PBMs Under Fire, the World Pharmacist Challenge & CRUSH COST | TWIRx

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1:20Welcome to This Week in Pharmacy. Twerks is the weekly pulse of the pharmacy profession. And now, here's Pittsburgh native, bleeding black and gold, pharmacy's first podcaster and founder of the Pharmacy Podcast Network, the RxPodfather, our host, Todd Urie.

1:43Hey there, hey there. It's time to twerks. October 30th, 2026. It's Halloween.

2:00Are you dressing up for Halloween? Do you dress up for Halloween? What's going on at the pharmacies today? Hopefully it's a fun day.

2:12I am ready for a weekend. My daughter has something going on. I don't know what it is, but we are ready to twerks. It's a Steeler football weekend as well. Go Pittsburgh Steelers. I do want to say thank you to everyone who has been voting for the Top Host Award. I don't know if you guys heard about this, but Top Host Award is a Ryan Seacrest initiative to find and to award a top host in podcasting. And yours truly, Todd Urie, a candidate for that award. And if I win, I'm going to bring massive attention back to pharmacy and pharmacists and what they do for public health. Can't wait to find out what happens.

3:09I don't know exactly when the final decision is made, but I am a candidate. Hey, we are excited about twerks today. We have two incredible guests. First up is Dr. Jesse McCullough, my friend and founder of the 31-Day Challenge. With that, let's bring in Jesse. Hello, everyone. Jesse McCullough here with the 31-Day Challenge for American Pharmacist Month. Here we are. We are now at the end of October 2026. And this brings us to our final exclusive challenge for listeners of This Week in Pharmacy and the Pharmacy Podcast Network. Mark, before we get to what that challenge is, I'd like to just take a minute to thank everybody who has participated.

4:03If you have participated in one or all of these challenges, I cannot thank you so much. I trust that you have found value in the various challenges that have been brought forth this year. And even if you've gone back to check out some of the challenges from last year, they were intended to be able to meet you where you're at and help just help you take one positive step. forward, either in your personal or professional life. So I trust that you found value with that. I also need to thank all the guests that have come by. I think when it's come down, we have well over 50 different guests have stopped by over the last two years to share a challenge, something that often has made such an impact in their careers, such an impact in their lives, that they wanted to share it.

4:51And I'm so happy and excited to be able to bring some of those stories to you and bring some of those challenges to you. And of course, I need to thank Todd and the entire team at the Pharmacy Podcast Network. Whenever I started this, Todd was one of the very first supporters on board. And he said, hey, I would love to feature an exclusive challenge on the network. And it's become something that I know I look forward to. I hope you look forward to it as well with that. But we're going to wrap up 2026, but I want you to know there's more to come. There's still a lot more to come, actually. American Pharmacist Month may be done, but we're actually going to shift to a World Pharmacist Challenge.

5:34And for this, I'm going to tell you right now I need some help. I need your help because with this challenge, we're going to be featuring pharmacists and people working alongside and supporting pharmacists from all over the planet to come forth and share their stories and to share their challenges, the things that made a difference in their careers. So if you or somebody you know has a wonderful story like that to share, I'm going to ask you to please reach out to me. Reach out to me. I'd love to hear your story and look at how we might be able to turn that into a challenge to be able to feature it as part of the World Pharmacists Challenge.

6:11And I can tell you right now, the first challenge is already recorded. It's going to be coming out here in the very near future. So keep an eye out for that. um let's move in let's move into our final challenge you know as i did this i i you have a lot of time to think about and and you you also get exposed to all these different ideas as i've talked with the various guests that have come on and i wanted to share a story with you today um this is a particularly impactful story at least to me and so i'll share it with you So the story actually has a title. It's known as the story of the unknown monk.

6:57And the story goes like this. When I was a young man, I wanted to change the world. I found it was difficult to change the world. So I tried to change my nation. When I found I couldn't change the nation, I began to focus on my town. I couldn't change the town. And as an older man, I tried to change my family. Now, as an old man, I realized the only thing I can change is myself. And suddenly I realized that if long ago I had changed myself, I could have made an impact on my family. My family and I could have made an impact on our town. Their impact could have changed the nation, and I could indeed have changed the world.

7:38You know, there's so many pharmacists out there that are doing world-changing work, And you may be one of them. I actually, if I was a betting man, and I'm not, but if I was a betting man, I would actually bet that you're involved in some world-changing work. And I want to applaud you for doing that. But I want to share with you the challenge that comes from this story. Because a lot of times we step out and we want to make a big impact. We want to change things on a global, on the global level. But really where change happens is it happens at the individual level and it happens inside out. That's the way the best change happens.

