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In this episode, host Taylor Watterson, PharmD, PhD, welcomes Shane Desselle, RPh, PhD, FAPhA, professor of Pharmacy Practice and Social Pharmacy at Touro University California.

Amplifying Technicians: Shane Desselle, RPh, PhD, FAPhA

Articles

Amid ongoing approaches to lower drug prices for US patients, like the Most-Favored-Nation policy, this is another partnership the Trump Administration believes will improve access challenges.

White House Strikes Deal with Pfizer for Lower Drug Prices, Online DTC Website

In part 2 of our interview, Lissette Logan, PharmD, and Danielle Weaver, RPh, discuss the evolution of contraceptive services and how pharmacy is supporting rural communities and their patients.

Q&A: How Rural Pharmacists Are Stepping Up in Areas of Contraceptive Care

In part 3 of our interview with Bill Wolfe, COO of WriteWise, he discusses the technology backing his team’s approach to forever changing how pharmacy benefits are distributed in the US.

Q&A: The New Technology Platform Revolutionizing How Pharmacy Benefits Are Managed

Drug Topics connects pharmacists across retail, health system, and specialty practice with clinical updates, pharmacy trends, and regulatory news.

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Danielle Weaver, RPh, owner of Big Sandy Pharmacy and Wolves Den Pharmacy in rural Montana

CVS and Walgreens will limit their offerings for the COVID-19 vaccine, even for those who meet the new criteria from the FDA, according to 

 The new criteria limit who can receive a COVID-19 vaccine, with 4 different vaccines having different indications on who can receive the immunization.

CVS will now offer COVID-19 vaccines in 13 of 16 states and the District of Columbia to those who have a prescription from their physician or other medical provider. The states include Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, North Carolina, New York, Pennsylvania, Utah, Virginia, and West Virginia. CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico. According to 

, CVS will offer updated COVID-19 vaccines in the remaining states pending Advisory Committee on Immunization Practice (ACIP) guidelines. For Walgreens, patients need prescriptions for 16 states but not all of them overlap with CVS, and it is unclear which states include these 16, according to 

The FDA recently approved 4 updated COVID-19 vaccines: Pfizer and BioNTech’s Comirnaty, Novavax’s Nuvaxovid, and Moderna’s Spikevax and mNexspike. All have been approved for adults 65 years and older to prevent COVID-19. Other indications include

Nuvaxovid: for patients aged 12 years through 64 with at high risk of severe disease with least 1 underlying condition

Spikevax: for patients 6 months through 64 years at high risk of severe disease with at least 1 underlying condition

mNexspike: for patients aged 12 through 64 years at high risk of severe disease with at least 1 underlying condition

Comirnaty: for patients aged 5 through 64 years at high risk for severe disease with at least 1 underlying condition

Guidance and information on the upcoming 2025-2026 respiratory season have been met with confusion. Recommendations, which were once aligned across organizations, are now conflicting, which included government organizations, such as the CDC, as well as the health care organizations, such as the American Academy of Pediatrics (AAP). Pregnancy has been removed from the adult schedule, even though some health care providers consider it an underlying condition leading to severe disease.

“We need to take the politics out of immunizations and rely on medical experts with years of education, the experience, and the knowledge to interpret that data to provide evidence-based recommendations," Laura Knockel, PharmD, BCACP, clinical associate professor at the University of Iowa College of Pharmacy, said.

AAP published its annual immunization schedule, which covers guidance for influenza, respiratory syncytial virus, and COVID-19. Although recommendations from the organization typically follow ACIP guidelines, this year the schedule differs from the recent recommendations from the committee.

“[Patients are] understandably confused. The space around vaccines is changing so rapidly,” Knockel said.

 “There's so much misinformation and disinformation out there, so I really think the first step is to acknowledge that concern, and again, coming from the point of they want to do what's best for their child.”

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our

1. Astor M, Blum D. CDC uncertainty upends COVID vaccine access at CVS and Walgreens. 

. August 28, 2025. Accessed September 2, 2025. https://www.nytimes.com/2025/08/28/well/cvs-pharmacy-covid-vaccine-16-states.html

2. Levy S. CVS, Walgreens limiting offerings of new COVID-19 vaccines. 

. September 2, 2025. Accessed September 2, 2025. https://drugstorenews.com/cvs-walgreens-limiting-offerings-new-covid-19-vaccines

3. Gallagher A. FDA approves COVID-19 vaccines for patients 65 years and older. 

. August 23, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-covid-19-vaccines-for-patients-65-years-and-older

4. Gallagher A. New COVID-19 vaccine recommendations cause confusion among public, health care providers. 

. June 10, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/new-covid-19-vaccine-recommendations-cause-confusion-among-public-health-care-providers

5. Gallagher A, Knockel L. Q&A: pharmacist advocates for evidence-based immunization guidelines for COVID-19 vaccines. 

. September 1, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/q-a-pharmacist-advocates-for-evidence-based-immunization-guidelines-for-covid-19-vaccines

6. Gallagher A. FDA approves updated 2025-2026 COVID-19 vaccine for patients 65 years and older. 

. August 27, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-updated-2025-2026-covid-19-vaccine-for-patients-65-years-and-older

CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico.

Clinical

CVS, Walgreens Will Limit COVID-19 Vaccine Offerings in 16 States

journal explores issues within pharmacy, from the impact advocacy can have in community pharmacies to staffing shortages across multiple sectors within pharmacy. This month’s issue also explored the importance of disease awareness months and how they are opportunities to maximize valued care. Check out a preview of this month’s issue here.

download the PDF of the Total Pharmacy August 2024 issue here

Don’t get left behind: Sign up today for our 

 and get the latest drug information, industry trends, and patient care tips delivered straight to your inbox.

See what’s trending in pharmacy with a preview of the Total Pharmacy August issue.

Total Pharmacy

In This Issue: Total Pharmacy August 2024

Combining sodium glucose co-transporter 2 inhibitors (SGLT2is) with glucagon-like peptide-1 receptor agonists (GLP-1RAs) may offer additional protection against cardiovascular and kidney disease in patients with type 2 diabetes (T2D), according to the results of a new meta-analysis published in 

 and presented at the 61st European Renal Association Congress in Stockholm, Sweden.

Separately, SGLT2is and GLP-1RAs have demonstrated cardiovascular benefits. However, little clinical literature has focused on outcomes associated with using the medicines together. Due to the growing prevalence of GLP-1RAs in the 

 and obesity landscape, accelerated by an increasing number of indications for the agent class, this is a crucial area for further study.

The SGLT2 Inhibitor Meta-analysis Cardio-Renal Trialists’ Consortium (SMART-C) is the largest assessment of outcomes for the combined therapeutic use of SGLT2is and GLP-1RAs. The study gathered data from 12 large-scale, placebo-controlled trials of SGLT2is involving 73,238 patients with diabetes. Of these, 3065 were already receiving GLP-1RAs.

Overall, SGLT2is lowered the risk of major adverse cardiovascular events by 11% and hospitalization for heart failure or cardiovascular death by 23% compared to placebo. Notably, this benefit was seen regardless of whether patients were also taking GLP-1RAs.

When used together with GLP-1RAs, SGLT2is reduced the risk of chronic kidney disease progression by 33% and slowed the annual loss of kidney function by nearly 60%.

The study found no additional safety concerns when SGLT2is were used in combination with GLP-1RAs.

Study Reveals Robust Benefits of Semaglutide in Protecting Against Kidney, CV Events in Patients With T2D

Current meta-analysis results build off positive results of the landmark FLOW trial (

). Published earlier in May, results of the international, double-blind, randomized, placebo-controlled phase 3 trial spotlighted semaglutide’s effectiveness in lowering the risk of kidney failure, decelerating worsening kidney function, and protecting against the risk of cardiovascular events and death, in patients with T2D.

“SGLT2 inhibitors have clear protective effects against heart failure and chronic kidney disease, while GLP-1 receptor agonists can reduce the risk of heart attack, stroke, and also kidney disease—as recently demonstrated in the landmark FLOW trial,” said Brendon Neuen, lead author, clinical associate professor, senior research fellow at The George Institute for Global Health, and director of kidney trials at Sydney’s Royal North Shore Hospital, in a news release.

 “Our findings support using this combination to further improve outcomes in patients with type 2 diabetes who meet guideline recommendations for both therapies.”

Elevated glucose from diabetes can damage blood vessels in the heart and kidneys, increasing the risk of 

 and kidney disease. In fact, diabetes is the most common cause of chronic kidney disease.

Moreover, estimates predicting that T2D prevalence will more than double in the next 30 years, surpassing 1 billion global cases by 2050, further strengthen the need for research into diabetes care.

 According to Neuen in an interview with 

 conducted over email, the current study offers valuable insights for developing global treatment strategies for the condition.

