The Evolving Role of Hospital Pharmacy | Love Your Pharmacist Awards presented by Clinigen

Hospital pharmacy is evolving rapidly — and pharmacists are playing a more influential role than ever in shaping safe, personalised and effective patient care. In this first episode of a special three-part series presented in partnership with Clinigen’s Love Your Pharmacist Awards, we explore how hospital pharmacy has transformed from a traditionally dispensing-focused profession into a highly clinical, technology-enabled and collaborative discipline. Host Todd Eury welcomes Dr. Varun Sethi, SVP, Asia-Pacific and Japan Region at Clinigen, and Alison Tennant, former Chief Pharmacist and recipient of the 2025 Love Your Pharmacist Lifetime Achievement Award. Together, they discuss how pharmacists are helping solve complex treatment challenges, manage medicine shortages, support multidisciplinary clinical decisions and improve access to specialised therapies. The conversation also examines the growing influence of artificial intelligence, electronic prescribing, automation, pharmacogenomics and personalised medicine — and why human judgement, empathy and patient advocacy remain irreplaceable. The episode also looks ahead to emerging innovations including advanced formulations, precision therapies and 3D-printed medicines. At the heart of the discussion is a simple message: hospital pharmacists are often working behind the scenes, but their impact can be felt throughout the entire patient journey. The Love Your Pharmacist Awards celebrate those extraordinary contributions.

• 0:05Speaker 00

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

• 0:22Speaker 01

  Welcome to the first episode of our special podcast series, celebrating hospital pharmacy in partnership with Clinigen's Love Your Pharmacist Awards. Clinigen works closely with hospital pharmacists around the world to help healthcare professionals access the medicines their patients need, particularly when treatment pathways are complex or access challenges arise. That's one reason why the Love Your Pharmacist Awards were created, to recognize the expertise, dedication, and often unseen contribution hospital pharmacists make to patient care every day. Today, we're joined by Dr. Varun Sethi, SVP, Asia-Pacific and Japan Region at Clinigen, and Alison Tennant, former

• 1:02Speaker 01

  Chief Pharmacist and recipient of the 2025 Love Your Pharmacist Lifetime Achievement Award.

• 1:12Speaker 02

  Hey, welcome to Clinigen's Love Your Pharmacy Awards presentation. This is episode one in our series. This is evolving role of hospital pharmacy. I'm so excited. We're talking international gathering of people in pharmacy, passionate people in pharmacy. I'd like to introduce our guests today. Dr. Varun Sethi is a Senior Vice President of Asian-Pacific and Japan Region at Clinigen, and Alison Tennant is former Chief Pharmacist and recipient of the 2025 Love Your Pharmacist Lifetime Achievement Award. Welcome, Allison and Varun. How are you this morning?

• 1:57Speaker 03

  I'm good this morning, thank you. It's a nice wet day here in England, so we're enjoying a bit of rain.

• 2:04Speaker 04

  And likewise, so am I, Todd. It is a nice and balmy 33 degrees centigrade here in Singapore where I am.

• 2:11Speaker 02

  All right, well, it's Pittsburgh, Pennsylvania weather, and it's all over the map. We start off in a cold mornings, and we could get up to 80 Fahrenheit, 90 Fahrenheit. Who knows what's going to happen? We don't get enough sunshine, in my opinion, in the Pittsburgh area, but I'm so excited that you're both here. I want to say congratulations to Allison. It means a lot to me that you're sharing this time with me because I am a fan of pharmacists and what pharmacists are doing to impact the lives of so many millions and millions of people every day, rely on their pharmacist to guide them and to keep them alive, and

• 2:52Speaker 02

  the honor that we're bestowing on pharmacists through this special month and this special award, that means something special to me, and I love being a part of it. So Allison, how did it feel? I mean, it's, it's kind of like, it plays on your ego, and pharmacists are not egotistical. They're always driven by their heart and their information in your mind to keep our people and patients alive and safe. But how did it feel when you found out that you won the Pharmacist Lifetime Achievement Award last year?

• 3:23Speaker 03

  It was incredibly special, and the most special part for me was that it was one of my team that nominated me. So, and in fact, one of my procurement staff, so one of the really backroom of the backroom team, and I'm not your typical pharmacist in that I do speak up. We also, we were very lucky as a team, a few years ago, we won the Clinical Team of the Year for our trust, Outstanding Clinical Team of the Year, and I sort of was saying to the team, fantastic, well done, and they said, thank you, but the trust only knows

• 4:06Speaker 03

  what we do because you've been out there shouting about us. So this felt, again, that recognition of a, of a profession that, as you say, tends to sit quietly, making sure that people get the right medicines at the right time, in the right way, and just quietly gets on with it and doesn't ask for recognition. So this was really special on a personal basis, but also on behalf of my profession.

