Forum

About Dr. Shane Jerominski, PharmD

Dr. Shane Jerominski is a pharmacist, Navy veteran and nationally recognized pharmacy advocate known as “The Accidental Pharmacist.” In 2025, his professional peers selected him as one of the “50 Most Influential People in Pharmacy.”

Through his influential social-media platform, Shane combines humor, candid commentary and frontline experience to advocate for safer working conditions, professional unity and meaningful reform throughout pharmacy practice. He is also a co-founder of The Pharmacy Guild and has become a prominent voice for pharmacists and pharmacy technicians nationwide.

A Call for Collaborative Advocacy

Patients should not be stigmatized because they require pain treatment. Pharmacists should not be vilified for complying with laws and professional obligations that can place their licenses and livelihoods at risk.

Progress requires both communities to recognize that many barriers originate beyond the pharmacy counter. Patients, pharmacists, prescribers and advocacy organizations share an interest in policies that protect medication safety without denying appropriate, individualized care.

The goal is not to determine which group has suffered more. The goal is to replace mistrust with understanding—and turn that understanding into stronger, unified advocacy.

This episode is intended for education and discussion. It does not provide legal or medical advice, and regulatory requirements may differ by jurisdiction and circumstance.

Y8mIl2V5tNxFiC3PBxmn

Independent pharmacies need partners they can trust—and patients need a prescription-drug system that puts access ahead of profits.

In this episode of This Week in Pharmacy, Todd Eury welcomes Rick Seipp, PharmD, President of Value Drug Company, to discuss the importance of choosing a dependable wholesale distribution partner. Following Smith Drug Company’s announced operational transition, Value Drug Company is prepared to help affected independent pharmacy owners evaluate their purchasing, distribution and operational needs while developing an orderly transition that protects continuity of service.

For more than 90 years, pharmacist-led Value Drug Company has supported community pharmacies through transparent pricing, dependable distribution, collective purchasing power and programs designed to improve efficiency, growth and profitability. Rick explains how the company will provide transition assistance and regional gatherings where pharmacy owners can speak directly with Value Drug Company leadership.

The episode also features a follow-up conversation with patient advocate Bil Schmidtknecht about the continuing fight for Cole’s Act. Named in memory of Bil’s son, Cole, the proposed reforms seek to protect patients from unexpected formulary and coverage changes that can suddenly make essential medications unaffordable.

“Patients can’t afford more delays, and lives should never be collateral damage in a profit-driven system,” Bil says. The discussion examines PBM accountability, medication affordability and why families must receive meaningful notice before coverage changes place lifesaving treatments beyond their reach.

TWIRx News: Week Ending August 14, 2026 Employers Are Moving Away from the “Big Three” PBMs

A new employer survey points to growing disruption in the PBM marketplace. Forty-six percent of surveyed employers reported using a PBM outside CVS Caremark, Express Scripts and Optum Rx—up from 37% the previous year. Employers are increasingly seeking transparent pricing, access to claims data and greater control over prescription-drug spending.

Read the Axios report

FDA Delays Major iPLEDGE Changes Until November

The FDA has postponed implementation of updated iPLEDGE REMS requirements from August 8 to November 15, 2026, to allow additional system testing. The forthcoming changes are intended to reduce burdens on patients, pharmacists and prescribers while maintaining safeguards surrounding isotretinoin.

Read the FDA iPLEDGE update

Episode Resources

• Value Drug Company transition-support announcement
• Value Drug Company transition assistance: 1-866-226-1772
• Patient Protector
• Modern Medical Mafia: PBM Reform
• Pharmacy Podcast Network

About the Guests

Rick Seipp, PharmD
President, Value Drug Company

Bil Schmidtknecht
Patient advocate and father of Cole Schmidtknecht

The Value of a Trusted Wholesaler & Cole’s Act Update | TWIRx

In the first episode of this three-part CurifyLabs Podcast Series, we provide a broad overview of the CurifyLabs platform and its role in modernizing personalized medicine and pharmaceutical compounding. The discussion explores how the platform combines digital workflows, automated production technology, and standardized processes to help pharmacies and healthcare organizations improve efficiency, consistency, quality, and scalability.

