“This isn’t goodbye, it’s ‘see you later,’ as we continue our shared commitment to advancing pharmacy services for the people who rely on us.”

See You Later!

As I move forward in my career journey, I want to thank you all for the honor of working alongside such a dedicated and professional team.

Together, we’ve shaped what a system strategy can be through the CPO Council, expanded retail and specialty pharmacy access to limited drugs, strengthened our strategic partnerships both externally and within our health plan for better pharmacy benefit management and outpatient pharmacy partnership, and stood together in advocacy for the 340B program to protect and expand access for our patients and communities.

These efforts reflect our shared commitment to the people who rely on us. This isn’t goodbye, it’s “see you later!” Wishing you all continued success in the important work ahead.

Teamwork makes the dream work! Over the past few months, our Pharmacy Collaborative Teams have finalized their annual projects. There were several amazing and successful projects! The Anticoagulation and Controlled Substances teams are just two examples.

Anticoagulation Team: The team’s project over the last year focused on improving patient education on anticoagulation therapy before hospital discharge by setting up a dashboard to track and benchmark progress. The primary aim was to create a baseline of anticoagulation education on new oral anticoagulants provided prior to discharge. This baseline is specific to each UC campus and will ultimately serve as a jumping-off point to increase the percentage of patients who receive and complete this critical education. The goal of the education is to enhance medication adherence and reduce risks associated with these products such as bleeding or embolism. By addressing missed opportunities for education, the initiative is expected to improve clinical outcomes, lower hospital readmissions related to VTE or bleeding, and support compliance with safety regulations (NPSG.03.05.01). Overall, it ties directly to the organization’s quality and safety goals

Controlled Substances Team: The CS team worked on a DEA Mock Audit Checklist to help every UC stay audit-ready when it comes to controlled substances. Mock audits are an essential part of a regulatory readiness plan and can not only reduce the financial impact of visits by regulatory bodies but also identify areas for improvement in current processes. This tool guides teams in maintaining accurate records and reports that meet strict federal, state, and local requirements—protecting patient safety while minimizing risks of drug diversion. By being proactive, we not only reduce the likelihood of costly fines, which can be up to $18,040 for each violation, but also improve operational efficiency and financial sustainability. It’s all about staying prepared, compliant, and confident ahead of any DEA site visit

Vaccines in pharmacy are gaining traction and receiving recognition from the broader hospital system. With new Pay-for-Performance criteria around Adult Immunization Status, and recent pilots at several retail sites, physicians and nurses are beginning to partner with pharmacy teams to improve vaccine uptake. As such, the Vaccine Implementation Task Force has identified three charges to work on over the next year to improve vaccine uptake across the system.  The charges are below and will assist with improving documentation, billing and reminder systems to help increase the number of patients in our system getting their vaccines.

1.        Clinic dispense/Pharmacy bill – Working with EPIC, UC Legal, and Compliance to determine the best approach for providing and billing pharmacy vaccines in the clinic setting. (See the graphic from CMS that provides an example of this work)

2.       Reconcile vaccines in EPIC – Collaborating with IT to ensure accurate CAIR data transfer and developing a workflow for reconciliation.

3.       Patient reminders via MyChart – Implementing annual reminders and scheduling options in WAM.

Credentialing and Privileging

In addition to vaccines, pharmacy practice continues to expand. A recent law now allows pharmacists to provide additional services and bill for them. Many pharmacists work beyond the traditional pharmacy walls, however there is a way for pharmacists to bill for their services as well.  We have discovered that payors will allow pharmacists in the clinics to bill for their services, but it requires them to be credentialed and privileged at the hospital site and get onto the hospital cost report.

Some sites already have processes in place to get their pharmacists these designations, but others are just beginning. At the system level, efforts are underway to create a standardized pathway so that pharmacists can be included on the hospital cost report—unlocking the ability to bill for ambulatory care services.

Both the vaccine and billing initiatives reflect our shared commitment to advancing pharmacy practice, strengthening partnerships, and delivering better care for our patients.