• 4:32Speaker 02

  Love it. I love it. I love the fact that you are an ever learner, but you're supporting, you're there, and people need you, people need that, that guidance. And what I love also being part of this is that Clinigen has recognized these amazing healthcare providers. And Varun, Clinigen's Love Your Pharmacist Award is now in its fifth year and has expanded globally. Why do you think that's important to recognize our hospital system pharmacists?

• 5:06Speaker 04

  Listen, I've been, I've been fortunate, Todd. I mean, I started actually my career as, as a pharmacist, and having been trained in India, and then subsequently moving to the, to the United States where I actually had a chance to work directly, you know, in the hospital pharmacy, in the, you know, kind of Chicago Medical District. I've actually seen firsthand what difference, you know, hospital pharmacists actually make to, to patients every day. They're actually constantly solving complex treatment challenges, answering, you know, difficult medicine questions, finding practical ways by which they can ensure that the patients can actually get the, the access to the therapy that they really need.

• 5:49Speaker 04

  What's actually really striking, and this is, you know, many of us as pharmacists would be able to associate with this, that the work's always happening behind the scene, right? And the patient would, would know the doctor, the nurse, or even the caregivers for that matter, because they tend to, you know, interact with them, but they often don't even see the pharmacist who is behind the scene. It's their expertise, to a large extent, that has actually helped make that treatment possible. I think it was fascinating for me, I had a chance to, to walk the floor with several physicians when I was at the University of Illinois Medical Center, and you would see the doctors immediately, even at the bedside, refer back to the pharmacist to, to check in if they were making the right decision. Probably at that time, the patients would notice it, but it's still, you know, you're

• 6:33Speaker 04

  dressed in a very similar manner, they wouldn't know if you're a pharmacist or you're another physician. So I think it's that, that power of finding those real, you know, solutions within the complex problems that pharmacists are constantly trying to, to solve for. So I think that when we think about from a Clinigen, you know, viewpoint, we, we work very closely with hospital pharmacists from all across the world, you know, whether it's helping these healthcare professionals access medicine. In fact, it's us as Clinigen that facilitate bringing the right medicine to the right patient at the right time, and nine out of 10 times, if not across all the board, it's the pharmacists that are basically our port of call.

• 7:14Speaker 04

  They are the ones that are supporting these treatment paradigms, these various optionalities, navigating supply chain challenges, which could be quite daunting in certain markets where pharmaceutical products may not be approved, right? So you're trying to figure out, how do you get the right therapy? And that's what makes this purpose of Love Your the Pharmacist Award so critical for us to recognize this particular community, and the dedication and the impact that this, this profession actually has directly, and, and create visibility, you know, at a broader context. And I think as a, you know, as you think about as a pharmacist, they are part of this multidisciplinary healthcare team that's working, you know, to solve basically the

• 7:55Speaker 04

  clinical challenges that are presenting themselves for all the cases that they actually encounter. It's that expertise that they bring, plus truly keeping the patient advocacy, which is the central tenet of whatever they do, right? That's the one single thing that I think every pharmacist always strives to achieve, and that's why these awards are so important, right? It gives us the opportunity to celebrate the individuals who are changing people's lives, but never seeking the recognition for it. So they are behind the scene, and it's important that we as an organization or enterprise recognize these people. That's why it's so important for us.

• 8:33Speaker 02

  Oh my gosh, I heard so many stories that pharmacists feel that they're not heard, that they're not recognized. And it bothers them because they're putting, this is their life's work. This is their career. This is what they went to school for. This is the university that they're proud of. And Alison, I think of you going back in time and remembering in your own career, that one example that demonstrates the difference hospital pharmacists are making behind the scenes, that people just don't know what's going on. But share that with us. I'd love to hear a story from you.

• 9:12Speaker 03

  So the, I've got two, I'm going to be cheeky and try and push in two, but I'll be brief.

• 9:20Speaker 02

  Oh, no, I'm ready.