"These findings, which represent the largest and most comprehensive evaluation of the combined use of SGLT2i and GLP-1RA, provides the clearest evidence yet that combined use of both medicines can further reduce cardiovascular and kidney disease," said Neuen. "We anticipate that these findings will inform how people with diabetes are treated worldwide, including influencing major clinical practice guidelines.

Although current results suggest that using SGLT2is and GLP-1RAs in tandem may offer robust protection against cardiovascular and kidney disease, further research is needed to fully understand the long-term effects of the combination therapy.

Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our 

 and get the latest drug information, industry trends, and patient care tips, straight to your inbox.

1. Apperloo E, Neuen BL et al. Efficacy and safety of sodium glucose co-transporter 2 inhibitors with and without glucagon-like peptide-1 receptor agonists: A SMART-C collaborative meta-analysis of randomised controlled trials. 

. 2024. doi: 10.1016/S2213-8587(24)00183-9

2. Massaro L. Study reveals robust benefits of semaglutide in protecting against kidney, CV events in patients with T2D. 

https://www.drugtopics.com/view/study-reveals-robust-benefits-of-semaglutide-in-protecting-against-kidney-cv-events-in-patients-with-t2d

3. Combining popular diabetes drugs offers complementary heart and kidney benefits. News release. The George Institute for Global Health. July 9, 2024. Accessed July 10, 2024. 

https://www.georgeinstitute.org/media-releases/combining-popular-diabetes-drugs-offers-complementary-heart-and-kidney-benefits

4. Mayo Clinic Staff. Chronic kidney disease. Fact sheet. Accessed July 8, 2024. 

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

5. Klein HE. Diabetes prevalence expected to double globally by 2050. 

https://www.ajmc.com/view/diabetes-prevalence-expected-to-double-globally-by-2050

When used together, sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) were able to lower the risk of major adverse cardiovascular events and kidney disease by 11% and 33%, respectively.

SGLT2i, GLP-1RA Combination Therapy Offers Robust Protection Against Cardiovascular, Kidney Disease

Menstrual pain management has evolved to a comprehensive, patient-centered approach that empowers women through multiple treatment strategies. Pharmacists now recommend a holistic method combining lifestyle modifications, nonpharmacological interventions, and medical treatments, ranging from yoga and dietary changes to prescription medications. Joanna Lewis, PharmD, MBA, 340B program director at Baptist Health, discusses how social media is increasing awareness and encouraging women to explore various options like heating pads, specific yoga poses, magnesium supplements, and hormonal contraceptives. Pharmacists are playing a crucial role in this transformation, positioning themselves as key educators who can provide evidence-based guidance, help patients navigate complex health information, and destigmatize women's health issues. This progressive approach not only addresses menstrual pain but also represents a broader shift towards more comprehensive, personalized women's health care.

What are some of the nonpharmacological strategies pharmacists can recommend for managing menstrual pain? How can pharmacists integrate these into a patient counseling session?

The first thing I would ask my patient when they came to me asking for different modalities is, "what have you already tried? And did it work? Did it not work?" And then I would go from there. I would also ask about their diet and exercise as a starting point. There are a lot of different strategies people can try. Heating pads are a very easy thing to try. Regular exercise has been shown to help; yoga, especially Child's Pose, Cat-Cow, and Cobra, has been effective in reducing pain; stretching; magnesium-rich foods; or supplements—we've talked about that already. [Food] has been shown to mildly reduce cramps, and then overall, an anti-inflammatory diet with more fruits and vegetables and whole grains can help. I would also say less caffeine, which I know is hard for all of us [and] more hydration. Some people like tea, chamomile tea, and then acupuncture. Depending on how comfortable the patient is, acupuncture is also a nonpharmacological strategy that people can use so well.

How can pharmacists counsel a patient who presents with severe, debilitating menstrual pain that has not responded to multiple OTC therapies?

Often we have to try multiple therapies or a combination of therapies to really get the proper relief. If multiple modalities are not working, like if they're trying yoga plus supplements plus ibuprofen, and they're still not getting any relief, there are prescription-strength NSAIDs that we can try. These include higher doses of ibuprofen, higher doses of naproxen, and then there's another NSAID called mefenamic acid that's available with a prescription. Then some providers will actually prescribe birth control. This hormonal contraception works by thinning the uterine lining, and it reduces ovulation, which lowers prostaglandin production and cramp severity. So some people need to go on birth control. Then there are a few other prescription medications that are available for specific symptoms, like if you had a severe case that was linked to endometriosis, heavy bleeding, or even symptoms of irritability and sadness, all of these can be prescribed by your OB [obstetrician] or medical provider based on your individual need.

