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In hospitalized patients with obesity, researchers conduct a study detailing how electronic clinical support helps participants optimize their treatment regimens.

Digital Clinical Decision Support Improves Treatment for Patients With Obesity

Along with additional bills to further bolster PBM reform, the organizations are aiming to pass the PBM Reform Act for improved medication costs and community pharmacy sustainability.

NCPA: More Than 125 Groups Urge Congress to Pass PBM Reform 

Andrea Sikora, PharmD, MSCR, FCCM, FCCP, BCCCP, chair of the committee presenting new guidelines, discussed her role in bolstering pharmacists’ support in the ICU.

Q&A: New ICU Guidelines Highlight, Confirm Role of Critical Care Pharmacists

Among individuals with both diabetes and HIV, researchers determine patients’ adherence to comprehensive diabetes care interventions.

Diabetes Care Significantly Lacking For People With HIV

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

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Check out these top featured stories from Drug Topics in April 2024.

In Depth Perspectives: Psychedelic Medicine, Scope Creep, And More

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.”

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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

Hispanic and Black adults aged 65 or older exhibited increased influenza vaccine rates during the COVID-19 pandemic (2019-2022), according to study data  published in 

 White adults of the same age living in rural areas and having low educational attainment saw decreased flu vaccine rates during the same time period.

“Although influenza vaccination rates have slowly increased over the past 
10 years and are highest among older adults, vaccination remains underused, particularly for American Indian or Alaska Native, Black, and Hispanic adults,” wrote the study authors. “When considering all adults, influenza vaccination during the 2021-2022 season was lower among Hispanic (37.9%), American Indian or Alaska Native (40.9%), and Black (42.0%) adults than among White (53.9%) and Asian American (54.2%) adults; this pattern continued through the 2022-2023 season and has been consistently observed since the 2010-2011 season.”

Vaccine disparities among races have been historically notable across the health care sector. Going back to the COVID-19 pandemic and the years that followed, CDC statistics for the 2021-2022 flu season show that approximately half of all US patients received a flu vaccine, yet only 43% of Black, Hispanic, and American Indian/Alaska Native adults received one.

FDA Approves COVID-19 Vaccines for Patients 65 Years and Older

While a variety of personal challenges can impact any patients’ ability to get vaccinated, there are often 3 key issues that perpetuate racial disparities between White patients and those of other races when it comes to vaccination. Those issues include access, missed vaccination opportunities, and mistrust or misinformation.

Because minority groups such as Black and Hispanic patients are often impacted by financial and socioeconomic inequities, their access to essential vaccines is often hindered. There have also been reports of missed opportunities to vaccinate Black and Hispanic patients who even had insurance and regularly checked in with their medical providers. Despite many patients in minority groups reporting these regular visits, their vaccination rates were still significantly lower than those of White patients.

Finally, the CDC mentions misinformation—a phenomenon that skyrocketed in notoriety during the pandemic. While misinformation and distrust during the pandemic were not exclusive to specific groups of patients, minority groups have historically been led to distrust medical information because of events like the Tuskegee Syphilis Study—which was a massive mistreatment of research study participants who were mostly Black.

Among all the historical data and more recent exploration of trends during the pandemic, researchers wanted to further progress their knowledge of influenza vaccination rates throughout this time and how older adults specifically felt toward the vaccine during an unprecedented medical emergency.

“In this study, we use national data from the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey to examine patterns of influenza vaccination among older adults in the US before vs late in the COVID-19 pandemic,” continued the authors.

 “The larger sample size and richer data allow for the investigation of national patterns by race and ethnicity, educational attainment, and rurality.”

This served as a more encapsulating approach to flu vaccine data during the pandemic, and researchers hoped to provide a larger scope of these trends and understand them specifically among older adults of varying social lifestyles. They conducted a retrospective study of MCAHPS survey respondents from 2019 and 2022. Participants had to be Medicare Advantage or Medicare fee-for-service enrollees aged 65 or older living in the 50 US states or Washington, DC.

A total of 285,265 survey responses (54.5% women; 76.2% White) were included in the study. Overall, influenza vaccination rates increased modestly, by 0.7%, throughout the 4-year period. However, while rates among White, Asian American, Native Hawaiian, and Other Pacific Islander adults were relatively unchanged, older Black (3.8%) and Hispanic (2.3%) adults experienced increases in flu vaccination.

“Rural Black and Hispanic older adults had the largest estimated increases during this period, at 7 percentage points for Black older adults and 8.2 percentage points for Hispanic older adults, while White older adults with lower educational attainment and/or living in rural areas had the largest estimated decreases in influenza vaccination rates at approximately 2 percentage points,” the authors wrote.

 “These findings are encouraging for populations that have been historically more difficult to reach with interventions.”

The researchers do not have concrete evidence as to why some races overtook others during the pandemic regarding flu vaccine rates. However, they believe that the pandemic itself had spillover effects, with heightened efforts to increase COVID-19 vaccine rates translating to higher rates of the flu vaccine. And while all races were encouraged to receive the COVID-19 vaccine, the increased efforts in underserved populations may correlate with increased rates among Black and Hispanic older adults.

However, because there is significant uncertainty about why these rates differed by race, future research into this data pool during the pandemic is warranted.

“Although overall influenza vaccination rates did not change substantially from 2019 to 2022, there were substantial increases for Black and Hispanic older adult populations with historically low vaccination, while White older adults with lower educational attainment and/or living in rural areas had decreased rates of vaccination,” they concluded.

 “Determining the reasons for these divergent changes is a high priority for future studies.”

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Among older adults with Medicare, researchers investigated national influenza vaccination patterns by race, education level, and rurality.

Drug Topics Staff

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