Community Pharmacy Freedom, Cash-Based Models & AI-Powered Medication Optimization | TWIRx

Today’s episode of This Week in Pharmacy — #TWIRx is sponsored by Value Drug Company and explores two major forces reshaping pharmacy: the evolution of the community pharmacy business model and the expanding role of artificial intelligence in medication optimization and value-based care. PART ONE: The Impact of the Cash-based Community Pharmacy Special Guest: Rick Seipp, PharmD President, Value Drug CompanyCommunity pharmacy is entering a new era. In Part One, Todd Eury sits down with Rick Seipp, PharmD, President of Value Drug Company, to discuss the continued evolution and expansion of independent community pharmacy and the many different business models emerging across the profession. Independent pharmacy owners are increasingly evaluating new ways to build sustainable businesses while creating greater professional freedom for pharmacists. One of the most interesting developments is the growth of cash-based and cost-plus pharmacy models that reduce or eliminate dependence on traditional insurance reimbursement and PBM-controlled prescription economics. These models can give pharmacy owners greater control over pricing, patient relationships, clinical services and the overall direction of their businesses — while allowing pharmacists to practice with significantly less interference from insurance companies and pharmacy benefit managers. Two pharmacies in the Pittsburgh region are demonstrating how powerful this model can become:Blueberry Pharmacy — Kyle McCormick, PharmD has built Blueberry Pharmacy around a transparent, cash-based model designed to simplify prescription pricing and create a more direct relationship between the pharmacist and patient. Forward Rx Pharmacy — Brandon Antinopoulos, PharmD is another emerging example of how pharmacists can create innovative pharmacy businesses built around transparency, accessibility and freedom from many of the traditional constraints of third-party reimbursement. Todd and Rick discuss what these models mean for the broader independent pharmacy marketplace and why community pharmacy may be moving toward a much more diversified future. Sponsored by Value Drug Company, a pharmacist-led wholesale distribution partner committed to supporting the continued growth and independence of community pharmacy.https://lnkd.in/ehf76qUsPART TWO: AI-Powered Medication Optimization Special Guests:Yoona Kim, PharmD, PhDCo-Founder & CEO, ArineJenny Behan, PharmDLead Clinical Pharmacist, ArineIn Part Two, #TWIRx shifts from pharmacy business innovation to one of the most important developments occurring in clinical pharmacy: the use of artificial intelligence to optimize medication therapy at scale. Arine is an AI-powered medication optimization platform designed to improve patient outcomes and reduce healthcare costs by helping ensure patients receive the most effective and appropriate medications. Listen to This Week in Pharmacy — TWIRx on the Pharmacy Podcast Network across Apple Podcasts, Spotify, Amazon Music, iHeartRadio, YouTube and all major podcast platforms. Pharmacy Podcast Network — Amplifying the Voice of Pharmacy.

• 0:05Speaker 00

  You are listening to the global network of podcasters dedicated to the pharmacy profession. Welcome to the pharmacy podcast network.

• 0:39Speaker 01

  Hey, we are here with Rick Sype. He's back on twerks. Rick, it's so good to see you.

• 0:44Speaker 02

  It's great to be on the program and thanks for coming and visiting us.

• 0:47Speaker 01

  We get to be at value drug companies headquarters here. It's Duncanville, right?

• 0:54Speaker 02

  Duncanville, yes.

• 0:55Speaker 01

  Duncanville.

• 0:56Speaker 02

  We're so happy to have you here.

• 0:58Speaker 01

  Well, I got to tour the facilities and I was blown away. The modernization, the automation, the conveyor belts, but as John De James said, the cleanliness of this facility is just amazing. And it doesn't, I was talking to Kathy and she said, we're about 10 years old. This place looks brand new.

• 1:19Speaker 02

  Really appreciate that. The team has a lot of pride in what they do every day, making sure we're supporting our pharmacies. But if you can't keep the warehouse clean, that's, that's the product that are getting into patients' hands. So we're trying to make sure that everything is, is ready and, and ready to use for our patients. So.

• 1:37Speaker 01

  Values Drug, Value Drug Company, your, your growth is phenomenal. You're, you've reached your 90th year.

