Pharmacy Podcast Network

Technology Impact on Long term Care Pharmacy at Home | Pharmacy Tech Trends; PrimeRx

This podcast discussion with Paul Shelton zeroes in on a pivotal shift underway in community pharmacy: the expansion of Long-Term Care at Home (LTC@Home) as both a care model and a sustainable business opportunity.Shelton frames LTC@Home not as a reinvention of pharmacy practice, but as a formalization and monetization of services pharmacies are already delivering—medication synchronization, adherence packaging, clinical oversight, caregiver support, and coordination with providers. The core issue isn’t capability—it’s structure and reimbursement. Many community pharmacies are بالفعل functioning as LTC providers informally, but without the regulatory designation and billing pathways that unlock consistent revenue.A major theme in the conversation is conversion strategy. Shelton discusses how pharmacies can transition into LTC@Home providers by aligning operations with compliance standards, documentation requirements, and payer expectations. This includes setting up the right workflows, leveraging technology for med management and reporting, and ensuring staff are trained to operate within an LTC framework. Importantly, these conversions are not out of reach—they are highly achievable with the right guidance, and they allow pharmacies to immediately begin capturing value for existing services.The financial upside is significant. LTC@Home opens access to enhanced reimbursement models, service-based payments, and stronger payer relationships, especially within Medicare Advantage and managed care environments. Shelton emphasizes that pharmacies are leaving money on the table by not formalizing these services—and that LTC@Home is a direct path to correcting that.Strategically, this model positions community pharmacy at the center of aging-in-place healthcare, one of the fastest-growing segments in the industry. As more patients remain in their homes rather than institutional settings, pharmacies that adapt to LTC@Home will become essential care hubs—supporting not just medication dispensing, but ongoing clinical and logistical care.The takeaway is clear: LTC Pharmacy at Home is not just an opportunity—it’s a directional shift for the profession. Pharmacies that move early can differentiate, stabilize revenue, and deepen their role in patient care, while those that delay risk being left behind as the model becomes standard.

She's Back! Sex Therapy 101 | Sex PharmD

Re-introducing Dr A back to host Sex PharmD. Sex Therapy 101 and the 5 Love Languages
 

This Study Says Soda BOOSTS Testosterone | RxRated

Soda boosting testosterone sounds like the perfect "have your cake and eat it too" health hack, but is there any actual science behind the viral headlines? We’re breaking down the mouse study that set the internet on fire and comparing it to massive human data that tells a completely different, and much darker, story for your hormones.A 2022 study found that mice drinking 100% Coke or Pepsi actually had larger testicles and higher testosterone levels. But before you go buy a 12-pack, you need to realize that men are not mice, and what works in a 15-day rodent trial often fails miserably in humans. In fact, when we look at data from thousands of men, the reality is that high sugary drink consumption is linked to more than double the risk of clinically low testosterone. We dive into why the sugar in your soda fuels obesity and insulin resistance—two of the biggest "testosterone killers" on the planet.This show is intended for educational and informational purposeWebsite: https://RatedRxMedia.comYouTube: https://www.youtube.com/@RatedRxMediaInstagram: https://www.instagram.com/ratedrxmedia/TikTok: https://www.tiktok.com/@ratedrxmedia/Facebook: https://www.facebook.com/people/Rated-Rx/61574813907982/Spotify: https://open.spotify.com/show/7KATtG1c3HwwYpVMtRuNubApple Podcasts: https://podcasts.apple.com/us/podcast/rated-rx/id1804181016

Reliable Supply, Real Impact: How Consistent, On-Time Delivery Supports Pharmacy Operations | Yaral Pharma

In this industry-focused, conversational interview, Pharmacy Podcast Network Host Todd Eury speaks with Stephen Beckman, CEO of YARAL Pharma. The discussion explores YARAL Pharma’s commitment to continuity of supply, how consistent on-time delivery supports pharmacy operations, and the company’s philosophy of “Doing Things Differently” — redefining what it means to be a trusted generics partner.
 

