Manufacturer Direct D2C and the Future of Independent Pharmacy

Shelley Bailey (00:05):

You are listening to the Global Network of Podcasters dedicated to the pharmacy profession. Welcome to the Pharmacy Podcast Network.

Todd Eury (00:39):

Hey, the landscape of pharmacy, I don’t have to tell you, goodness gracious, is undergoing a massive plate tectonics structural shift. Our manufacturers are now direct sourcing and direct-to-consumer, which is known as D2C pharmacy models. They’re rapidly accelerating. And it’s been pioneered by organizations like LillyDirect and Pfizer Direct and these portals and TrumpRx, and it’s very confusing. It needs demystified. We need to know where it’s showing up, how it’s being leveraged, how it’s going to impact our independent community pharmacies, and therefore we have to reach out to people that know what’s going on. I want to introduce a friend of mine who’s been in my network for, I’m going to sound old saying this, but it’s been over 15 years, maybe 20 years. I don’t want to say 20 years, but it could be. Shelley Bailey, welcome to the show. How are you?

Shelley Bailey (01:36):

Oh, hello, Todd. Thanks for having me. Yeah, you just aged both of us, so thanks for that. But no, thank you for having me here today. I work on different strategic initiatives here at IPC, and some of those initiatives include partnerships with manufacturers, which is why we’re having the conversation here today. But I do want to welcome Sammy Salem to this conversation. Sammy?

Sammy Salem (02:00):

Hey, Shelley, how are you? Thank you for having me on this podcast today, Todd. I am a retail pharmacy owner. I’m also the owner of and CEO of Vios Compounding Pharmacy, as well as the executive board member with AAPA, an affiliate under IPC. So, it’s a pleasure to be on this podcast today, and let’s get to it.

Todd Eury (02:24):

All right, so I want to set some groundwork and I’m going to turn this over to Shelley because that’s why we have you here today is that authority and understanding. And like you said, the relationships that you’re building with the manufacturer are so key and things are changing. PBMs are changing, payment models are changing, how things are being paid for, access is changing, supply chain. So when I think of the threat to manufacturer to consumer of what that means for education and safety, when I think of the opportunity that manufacturers have to the end all source, which is of course our outputs, our pharmacies out there, there’s a lot that goes into this. So kind of open up from the beginning, let’s set the stage direct-to-consumer and the future of independent pharmacy. Shelley, give us the groundwork here.

Shelley Bailey (03:16):

Yeah, absolutely. I like to start things usually by talking to people about where things have been up until very recently with the explosion of direct-to-consumer or direct-to-employer. I would say over the last three years, I mean especially heightened when Pfizer launched their direct program for vaccines, we started this new world where pharmacies were traditionally used to, we have a PSAO, we sign up, we get all of our PBM contracts through that channel. We don’t have too much discretion related to that and we just move forward with claims adjudication. And as all these novel programs came out, there wasn’t necessarily a role in a more strategic way for retail pharmacy to benefit. So retail pharmacy kept really helping the nation during a really critical time where we needed all hands on deck to pull through healthcare access for people. But as this explosion of D2C really started to happen, retail wasn’t at the table.

(04:21):

And so for the last few years, what we find from pharmacy owners, I was a pharmacy owner myself, which is how I met Todd probably in 2010 or something. But while retail pharmacy was out there saving lives, these innovative models started to pop up. And until recently, retail pharmacies just haven’t been really strategically included in the D2C or D2E space. And so we’ll talk more about it throughout our discussion, but I think it’s really exciting now to be at a position where through partnerships like what we’ve built here with IPC, that we can really bring retail pharmacy to the table related to D2C that clearly benefits patients, it benefits the pharmacy, it benefits local payers in a more strategic way in the past. And I guess from my perspective, Sammy, as you have still your pulse on working the bench to seeing all this play out in real time, have you seen any shift from what commercial payers are doing, what cash pay is doing, and then also where things are headed to D2C?

(05:34):

And are you finding that you’ve been historically carved out? Are you finding that you’ve had to refer people out because you couldn’t match the D2C price? What are you really seeing in real time up until some of these new programs that you’ve been participating in?

