Episodios

  • Healthcare Without Walls: The Growth of Consumer - Driven Care

    Healthcare Without Walls: The Growth of Consumer - Driven Care
    May 26 2026

    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, MPH Senior Associate, Sg2 Intelligence Vizient, Inc.

    Hailey Mulliner, MS-HSM Senior Director, Sg2 Intelligence Vizient, Inc.

    Heather Pace, Pharm.D. Senior Clinical Manager, Ambulatory Vizient, 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 health
    • Women’s contraceptives
    • Dermatology and acne care
    • Behavioral health
    • GLP-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 management
    • Type 2 diabetes
    • Orthopedic care
    • Cardiometabolic disease monitoring

    (04:31) Discussion shifts to the benefits and drawbacks for patients, including:

    • Increased convenience and access
    • More comfortable treatment environments
    • Greater patient empowerment
    • Risks of fragmented care and disconnected treatment plans

    (06:07) Emily outlines concerns for health systems, including:

    • Increased emergency department utilization
    • Lack of coordinated care
    • Medication management gaps
    • Challenges 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 clinicians
    • Provider burnout
    • Flexibility 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.

    Subscribe Today!

    Apple Podcasts

    Spotify

    YouTube

    RSS Feed

    Más Menos
    15 m
  • Beyond Revenue: Measuring Specialty Pharmacy Team Value

    Beyond Revenue: Measuring Specialty Pharmacy Team Value
    May 12 2026

    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, MBA Associate Director, Specialty and Infusion Pharmacies University of Illinois Hospital and Health System

    Thom Platt, PharmD, PhD, MBA ,BCPS Director of Specialty Pharmacy Services UK HealthCare

    Host: 

    Carolyn Liptak, MBA, BS Pharm Pharmacy Executive Director, Regulatory Compliance Vizient Center for Pharmacy Practice Excellence

    Show Notes:

    00:05 – Introduction Overview of VerifiedRx and the focus on pharmacy practice excellence.

    00:14 – Episode Overview & Guest Introductions Host Carolyn Liptak introduces the topic: capturing the value of pharmacist interventions beyond prescription revenue. Guests:

    • Dr. Karen Thomas, University of Illinois Chicago
    • Dr. Thom Platt, UK Healthcare

    00:57 – Health System Backgrounds

    • UIC serves a diverse urban population with a strong Medicaid and Medicare presence
    • UK Healthcare supports patients across Kentucky and surrounding states, including rural populations traveling long distances for specialty care

    01:48 – What Sparked the Research

    • Originated from a Vizient work group focused on outcomes and value
    • Need for clearer frameworks to document and report pharmacist interventions
    • Lack of standardized guidance from accrediting bodies and payers

    02:56 – Survey Goals and Key Findings

    • Explored how health systems define and document interventions
    • Identified major variability in data collection and reporting
    • Found alignment in defining clinical interventions, less consistency in non clinical ones
    • Included responses from 24 health systems

    04:21 – Broader Impact on Pharmacy Practice

    • Reinforces the value of pharmacist contributions beyond revenue
    • Highlights prevention of hospital visits and improved patient outcomes
    • Emphasizes the need to better capture and communicate this value

    05:38 – Applying the Research in Practice

    • UIC developed a structured framework and documentation tool
    • Supports initiatives like waste avoidance studies
    • Aims to quantify cost savings from pharmacist interventions

    06:49 – Relevance Beyond Specialty Pharmacy

    • Concepts apply across all pharmacy settings
    • Data can support staffing, funding, and program expansion decisions
    • Helps communicate value to internal and external stakeholders

    07:52 – Role of Pharmacy Technicians

    • 96 percent of sites report technician involvement in non clinical interventions
    • Examples include resolving medication access issues and addressing social barriers
    • Technicians play a critical role in patient support and care coordination

    09:58 – Future Opportunities

    • Push toward standardizing intervention data collection
    • Opportunity to reduce duplication of effort across health systems
    • Goal to create scalable, shared frameworks

    10:41 – Strategic Value of Intervention Data

    • Supports conversations with leadership and external partners
    • Demonstrates impact on outcomes like reduced ED visits and length of stay
    • Strengthens partnerships with payers and manufacturers

    11:34 – Additional Resources

    • Study published in the Online Journal of Pharmacy
    • Link available for listeners to explore further

    12:03 – Closing Remarks Final thoughts and appreciation for guests Call to action: subscribe, share feedback, and stay engaged with VerifiedRx

    Links and Resources: https://www.mdpi.com/2226-4787/13/6/172

    Subscribe Today!

