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Direct-to-consumer healthcare is changing how patients engage with care, driven by growing demand for convenience, accessibility, and personalized experiences. VerifiedRx host Stacy Lauderdale is joined by Emily Fitt, Hailey Mulliner, and Heather Pace to discuss the continued rise of telehealth and direct-to-consumer healthcare platforms, the areas experiencing the most growth, and what these evolving models may mean for patients, providers, and health systems in the future.
Guest Speakers: Emily Fitt, MHA, MPHSenior Associate, Sg2 IntelligenceVizient, Inc.
Hailey Mulliner, MS-HSMSenior Director, Sg2 IntelligenceVizient, Inc.
Heather Pace, Pharm.D.Senior Clinical Manager, AmbulatoryVizient, Inc.
Host: Stacy Lauderdale, Pharm.D., BCPS AVP, Evidence-Based Medicine Vizient
Show Notes:
(00:52) The panel discusses where direct-to-consumer healthcare has gained the most traction, including:
Men’s reproductive healthWomen’s contraceptivesDermatology and acne careBehavioral healthGLP-1 and obesity management(01:59) Heather explains how GLP-1 medication shortages fueled growth in compounded obesity medications and expanded telehealth services.
(02:47) Hailey shares insights from SG2 consumer surveys, emphasizing how patients increasingly want customizable, convenient healthcare experiences like other consumer industries.
(03:26) The group explores future expansion areas for direct-to-consumer healthcare, including:
Cardiovascular disease managementType 2 diabetesOrthopedic careCardiometabolic disease monitoring(04:31) Discussion shifts to the benefits and drawbacks for patients, including:
Increased convenience and accessMore comfortable treatment environmentsGreater patient empowermentRisks of fragmented care and disconnected treatment plans(06:07) Emily outlines concerns for health systems, including:
Increased emergency department utilizationLack of coordinated careMedication management gapsChallenges identifying medications prescribed outside the health system(07:03) Heather discusses medication stewardship concerns, particularly as weight loss impacts management of other chronic conditions like hypertension.
(07:29) The panel highlights operational challenges for hospitals and procedural teams when patients fail to disclose GLP-1 medications prior to surgeries or colonoscopies.
(07:58) The conversation turns to how direct-to-consumer healthcare is permanently changing consumer expectations around convenience and accessibility.
(08:36) The panel debates whether health systems should compete with direct-to-consumer companies or pursue partnership strategies.
(09:51) Emily discusses how health systems can differentiate themselves by offering the full continuum of care that virtual only providers cannot.
(10:20) Heather Pace emphasizes the importance of partnerships between health systems and direct-to-consumer platforms to improve access while maintaining coordinated care.
(10:55) The group discusses emerging partnerships in the marketplace, including collaborations between pharmaceutical manufacturers and direct-to-consumer platforms.
(12:14)Workforce challenges are explored, including:
Competition for cliniciansProvider burnoutFlexibility offered by virtual care employers(13:17) The panel examines future trends involving AI, including patients using AI to interpret labs and emerging AI-assisted prescribing models in behavioral health.
(14:24) Closing thoughts on how direct-to-consumer healthcare is reshaping patient expectations and forcing health systems to rethink care delivery models.
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Defining and documenting pharmacist interventions beyond prescription revenue is essential to demonstrating the full value of pharmacy teams. Host Carolyn Liptak is joined by Dr. Karen Thomas from the University of Illinois Chicago and Dr. Thom Platt from UK Healthcare to share insights from a multi-system survey exploring how interventions are captured and used. They discuss the variability in current practices, the important role of both pharmacists and technicians, and the opportunity to better quantify clinical and operational impact to C-suite.
Guests:
Karen C. Thomas, PharmD, PhD, MBAAssociate Director, Specialty and Infusion Pharmacies University of Illinois Hospital and Health System
Thom Platt, PharmD, PhD, MBA ,BCPSDirector of Specialty Pharmacy Services UK HealthCare
Host:
Carolyn Liptak, MBA, BS PharmPharmacy Executive Director, Regulatory ComplianceVizient Center for Pharmacy Practice Excellence
Show Notes:
00:05 – IntroductionOverview of VerifiedRx and the focus on pharmacy practice excellence.
00:14 – Episode Overview & Guest IntroductionsHost Carolyn Liptak introduces the topic: capturing the value of pharmacist interventions beyond prescription revenue.Guests:
Dr. Karen Thomas, University of Illinois ChicagoDr. Thom Platt, UK Healthcare00:57 – Health System Backgrounds
UIC serves a diverse urban population with a strong Medicaid and Medicare presenceUK Healthcare supports patients across Kentucky and surrounding states, including rural populations traveling long distances for specialty care01:48 – What Sparked the Research
Originated from a Vizient work group focused on outcomes and valueNeed for clearer frameworks to document and report pharmacist interventionsLack of standardized guidance from accrediting bodies and payers02:56 – Survey Goals and Key Findings
Explored how health systems define and document interventionsIdentified major variability in data collection and reportingFound alignment in defining clinical interventions, less consistency in non clinical onesIncluded responses from 24 health systems04:21 – Broader Impact on Pharmacy Practice
Reinforces the value of pharmacist contributions beyond revenueHighlights prevention of hospital visits and improved patient outcomesEmphasizes the need to better capture and communicate this value05:38 – Applying the Research in Practice
UIC developed a structured framework and documentation toolSupports initiatives like waste avoidance studiesAims to quantify cost savings from pharmacist interventions06:49 – Relevance Beyond Specialty Pharmacy
Concepts apply across all pharmacy settingsData can support staffing, funding, and program expansion decisionsHelps communicate value to internal and external stakeholders07:52 – Role of Pharmacy Technicians
96 percent of sites report technician involvement in non clinical interventionsExamples include resolving medication access issues and addressing social barriersTechnicians play a critical role in patient support and care coordination09:58 – Future Opportunities
Push toward standardizing intervention data collectionOpportunity to reduce duplication of effort across health systemsGoal to create scalable, shared frameworks10:41 – Strategic Value of Intervention Data
Supports conversations with leadership and external partnersDemonstrates impact on outcomes like reduced ED visits and length of stayStrengthens partnerships with payers and manufacturers11:34 – Additional Resources
Study published in the Online Journal of PharmacyLink available for listeners to explore further12:03 – Closing RemarksFinal thoughts and appreciation for guestsCall to action: subscribe, share feedback, and stay engaged with VerifiedRx
Links and Resources: https://www.mdpi.com/2226-4787/13/6/172
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Saknas det avsnitt?
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Alpha-gal syndrome is an emerging and often underrecognized allergy triggered by a tick bite that can cause delayed reactions to red meat and mammalian-derived products. In this episode, host Stacy Lauderdale is joined by clinical experts Zack Stacy and Kyna Henrici to unpack the science behind alpha-gal, its implications in healthcare settings, and the operational challenges providers face in managing this complex condition.
Guest Speakers: Zachary Stacy, Pharm.D., MS, FCCP, BCPS Clinical Pharmacy Specialist, Surgery BJC Health
Kyna Henrici, RN Medical Evidence Director - Cardiovascular Vizient, Inc.
Host: Stacy Lauderdale, Pharm.D., BCPS AVP, Evidence-Based Medicine Vizient, Inc.
00:05 – Introduction
Podcast introduction and welcome to VerifiedRx00:14 – What is alpha-gal syndrome
Overview of alpha-gal syndrome Delayed allergic reactions after eating red meat Often linked to tick bites00:48 – Meet the Guests
Zack Stacy, clinical pharmacy specialist Kyna Henrici, medical evidence director01:10 – Understanding the Allergy
Alpha-gal is a carbohydrate in nonprimate mammals that can trigger an allergy in humans Key difference is delayed reaction timing Symptoms are not always easy to trace01:32 – How It Develops
Triggered by tick bites Immune system produces IgE antibodies Oral exposure to alpha-gal leads to delayed reactions IV exposure to alpha-gal can cause immediate reactions02:17 – Prevalence and Diagnosis Challenges
More common in Midwest and southern United States Likely underdiagnosed Often mistaken for general food allergies Allergy may fade over time03:07 – Risks in Healthcare Settings
Patient safety concerns beyond food Mammalian components in medications and devices Examples include heparin and surgical materials03:44 – Hidden Medication Risks
Inactive ingredients can be animal derived Examples include glycerin, lactose, amino acids, stearates Difficult to identify and track04:42 – Lack of Transparency
No centralized ingredient database Sourcing can change frequently Variability across manufacturers and batches05:33 – Screening in Surgical Settings
Medication review at NDC level Identification of active and inactive ingredients May require contacting manufacturers06:45 – Timing Challenges
Urgent procedures limit investigation time Manufacturer responses may take days Alternative medications often needed07:14 – Identifying At Risk Patients
Many patients are unaware they have alpha-gal syndrome Screening includes questions about dairy tolerance Three patient categories used for evaluation08:32 – Using Dairy as a Screening Tool
Dairy tolerance helps guide risk level Food exposure typically higher than medication exposure Determines need for deeper review09:12 – Managing Emergencies
Focus shifts from avoidance to risk mitigation Use of team communication and clear documentation Preparation for unavoidable exposure10:03 – Prevention and Preparedness
Stock alpha-gal safe medications when possible Prepare for allergic reactions with standard treatments10:47 – Team Based Care Approach
Collaboration across care teams is essential Premedication strategies may be used Close monitoring for reactions11:11 – Gaps in Care
Limited visibility into product ingredients Need for better labeling and transparency11:33 – Need for Standardization
Call for clearer guidance and clinician education Desire for centralized resource for medication ingredients12:24 – Monitoring Challenges
CDC tracking decreased after privatization of testing Cases likely still increasing12:53 – Closing Remarks
Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC
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AI is rapidly reshaping pharmacy practice, raising both concern and opportunity for healthcare teams. Vizient host Kerry Schwarz is joined by Dr. Jason Chou, Vice President of the System Pharmacy Service Line, and Dr. Catherine Oliver, System AVP of Clinical Pharmacy Services at Ochsner Health, to explore how AI is improving efficiency while redefining how pharmacy teams spend their time. They discuss where technology is already making an impact and where its limits still require human expertise.
