The topic of today’s podcast, I’ve called it a December to remember and know it is not a Lexus commercial. It’s a December to remember, no? and some other good things that happen in pharmacy 2020. Well, what are you? I mean, wow.

I don’t even know where to begin. I mean, we all know how absolutely horrifying 2020 was. It was… words fail me of how difficult 2020 has been for all of us.

Dealing with the pandemic on a personal level, it was one of the most excruciatingly painful and emotional years for me.



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What you will learn

  • After a HELL year why it’s a December to Remember for pharmacy
  • Rutledge vs PCMA
  • Ninth Circuit Reinstates HIV Discrimination Claims Against CVS Prescription Drug Mail-Order Program
  • California State Board of Pharmacy Waivers for Covid-19 Vaccinations
  • PrEPping for PrEP and PEP
  • Getting the Covid-19 vaccine

Links & Resources

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Hi, this is Michelle Sherman, president of Michelle Rex pharmacist consulting services and your host of the conscious pharmacist podcast. The conscious pharmacist podcast is a proud podcast of the pharmacy podcast network. And we are proud to be part of the pharmacy podcast for me, the topic of today’s podcast, I’ve called it a December to remember and know it is not a Lexus commercial. It’s a December to remember eight, no, and some other good things that happen in pharmacy 2020. Well, what are you? I mean, wow. I don’t even know where to begin. Right. I mean, we all know how absolutely horrifying 2020 was. It was words fail me of how difficult 2020 has been for all of us dealing with the pandemic on a personal level, it was one of the most excrutiatingly painful and emotional years for me as is all my listeners know.

And from previous podcasts I lost my father when Dell Sherman on July 31st, and it’s been excruciating, it’s been excruciating. The darkness of 2020 has been unimaginable. And as the conscious pharmacist, I have to sit and bring myself back to center back to focus, digging deep within myself to find the light and December as a pharmacist and as pharmacists and, you know, fighting for the pharmacy profession and being an active general in the farmy, if you will. There was a lot of light for pharmacy in December. And that’s why I’ve called this episode December to remember. And now it’s not the Lexus ed, but what happened in this in December? So let’s just start on December 6th, the ruling, the Supreme court ruling came down you know, Rutledge versus PC MMA. And we as pharmacists and all those within the pharmacy industry had been waiting with bated breath for this ruling to come down from the Supreme court.

And this was an eight, no ruling. Judge Amy Coney Barrett was not able to participate in this ruling. And therefore the, the ruling from the Supreme court was eight and Oh, and it was a unanimous ruling against the PCMA and a great one for Leslie Rutledge, the attorney general of the state of Arkansas and this ruling really brought to light how States are able to now go forward and bring these prescription benefit managers into check, which is way, way, way beyond time that we can do this, all this egregious shenanigans and bad practices and absolute highway daylight, highway robbery, and thievery being put forth by this prescription benefit managers on a daily basis to employers, to patients and to, and to community pharmacies is absolutely egregious. And this hopefully this this ruling by the Supreme court will really hold this in light.

And we can now move forward to, to stop this, this behavior, this absolutely like ridiculousness from, from the PBMs the opinion was, was delivered by justice, Sonia Sotomayor, and she delivered the opinion on December 10th. And I will put the whole Supreme court opinion a link to it in, in the resources here. So you can read it when, when you, when you have time, but this was a great win and kicked off December with some good strategy going forward for, for pharmacy and some good things happening for pharmacy. The next thing happened on December 9th. So that was a busy week for good rulings against these monsters, these PBMs for discrimination and bear behavior coming down. So the first one was from the Supreme court of the United States

You know

And ignore decision for Leslie Rutledge and the state of Arkansas against PCMA and the PBMs. The, the one on December 9th was also a great one. And as an HIV pharmacist are welcomed as with open arms. So this one was a lawsuit from consumer watchdog, which has been very aggressive in going off the insurance companies and PBMs over the years for discrimination against people living with HIV. So on December 9th, the Supreme court, the ninth circuit court of appeals reinstated that HIV discrimination claims against CVS prescription drug mail order program. What happened was, was that CVS came across, requiring people with HIV to get the prescriptions through the mail order specialty. And you can’t see me, but I’ve got massive quotation marks pharmacy, and not allowing them to utilize their own local HIV specialty community pharmacies, where they have pharmacists that they know like, and trust who have been taking care of them for many years.

Now, one thing to remember is that this ruling by the ninth circuit, not only includes HIV medications for HIV infected patients, but it was also a discrimination against those patients seeking prep and pep. So that is also included in this. So CVS came off, cannot force people that are trying to take care of themselves by being on prep, to utilize and be forced to use the mail order pharmacy. And as an advanced practice pharmacist who prescribes prep for some of my patients, I’ve had this come up many times where my patient cannot go utilize the local community pharmacy that they know like, and trust that has been providing prep to them for a long time. And they’ve now been forced to go and use CVS Caremark is a mail order pharmacy to provide a prep. We know what happens. I don’t have to tell any of you, my listeners, what this means that the HIV patients, the prep patients half the time they drugs never arrive on time. And we know all the challenges that go along with being forced to mail order pharmacy. So I’m not going to go into it in, in, in this protocols, but we all know what those are. So the ninth circuit overturned a lower court decision holding,

You know, that the

Lower court actually ruled basically CVS could destruct discriminate against people who are living with HIV. So the ninth court of appeals reversed the lower court decision that found that plaintiffs had not adequately alleged the disability discrimination claim, finding the plaintiffs properly alleged that CVS may order program violated the anti-discrimination provisions of the affordable care act. The decision is an important victory for HIV patients who sought to vindicate their healthcare rights and octane the life sustaining medications in a medically appropriate mannequin manner. So Jerry Flanagan of consumer watchdog. So this opinion from the ninth circuit is also available in, in the resources here. So you can go and read, read through this and everything. So this was a huge one for people living with HIV and people at accessing prep at CVS Caremark cannot force HIV infected patients or people seeking prep and pep to utilize the mail order pharmacy.