• 9:21Speaker 03

  Because, because, because I think they're both great examples. One is the ADHD drug shortage. So, you know, we hit a point at which there was a real shortage of the treatments for ADHD. And the pharmacy teams across the country in the UK took a grip of this. And the hospital pharmacy teams, my hospital pharmacy team was communicating with the clinicians. So what was available? What could they prescribe? How much could they prescribe? But they were also liaising with the patients. So that we're reassuring the patients that we haven't forgotten them. We understand the impact that the lack of these drugs makes on their lives. So the

• 10:04Speaker 03

  element for us is that we really, and this was work that isn't, you know, isn't officially part of the job description around communicating with the patients, communicating with clinicians, the sort of all, at times almost daily emails about what can you prescribe? If you can't prescribe, what do we put you on? And reassuring the patients and dealing with the anxiety that the lack of these drugs was raising. And that continued business as usual for quite a while. So we do that on a daily basis around medicine shortages. But the one that

• 10:46Speaker 03

  particularly also then demonstrates that when the acute need is there, the pharmacy, pharmacists put their capes on and swing into action. We had a baby. So about once every five years in the UK, a baby develops botulinum poisoning. And we had to source infant botulinum antitoxin from California. The only place in the world that holds it is the Californian Department of Public Health. And so this, there was no protocols, there was no, you know, we were able to contact somebody who'd done it five years previously,

• 11:27Speaker 03

  but we had to swing into action. And of course, it happens at four o'clock on a Friday afternoon. So we're sat there, I can remember sitting with my procurement team, on the, one of us on the phone, because I'm trying to get hold of the regulatory authorities to ensure that we can get it into the country, expedite it coming through. I'm calling on my personal network to get to the right person. My procurement team are working, actually with Clinigen, to help us do the procurement. We're talking to California with the time difference and everything else. And then also communicating internally to our ITU team, who are dealing

• 12:12Speaker 03

  with this baby that is deteriorating rapidly. I got introduced to Flight Radar 24, where you are tracking planes across the globe to ensure that the drug was reaching the UK, and then tracking it with the courier to get up to the hospital. And one of my pharmacists was sending me pictures of the drug arriving at the hospital and getting up onto the ward. So the element for us is sometimes we're dealing with that access to medicines on a regular basis, keeping people updated. And sometimes you have to pull all the stops out in an acute scenario. And pharmacists don't recognize the skill that's involved

• 12:57Speaker 03

  in that, the juggling, the logistics, the medicine's information, the regulatory information. You have to know the legal elements of things. Medicine storage, what temperature was it being transferred at? And I think that's part of what I love about pharmacy is that puzzle solving. You have to take all that information to make sure that a medicine arrives at the patient's bedside. And the really special bit of that for me, for the botulinum antitoxin, was what the pharmacist rang me one day, and she happened to be at the bedside when the baby moved for the first time, because the botulinum antitoxin was

• 13:38Speaker 03

  taking effect. So she saw the impact of what she'd done. And that was so special for her.

• 13:46Speaker 02

  That is special. And once again, our physicians and nurses, and most important, the patient and their families, may not understand the intricacy and the complexity of what's happening behind the scenes, and how you're picking up on those things and saving lives. And that's happening every day, hundreds of times, if not thousands of times a day, of what's happening with our hospital system pharmacists. And that kind of brings me to that main topic of today, which is the evolution of health system and hospital pharmacy. Alison, you've spent decades in this profession. How do you see the role changing?

• 14:30Speaker 03

  So I think that bit about, when I started, pharmacists were only just coming out on to wards. So the element for me is we were moving from the dispensary on to the wards. These days, we're not just in the wards, we're in the clinics. So you now have pharmacists running clinics themselves. People are being referred to see the pharmacist, because it's their medication that needs reviewed. And alongside of that, we're seeing the development of the pharmacy technician workforce. So the element for me now is that actually pharmacy

• 15:09Speaker 03

  technicians are really coming to the fore, freeing up the pharmacist's time, in terms actually often of that supply and procurement and that logistical element of the service. So they're doing the, but they're also great at talking to the patients. Patients will tell pharmacists and pharmacy technicians things that they won't tell doctors. So you can pick up a lot of information that you can then feed back into the clinical team. But I think that that evolution of pharmacists being part of a multidisciplinary team. I wanted an interesting conversation with a consultant, who was saying to me, oh, we've

• 15:52Speaker 03

  had the MDT. And I went, no, you've had a multi-specialist meeting, where you've had lots of different doctors from different specialties around this patient, but you haven't had a multidisciplinary team with a view from a nurse, a pharmacist, a dietitian, whoever else is needed to look after that patient. I think that's how healthcare is evolving, that actually that profession, multi-professional input is now being seen as much more of a team around the patient. And the pharmacist and pharmacy technicians

• 16:30Speaker 03

  know the story of the journey of the medicine, from development, research, curement, supply, storage, getting it into the patient, right the way to how do we destroy these drugs safely when they're no longer needed?