Guest Speakers:
Dr. Jason Chou, Pharm.D., MSVice President, System Pharmacy Service LineOchsner Health
Dr. Catherine Oliver, Pharm.D., BCPS, DPLA, CPGxSystem AVP, Clinical Pharmacy ServicesOchsner Health
Host Dr. Kerry Schwarz, Pharm.D., MPHSenior Clinical Manager, Evidence-Based Medicine and OutcomesVizient Center for Pharmacy Practice Excellence
Shownotes:
00:05 — Introduction
Announcer welcomes listeners to VerifiedRx, produced by the Vizient Center for Pharmacy Practice Excellence.00:14 — Episode Overview
Host Kerry introduces the topic: the role of artificial intelligence (AI) in healthcare and pharmacy.Key themes:Addressing fears of job replacementIdentifying real-world use casesUnderstanding limitations of AIPractical strategies for adoptionGuests:Dr. Jason Chou, VP, System Pharmacy Service Line, Ochsner HealthDr. Catherine Oliver, System AVP, Clinical Pharmacy Services, Ochsner Health01:04 — Will AI Replace Healthcare Jobs?
Concern exists, but largely driven by misunderstandingAI is expected to:Augment, not replace, pharmacy rolesImprove efficiency in daily workflowsAI is not capable of:Independent clinical judgmentMeaningful patient interactionsHuman elements—trust, empathy, and nuance—remain essential.02:20 — Where AI Can Add Value Today
Focus should shift from fear to practical use casesIdeal applications:Reducing non-value-added tasksImproving efficiencySupporting clinical decision-making preparation (not replacing it)02:39 — Early Use Cases: Operational Efficiency
AI can reduce administrative burden such as:Prior authorizationsInsurance-related communicationsData gathering and documentationOpportunity to eliminate “busy work” and improve staff satisfaction03:31 — Clinical Workflow Support
AI can:Summarize patient charts, labs, and notesOrganize large volumes of clinical dataEnables pharmacists to:Spend less time preparingSpend more time in patient care and provider interaction04:08 — Additional Opportunities: Supply Chain & Operations
AI can support:Inventory managementPurchasing optimizationMulti-site coordinationBenefits include:Cost savingsImproved efficiencyBetter resource utilization05:00 — Where to Draw the Line
AI should not replace clinical decision-makingLimitations include:Lack of experience and judgmentInability to incorporate patient values and preferencesFinal decisions must remain with clinicians.05:42 — Preserving the Human Element
Patient care involves:TrustEmpathyRelationship-buildingOver-reliance on AI risks eroding patient confidence.06:11 — Patient Interaction & Transparency
Patients want to know:When AI is usedHow it impacts their careTransparency and communication are critical06:48 — AI in Direct Patient Care: Ambient Listening
AI tools can:Capture conversations during patient visitsReduce documentation burdenImportant considerations:Patient consentAbility to opt outPrivacy concerns07:31 — Risks of Poor Implementation
Poorly designed AI interactions can:Frustrate patientsReduce trustHealthcare AI must avoid:Impersonal experiencesInefficient automation08:21 — AI as a Tool, Not a Replacement
Comparable to tools like:Search engines (e.g., Google)Enhances efficiency without replacing professional roles.09:12 — Early Success Stories
Prior Authorization Optimization
AI improves:Data extractionDocumentation speedApproval timelinesBenefits:Faster patient access to therapyImproved staff satisfaction10:07 — Clinical Decision Support Enhancements
AI-driven rule systems:Identify high-risk patientsReduce unnecessary chart reviewsExample outcome:Reduction in time spent reviewing charts without interventionFrees pharmacists for:Medication reconciliationPatient counseling11:11 — Impact on Workforce Engagement
Staff report:Increased satisfactionMore time for meaningful workAI seen as an enabler rather than a threat12:03 — Vendor Landscape & Challenges
Rapid growth of AI vendors addressing niche problemsKey risks:Data security concernsVendor quality variabilityOverlapping or redundant solutions12:51 — Integration & Workflow Considerations
Successful AI tools must:Integrate with EHRsAlign with pharmacy workflowsAvoid siloed systemsPoor integration leads to inefficiency and adoption barriers14:04 — Vendor Evaluation Considerations
Assess:Clinical and operational expertiseProduct maturityImplementation effortRisk vs benefitBalance between:Ready-made solutionsCustom-built tools requiring internal resources14:56 — Practical Advice for Health System Leaders
Develop a system-wide AI strategyCollaborate across departments (not siloed decisions)Engage:ITLegalEthics teamsAvoid duplicative solutions across service lines15:31 — Building Organizational Readiness
Be open to learning and experimentationAsk questions and maintain healthy skepticismFocus on:Improving workflowsEnhancing patient outcomesSupporting workforce engagement16:02 — Infrastructure & Speed of Innovation
AI vendors move quicklyOrganizations must:Be prepared to adapt rapidlyAvoid delays that hinder innovationBalance speed with governance and safety16:27 — Closing
Kerry thanks the guests for their insightsEncourages continued exploration of AI’s evolving role in healthcareReminder to subscribe and engage with VerifiedRx.Subscribe Today!
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In this episode of VerifiedRx, Carolyn Liptak is joined by Dr. Jennifer Tussey, Senior Specialty Pharmacy Manager at BJC Health, to discuss early experiences with the Medicare Transaction Facilitator (MTF) and the Medicare Drug Price Negotiation Program. From managing complex data flows and delayed payments to coordinating cross-functional teams and evolving workflows, they share practical insights from the first cycle of implementation. Tune in to learn what’s working, what’s challenging, and how health systems are adapting in real time.
Guest speaker:
Jennifer Tussey, PharmD, CSP, AAHIVP
Senior Specialty Pharmacy Manager
Specialty, Oncology, Mail Order
BJC Health East Region
Host:
Carolyn Liptak, MBA, BS Pharm
Pharmacy Executive Director, Regulatory Compliance
Vizient Center for Pharmacy Practice Excellence
Show Notes:
00:05 — Introduction
Announcer welcomes listeners to VerifiedRx, produced by the Vizient Center for Pharmacy Practice Excellence.00:14 — Episode Overview
Host Carolyn Liptak introduces the topic: early experiences with theMedicare Drug Price Negotiation Program (MDPNP) and the Medicare Transaction Facilitator (MTF).Discussion focuses on:Implementation planningEarly operational challengesPayment and data flow issuesLessons learned from initial rolloutGuest: Dr. Jennifer Tussey, Senior Specialty Pharmacy Manager at BJC Health.00:14 — Key Program Definitions
Medicare Drug Price Negotiation Program (MDPNP):Created under the Inflation Reduction Act (2022)Allows CMS to negotiate prices for select high-cost drugs without generic/biosimilar competitionEstablishes a Maximum Fair Price (MFP)Medicare Transaction Facilitator (MTF):Operational system supporting:Data exchangePayment processingCoordination between CMS, manufacturers, and dispensersEnsures Part D beneficiaries receive negotiated pricing02:00 — Health System Context
Jennifer oversees specialty, oncology, and mail-order pharmacy operations within BJC Health’s east region.Approximately 12 pharmacies impacted by MTF processes.02:27 — Implementation Strategy
Initial steps:Participation in CMS webinarsFormation of a multidisciplinary teamKey roles involved:Pharmacy leadershipData analystBusiness managerReconciliation technicianRevenue cycle teamResponsibilities include:Tracking claims and payment statusManaging 340B eligibilityReconciling payments across multiple systems (MTF, Beacon, internal systems)03:54 — Enrollment Experience
Enrollment process was relatively straightforward:Entity signaturesSystem setup for remittance processingComplexity increased post-enrollment due to:Data fragmentation across systemsLimited access for revenue cycle teamsRequired strong coordination across departments.05:09 — Data & Payment Flow Challenges
Data flow remains slow but improving.Current timeline:~19 days for payment finalizationUp to 45 days for resolution if inquiries are requiredEarly collection rates:Initially ~10%Improved to ~60%05:09 — Operational Workflow Adjustments
Monitoring cadence evolved:From daily tracking → now biweekly review cyclesTeams review claims approximately 45 days in arrears.06:02 — Inquiry & Tracking Challenges
System limitations:Inquiry submissions may not be saved reliablyLack of built-in tracking toolsRequires manual documentation and tracking to monitor claim status and follow-ups.06:18 — Managing Payment Inconsistencies
Payment discrepancies handled through inquiry process.Key challenges:Delayed initiation (must wait for processing window)Extended resolution timelines (up to 45 days)Requires proactive and continuous follow-up.06:53 — Financial & Resource Challenges
Low reimbursement margins under standard refund amounts.Even large systems with wholesale discounts experience tight margins.Significant FTE investment required to manage the process.Smaller systems may face:Greater operational burdenLimited staffing capacity07:33 — Operational Evolution
Processes are continuously evolving.Key success factors:Ongoing process refinementStrong internal documentationRapid incorporation of lessons learnedExample:Identifying system issues with inquiry tracking and adjusting workflows accordingly08:14 — Key Advice: Patience & Persistence
Success requires:Patience with slow-moving processesMeticulous follow-upStrong tracking systems (e.g., Excel-based workflows)High claim volume (500+ scripts at a time) necessitates structured tracking tools.09:07 — Additional Financial Considerations
Low net margins combined with high operational workload.Challenges amplified for:Smaller pharmaciesSystems with fewer resourcesEmphasizes importance of operational efficiency and resource planning.09:36 — Final Takeaways
MTF implementation is:ComplexResource-intensiveStill evolvingKey themes:Strong cross-functional collaboration is essentialProcesses will require ongoing refinementFinancial sustainability remains a concern09:46 — Closing
Carolyn thanks Jennifer for sharing insights and real-world experience.Reminder to subscribe, provide feedback, and stay engaged with VerifiedRx content.Links | Resources:
Medicare Drug Price Negotiation Program: Click Here
Medicare Transaction Facilitator General Resources: Click Here
Pharmacy and Dispensing Entity Resources: Click Here
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Immune checkpoint inhibitors targeting PD-1 and PD-L1 have transformed the treatment landscape across a wide variety of cancers, becoming foundational therapies in oncology. Dr. Stacey Sobocinski and Dr. Michele Rice join host Dr. Kerry Schwarz to discuss what the new subcutaneous PD-1/PD-L1 immune checkpoint inhibitors could mean for oncology practice. They cover the three agents that have become available in subcutaneous formulations, their advantages and disadvantages, other important operational, financial, clinical, and safety issues for health systems to consider.