The UC Specialty Pharmacies are a Corporate Member with NASP. At the NASP Annual Meeting, 10 UC SP team members attended and represented the UC SP teams. Below are a few highlights from the conference showing the impact of UC Health on this national specialty pharmacy platform.

Presentations:

·         “Navigating the Rare Disease Landscape: Developing a Specialty Pharmacy Program.” An overview of establishing a specialty pharmacy program to service patients with rare diseases. Presented by: Kanika Chandra (UCOP), Jason Bailly (UCSD), Tiffany Phung (UCD), Alyssa Yousif (UCSF).

·         “The role of health system specialty pharmacies in rare disease patient identification processes”. Case Study: University of California Health System Specialty Pharmacies. Presented by: Kanika Chandra (UCOP), Ghada Ashkar (UCLA).

·         “Navigating Affordability and Access”. Presented by: Mackenzie Clark (UCSF).

Posters:

·         “Prescription for Sustainability – Environmental, Financial, and Performance Outcomes of Eco-Friendly Cold-Chain Packaging.” Presented by: Kristine Chin (UCD), Myra Pascua (UCSF), Mackenzie Clark (UCSF), Kalpan Patel (UCLA), David Mitchell (UCD), Tiffany Phung (UCD), Jeremiah Duby (UCD).

Nominations:

·         The UC Health Specialty Pharmacies were nominated for the “Specialty Pharmacy of the Year” award.

Congratulations to all the UC Specialty Pharmacy teams on a successful conference and representation of our UC sites on a national platform!

TBD

The 340B Program is at a crossroads - new state mandates, pricing pilots, and manufacturer constraints are reshaping its future. With billions at stake for safety-net providers and mounting legal and financial complexities, staying informed has never been more critical. Click “Read More” to uncover what’s driving change.

·         HRSA Launches 340B Rebate Model Pilot

o   On June 1, 2025, HHS and HRSA submitted proposed 340B rebate guidance to the Office of Management and Budget for regulatory review. Shortly after, HRSA announced a voluntary 340B Rebate Model Pilot Program, inviting pharmaceutical manufacturers to submit plans. Deadlines are September 15, 2025, for plan submission and September 8, 2025, for public comments. This initiative could transform how cost savings are delivered-shifting from upfront discounts to data-driven rebates.

·         States Push Back Against Manufacturer Restrictions

o   States are increasingly stepping in to protect covered entities:

§  Tennessee enacted a law preventing manufacturers from limiting 340B pricing via contract pharmacies or requiring data submissions unless federally mandated.

§  Indiana passed legislation, effective July 1, 2025, requiring covered entities to report annually on drug acquisition costs, contract pharmacy payments, and use of savings, joining Idaho, Maine, Minnesota, and Washington in transparency efforts.

§  18 states have now passed laws that prohibit manufacturers from restricting contract pharmacy access to 340B pricing.

·         Major Manufacturer Policy Changes

o   Several drugmakers are revising their 340B contract pharmacy strategies:

§  Genentech, effective May 31, 2025, now requires covered entities to submit claims data via 340B ESP to access 340B pricing.

§  Bristol Myers Squibb is expanding its restrictions starting July 1, 2025, limiting contract pharmacies for the oncology drug Augtyro (repotrectinib) to up to five per covered entity that lacks an in-house pharmacy.

Open enrollment for the employee health plans is right around the corner.  The 2026 plan year will showcase limited benefit changes to coverage while promoting a revamped premium for each program.  Open enrollment will start in October.  Members will still have several plan options to choose from including

1.     UC Blue and Gold HMO

2.     PPO options

3.     Kaiser

While the benefits are mostly unchanged for the 2026 plan year, members will notice some small changes to the type of plans offered and premiums.  Most of the changes are:

1.     New High Deductible plan option

2.     More affordable premium options

3.     More competitive premium for the Blue and Gold program when compared to Kaiser

Overall, the benefits are going to be the same when looking at the deductibles, copays, formulary and pharmacy networks. 

Coverage changes for 2026 will impact weight loss coverage.  For 2026, plans are making changes for the prior authorization process for weight loss coverage.  Many of the plans will require a higher BMI in order to be eligible for coverage.