Sammy Salem (05:50):

Yeah, Shelley, really there isn’t a true access to these opportunities or to these programs for the likes of our standard retail independent pharmacies. Our pharmacies are reporting back where these scripts are leaving. They’re seeing it leave and our pharmacists are not identifying it as a channel shift. They’re calling it just a loss in a prescription. Their patients are coming to the counter and saying, “My doctor told me to go to this website or my insurance won’t cover it. They asked me to go to this manufacturer for support.” That’s how they’re identifying these types of opportunities or these manufacturer programs as it pertains to what’s happening at the retail side.

(06:35):

Has there been a true opportunity or access to these types of programs for retail pharmacies? There hasn’t been until this point in time with the programs that you’re creating through IPC. And it is a very good program. I mean, some of the patients that I’ve worked with recently through this program have appreciated the opportunity to gain access to certain medications that they just didn’t have access to before in a more affordable fashion. And frankly speaking, the economics on the pharmacy level have been favorable and in many cases more favorable than the traditional model. So it’s been a welcoming program to be a part of.

Shelley Bailey (07:11):

Well, thank you for sharing that perspective, Sammy. I guess so one of the things I think of when I’ve been listening to you speak right now is how in some ways everything ended up a little bit fragmented, even more fragmented than before, let’s say kind of post-COVID with the explosion more of digital pharmacies and things. So maybe some of these new programs are kind of bringing it back so it’s more manageable for a pharmacy to be able to deploy these programs. When you think of how cash used to work where the patient would pay out of pocket, there was an expense associated, the pharmacy would adjudicate. When I think of how manufacturers can be more strategic in a closer relationship, whether that’s D2C or D2E, from my perspective, I think a lot about… Well, I always think about policy because I’m a pharmacy nerd and I like to think about nerdy pharmacy things like policy.

(08:08):

I think of some of the laws like what West Virginia did related to point-of-sale rebates. That was a law that West Virginia passed. But as you try to figure out what the heck a point-of-sale rebate looks like, how does it ultimately benefit the end consumer? I think a lot of… it’s easy to talk about, but hard to do. So when I think of these types of manufacturer-supported and manufacturer-sponsored programs, I think of these really as no better world to create an opportunity for a real point-of-sale rebate than these types of programs. I get asked, I don’t know if you do, Sammy, when you’re hearing from consumers or local companies and organizations you work with, a lot of people have told me lately with some of these manufacturer-sponsored programs, Shelley, this sounds too good to be true.

(09:00):

Who’s losing in these types of arrangements where the pharmacy makes more, the patient pays the same out of pocket? I mean, I have my perspective on who might be losing and maybe some will share, some won’t, but do you see this as a lose-lose? Does one person win and one person lose or can everyone be better together when you look at the supply chain, how rebate structures work? Is there a loser in this or is there kind of a mutual win-win?

Sammy Salem (09:32):

My honest opinion is that when you gain access or when you provide access to these types of services or programs, you’re actually putting more product out into the market. These are individuals, these are patients that have not been able to gain access at an affordable price point previously. So if you’re able to put more product into the marketplace, I don’t think anybody within the supply chain or within the vertical is going to have any issues with that directly, especially in the situation that it’s almost in a very transparent model. We’re seeing a situation where right at the point-of-sale, we’re seeing what the front end, what the cost is to the patient, what the reimbursement is or what the quote-unquote rebate would be for us at the pharmacy level. And it’s really straightforward. I mean, there’s no hidden costs associated with it or DIR, what you would call any type of back-end clawback.

(10:28):

It’s really a model that makes sense across the board. And going back to your question, who’s losing in this? I mean, ultimately we’re here for the patient. We’re a patient-centered approach no matter what we do. Every one of our pharmacies operate in that manner. We would not be around here if we didn’t have that patient relationship, which is what we value at the independent pharmacy level is maintaining that relationship with our patients and making sure that we’re there for them. And ultimately, if they’re the ultimate benefactor in this relationship or in this transaction, then guess what? There is no loser.