• 16:45Speaker 02

  That's a really good point. Sometimes we overlook that. Varun, another thing that's changed is organizations like Clinigen are recognizing the vital importance of pharmacists and how it's saving lives, but also helping systems to understand medication management, expense of medications, keeping people adherent. What have you experienced, Varun, in just understanding the changes that are happening in, in hospital system pharmacy?

• 17:22Speaker 04

  Listen, I think what we have seen, right? I mean, obviously, there's a lot of tools, various specialized therapies, the healthcare, but the systems look very different than they were probably just, you know, even five years ago for that matter, or even a decade ago. But I think what's remaining consistent actually is the fundamental mission of what we are trying to solve for as pharmacists and, you know, the pharmacy community, which remains unchanged. I think, and I've seen that, you know, evolve even even from the days when I worked in the in the hospital pharmacies, right? And I've seen it throughout my career. The common thread has still been, and I think what Alison just mentioned, right? If we really do keep that multidisciplinary concept together, rather than a multi-specialty

• 18:07Speaker 04

  concept, the role of each and every individual that comes around this multidisciplinary team is going to be super important. And I think that's continuing to gain a little better traction as we go along, right? Moving from multi-specialty to multidisciplinary, I think that's going to be critically important if everybody keeps the cohesive need for the patient at the center of everything that they do. And I think the central question over here is what's the best way to help the patient, right? There is a clinical element to it, but then there is also medication management. There is adherence. I think it's a great example of what Alison mentioned, right? Information that patients might share with the pharmacist, or even with the pharmacy technician, could be quite different from

• 18:51Speaker 04

  what they might tell their own physicians, for that matter. And thus, using maybe technology, and I think, well, it's it's kind of the central tenet. Everybody talks about it today, the ghost in the room, which is AI. And we can probably talk about what that means and how that's going to influence and what's happening today. But I think technology needs to become an enabler. The processes and the healthcare models will need to evolve to meet that goal. And I think that's to us as an organization, the support that we want to provide to the pharmacist, and how can we enable it, right? Across the different geographies that we work in, you know, as a clinician. And I think that's our central goal, is patient well-being, and what can we do to help?

• 19:31Speaker 02

  Patient well-being. Varun, you hit the nail on the head. And we've talked about how much has changed. But what's one thing that has stayed the same, Alison? And you were talking about this and hitting on it with regards to like patient advocacy. And talk to us about what do you think? What do you think has stayed the same?

• 19:51Speaker 03

  So I think that element's about wanting to do the best for the patient in front of you. So the interesting bit, I once was doing a medication review with a patient. And I'm always open with the, what do you want to get out of your medicines? So actually, that's where we start the the review from. And it was really interesting because the patient went, I want to be able to walk my dog. And they went, he just had some surgery, and he was kind of, I just want to be able to walk my dog. So he was on blood pressure medication, pain medication, etc. And actually, so we sat and went through things like the

• 20:31Speaker 03

  timing of his medication, what each medication was doing. And I think that pharmacist role of talking to the patients about what are they getting out of their medication and helping them understand how to do that medicines optimization. The one bit, and Varun's thrown the AI into the conversation, the the bits that actually has, the bit that has changed is that where patients used to come with the, I've just read those horrible small-print patient information leaflets with a load of questions. They now come with the, I've

• 21:10Speaker 03

  asked AI about this medicine. And they come with a, something they've pulled off the internet. So I think the element for us about talking to the patients, particularly about risk, patients read something that worries them. So they they want a medicine that's going to work for them, but they have concerns. And the one thing, even in this busy day, that, you know, busy world, that pharmacists try and do is make time to talk to people. AI will never replace that ability to ask a question and put it into the context for

• 21:55Speaker 03

  your world. In my current, in my current hospital that I work in, we have some really highly educated, really professional people. We also have people who are living in a place where they don't have a fridge to store their insulin, where they are living in houses that are covered with mold. So how do we help patients use and store their medications safely? What questions have they got about their medicines? And I think one of the bits I love about pharmacy profession is that you can be talking to a consultant one day where you're having to use really complex language, really, you know, challenging intellectual

• 22:38Speaker 03

  conversations. And then a different type of challenging intellectual conversation, which is how do I help this family with four kids, no fridge, moldy house, who are managing two of them with a rare disease? And that, to me, is part of the joys of my day, is that opposite ends of the spectrum.