Own Your Brand: Why a Website is Crucial for your Pharmacy | Marketing Vitals

A website is your brand identifier and how people find out about your business. We discuss why just social media isn't enough, but how it can work in tangent with a website. And also the benefits of working with a vendor that works with you in building a custom site and gives you access for ongoing management if you choose. 

The New Revenue Blueprint & Pharmacy Profit Summit 26 | PharmacyTech Trends; PrimeRx

Welcome to Tech Trends Pharmacy Podcast sponsored by PrimeRx, today's a special epsiode features the original "Pharmacy Badass" CEO of DiversifyRx, and founder of the Pharmacy Profit Summit, Dr. Lisa Faast. PAUSE, Get ready for a discussion on a blueprint on generating new non-PBM revenues and a sneak peak of "Pharmacy Profit Summit 2026 in Dallas, coming March 28 through 29th in Dallas.

The Pennsylvania Pharmacist Association's Annual Conference Post Show | Part Three (Finale)

Welcome to this special three-part press coverage series from the Pharmacy Podcast Network, recorded on location at the Pennsylvania Pharmacists Association Annual Conference, held February 20th through the 22nd at the Hilton Harrisburg.
This series is proudly sponsored by Value Drug Company and the Pennsylvania Pharmacists Care Network — PPCN — as they celebrate their 10th anniversary of advancing pharmacist-led patient care across the Commonwealth.
 
In this episode we hear from:
Nicole Mannella Hasson - Value Drug
Kyle McCormick PharmD & Brandon Antinopoulos, PharmD
Kerry Trueman - AlignRx
Nishaminy (Nish) Kasbekar, PharmD, BSPharm, FASHP - Penn Medicine 
Mark Pilkington, BS Pharm, MS
Justin Leonard - PrimeRx
Michael D. Hogue, PharmD, FAPhA
Victoria Elliot - CEO PPA

The Compounding AI Primer Episode | Essential; Pharmacy Compounding Podcast APC

This week we look at a somewhat confusing, possibly problematic FDA statement, as well as the anti-compounding bills popping up across the country. Our Deep Dive this week is a hot topic: AI in pharmacies — how it’s being used successfully, but also how you can use it to streamline your workflow and, yes, even increase your bottom line. Our expert will tell you what to look for, and what easy pitfall you need to avoid. Links from the podcast: The troublesome FDA statement: https://fllw.me/4utzQIw APC’s Snapshot of Pharmacy Compounding: https://a4pc.org/snapshot Read more about the 2002 Supreme Court case "Thompson v. Western States Medical Center": https://www.oyez.org/cases/2001/01-344 TJM Labs: https://tjmlabs.com Join APC: https://a4pc.org/join

The Pennsylvania Pharmacist Association's Annual Conference Post Show | Part Two

Welcome to this special three-part press coverage series from the Pharmacy Podcast Network, recorded on location at the Pennsylvania Pharmacists Association Annual Conference, held February 20th through the 22nd at the Hilton Harrisburg.
This series is proudly sponsored by Value Drug Company and the Pennsylvania Pharmacists Care Network — PPCN — as they celebrate their 10th anniversary of advancing pharmacist-led patient care across the Commonwealth.
 
In this episode we hear from:
Darryle Tillman, RPh & John DeJames
Jonathan Ference PharmD
Jake Reckenbauher
Dr Gavin Merin & Angela York - Value Drug
Tom DePietro

AI, Pharmacy System Evolution & Emerging Therapies | TWIRx

On this week’s This Week in Pharmacy (TWIRx), we explore how innovation, technology, and emerging therapies are reshaping pharmacy practice. From the growing influence of AI in medical information research, to the next generation of pharmacy management systems, and the expanding role of cell and gene therapies, this episode brings together industry leaders to discuss what’s next for pharmacy.
Special thanks to this week’s sponsors Cardinal Health, Independent Pharmacy Cooperative (IPC), and Nested Knowledge for supporting the podcast.
Segment 1 – AI & the Future of Medical Information with Nested Knowledge
Nested Knowledge returns to TWIRx as we welcome back Keith Kallmes, Co-Founder of Nested Knowledge, for an update on how artificial intelligence is transforming the way healthcare professionals access and interpret medical information.
Keith explains how AI-powered tools are improving evidence synthesis, systematic literature reviews, and clinical decision support, helping researchers and clinicians navigate the growing volume of medical literature while enabling faster, more reliable insights.
Segment 2 – The Evolution of Pharmacy Management Systems with Outcomes
Next, we’re joined by Lou Ann Myers from Outcomes to discuss how pharmacy management systems are evolving beyond traditional dispensing.
Modern pharmacies require integrated technology connecting billing, treatment planning, clinical tracking, inventory management, and revenue-generating services. Lou Ann shares why these systems must support both clinical services and business sustainability as pharmacies expand into value-based care and new service models.
Segment 3 – Emerging Therapies with Cardinal Health
In our final segment, we welcome Dr. Fran Gregory, PharmD, Vice President of Emerging Therapies (Cell & Gene, Biosimilars) at Cardinal Health, to discuss one of the most transformative areas in healthcare.
Dr. Gregory explores the growing impact of cell and gene therapies and biosimilars, and what these innovations mean for pharmacists, health systems, and specialty pharmacy providers as the industry prepares for new challenges in distribution, access, and reimbursement.
About TWIRx (This Week in Pharmacy)TWIRx is the flagship news and commentary podcast from the Pharmacy Podcast Network, delivering weekly insights on the business, technology, and policy shaping the pharmacy profession.

Pharmacy 50 Awards with Ellaine Sisomphou-Ramos | CPhT Connect Podcast

In this inspiring episode of CPhT Connect, host Mike Johnston, CPhT-Adv, sits down with Ellaine Sisomphou-Ramos, a nationally certified pharmacy technician whose career is a masterclass in professional growth and self-advocacy. Originally trained as a nurse in the Philippines, "Ella" shares her remarkable journey of transitioning to the U.S. pharmacy landscape, moving from high-volume retail to a specialized role in outpatient infusion and specialty pharmacy. Her dedication to clinical excellence recently earned her a nomination as one of the Top 50 Most Influential Leaders in The Pharmacy 50 Awards by Pharmacy Podcast Network, where she ranked in the top 45—a powerful testament to the impact a technician can have on the entire profession.