Now, you wonder why this is like crazy. So when, when I prescribe prep for, for some patients, some of them choose to go to CVS and they go to CVS specialty pharmacies that live day in and day out, providing prescriptions for people, living with HIV and prep, and even those CVS specialty pharmacies or unable to fill these prescriptions for these patients, they are still forced to go to the mail order, CVS Caremark best pharmacy, somewhere out there that doesn’t take care of patients. We all know that we all know that’s true. So right at the beginning of December, great huge wins for pharmacy, the Rutledge the HIV discrimination lawsuit overturned and, you know, upheld by the non circuit of appeals for HIV discrimination against CVS Caremark.

What, what else happened? So

You know, on 1217, the California state board of pharmacy issued some waivers allowing pharmacists to administer

COVID vaccines. So

Waiver, which became effective December 17th and expires on February 28th, 2021 States that a pharmacist shall not required be required to notify each pace patients, primary care provider Of a COVID 19 Vaccination administration under the provisions of 16 CC or section 1740 6.4 under the following condition, the patient receives a copy of the CDC immunization code or printer that documents, what COVID vaccination was administered the date and where the vaccination was received. The patient is advised that the primary care provider will not be provided with such a notification. And if the pharmacist has access to shared patient record system, the pharmacist must comply with the rules

Requirement. So

That was a huge thing. On 1222 the board also issued another waiver that allows the administration of vaccines by pharmacy technicians. Once they’ve undergone some training. So this is allowing the state of California to ramp up administration of vaccines. COVID vaccines to the community and

Help with, with the,

You know, the eradication of COVID 19 in California, which as you all know, is absolutely buckling under the pressure of new infections right now.

Another great thing that was released and our last podcast was on this on the prep training by the California pharmacists association for pharmacists to be able to provide prep and pep and the SB

One, five, nine,

There’s a link also to the CPHI training for any pharmacists that are interested in undergoing this providing prep and pep or huge public health initiatives having easy access to the, the access of prep and pep from, from community pharmacies is really going to uptick the use of prep and pep in the state of California and hopefully decrease HIV infections. When we all talk about ending the HIV epidemic it’s a multi pronged approach. We’ve got to get people tested and people that are positive on treatment, because we know when they undetectable and have been undetectable for six months, undetectable is untranslatable, you equals you. They can’t transmit the virus to somebody else, but we also have to protect people that are HIV negative and people that are at high risk. If they go on prep, they can protect themselves 99% effective with the use of daily prep in protecting themselves from getting HIV.

And then of course, pep the non-occupational post-exposure prophylaxis very easy to access your community pharmacy, get, get pet and protect yourself. Well within that 72 hour window of the HIV exposure. So you know, all, this is really great steps in the right direction in reducing and ending the HIV epidemic in California and other States have adopted, you know Colorado now allows pharmacists to prescribe prep and pep. So these initiatives are being adopted across the country. Another great positive step in the direction of pharmacists has healthcare providers helping our patients take care of their health and then to wrap up the year was a personal gift that was afforded to me on 1231, I received the Medina COVID 19 vaccination. And it was so I felt so grateful and thankful and felt privileged that I was able to get this vaccine. I will get the second dose on the 28th of January. And it was a great step forward. And, you know, for me personally felt like a great way to, in such a

Horrible, horrible dark.

So I was very grateful and thankful to receive the vaccine for all the listeners out there as far as side effects and things like that. But the only real side effect that I experienced was the pain at the injection site. I didn’t feel like when the nurse gave me the injection initially, I didn’t even know she’d done it. I couldn’t feel a thing. And throughout the first day it felt fine. It was the next day, new year’s day when I really could feel the pain at the injection site and it lost it for about three days, getting less and less and nurses for three days passed. And then that was the only side effect that I, I felt also what I did was I signed up for the CDC vaccine information and received like texts from the CDC every day to discuss her, you know, to notify them how it felt and if I experienced any side effects.

So I would encourage all of you to do the same if, you know, if, and when you get the vaccine and for those of you that have it, you know, we’re, we’re really helping along. So I was very grateful and felt privileged to be able to get the vaccine to protect not only myself and my family, but my patients as well. So I feel, you know, when, when so many healthcare providers or not getting the vaccine or people are not sure whether they want to get the vaccine. For me, it was a choice for me getting the vaccine. I’m protecting my family, myself and my patients. If I’m getting COVID. So this is how the year ended. So you, what we’ve gone through today on the podcast, you can see really, was it December to remember? We, we struggled, we be fighting PBMs for years and years and years and years, and to be able to get the Ratledge ruling from the Supreme court for, for the ninth circuit to turn the lower court’s ruling about a CVS came up discriminating against people with HIV.

That’s huge. The, the California board of pharmacies waivers for allowing pharmacists and technicians to provide COVID-19 vaccines or so huge. The, the prep training that’s now available for pharmacists in California, to be able to fulfill their obligation in SB one, five, nine, and then ultimately ending on a personal note with me being able to get the COVID vaccine. So I look forward to a great year of guests and podcasting from the conscious performances podcast in coming episodes. We’ll talk about what’s coming up with Michelle X consulting and our podcasts, and just everybody stay safe out there. Let’s fight the fight and, you know, remember all of you, we’re not, we don’t want to be the change. You all are the change. So until next time, we’ll see you on the other side.