• 23:00Speaker 02

  Alison, there's more to healthcare than the medicine, or the procedure, or setting a bone that's been broken in the in the specialist, or researching the disease. There's the humanity part of this, the human element of it. And there's tools out there. When I entered pharmacy, my goodness, 2004, it technology was just kind of peeking out of the closed system to an open system. There's a database out there called SQL, which gives you access to really everything. And that was a new thing back then. And it was still up to the pharmacist to discern all of that information and make changes. So artificial intelligence

• 23:45Speaker 02

  is just incredible, mind-blowing of the capabilities. But it still comes down to the individual pharmacist with the individual patient, with the individual situation and case, where they're going to step in and be the end-all decision with the with the assistance of the general practitioner and the physicians. Those tools that are in place are just, like I said, amazing. And that's, that's great. But one of the biggest changes that we've seen in the rise of our digital technologies is artificial intelligence. How do you think that's affected pharmacy, Varun?

• 24:26Speaker 04

  Yeah, listen, I can see there's been a lot of attention, right? AI is like the buzzword of the the current decade, clearly. And to be fair, right? I mean, in reality, it is really starting to support, you know, pharmacy practice in a number of very practical ways. And it's not, you know, futuristic robots replacing pharmacies, or, you know, helping them manage increasing levels of complexity, or, you know, better informed decisions. I think it is effectively identifying data patterns, right? Which is where AI comes in very, very handy. When you think about the large amount of patient volume, you know, around the data sets, healthcare data that's actually available. Otherwise, it's difficult

• 25:11Speaker 04

  for the innate, you know, mind to kind of be able to spot all the kind of trends that might be available, which AI can do pretty quickly, whether you throw it into Claude or GPT, or whatever your favorite AI engine is, you'd be able to see patterns. And I think that's where the pattern recognition is really helping the healthcare teams identify risk. And it all comes down to managing patient risk. How can we mitigate readmission risk? How can we, you know, mitigate clinical deterioration, challenges that might be there in in treatment adherence? I think that's a very, you know, common challenge with patients, I think, in terms of medication management and medication adherence, right? And I think

• 25:54Speaker 04

  how do we intervene sooner? AI can actually enable a lot of that, you know, systems that can be built around that. So I think that's where we are seeing, if AI used appropriately, can really improve the operational side of, you know, the delivery of healthcare. And I think it can really help, on the other end, which we are seeing from an organizational standpoint, is identify trends so that we can manage demands for medication. If you heard, I mean, earlier, I mentioned about supply chain challenges. So this can really help manage demand-supply, you know, any kind of abnormalities that might come in, and deter any potential future supply issues that can create critical problems. I think looking at what Alison mentioned about the ADHD drug shortage a while back, to put it

• 26:39Speaker 04

  fast forward now from, you know, from that example she was giving, it can really help, you know, abrogate some of those risks that we might see, right? So that's kind of one very clear, you know, mechanism of where we see an impact. And it's already starting to happen. The other element, which I think is also well-recognized, is I talked about the huge amount of data information that actually flows through. Think about the amount of notes and unstructured data that's sometimes going into, you know, patient records, for example. So if that can be collated, you know, historically, much of that insight was very difficult to access, right? So now, AI can really enable extracting that meaningful data, and it can overall support and enhance effectively patient care. That's, I'll tell

• 27:23Speaker 04

  you honestly, personally, really excites me the most, right? It's not about will the role of the pharmacist change? I think the role of the pharmacist will evolve, clearly, and how they leverage this data in the administration, and streamlining some of the burden and data gathering that they actually have had historically, you know, been a bane of what they do. That can then further, you know, streamline clinical, you know, management, better judgment with the, you know, the insights that they might be able to gather. And at the end of the day, it'll all focus back on one thing, which goes back to improving patient care. I think to me, this is the exciting part that's continuing to evolve.

• 28:03Speaker 02

  Allison, what about you? What have you seen in the realm of AI? And how does that affect your your position and your job there in the hospital system?

• 28:14Speaker 03

  So I think, as Varun has mentioned, some of it's about summarizing stuff. I think that analysis, the element for us is we have more data than we know what to do with at the minute. What we have is very little information. So the element that we are looking to AI towards, particularly in my field of pediatrics and women's health, is gathering, using those big data sets to do that analysis. So actually, if we were talking about, so when I work with other pediatric centers across the UK, and I might have three patients on a drug for a particular indication,

• 28:56Speaker 03

  and Gray Ormond Street's got four, and Liverpool's got two, and, you know, somewhere up north's got one. We can pull all of those together because we can get the AI to go into our systems and go find this patient with this criteria, tell us what treatment was given, what were the outcomes for it? And AI speeds a lot of that up for us then to go in and know where to look. So the bit for me at the moment, as I think of AI in our field as slightly a bit like a meerkat, it's telling us what's coming over the hill, telling us where we can, where we need to be looking, and where we need to be going into things in more depth.