Why Dental Care During Pregnancy Is Critical; Dr. Michael Duboff | MaternalRx

Dental care during pregnancy is often overlooked in routine prenatal counseling, yet hormonal changes, frequent vomiting, dehydration, and acid exposure can significantly impact oral health in pregnancy.In this episode of the MaternalRx Podcast, host Dr. Danielle Plummer, PharmD speaks with Dr. Michael Duboff, DMD, about the critical importance of dental care during pregnancy and how pharmacists and healthcare providers can help prevent long-term complications.From enamel erosion caused by hyperemesis gravidarum to pregnancy gingivitis and periodontal disease, this conversation explores what happens inside the mouth during pregnancy, when tooth damage becomes irreversible, and what practical steps patients and healthcare providers can take to protect oral health.Dr. Duboff also addresses common misconceptions about the safety of dental treatment during pregnancy, including fluoride use, dental X-rays, anesthetics, and the importance of preventive dental care. The episode also highlights insurance and access issues, including how some insurance plans and Medicaid programs may expand dental coverage during pregnancy, an important opportunity for patients to receive needed care.This episode emphasizes the critical role pharmacists can play in maternal health education, early identification of oral health risks, and patient counseling.You'll Learn:• How repeated gastric acid exposure from vomiting can weaken tooth enamel during pregnancy• Why brushing immediately after vomiting can worsen enamel erosion• Safe oral care strategies for pregnant patients with severe nausea or hyperemesis gravidarum• What pregnancy gingivitis is and why hormonal changes increase gum inflammation and bleeding• How fluoride varnish and high-fluoride toothpaste help protect enamel during pregnancy• Why dental cleanings every 3 months may benefit pregnant patients• The link between periodontal disease and adverse pregnancy outcomes, including preterm birth and low birth weight• Why dental treatment—including X-rays and local anesthetics—is generally safe during pregnancy• Restorative treatment options for enamel erosion and tooth decay, including fillings, crowns, and bonding• How insurance coverage and Medicaid policies may provide expanded dental benefits during pregnancy• The important role pharmacists can play in oral health counseling for pregnant patientsKey Clinical Takeaways1. Gastric Acid Damages Tooth EnamelFrequent vomiting exposes teeth to stomach acid, which erodes enamel and exposes the underlying dentin, increasing the risk of decay and sensitivity.2. Do NOT Brush Immediately After VomitingBrushing immediately after vomiting can scrub away weakened enamel.Instead:Rinse with water or a baking soda solutionWait about 30 minutes before brushing3. Pregnancy Increases Risk of GingivitisHormonal changes during pregnancy increase gum inflammation and bleeding, making good oral hygiene and professional cleanings even more important.4. Dental Care During Pregnancy Is SafePreventive care and many dental treatments—including dental X-rays with shielding and local anesthetics—are considered safe, particularly during the second trimester.5. Preventive Care Is EssentialRegular dental visits, fluoride treatments, and proper oral hygiene can help prevent irreversible enamel damage and periodontal disease.6. Insurance Coverage May Improve During PregnancySome insurance plans and Medicaid programs expand dental coverage for pregnant patients, providing an important opportunity to receive preventive care and necessary dental treatment.Practical Counseling Tips for PharmacistsPharmacists can support pregnant patients by recommending:• Rinsing with water or baking soda solution after vomiting• Waiting 30 minutes before brushing teeth• Using fluoride toothpaste or prescription high-fluoride toothpaste if appropriate• Maintaining hydration whenever possible• Scheduling regular dental visits during pregnancy• Seeking evaluation for bleeding gums, tooth sensitivity, or oral painBecause pharmacists are often the most accessible healthcare professionals, they play an important role in identifying oral health risks early and encouraging patients to seek dental care.Connect With Our GuestsDr. Michael Duboff, DMDPractice: AXIS Dental – Las VegasEmail: SmileDesignersLV@yahoo.comDr. Danielle Plummer, PharmDWebsite:www.Obstet-Rx.comLinkedIn:https://www.linkedin.com/in/daniellerplummer/

Precision Psychiatry in Practice – A Pharmacist–Physician Collaboration| Precision Medicine Pharmacist Podcast

Welcome to PPN – The Precision Medicine Pharmacist, the podcast where science, innovation, and collaboration are redefining patient care.We are kicking off a special two-part series titled Precision Psychiatry in Practice – A Pharmacist–Physician Collaboration. In this series, we explore how precision medicine is reshaping mental health treatment — and what becomes possible when pharmacists and psychiatrists work together with shared clinical goals.Today’s episode, The New Frontier: How Pharmacists and Psychiatrists Are Teaming Up for Precision Mental Health, focuses on how this collaboration began — the challenges that inspired it, the early conversations that shaped it, and the practical steps taken to bring pharmacogenomics into psychiatric care.Joining us is Dr. Saba Arshad, clinical pharmacist, founder of Med DNA Health, and a strong advocate for integrating pharmacogenomic insight into mental health treatment. We will also hear from Dr. Afshan Khan, psychiatrist and clinical partner in this model of care, as we explore how their professional paths aligned to create something new.In this first episode, we will lay the foundation — examining the “why” behind precision psychiatry and the systems that had to evolve to support it.Then, in part two, Dr. Khan will join us more extensively as we move from framework to real-world impact, sharing patient cases, clinical outcomes, and lessons learned from implementing precision medicine in practice.

Healing Under Pressure with Hyperbaric Oxygen Therapy w/ Nicole Garrett | The Holistic Pharmacy Podcast

Welcome back to season 9! We’re kicking it off with my first powerhouse guest, whose mission is to bring clarity, safety, and evidence-based understanding to hyperbaric oxygen therapy and integrative wellness. There is a growing wave of interest in longevity and recovery therapies, but also a lot of confusion and misinformation. She breaks down the science (and safety) of one of the most powerful, foundational tools we have for reducing inflammation, accelerating healing, and supporting long-term health. Nicole Garrett is the CEO of Under Pressure Hyperbarics, a premier hyperbaric oxygen therapy center in Beverly Hills recognized for its clinical-grade safety standards and results-driven approach to wellness. With nearly two decades of experience in hyperbaric medicine, her career began as a commercial diver and dive medic, where she first learned the life-saving applications of pressure and oxygen in extreme environments.Since then, Nicole has helped open and operate HBOT centers across the country and has become a trusted leader in the field. Her work bridges the gap between medical-grade hyperbaric therapy and modern holistic wellness, offering patients a safe and effective path to healing, recovery, and long-term vitality. Nicole is especially passionate about educating clinicians, patients, and the wellness community on the science, indications, and proper protocols behind hyperbaric therapy.Today, she leads a multidisciplinary team at Under Pressure Hyperbarics that supports surgical recovery, sports performance, chronic inflammation, and overall health optimization using hospital-grade chambers and evidence-aligned treatment plans.Connect with Nicole via:Email: nicole@underpressure.com Website: Under Pressure HyperbaricsFB: Under Pressure HyperbaricsIG: @underpressurehyperbaricsLinked In: Under Pressure Hyperbarics

The Pennsylvania Pharmacist Association's Annual Conference Post Show | Part One

Welcome to this special three-part press coverage series from the Pharmacy Podcast Network, recorded on location at the Pennsylvania Pharmacists Association Annual Conference, held February 20th through the 22nd at the Hilton Harrisburg.
This series is proudly sponsored by Value Drug Company and the Pennsylvania Pharmacists Care Network — PPCN — as they celebrate their 10th anniversary of advancing pharmacist-led patient care across the Commonwealth.
 
In this episode we hear from:
Margie Lydon - Value Drug Company
Darren Mensch, PharmD, BCPS, BCACP
Hayleigh Monroe - P4 Pharmacy Student
Mayank (Dr. Mak) Amin, PharmD, RPh, MBA 
Todd Laser - Value Drug Company
Jonathan Adly - TJM Labs 
Jennifer (Pekich) Urso
 

