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💊 The Big Fill This Week: Trump’s Sweeping Drug Pricing Order Targets PBMs and Global Price Disparities
What’s happening?
On May 12, 2025, President Donald Trump signed a significant executive order aimed at reducing prescription drug prices in the U.S. The order seeks to tie Medicare payments to the lowest prices paid in other developed countries, a concept known as the "most-favored-nation" pricing model. This initiative revives and expands upon a similar plan from his previous term.
Quick Doses:
- PBM Disruption: The order targets pharmacy benefit managers (PBMs), aiming to reduce their influence by enabling direct drug purchases from manufacturers at lower prices.
- International Price Benchmarking: Medicare would negotiate drug prices based on the lowest prices available in other wealthy nations, potentially leading to significant cost reductions.
- Industry Reaction: While some analysts view the order as a bold move towards price transparency, others express concerns about its implementation and potential impact on pharmaceutical innovation.
Why this matters:
The executive order represents a substantial shift in U.S. drug pricing policy, aiming to alleviate the financial burden on patients and the federal government. By challenging the traditional roles of PBMs and benchmarking prices internationally, the administration seeks to foster a more competitive and transparent pharmaceutical market.
What this means for you:
Pharmacists may see an increase in patient questions about medication pricing and availability as new Medicare pricing models take effect. Staying informed about formulary shifts, supply chain adjustments, and reimbursement updates will be critical to maintaining continuity of care and counseling accuracy.
Retail and independent pharmacies should closely monitor how reduced PBM influence and direct-to-manufacturer purchasing could impact reimbursement rates, contract terms, and drug access. While the long-term effect may improve transparency and margins, the transition period could bring operational and financial uncertainty. Read more here.
📊 Industry Trends
Walgreens Announces Closure of 54 Additional Stores Amid Strategic Restructuring
Walgreens has revealed plans to close 54 more stores across 17 states, as part of an ongoing effort to streamline operations and address financial challenges. This move follows a previous announcement to shutter 450 locations under a strategic investment deal with Sycamore Partners, aimed at revitalizing the business.
Quick Doses:
- Store Closures: The newly announced closures will affect stores in states including Massachusetts, Georgia, and West Virginia, with some locations set to close as early as next week.
- Prescription Transfers: Customers of the affected stores will have their prescriptions transferred to nearby Walgreens locations and will be notified by mail.
- Strategic Focus: CEO Tim Wentworth stated that approximately 25% of Walgreens locations are not aligned with the company's long-term growth strategy, prompting the decision to close underperforming stores.
Why it matters:
The continued downsizing of major pharmacy chains like Walgreens reflects broader challenges in the retail pharmacy sector, including increased competition, changing consumer behaviors, and financial pressures. These developments may lead to reduced access to pharmacy services in certain communities, particularly in underserved areas.
What this means for you:
Pharmacists and healthcare providers should be aware of potential changes in local pharmacy availability, which may affect prescription fulfillment and patient counseling services. Engaging with patients to navigate these transitions will be essential in maintaining continuity of care. Read more here
🗞 Quick Scripts: Other Industry News
California Proposes PBM Regulations and Drug Price Controls
California is moving to tighten oversight of pharmacy benefit managers (PBMs) through proposed legislation that would require licensing, increased transparency, and detailed financial disclosures. Governor Gavin Newsom’s plan also includes expanding the state-run CalRx initiative to manufacture affordable, name-brand abortion medications. Supporters argue the move could reduce drug costs and limit conflicts of interest in the pharmaceutical supply chain. If passed, this could set a precedent for other states exploring PBM reform and public-sector drug production. Read more here.
Independent Pharmacies Poised for Growth in 2025
Independent pharmacies are poised for significant growth in 2025 as large chains like Rite Aid and Walgreens continue to close underperforming locations. These closures are creating access gaps, especially in underserved communities, where independents can step in to offer personalized, community-based care. Many are expanding services beyond dispensing, including immunizations, chronic disease management, and telehealth. By staying nimble and adopting new technologies, independent pharmacies are well-positioned to meet evolving patient needs and strengthen their role in local healthcare delivery.