    Apple Podcasts

    Spotify

    YouTube

    RSS Feed

    Más Menos
    13 m
  • Alpha-gal Syndrome and Impact on Patient Safety

    Alpha-gal Syndrome and Impact on Patient Safety
    Apr 28 2026
    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 VerifiedRx 00:14 – What is alpha-gal syndrome Overview of alpha-gal syndrome Delayed allergic reactions after eating red meat Often linked to tick bites 00:48 – Meet the Guests Zack Stacy, clinical pharmacy specialist Kyna Henrici, medical evidence director 01:10 – 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 trace 01:32 – 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 reactions 02:17 – Prevalence and Diagnosis Challenges More common in Midwest and southern United States Likely underdiagnosed Often mistaken for general food allergies Allergy may fade over time 03:07 – Risks in Healthcare Settings Patient safety concerns beyond food Mammalian components in medications and devices Examples include heparin and surgical materials 03:44 – Hidden Medication Risks Inactive ingredients can be animal derived Examples include glycerin, lactose, amino acids, stearates Difficult to identify and track 04:42 – Lack of Transparency No centralized ingredient database Sourcing can change frequently Variability across manufacturers and batches 05:33 – Screening in Surgical Settings Medication review at NDC level Identification of active and inactive ingredients May require contacting manufacturers 06:45 – Timing Challenges Urgent procedures limit investigation time Manufacturer responses may take days Alternative medications often needed 07:14 – Identifying At Risk Patients Many patients are unaware they have alpha-gal syndrome Screening includes questions about dairy tolerance Three patient categories used for evaluation 08:32 – Using Dairy as a Screening Tool Dairy tolerance helps guide risk level Food exposure typically higher than medication exposure Determines need for deeper review 09:12 – Managing Emergencies Focus shifts from avoidance to risk mitigation Use of team communication and clear documentation Preparation for unavoidable exposure 10:03 – Prevention and Preparedness Stock alpha-gal safe medications when possible Prepare for allergic reactions with standard treatments 10:47 – Team Based Care Approach Collaboration across care teams is essential Premedication strategies may be used Close monitoring for reactions 11:11 – Gaps in Care Limited visibility into product ingredients Need for better labeling and transparency 11:33 – Need for Standardization Call for clearer guidance and clinician education Desire for centralized resource for medication ingredients 12:24 – Monitoring Challenges CDC tracking decreased after privatization of testing Cases likely still increasing 12:53 – Closing Remarks Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed
    Más Menos
    14 m
  • Efficiency to Excellence: AI’s Role in Modern Pharmacy Practice

    Efficiency to Excellence: AI’s Role in Modern Pharmacy Practice
    Apr 14 2026
    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., MS Vice President, System Pharmacy Service Line Ochsner Health Dr. Catherine Oliver, Pharm.D., BCPS, DPLA, CPGx System AVP, Clinical Pharmacy Services Ochsner Health Host Dr. Kerry Schwarz, Pharm.D., MPH Senior Clinical Manager, Evidence-Based Medicine and Outcomes Vizient 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 adoption Guests: Dr. Jason Chou, VP, System Pharmacy Service Line, Ochsner HealthDr. Catherine Oliver, System AVP, Clinical Pharmacy Services, Ochsner Health 01:04 — Will AI Replace Healthcare Jobs? Concern exists, but largely driven by misunderstandingAI is expected to: Augment, not replace, pharmacy rolesImprove efficiency in daily workflows AI is not capable of: Independent clinical judgmentMeaningful patient interactions Human 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 documentation Opportunity to eliminate “busy work” and improve staff satisfaction 03:31 — Clinical Workflow Support AI can: Summarize patient charts, labs, and notesOrganize large volumes of clinical data Enables pharmacists to: Spend less time preparingSpend more time in patient care and provider interaction 04:08 — Additional Opportunities: Supply Chain & Operations AI can support: Inventory managementPurchasing optimizationMulti-site coordination Benefits include: Cost savingsImproved efficiencyBetter resource utilization 05:00 — Where to Draw the Line AI should not replace clinical decision-makingLimitations include: Lack of experience and judgmentInability to incorporate patient values and preferences Final decisions must remain with clinicians. 05:42 — Preserving the Human Element Patient care involves: TrustEmpathyRelationship-building Over-reliance on AI risks eroding patient confidence. 06:11 — Patient Interaction & Transparency Patients want to know: When AI is usedHow it impacts their care Transparency and communication are critical 06:48 — AI in Direct Patient Care: Ambient Listening AI tools can: Capture conversations during patient visitsReduce documentation burden Important considerations: Patient consentAbility to opt outPrivacy concerns 07:31 — Risks of Poor Implementation Poorly designed AI interactions can: Frustrate patientsReduce trust Healthcare AI must avoid: Impersonal experiencesInefficient automation 08:21 — 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 timelines Benefits: Faster patient access to therapyImproved staff satisfaction 10:07 — Clinical Decision Support Enhancements AI-driven rule systems: Identify high-risk patientsReduce unnecessary chart reviews Example outcome: Reduction in time spent reviewing charts without intervention Frees pharmacists for: Medication reconciliationPatient counseling 11:11 — Impact on Workforce Engagement Staff report: Increased satisfactionMore time for meaningful work AI seen as an enabler rather than a threat 12:03 — Vendor Landscape & Challenges Rapid growth of AI vendors addressing niche problemsKey risks: Data security concernsVendor quality variabilityOverlapping or redundant solutions 12:51 — Integration & Workflow Considerations Successful AI tools must: Integrate with EHRsAlign with pharmacy workflowsAvoid siloed systems Poor integration leads to inefficiency and adoption barriers 14:04 — Vendor Evaluation Considerations Assess: Clinical and operational expertiseProduct maturityImplementation effortRisk vs benefit ...
    Más Menos
    17 m
  • Inside the Medicare Transaction Facilitator: Early Wins and Growing Pains