How can pharmacists stay up-to-date on new guidelines, medications, and nonpharmacological treatments related to women's health conditions like dysmenorrhea, PCOS, or menopause?

So my favorite resource for women's health is through ACOG, which is the American College of Obstetricians and Gynecologists. They publish guidelines, and they have a great online website that you can reference. The American Pharmacist Association also has CE and resources, as well as other pharmacy organizations. Also the Journal of Women's Health kind of hits all of those topics we just talked about, and then as far as online resources that most of us have access to in our practice, UpToDate and LexiComp are always good resources on the current guidelines.

How do you see the role of the pharmacist evolving in the area of women's health, particularly with the growing number of OTC options and direct-to-consumer health care models?

The good news about the world we live in today is that women are starting to speak out more and not suffer in silence. I think women used to just see menstrual pain as a cross to bear but now they realize that there are remedies available, and even on social media, there are a lot of influencers and just regular people bringing awareness to women and destigmatizing so that we don't suffer alone. I see this a lot too around perimenopause symptoms, and I'm glad that more people are speaking up about that because that will give us the awareness and the chance to develop more remedies in the future. So this is an exciting time to be a pharmacist because of all the social media content, though sometimes the consumer needs help sifting through the noise, so pharmacists really need to stay up to date on the current trends and remedies so that we can counsel on what works and what doesn't. I also see, in the future, pharmacists carving out more of a niche role around women's health. Our jobs are evolving so much, and there may be opportunities for us to be more involved in the public and women's health and perimenopause and menopause, so pharmacists can take a very active role in educating their patients and the public about these public health concerns.

Pharmacists enhance menstrual pain management by integrating holistic strategies, empowering women with personalized care and evidence-based guidance for better health outcomes.

Q&A: Pharmacists Play Essential Role in Women's Health Care

Pharmacists discuss state barriers and scope of practice challenges

Pharmacists Break Down State Barriers and Challenges in Scope of Practice

In the evolving landscape of health care, pharmacists are emerging as critical frontline providers, pushing the boundaries of their traditional roles and seeking recognition for their expanding clinical capabilities. The current health care system presents a complex patchwork of regulatory challenges that significantly limit pharmacists' potential to deliver comprehensive patient care. Across the United States, the scope of practice for pharmacists varies dramatically from state to state, creating a fragmented approach to health care delivery that ultimately impacts patient access and quality of care.

These variations manifest in critical areas such as prescribing authority, lab test ordering, and the extent of physician oversight required. Community pharmacies, in particular, face substantial obstacles in providing consistent, high-quality services, especially in sensitive areas like reproductive health. The inconsistency extends beyond clinical capabilities, encompassing fundamental operational aspects like technician staffing ratios and the ability to administer specific medications. Perhaps most significantly, pharmacists continue to face a fundamental challenge at the federal level: they are not recognized as reimbursable providers under Medicare. This systemic exclusion creates a substantial financial barrier that prevents pharmacists from fully leveraging their extensive medical training and potential to improve patient outcomes.

The conversation around pharmacists' scope of practice is not merely about professional expansion but about fundamentally reimagining health care delivery. Pharmacists represent a largely untapped resource in the health care ecosystem, with advanced training and daily patient interactions that position them uniquely to provide preventative care, disease management, and critical health interventions.

Emerging voices in the pharmacy profession are calling for a more collaborative, patient-centered approach. They argue that by breaking down institutional barriers, standardizing practice guidelines, and creating sustainable payment models, pharmacists can become integral partners in comprehensive health care delivery. The goal is not to replace traditional medical providers but to complement their work, filling critical gaps in patient care and improving overall health outcomes. As health care continues to evolve, the role of pharmacists stands at a critical juncture. The profession is poised to transform from a traditional dispensing model to a dynamic, clinically engaged approach that could revolutionize how we understand and deliver primary care.

Pharmacists advocate for standardized scope of practice, improved collaborative care models, and equitable reimbursement to enhance patient services across different states.

Total Pharmacy Interviews

Pharmacists Break Down State Barriers and Collaborative Care Challenges

Public trust in vaccination is at some of the lowest points in history.

Pharmacist Discusses Concerns Over Immunization Changes

Laura Knockel, PharmD, BCACP, expresses concerns about how vaccine recommendations are being communicated, noting a shift away from traditional, transparent discussions to less formal channels such as social media.

Danielle Weaver, RPh

Articles

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