Texas Pharmacist Sentenced in $110 Million Fraud Scheme:
John Aguedo Rodriguez, owner of Pharr Family Pharmacy in Texas, has been sentenced to five years in federal prison for defrauding insurers of over $110 million. The scheme involved billing for medically unnecessary prescriptions and using kickbacks to generate high-volume claims. Investigators found that Rodriguez worked with marketers and prescribers to exploit reimbursement systems for personal gain. The case underscores how large-scale fraud can occur within pharmacy operations and the significant financial impact such schemes have on the healthcare system. Read more here.
Drug Spotlight:
Fitusiran (Qfitlia) – A Novel RNAi Therapy for Hemophilia A and B
Fitusiran, marketed as Qfitlia, is a groundbreaking RNA interference (RNAi) therapy approved by the FDA in March 2025 for routine prophylaxis to prevent or reduce bleeding episodes in individuals aged 12 and older with hemophilia A or B, with or without inhibitors. Developed by Sanofi, fitusiran targets antithrombin production, enhancing thrombin generation and promoting hemostasis.
Clinical Trials
The FDA's approval was based on two multicenter, randomized clinical trials involving 177 participants. These studies demonstrated that monthly subcutaneous injections of fitusiran significantly reduced annualized bleeding rates compared to on-demand treatments. The therapy was generally well-tolerated, with common side effects including viral infections, nasopharyngitis, and bacterial infections.
Looking Ahead
Fitusiran represents a significant advancement in hemophilia management, offering a once-monthly, subcutaneous prophylactic option that reduces the treatment burden for patients. Its novel mechanism provides an alternative for those with inhibitors to factor VIII or IX, addressing a critical unmet need in the hemophilia community. Read more here
🌟 Pharma Spotlight
Each week, we highlight pharmacy professionals and industry leaders who are making a real impact. This is our way of celebrating the work and dedication of professionals who drive pharmacy forward.
An oncology pharmacist, educator, and founder of KelleyCPharmD.
After a deeply personal encounter with cancer in her own family, Kelley built a career rooted in hematology/oncology excellence, training at institutions like Dana-Farber and Cleveland Clinic. But it was her experience in a small community hospital that reshaped her perspective, revealing how under-resourced many oncology pharmacists are outside of academic centers.
Kelley’s mission is clear: ensure every pharmacist has access to specialty training that transforms their confidence, clinical decision-making, and career. In this conversation, she shares her journey, the origin of her educational programs, and how she’s helping pharmacists navigate one of healthcare’s most complex and fast-evolving specialties.
1. Your career journey has taken you from clinical oncology pharmacy to founding KelleyCPharmD. What inspired you to make this transition, and how has it influenced your perspective on the pharmacy profession?
“I did not expect to start a business. It was completely serendipitous… A lot of pharmacists kept reaching out to me through LinkedIn, sending messages and asking for help… That’s when I recognized there was a big gap in oncology education. And it wasn’t really until I left clinical practice that I saw the gap, and thought of creative ways to fill it.”
“When you’re in a traditional clinical role… being a W2 employee, it’s a different mindset. You don’t really think of that type of opportunity.”
“Most of my clients are in the community setting… treating the vast majority of patients with cancer across the country… Maybe they’re the only oncology pharmacist there. It gave me a really good perspective on what kind of support they need.”
2. Through your Enjoy Learning Oncology (ELO) programs, you’ve mentored many pharmacists. What common challenges do you observe among pharmacists entering the field of oncology, and how does your program address them?
“The number one challenge is overwhelm. There’s so much information, disease biology, mechanisms, toxicities, placement in therapy, it’s a lot, especially for newer pharmacists.”
“My program is structured in a consistent, linear way… with weekly lessons and daily content broken into bite-sized pieces. People can fit it around their life… the idea is to help them make progress without feeling like they’re drowning.”
“It’s my job to remind them, hey, you’ve really come far. Keep putting one foot in front of the other.”