• 1:47Speaker 02

  Yes, we're actually, this is your 93 for us. So.

• 1:50Speaker 01

  And the changes from my perspective is pharmacy is going through massive change in and of itself. We're leaning much more into clinical services. We're spending a little bit more time with the clients or the patients that are dealing with our chronic disease states, backing that up with products that are constantly there. Last time you were on twerks, we were talking about the importance of getting the product, the timeliness of it, the shipping of it. Today, we're going to shift into the same element of change and some of that change starts falling into that cost plus model. Shout out to Mark Cuban,

• 2:31Speaker 01

  Cost Plus Drugs and what they've done throughout the nation and bringing attention. Not so much him as a, as a source. That's not where I like to go per se. I'm always about the independent community pharmacy and, and value drug company, but he brought a lot of attention to the term and people got curious. People started digging in and they realized, holy cow, PBMs and the way that their yesteryear model is now being forced to change because they're just not accepting it. So talk to us about the evolution of how value drug is now that next generation wholesaler, full line wholesaler and not kind of like the way it was 20, 50 years ago.

• 3:12Speaker 02

  Absolutely. And, and we're very proud that we partner with all of our pharmacies and our shareholders and even our non shareholders. So any independent pharmacy, we're happy to service and, but it's not just servicing, it's partnering. And when you're partnering, you need to make sure you understand where they're going and meet them there. So as you mentioned, we're happy, want to make sure the product is getting there securely and without problems and clean. But at the same time, the pricing models are really important as well. So as reimbursement has continued to be less and more restrictive, there's some evolution to cost plus and cost plus pharmacies, especially the pharmacies that just won't

• 3:55Speaker 02

  accept third party contracts or PBMs. And they're trying to make sure that they can service their patients efficiently, effectively, and have that patient care. And they could do that for minimum cost. And we have two very strong partners out in the Pittsburgh market and Forward RX and Blueberry Pharmacy. And we have been very happy to pilot with them, our cost plus program for the last several months. We're finishing our pilot here in the next month or so, and then we will be rolling that out to any pharmacy that like to within our, within our area. And really it's a matter to get them cost of goods, very reasonable for, for generic products. So they can turn around and then have even

• 4:38Speaker 02

  more patients to be able to be serviced by them and take care of many of those burdens that they would have otherwise. They don't have to contract with their parties, et cetera. And at that point in time, it's a win-win for them and their pharmacies. They don't have to worry about the issues that they run into with other wholesalers and just, just eases that burden.

• 4:59Speaker 01

  There's a freedom in that. The relationship that you have with your patients as an independent community pharmacy, there's freedom just at that starting point. But then when you add into that a cost plus model, you really get to drill down into care much more and you're not being dictated by a formulary, you're not being dictated by pricing changes. I think it's a safer environment in a lot of ways, too. More of this information is going to come out of the practice. More pharmacies throughout the nation are moving to cost plus drug. I've talked to several owners throughout the nation who say when they're opening stores that have been closed down based on Rite Aid closing or someone going

• 5:40Speaker 01

  out of business and they're picking up stores, they're taking a time out and saying, maybe this needs to be my cost plus. And now they have four or five stores in the, in the traditional model, and now they have a new store that's coming out in, in the cost plus model.

• 5:55Speaker 02

  We see more and more of those type of different, I'll say, classes of trade or subclasses of trade of pharmacies for sure. And I think you'll see more evolution even in third party payers as well, going to a cost plus basis in the next probably five years, even for brand products as well. The changes that are happening from regulations, from the federal government and making sure that costs are controlled and contained and, and pulled out of the system really lead to that. But the most important piece is that they're able to care for their patients. Just visited one of those cost plus pharmacies in the last several weeks and talked about really taking care of those patients and talking about them holistically, not just their medication, but nutrition and other areas as well. And

• 6:39Speaker 02

  that should be really what's happening in that frontline engagement with patients in the pharmacies, because we are really the most readily, readily available provider for, for healthcare for patients. And, and they're taking advantage of it, which is so great to see.