Guest speaker:
Stacey Sobocinski, Pharm.D., BCPS
Associate Director, Pharmacy Medication Management & Informatics
MD Anderson Cancer Center
Michele Rice, Pharm.D., BCOP
Senior Consulting Solutions Director
Vizient Pharmacy Enterprise Solutions
Host:
Kerry Schwarz, Pharm.D., MPH
Senior Clinical Manager, Evidence-Based Medicine and Outcomes
Vizient Center for Pharmacy Practice Excellence
Show Notes:
00:05 — IntroductionAnnouncer welcomes listeners to VerifiedRx, produced by the Vizient Center for Pharmacy Practice Excellence.00:14 — Episode OverviewHost Kerry introduces the topic: new subcutaneous formulations of PD-1 and PD-L1 immune checkpoint inhibitors.These therapies have traditionally been administered intravenously (IV) in infusion centers.Recently approved subcutaneous versions include:Pembrolizumab (Keytruda Qlex)Nivolumab (Opdivo Qvantig)Atezolizumab (Tecentriq Hybreza)Potential benefits include shorter administration times and relief for infusion centers operating at capacity.Guests: Stacy Sobacinski, Associate Director of Pharmacy Medication Management and Informatics, MD Anderson Cancer Center Michelle Rice, Senior Pharmacy Enterprise Solutions Director, Vizient01:39 — Clinical Data: Efficacy, Safety & PharmacokineticsSubcutaneous formulations were approved in combination with hyaluronidase, allowing full-dose subcutaneous administration.Clinical studies demonstrated:Comparable pharmacokineticsSimilar efficacySimilar safety profiles compared to IV formulationsThe main difference observed was local injection site reactions, expected with subcutaneous administration.02:32 — Confidence in Clinical ComparisonsAlthough direct head-to-head trials are limited, extensive experience with IV formulations supports confidence in safety and efficacy.Differences largely relate to administration method, not drug activity.03:11 — Operational Impact: Changes to WorkflowSubcutaneous administration introduces new operational considerations.Shorter injection times may appear advantageous, but real-world workflow impact is still being evaluatedMuch of a patient’s visit still involves:Waiting room timeLaboratory testingProvider visitsCare coordination04:06 — Chair Time vs Total Visit TimeFor therapies previously requiring longer infusions, switching to subcutaneous injections can significantly reduce chair time.For therapies previously infused over 30 minutes, the difference between IV and subcutaneous administration time may be less impactful.04:24 — Administration ChallengesSubcutaneous doses are not small-volume injections.Injection volumes may reach 10–15 mLNursing considerations include:Patient tolerance for larger-volume injections.IV infusions allow nurses to start the infusion and attend to other tasks.Subcutaneous injections require continuous nursing presence during administration.This may increase direct nursing time.05:05 — Equipment ConsiderationsSome centers may use syringe pumps to administer subcutaneous injections.Many adult infusion centers do not currently have pumps since chemotherapy is typically delivered via IV using infusion pumps.Implementing syringe pumps could require additional equipment and associated procedures.05:32 — Operational ComplexityTransitioning to subcutaneous therapy involves more than simply switching order sets.Organizations must evaluate:Staffing modelsNursing workflowsEquipment availabilityInfusion center capacity management.06:25 — Financial ConsiderationsSubcutaneous formulations are currently priced roughly at parity with IV versions.Manufacturers may be incentivized to transition providers to subcutaneous formulations before biosimilars enter the market.07:07 — Anticipating Market DynamicsOver time, pricing strategies may shift to encourage broader adoption.Biosimilar competition for these agents is expected within the next few years.07:11 — Site of Care ConsiderationsAdoption may vary by care setting:Hospital outpatient departmentsPhysician officesFreestanding infusion centers08:06 — Strategic Timing DecisionsHealth systems may weigh:Operational advantages of subcutaneous administrationPotential cost reductions from future biosimilarsSome organizations may delay adoption until biosimilar competition arrives.08:24 — Infusion Center OptimizationSubcutaneous therapies could increase turnover.Some centers may develop “express lanes” for subcutaneous administration.09:01 — Payer InfluenceIf subcutaneous formulations are perceived as cheaper or operationally simpler, payers may:Restrict site of carePrefer administrations in physician offices or non-hospital settings.09:45 — Key Questions for Health SystemsOrganizations should consider:
What value does the new dosage form provide?Which patients benefit most from subcutaneous administration?How will payer policies evolve?10:05 — Evaluating Clinical ValueInstitutions often approach new dosage forms with caution.Subcutaneous PD-1/PD-L1 inhibitors may not offer the administration time reductions seen with other biologics because there is not as large of a difference in administration times (30 minutes versus 5 minutes).10:53 — Patient Selection ConsiderationsSubcutaneous formulations may be most beneficial for patients:
Receiving monotherapyWith difficult IV accessPatients receiving combination therapies may see less benefit since IV access is already required.
11:12 — Additional Patient FactorsSome patients have low body mass or cachexia, making high-volume subcutaneous injections more difficult.Physicians may prefer individualized treatment decisions rather than blanket formulary changes.11:33 — Final ThoughtsTransitioning to subcutaneous PD-1/PD-L1 inhibitors involves clinical, operational, and financial considerations.Observation times, administration practices, and workflow models continue to evolve.Ongoing monitoring of emerging best practices is encouraged.12:15 — Closingongoing monitoring of emerging best practices.Listeners are invited to subscribe and follow VerifiedRx for future episodes.Subscribe Today!
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Dr. Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence, and Dr. Heather Pace, Senior Clinical Manager, Ambulatory Care, join host Carolyn Liptak to discuss the Vizient Winter 2026 Spend Management Outlook, with a focus on pharmacy projections and key changes from prior outlooks. The episode also covers ambulatory care and self-administered drugs, biosimilar therapeutic insights, and dynamic pharmacy market forces.
Guest speaker:
Jeni Hayes, PharmD, BCPS
Senior Clinical Manager, Strategic Clinical Intelligence
Vizient Spend Management Solutions
Heather Pace, PharmD
Senior Clinical Manager, Ambulatory Care
Vizient Center for Pharmacy Practice Excellence
Host:
Carolyn Liptak, MBA, BS PharmPharmacy Executive Director, Regulatory Compliance & Revenue IntegrityCenter for Pharmacy Practice Excellence (CPPE)Vizient
Show Notes:
00:05 — Introduction
Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.00:14 — Episode Overview
Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the Winter 2026 Spend Management Outlook (SMO).Focus areas:Pharmacy inflation projectionsAcute vs ambulatory care trendsProvider-administered vs self-administered drugsBiosimilar therapeutic insightsDynamic pharmacy market forces shaping 2026–2030Guests: Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence Heather Pace, Senior Clinical Manager, Ambulatory Care01:09 — What Is the Spend Management Outlook (SMO)?