Shelley Bailey (11:00):

Well, Sammy, I’m glad that you shared that perspective because clearly community pharmacy certainly is patient-centric because if they weren’t, they wouldn’t be selling a lot of these branded medications because so many of the commercial payer arrangements have pharmacies very significantly below just cost of drug, not cost to dispense, but cost of drug. So I appreciate that you reinforced the concept that no matter what programs are on the market, no matter what you can access, what you can’t access, what drives retail pharmacies, community pharmacies is always patient first. Related to, from my perspective, who might win, who might lose, a lot of stores since we went live with our new network have said, “Wow, Shelley, isn’t this somehow bad for manufacturers? I have a much better reimbursed rate. The patient’s paying the lower out-of-pocket. Isn’t this bad for manufacturers? Why would a manufacturer do this?” And from my perspective, we all know how…

(12:01):

And this program is a rebate-based model, but really just a true-up of the patient out of pocket and the adjudicated reimbursement amount. But in the rebate world, in the funded space, we all know how that works. A claim adjudicates, 180 days later, there’s a bundled rebate from the PBM or from the manufacturer to the PBM. Whoever’s carrying that cost, which is often the plan and the employer, there’s a huge days-to-cash related to that, and then the pharmacy loses because of the aggressive network rate. From my perspective, doing these things, manufacturer rebates are so aggressive in the funded space and they have to be for formulary management and all the sorts of things to be able to have key product placement. I look at this as there’s one big middleman in this discussion that is eliminated from doing this. And so when you do that, there’s a lot more money to be shared.

(13:01):

So pharma’s not given more than they otherwise are giving to one of the big five.

(13:06):

Pharmacy’s benefiting, the patient’s benefiting. But I also think there’s an empowerment piece of this, both for the pharmacy and also for the manufacturer, because the manufacturer now has a world where they can work with community-based pharmacies in an economic model that works for the pharmacy and also works for the manufacturer, which also improves affordability and access to the consumer. And so I think it’s funny, the number of calls I get that people are like, “Oh, Shelley, these programs are… From a strategic perspective, why the heck would you ever do anything like this? You’re never going to be friends with a manufacturer ever again.” But the reality is the manufacturers are really leaning in. They’re leaning into this direct-to-consumer channel. They’re leaning into direct-to-employer. They’re leaning a little bit out of the traditional PBM model. And while we’re all pharmacy owners serving patients, a lot of our patients own companies.

(14:10):

They’re employers. We can be the ambassador and market access team for… I mean, we can do so many things at the pharmacy point-of-sale that really help pull through new innovation. When I explain what IPC is or what we do to stakeholders outside of independent pharmacies, I always explain this as how many voters are within our wingspan of ecosystem. Because when you’re talking externally and you’re really trying to gain support for PBM reform or other strategic initiatives we have, pharmacists as medical providers and all these types of things, I like to explain that if we want to be successful in being able to improve affordability for more patients, we’re empowering all of our strategic partners when we lean into these types of innovative programs. And so I know that was a super long-winded question to you, Sammy, and response back, but I just get pretty excited about how these types of programs work.

Todd Eury (15:19):

I want to ask a dumb question. How the heck does a pharmacy get paid? I mean, how are they… I’ve watched the economics of all of this and I’m wondering how do they actually make money?

Shelley Bailey (15:37):

You

Sammy Salem (15:37):

Are you talking about in this program or are you talking about in the traditional model? Because I’m still trying to figure out the answer to that question when it comes down to the traditional model, Todd. So that’s another podcast in itself. How does that

Shelley Bailey (15:49):

Sound? Well, and on this program, I’m happy to lean into the how. When we think of the how, there’s different mechanisms for how in some of these new programs it’s working. We know how it works with IRA, right? There’s the MFP that kind of lives in the middle and trues up a pharmacy. That’s very complex. There’s all sorts of challenges when you’re trying to do things like that. Different states are trying to do things like that with their drug affordability boards and things. And that’s why with this program, I think it’s the cleanest way that I’ve seen an opportunity to build margin, lower out-of-pocket expense, is because it’s built in the same workflow as other adjudicated transactions. So Todd, to answer that question, in these types of models, the pharmacy doesn’t have to work with manufacturer by manufacturer, so they’re not calling the drug company and trying to work something out.

(16:46):

So all the opportunities are kind of bundled under one solution. Once a pharmacy joins into one of these solutions, claims adjudicate within standard workflow. So you have it the product dispensed, you adjudicate the transaction just like you would a funded claim. The patient pays whatever the identified patient out-of-pocket amount is. The remaining delta from the contract rate and the patient out of pocket is paid in the same type of workflow as a covered benefit claim would be. So a third-party administrator pays the delta just like in a commercial claim or a Medicaid claim or something. And so I think that’s really interesting because we’ve always had pharmacies for the last 10 to 20 years trying to do unique things with local payers or with other strategic partners, but it’s always been how much do you ask a pharmacy to go outside of workflow to be successful?