Listeners will learn how CurifyLabs supports the preparation of customized medications while helping pharmacy teams reduce manual complexity, strengthen documentation, and expand access to patient-specific therapies. This opening episode establishes the foundation for the series and examines how technology can help transform the future of pharmaceutical compounding.

The Independent Pharmacy Cooperative is partnering with Fullscript to help independent pharmacies expand their wellness offerings without adding inventory, storage costs, or fulfillment responsibilities.

Through the partnership, IPC members receive free access to Fullscript’s digital platform, featuring more than 375 trusted supplement brands. Pharmacies can recommend personalized wellness protocols, earn approximately 35% margins on online sales, and benefit from direct-to-patient shipping, automated refill reminders, and optional auto-ship services.

Fullscript manages product inventory, payment processing, and delivery, giving independent pharmacies a practical way to generate recurring revenue while supporting patient adherence and long-term wellness goals.

Guests:

Kelli - IPC

Christopher - FullScript

Shannon - IPC

Andrea - Pharmacy Owner

Emlah Tubuo - Pharmacy Owner

Independent pharmacies are facing growing reimbursement uncertainty, especially when dispensing high-cost brand medications such as GLP-1 therapies. In this exclusive Pharmacy Podcast Network special feature, we examine how GoodRx Community Link provides independent pharmacies with predictable pricing and favorable economics across both brand and generic medications, ultimately helping pharmacies remain solvent while providing consumers affordable prescription prices.

Todd Eury is joined by David Graziano, Head of Retail Network at GoodRx, and Tom DePietro, independent pharmacy owner at DePietro’s Pharmacy, for a practical discussion about the pressures affecting independent pharmacy and the need for reimbursement models that support pharmacy viability.

The conversation explores how Community Link supports brand medications through manufacturer-funded savings that flow back to the pharmacy through GoodRx, while the manufacturer covers the administrative fee. For generic medications, the program uses a NADAC-based cost-plus model intended to provide clearer visibility into reimbursement.

Listeners will also hear how independent pharmacies are impacted by rising deductibles, prior authorizations, narrow formularies, cash-pay growth, and increased competition. David and Tom discuss the importance of transparent pricing, digital engagement, streamlined fulfillment, personalized patient care, and sustainable economics for local pharmacies.

Key discussion points include:

• The financial risk of dispensing high-cost brand medications like GLP-1s
• Predictable reimbursement for brands and generics
• The role of manufacturer-funded savings for brand medications
• NADAC-based cost-plus pricing for generics
• Pharmacy access to GLP-1 cash-pay programs
• Competing through service, technology, and patient relationships
• Protecting local healthcare access through independent pharmacy

Explore how GoodRx Community Link can bring greater transparency and predictability to brand and generic dispensing, helping independent pharmacies serve patients sustainably and with confidence.

Featured Guests:

David Graziano — Head of Retail Network, GoodRx

Tom DePietro — Independent Pharmacy Owner, DePietro’s Pharmacy

Host:

Todd Eury — Founder, Pharmacy Podcast Network

Visit http://goodrx.com/CommunityLink to learn more

GoodRx is NOT insurance.

Specialty pharmacy is becoming one of the most important access points in modern healthcare, particularly for patients managing complex, chronic, rare, and high-cost conditions. As therapies advance and patient needs become more sophisticated, health systems are rethinking how specialty pharmacy can improve medication access, continuity of care, clinical outcomes, affordability, and the overall patient experience.

In this special episode of This Week in Pharmacy, the Pharmacy Podcast Network introduces Specialty Care Close to Home, a new series examining how hospitals and health systems are designing, building, supporting, and scaling specialty pharmacy services across health-system and community-based care models.