Biannual Vizient publication projecting price trends across healthcare spend categories.Pharmacy headline:Inflation slightly lower than last editionTotal spend still rising, driven by utilization growth and new technologies01:49 — Top-Line Pharmacy Inflation Projection
2.84% projected drug inflation for purchases between July 2026 – June 2027.Down from 3.35% in the prior edition.Based on October 2024 – September 2025 wholesaler data.Heavily weighted toward highest-spend drugs.Contracted products show lower inflation; non-contract drugs still ~70% of spend.02:45 — Inflation by Site of Care
Acute Care
3.03% projected inflationDriven by:SugammadexKcentraClotting factorsAmbulatory Care
2.85% overall, but with key divergence:Provider-administered drugs: 3.35%Self-administered drugs: 2.43%04:02 — Provider-Administered Drugs: What’s Driving Growth
Oncology infusions are the main drivers.Key agents:KeytrudaDarzalex FasproContinued growth due to:Expanded indicationsIncreased outpatient infusion utilizationOncology split by site of care:Inpatient: High-cost CAR T (e.g., Yescarta)Outpatient: Infusions, bispecifics, emerging cellular therapiesEmphasizes importance of site of care strategy.05:14 — Self-Administered Drugs: Utilization Over Inflation
Five key drivers:Autoimmune / inflammatory: Skyrizi, Dupixent, RinvoqDiabetes / metabolic / weight loss: Ozempic, Wegovy, Mounjaro, ZepboundSpend growth fueled by:Media exposureExpanded indicationsIncreased patient demandOpportunity for:Retail & specialty pharmacy optimizationMargin capturePatient support (adherence, counseling, benefits investigation)06:45 — New Section: Dynamic Pharmacy Market Forces (2026–2030)
Seven strategic forces influencing pharmacy practice:
Growth in specialty and cell & gene therapiesExpansion of value- and outcomes-based contractingSiteofcare shifts toward ambulatory and homeDigital transformation & automationSupply assurance and resilienceExpanded pharmacist clinical scope & workforce modelsRegulatory and policy efforts to lower drug prices340B changesIRA Medicare Part D negotiations09:37 — Practical Takeaways for Pharmacy Leaders
Use 2.84% inflation as a baseline — then customize using Vizient Pharmacy Analytics.Leverage segmented views to prioritize:Acute vs ambulatory strategiesProvider-administered vs self-administered drugsIdentify top spend movers and align them with long-term market forces.Consider:Specialty pharmacy expansionSite of care optimization10:48 — Biosimilar Therapeutic Insights: 2025 Recap
Heather Pace highlights:
Shift from biosimilar approval to active adoption management.Ustekinumab (Stelara) as defining example:Multiple biosimilarsUptake driven by payer and PBM strategyUtilization varies widely based on:Formulary designBenefit alignmentBiosimilars now actively steered, not passively adopted.11:50 — Why Stelara Was a Turning Point
PBM-developed, private-label biosimilars drove adoption.Net cost and copay design outweighed:Interchangeability statusManufacturer differentiationSets expectations for future biologic launches.12:25 — Operational Impact for Health Systems
Expect payer-specific product preferences.Frequent switching will become routine.Key considerations:Siteofcare mandatesProduct presentationSupply chain logisticsBilling & reimbursement complexityClinical barriers are decreasing; workflow flexibility is critical.13:09 — What to Expect From Biosimilars in 2026
Faster adoption timelinesEarlier payer-driven switchingFewer preferred productsLess reliance on reference product trial periods13:45 — Biosimilars With Major 2026 Impact
Eylea — multiple launches expected post-litigationXolair — expansion into asthma/allergy and retail specialtyPerjeta — oncology pathway disruption expected late 2026 / early 202715:01 — 2025 Biosimilars Impacting 2026
Ustekinumab (Stelara): broader formulary shiftsDenosumab (Prolia, Xgeva): full year of impact; all interchangeableEculizumab (Soliris): first rare-disease biosimilar entry15:58 — FDA Biosimilar Guidance to Watch
Late-2025 FDA guidance:Reduced reliance on clinical efficacy trialsGreater emphasis on analytical similarityAims to:Reduce development costAccelerate market entry16:26 — Interchangeability: Where Things Are Headed
Moving toward expectation that all biosimilars are interchangeable.Shifts responsibility to:PayersHealth systemsPharmacists managing transitions and education17:17 — Biggest Shift in the Biosimilar Landscape
Faster launchesLarger scale adoptionPayer strategy more influential than timing of approvalSuccess depends on:Formulary fitChannel alignmentOperational simplicity17:41 — Final Biosimilar Insight
Biosimilar strategies must be molecule-specific.One-size-fits-all approaches are no longer effective.18:13 — Final Thoughts on the SMO
Inflation projections are a starting point.Leaders should:Focus on top spend drugsUnderstand siteofcare and specialty driversTranslate projections into actionable budgets18:40 — Resources
Winter 2026 Spend Management Outlook available on Vizient’s SMO Hub.Includes current and prior editions and related insights.18:58 — Closing
Carolyn thanks Jeni and Heather.Reminder to subscribe, like, and share feedback.Verified Rx is produced by the Vizient Center for Pharmacy Practice Excellence.Links | Resources:
Vizient Spend Management Outlook webpageVizient Winter 2026 Spend Management OutlookVizient Biosimilars Therapeutic InsightsSubscribe Today!
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John Schoen, Senior Clinical Manager of Evidence-Based Medicine and Drug Information in Vizient's Center for Pharmacy Practice Excellence and Vizient's vaccine subject matter expert, joins host Stacy Lauderdale to discuss key updates to the CDC's childhood Immunization schedule and what they mean for practice.
Guest speaker:
John Schoen, PharmD, BCPS
Senior Clinical Manager of Evidence-Based Medicine and Drug Information
Vizient Center for Pharmacy Practice Excellence
Host:
Stacy Lauderdale, PharmD, BCPS
Associate Vice President
Vizient Center for Pharmacy Practice Excellence
Verified Rx Host
Show Notes:
00:00 — Introduction
Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.00:14 — Episode Overview
Host Stacy Lauderdale introduces the topic:updates to the CDC’s U.S. Childhood Immunization Schedule, revised January 20, 2026.Goal of the episode: explain what changed, what didn’t, and what it means in practice for providers, pharmacists, and families.Guest: John Schoen, Senior Clinical Manager of Evidence-Based Medicine and Drug Information at Vizient and vaccine subject matter expert.01:16 — What Changed in the CDC Immunization Schedule
CDC reorganized the schedule into three recommendation categories.Vaccines were reclassified, not removed.Number of diseases covered under “routine” recommendations decreased from 17 to 11 due to recategorization.01:50 — Stated Rationale Behind the Changes
Rationale provided in executive summary of scientific assessment.The supporting scientific assessment is available online and referenced for transparency (link in resources below).03:19 — Were Any Vaccines Removed?
No vaccines were removed from the CDC schedule.Some vaccines were shifted into different recommendation categories.03:40 — Category 1: Routine Childhood Vaccinations
Vaccines still routinely recommended for all children include:
MMR (measles, mumps, rubella)PolioTdap / DTaPHib (Haemophilus influenzae type B)PneumococcalHPVVaricella (chickenpox)04:27 — Category 2: Vaccines for High-Risk Populations
Vaccines recommended for children who meet specific high-risk criteria:
RSV monoclonal antibodies (mAb)Hepatitis AHepatitis BQuadrivalent meningococcalMeningococcal group BDengue05:19 — What Changed vs. Stayed the Same
Hepatitis A, Hepatitis B, and quadrivalent meningococcal moved from routine to high-riskRSV mAb recommendations are effectively unchanged, as high-risk infants are defined as those born to mothers who did not receive the maternal RSV vaccine.Dengue remains risk-based.Meningococcal group B remains a mix of risk-based and shared clinical decision-making.06:31 — Category 3: Shared Clinical Decision Making (SCDM)
Defined by ACIP as an individualized decision made jointly by provider and parent/guardian.Allows vaccination when risk-based criteria are not met but benefit is still considered.06:52 — Vaccines Under SCDM
Vaccines now include:
InfluenzaCOVID-19RotavirusHepatitis AHepatitis BQuadrivalent meningococcalMeningococcal group B08:05 — What’s New in SCDM
Influenza and rotavirus moved from routine to SCDM.Hepatitis A, hepatitis B, and quadrivalent meningococcal also shifted.COVID-19 moved to SCDM in September 2025 for individuals ≥6 months.08:28 — Insurance Coverage Implications
No expected changes in coverage.Vaccines recommended by CDC as of December 31, 2025 remain:Covered without cost-sharing under Affordable Care Act (ACA) plans.Covered by Medicaid, Children’s Health Insurance Program (CHIP), and Vaccines for Children (VFC) program.09:14 — Impact on Pharmacy Vaccine Access
Pharmacists are considered healthcare providers under CDC SCDM definitions.Authority to administer vaccines primarily determined by state laws.Standing orders, protocols, and collaborative practice agreements may need to be updated, as applicable, to address language related to ‘routine’ immunizations for children.
10:27 — Recommendations for Providers & Organizations
For providers:
Become familiar with schedule changes.Be prepared for patient and parent education.Recognize differences between CDC and other professional guidelines.For organizations:
Review EHR documentation and order sets.Consult local state regulations to ensure compliance with vaccine administration practices. Review standing orders/protocols and collaborative practice agreements to determine if revisions are needed. Monitor vaccine utilization and adjust inventory accordingly.11:24 — Resources & Closing
Additional CDC and Vizient resources will be linked in the show notes.Announcer closes with subscription and feedback reminder.Links | Resources:
HHS press release on changes to childhood immunizations schedule
Assessment of US childhood and adolescent immunization schedule
HHS fact sheet: CDC childhood immunization schedule
Revised CDC child and adolescent immunization schedule
ACIP shared clinical decision-making recommendations
Vizient resource
Minute Market Insight
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The Centers for Medicare and Medicaid Services has finalized the 2026 Outpatient Perspective Payment System (OPPS) rule, with most policies taking effect on January 1, 2026. Jenna Stern, Vice President of Regulatory Affairs and Public Policy at Vizient, joins host Carolyn Liptak, Pharmacy Executive Director in Vizient's Center for Pharmacy Practice Excellence, to discuss key updates to payment policies, payment rates, and quality provisions affecting Medicare beneficiaries receiving care in hospital outpatient departments and ambulatory surgical centers.
Guest speaker:
Jenna Stern Vice President of Regulatory Affairs and Public Policy
Vizient
Host:
Carolyn Liptak, MBA, RPh
Pharmacy Executive Director
Vizient
Show Notes:
00:05 — Introduction
Announcer welcomes listeners to VerifiedRx.Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the episode focus: the 2026 CMS Outpatient Prospective Payment System (OPPS) Final Rule.Guest: Jenna Stern, VP of Regulatory Affairs and Public Policy at Vizient.01:12 — Overview of the OPPS Final Rule
OPPS sets Medicare payment for most hospital outpatient services.Published annually (typically November), effective January 1.Covers payment rates, policies, quality programs, and compliance requirements.Note: CMS delayed enforcement of hospital price transparency requirements until April 1, 2026.01:34 — Key Takeaways From the 2026 Final Rule
Jenna’s high-level insights:
Hospitals will continue facing financial pressure in 2026.Modest payment rate increase combined with reimbursement-reducing policies.Expansion of site-neutral payment policies will be particularly impactful.Rule reflects emerging administration priorities shaping future policy.02:21 — OPPS Payment Rate Update for 2026
CMS finalized a 2.6% OPPS schedule increase factor for hospitals meeting quality reporting requirements.02:40 — What the 2.6% Increase means
Based on:3% market basket update–0.7% productivity adjustmentResults in a modest net increase.Slightly better than the proposed 2.4% increase, though still viewed as inadequate.CMS estimates $8 billion increase in total OPPS payments compared to 2025.03:37 — 340B Remedy Offset: Background
From 2018–2022, CMS paid for 340B drugs at ASP –22.5%.Prior Supreme Court decision from 2022 found that CMS lacked authority to vary rates as finalized in prior rulemaking (e.g., without using drug acquisition cost surveys to inform policy).04:13 — 340B Remedy Offset in the 2026 Final Rule
CMS considered increasing the remedy offset from 0.5% to 2%.Stakeholders strongly opposed the increase due to hospital financial strain.05:10 — Final Outcome
CMS retained the 0.5% offset for 2026.CMS signaled that larger offsets may be proposed for 2027.This marks the first year the remedy offset takes effect,06:00 — Site-Neutral Payment Policy: What It Is
Concept: same service = same payment, regardless of site of care.Hospital concern: policy reduces hospital reimbursement without accounting for site of care differences, patient acuity, overhead, or service complexity.06:15 — Site-Neutral Expansion in the 2026 Rule
CMS expanded site-neutral payment to include drug administration services at excepted off-campus provider-based departments.07:08 — Financial Impact
Reimbursement aligns with Physician Fee Schedule rates.CMS estimates $290 million reduction in outpatient spending for 2026.$220 million of savings accrue directly to Medicare.Not implemented in a budget-neutral manner.08:14 — Non-Opioid Pain Management Payments
Temporary additional payments began January 1, 2025.Authorized under the NO PAIN Act (Consolidated Appropriations Act of 2023).08:28 — What’s New for 2026
CMS finalized the renewal of:5 drugs13 medical deviceseligible for separate payment in HOPD and ASC settings.Per statue, payments available through December 31, 2027.09:32 — Process Improvements
CMS will allow more frequent consideration of new qualifying products (not limited to annual updates).Quality criteria unchanged; timing flexibility added.CMS released guidance on how stakeholders can engage for inclusion.10:58 — OPPS Drug Acquisition Cost Survey
CMS finalized plans to survey hospitals on acquisition costs for separately payable OPPS drugs.11:21 — Why CMS Is Advancing the Survey
Addresses Supreme Court requirements from prior 340B litigation.Aligns with White House Executive Order on lowering drug prices.Positions CMS to use survey data for 2027 rulemaking.12:47 — OPPS Packaging Thresholds for 2026
Drugs and biologics: Threshold remains at $140.Diagnostic radiopharmaceuticals: Increased to $655 (from $630).Products below thresholds retain Status Indicator “N” (packaged payment).13:26 — Why Billing Packaged Drugs Still Matters
Even though not separately payable, hospitals must bill for packaged drugs.Billing data feeds cost reports used to calculate future bundled payments.Failure to bill can result in inaccurately low reimbursement.14:14 — Elimination of the Inpatient-Only (IPO) List
CMS finalized a three-year transition to eliminate the IPO list by January 1, 2029.14:32 — Why This Change Is Significant
IPO list historically ensured certain services were provided inpatient only.CMS emphasizes provider judgment in determining site of care.Raises concerns about:Patient safetyPayer coverage changesPressure to move services outpatient16:28 — ASC Covered Procedure List Expansion
CMS expanded the ASC Covered Procedure List.Enables more Medicare covered services to be performed in the ASC settings.16:48 — Price Transparency: Still a Priority
No major overhaul, but continued refinement.CMS exploring new uses of price transparency data beyond patient comparison.17:46 — Most Critical Policies to Watch
Jenna highlights:
Modest OPPS payment increaseSite-neutral payment expansion340B remedy offsetDrug acquisition cost surveyBroader regulatory activity beyond OPPS18:43 — Available Vizient Resources
OPPS Final Rule SummaryGovernment Relations & Public Policy SummariesAdvocacy
19:20 — Closing
Carolyn thanks Jenna for her insights.Reminder to subscribe, like, and share feedback.VerifiedRx is produced by the Vizient Center for Pharmacy Practice Excellence.Links | Resources:
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots: Click HereCMS fact sheet on the Final Rule: Click HereOutpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey: Click HereVizient Office of Public Policy and Government Relations final rule summary: Click HereFinal List of Qualifying Products for Separate Payment for non-opioid pain medications: (Table 136, pgs. 1138-1140)VerifiedRx Listener Feedback Survey:
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Pharmacy buyers play a critical role in keeping hospitals running—and their partnership with a GPO can make all the difference. In this episode of Verified Rx, Jackie Stokes sits down with Theresa Brown and Michelle Crump, two powerhouse pharmacy buyers and members of Vizient’s Pharmacy Technician Committee, to talk about the tools, programs, and peer networks that help them thrive in their roles. From leveraging pharmacy analytics to navigating shortages, maximizing NovaPlus value, and strengthening buyer-to-buyer collaboration, this episode is packed with insights to help pharmacy teams work smarter, save money, and support better patient care.
Guest speakers:
Theresa Brown National Pharmacy Purchasing Specialist
Prospect Medical Holdings
Michelle Crump, ASBA, CPhTNational Certified Pharmacy Technician Buyer
Pharmacy
Host:
Jackie Stokes
Program Services Manager
Center for Pharmacy Practice Excellence (CPPE)
Vizient
Show Notes:
[00:48] — Guest Introductions
Theresa
National pharmacy purchasing specialistBackground: inventory control, home infusion startup, pharmacy technician educator[01:14] — Michelle
Nationally certified pharmacy technician since 2016Pharmacy buyer at a small independent county critical access hospitalTransitioned from accounting into pharmacy purchasing[01:26] — The Role of Vizient in Supporting Pharmacy Buyers
Theresa:
Biggest benefit: relationship with pharmacy executive & sourcing teamUses Pharmacy Analytics (formerly VSAP) to evaluate spend and inventory control across 63 facilities[02:16] — How Pharmacy Analytics Supports Buyers
Theresa:
Data mining on spend increases/decreasesTracks product returnsIdentifies sharing opportunities to prevent waste[02:59] — Michelle’s Experience
Analytics helps mitigate wasteCollaboration with other buyers has been essential — especially for someone new to the buyer roleLearns navigation of Vizient systems and how to work with the local GPOPeer support helps demystify a “diverse and complex” buyer role[04:02] — Value of the Vizient Pharmacy Technician Committee
Provides national peer networkingHelps buyers learn from subject matter expertsEven highly experienced buyers (35+ years) learn from every call[04:41] — Vizient Programs: NovaPlus, NES, Forum Calls, Hot Info
Bimonthly Forum Calls
Provide regulatory updatesHelp expand buyer knowledge in real timeHot Info Weekly Updates
Keeps users informed on inventory, shortages, spend impacts[05:31] — Michelle on Program Impact
Calls and shared expertise were critical when she was newNovaPlus program especially valuable in critical access settings[06:32] — Deep Dive: How the NovaPlus Program Works
Michelle explains:
NovaPlus (Y-label) aligns with manufacturer-labeled products (M-label)Quarterly rebates provide significant savingsCritical access hospitals benefit via 340B optimizer software that extracts outpatient utilization to qualify for discounted M-label purchasingCan result in “significant savings” depending on contract structure[08:38] — What If NovaPlus Pricing Isn’t the Best Price?