The Power of Patient 1st Care in Pharmacy and PBM Reform Progress | TWIRx

Welcome to another episode of TWIRx – This Week in Pharmacy, where we break down the most important developments impacting the pharmacy profession. This week’s show features leaders from across community pharmacy, health systems, healthcare advocacy, and international patient engagement. From PBM reform to patient-centered care and health system growth in Western Pennsylvania, this episode brings together voices shaping the future of pharmacy.
Sponsored by
Sykes & Company, P.A.Accounting, tax strategy, and advisory services dedicated exclusively to independent pharmacy operators.
Segment 1
Austin Murray
Communications and Marketing Director – Sykes & Company, P.A.
We kick off TWIRx with Austin Murray from Sykes & Company, discussing the NCPA Consumer Marketing Campaign designed to educate the public about the value of community pharmacies.
Austin shares insights on:
• The importance of telling the community pharmacy story directly to consumers• Why independent pharmacies remain essential healthcare access points• The evolving state of independent pharmacy nationwide• Continued momentum around PBM Reform• Strategic accounting and tax advantages pharmacy operators should understand in today’s challenging reimbursement environment
Austin also explains how pharmacy-focused accounting firms like Sykes & Company help owners navigate reimbursement pressure, tax planning, and business strategy.
Segment 2
Mark Duman
Pharmacy 50 Award Winner – United Kingdom
International healthcare thought leader Mark Duman joins TWIRx to discuss one of the most important principles in healthcare transformation:
The patient must come first.
Mark shares his perspective on:
• Why healthcare systems must remain patient-centered• How pharmacy can lead the way in improving patient outcomes• Lessons learned from patient engagement initiatives in the UK healthcare system• Why meaningful healthcare innovation always begins by focusing on the patient experience
Mark emphasizes that when healthcare professionals keep the patient as the constant focus, better pharmacy care and stronger health systems follow.
Segment 3
Dr. Laura Mark, PharmD
Vice President of Pharmacy – Allegheny Health Network
Next, we welcome Dr. Laura Mark, Vice President of Pharmacy at Allegheny Health Network (AHN), who shares exciting news about new pharmacy operations facilities recently built in Butler County, Pennsylvania.
Todd and Laura also reflect on their shared roots growing up in Butler County, while discussing how AHN is investing in the future of pharmacy.
Topics include:
• The new pharmacy operations infrastructure in Western Pennsylvania• How AHN is expanding pharmacy services across the Greater Pittsburgh region• The role of health system pharmacy in improving access to care• Strategic positioning for future healthcare growth and integration
AHN continues to strengthen its pharmacy operations as a key component of coordinated patient care throughout the region.
Segment 4
Eric Pusey
Independent Pharmacy Owner – Pennsylvania
Closing out this week’s episode, pharmacy owner Eric Pusey joins TWIRx to discuss the latest updates on PBM Reform in Pennsylvania.In 2024, Pennsylvania enacted Act 77, a landmark law aimed at increasing oversight and fairness in pharmacy benefit management.
Eric explains how the law:• Grants new regulatory authority to the Pennsylvania Insurance Department• Restricts PBM patient steering to pharmacies owned or affiliated with benefit managers• Improves transparency requirements for PBM operations• Establishes payment protections intended to level the playing field for community pharmacies
Patient steering practices have long limited competition and reduced patient choice. Eric shares why these reforms represent an important step toward protecting both patients and independent pharmacy providers across the Commonwealth.
Listen & Subscribe
Stay informed on the business, policy, and innovation shaping the pharmacy profession.
Follow TWIRx – This Week in Pharmacy on the Pharmacy Podcast Network, featuring conversations with the leaders and advocates advancing pharmacy practice.

PBM Reform Update from CPhA | PBM Reform Podcast

In this episode, listeners get to know the leadership of the California Pharmacists Association (CPhA), exploring their professional journeys, personal backgrounds, and the experiences that shaped their commitment to advancing the pharmacy profession.
Susan Bonilla, CEO of the California Pharmacists Association, joins Dr. Sean Kim, PharmD, Vice President of Practice & Professional Development at CPhA, to discuss California’s progress in pharmacy benefit manager (PBM) reform. As the largest state in the nation, California continues to play a significant role in shaping policies that strengthen patient access to pharmacy care and improve transparency within the prescription drug supply chain. Bonilla and Kim share insights into the reforms California has achieved, the legislative and regulatory priorities currently underway, and how these efforts may influence PBM reform conversations across the country.
The PBM Reform Podcast is sponsored by the American Pharmacy Cooperative, Inc. (APCI). APCI’s sponsorship supports the production of this program but does not imply affiliation with the individual guests, nor endorsement of the views, opinions, or insights shared by podcast hosts or guests. APCI does not endorse any statements or content discussed on the PBM Reform Podcast or across the Pharmacy Podcast Network. Please reach out to the APCI Communication's team for additional information. 

Peddling a Fantasy: How Drugmakers are Misleading State Lawmakers| Essential: Pharmacy Compounding Podcast APC

In this edition of Essential, we look at two major issues facing pharmacy compounding. First is a state-by-state effort by pharma companies to pass laws restricting compounding, and second is a cryptic statement from the FDA about  possible limitations on compounding with GLP-1 ingredients. They’re both Very Big Deals for pharmacists across the country.LinksFDA statement on GLP-1 drugs: https://www.fda.gov/news-events/press-announcements/fda-intends-take-action-against-non-fda-approved-glp-1-drugs… and APC’s response: https://a4pc.org/news/apc-responds-to-fdas-glp-1-statement Stay up to date on our state Compounding Defense Initiative: compounding.com Join APC today: https://a4pc.org/membership Find us on social:LinkedIn: https://www.linkedin.com/company/a4pcrx/Facebook: https://www.facebook.com/a4pcrx/Instagram: https://www.instagram.com/a4pcrx/