Featured Guests

Dr. Laura Mark, PharmD
Vice President of Pharmacy, Allegheny Health Network

Allison Arant
Senior Vice President, Clearway Health

Chris Corsi
Chief Executive Officer, CassianRx

Together, the guests discuss why health-system specialty pharmacy expansion matters, what successful programs require, and where the greatest strategic and operational challenges exist. The conversation explores how strong partnerships, integrated clinical workflows, patient-centered technology, and coordinated care teams can reduce fragmentation and improve specialty medication access.

Discussion Highlights

• The growing strategic role of health-system specialty pharmacy
• Keeping patients connected to trusted local care teams
• Improving access, adherence, affordability, and therapy management
• Building scalable specialty pharmacy infrastructure
• Integrating clinical, operational, and technology capabilities
• Overcoming payer, workflow, workforce, and reimbursement challenges
• Creating collaborative models that support long-term sustainability

Future episodes of Specialty Care Close to Home will explore accreditation, payer access, manufacturer relationships, clinical workflow, patient engagement, technology infrastructure, data reporting, community access, workforce development, and financial sustainability.

The series will also feature pharmacy directors, vice presidents, executives, operators, and innovators from health systems across the country who are leading the next generation of specialty care delivery.

Host: Todd Eury, Founder of the Pharmacy Podcast Network

Coming Soon: Specialty Care Close to Home—a national conversation about bringing advanced specialty pharmacy services closer to where patients live, work, and receive care.

AI in Pharmacy Standards and Drug Supply Chain Upgrades
This Week in Pharmacy — July 17, 2026

Artificial intelligence and supply chain modernization are reshaping pharmacy practice, patient access, and healthcare operations.

In this episode of This Week in Pharmacy, host Todd Eury speaks with leaders from URAC and Cencora about responsible AI adoption and the growing gap between drug availability and real-world access.

Guests

Shawn Griffin, MD
President and CEO, URAC

Brent Wilhelm
Senior Vice President, Global Supply Chain Center of Excellence, Cencora

Tim Weber
Pharmacy Operations and Regulatory Executive

AI is already supporting clinical documentation, patient communication, risk prediction, and workflow automation. URAC President and CEO Shawn Griffin, MD, explains why healthcare organizations need clear governance, defined accountability, human oversight, and continuous monitoring before deploying AI at scale.

The discussion addresses transparency, performance evaluation, bias, data integrity, cybersecurity, and the role accreditation standards may play in promoting safe and responsible AI adoption.

• Governance and accountability for AI outputs
• Human review of AI-supported decisions
• Monitoring safety, accuracy, and bias
• The role of accreditation in AI oversight
• Balancing innovation with patient protection

Drug Availability Versus Patient Access

Brent Wilhelm of Cencora discusses why a medication may exist somewhere in the supply chain but still remain difficult for providers to obtain.

Dosage limitations, delivery timing, ordering complexity, reimbursement barriers, cold-chain requirements, and site-of-care restrictions can all delay patient access.

Wilhelm explains why the industry must look beyond inventory levels and focus on whether providers can obtain the correct therapy, at the right location, when the patient needs it.

• Inventory visibility versus actual access
• Differences across pharmacies and sites of care
• Specialty and temperature-sensitive therapies
• Provider demand forecasting
• Reducing delays, shortages, and waste

Tim Weber adds the pharmacy operations and regulatory viewpoint, discussing inventory planning, compliance, product tracing, reimbursement, and patient fulfillment.

The conversation highlights the need for better coordination among manufacturers, distributors, pharmacies, health systems, payers, and regulators.

Integrative Care Impact and the Expanding Role of the Pharmacist | TWIRx

Today’s episode of This Week in Pharmacy explores two major opportunities shaping the future of the profession: the growth of holistic and integrative pharmacy services inside community pharmacies, and the expanding demand for pharmacists across the business, insurance, and PBM sectors.