(17:48):

And I think we could have another podcast about that and all the other types of things that we ask pharmacies to do outside of workflow. But what we know is if we want to be able to empower the pharmacy to help themselves, we have to work within standard workflow. So what’s exciting to me about making sure that a pharmacy’s paid the right rate, they’re paid timely, they’re paid all these things, is to make sure that things adjudicate no differently than any other standard transaction that a pharmacy might participate

Sammy Salem (18:18):

In. Yeah, and I’ll follow up on my personal experience within the program that I’m currently enrolled with IPC. Usually within 21 to 25 days, I’ve seen reimbursement come in. And frankly speaking, that’s in a very, very reasonable timeline. So to answer your question, Todd, normal workflow, like Shelley just answered, the pharmacist doesn’t experience any type of additional strain or another channel they have to go through is submitting a claim and getting reimbursed and actually in a more aggressive timeline than some other payers do.

Shelley Bailey (18:55):

And I think for seamless reconciliation and things like that, the payment is actually still facilitated through a traditional PSAO agreement. So the pharmacy still gets the 835, they can track the timing of payment and things, and so it works within traditional workflow. I know if I was a listener, because as you know, Todd, I’ve been a listener for a very long time. When I was building my own retail pharmacy, if I was listening right now, obviously something I would think about is rates. I’m just going to address the elephant in the room here. I’m a straight shooter, as you know. I can say that while rates, we can’t get into the exact specifics in this type of format. What I can say is I haven’t seen these types of reimbursement rates to a pharmacy available at scale in over a decade. I remember when the market really shifted over 10 years ago now, but I haven’t seen rates this favorable for 10 to 13 years.

(20:00):

Again, someone’s going to say, “Well, that sounds too good to be true. Where’s all this magic pot of gold that wasn’t otherwise available?” There is no magic pot of gold. It’s just more of that money is coming from the manufacturer directly to the pharmacy. And that is what excites me is to be able to build that margin back to the pharmacy.

Todd Eury (20:24):

I like that. I like the sound of that. It sounds good. Let’s play make-believe. If I melted the system down and started all over again, there’s a trend happening. And actually, I’m very proud to say in the Pittsburgh area, there’s two of them, so it’s not even like it’s condensed because these two pharmacists and pharmacy owners went to school together. Kyle McCormick and Brandon Antonopoulos have cost-plus pharmacies in their community, and they dictate everything. They get to do whatever they want, and they’re not subject or hostage to any payment system. So if I went back in time and I melted it all down and we started all over again, do you think this is the future? Do you think cost-plus and direct-to-consumer and getting the pharmacist as the only gatekeeper between a medication and the patient once the physician prescribes, is that where we want this to go?

Shelley Bailey (21:29):

I mean, Todd, you’re asking me the kind of nerdy stuff that I love to talk about all day every day. I would say yes. I mean, I think there’s already a trend in this, and I’d be really interested to see what Sammy sees at the counter as well, but I think there’s a huge trend on all these sorts of off-benefit models. I think 2026 is going to probably be the biggest year of commercial coverage for programs like GLP-1s under the traditional funded benefit, because now there’s all sorts of innovative programs like what we’re working on, what other partners in the industry are doing, where employers are getting smarter and they’re like, “Look, we’re going to have maybe a watered-down drug benefit, like an ICRA plan or something.” And I know this isn’t directly your question, but I’ll get to the more direct answer, but I think drug benefits are going to be narrowed considerably.

(22:25):

Everyone’s going to know where the top 20 high-impact drugs live from a gross to net access ability for payers. And if I’m the total rewards manager at a large employer, self-insured employer or something, I’m going to say, “These 10 NDCs, you go to this partner because they’re already getting the point-of-sale rebate. I don’t have to wait to get my money. These other 15 NDCs, you go that way and I cover it on an HSA or a debit card.” So in many ways, we’re going backwards. So I remember in the late ’90s where my grandparents’ medicine shop pharmacy, every drug we dispensed was cash, and once in a while, someone would come in with a covered benefit and we didn’t even barely know how to bill a third party, and you just prayed no one came in because you had no idea how…

(23:12):