LTC Pharmacy at a Crossroads: Maximum Fair Price, the IRA, and What DC Means for 2026 and Beyond

In this episode of Framework Focus, Dr. Dae Lee breaks down the regulatory and reimbursement shifts reshaping long-term care (LTC) pharmacy. With the Inflation Reduction Act (IRA) moving from policy theory to operational reality, Medicare’s Maximum Fair Price (MFP) program, Part D redesign, and inflation rebate enforcement are now active forces that LTC operators must navigate.
This conversation moves beyond headlines and into real-world implications: cash flow risk, administrative burden, contracting exposure, and strategic readiness for closed-door and combo LTC pharmacies.
Key Discussion Points
Medicare Drug Price Negotiation Is Now Operational The IRA authorizes Medicare to negotiate prices for certain high-spend Part D drugs, with the first 10 Maximum Fair Prices (MFPs) effective January 1, 2026. This marks a structural shift in federal drug pricing and directly impacts LTC dispensing economics.
Maximum Fair Price and LTC Reimbursement Compression MFP caps reimbursement on selected drugs, creating potential margin compression if acquisition costs and payment timing are misaligned. For LTC pharmacies operating on tight spreads and high-volume chronic utilization, even small deltas can materially affect profitability.
Medicare Transaction Facilitator (MTF) and Payment Timing Risk The MTF system introduces new payment mechanics between manufacturers, plans, and pharmacies. LTC pharmacies must understand how effectuation and reconciliation work, particularly if payment timing differs from traditional Part D adjudication flows. Cash flow modeling becomes essential.
Administrative Complexity and Claims Reconciliation Identifying which NDCs are subject to MFP, managing claim reversals, handling price disputes, and monitoring plan-level compliance will increase administrative workload. LTC pharmacies will need structured internal workflows to prevent reimbursement leakage.
Dispensing Fees and the LTC Service Intensity Problem Unlike retail, LTC pharmacy includes compliance packaging, emergency kits, cycle fills, consultant pharmacist oversight, and regulatory documentation. Current IRA implementation does not automatically adjust dispensing or supply fees to reflect this complexity, raising sustainability concerns.
Congressional Efforts to Stabilize LTC Pharmacy Legislative proposals such as the Preserving Patient Access to LTC Pharmacies Act aim to create supply fee protections tied to MFP drugs. The episode explores whether policy corrections are likely — and how quickly DC can realistically respond.
Expansion of Negotiated Drug Lists The initial 10 negotiated drugs are only the beginning. Additional rounds of negotiation are underway, expanding exposure across more therapeutic classes. LTC pharmacies must treat MFP as a growing structural feature — not a limited pilot.
Part D Redesign and the $2,100 Out-of-Pocket Cap Beginning in 2026, the redesigned Part D benefit changes liability distribution among plans, manufacturers, and CMS. The new out-of-pocket cap alters plan incentives and may lead to tighter utilization management, formulary shifts, and network recalibration — all of which LTC pharmacies must monitor closely.
Inflation Rebates and Market Distortion The IRA’s inflation rebate provisions penalize manufacturers for price increases above inflation benchmarks. While not directly adjudicated at the pharmacy counter, these provisions influence manufacturer pricing strategy, launch pricing behavior, and downstream PBM negotiations — indirectly affecting LTC acquisition costs.
Strategic Readiness as a Competitive Advantage The episode concludes with practical recommendations: • Conduct an MFP exposure audit across top-dispensed NDCs • Reassess PBM contracts and network participation clauses • Model cash flow under delayed reimbursement scenarios • Educate facility partners on regulatory changes • Build internal compliance tracking specific to negotiated drugs
Why This Matters NowFor LTC pharmacies, this is not simply a policy conversation — it is a structural shift in reimbursement architecture. As federal oversight expands and pricing authority evolves, operational precision and legal literacy will define which organizations adapt successfully.
About our guest: 
Dr. Dae Lee, Pharm.D, Esq., CPBS 
Shareholder - Buchanan Ingersoll & Rooney PC 
Email: dae.lee@bipc.com Dae Y. Lee is a pharmacist-attorney and Certified Pharmacy Benefits Specialist™ (CPBS™) who represents pharmacies, healthcare stakeholders, and plan sponsors in high-stakes disputes and regulatory matters involving Pharmacy Benefit Managers (PBMs) and government payors. Drawing on his dual training as a pharmacist and attorney, Dae focuses his practice on defending clients in audits, investigations, enforcement actions and complex reimbursement and compliance matters.
Dae routinely represents pharmacies nationwide in PBM and payor audits, including Fraud, Waste and Abuse (FWA) investigations, extrapolation disputes, overpayment recoupments, credentialing denials, network suspensions and terminations. He advises pharmacies on compliance with applicable state pharmacy fair audit laws, PBM provider manuals, and reimbursement standards, with the goal of minimizing financial exposure while preserving network participation and business continuity.