• 6:53Speaker 01

  And then there's the ability to add on. So as I'm walking through the warehouse and I realizing the OTC products that are available, the creativity that your client base could shout out to the rep that is the value drug rep and saying, hey, let's start carrying something on purpose in order to a back to school special or something seasonal. But something that's exciting me is with the cost plus drug models, it's going to become the creativity of the owner in DME, for example. And the reason is, is because the, the element of long-term care pharmacy at home, that's the buzzword right now. And now you can surround

• 7:37Speaker 01

  them with more than just a product or more than just a medication. So talk to us about the other product portfolio that really complements not only cost plus drugs, but also their element of long-term care at home.

• 7:49Speaker 02

  Oh, that, yes. And I couldn't have said any better than what you just did because it's, it's the holistic patient, right? It's not just giving the medication for diabetes or for cardiovascular issue that someone has. It's anything from an over the counter to durable medical equipment, home healthcare. Those are the items that are also impacted when that wholesaler partnership and relationship with a pharmacy in that cost plus scenario. Many of those costs that they're used to seeing are different in a cost plus type of environment and allows them to have, to have better products for their patients at a cheaper price and be able to let them treat and have more time with their patients. And then you get to that whole patient, the long-term care at home patient needs some

• 8:32Speaker 02

  additional assistance. Part of that qualification in that long-term care at home setting really leads you to have more, a more diverse portfolio to care for them and to let their families know. Cause often it's not just the patient, it's other caregivers and it puts their mind at ease that the pharmacy really can give everything they can to them. And so one of the things that we have is the full portfolio, all the durable medical equipment information or products that they would need or home healthcare, et cetera. So.

• 9:04Speaker 01

  All right. And then part of that long-term care pharmacy at home, we're crossing into the element and we're starting to see reimbursement for remote patient monitoring and blood pressure cuffs and things that are kind of tied into that. Talk to us about some of the technology products that you actually are having to.

• 9:21Speaker 02

  Yeah. So we continue, we have our pharmacy strategy team. And so we have a team of pharmacists. I know you mentioned John and there's Sydney and Nicole also on our teams because those are, those are folks that we want to help to support our pharmacy partners with. And we continue to bring our partners, not only our team members, but our partners outside of value drug as well, and bringing them forward to allow those different types of initiatives forward. So RPM continues to be a focus for us. We're bringing other partnerships forward to our pharmacies and we see that, that is really just an avenue for the future. And it's not only just, just that direct patient, but it's also collaboration with

• 10:04Speaker 02

  their provider as well. And those are billable events that then helps them that the overall profitability and care for a patient. So that patient now is more than just that a tinalol prescription or that diabetes medication. It's their holistic, how is their blood pressure? How is their diabetes? And making sure that you can pick up on things that could help with their outcomes. And at the end of the day, we're all in this industry, or hopefully we're all in this industry. One is there's some profitability, but at the end of the day, you're hopefully here to help to care for the patient. And we can be a partner with them to bring forward those services to help them care for their patient.

• 10:39Speaker 01

  And you have to be, this isn't the way it was when I entered pharmacy. 2004, goodness gracious, 22 years. I'm getting old, Rick. And you know what makes me really feel old is Kyle McCormick and Brandon Antonopoulos make me feel old because I remember when they were P2s. And I met them first time at one of the Pennsylvania Pharmacists Association annual meetings. And Brandon and both Brandon and Kyle were so aggressive about patient care. And they were creative and they had these ideas. And both of those servant leaders have transformed

• 11:18Speaker 01

  an idea at a student level to a business model that they're running right now. And to back that up with a wholesaler that can keep up with those kinds of changes, it's a must.

• 11:29Speaker 02

  You really, it has to be partnership. And really, it's that collaboration of coming together and seeing those, that next generation come forward is just so exciting. Both of them are future leaders of the Pennsylvania Pharmacists Association. And I won't say future, but current. And then going to be taking the leadership reins is really exciting. And to see, how does that change? How does that transform what we do in the state from advocacy from within the state? And really just changing pharmacy practice? And their ideas, as you said, is that was nurtured as students and then allowed to grow is really making an impact in their communities. And you could see it, you could see it as people walk in off the street and