I mean, you prayed that no one with a funded benefit came in because you had no idea how to even bill that transaction. And so I think that what’s covered on benefit will shrink. The PMPMs that are charged to employers will shrink, you hope. That’s probably a bad assumption to make, but it might work. And then all these pharmacies that want to do cost-plus, I think there’s limitations on cost-plus. You can control a piece of that. I think in the generic space, it works real well. You can factor in your cost to dispense. It’s like a NADAC plus. It’s like an average actual acquisition cost. I’m from Oregon, so we do all that kind of stuff. But you’re going to be limited on the high-impact branded drugs because you’ll never be able to do cost-plus in a way that works for the patient or for the consumer.

(24:08):

And that’s where when more of these types of programs come to life, you could open a pharmacy, you could grab the programs from the partners you want and make sure if you’re those two Pittsburgh pharmacies that you’ve leaned into your own cost-plus for lower WAC items, and then you plug the holes on the high-impact drugs with programs like this. So I think that we’re going backwards in a good way, I guess is how I would frame it. But Sammy, what are you seeing related to, are more patients just paying out of pocket because they can’t access a high deductible?

Sammy Salem (24:47):

From my perspective, Shelley, I mean, honestly, if you look at it at a macro level, the amount of people that are uninsured nationally and the amount of people that are underinsured nationally is at an all-time high. And that’s why, Todd, the two individuals that you mentioned in Pittsburgh went into this area and opened up these cost-plus pharmacies because fact of the matter is there is a good market out there for people to gain access to medications or therapies that are available in a cost-plus fashion that’s fully transparent to them that they’re not being overcharged on and they’re gaining access to these medications. I mean, fact of the matter, that’s exactly what’s happening nationally no matter where you look or turn. And it’s because of the simple fact that we have a ton of people that are underinsured and uninsured. Even at the government level, when you look at Medicaid and Medicare, a lot of states, the majority of the states out there have adopted the cost-plus model with their Medicaid reimbursement.

(25:49):

I know in Michigan, I have a lot of experience, AAPARxRx as a GPO, pushed for legislation and passed it in the state of Michigan and has helped NCPA advocate for it at the federal level. But what I will tell you that that cost-plus model has saved, for example, the state of Michigan nearly $40 to $60 million, depending on the year, improving the Medicaid program’s bottom line in the Medicaid program. And that number, if you look at it in an indirect fashion, could be much higher if you look at what they were able to do with respect to their rebate model within their preferred drug list. But with that being said, this is kind of what this whole program is all about. This direct-to-consumer manufacturer program that IPC and Shelley have created is being able to feed into that system, being able to feed into that uninsured, underinsured or that carve-out that some of these payers or commercial plans are putting their members into because they just can’t afford to be able to serve or manage an entire drug benefit program.

(26:52):

It’s hard. Will that be a program that’s sustainable long term? I do believe that managing drug benefits are going to be front and center for any type of health plan moving forward because it’s always the anchor of the premium, the cost associated with it. Do I think that we’re going to be in a world or in a situation where we could be creative like these types of programs or a cost-plus cash pay model that could help drive down premium costs, carving out some of the drug benefit? I do think that’s going to happen in the near future, and it will be beneficial for the pharmacist because they will be able to control that conversation like we’re doing right now with this program with IPC.

Shelley Bailey (27:36):

So Sammy, you mentioned quite a few things that I wanted to make sure to lean into. Now I forgot a couple of them, but one thing that came top of mind when you were discussing this made me think of was also 340B. I think something that comes up for me a lot is when you talk about cost-plus, that’s kind of what sliding scale was 20 years ago, 15 years ago and things. But with the new 340B rebate model,

(28:05):

And we know that a lot of independent pharmacies and just retailers in general are contract pharmacies, as we know that model is shifting, there’s going to be, in my 25 years, people have been telling me 340B is going to change and I continue to move forward as I did, but I do believe now there will be changes in the next 24 to 36 months, even quicker with the rebate. But I think this is also another way that gets to the cost-plus for some of the individuals that need to benefit from it and gets to the net that a lot of pharmacies are trying to support for their local employers and things, keeping in mind that 340B is changing, but as 340B changes, manufacturer direct-to-consumer, manufacturer direct-to-employer is going to increase. So you’re a pharmacy now doing contract pharmacy, you’re going to see, I mean, just speaking frank, you’re going to see a reduction in 340B claims ultimately at some point in time, but can you lean into these types of programs to give you a lift that gets you the patient?

