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However, a large majority of parents in the US believe routine childhood vaccines, such as the measles, mumps, and rubella vaccine and polio vaccine, are safe and important.

One in 6 Parents in US Delay or Skip Routine Vaccination for Children

Using the vaccine adverse event reporting system database, researchers address adverse events following pneumococcal vaccination as well as the association between adverse events and vaccine administration.

Adverse Events Prominent During Post-Pneumococcal Vaccination

Merck’s pneumococcal 21-valent conjugate vaccine was noninferior to the pneumococcal 23-valent polysaccharide vaccine for all 12 shared serotypes and superior to 9 unique serotypes.

Capvaxive Shows Immune Responses to All 21 Serotypes for Children, Adolescents

Andrew Maiorini, PharmD, FAHM, vice president of clinical programs at PerformRx, discusses the ongoing issue of medication nonadherence and the pharmacists’ crucial role in managing it.

Q&A: Pharmacists Guide Patients Through Clinical, Social Determinants of Nonadherence

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

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FDA approves apalutamide for castration-resistant prostate cancer.

Apalutimide for Prostate Cancer: What to Know

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

Approximately 39% of pharmacies in the US dispensed buprenorphine in 2023, which is a 6% increase from 2017, according to an article published in 

. Buprenorphine is the only scheduled medication for opioid use disorder that can be prescribed at both the primary care and pharmacy levels in the US. Although dispensing did increase, investigators found persistent disparities in who can access treatment. In pharmacies in predominantly Black and Latino neighborhoods, only 18% and 17%, respectively, were likely to carry buprenorphine compared with 46% in predominantly White neighborhoods.

“Relaxing buprenorphine prescribing rules was an important step in making this critical treatment more accessible, but too many patients lack a nearby pharmacy that carries it,” Dima Mazen Qato, senior scholar at the Schaeffer Center and the Hygeia Centennial Chair at the USC Mann School of Pharmacy and Pharmaceutical Sciences, said in a news release.

 “Federal and state policy makers must reduce barriers that make it difficult for pharmacies to stock buprenorphine, especially in some of the more vulnerable communities.”

Even with most states increasing buprenorphine availability, Florida, Ohio, Tennessee, Washington, Virginia, and Washington, DC all had significant decreases. In California, Illinois, and Pennsylvania, the availability in Black or Latino neighborhoods was about 4 to 5 times lower than in White neighborhoods. Additionally, investigators noted that independent pharmacies in Black and Latino neighborhoods were significantly less likely to have buprenorphine and more likely to stop carrying it over time. Furthermore, independent pharmacies were more likely to fill approximately twice as many prescriptions per month than any other type of pharmacy.

“If policymakers fail to introduce policies that increase equitable access to buprenorphine at local pharmacies, existing racial and ethnic disparities in opioid use disorder treatment and recovery will likely worsen,” Jenny S. Guadamuz, an assistant professor at the University of California, Berkeley School of Public Health, said in the news release.

In addition to buprenorphine, methadone treatment is also an option to treat opioid use disorder, and although it seems to be accepted by patients, significant barriers remain. In fact, patients who received pharmacy-based methadone treatment embraced the model despite the restrictive practices in place for opioid treatment programs (OTPs), according to results of a study published in 

To enable pharmacy-based methadone treatment programs, community pharmacies must partner with OTPs that create medication units to dispense the drug. However, these are rarely implemented because the approval process and regulatory requirements are very complex. Furthermore, pharmacies can also face state legislative challenges as well as reimbursement barriers. Changes to federal law and regulations can also allow physicians to prescribe the drug and community pharmacies to dispense it.

There were 31 individuals included in this study, with 3 patients who were in long-term recovery and experienced access to methadone, 5 patients in early recovery using either methadone or buprenorphine, 5 OTP leaders, 7 pharmacy leaders, 6 payers, and 5 policy makers. Investigators found that people from all groups said reducing stigma and increasing privacy are important for the outcomes of these programs. Further, participants stated that decentralizing methadone services through pharmacies could allow more access to patients and reduce exposure to open-air drug markets, making it safer. However, the current laws and regulations are restrictive for access, according to the study authors.

“Results identified potential advantages to pharmacy-based methadone, including the geographic convenience of pharmacies and that care delivered at the pharmacy may be an overall more patient-centered experience than that delivered at an OTP,” the study authors said.

 “The most salient disadvantages related to pharmacy-based methadone generally were concerns about diversion and increasing overdose deaths and the lack of comprehensive medical and social services available at pharmacies.”

Mental and Behavioral Health Resource Center

1. Guadamuz JS, Axeen S, Qato DM. Trends in the availability of buprenorphine at US retail pharmacies, 2017-23. 

. 2025;44(9):1157-1163. doi:10.1377/hlthaff.2025.00349

2. Despite relaxed prescribing rules, opioid addiction treatment still hard to find at pharmacies. News release. University of South Carolina. September 2, 2025. Accessed September 3, 2025. https://www.eurekalert.org/news-releases/1096113

3. Stewart MT, Feltus SR, Tschampl CA, Bratberg JP, Green TC. Key-informant perspectives on pharmacy-based methadone treatment for opioid use disorder in the US. 

. 2025;44(9):1164-1172. doi:10.1377/hlthaff.2025.00344

In pharmacies in predominantly Black and Latino neighborhoods, only 18% and 17% were likely to carry buprenorphine compared with White neighborhoods.

About 1 in 4 Pharmacies Dispense Buprenorphine, But Disparities Persist

Pneumococcal disease mortality trends changed significantly in the US following the onset of the COVID-19 pandemic, according to study findings published in the 

Exploring the influences of pneumococcal disease mortality and events of the COVID-19 pandemic, researchers investigate changes in US pneumococcus survival rates since 2020.

Stephanie Trexler, PharmD Candidate

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