• 12:13Speaker 02

  walk into their pharmacies. And that's so exciting. And it's exciting to be a partner with them, to help them in that process. It kind of, it gives you some pride. But you don't own it, they own it. And they've done such a great job. And you just want to be there to help them through the process. And it's exciting to let us change to evolve with that, just like they've, they've started that evolution. And you're a part of that, too. And having those conversations and bringing these topics forward is really important, because that's how we change the profession. And changing the profession and evolving it is critical. I remember literally manual claim forms within my time as being a pharmacist. And we're so far away from that, it's not even funny. So it's so exciting to see and see pharmacists having the interaction

• 12:57Speaker 02

  that they're having, like what you're talking about, remote patient monitoring is something that was never dreamed of, or really done. So it's exciting. Thanks for bringing that up.

• 13:05Speaker 01

  Oh, yeah. And I like the fact that you're right there. It's not something that your clientele and your customers have to say, hey, Value Drug Company, you think you could get into? Uh-uh. You're already in it, and you're ready to go.

• 13:17Speaker 02

  And that's, that's our goal. Our goal is to hopefully get ahead of them. So we have things prepared. And there are some times where, you know what, we're not, but you want to listen to them. And we're happy if someone wants to bring something to us, we're happy to work with them, because you want to figure out a way to say yes, not a way to say no. So hopefully, we can say yes as many times as we can, and be that good business partner.

• 13:41Speaker 01

  Hey, Rick Sype with Value Drug Company. We'll be back on Twerks. We're going to be talking about, what's that next subject we're going to be on?

• 13:49Speaker 02

  I think just expansion, and being able to help in those different areas and expanding what we're learning here, and going into other areas of the country.

• 13:57Speaker 01

  Tune in next time on This Week in Pharmacy with Rick Sype and the Value Drug Company here on Twerks and the Pharmacy Podcast Network.

• 14:06Speaker 02

  Thank you. Appreciate it.

• 14:07Speaker 03

  Your patients need convenient and cost efficient healthcare. And in the increasingly competitive pharmacy environment, independent pharmacies shouldn't have to struggle. That's where Value Drug Company steps in. At Value Drug, we treat our members like family, providing first rate, personalized service and the support they deserve. While you provide exceptional care for your patients, we provide you comprehensive solutions to help you become efficient, productive, and profitable. We offer online ordering and mobile capabilities with our state of the art distribution center to maintain quality and control. We help your community pharmacy get connected to the right service providers and access your market. And we don't stop there.

• 14:50Speaker 03

  Learn more about how Value Drug can help your pharmacy thrive at valuedrugco.com. That's valuedrugco.com. Value Drug Company is a proud sponsor of the Pharmacy Podcast Network.

• 15:08Speaker 01

  Hey, welcome back to This Week in Pharmacy. There is a pharmacist out there that I've, I guess you could say, I'm a little bit of a stalker, not a dangerous stalker per se, someone that really admires what pharmacists are doing, entrepreneurial pharmacist. And I ran into Yoona Kim years ago, 2019. And I think, I think Yoona was with Proteus at the time, which was so innovative and was fascinating. But then, all of a sudden, when I was following her on LinkedIn, she was a founder of Areen. And now I get an opportunity to bring her on to Twerks and to feature her and her work. And also, I get two for the price of one,

• 15:53Speaker 01

  Dr. Jenny Behan is with us as well. Welcome to Twerks, Jenny and Yoona. How are you?

• 15:59Speaker 04

  Good. Thank you for having us, Todd. You know, I've also been stalking you and your podcast. So the feeling is mutual. And we are so happy to be here. I'm especially happy to be here with one of our lead pharmacists, Jenny, who can really outline what impact we're having on patient lives.

• 16:19Speaker 05

  I am super excited, Todd. Again, I've kind of, I've been with the company for almost six years now. So watched a lot of it being built from the ground up. And we continue to expand into new areas of pharmacy and have new improved impacts on our patients. And again, the goal is always to make the experience of working with patients easier and honestly more joyful for our pharmacists and our practitioners. So I'm very, very excited. Kind of how you have expanded with your podcast. It's just exciting to watch the journey.