(29:23):

It still keeps affordability at the forefront for the consumer, but also helps keep margin to the pharmacy so that the pharmacy can keep their doors open. We always said when we owned our pharmacy: we have to make money to help people, right? If we don’t make money, we cannot help anyone. And so as 340B, that’s something that we’re all talking about right now. We’re all very much closely watching these types of manufacturer-supported programs, I think, are a way to bridge the gap for both consumers and for the pharmacy

Todd Eury (30:00):

Sammy, I have this glass half full mentality. I can’t help it. I wake up in the morning, I say some prayers, try to get some breakfast, try to get some exercise in, and I want to light the day on fire. So I want good things to happen. And I hear about how the future of pharmacy isn’t just the prescription, it’s not just the dispensing fee, it’s immunizations, it’s treatment management, it’s getting paid for remote patient monitoring, it’s digging into supplement business and managing that. It’s preemptive services that can help people live longer, healthier lives. Is that a realistic way of thinking? Is that the future of our independent community pharmacies?

Sammy Salem (30:51):

Well, Todd, I think it’s a part of it. When you say is it the future, I do think the core of who we are as pharmacists, independent pharmacists and providing a service or a level of care to our patients is always going to be the dispensing piece. But what accompanies that or what comes with the type of service that our patients are going to expect out of us is providing those type of services and the ability for our pharmacists to adapt and provide those services. And I know we’ve spent a lot of time, in states and nationally, on the ability to provide some of those services, whether it be immunization or the types of monitoring that you’re referring to, whether it be remote therapeutic monitoring or RPM or chronic care management to a degree to work with our providers that we work with on a day-to-day basis, primary care providers that is.

(31:45):

I think that’s all going to be a part of who we are as pharmacists in the future, 100%, simply because the ability for the patient to access us on a daily basis. They touch us, they feel us, they’re able to see us, they’re able to communicate with us freely, and we have to be a part of that conversation. We will be a part of that conversation. But is it solely the future? When people talk about that, I think some people envision the dispensing side going away, and I don’t think that’ll ever go away. True. I

Todd Eury (32:15):

Agree.

Sammy Salem (32:16):

Every patient’s going to come in and need that type of service, whether it’s an urgent care medication or whether it’s a maintenance medication or whatever it may be, pharmacists are going to always be there for that, for all levels of service. And one thing that our pharmacies need to be a part of is being able to adapt to that ability to offer those other types of ancillary services.

Todd Eury (32:38):

I want the listeners to listen in and maybe listen to this podcast again, but reaching out to people like Shelley and reaching out to IPC and reaching out to AAPARx and Sammy and people that know what’s going on to demystify, to understand and where to go, Shelley, help our listeners understand how to get the pharmacies involved, how to get the pharmacists involved, how to corral this so that they can feel in control and getting involved with direct-to-consumer and tighter relationships with our manufacturers. Yeah,

Shelley Bailey (33:14):

Absolutely. Thank you for asking, Todd. I mean, I would say just a very low-level way to get started would be for those that want to access programs like this would be to reach out to the IPC digital health team. Sure, Todd, for the notes for the podcast, you’d be able to put that contact information there. I think that’s just a real dip-your-toe-in-the-water kind of way that gets started, you see how it works, you then can see in real time if those economics are in alignment with what works for your pharmacy.

(33:46):

I believe I’m a trustworthy person, but every pharmacy has a different model of what reimbursement works for them and things. I believe strongly a model like this will work, but again, I would just encourage people to try. And then once you’ve dipped your foot in the water, you’ve tried a little bit, again, I would continue to, I mean, just being the pharmacy person I am, it’s listening to podcasts, more of the different podcasts that you do, Todd. My favorite time to listen to you, Todd, was always like 10:00 PM to midnight when I was working on prior auths, but listen and learn from others that are already doing these types of things. Listen to more webinars that IPC has a myriad of things that we’re doing in this space and just learning from others, attending conferences, attending all the independent pharmacy conferences that are coming up, the wholesaler conferences that are coming up.