8:19And my challenge to you as we wrap up this year's 31-day challenge is this, it's change yourself. It's change yourself. And how do you do that, right? And I would suggest to you that each day in the 31-day challenge, there has been a little challenge that has the potential to help you change yourself. You can go back. You can review those. You could actually go through. You could do each of the challenges month after month after month. And I trust you would still find value in those because what they do is they are all intended to point you in a positive direction, to move you forward. And so my encouragement for those of you that have participated in the challenge, or maybe you were a spectator this year, maybe you thought, well, some of these challenges are cool, but maybe they're not quite for me.

9:14I want to encourage you to change yourself. And the add-on to that is don't stop. Don't stop changing. Don't stop improving. Don't stop doing those little things that you can do on a daily basis that can change yourself. And what that can do is that can change your team and that can change your organization and that can change your country and that may indeed change the world. So I thank you so much for the opportunity to share these challenges with you again this year. Again, the World Pharmacy Challenge or World Pharmacist Challenge is going to be coming along here in the next several days. So stay tuned for that.

9:58Reach out to me. give, you know, I would love to hear your stories. I would love to love to hear the challenges that you have that have made an impact in your career. I would love the opportunity to potentially feature you as part of that World Pharmacist Challenge. And I will remind you as I do with each of these challenges that the challenge that I share here with you today, it's not just for you. It's for all of us. And I want to encourage you, no matter how you're consuming this podcast today, I want to encourage you to share it with two people because when we each get better, we all get better.

10:34And with that, Todd, I'm going to send it back to you, my friend. And thank you again so much for the opportunity to share with Pharmacy Podcast Network and bigger and better things are coming for all of us. So look forward to continuing the conversation in the coming month.

11:02Jesse, Jesse McCullough, he is a champion. We need more Jesse McCulloughs in this world, in the pharmacy profession, helping us to move forward and just be there for each other and challenge each other, challenge each other to be better and to do more. And I am charged up about his challenge and in his efforts and going international with this is going to be absolutely incredible. Hey, we got twerks news. And now here's the latest in pharmacy coming up on twerks news.

11:43All right. First up, PBMs are forced to open their books. And guess what? They're fighting back because they don't want to pay the fees. They don't want to pay the penalties. The Department of Labor finalized a regulation requiring PBMs to disclose fees, rebates, spread pricing, revenue, and other compensation to covered employer health plans. the PBM Industry Trade Association, the good old PCMA argues that the rule is redundant, costly, and potential harmful to smaller PBMs. It's considering ways to challenge the regulation. And I want to say this to PCMA and everybody out there listening. If PBMs are already transparent, Why is revealing their revenue?

12:40Why is that such a problem? Why? Why, why, why? I want to know why. So good news coming out of this week in pharmacy and just to be able to dig in. I want you to read PCMA's response. I'll put it in the show notes of today's podcast. next up pbm has retaliated against independent pharmacies we knew this was happening um the house oversight chairman james comer has launched an investigation into whether cvs health caremark express scripts and optim rx used burdensome audits against pharmacies that publicly supported pbm reform legislation. One particularly striking allegation in an audit involving, listen to this, this is crazy, an audit involving a 99 cent medical claim, a PBM claim reportedly consumed hundreds of hours of a pharmacy staff's time.

13:49These are the allegations under investigation, not established findings of retaliation. It's obvious what's happening. I'm going to put in the show notes. You're going to read the congressional announcement in the letter of this investigation. And I want to know, are pharmacy audits legitimate program integrity tools or are they being weaponized to silence independent pharmacies? We know this is happening. I've heard from pharmacy owners that this is in fact happening and it's absolutely crazy. And I want to see it stop. Not sure what we can do to stop it other than just to keep it in the news.

14:32And that's why it's on This Week in Pharmacy. All right, last on the news, HHS opens the door to six controversial peptides. They published an interim enforcement discretion policy covering six peptides, which include BPC-157, Eptalon, KPV, MOTS-C, as in cookie, as in C is for cookie. It's good enough for me. And CMAX and TB-500, this could expand access through qualifying 503A compounders under specified safeguards, but the substance are not FDA approved and major questions about human safety and effectiveness remain. The FDA scientists have raised objections. So I want to know, is this a breakthrough for personalized medicine or are we exposing patients to experimental substances before the science catches up?

15:42In the show notes, I'm going to have a link to HHS Federal Register Notice. And a shout out to our compounding pharmacies. What do you guys think? You're the ones that I want to hear from and you're the ones that I trust. And also the Alliance for Pharmacy Compounders and Compounding, Scott's team over there. I'd love to hear on this issue. I'm going to look up some information. I'm sure they have something out. They're always putting great information out on the latest in compounding and pharmacy compounding. Shout out to Curify Labs, by the way. Curify Labs is doing some amazing things in 3D printing, in compound creation.

16:25If you haven't heard about them, go to curifilabs.com. Once again, curifilabs.com. We're going to be doing a three-part series with Curify Labs. You're not going to want to miss it. just understand the revenue opportunities in non-sterile compounding is huge actually in all compounding but more specifically non-sterile and we want to see more of that man hey this outfit if you're listening on the on the rss feed you're missing out on a treat if you're watching me on YouTube or LinkedIn, you get to see my Halloween costume. It's absolutely nuts. It's crazy. I actually bought this for my father's 80th birthday.

17:13I can't wait to surprise him. I'm going down to Florida, meeting up with my sisters and brother and family to celebrate my father's 80th. And I'm going to show up in this ridiculous costume. And I even put a little Steelers on it, number 92, Harrison the Great. If you are a football fan, I'd love to hear from you and how your team's doing this week in pharmacy. Hey, when we come back from the break, we are going to hear from Pharmacy 50's most influential person in pharmacy for the 2025 season. And with that, I also want to say that voting for the Pharmacy 50 2026 season is coming up. Voting starts on November 4th.

18:03Do not forget, go to pharmacy50.us. Once again, that's pharmacy50.us to put in your vote and vote for somebody that you think a lot of and that maybe doesn't get enough recognition. Pharmacy 50 has brought so much attention to people in the pharmacy industry who have not received a lot of attention in their work. And their work is monumental. It's changing lives. It's changing healthcare. And we're excited to continue to push advocacy for pharmacists, our technicians, and people who are behind the scenes with the Pharmacy 50. yeah I tell you what Grant Harding is coming up Pharmacy 50's most influential you don't want to miss this interview and we are so excited about the future pharmacy man and what's happening we will be right back

19:09This episode is sponsored by Independent Pharmacy Cooperative, widely known as IPC. Established in 1983, IPC is the nation's largest group purchasing organization owned by Independent Pharmacy. With a mission of maximizing the success of community pharmacists, IPC works to provide members with access to effective programs and services designed to enhance profitability for independent pharmacy. Read more about our mission by checking out our website at IPCRX.com. That's IPCRX.com.

19:50Hey, welcome back to this week in pharmacy in the studio. I always say in the studio, but literally in the studio, one of our pharmacy 50 most influential, or I should say, take that back the most influential for 2025, just this past year. Right? Grant Harding. Yes. I was the winner for the great award. I'm very happy about that. Yeah, you did an amazing job promoting it. And I want to say we're getting ready for the 2026 awards. And the voting will start the first, I think the first week in November. And I just want to say to everybody listening, nominating somebody that you think a lot of, nominating somebody that you know behind the scenes doesn't get enough recognition for what they're doing for public advocacy, for a specific vein of pharmacy care.

20:48It's so important because I know when I get talked about positively on LinkedIn or Instagram or something, it makes such a difference. It lightens my heart and then bringing recognition to a technician, to a pharmacist to something but what what was it like um through i mean campaigning for yourself for this award is kind of like it's a weird feeling because you like don't necessarily want to do it but the advocacy that you bring to the profession when you win that award there's something to that too grant yeah it does feel a bit weird you know saying vote for me like i'm not a politician like crying out loud but i i knew what kind of fan base i had and what kind of viewers I had.

21:30I knew they were very supportive and they wanted to be involved. They wanted to have that feeling of, we got this award. It wasn't necessarily, let's throw a grant up there. But they felt a sense of camaraderie, I guess you could say with that. So when I kind of looked at it from that perspective, it was kind of like me and my friends, completing a goal together is really what it felt like um and i was just i mean i was incredibly happy with the way we responded like my goodness i i think we like broke a record or something you did that yeah yeah you had over 2 000 votes it was amazing yeah i think the next to you was in the 200s wow so it was it was massive and it was because of your fan base and that that's the whole point of of influence and what, what you do, like that's famous Spider-Man line, uh, that Uncle Ben said to Peter Parker, uh, with great, um, power comes great responsibility.

22:34And I say that back to my winners. We've had 200 alumni and I've met up with so many of them since. And I've said, what did you do with that exposure to move the profession forward or to help somebody or to get more attention around a political situation that's holding back pharmacy care. And there are so many of our alumni winners, Nadia Ahmad and Jordan Smith, and so many people that are using their status to do other things. And I'm like, yeah, that's the whole point of it. Yeah, that literally is the whole point of it. You use that connection, you use that, I guess, notoriety for lack of a better term, out to hopefully create some good in this world and in the profession because now I can put that on my name I can put that in my bio and it adds to the validity it adds to the sincerity and whenever people see that they're like okay well I can I can trust this guy whenever he says this is an issue and we should be looking out for it and we should try to avoid it or here are ways that maybe we can avoid this issue or something along those lines, to be a little bit vague there.

23:53But yeah, it definitely just helps the general feel of what we're trying to do whenever you have, I can say I was number one. And that carries a lot of weight to these folks who view me. Yeah, and so talk to our listeners real quick, just in case they don't remember or they don't know. So if you're not looking and watching Grant on TikTok, tell us about kind of what you're doing with your platform.

24:24Man, it's been a really fun ride, honestly. So I guess the way this started was, I guess we can go back to whenever I was working as a traditional retail pharmacist at Rite Aid, the now defunct Rite Aid. and I just hated how nobody would listen to me whenever I would say, don't buy this, buy this instead. It's a third of the cost, but everybody gets shiny package syndrome and they think the price is somehow tied to the efficacy or the value that a product provides. But I'm guilty of that. yeah we all are i am too i'm it's so psychological i'm looking for a chainsaw right now and i'm comparing husker vana which i've already owned still and echo and i'm gravitating towards the still because of ratings and rankings but there was a price difference that made me think well maybe this is you know it's priced a little bit more maybe it's worth a little bit more wait Which one was priced more?

25:37The still. Well, I come from a still family, so I think you probably might be right on that one. Yeah. So it's like, and there's one called the farm cutter, and then there's other ones like the wood cutter. And I know I'm butchering those names, but it's one's farm and one's wood. And the farm one is like, if you heat your house with wood, you know get the farm cutter whereas if you're just like putzing around in your yard and you want quality get the get the wood cutter so i'm probably ended up with the wood cutter oh i'll let you know how it turns out i would love to come down and do a review of it someday so they uh yeah so people do that and nobody would listen to me so i just stopped saying anything uh and then i started posting on social media uh i read the entire bible and i read another book that kind of basically said people love learning.

26:35And I was like, okay, well, I'm going to teach people something that I'm very passionate about because I'm tired of watching 60-year-old ladies spend money that they don't have on junk medications. And it was a real hit. And then after that, I started looking into these sketchy gas station pills. I have a relationship with a lab out in California that tests them for me. and it's it's really shocking stuff what we get back from some of these uh things that no mortal human should ever be buying and uh that's pretty much uh what we do today and then uh the underlying theme is how to help people save money on medication but you've taken some of these crazy ass gas station pills i used to used to what makes you did you make you stop like this is dangerous Yeah, two or three lab results coming back made me stop that one.

27:29I initially did that because I thought, okay, I guess to just catch everyone up to speed. There's these sketchy gas station pills like the rhino pill, etc. And on the back, it says, you know, Tongat Ali, Maka, like all these herbal supplements that don't really do anything. And people are like, don't take that. It's like, you'll die. And I was like, you're dumb. These don't do anything. And I would take it initially to prove to people how unfounded their concern was. And then I sent a couple to a lab, and lo and behold, they did come back with sildenafil is the one I mostly find. So I stopped taking them after that because the people and their concern was very much valid and correct.

28:24And I was the dumb one actually for believing what was written on the package actually was in the pill. So I learned the hard way there that they were right and I was wrong. Have you ever thought of teaming up with like an FDA hotline? I have been praying for someone from the FDA or the DEA to reach out to me. I've reached out to them. No response, nothing. I think someday they will. I would like to have a little bit more of an intimate relationship with these folks. But so far, nothing. And for the safety of the public, you would think they'd pay attention a little bit more to a pharmacist. that that's the whole existence of you as a PharmD is to ensure the public safety of drug-drug interactions or drug allergies or something.

29:25And you're out there gas station sleuthing, and it makes sense to have a pharmacist do that. Yeah. Yeah, I think someday somebody will eventually say something. But yeah, I don't know. Right now they just put out their little warnings warnings, announcements, and then nothing happens after that. That's typically what happens. There's a crackdown happening now on Kratom. Yeah. I've heard about the Kratom crackdown. Yeah, I mean, I know of it. I don't have a whole lot of opinion on that, on Kratom or anything involving it. And then the vapes in the state of Pennsylvania evaporated overnight where you're not allowed to sell either that.

30:12I'm misquoting because I don't have it pulled up in front of me. I should, but the Pennsylvania state, I don't know what department that would be. Maybe the, is there a separate FDA's? Not really. I don't know. Whatever department like decides what is going to be sold. I think they sent either a 30 day notice or some notice to every organization that has publicly said that they sell electronic vapes, that it's going to be coming to an end or is an end or something like nicotine no everything i think um let me see atf atf maybe maybe that was it pennsylvania i didn't know that more of a sketchy gas station pill kind of guy myself all right so let's see pennsylvania enforces strict regulations on electronic nicotine delivery systems, including major cell registry laws that went into effect on October 19th of 2026.

31:14It says the Act 57 Vape Registry Law. And this means that the Pennsylvania Office of Attorney General maintains an official directory of approved e-cigarettes and vaping products. So you have to have an approved brand and you have to allow manufacturers the registry currently features products from six approved manufacturers so the approved are jewel reynolds vapor company enjoy blue nine custom technologies and the swartz the swartz e-liquid do you remember the schwartz from the space ball movie long time ago I never saw that, actually. It was stupid. Okay, vape laws. Age limits. It's illegal to sell.

32:04We knew that. Anyone under 21. So it's not only 18, it's 21. And then... Or under 18 if they're active duty military veteran. Yeah, I wish they'd say that about a lot of things because you're 18 and serving. You're putting your life on the line. You can't even drink a beer. Yep. And then sales restrictions. self-service displays are restricted to specialty tobacco stores. All right. So I'm still confused what they've actually done here, but nonetheless. Looks like they just need some sort of approval process to sell. Maybe that's how I interpreted all that. Yeah. So, I mean, sketchy gas station pills should be scrutinized a little bit more.

32:44Yeah, they really should. It's kind of weird, actually, when you think about it. Yeah. Yeah, but you're continuing with this. Excited that you got to stop by and be on twerks because we've been waiting for this interview since you won the awards when you were here, goodness gracious, back in January. Yeah, it's been tough to get down here. How far away is the drive from where you're at? Only about an hour. Scheduling difficulties is where we run into an issue. Yeah, very coincidental. that I just so happen to live very, very close relatively speaking to this particular studio. Yeah, we've had several award winners.

33:32The farthest traveled was Fiona Sertoretto and she won two years ago. She wasn't number one. I think she was in the top maybe ten and she came in from Italy. She flew in? She flew in from Italy. Now, when she was here, she did more business, right? Oh, she did? But she initially was coming to accept her award, which is pretty cool. That is so cool. She has the record for travel to personally accept her award. Wow. Oh, and BTWs. I don't... For folks who maybe are unfamiliar with my channel, I also go to other countries and look at their meds. That is so fun. And I have been to Italy. And I've been to the Vatican as well.

34:14They have a pharmacy in the Vatican. And I just look at all the... you know i buy drugs in other countries that require prescription here and i buy them over there without a prescription um and just look at them and test them out at times which is the coolest hobby i think anyone could ever have when you nerd out as a pharmacist that's the coolest job of a hobby a pharmacist could have yeah every time i go somewhere people are like oh did you go to the beach or something like that no way cooler way cool went to a pharmacy that would be me though i i my family my daughter my wife um kids they cannot stand when i'll go to a target or a walmart or something and i'm like hey i'll be right back and they know exactly where i'm going i'm better tools i'm going going back to the pharmacy to hand out a pen or to say hello and you know what what which one of the biggest compliments my hometown um walmart brownsville Walmart in Brownsville, Pennsylvania.

35:16I went there and I went back just to see who was working because I know a couple of them. And as I walked up to the desk, I didn't recognize anybody. And all of a sudden, one of the technicians is like, hey, you're Todd. And I'm like, yes, you know me. I was like, I'm known by Walmart pharmacist technicians. Yay. Yeah. All right. Well, we appreciate you. You have to promise to not to wait to almost a year to come back. Maybe even we'll zoom in if you if you can't make the one hour drive that sounds amazing all right hey to learn more about grant what he's got going on uh take a look at crushcost.com and um stay tuned we're gonna have a special interview with grant we're gonna dig down into crush costs and what exactly that is here on twerks this week in pharmacy see ya bye

36:16Thank you.