• 16:55Speaker 01

  Yes. And if you would have said these things 10, 15 years ago, it would have been like you had two heads and, you know, four eyes, and people would have looked at you strange. They would have tried to push you into the MTM box. They would have tried to stuff you in medication therapy management. And we know now, today, with specialty rare disease, and things that are happening in people's lives, the expense of guessing, God bless our physicians, but throwing darts at a dartboard with a blindfold on, trying to think of, you know, how is this medication going to work? And how long are we going to give it to titrate or get into their system and metabolize the right way and blah, blah,

• 17:40Speaker 01

  blah. So to be able to reduce hospital admissions by 40%, being able to drill down into the complex disease states and mitigating risk, this is a mission, Yoona, that you had in mind, and it was in your heart. And I think that's what's happening to pharmacy care is, is the cream of the crop pharmacists are bubbling up. And they're saying, timeout, this is not about getting the medication as quickly as possible to the, to the patient, just, just for getting it to their, into their system for that sake. It's actually taking a little bit of a pause and saying, why did we go to school in the first place to become pharmacists? Yoona, give

• 18:23Speaker 01

  our listeners a little overview of, of the organization and your dream.

• 18:29Speaker 04

  So Todd, you're spot on. Areen's mission is to ensure safe and effective medication therapy. So going right back to the core and the Hippocratic Oath that we take in pharmacy school. And the way that we do that is through our medication intelligence platform that can take in all available data and turn it into actionable recommendations around who needs a medication change, and what should that right drug and, and dose be in order to improve patient lives and ensure that they are leaving, living the healthiest lives possible. From our customer perspective, who are payers and the risk band providers, this means that they do see a reduction in utilization and a reduction in total cost of care as a result.

• 19:13Speaker 04

  So it is a way to provide more care, and at the same time, save healthcare dollars and create a more sustainable system. So extremely passionate about what we're doing. At Proteus, as you know, we're focused on medication adherence. And being there, I started to ask myself, and back then, everybody was focused on adherence and dispensing and delivery solutions. But nobody was focused on the core root. Is it the safest and most effective one? So that's where we wanted to put our focus and solve that core root problem.

• 19:51Speaker 01

  Jenny, you get out of pharmacy school, you're thinking, hey, what do I want to do now that I have this extremely expensive degree? You get beat up in retail for a while, but that's so necessary to really connect with patients and understand so much of the mix of what's happening in healthcare and how much of a messed up jigsaw puzzle it can be. And these patients will look you in the face and not really even understand why they're taking medication or what they're doing. So this platform that's been built out, talk to us from your perception and your perspective, you know, what this means for patient care.

• 20:32Speaker 05

  Yeah, Todd, I think that's such a great call out. And I did start in retail, actually, even before I went to pharmacy school, I was a technician. And I loved the work and definitely saw like, hey, these pharmacists want to spend time talking to a patient. But there's a big red X flashing on their screen that they're not going fast enough and their assembly line has slowed down. And that's one of the outcomes that, again, retail is looking for. And we need our retail pharmacists, right? They still are some of the most trusted professionals.

• 21:03Speaker 01

  Absolutely.

• 21:04Speaker 05

  And I did love my, my rotation in retail after that. I was in substance use and mental health with the Department of Public Health for many years. And that was an absolutely enlightening journey that has helped me at Areen because what I really noted is, you know, you talked about the speed of the prescription getting in the hands of the patient, right? And there's the speed, but there's also the, the knowledge gap. So why am I picking up another prescription? And then there's many, many patients that the prescriptions are just sitting in their closet or they're picking and choosing when they're going to take them. And so what I love about Areen is we're diving in, calling these patients, you know, our,

• 21:46Speaker 05

  our platform is kind of presenting patients, it could be a sentinel event, it could be it's looking at labs and things looking are going in the wrong direction. And you're getting the patient at the right time and able to spend time diving into kind of the meat of what's going on. How is this medication working for you? That shared decision-making is such an important piece of getting a patient on the right medication, right? And sometimes they're at a doctor's visit, starting a new medication or getting a new diagnosis. And that is a very time pressured scenario and they walk out of that appointment and they're not sure what the impact of the medication is.