Michelle:
Buyer’s responsibility to identify price discrepanciesCommunicates with Vizient representative to reassess contracting needsOften resolved through rebates or future price adjustments[09:30] — Theresa:
Price challenges taken seriouslyMany result in price reductions visible in Hot Info the next weekDemonstrates importance of strong GPO relationships[10:07] — Understanding NES: NovaPlus Enhanced Supply
Theresa:
Her hospitals are exploring NES participationRequires 90% compliance (higher than standard 80%)Benefits include prioritized product access during shortagesCritical when national backorders exceed 200+ itemsEnsures better patient care continuity[11:34] — Supply Assurance & Mitigation Strategies
Michelle:
During the North Carolina hurricane, Vizient’s mitigation strategy was “imperative”Vizient engaged Baxter directly to resolve critical fluid shortagesSmall hospitals especially reliant on support in crisis situations[12:36] — Theresa:
Shortage team provides substitution guidance and clinical appropriateness informationVizient recommendations support discussions with local clinical teamsCrucial during COVID start date — her first day in national role[13:23] — Continuing Education (CE) Programs
Theresa:
Vizient CE programs help maintain technician licensureWebinars are interactive, engaging, and more informative than generic CE resources[14:07] — Networking and Pharmacy Aggregation Groups (PAGs)
Theresa:
PAGs offer cost savings and peer collaborationAbility to share information and bring value back to her own network[14:44] — Michelle’s Example of System-to-System Collaboration
Shared compounded syringes (from a 503B facility) with another hospital to prevent wasteHighlights real-world benefits of PAG networking[15:52] — Addressing National Challenges Together
Theresa:
PAG roundtables help uncover shared struggles (e.g., DSCSA serialization issues)Members provide actionable advice on what’s working in their systemsReinforces “we’re all in the same boat”[16:50] — Supporting and Elevating Pharmacy Technicians
Jackie’s goal:
Support technicians and recognize the value they bringCommittee exists to uplift and empower pharmacy buyers/techs[17:05] — Michelle:
Worked with leadership to create a tiered technician level systemHelps techs gain skills, feel valued, and earn raisesImproves career satisfaction and retention[17:46] — Closing Reflections
Theresa:
Being part of Vizient is “an honor and a privilege”Values shared knowledge and strong relationships[18:00] — Michelle:
Gratitude for collaboration and guidance over the yearsVizient connections were vital for adapting to the buyer roleVerifiedRx Listener Feedback Survey:
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In Part 2 of the 2026 pipeline series, host Carolyn Liptak welcomes Dr. Amanda Frick, Senior Clinical Manager, Strategic Clinical Intelligence at Vizient, to explore the advanced therapies pipeline: cell therapies, gene therapies, tissue-engineered products, and combination advanced therapy products.
The discussion explores major pipeline trends, six leading products to watch, and the growing innovation expected to shape clinical practice in 2026.
Guest speakers:
Amanda Frick, PharmD, BCPSSenior Clinical Manager, Strategic Clinical Intelligence
Spend Management
Vizient
Host:
Carolyn Liptak, MBA, BS Pharm
Pharmacy Executive Director
Center for Pharmacy Practice Excellence (CPPE)
Vizient
Show Notes:
[00:05] — Introduction
Announcer opens the episode.Host Carolyn Liptak introduces the focus on advanced therapies:cell & gene therapies, tissue-engineered products, and combination products.Guest: Dr. Amanda Frick, Senior Clinical Manager, Strategic Clinical Intelligence at Vizient.[01:07] — Defining Advanced Therapies
FDA groups cell and gene therapies within advanced therapies.Total FDA-approved advanced therapies: 46.Amanda monitors 29 drug-like therapies within that group.[02:01] — Pipeline Size and Approval Activity
S. pipeline: 264 agents in development.About 10 agents approach FDA decision annually.Actual approvals: 5–7 per year on average.[02:56] — Big-Picture Trends in Cell & Gene Therapy
Oncology dominates
40–50% of all CGTs in development.Expanding into autoimmune, neurology, and earlier-phase therapies for diabetes, angina, osteoarthritis.Movement toward allogeneic ("off-the-shelf") therapies
Designed to overcome limits of autologous cell manufacturing.Reduces wait time and manufacturing failures.Resurgence of therapeutic vaccines
Currently 3 approved (Sipuleucel-T, Talimogene, Papzimeos).20+ vaccines in the pipeline, largely targeted to cancer.CE program coming Jan 29.[06:13] — Therapy #1: Tabelecleucel or Tab-cel (Allogeneic EBV-Specific T-Cell Therapy)
First allogeneic T-cell therapy expected in the U.S.For EBV-positive post-transplant lymphoproliferative disorder (PTLD).“Off-the-shelf” and donor-derived.[07:07] — Clinical Need & Outcomes
Currentstandard of care: rituximab.After relapse, survival <1 month (HSCT) or <4 months (solid organ).Phase 3 data: 90% one-year survival.Regulatory Status
Prior FDA CRL due to manufacturing (third-party issues).Expected approval: January 10, 2026.[09:00] — Therapy #2: Kresladi (Autologous Gene Therapy for LAD-I)
Treats severe leukocyte adhesion deficiency (LAD-I), typically diagnosed in infancy.Could eliminate need for stem cell transplant (often limited by lack of matched donors).[11:39] — Clinical Outcomes
Phase 1/2 data (n=9):100% survival at one yearMajor reduction in hospitalizationsDiscontinuation of prophylactic antibioticsRegulatory Status
Multiple delays due to CMC (chemistry, manufacturing, controls) questions.Resubmitted Oct 2025; anticipated approval March 28, 2026.[13:27] — Therapy #3: ORCA-T (Enhanced Allogeneic Stem Cell Transplant)
Allogeneic hematopoietic stem cells + regulatory and conventional T cells (Tregs + Tcons).Designed to improve:Graft-versus-tumor effectGraft-versus-infection protectionReduction in graft-versus-host disease (GVHD)[14:31] — Clinical Significance
Could markedly improve quality of life after transplant.Regulatory Status
Anticipated approval: April 6, 2026.[15:01] — Therapy #4: Vusolimogene oderparepvec (RP1) (RP1 — Oncolytic HSV-1 Virus)
Off-the-shelf genetically modified HSV-1 oncolytic virus.For advanced melanoma after prior PD-1 inhibitor therapy.[16:17] — Why It Matters
Currently, poised to compete with Amtagvi (TIL therapy).TIL therapy is autologous and slow to manufacture; RP1 is ready-to-use and combines with nivolumab (Opdivo).Regulatory Status
PDUFA: April 10, 2026.[16:34] — Therapy #5: INO-3107 (Therapeutic Vaccine for RRP)
Targets HPV 6 and 11, which cause recurrent respiratory papillomatosis (RRP).Patients can require several surgeries per year to remove papillomas.[17:34] — Vaccine Mechanism
DNA plasmid (vs viral vector in PAP).Lower insertional oncogenesis risk.Potentially improved durability of response.Regulatory Status
Manufacturer aims to finish BLA by end of 2025.Expected approval (with priority review): mid–late 2026.[19:17] — Therapy #6: Clemidsogene lanparvovec (Intracerebral Gene Therapy for Hunter Syndrome)
One-time treatment for MPS II (Hunter syndrome).Designed to deliver therapy directly into the brain to address neurological progression.[21:21] — Competing Agent Emerging
New enzyme therapy tivedenofusp alfa crosses the blood-brain barrier — unlike current ERT (idursulfase).Expected approval: April 5, 2026.Raises payer & clinical sequencing questions:One-time gene therapy vs repeat annual enzyme therapyDurability vs cost (ERT ~$500K/year)Regulatory Status
Clemidsogene lanparvovec anticipated approval: February 8, 2026.[22:45] — Cost, Value, and Durability Considerations
Gene therapies may reach multi-million-dollar cost brackets.Durability becomes critical for payer adoption.Hospitals face long onboarding timelines for advanced therapies and must choose which to implement.[22:56] — Where to Learn More
Spend Management Outlook (formerly Pharmacy Market Outlook)Oncology and pediatric Vizient therapeutic web pagesFDA cell/gene therapy webpageCE session on therapeutic vaccines (Jan 29)[23:46] — Closing
Carolyn thanks Amanda.Reminder to subscribe, send comments, and explore further resources from Vizient.Links | Resources:
Spend Management Outlook: Click hereTherapeutic class insights: Click hereFDA webpage: Click hereSubscribe Today!
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If you're wondering which therapies may influence care delivery, budgets, and decision making in 2026, the pipeline offers an early preview and it points to a year defined by innovation. We're seeing new first in class treatments, thoughtful next generation agents, and a biosimilar market where fewer launches are offset by important competitive shifts driven by recent approvals. John Schoen and Heather Pace from the Center for Pharmacy Practice Excellence join Stacy Lauderdale, Associate Vice President of Evidence-Based Medicine and Drug Information and your Verified RX program host to highlight pipeline agents worth watching and discuss what they may mean for care delivery and spend management in the year ahead.
Guest speakers:
John Schoen, PharmD, BCPS
Senior Clinical Manager of Drug Information
Vizient Center for Pharmacy Practice Excellence
Heather Pace, PharmD
Senior Clinical Manager of Drug Information
Vizient Center for Pharmacy Practice Excellence
Host:
Stacy Lauderdale, PharmD, BCPS
Associate Vice President
Vizient Center for Pharmacy Practice Excellence
Show Notes:
[01:01] — Episode Scope
The focus is non-CGT therapies; CGT pipeline will be covered in Part 2.[01:50] — Therapeutic Areas With the Most Approvals
Oncology leads the pipeline.Others include infectious disease, neurology, rare disease, endocrine, hepatology, dermatology, and rheumatology.[02:37] — Biosimilars in 2026: Momentum or Headwinds?