Pharmacy Profit Summit 2026 + Rare Disease Day 2026 | TWIRx

On this episode of This Week in Pharmacy, we spotlight two major conversations shaping the future of pharmacy practice in 2026.
First, we welcome Dr. Lisa Faast, PharmD, founder of DiversifyRx, to discuss the Pharmacy Profit Summit 2026 and how independent pharmacies can strengthen margins, diversify revenue streams, and build sustainable growth models in today’s reimbursement environment.
Then, we turn to Rare Disease Day 2026 with Richard Faris, PharmD, Chief Commercial & Clinical Officer at PANTHERx Rare, to discuss specialty pharmacy leadership, pharmacist impact, and new patient feedback data revealing communication gaps in rare disease care.
Segment 1: Pharmacy Profit Summit 2026Guest: Dr. Lisa Faast, PharmD | Founder, DiversifyRx
Dr. Faast joins us to break down the vision behind Pharmacy Profit Summit 2026 — an event designed to equip pharmacy owners with practical strategies to increase profitability while maintaining clinical excellence.
Key Topics Covered:
• Why independent pharmacies must move beyond traditional dispensing revenue • Diversification strategies including niche services and high-value offerings • Real-world financial benchmarks pharmacy owners should track • How mindset, leadership, and data discipline drive sustainable profitability • The importance of collaboration and shared intelligence among pharmacy entrepreneurs
The Pharmacy Profit Summit is not just about revenue — it’s about equipping pharmacy owners to compete intelligently in a rapidly consolidating healthcare market.
Segment 2: Rare Disease Day 2026Guest: Richard Faris, PharmD | PANTHERx Rare Pharmacy
In recognition of Rare Disease Day 2026, we are honored to welcome Richard Ferris, PharmD, to discuss the critical role pharmacists play in specialty pharmacy and rare disease care.
PANTHERx Rare recently released survey findings examining patient and caregiver experiences within rare disease treatment journeys.
Key Study Highlights:
• 90% of patients and caregivers report delays due to communication gaps • 68% report waiting for updates from providers, pharmacies, or insurers • 90% say they manage the care process themselves • 72% desire a dedicated care coordinator • 73% agree it is unclear who is responsible for coordinating rare disease care
Despite advances in specialty therapeutics, patients are still asking for the fundamentals: clear communication, coordinated care, and personalized support.
Richard discusses:
• The growing importance of specialty pharmacists as care coordinators • Why rare disease patients often feel burdened by system fragmentation • How specialty pharmacy can close communication gaps • The need for pharmacist-led continuity in complex therapy management
Rare Disease Day reminds us that specialty pharmacy is not only about high-cost medications — it is about human connection, long-term coordination, and advocacy for patients navigating some of the most complex clinical journeys in healthcare.  From business sustainability to patient-centered specialty care, this episode reinforces two realities:
Pharmacy must remain financially strong to survive.Pharmacists must remain clinically present to lead.
As the profession evolves, profitability and patient advocacy are not opposing forces — they are interdependent pillars of pharmacy’s future.
Listen now and join the conversation shaping Pharmacy in 2026.