• 29:38Speaker 03

  I mean, AI has a lot of practical issues as well on the patient front. So AI can help us translate into patients' own languages, context, et cetera. Again, slight, a bit of a health warning there, you've got to be careful you're using the right AI tools, the right context, et cetera. So I think this bit about AI working with humans is the bit that I see the hope for. Where can I get AI to summarize a meeting for me? So we've just had a discussion of all the pediatric centers, and AI can do the notes for me, rather than me trying to go back and remember. So I can chair a meeting, and AI can tell me what we talked about in the meeting,

• 30:20Speaker 03

  and particularly tell us what actions we need to do out of the end of it. That's brilliant. AI can analyze the data for us. AI can help us summarize something in a patient context in easy language to understand. But you need that human element alongside of it to make it meaningful and to ensure that what you're getting is real and relevant.

• 30:46Speaker 02

  In 2016, I learned a word and its meaning, and I dug into the science, and it's called pharmacogenomics. And I did mention that just in our intro as we were, we were starting today's, today's program. And now we jettison ahead 2026, and how PGX pharmacogenomics is really becoming a major tool in making sure that our patient is able to metabolize and, and, and digest and use, and, and making sure that your genes are reacting to a medication as intended.

• 31:26Speaker 02

  And the development of pharmacogenomics, Varun, what, when did you see the shift begin? And why is that becoming such an important part of pharmacy care?

• 31:37Speaker 04

  That's an excellent question, Todd. I mean, listen, the foundation of, you know, pharmacogenomics or quote unquote personalized medicines has been out there for decades, right? So it started pretty much back in 2003 at the completion of the Human Genome Project, which was a major milestone, right? Because it gives us a much deeper understanding of the true nuances of the genetic differences that can influence disease and how patients respond to the variety of different treatments. So in terms of, you know, for us to really deeply understand, it's not a one size that fits all. I think that's the most important element, right? And, and for many years, the, the healthcare community has been evolving around these

• 32:18Speaker 04

  to understand the variety of different factors, whether it's genetics, whether it's the disease biology, whether it's individual patients and how they react, what are the different characteristics around it? And how does all that actually influence the effectiveness and efficacy and tolerability of the various products that they actually get? So I think, to me, the importance of pharmacogenomics is, is continuing to become a pretty central tenant of, you know, now understanding, in many cases, even the variety of biomarkers that people have, that there are differences, you know, if you look at certain disease progressions of how one patient could become so different in the treatment paradigms that need to be followed.

• 32:58Speaker 04

  And actually, it all is in the pursuit of reducing a risk to other adverse reactions, avoid any kind of, you know, true trial and error in the prescription patterns that we need to follow. I think these become very important at the end. We want the best efficacy for the patient, right? So I think this is where the, the excitement of, you know, personalized medicine or pharmacogenomics will, will continue to, to kind of expand. And now we've got a variety of these consortia that are coming together, right? That have developed prescription guidelines for various drug gene pairs. And they've all come through the various clinical decision-making support processes, including what the FDA has done with pharmacogenomics biomarkers

• 33:43Speaker 04

  that they have actually put out there through their guidelines. I think the scale of this opportunity, as it continues to evolve, is significant, right? And I think if you think about it, 95% of the people, based on data that we know at this point in time, carry some kind of genetic variant, right? That could influence on how they react or how they metabolize, you know, certain medications. And I think this is, is going to be critically important, right? As we continue to look at large US data that's available, you know, where a population has been studied, like, for example, of veterans, where there is even a higher level of variability that's, that's prevalent. Through it's been published, actually, in a, in a JAMA journal article that was published, you know, on pharmacogenomics.

• 34:26Speaker 04

  I think the impact of pharmacogenomics on the pharmacy, it's going to, it's going to lead to more and more of a profound shift, right? As we become more catered towards prescribing medicines that are very tailor-made to individuals. And I think with the focus that we see in certain areas, whether it's in, in a rheumatology, whether it's in oncology, and in those spaces, you actually see more and more specialized therapies that are actually being targeted in that particular space. And I think the role of the pharmacist in terms of chaperoning this process and ensuring the right medicine reaches the right patient is going to be a very profound one as time goes on.

• 35:06Speaker 02

  Allison, it's fascinating to me to think that we can start tailoring

• 35:12Speaker 02

  a compound, a specific medication, and even vitamin and OTC products, over-the-counter products, to teach our, our people out there that, hey, your genes are just slightly different than someone else's, and you're going to react to medications a little bit differently. But where do you think, where do you think pharmacists belong in all of this? In the health system pharmacist role to become more involved in that personalized treatment and decision-making in the future?

• 35:43Speaker 03

  So we actually ran a project in mental health prescribing, where we did pharmacogenomic testing.

