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In the filing with the FDA, the manufacturer reported only 14 pregnancies among the 955 participants in 1 of the submitted studies, with an adherence rate also greater than 90%.2 Meanwhile Many States Have Approved or Are Condisering Pharmacist-Prescribed Oral Contraceptives At least 24 states have laws and policies in place to allow pharmacists to prescribe an array of oral contraceptives.3 These policies give pharmacists varying levels of autonomy, from state statute or statewide protocol to collaborative practice agreements (CPAs), which can offer more formal and direct supervision, depending on the CPA requirements in that state. Cost, Access, Misuse Were All Considerations in OTC Approval Nearly all involved in the process of approval, from the data scientists reviewing the supporting studies to the advocacy groups and health care provider associations, agree there is some risk associated with allowing this new OTC product to come to market, and they will all likely be considering combination products soon. The pandemic confirmed that community pharmacies are the now-undisputed champions of convenient access to safe and effective protocol-based assessment, as well as ordering and administering treatments and diagnostics for products and conditions where evidence-based protocols are possible.

Recurrent hospitalizations represent a substantial and often preventable human and financial burden in the United States. In 2008 North Carolina initiated a statewide population-based transitional care initiative to prevent recurrent hospitalizations among high-risk Medicaid recipients with complex chronic medical conditions. In a study of patients hospitalized during 2010-11, we found that those who received transitional care were 20 percent less likely to experience a readmission during the subsequent year, compared to clinically similar patients who received usual care. Benefits of the intervention were greatest among patients with the highest readmission risk. One readmission was averted for every six patients who received transitional care services and one for every three of the highest-risk patients. This study suggests that locally embedded, targeted care coordination interventions can effectively reduce hospitalizations for high-risk populations. [PUBLICATION ABSTRACT]

Optimizing Tools to Reduce the Burden of Health Care Administration Typically, Epic Systems and other technology solution providers' first entry into AI implementation comes in the form of reducing menial tasks and attempting to automate patient-customer interactions. [...]all of us are more likely to be assigned an AI assistant as a customer than to use one as a health care provider at this juncture. AI is already in place for many physicians and other health care providers, and I fear pharmacy may actually be late to the game in an arms race to make the drug assessment–prescribing–filling process even more efficient. There is so much work to do, from regulatory discussions with our state boards of pharmacy to scoping the future of practice alongside technology solution providers to teaching the next generation of pharmacists as well as those already in practice about how to use AI to deliver safer, more effective, and more innovative care.

Among the nearly 900 pages of legislation are changes to health care coverage and financing that may have far-ranging effects on community and health system outpatient pharmacies.1 As criticism of \"middlemen\" and the supply chain accelerates, pieces of this legislation may act as a coenzyme to transparency, pharmacy benefit manager (PBM) reform, and favored-nation efforts. Some proportion of the prescription fills lost due to loss or reductions in coverage will be preserved through conversion to cash pay or 100% out-of-pocket payments from patients who still see the benefit of the drug product against the full cost. * More direct purchase eligible: In July 2025, manufacturers announced another drug entry into this strategy with Eliquis (apixaban; Bristol Myers Squibb, Pfizer) to be sold directly to patients (meaning no PBM) at a 40% discount.3 This strategy aligns with a decades-long strategy of price discrimination based on ability to pay as a cornerstone of profitability, with rebates and patient assistance programs being the mechanisms to accomplish this go-to-market pricing strategy. Expect More Cash Market Plays From Community Pharmacies It would be prudent for community pharmacies to prepare for and court uninsured patients as they come off coverage in an accelerated manner due to the downstream effects of OBBBA.

What about a central fill and shipping facility now becoming more popular within health systems to serve patients across multiple hospitals and clinics using mail-order methods? [...]it would be accurate to say that mail order does not maintain a dominant position, but it is inaccurate to say that mail order is not a big and profitable (for some) business, especially if you have procurement price advantages or you can set the reimbursement price to yourself at a different rate (ie, you are a pharmacy benefit manager [PBM]). Removing PBMs' ability to become a dispenser should open up opportunities for health systems to grow their market share. [...]more and more states are carving out managed care organizations and switching to a single PBM to administer on behalf of the state.

Prior to Part D, any Medicare enrollees without a retirement benefit that included a drug benefit had to pay for prescription drugs entirely out of pocket, and thus the political pressure to lower prices was acute. [...]yes, post-rebate estimates put prescription drug and medical goods spending at a higher level ($1635 vs $944) than other countries, but the extra spend is dominated by inpatient and outpatient care delivery ($7500 vs $2969), making total payments to hospitals, physicians, and other providers a much bigger budget discrepancy than prescription drugs.5 The Most Significant Driver of Health Care Spend Isn't Drugs—It Isn't Even Close Pharmaceutical manufacturers are a frequent punching bag for politicians, mostly because they are easy targets, and they tend to have more visible out-of-pocket exposure. Patients like to view brand-name drugs as a commodity (erroneously so) because the cost to the next unit off the line (incremental cost) is very low compared with the price tag (frontloaded with research, go-to-market, and regulatory fixed costs), whereas physician visits and hospitalizations are personalized and specific to their own encounters. [...]market forces would bring effectiveness and efficiencies, so we enlisted pharmacy benefit managers (PBMs) to facilitate economist Adam Smith's invisible hand with formulary selection and patient access rewards for data-driven evidence of outcomes. Accessed May 27, 2025. https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going#:~:text=Administrative%20costs%2C%20prescription%20drugs%2C%20and,large%20portion%20of%20the%20remainder Prescription Drugs - Image credit: JJAVA | stock.adobe.com Prescription Drugs - Image credit: JJAVA | stock.adobe.com data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%275472%27%20height=%273744%27/%3e data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7 https://www.pharmacytimes.com/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpharmacytimes%2Fd8ded367491c4a5388d203394ab04cf45428f700-5472x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 https://cdn.sanity.io/images/0vv8moc6/pharmacytimes/d8ded367491c4a5388d203394ab04cf45428f700-5472x3744.jpg?fit=crop&auto=format