Discussion of potential “biosimilar void”—only 10% of expiring biologic patents have biosimilars in development.Emerging role of PBM private-label biosimilars.[03:51] — FDA Draft Guidance on Interchangeability
FDA exploring interchangeable designation for all biosimilars.Potential shift away from clinical efficacy studies in favor of analytical comparisons.Guidance still in draft and open for public comment.[05:34] — John’s Top Picks for First-in-Class Agents
06:11 — OrviglanceFirst manganese-based, oral MRI contrast agent.Advantages for patients with kidney impairment.Used for liver imaging.[06:20] — Why Non-Gadolinium Matters
Lower risk of nephrogenic systemic fibrosis.[06:46] — Tabelecleucel
First allogeneic EBV-specific T-cell therapy.For EBV-positive PTLD post-transplant.Could become new standard of care.[07:42] — Tanruprubart
First therapy specifically for severe Guillain-Barré Syndrome (GBS).Shows improved outcomes over IVIG and plasma exchange.[08:20] — Comparing to Standard of Care
Review of improved real-world data outcomes.[09:03] — Therapies That May Shift Care Delivery
[09:32] — Icotrokinra: First oral IL-23 antagonist for plaque psoriasis.
[10:00] — Insulin Icodec
First once-weekly basal insulin for type 2 diabetes.Resubmitted after safety concerns in type 1 diabetes.[10:59] — Honorable Mentions
Camizestrant
SERD for ER+/HER2– metastatic breast cancer.Ensitrelvir (COVID-19)
Oral option for pre-exposure prophylaxis.Also being evaluated for treatment.Doravirine + Islatravir (HIV)
Introduces new NRTTI class.Cefepime + Zidebactam
Active against metallo-β-lactamase–producing organisms.14:05 — Key Biosimilar Launches
Omalizumab (Xolair)
First biosimilars in asthma/allergy space.Aflibercept (Eylea)
High competition expected pending litigation.Pertuzumab (Perjeta)
First biosimilar anticipated in oncology.[15:31] — Biosimilars Approved in 2025, Impacting 2026
Ustekinumab (Stelara): first full year of competitionDenosumab (Prolia/Xgeva): 10–15 biosimilars expectedEculizumab (Soliris): notable for rare disease market entry[17:17] — John’s Closing Thoughts
Strong mix of first-in-class advances and next-gen convenience therapies.[17:36] — Heather’s Closing Thoughts
2026 will focus on speed and scale after the 2025 biosimilar wave.Pharmacists pivotal in ensuring smooth patient transitions.VerifiedRx Listener Feedback Survey:
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Pharmacy and Therapeutics (P&T) committees historically operated at the individual hospital level but have evolved into enterprise-wide governance programs due to health system expansion, unprecedented clinical and financial complexity of care, and the emergence of high impact and novel therapeutics.
To address this, the Vizient Center for Pharmacy Practice Excellence convened an expert panel that concluded health system enterprise P&T committees are uniquely positioned to balance clinical value with financial stewardship and minimize practice variation. They issued best practice considerations representing a dynamic framework designed to evolve alongside emerging therapies, evolving technologies, and the ongoing transformation of health systems.
Joining us today are two members of the expert panel. We have Conor Hanrahan, AVP, enterprise pharmacy services, medication outcomes and stewardship with Intermountain Health and Prabashni Reddy, who at the time of the panel was the executive director of medication use and policy at Mass General Brigham.
Guest speakers:
Prabashni Reddy, RPh, PharmD, MMedSc(former) Executive Director of Medication Use and Policy
Mass General Brigham
Conor Hanrahan, PharmD, MHA, MS, BCPS, CPHQAVP, Medication Policy, Outcomes, and Stewardship
Intermountain Health, Enterprise Pharmacy Services
Host:
Kerry Schwarz, PharmD, MPH
Senior Clinical Manager, Evidence-Based Medicine and Outcomes
Center for Pharmacy Practice Excellence (CPPE)
Show Notes:
[01:02-03:38] The value Prabashni and Conor saw in joining the expert panel
[03:39-05:33] What Prabashni and Conor learned from interactions during the expert panel
[05:34-10:55] Intriguing actionable enterprise P&T program insights panelists brought to the table that listeners can use
[10:56-14:01] Use of criteria and principles to create successful and broadly applicable best practices
[14:56-16:00] How our listeners can put this panel's best practices into action
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Artificial intelligence, or, AI is on everyone's minds, and we're all still figuring out how to trust it, teach it, and use it responsibly. Today we take a deep dive into how AI is affecting the education of current and future pharmacy students. With us is Jennifer Trujillo, associate Dean for education and professor in the Department of Clinical Pharmacy at the Skaggs School of Pharmacy and Pharmaceutical Sciences on the University of Colorado Anschutz Medical Campus in Aurora, Colorado, and Logan Tinsen, the clinical pharmacy manager and residency program director at Benefis Hospital in Great Falls, Montana.
Guest speakers:
Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADMAssociate Dean for Education
Professor, Department of Clinical Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences
University of Colorado Anschutz Medical Campus
Logan Tinsen, PharmD, FMPAClinical Pharmacy Manager and Residency Program DirectorBenefits Hospitals
Host:
Kerry Schwarz, PharmD, MPH
Senior Clinical Manager, Evidence-Based Medicine and Outcomes
Center for Pharmacy Practice Excellence (CPPE)
Show Notes:
[01:02-03:45] Challenges with AI in pharmacy education
[03:46-05:59] The AI adoption spectrum: Pitfalls of extremes between full and limited adoption
[06:00-11:18] Approaches to pharmacy education in the early stages of AI
[11:19-14:55] Guardrails and safeguards
[14:56-16:29] Key takeaways about AI right now for pharmacy educators
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From CAR-T therapies to viral vectors, cell and gene treatments are redefining the boundaries of pharmacy practice—but with innovation comes complexity. Host Carolyn Liptak welcomes Dr. Mark Wiencek, Principal Microbiologist with the Technical Services Group at Contec, and Dr. Amanda Frick, Senior Clinical Manager of Market Intelligence at Vizient, to break down the challenges of compounding these advanced therapies.
Listen in as they discuss real-world risk assessments, biosafety considerations, and how hospital pharmacies can safely manage these groundbreaking yet high-risk treatments.
Guest speakers:
Mark Wiencek, PhDPrincipal Microbiologist, Technical Services Group
Contec
Amanda Frick, PharmD, BCPSSenior Clinical Manager, Market IntelligenceVizient
Host:
Carolyn Liptak, MBA, RPh
Pharmacy Executive Director
Vizient
Show Notes:
[01:02-01:51] Mark shares his background and experience in microbiology
[01:52-04:04] Overview of the types of cell and gene therapies (CGT) currently used in clinical practice
[04:05-05:14] Which CGT therapies are most applicable to pharmacy compounding and why
[05:15-10:29] Things not on the NIOSH list and the risks
[10:30-12:03] Evaluating whether viral vectors can penetrate intact skin and the true occupational exposure risks
[12:04-13:18] If hazards are not defined by the NIOSH list, how should these CGT hazards be classified
[13:19-15:03] Determining the safest environment for compounding CGT therapies
[15:04-20:14] Best practices for decontamination, disinfection, and viral vector handling
[20:15-20:59] Do you need a dedicated biosafety cabinet for CGT therapies
[21:00-22:55] Recommended resources for further learning
Links | Resources:
Blind and colleagues (Nationwide): Click hereWang and colleagues (Stanford): Click hereCONTEC HEALTHCARE WEBINAR Using Bugs as Drugs: Compounding Viral Vectors in Cell & Gene Therapy for Hospital Pharmacies, Mark Wiencek, May 13, 2025: Click hereBlind, J.E., Ghosh, S., Niese, T.D., Gardner, J.C., Stack-Simone, S., Dean, A. and Washam, M., 2024. A comprehensive literature scoping review of infection prevention and control methods for viral-mediated gene therapies. Antimicrobial Stewardship & Healthcare Epidemiology, 4(1), p.e15. Click hereDeramoudt, L., Pinturaud, M., Bouquet, P., Goffard, A., Simon, N. and Odou, P., 2024. Method for the detection and quantification of viral contamination during the preparation of gene therapy drugs in a hospital pharmacy. Occupational and Environmental Medicine, 81(12), pp.615-621. Click hereKorte, J., Mienert, J., Hennigs, J.K. and Körbelin, J., 2021. Inactivation of adeno-associated viral vectors by oxidant-based disinfectants. Human Gene Therapy, 32(13-14), pp.771-781. Click here (abstract only; full article available for purchase)Martino, J.G., McConnell, K., Greathouse, L., Rosario, B.D. and Jaskowiak, J.M., 2024. Cellular therapy site-preparedness: Inpatient pharmacy implementation at a large academic medical center. Journal of Oncology Pharmacy Practice, 30(8), pp.1442-1449. Click herePenzien, C., 2023. Safe handling of BioSafety drugs and live virus vaccines. Pharm Purch Prod, 20(4), p.12. Click herePetrich, J., Marchese, D., Jenkins, C., Storey, M. and Blind, J., 2020. Gene replacement therapy: a primer for the health-system pharmacist. Journal of Pharmacy Practice, 33(6), pp.846-855. Click hereWang, A., Ngo, Z., Yu, S.J. and MacDonald, E.A., 2025. Implementing standard practices in the safe handling of gene therapy and biohazardous drugs in a health-system setting. American Journal of Health-System Pharmacy, p.zxaf026. Click hereVerifiedRx Listener Feedback Survey:
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New data from the summer Vizient Spend Management Outlook show that in the inpatient space, high-cost drugs, especially CAR-T treatments like Yescarta and Breyanzi are major drivers of drug spend. To help offset these costs, certain therapies may qualify for additional reimbursement through the New Technology Add-On payment (NTAP), a program that supports innovations that substantially improve care for Medicare beneficiaries. Carolyn Liptak, Pharmacy Executive Director at the Vizient Center for Pharmacy Practice Excellence joins host Stacy Lauderdale, Associate Vice President of Evidence-Based Medicine and Drug Information at Vizient to cover the purpose of this add-on payment, the criteria necessary for drugs to qualify and strategies to capture its full value.