Kelley’s ELO program isn’t just an educational resource, it’s a full support system for pharmacists who feel overwhelmed stepping into oncology. The structure she’s built reflects a deep understanding of adult learners who are balancing clinical responsibilities, families, and everyday life. By breaking complex oncology topics into digestible, actionable pieces, she creates a path forward for pharmacists who might otherwise feel paralyzed by the depth and pace of the specialty. Her weekly encouragement and incremental progress model has helped countless pharmacists not only build competence, but regain confidence in their clinical decision-making. In a field where imposter syndrome runs high, Kelley’s voice is often the one reminding pharmacists they are capable and making real progress.
3. You’ve developed a comprehensive BCOP question bank to aid pharmacists in their certification journey. What gaps in existing resources did you aim to fill with this tool, and how has it been received by the pharmacy community?
“Practice questions are a good way for long-term retention. In oncology, you need to remember the information long-term, the basics about alkylating agents aren’t going away.”
“I got a lot of people saying, ‘Hey, I’m taking the BCOP exam in a month, do you have anything?’ They didn’t have time to go through the full program, so I made the question bank a standalone product.”
“There’s over 480 questions now, plus a full mock exam to help simulate the actual experience.”
Kelley’s BCOP question bank is more than a cram tool, it’s designed for mastery. Built on evidence-based learning strategies like active recall and test simulation, her resource helps pharmacists retain critical oncology knowledge far beyond exam day. Her recognition that many pharmacists needed a flexible study tool led her to break out the question bank from her broader program, making it accessible even to those on a tight deadline. With over 480 meticulously designed questions and a full mock exam, it’s become one of the most trusted tools for pharmacists preparing for board certification. Kelley’s attention to cognitive science, exam psychology, and the realities of pharmacist schedules makes this question bank a standout resource in the BCOP space.
4. How do you recommend pharmacists stay current and confident in such a dynamic field like oncology?
“Everybody needs to create a plan that works for them… Personally, I like in-person events and discussions, but that’s not for everyone.”
“The ASCO Post, OncoPharm podcast, and others are helpful, what matters is finding resources you’ll actually use and pay attention to.”
What makes Kelley’s approach different is that she doesn’t push a one-size-fits-all solution. Instead, she encourages pharmacists to find tools that match their learning style, whether that’s through listening, reading, or peer discussion, and build a routine around them. Her message is clear: consistency and engagement matter more than any single source, and staying informed should feel empowering, not exhausting.
5. You’ve been vocal about the importance of specialized training in pharmacy. What advice would you give pharmacists considering a specialization in oncology?
“I have no qualms about saying oncology is the best specialty in pharmacy. We’ve got job security, innovation, and incredible science.”
“When people first get into oncology, they’re like, ‘This is great.’ But then they start to fall off the cliff. That’s the Dunning-Kruger effect—you realize there’s a lot more here than you thought.”
“I tell people: oncology is like a hurricane. At first, you’re the weatherman dodging lawn chairs. Eventually, you get to the eye of the storm—it’s still chaos around you, but it’s calm, and you can see everything. You’re not ducking anymore. You can handle it.”
Insights for Pharmacists and Students
Kelley’s work fills a critical educational gap in oncology pharmacy, particularly for those in community settings or without residency training. Her ELO program offers structure and guidance when the field feels overwhelming, while her BCOP question bank gives pharmacists a proven tool to solidify long-term retention. For students and new practitioners, her platforms provide a practical, supportive entry point into a complex specialty.
Whether you’re preparing for board certification, transitioning into oncology, or just looking to stay sharp, KelleyCPharmD is more than a resource, it’s a community built around clarity, confidence, and continual growth.
Reach out through LinkedIn , visit kelleycpharmd.com to explore her programs, or email her at kelley@kelleycpharmd.com
That’s it for today’s fill!
Stay tuned for next week’s issue. If you enjoyed this, please share it with your pharmacy friends. Until then, keep filling those scripts 🫡
Doses and mimosas, ShiftRx team
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