• 22:29Speaker 05

  So having a platform that highlights, again, impactful medications, highlights the full picture, you know, we can see a lot of medical claims, hospitalizations, what's going on with this patient? How has their health been changing over time? And, and it's really packaged for us to highlight, here's some areas of concern that we need to dive in with the patient. That opens up time to give the patient a chance to also talk about their concerns. Because I know if you've ever been in like a busy visit with a patient reviewing something, you have your own agenda. And then if you're digging through and trying to document, it's really taking away time from the patient experience. So I think that's what I love about Areen.

• 23:14Speaker 05

  Its platform is really built to take the pressure off the clinician of the documentation of writing out your recommendations. It has a lot of canned, kind of recommendations that are ready to go in patient and provider language. And then it gives you back the time by highlighting needs. And if it's not the patient's goal, right? You kind of have a prioritized list of like, okay, this is not the patient's goal right now. Their diabetes is very out of control. They have an A1C of 11, but right now their PHQ9 is through the roof and their depression is what their main focus is. So it's, it's very helpful for allowing us to kind of navigate through that.

• 23:59Speaker 01

  Yoona, I think of what makes sense, and like I said, back up 10, 15 years ago, and you, you know, they'd look at you strange and what are you talking about? But now payers are looking for you and they're like, this has to make sense. These medications are expensive, the insurance has gone through the roof. If it, if it doesn't align, if it doesn't work, if it's not helping, then why are we doing it? You had some massive success. I want to just give a shout out. Areen secured 30 million, Series C raised for AI-based medication optimization platform.

• 24:41Speaker 01

  However, you did not release the genie out of the bottle. The genie I'm talking about is AI, the craziness of AI right now. You built the system first and then you brought AI into it. And by the way, I'm a, that's my roots is pharmacy management software and, and all of those organizations that are out there that are racing to get attention, AI, AI over here, AI over there, that's great. But if you don't do thing meticulously and set some foundations and you start trying to build it from an AI perspective first, and I think in my opinion, it's the wrong way to go for cybersecurity and for HIPAA and for issues of API integration.

• 25:22Speaker 01

  So you set this, this powerful system first and now all of a sudden you're starting to wrap AI into it. So talk to our listeners about how that has made a huge impact, especially with connections to these, these payers.

• 25:36Speaker 04

  Sure, sure. So first shout out to the pharmacists because the pharmacists were very instrumental in helping to develop our platform. So we've employed pharmacists from day one, they've been on the product development side, on the tech side, and then also on the clinical care side where, where Jenny sits. And by having our own clinical care team, that essentially functions as our R and D lab. We can ensure that our platform is surfacing the right information so pharmacists can provide the best clinical care and work at the top of their license. The foundation of Areen, it's a data platform at its core. So our goal is to surface really meaningful insights, again, on proper medication use

• 26:21Speaker 04

  and the medication recommendations. So from the beginning, we were using things like machine learning models to identify the right patients to target. And then we have our recommendation models, which look at the full patient picture, what medications have been tried and failed in the past? What are the comorbidities? What are the social demographic characteristics in order for us to really surface very targeted recommendation, given that patient's circumstances? Now, now that we set all of that foundation, we have added other elements now of Gen AI. So now we have AI agents who are making calls to pharmacies to, you know, identify where

• 27:03Speaker 04

  prescription status, help patients facilitate refills, take away that extra step. We also have ambient listening in, within our platform as well. This again, auto takes notes for the clinicians like Jenny, automatically creates next best action. And then from an intelligence perspective, what allows us to do is really hear the patient conversation, identify patient sentiment, other needs that the patient is expressing about their medications. And we can actually feed that into our learning models so that we can continuously improve and personalize our recommendations. So we see it as a additional tool that allows us to actually achieve better outcomes more efficiently and effectively.

• 27:48Speaker 04

  But certainly AI has to come with its guardrails and that's where we have the clinician testers, we have an AI governance committee in-house. And at the end of the day, what, we are an outcomes-focused company. So we know that our solution is working when we can keep patients out of the hospital and when we can reduce total cost of care and when we can improve quality of care.