• 35:53Speaker 03

  And that was quite fascinating. We've got a specialist mental health service. And the interesting bit for us is that we, so first of all, pharmacogenomics is just another piece of the puzzle. We've already talked about the complexity of patients' lives, about medication usage, et cetera. And you still have to take all of that into account. So this was a little bit more of a piece of information, which leads to some interesting discussions with patients.

• 36:24Speaker 03

  Because the one thing we talked about was this is about how you metabolize this drug. So where you used to sit there and say to a patient, let's try this drug and see how you get on with it, we could shift that conversation. And I think the pharmacist's role, so when we were doing our project, the pharmacist's role became, the patient was diagnosed, and then sent to the pharmacist for a conversation about what's the best medication for you. And the element, so it brought us into that real prescribing area. And I think the element for us is, is working with the medics and specialist nurses

• 37:07Speaker 03

  around saying, you need to take this into account. Are they a fast metabolizer, a slow metabolizer, et cetera? And the interesting bit for us is kind of where along the journey that needs to happen. Because actually, what we discovered through our project was you either have to do it at the treatment, treatment naive stage, so before they've started the medication, or at the really complex stage, that was where it really added the value. And the pharmacist, again, helps at both ends of those spectrums. A, explaining to the patient, what do we mean? When we say fast metabolizer, what do we mean?

• 37:46Speaker 03

  And the, the element about giving the clinicians that extra piece of the jigsaw, that we can have that MDT discussion on what's the, the best for the patient. I think the other interesting element for us is, again, that patient advocacy. We dealt with a lot of questions from patients who were quite concerned about what was happening with this data. So that pharmacogenomics, if you were to say to somebody, we're testing your DNA, we immediately, the one thing we learned was never ask a paranoid patient whether you're okay if they test, you to test their DNA or not, because we got some really bad reactions.

• 38:23Speaker 03

  But the element, patients want to know what's happening. So that's the other factor, is patients want to know what's happening with this data. This is data about them. So actually, you know, we talk about pharmacogenomics, a huge field, huge databases, huge increase in knowledge. Patients want to know what it means for them individually. And again, the pharmacist is often able to explain, now, this is about you. This is, this is this true personalized medicine, where we're saying, you metabolize this, this drug slower, so we're going to give you a lower dose to start with. You might still have the side effects, it's not a magic bullet. It's not going to, you know, it's not going to mean that you're not going to get side effects,

• 39:07Speaker 03

  but we can minimize them, we can explain what you're going to, what's going to happen. And I think that element, and again, it brings us closer into that clinical team. It binds that team around the patient much more better. And pharmacists are using their skill of talking to a clinician, talking to a patient, analyzing and interpreting data.

• 39:29Speaker 02

  Varan, I think of what this means for drug development and what it means for the data. Once again, we have all this data. We've been collecting PGX pharmacogenomics been around for 20, 30 years in concept. And like you said, 2003, the Human Genome Project started pouring out all of these answers. So talk to me about the innovation of these global trends in manufacturing and in advancing medication development and what could be next in the pharmaceutical lifecycle and ecosystem.

• 40:08Speaker 04

  I think it's a fascinating area, right? Because effectively, what's going to happen as we start becoming more and more customizable, one can't ignore the potential of, you know, potential of 3D printing products in the future, as an example, right? We talk about personalized medicines in terms of selecting the right treatment for the right patient. And I think technology is evolving, and 3D printing could actually take that a step further by allowing medicines themselves to be tailored for individual needs. And yet, visualize or imagine a future where a many, you know, particular dose, a formulation, a release profile could be actually adapted for a specific patient's needs to receive that exact product. Goes

• 40:52Speaker 04

  back to what Allison was just saying, in terms of a fast or a slow metabolizer, and what else could be actually maybe even inherently dictated by some of the biomarkers or the complex conditions that the patient presents, or even a pediatric population where, and I remember back in the day when I was moonlighting in the, in the hospital basement, you know, compounding products that would go up to the hospital floor, whether it's for oncology or any others. I mean, it was all pharmacists doing that customization, right? That basically enabled it in the future as scale continues to evolve. I think that could easily be, you know, something that can be done from a commercial scale standpoint. I think that's really exciting because at the end of the day, this could expand truly the role of the hospital pharmacist.

