Hosts:

John Kitchens, MD

Scott Krzywonos

Guest:

Shane Dixon, Vice President of Vision, Strategic Advancement & Business Development, Cencora Specialty GPO

Show Summary:

In this episode, John and Scott continue their coverage of the Cencora Vision Exchange meeting with an in-depth conversation about the economic, policy, and operational forces reshaping retina practices. The discussion opens with key takeaways from the meeting’s opening sessions, including a deep dive into drug pricing policy, the downstream impact of federal legislation on how retina practices are reimbursed for care, and the coding and billing changes showcased at the Cencora Vision Exchange meeting.

John then sits down with Shane Dixon, VP at Cencora Specialty GPO, to unpack what a Group Purchasing Organization actually does—and why its role has become increasingly critical. Drawing on his experience as a physician assistant, former Regeneron launch leader for Eylea, practice executive, private equity operator, and now GPO executive, Shane offers a rare, 360-degree view of how drugs move from manufacturer to patient, how contracts are structured, and how practices can survive tightening margins.

Topics Covered:

1. Key takeaways from the Cencora Vision Exchange meeting
2. Federal drug pricing policy and “Most Favored Nation” pricing
3. How government policy is reshaping retina drug economics
4. Coding and billing risk, including increased scrutiny of Modifier 25
5. CMS’s use of AI for claim detection, audits, and recovery
6. Declining surgical reimbursement and its impact on access to care
7. The collapse of the Good Days patient assistance fund and what replaces it
8. What a Group Purchasing Organization (GPO) is and how it works
9. How Cencora’s GPO leverages scale, segmentation, and contracts
10. Differences between private practice and large aggregators

Key Quotes:

1. “The way we get paid for drugs is going to fundamentally change—and it’s going to change fast.” — John Kitchens, MD
2. “We’re not just doing contracts. We’re helping practices think strategically about how they operate.” — Shane Dixon
3. “Documentation isn’t optional anymore. ‘I didn’t know’ is not going to cut it.” — John Kitchens, MD

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube

Hosts:

John Kitchens, MD; Scott Krzywonos

Guest:

Eric Besse, Vice President & General Manager, Besse Medical (a Cencora company)

Show Summary:

In this episode, Scott and John return from the Cencora Vision Exchange meeting in Dallas and sit down with Eric Besse, VP and General Manager of Besse Medical, to unpack the unseen infrastructure that keeps retina practices running. Eric shares how his family’s corner pharmacy grew into one of the most influential specialty distributors in the country and explains why drug distribution is far more than logistics — it’s practice support, financial stewardship, technology integration, and practice-level partnership.

The conversation spans everything from cold-chain handling and inventory management to sustainability and the future of practice support. For retina specialists, this is a rare, behind-the-curtain look at the systems that make allow retina practices to operate smoothly.

Topics Covered:

• What the Cencora Vision Exchange meeting is and who attends
• The family origins of Besse Medical and its growth into a national distributor
• How Cencora and Besse Medical fit together
• Why distributors manage more than just shipping
• Technology platforms such as CubixxMD and PODIS
• How drug distributors support retina workflows, billing, and compliance
• The importance of stable, long-tenured support teams for practices
• Cencora’s new recyclable, corrugated cold-chain packaging initiative

Key Quotes:

• “We don’t want to be viewed as a distributor that picks, packs, and ships product. We want to be more than that, and we push ourselves to be more than that.” — Eric Besse
• “If the soda fountain down the street puts two cherries on top, you put three. If they put three, you put four.” — Eric Besse, on his family’s philosophy of service
• “If I were starting a practice today, [Cencora] would be the first place I would turn to partner.” — John Kitchens, MD

Hosts:

John Kitchens, MD

Scott Krzywonos

Guest:

Alexander Gaffney, VP of Regulatory Policy & Intelligence, Agency IQ / POLITICO

Show Summary:

In this episode, Scott calls in from the Outer Banks to discuss two major clinical headlines before turning to federal policy. First up is the PRIMA retinal prosthesis, a wireless subretinal chip that helped patients with geographic atrophy regain partial reading vision. Then, Scott and John analyze the rapidly expanding — and often contradictory — body of research on GLP-1 receptor agonists and their links to retinal disease.

In the second half, they welcome Alexander Gaffney from POLITICO’s Agency IQ for a deep dive into how the ongoing government shutdown and widespread staff reductions are affecting the FDA’s ability to review and approve ophthalmic therapies. From PDUFA carry-over funds to workforce attrition, Alec explains why the true impact may not be the shutdown itself, but the backlog that follows.

Topics Covered:

• PRIMA retinal implant: wireless innovation and its surgical challenges
• The trade-off between functional vision gains and expanded atrophy area
• GLP-1 receptor agonists: mixed data on AMD, DR, and DME risk
• FDA shutdown implications for ophthalmic trials and approvals
• The reduction in force across FDA divisions and its effect on review capacity
• How new leadership and the National Priority Voucher Program aim to modernize the agency
• Why backlogs could extend into 2026 for gene therapy and TKI programs

Key Quotes:

• “I’m less worried about the shutdown itself — I’m worried about what happens afterward.” — Alexander Gaffney
• “You might not be able to read or drive, but that peripheral vision is what lets you move through the world. Losing more of that matters.” — John Kitchens, MD
• “We don’t always know what we’ve lost — how much faster certain drugs might have reached patients.” — Scott Krzywonos

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube