VerifiedRx

Vizient Center for Pharmacy Practice Excellence
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Delivering short doses of insight for hospitals’ frontline pharmacy professionals, the Vizient pharmacy team brings together experts to verify best practices for navigating today’s pharmacy practice challenges and accelerating career growth. It’s a prescription for success, delivered by the Vizient Center for Pharmacy Practice Excellence.

  1. 2 NGÀY TRƯỚC

    Alpha-gal Syndrome and Impact on Patient Safety

    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

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    Efficiency to Excellence: AI’s Role in Modern Pharmacy Practice

    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 replacement Identifying real-world use cases Understanding limitations of AI Practical strategies for adoption Guests: Dr. Jason Chou, VP, System Pharmacy Service Line, Ochsner Health Dr. Catherine Oliver, System AVP, Clinical Pharmacy Services, Ochsner Health  01:04 — Will AI Replace Healthcare Jobs? Concern exists, but largely driven by misunderstanding AI is expected to: Augment, not replace, pharmacy roles Improve efficiency in daily workflows AI is not capable of: Independent clinical judgment Meaningful 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 cases Ideal applications: Reducing non-value-added tasks Improving efficiency Supporting clinical decision-making preparation (not replacing it)  02:39 — Early Use Cases: Operational Efficiency AI can reduce administrative burden such as: Prior authorizations Insurance-related communications Data gathering and documentation Opportunity to eliminate “busy work” and improve staff satisfaction  03:31 — Clinical Workflow Support AI can: Summarize patient charts, labs, and notes Organize large volumes of clinical data Enables pharmacists to: Spend less time preparing Spend more time in patient care and provider interaction  04:08 — Additional Opportunities: Supply Chain & Operations AI can support: Inventory management Purchasing optimization Multi-site coordination Benefits include: Cost savings Improved efficiency Better resource utilization 05:00 — Where to Draw the Line AI should not replace clinical decision-making Limitations include: Lack of experience and judgment Inability to incorporate patient values and preferences Final decisions must remain with clinicians.  05:42 — Preserving the Human Element Patient care involves: Trust Empathy Relationship-building Over-reliance on AI risks eroding patient confidence.  06:11 — Patient Interaction & Transparency Patients want to know: When AI is used How 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 visits Reduce documentation burden Important considerations: Patient consent Ability to opt out Privacy concerns  07:31 — Risks of Poor Implementation Poorly designed AI interactions can: Frustrate patients Reduce trust Healthcare AI must avoid: Impersonal experiences Inefficient 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 extraction Documentation speed Approval timelines Benefits: Faster patient access to therapy Improved staff satisfaction  10:07 — Clinical Decision Support Enhancements AI-driven rule systems: Identify high-risk patients Reduce unnecessary chart reviews Example outcome: Reduction in time spent reviewing charts without intervention Frees pharmacists for: Medication reconciliation Patient counseling  11:11 — Impact on Workforce Engagement Staff report: Increased satisfaction More 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 problems Key risks: Data security concerns Vendor quality variability Overlapping or redundant solutions  12:51 — Integration & Workflow Considerations Successful AI tools must: Integrate with EHRs Align with pharmacy workflows Avoid siloed systems Poor integration leads to inefficiency and adoption barriers  14:04 — Vendor Evaluation Considerations Assess: Clinical and operational expertise Product maturity Implementation effort Risk vs benefit Balance between: Ready-made solutions Custom-built tools requiring internal resources  14:56 — Practical Advice for Health System Leaders Develop a system-wide AI strategy Collaborate across departments (not siloed decisions) Engage: IT Legal Ethics teams Avoid duplicative solutions across service lines  15:31 — Building Organizational Readiness Be open to learning and experimentation Ask questions and maintain healthy skepticism Focus on: Improving workflows Enhancing patient outcomes Supporting workforce engagement  16:02 — Infrastructure & Speed of Innovation AI vendors move quickly Organizations must: Be prepared to adapt rapidly Avoid delays that hinder innovation Balance speed with governance and safety  16:27 — Closing Kerry thanks the guests for their insights Encourages continued exploration of AI’s evolving role in healthcare Reminder to subscribe and engage with VerifiedRx.   Subscribe Today! 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    Inside the Medicare Transaction Facilitator: Early Wins and Growing Pains

    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   Verified Rx Host    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 planning Early operational challenges Payment and data flow issues Lessons 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 competition Establishes a Maximum Fair Price (MFP) Medicare Transaction Facilitator (MTF): Operational system supporting: Data exchange Payment processing Coordination 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 webinars Formation of a multidisciplinary team Key roles involved: Pharmacy leadership Data analyst Business manager Reconciliation technician Revenue cycle team Responsibilities include: Tracking claims and payment status Managing 340B eligibility Reconciling payments across multiple systems (MTF, Beacon, internal systems)   03:54 — Enrollment Experience Enrollment process was relatively straightforward: Entity signatures System setup for remittance processing Complexity increased post-enrollment due to: Data fragmentation across systems Limited 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 finalization Up 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 reliably Lack 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 burden Limited staffing capacity   07:33 — Operational Evolution Processes are continuously evolving. Key success factors: Ongoing process refinement Strong internal documentation Rapid 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 processes Meticulous follow-up Strong 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 pharmacies Systems with fewer resources Emphasizes importance of operational efficiency and resource planning.   09:36 — Final Takeaways MTF implementation is: Complex Resource-intensive Still evolving Key themes: Strong cross-functional collaboration is essential Processes will require ongoing refinement Financial sustainability remains a concern   09:46 — Closing Carolyn thanks Jennifer for sharing insights and real-world experience. Reminder to subscribe, provide feedback, and stay engaged with VerifiedRx content.   Links | Resources:  Medicare Drug Price Negotiation Program: Click Here   Medicare Transaction Facilitator General Resources: Click Here   Pharmacy and Dispensing Entity Resources: Click Here   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed

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    Checkpoint Change: Rethinking How PD-1/PD-L1 Inhibitors Are Delivered

    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 pharmacokinetics Similar efficacy Similar 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 evaluated Much of a patient’s visit still involves: Waiting room time Laboratory testing Provider visits Care 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 mL Nursing 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 models Nursing workflows Equipment availability Infusion 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 departments Physician offices Freestanding infusion centers   08:06 — Strategic Timing Decisions Health systems may weigh: Operational advantages of subcutaneous administration Potential cost reductions from future biosimilars Some organizations may delay adoption until biosimilar competition arrives.   08:24 — Infusion Center Optimization Subcutaneous therapies could increase turnover. Some centers may develop “express lanes” for subcutaneous administration.   09:01 — Payer Influence If subcutaneous formulations are perceived as cheaper or operationally simpler, payers may: Restrict site of care Prefer administrations in physician offices or non-hospital settings.   09:45 — Key Questions for Health Systems Organizations should consider: What value does the new dosage form provide? Which patients benefit most from subcutaneous administration? How will payer policies evolve?   10:05 — Evaluating Clinical Value Institutions often approach new dosage forms with caution. Subcutaneous PD-1/PD-L1 inhibitors may not offer the administration time reductions seen with other biologics because there is not as large of a difference in administration times (30 minutes versus 5 minutes).   10:53 — Patient Selection Considerations Subcutaneous formulations may be most beneficial for patients: Receiving monotherapy With difficult IV access Patients receiving combination therapies may see less benefit since IV access is already required.   11:12 — Additional Patient Factors Some patients have low body mass or cachexia, making high-volume subcutaneous injections more difficult. Physicians may prefer individualized treatment decisions rather than blanket formulary changes. 11:33 — Final Thoughts Transitioning to subcutaneous PD-1/PD-L1 inhibitors involves clinical, operational, and financial considerations. Observation times, administration practices, and workflow models continue to evolve. Ongoing monitoring of emerging best practices is encouraged. 12:15 — Closing ongoing monitoring of emerging best practices. Listeners are invited to subscribe and follow VerifiedRx for future episodes.   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed

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    Winter 2026 Spend Management Outlook

    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 projections Acute vs ambulatory care trends Provider-administered vs self-administered drugs Biosimilar therapeutic insights Dynamic 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 edition Total 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 inflation Driven by: Sugammadex Kcentra Clotting 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: Keytruda Darzalex Faspro Continued growth due to: Expanded indications Increased 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, Rinvoq Diabetes / metabolic / weight loss: Ozempic, Wegovy, Mounjaro, Zepbound Spend growth fueled by: Media exposure Expanded indications Increased patient demand Opportunity for: Retail & specialty pharmacy optimization Margin capture Patient 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 therapies Expansion of value- and outcomes-based contracting Siteofcare shifts toward ambulatory and home Digital transformation & automation Supply assurance and resilience Expanded pharmacist clinical scope & workforce models Regulatory and policy efforts to lower drug prices 340B changes IRA 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 strategies Provider-administered vs self-administered drugs Identify top spend movers and align them with long-term market forces. Consider: Specialty pharmacy expansion Site 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 biosimilars Uptake driven by payer and PBM strategy Utilization varies widely based on: Formulary design Benefit 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 status Manufacturer 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 mandates Product presentation Supply chain logistics Billing & reimbursement complexity Clinical barriers are decreasing; workflow flexibility is critical. 13:09 — What to Expect From Biosimilars in 2026 Faster adoption timelines Earlier payer-driven switching Fewer preferred products Less reliance on reference product trial periods 13:45 — Biosimilars With Major 2026 Impact Eylea — multiple launches expected post-litigation Xolair — expansion into asthma/allergy and retail specialty Perjeta — oncology pathway disruption expected late 2026 / early 2027 15:01 — 2025 Biosimilars Impacting 2026 Ustekinumab (Stelara): broader formulary shifts Denosumab (Prolia, Xgeva): full year of impact; all interchangeable Eculizumab (Soliris): first rare-disease biosimilar entry 15:58 — FDA Biosimilar Guidance to Watch Late-2025 FDA guidance: Reduced reliance on clinical efficacy trials Greater emphasis on analytical similarity Aims to: Reduce development cost Accelerate market entry 16:26 — Interchangeability: Where Things Are Headed Moving toward expectation that all biosimilars are interchangeable. Shifts responsibility to: Payers Health systems Pharmacists managing transitions and education 17:17 — Biggest Shift in the Biosimilar Landscape Faster launches Larger scale adoption Payer strategy more influential than timing of approval Success depends on: Formulary fit Channel alignment Operational simplicity 17:41 — Final Biosimilar Insight Biosimilar strategies must be molecule-specific. One-size-fits-all approaches are no longer effective. 18:13 — Final Thoughts on the SMO Inflation projections are a starting point. Leaders should: Focus on top spend drugs Understand siteofcare and specialty drivers Translate projections into actionable budgets 18:40 — Resources Winter 2026 Spend Management Outlook available on Vizient’s SMO Hub. Includes current and prior editions and related insights. 18:58 — Closing Carolyn thanks Jeni and Heather. Reminder to subscribe, like, and share feedback. Verified Rx is produced by the Vizient Center for Pharmacy Practice Excellence.   Links | Resources:  Vizient Spend Management Outlook webpage Vizient Winter 2026 Spend Management Outlook Vizient Biosimilars Therapeutic Insights   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed

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    CDC Childhood Immunization Schedule Updates (January 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) Polio Tdap / DTaP Hib (Haemophilus influenzae type B) Pneumococcal HPV Varicella (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 A Hepatitis B Quadrivalent meningococcal Meningococcal group B Dengue 05:19 — What Changed vs. Stayed the Same Hepatitis A, Hepatitis B, and quadrivalent meningococcal moved from routine to high-risk RSV 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: Influenza COVID-19 Rotavirus Hepatitis A Hepatitis B Quadrivalent meningococcal Meningococcal 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 immunization schedule ACIP shared clinical decision-making recommendations   Vizient resource Minute Market Insight   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed

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    2026 OPPS Final Rule: What Hospitals Need to Know

    The Centers for Medicare and Medicaid Services has finalized the 2026 Outpatient Perspective Payment System (OPPS) rule, with most policies taking effect on January 1, 2026. Jenna Stern, Vice President of Regulatory Affairs and Public Policy at Vizient, joins host Carolyn Liptak, Pharmacy Executive Director in Vizient's Center for Pharmacy Practice Excellence, to discuss key updates to payment policies, payment rates, and quality provisions affecting Medicare beneficiaries receiving care in hospital outpatient departments and ambulatory surgical centers.   Guest speaker:  Jenna Stern Vice President of Regulatory Affairs and Public Policy Vizient Host:   Carolyn Liptak, MBA, RPh  Pharmacy Executive Director Vizient    Show Notes: 00:05 — Introduction Announcer welcomes listeners to VerifiedRx. Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the episode focus: the 2026 CMS Outpatient Prospective Payment System (OPPS) Final Rule. Guest: Jenna Stern, VP of Regulatory Affairs and Public Policy at Vizient. 01:12 — Overview of the OPPS Final Rule OPPS sets Medicare payment for most hospital outpatient services. Published annually (typically November), effective January 1. Covers payment rates, policies, quality programs, and compliance requirements. Note: CMS delayed enforcement of hospital price transparency requirements until April 1, 2026. 01:34 — Key Takeaways From the 2026 Final Rule Jenna’s high-level insights: Hospitals will continue facing financial pressure in 2026. Modest payment rate increase combined with reimbursement-reducing policies. Expansion of site-neutral payment policies will be particularly impactful. Rule reflects emerging administration priorities shaping future policy. 02:21 — OPPS Payment Rate Update for 2026 CMS finalized a 2.6% OPPS schedule increase factor for hospitals meeting quality reporting requirements. 02:40 — What the 2.6% Increase means Based on: 3% market basket update –0.7% productivity adjustment Results in a modest net increase. Slightly better than the proposed 2.4% increase, though still viewed as inadequate. CMS estimates $8 billion increase in total OPPS payments compared to 2025. 03:37 — 340B Remedy Offset: Background From 2018–2022, CMS paid for 340B drugs at ASP –22.5%. Prior Supreme Court decision from 2022 found that CMS lacked authority to vary rates as finalized in prior rulemaking (e.g., without using drug acquisition cost surveys to inform policy). 04:13 — 340B Remedy Offset in the 2026 Final Rule CMS considered increasing the remedy offset from 0.5% to 2%. Stakeholders strongly opposed the increase due to hospital financial strain. 05:10 — Final Outcome CMS retained the 0.5% offset for 2026. CMS signaled that larger offsets may be proposed for 2027. This marks the first year the remedy offset takes effect, 06:00 — Site-Neutral Payment Policy: What It Is Concept: same service = same payment, regardless of site of care. Hospital concern: policy reduces hospital reimbursement without accounting for site of care differences, patient acuity, overhead, or service complexity. 06:15 — Site-Neutral Expansion in the 2026 Rule CMS expanded site-neutral payment to include drug administration services at excepted off-campus provider-based departments. 