• 28:13Speaker 05

  I have to say, Todd, like, because from a user experience, right? There's this, Yoona's talking about our ambient listening tool that's kind of documenting for the provider. And we see this in a lot of healthcare systems now, right? I know Kaiser's using one and the provider will say, hey, is it okay with you if I use this and, you know, help me take notes? And then they're looking at you the whole time. And so the first time I had someone using AI in a live setting, I was like, wow, this is bizarre. Like the doctor is looking at me and speaking. And there's been many times, right? Where their back is to you and they're taking notes. And there's so much literature on how much interruptions there are, just in the way we

• 28:56Speaker 05

  currently think and learn, even the buzzing of a phone or looking at a phone can totally interrupt your flow. And so what, from the user side, what they're able to do is focus on the patient. And that is, I feel like a game changer, right? Like, I don't know any clinician that would ever tell you, hey, Todd, I love documenting. That's my favorite part. I think that's where everybody just gets very bogged down in healthcare. So having a system that can help you write follow-up notes, so whoever takes, you know, the patient calls in and you're not available and they see, hey, here's what Jenny and, you know, Todd talked about, and here was Todd's goals.

• 29:40Speaker 05

  So I can, I can just go in quickly and ask about that. And, and yeah, and that hands-free focus on the patient, you lose insights when you're trying to note take and also pay attention to someone. So it's been a big win and our clinicians are, have really embraced, thank you, the way we're going to drive outcomes and do even better shared decision-making and listen for sentiment cues at a more heightened level is to take some of this pressure off the clinician, to be doing too many things at the same time.

• 30:11Speaker 01

  Jenny, I show up at graduation day in 2012, University of California, San Francisco School of Pharmacy, and I come up to you, you got your cap and gown on, and I say, I know this is going to sound crazy, Jenny, but I'm from the future and you're going to use artificial intelligence to help manage very complex, rare diseases and you won't necessarily be dispensing anything. How crazy would you think I was standing there before you?

• 30:43Speaker 05

  Um, pretty crazy, Todd, I would say. Todd from the future. I think that sounds like a beautiful future, but I don't know if I trust it. And still, everybody are like, AI, what do you mean it's gonna help me? And um, it's like I said, a game changer. You're in there using your skills, communicating back and forth with the patient with full focus. And I absolutely love it. And I can't say enough, Todd, you mentioned earlier, like, hey, you have to be very careful about AI. And we have students coming in, you know, it's very supportive of like, get our newest people in so they can see where the industry is going. And they are very quick to use

• 31:26Speaker 05

  Dr. Google and the AI answers. And I have them do some exercises of change your tone. Because what you'll see if you change your question is Google, Dr. Google and some AI tools will come back and give you the answer that they it thinks you're looking for. And so I love that about our platform that we can trust it. It's constantly being updated by real guidelines and by the amazing team of clinical pharmacists and specialists that you now has put together.

• 31:56Speaker 01

  You know, our pharmacy technicians have come a long way, just as our pharmacists have. And if we have a 15, 20 year pharmacy technician, veteran, that's doing some pre-work, maybe order entry or something in order to prepare something, helping to jettison a prescription or care plan in process, it still comes back to the licensed pharmacist to do the due diligence and to do everything that they would to double check, check and triple check the safety, the drug, drug, the allergies, the labs, everything that comes in. That's the whole purpose. So AI is no different, in my opinion, it's a tool. It's

• 32:37Speaker 01

  not anything that's to be relied on as the end all be all. It always comes back to the pharmacist. So talk to us about practicing at the top of your license and how AI can become a powerful tool, but it's always going to come back to the to the pharmacist decisions.

• 32:54Speaker 04

  Yeah, absolutely. You know, as Jenny mentioned, that shared decision making between a patient and a clinician, a pharmacist is so important in understanding their goals of therapy. So AI is a tool in that it can remove some of the administrative tasks from a clinician's plate. And in fact, we actually employ pharmacy technicians too. So our goal is to use every care team member at the top of their license. And our workflow engine will automatically create tasks for the appropriate care team member. So if it is seen in a pharmacy technician conversation, we hear from that ambient listening, that there is a clinical need and some sort of counseling point that the pharmacist needs to convey or dive deeper

• 33:37Speaker 04

  into, there is an automatic task from there that will be created for the pharmacist to follow up. So that workflow queue is again, meant to guide who's a right care team member for the intervention. And then tools like ambient listening help generate that next best action. So the right care team member from there intervenes with the patient. And yes, ultimately, it is the clinician's choice as to what recommendations to finalize and send directly from our platform is the pharmacist's choice.

