『VerifiedRx』のカバーアート

VerifiedRx

VerifiedRx

著者： Vizient Center for Pharmacy Practice Excellence
無料で聴く

概要

 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.Copyright 2025 All rights reserved. マネジメント マネジメント・リーダーシップ 科学 経済学 衛生・健康的な生活 身体的病い・疾患
エピソード
  • Winter 2026 Spend Management Outlook

    Winter 2026 Spend Management Outlook
    2026/02/03
    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 Center for Pharmacy Practice Excellence  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 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 84% projected drug inflation for purchases between July 2026 – June 2027.Down from 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 03% projected inflationDriven by: SugammadexKcentraClotting factors Ambulatory Care 85% overall, but with key divergence: Provider-administered drugs:35%Self-administered drugs: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 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; ...
    続きを読む 一部表示
    20 分
  • CDC Childhood Immunization Schedule Updates (January 2026)

    CDC Childhood Immunization Schedule Updates (January 2026)
    2026/01/27
    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 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: Additional 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 ...
    続きを読む 一部表示
    12 分
  • 2026 OPPS Final Rule: What Hospitals Need to Know

    2026 OPPS Final Rule: What Hospitals Need to Know
    2026/01/13
    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 Verified Rx Host 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 drugs13 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 ...
    続きを読む 一部表示
    20 分
まだレビューはありません