07:08 — Financial Impact Reimbursement aligns with Physician Fee Schedule rates. CMS estimates $290 million reduction in outpatient spending for 2026. $220 million of savings accrue directly to Medicare. Not implemented in a budget-neutral manner. 08:14 — Non-Opioid Pain Management Payments Temporary additional payments began January 1, 2025. Authorized under the NO PAIN Act (Consolidated Appropriations Act of 2023). 08:28 — What’s New for 2026 CMS finalized the renewal of: 5 drugs 13 medical devices eligible for separate payment in HOPD and ASC settings. Per statue, payments available through December 31, 2027. 09:32 — Process Improvements CMS will allow more frequent consideration of new qualifying products (not limited to annual updates). Quality criteria unchanged; timing flexibility added. CMS released guidance on how stakeholders can engage for inclusion. 10:58 — OPPS Drug Acquisition Cost Survey CMS finalized plans to survey hospitals on acquisition costs for separately payable OPPS drugs. 11:21 — Why CMS Is Advancing the Survey Addresses Supreme Court requirements from prior 340B litigation. Aligns with White House Executive Order on lowering drug prices. Positions CMS to use survey data for 2027 rulemaking. 12:47 — OPPS Packaging Thresholds for 2026 Drugs and biologics: Threshold remains at $140. Diagnostic radiopharmaceuticals: Increased to $655 (from $630). Products below thresholds retain Status Indicator “N” (packaged payment). 13:26 — Why Billing Packaged Drugs Still Matters Even though not separately payable, hospitals must bill for packaged drugs. Billing data feeds cost reports used to calculate future bundled payments. Failure to bill can result in inaccurately low reimbursement. 14:14 — Elimination of the Inpatient-Only (IPO) List CMS finalized a three-year transition to eliminate the IPO list by January 1, 2029. 14:32 — Why This Change Is Significant IPO list historically ensured certain services were provided inpatient only. CMS emphasizes provider judgment in determining site of care. Raises concerns about: Patient safety Payer coverage changes Pressure to move services outpatient 16:28 — ASC Covered Procedure List Expansion CMS expanded the ASC Covered Procedure List. Enables more Medicare covered services to be performed in the ASC settings. 16:48 — Price Transparency: Still a Priority No major overhaul, but continued refinement. CMS exploring new uses of price transparency data beyond patient comparison. 17:46 — Most Critical Policies to Watch Jenna highlights: Modest OPPS payment increase Site-neutral payment expansion 340B remedy offset Drug acquisition cost survey Broader regulatory activity beyond OPPS 18:43 — Available Vizient Resources OPPS Final Rule Summary Government Relations & Public Policy Summaries  Advocacy 19:20 — Closing Carolyn thanks Jenna for her insights. Reminder to subscribe, like, and share feedback. VerifiedRx is produced by the Vizient Center for Pharmacy Practice Excellence.   Links | Resources:  Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots: Click Here CMS fact sheet on the Final Rule: Click Here Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey: Click Here Vizient Office of Public Policy and Government Relations final rule summary:  Click Here Final List of Qualifying Products for Separate Payment for non-opioid pain medications: (Table 136, pgs. 1138-1140)   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed

    20 phút

  8. 30/12/2025

    The GOAT of GPO’s

    Pharmacy buyers play a critical role in keeping hospitals running—and their partnership with a GPO can make all the difference. In this episode of Verified Rx, Jackie Stokes sits down with Theresa Brown and Michelle Crump, two powerhouse pharmacy buyers and members of Vizient’s Pharmacy Technician Committee, to talk about the tools, programs, and peer networks that help them thrive in their roles. From leveraging pharmacy analytics to navigating shortages, maximizing NovaPlus value, and strengthening buyer-to-buyer collaboration, this episode is packed with insights to help pharmacy teams work smarter, save money, and support better patient care.   Guest speakers:  Theresa Brown National Pharmacy Purchasing Specialist Prospect Medical Holdings   Michelle Crump, ASBA, CPhT National Certified Pharmacy Technician Buyer Pharmacy Host: Jackie Stokes Program Services Manager Center for Pharmacy Practice Excellence (CPPE) Vizient   Show Notes: [00:48] — Guest Introductions Theresa National pharmacy purchasing specialist Background: inventory control, home infusion startup, pharmacy technician educator [01:14] — Michelle Nationally certified pharmacy technician since 2016 Pharmacy buyer at a small independent county critical access hospital Transitioned from accounting into pharmacy purchasing   [01:26] — The Role of Vizient in Supporting Pharmacy Buyers Theresa: Biggest benefit: relationship with pharmacy executive & sourcing team Uses Pharmacy Analytics (formerly VSAP) to evaluate spend and inventory control across 63 facilities   [02:16] — How Pharmacy Analytics Supports Buyers Theresa: Data mining on spend increases/decreases Tracks product returns Identifies sharing opportunities to prevent waste [02:59] — Michelle’s Experience Analytics helps mitigate waste Collaboration with other buyers has been essential — especially for someone new to the buyer role Learns navigation of Vizient systems and how to work with the local GPO Peer support helps demystify a “diverse and complex” buyer role   [04:02] — Value of the Vizient Pharmacy Technician Committee Provides national peer networking Helps buyers learn from subject matter experts Even highly experienced buyers (35+ years) learn from every call   [04:41] — Vizient Programs: NovaPlus, NES, Forum Calls, Hot Info Bimonthly Forum Calls Provide regulatory updates Help expand buyer knowledge in real time Hot Info Weekly Updates Keeps users informed on inventory, shortages, spend impacts [05:31] — Michelle on Program Impact Calls and shared expertise were critical when she was new NovaPlus program especially valuable in critical access settings   [06:32] — Deep Dive: How the NovaPlus Program Works Michelle explains: NovaPlus (Y-label) aligns with manufacturer-labeled products (M-label) Quarterly rebates provide significant savings Critical access hospitals benefit via 340B optimizer software that extracts outpatient utilization to qualify for discounted M-label purchasing Can result in “significant savings” depending on contract structure   [08:38] — What If NovaPlus Pricing Isn’t the Best Price? Michelle: Buyer’s responsibility to identify price discrepancies Communicates with Vizient representative to reassess contracting needs Often resolved through rebates or future price adjustments [09:30] — Theresa: Price challenges taken seriously Many result in price reductions visible in Hot Info the next week Demonstrates importance of strong GPO relationships   [10:07] — Understanding NES: NovaPlus Enhanced Supply Theresa: Her hospitals are exploring NES participation Requires 90% compliance (higher than standard 80%) Benefits include prioritized product access during shortages Critical when national backorders exceed 200+ items Ensures better patient care continuity   [11:34] — Supply Assurance & Mitigation Strategies Michelle: During the North Carolina hurricane, Vizient’s mitigation strategy was “imperative” Vizient engaged Baxter directly to resolve critical fluid shortages Small hospitals especially reliant on support in crisis situations [12:36] — Theresa: Shortage team provides substitution guidance and clinical appropriateness information Vizient recommendations support discussions with local clinical teams Crucial during COVID start date — her first day in national role   [13:23] — Continuing Education (CE) Programs Theresa: Vizient CE programs help maintain technician licensure Webinars are interactive, engaging, and more informative than generic CE resources   [14:07] — Networking and Pharmacy Aggregation Groups (PAGs) Theresa: PAGs offer cost savings and peer collaboration Ability to share information and bring value back to her own network [14:44] — Michelle’s Example of System-to-System Collaboration Shared compounded syringes (from a 503B facility) with another hospital to prevent waste Highlights real-world benefits of PAG networking   [15:52] — Addressing National Challenges Together Theresa: PAG roundtables help uncover shared struggles (e.g., DSCSA serialization issues) Members provide actionable advice on what’s working in their systems Reinforces “we’re all in the same boat”   [16:50] — Supporting and Elevating Pharmacy Technicians Jackie’s goal: Support technicians and recognize the value they bring Committee exists to uplift and empower pharmacy buyers/techs [17:05] — Michelle: Worked with leadership to create a tiered technician level system Helps techs gain skills, feel valued, and earn raises Improves career satisfaction and retention   [17:46] — Closing Reflections Theresa: Being part of Vizient is “an honor and a privilege” Values shared knowledge and strong relationships [18:00] — Michelle: Gratitude for collaboration and guidance over the years Vizient connections were vital for adapting to the buyer role   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! 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    19 phút
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Delivering short doses of insight for hospitals’ frontline pharmacy professionals, the Vizient pharmacy team brings together experts to verify best practices for navigating today’s pharmacy practice challenges and accelerating career growth. It’s a prescription for success, delivered by the Vizient Center for Pharmacy Practice Excellence.

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    Vizient Center for Pharmacy Practice Excellence
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    2020 - 2026
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    VerifiedRx

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