Guest Speaker:
Carolyn Liptak, MBA, RPh Pharmacy Executive Director Vizient Center for Pharmacy Practice Excellence
Host:Stacy Lauderdale, PharmD, BCP Associate Vice President Vizient Center for Pharmacy Practice Excellence
Show Notes:
[01:02-03:38] Overview of NTAP and why CMS created the program
[03:39-05:02] How DRG recalibration depends on broad adoption
[05:03-07:17] Criteria for medications to quality for NTAP status
[07:18-08:24] Who determines whether a therapy represents substantial clinical improvement
[08:25-10:05] The value NTAP provides to hospitals
[10:06-11:51] How to locate products that are eligible for NTAP
[11:52-16:22] Best practices to ensure that NTAP payment is captured when the drug is used
[16:23-17:22] Resources for additional information
Links | Resources:
Payment Updates: Preparing for 2026 - On DemandNew Medical Services and New Technologies FY 2026 IPPS Final Rule Home Page MAC Implementation File 8 (ZIP) – FY 2026 New Technology Add-on Payment CMS Web PricerVerifiedRx Listener Feedback Survey:
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As the Drug Supply Chain Security Act dispenser exemption period winds down, the Vizient Standards implementation team announced an important change to the Vizient Global Location Number (GLN) Management program. The data standards team will inactivate unmanaged GLNs, which will impact pharmacies and other providers who are not currently managing their Vizient assigned GLNs. Two experts leading that conversation, Carl Henshaw, Senior Director, Data Operations, Enterprise Information and Data Management, and Dawn Burtram, Lead Analyst, Standards Implementation at Vizient join host Carolyn Liptak, Pharmacy Executive Director in the Center for Pharmacy Practice Excellence at Vizient to discuss implications.
Guest speakers:
Dawn Bertram, MBA
Lead Analyst Standards Implementation
Vizient
Carl Henshaw
Senior Director, Data Operations, Enterprise Information and Data Management
Vizient
Host:
Carolyn Liptak, MBA, BS Pharm
Show Notes:
[01:08-01:59] Dawn and Carl’s background
[02:00-02:41] What exactly is a GLN and what does it mean to be self-managed
[02:42-07:26] Who creates and maintains GLNs in this data hub and the three different GLN products
[07:27-08:51] How to determine who actually enumerated the GLNs
[08:52-10:20] Educating and preparing providers for the DSCSA compliance deadline
[10:21-12:37] The recent decision to inactivate unmanaged GNS and why it's essential to maintaining the accuracy and reliability of GLN data
[12:38-15:05] What it means to participate in our program and who's eligible to participate
[15:06-17:51] Why the deadline of November 15th matters
Links | Resources:
Vizient GLN Learning Center
GLN Management Process Education Session (E-Learning)
VGMP Application
GS1 What is a GLN and How Do I Get One?
Drug Supply Chain Security Act
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The Joint Commission’s updated accreditation manual is designed to simplify requirements, enhance clarity, and better support healthcare organizations in survey preparation. In this episode of VerifiedRx, host Carolyn Liptak is joined by Dr. Robert Campbell of the Joint Commission and Diana Scott of Vizient to unpack the most significant changes. From the shift to National Performance Goals and medication safety priorities to the latest challenges in compounding, labeling, and hazardous drug handling, the conversation highlights practical insights to help pharmacy leaders stay compliant and survey-ready.
Guest speakers:
Robert Campbell, PharmD, BCSCP
Sr. Director, Standards Interpretation, Accreditation Decision Management,Medication Safety Division of Accreditation and Certification Operations
Joint Commission
Diana Scott, MHA, RN, CPHQ
Principal, Regulatory and Accreditation Services
Vizient
Host:
Carolyn Liptak, , BS Pharm, MBA
Vizient
Show Notes:
[01:16-01:51] Diana and Robert Backgrounds
[01:52-02:43] Changes made to the hospital and critical access hospital manuals
[02:44-03:09] Changes to the chapters themselves
[03:10-04:08] National Performance Goals and elaborate on those that are relevant to medication safety and pharmacy services
[04:09-05:15] The top medication management challenges
[05:16-06:29] Pain management not being aligned and titration orders
[06:30-06:56] Insufficient communication between pharmacists, prescribers and nurses when it comes to medication orders
[06:57-08:02] Themes around labeling requirements for stored medications
[08:03-08:46] Anything different in removing expired meds from patient care areas and in the pharmacy this area than previous years
[08:47-10:58] Issues related to storing meds specifically per the package insert
[10:59-11:55] Common issues seen inside the pharmacy regarding sterile compounding, noncompliance include hand hygiene, garbing, PPE, and cleaning and disinfecting
[11:56-13:12] More specifics in those area the physical environment and facility cleanliness along with cleaning and disinfection practices
[13:13-14:55] Explaination of how joint Commission defines and evaluates immediate use compounding
[14:56-16:09] The minimum required elements for immediate use compounding competency
[16:10-17:12] Compounding competencies besides immediate use
[17:13-17:54] Expectations for environmental services training
[17:55- 20:14] Concerns around hazardous drugs
[20:15- 21:14] Additional information
Links | Resources:
Joint Commission: THE NEW STANDARD: Accreditation 360
For Members: On-Demand webinar and CE information
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Drug diversion threatens patient and staff safety—and preventing it requires a coordinated, multidisciplinary approach. In this episode, Dr. Ruth Igwegbe and Shealee Mitchell of JPS Health Network join host Carolyn Liptak to share how their organization transformed a fragmented diversion process into a high-functioning, collaborative program. From building trust with frontline teams to using AI software and proactive data monitoring, Ruth and Shealee highlight how culture, consistency, and communication are essential to effective diversion prevention. Tune in for actionable strategies that elevate both patient safety and professional accountability.
Guest speakers:
Dr. Ruth Igwegbe PharmD, MBA,
Pharmacy medication safety officer
JPS Health Network
Shealee Mitchell, BS, RN, MJur
Pharmacy medication safety officer
JPS Health Network
Host:
Carolyn Liptak, BS Pharm, MBA
Vizient
Show Notes:
[01:02-02:32] Ruth and Shealee Backgrounds
[02:33-04:46] Background on diversion detection and prevention program at JPS
[04:47-06:55] Shealee's clinical background and how it shaped how she works with teams across the organization
[06:56-09:20] How the JPS diversion response team evolved
[09:21-13:55] Advice to our listeners to strengthen their own diversion prevention programs
[13:56-16:03] Where our listeners should go to get more information about drug diversion prevention and detection programs
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The Vizient Summer 2025 Spend Management Outlook (SMO) provides an integrated perspective on trends, factors and future expenses providers will face across the various dimensions of healthcare. In this episode, Dr. Carina Dolan and Dr. Jeni Hayes join host Carolyn Liptak to discuss pharmacy insights from the SMO including declining drug price inflation and how autoimmune conditions have surpassed oncology in total pharmacy costs. They also touch on pediatric spend drivers, biosimilar competition, and the impact of novel therapies. Tune in to VerifiedRx for practical insights to help pharmacy leaders plan for what’s ahead.
Guest speakers:
Carina Dolan, Pharm. D., MS Pharm, BCOP Associate Vice President, Clinical Oncology, Pharmacoeconomics and Market Insights Vizient Jeni Hayes, PharmD, MS Pharm, BCPS Senior Clinical Manager, Market Intelligence Vizient Host: Carolyn Liptak, BS Pharm, MBA VerifiedRx Host
Show Notes:
[01:13-02:41] Key pharmacy trends emerging from the Summer SMO
[02:42-04:00] Current pharmacy trends
[04:01-05:55] Pharmacy spend for autoimmune conditions has exceeded that of oncology
[05:56-07:36] Key takeaways
[07:37-08:47] Significant trends in this latest therapeutic insights update
[08:48-10:04] Challenges in gene and cell therapy space
[10:05-11:33] The Therapeutic Insights webpage for pediatrics
[11:34-13:41] Other reflections from the SMO
[13:42-14:49] How to locate the SMO
Links | Resources:
Vizient Spend Management Outlook
Vizient Therapeutic class insights
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- Visa fler