In our first segment, Todd Eury welcomes special guests Robert Kress, RPh, and Dr. Bianca Bradshaw, PharmD, owner of Elmore Pharmacy in Red Bluff, California. Together, they discuss the tremendous opportunity for independent pharmacies to build holistic and integrative health departments that respond to growing consumer demand for natural products, supplements, wellness solutions, and personalized care.

Dr. Bianca Bradshaw, PharmD

https://www.linkedin.com/in/bianca-bradshaw-141092205/

Patients are increasingly seeking more natural approaches to health, but they still need trusted clinical guidance. Community pharmacists are uniquely positioned to help patients evaluate products, avoid harmful interactions, understand evidence, and develop safer, more effective wellness plans. This conversation explores how pharmacies can create new service lines, improve patient relationships, and establish sustainable revenue opportunities through integrative care.

In our second segment, Dr. Bonnie Hui-Callahan, PharmD, returns to the show to discuss career opportunities for pharmacists within Judi Health and Capital Rx, as well as the broader business and insurance side of pharmacy.

Dr. Bonnie Hui-Callahan, PharmD

https://www.linkedin.com/in/bonnie-hui-callahan/

As PBMs continue to evolve, new-generation models are creating demand for pharmacists who understand clinical care, benefits, formulary strategy, patient access, data, and healthcare economics. Bonnie shares why pharmacists will remain essential as PBMs transform and why the profession should look beyond traditional dispensing and clinical practice roles when considering future career paths.

Today’s episode is sponsored byIndependent Pharmacy Cooperative and SuiteRx.

Listen to This Week in Pharmacy on the Pharmacy Podcast Network.

Today e celebrate 250 Years of Freedom during this 4th of July special with Scotty Sykes with Sykes & Company Pharmacy Accounting Experts. Next, a special interview with Virginia Halsey SVP of Strategy and Product Management and Brad Engels Product Manager at First Databank (FDB).

Today's TWIRx is sponsored by Sykes & Company

250 Years of Freedom - 4th of July Special | TWIRx

THIS WEEK IN PHARMACY
PBM Truth, Cash-Based Pharmacy, and Psychedelics in Medicine

Presented by SuiteRx Pharmacy Software Technologies
Learn more at SuiteRx.com

Episode Overview

On this episode of This Week in Pharmacy, Todd Eury brings together two timely conversations focused on pharmacy transformation, advocacy, clinical education, and the future role of pharmacists in healthcare.

First, Todd welcomes Brad Hart, owner of Forest Park Pharmacy, a cash-based independent pharmacy model challenging the traditional reimbursement structure many pharmacies operate under. Brad has become a powerful advocate for pharmacy transparency, using TikTok and social media to expose current PBM practices, share data, and speak directly to patients, pharmacy owners, and policymakers about the realities facing independent pharmacies.

Brad’s message is clear: patients deserve transparency, pharmacy owners deserve fair treatment, and the profession needs more voices willing to educate the public with facts and truth.

In the second half of the episode, Todd is joined by Dr. Colby Burns and Dr. Andy Krut from the Psychedelic Pharmacists Association. This discussion helps set the groundwork for understanding psychedelics in medicine, the evolving role of pharmacists in psychedelic education, and the clinical potential of psychotropic therapies historically limited by regulation, stigma, and lack of provider education.

As interest in psychedelic-assisted care grows, pharmacists must be part of the conversation. Dr. Burns and Dr. Krut explain why pharmacist education, medication safety, and clinical understanding are essential as healthcare explores emerging approaches to mental health, trauma, pain, and complex patient care.

Featured Guests

Brad Hart
Owner, Forest Park Pharmacy

Dr. Colby Burns
Psychedelic Pharmacists Association

Dr. Andy Krut
Psychedelic Pharmacists Association

Sponsored By

This episode of This Week in Pharmacy is brought to you by SuiteRx Pharmacy Software Technologies.

SuiteRx provides pharmacy software solutions designed to support independent pharmacies, improve workflow, enhance patient care, and help pharmacy teams operate more efficiently in today’s demanding healthcare environment.

Learn more at SuiteRx.com.