• 41:37Speaker 04

  As technology matures, pharmacists could actually become more closely involved in overseeing these personalized medicine productions. Because 3D printing could even come to a, an area closer to you, you know, a centralized area where that could be done potentially for specific patients at the end of the day. It will actually help determine what these individual patients need. And the highest safety and quality standards could be under the supervision of the hospital pharmacist. So to me, this is an increasingly higher skill set and expertise aided by digital technology in advanced manufacturing, which will then enable, again, you know, the customization as we talked about influence of pharmacogenomics,

• 42:19Speaker 04

  influence of customized medication. I think this is just a very, very positive evolution in terms of not only the personalized care, but also for the pharmacist playing a central role in helping turn this innovation into better outcomes for the patient.

• 42:34Speaker 02

  This has been a special interview. We really appreciate this. I want to come back to the awards. Love Your Pharmacist Awards. We've been discussing innovation and technology and the role of the pharmacist and patient advocacy. But at the heart of it all, it comes back to the people. It comes back to that patient. It comes back to the bedside and the customization of just caring, holding somebody's hand, looking in the eye and saying, listen, we're doing everything in our power to make sure that you're okay. And then the care people that are there, the people that are in the lives of that patient, to calm

• 43:13Speaker 02

  them down and say, listen, you are in good hands. You are in good care. Allison, what would you say to someone considering nominating another fellow pharmacist this year for Love Your Pharmacist Awards?

• 43:28Speaker 03

  Oh, I would say get writing. You know, those nominations. I think the lovely bit about the nominations is, yes, it brings joy and recognition to the person you nominated. And as we've talked about, I love my profession dearly, but deep as, at times, we can be martyrs to ourselves in terms of actually, you know, we sort of, we step back in the spotlight. And there's a bit, look around to a colleague that you really appreciate, or a team that you see, that you think really should be recognized. Because actually, the, let's

• 44:08Speaker 03

  go intellectual, the dopamine rush you get even just from a nomination means that you get recognition. It means that you continue that work. The other lovely bit, and there's a really lovely thing our trust does, which is called learning from excellence, which is nominate when something goes right. Because actually, the other thing they found through that research is the person you nominate gets that positive feedback, but you get a benefit. Because the element that you having done something for somebody else actually gives you that good feeling as well. And that's the bit. In these days of really challenging times, and the days when it feels like all you ever do is look at how hard it is, you

• 44:52Speaker 03

  know, everybody's asking to save money and everything's going wrong, particularly as pharmacists, we focus on the what went wrong far too much. So actually, the bit about bringing that appreciation in works not just for the person you've nominated or the team you've nominated, it's good for you as well. And as a recipient, that actually, the lovely bit for me was looking at the colleague who nominated me and seeing his joy at me being awarded, actually was also part of that, of that reward from the nomination. I'm very proud and, and humbled by the fact that I received it last year. And the impact that

• 45:34Speaker 03

  people have shared with me that I had on other people that I don't even remember doing. But, but they, you know, people said to me, you did this. And I go, did I? Okay. Thank you. And that, that was so lovely that, that brought me, you know, the element of yes, I am doing okay. I have made a positive impact on my colleagues and my patients. And that's really valuable to take home at night.

• 46:00Speaker 02

  Varan, this has been very special. I want to thank you and Clinigen for establishing and honoring pharmacists throughout the globe. So what's this mean to, to you? Because you're, you were a practicing pharmacist at one time, too.

• 46:20Speaker 04

  Indeed, Todd. And I think we are really honored to be able to, you know, kind of really exemplify this, this behavior that our pharmacists actually do, you know, kind of lead by example. I think the one thing I've learned throughout, throughout my career, and you said, you said it right, I've had a chance to be in their shoes on the front lines, is that there are so many moments that actually, you know, shape things that the pharmacist does, and they often go unnoticed. So I think it's exactly what Allison said. She didn't even, she may not even recall all the things that she's done, which people are, you know, thanking her for. But I think it's that conversation, that piece of advice, the problem that has been solved at that right time. It's the people that are responsible

• 47:05Speaker 04

  that rarely seek that recognition. And Allison is a great example. She just mentioned that. But that doesn't mean that they don't deserve to be recognized. And I think that's a very small way for us as an organization, Clinigen, where we work with so many pharmacists, to recognize that. And really, the simple message over here is to thank them and let them know that their work really mattered. It made a huge difference. And I think that's a powerful thing to say and for them to hear. And we want to thank them for it.

• 47:33Speaker 02

  Thank you. Thank you to Clinigen. Thank you to Allison. This has been so special for you to spend time with us and really describing the evolving role of our pharmacists and our health systems, and how important it is to be a champion of the people and to be an advocate for the people. And once again, Varan, thank you so much for being here with us. And a shout out to Clinigen for really helping to amplify the voice of our pharmacists. My name's Todd Urey with the Pharmacy Podcast Network, and stay tuned for, we'll be doing episode two upcoming. We thank you. Hope you guys have a great day.