• 34:11Speaker 05

  It's so important. And we really discuss that all the time with our clinicians, that AI will never replace you. It's actually here to support you, like you said, take administrative burden off. It may be, you know, bubbling up a recommendation based on what, you know, it's it's learning about the patient and kind of the whole host of inputs that it takes into consideration. And then it's presenting it to the pharmacist, but it's still ultimately going to be based on their critical thinking, partnership with the patient, and it will present the guidelines. So it's like, hey, here it is. This is where I'm getting this from. And if the pharmacist is comfortable, that makes sense to them, then that's a recommendation

• 34:54Speaker 05

  they will send. And if it doesn't, then they go ahead and they, you know, they decline. And so we're collecting that data to kind of how it gets smarter on like what clinicians are accepting and declining. But it's very important. I don't think we can say it enough. Like, the pharmacist, the individual who's taking care of the patient, they're not being replaced by AI, and it will never be 100% correct.

• 35:19Speaker 04

  Yeah. And Jenny, you bring up an important aspect of our platform as well, but the learning loop, the adaptive learning loop. So as we learn, again, which recommendations are accepted and implemented, and then ultimately improve patient outcomes, that's being fed back to both our models to select which patients need interventions and also our recommendation models. So it leads to continuous learning and improvement. You know, one, one saying I want to, we always repeat constantly to ourselves at Airene is that it's not what AI does, it's what outcomes AI delivers. And that is, that is important to our core and important to our mission.

• 36:03Speaker 05

  Yeah. And Todd, some of what it's doing is not just a recommendation, right? Like, for example, we have very quick kind of feedback loops, which is really helpful for our clinicians. So when we get a new population, our clinician team is kind of inputting information based on barriers they're seeing. And then we're getting the feedback of, okay, in this specific population, they're reporting costs as a barrier to X, Y, and Z medication. And then we can kind of pivot and have our clinicians directly address that in a different way. And they, and what's great is we get to do a lot of testing of, okay, how do we get patients to open up more if they're not comfortable talking about costs, but we definitely

• 36:47Speaker 05

  see that as a barrier? How can we change the way we open them up or we dialogue? And when we start getting better outcomes, sharing that through our platform. So it's, it's not always clinical recommendations. It's also like learning about like, what are the specific barriers? And how do we address them for very individualized populations and healthcare plans?

• 37:10Speaker 01

  So I want to give a shout out to your team. You should be very proud of yourselves. For three years in a row, you have been voted into the INC 5000. This is a prestigious award that's well known throughout the United States. And how very, very few companies can make it to this list. And then on top of that, the success that you've had, Yoona, for once again, three consecutive years. I just want to say congratulations.

• 37:42Speaker 04

  Thank you. We feel very privileged and grateful. And at the end of the day, really, our most important customer is the patient. So I think if we continue to focus there, then the rest will come.

• 37:56Speaker 01

  Absolutely. Hey, if you'd like to learn more about Airene, please check them out at A R I N E. That's A R I N E dot I O. Once again, Airene dot I O. Promise me Jenny and Yoona that you'll come back to twerks. Let's bring a pair with us. Let's bring a scientist or someone in labs and let's start digging into maybe some specific examples of how this system is moving pharmacy care very much further into the future and what we need. And also expanding what pharmacists really want when they come out of pharmacy school, our new farm Ds, some of them don't want to be in retail. Some of them don't

• 38:41Speaker 01

  want to necessarily go to health system. They'd much rather be working in the in the consultative space and certainly embracing technology. So thank you both for being on This Week in Pharmacy.

• 38:53Speaker 04

  Thank you. We'll be back.

• 38:55Speaker 05

  Thank you so much.

• 38:57Speaker 01

  That's awesome. Thank you so much for twerking with us. Hey, listeners, we appreciate you. Hope you had a great week. This was twerks for August 28. Can't not believe that we're almost to September 2026 is going fast. Continue to do what you do. Love every one of you out there, pharmacists, pharmacy technicians. Tune in next week for more twerks.