(34:42):

But it’s really, I think trying to not have the visceral reaction of these new things are happening, I don’t like it, it isn’t good for me, so I’m not going to participate. Someone told me way back in my 20s, if you’re not sitting at the table, you’re on the menu. And I think we all know that that’s been something that for going a couple decades back, I think pharmacy struggled with a little bit. And now we’ve been racing to catch up over the last 20 years and things that we’re all doing together, but we’re all better together. So the more of us that can lean in to empowering the partners that we want to work with empowers ourselves and empowers our patients. And so I would just really ask stores to be open and curious and use these types of tools. This is one tool in the toolbox, clinical services, billing for clinical services, that’s another tool, right Todd?

(35:42):

In whatever shape, way, and form 340B is, is another tool in the toolbox. Remote monitoring is another tool. And so I see them all working together, but it’s keeping an open mind because we’re traditionally pretty cautious of any sort of payer relationship. And so it’s listening to others, it’s listening to other podcasts on similar topics and just giving it a

Sammy Salem (36:05):

Try. Yeah, I’d like to add something there, Todd, if I may. The first thing is that it doesn’t cost any pharmacy anything to be a part of this. And that’s the first thing that everyone says, what’s a catch? I mean, Shelley said it a couple times, who’s losing? What’s going on here? And as far as the pharmacist is concerned, you’re not losing, you’re actually winning. So don’t worry about anything else. Second thing from an AAPARxRx perspective, our account management team led by Kelly Sneed and Shem Shibley, so you’ve had the pleasure of meeting Todd before. They spent a lot of time talking to our members about these types of programs exactly. Day to day, when these opportunities come up, a lot of my members will send me messages off topic sometimes and say, “Hey, Kelly and Shem took a lot of time to talk to me about this MTM program or whatever it may be.” And I know a lot of these pharmacy GPOs, including IPC, spend a lot of time training their account management representatives and calling their members and getting them aligned on these types of programs and getting them on board with them.

(37:07):

So I think that from the AAPARxRx’s perspective, from my view, a lot of our members are very receptive to this type of engagement, are usually highly engaged on these types of programs because of our account management team and the ability to reach out to them and their level of trust with us. So the way I see it moving forward is how do we get these pharmacies on board with these types of programs is leveraging all the great things Shelley and IPC are doing and making available to their affiliate pharmacies and encouraging and training and getting our account management team to be able to properly push this information out and get these pharmacies on board is critical moving forward. I mean, that’s going to break the ceiling, the glass ceiling that’s above us when it comes down to offering these types of services.

Todd Eury (37:54):

Listeners, as Shelley said in the show notes, if you’re driving, you’re doing something jogging, chopping vegetables, remember that Shelley, from Saturday Night Live? If you’re doing something, you can’t look at your screen, don’t worry about it, wait till you get back somewhere safe, go to the show notes. There’s going to be links there to get you access to these people and these experts and be able to ask questions and be able to understand how to get going. And that’s just it. It’s prep right now. You have to start thinking, what are we doing differently? What are we doing to build a new infrastructure to enter 2027, not just starting, but moving into a new program and moving into new marketing? And this is another thing, IPC has always been good and shout-out to AAPARx too. I’ve worked with them at the IPC conferences, amazing group.

(38:50):

They’re good at marketing. They’re good at communications. They’re going to teach you and help you push programs out to your community to make it understandable and to get your community involved, get them asking questions back to the independent community pharmacies and become the source of information, become the healthcare hub that you are in your communities. I am so honored to have had both of you on the show today. Thank you so much, Shelley, for bringing such a great guest to us, somebody that’s in the trenches that cares about his community and cares about what’s happening in healthcare today. Sammy, this has been great. I want to thank you both.

Sammy Salem (39:31):

Pleasure’s mine, Todd. Thank you so much. And Shelley, as always, we love to work with you guys and hopefully we can continue all the good work.

Shelley Bailey (39:38):

Absolutely. Thank you both for having me today.

Todd Eury (39:41):

Hey, you were listening to the Pharmacy Podcast Network, one of our programs sponsored by Independent Pharmacy Cooperative, ipcrx.com. Take a look, ask lots of questions. Let’s get ready for a new year coming up this fall. And if you’re going to NCPA, make sure we connect. We will be there as press covering the event. Make sure you connect with Shelley and the IPC team and just take time to meet each other. It’s so important that we get together. I say together, Rx. Hey, we’ll talk to you next time.