    Inside the Medicare Transaction Facilitator: Early Wins and Growing Pains
    Mar 31 2026
    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 the Medicare 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 rollout Guest: 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 dispensers Ensures Part D beneficiaries receive negotiated pricing 02:00 — 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 team Key roles involved: Pharmacy leadershipData analystBusiness managerReconciliation technicianRevenue cycle team Responsibilities 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 processing Complexity increased post-enrollment due to: Data fragmentation across systemsLimited access for revenue cycle teams Required 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 required Early collection rates: Initially ~10%Improved to ~60% 05:09 — Operational Workflow Adjustments Monitoring cadence evolved: From daily tracking → now biweekly review cycles Teams 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 tools Requires 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 capacity 07:33 — Operational Evolution Processes are continuously evolving.Key success factors: Ongoing process refinementStrong internal documentationRapid incorporation of lessons learned Example: Identifying system issues with inquiry tracking and adjusting workflows accordingly 08:14 — 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 resources Emphasizes importance of operational efficiency and resource planning. 09:36 — Final Takeaways MTF implementation is: ComplexResource-intensiveStill evolving Key themes: Strong cross-functional collaboration is essentialProcesses will require ongoing refinementFinancial sustainability remains a concern 09:46 — Closing ...
    Más Menos
    10 m
  • Checkpoint Change: Rethinking How PD-1/PD-L1 Inhibitors Are Delivered

    Checkpoint Change: Rethinking How PD-1/PD-L1 Inhibitors Are Delivered
    Mar 17 2026
    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 — Introduction Announcer welcomes listeners to VerifiedRx, produced by the Vizient Center for Pharmacy Practice Excellence. 00:14 — Episode Overview Host 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, Vizient 01:39 — Clinical Data: Efficacy, Safety & Pharmacokinetics Subcutaneous formulations were approved in combination with hyaluronidase, allowing full-dose subcutaneous administration.Clinical studies demonstrated: Comparable pharmacokineticsSimilar efficacySimilar safety profiles compared to IV formulations The main difference observed was local injection site reactions, expected with subcutaneous administration. 02:32 — Confidence in Clinical Comparisons Although 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 Workflow Subcutaneous 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 coordination 04:06 — Chair Time vs Total Visit Time For 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 Challenges Subcutaneous 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 Considerations Some 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 Complexity Transitioning to subcutaneous therapy involves more than simply switching order sets.Organizations must evaluate: Staffing modelsNursing workflowsEquipment availabilityInfusion center capacity management. 06:25 — Financial Considerations Subcutaneous 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 Dynamics Over 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 Considerations Adoption may vary by care setting: Hospital outpatient departmentsPhysician officesFreestanding infusion centers 08:06 — Strategic Timing Decisions Health systems may weigh: Operational advantages of subcutaneous administrationPotential cost reductions from future biosimilars Some organizations may delay adoption until biosimilar competition arrives. 08:24 — Infusion Center Optimization Subcutaneous therapies ...
    Más Menos
    12 m
  • Winter 2026 Spend Management Outlook

    Winter 2026 Spend Management Outlook
    Feb 4 2026
    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 Pharm Pharmacy Executive Director, Regulatory Compliance & Revenue Integrity Center 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 2026–2030 Guests: Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence Heather Pace, Senior Clinical Manager, Ambulatory Care 01:09 — 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 technologies 01:49 — 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 factors Ambulatory 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 Faspro Continued growth due to: Expanded indicationsIncreased outpatient infusion utilization Oncology split by site of care: Inpatient: High-cost CAR T (e.g., Yescarta)Outpatient: Infusions, bispecifics, emerging cellular therapies Emphasizes 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, Zepbound Spend growth fueled by: Media exposureExpanded indicationsIncreased patient demand Opportunity 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 prices 340B changesIRA Medicare Part D negotiations 09:37 — 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 drugs Identify top spend movers and align them with long-term market forces.Consider: Specialty pharmacy expansionSite of care optimization 10:48 — 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 strategy Utilization varies widely based on: Formulary designBenefit alignment Biosimilars 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 differentiation Sets 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 complexity Clinical barriers are decreasing; workflow flexibility is critical....
    Más Menos
    20 m
  • CDC Childhood Immunization Schedule Updates (January 2026)

    CDC Childhood Immunization Schedule Updates (January 2026)
    Jan 27 2026
    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 BDengue 05:19 — 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 B 08:05 — 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 ...
    Más Menos
    12 m