RxNews: Scams, AI, and Closures Rocking Pharmacy This Month

?? This Month in Pharmacy: Key Insights & Industry Updates

Why It Matters: From transformative AI tools to alarming fraud cases and weight-loss drug risks, the pharmacy landscape is shifting fast. Staying ahead of these changes is essential for protecting patients, ensuring compliance, and thriving in a challenging market.

Inside This Issue:

• Weight-Loss Drug Boom: Risks and scams creating chaos.
• Pharmacy Closures: A slow-motion healthcare crisis.
• Fraud Cases: Shocking schemes that tarnish the profession.
• AI’s Role: How tech is reshaping workflows and outcomes.

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Weight-Loss Frenzy: Risks and Scams on the Rise

?? The Big Picture: A surge in demand for weight-loss drugs like Ozempic has led to shortages—and dangers. From unregulated compounded medications to scams preying on desperate patients, the weight-loss boom is rife with risks.

?? Compounded Ozempic: High Demand, Higher Risks

The issue: Compounding pharmacies are stepping in to supply alternatives during Ozempic shortages, but some are using semaglutide sodium—an unapproved, untested form of the drug.

?? Why it matters:

• FDA Warning: Compounded semaglutide and semaglutide sodium are not FDA-approved.
• Health concerns: Patients face unknown side effects, questionable quality, and risky interactions.
• Additives: Ingredients like B vitamins or L-carnitine, commonly added, lack proven benefits and may pose additional risks.

?? State action: Regulators in states such as North Carolina and Mississippi are cracking down on pharmacies using unapproved semaglutide salts.

Go deeper: Compounded Ozempic by Compounding Pharmacies | FDA warnings

?? Scammers Exploit Desperation

The problem: Fraudsters are targeting patients through fake websites, social media ads, and marketplace listings.

?? The risks:

• Counterfeit products: Patients report mislabeled insulin pens filled with saline or other unsafe substitutes.
• Financial loss: Scams often promise discounts and demand risky payments like Bitcoin or Cash App.
• Health danger: Unregulated products bypass medical oversight, endangering lives.

?? By the numbers: Phishing attempts tied to weight-loss drugs spiked 183% in early 2024, according to McAfee.

Go deeper: Scammer deep dive

?? Novo Nordisk Fights Back Against Risks

The response: Novo Nordisk, the maker of Ozempic and Wegovy, is ramping up legal and regulatory efforts.

?? Key moves:

• Legal action: Over 50 lawsuits filed against compounding pharmacies producing unauthorized versions.
• FDA petition: Novo Nordisk is pushing to ban semaglutide compounding entirely.
• Eli Lilly’s support: The Mounjaro maker warns of compounded drugs’ risks, including contamination and overdoses.

?? The challenge: Without compounded options, patients could face monthly costs exceeding $1,000 and limited insurance coverage.

Go deeper: Novo Nordisk asks FDA to stop compounding pharmacies

? Takeaway: While compounded meds and cheap deals may seem appealing, health and safety come first: ? Verify pharmacies through state boards. ?? Avoid offers bypassing prescriptions or requiring sketchy payment methods. ?? Consult licensed healthcare providers for guidance.

?? Your thoughts? Have you encountered patients inquiring about compounded drugs or scams? Comment or reply here with your experiences!

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A Slow-Motion Healthcare Collapse

?? A Slow-Motion Healthcare Collapse

The Big Picture: Pharmacy closures and drug shortages push patients to the brink, creating a nationwide crisis. ???

Why It Matters:

• With 34% of adults managing three or more prescriptions daily, closures and shortages demand smarter, more accessible care solutions.?

?? Medication Access Breakdown

The Problem:

• Pharmacy Closures: Over 3,000 stores from CVS, Walgreens, and Rite Aid have (or will be) closed, leaving 59% of Americans worried about local access. ????
• Drug Shortages: 32% of patients report disruptions, and 12% missed prescriptions in the past year. ????

Who’s Hurting Most:

• Urban residents and families with kids—67% feel the impact. ?????
• Only 16% would consider online pharmacies, showing strong preference for in-person care.

?? Tech & Cost Solutions

Rising Prescription Prices:

• 52% of Americans rely on coupon sites like GoodRx for financial relief. ????

Tech Innovations:

• 74% are open to using QR codes for medication tracking.
• 48% would consult AI chatbots for prescription help. ????
• 58% value tools like smart pill organizers or medication apps. ??

?? Go deeper: Wolters Kluwer Health survey | Click here to check out my deep dive YouTube video on pharmacy closures

??? New York Forces PBM Transparency

What’s New: On November 27, 2024, New York’s DFS unveiled sweeping pharmacy benefit manager (PBM) regulations for transparency and consumer protection.

Why It Matters: PBMs must adapt policies and contracts immediately to avoid compliance risks. Mail-order pharmacies, networks, and health plans face major shifts.

Key Changes

• Compliance Costs: PBMs must disclose cost increases tied to compliance. ??
• Pharmacy Contracts: Credentialing is limited to once every three years, with all terms updated by Jan. 1, 2027. ???
• DFS Oversight: The DFS can access PBM service contracts and approve or block acquisitions based on broad criteria.
• Consumer Protections: Rules address unfair practices, pharmacy steering, and member ID card fairness. ???
• Pharmacy Audits: New standards for notices, timelines, and appeals.

Deadlines

• Most provisions are live now.
• Contract and formulary directory changes take effect July 1, 2025.

?? Your turn: What’s your take on these new PBM rules? Reply and share your thoughts! ???

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Broken Trust: Pharmacy Fraud Cases Exposed

?? White Coats, Dark Crimes: Fraud in Focus

Why It Matters: Fraud schemes in pharmacy erode public trust, inflate healthcare costs, and tarnish the profession’s integrity.

?? $46M Fraud: Compounding Scheme in Louisiana

• What happened: Former sales executive Christopher Casseri pleaded guilty to defrauding state and military health programs of $46 million.
• Tactics:
• What’s next: Casseri faces sentencing in March 2025; two co-conspirators face trial in January.

Go Deeper: Louisiana exploitation

?? $41M Scam: Fake Scripts in Dallas

Why It Matters: Scams like this undermine insurer trust, inflate premiums, and burden patients with higher costs.

• The scheme: Ivor Jallah billed insurers for undispensed medications using forged prescriptions, fake patient data, and falsified invoices.
• Fallout:

Go Deeper: Pharmacy owner fake scripts?

?? Identity Theft: Tennessee Pharmacy Owners Charged

Why It Matters: Abuse of patient trust and stolen identities highlight vulnerabilities in the system.

• Accusations: Anne Warren and Tiffany Haney of Rocky Hill Pharmacy allegedly altered prescriptions and used stolen identities to claim reimbursements.
• Key details:

Go deeper: Rocky Hill Pharmacy case

?? Michigan Brothers’ $15M Medicare Scam

Why It Matters: DOJ efforts to combat healthcare fraud protect taxpayers and uphold system integrity.

• The culprits: Michigan pharmacist Raad Kouza and his brother, Ramis, used their pharmacies as fronts to bill for undispensed medications.
• The impact:

Dive deeper: Michigan Brother scheme?

The Big Picture: These cases reveal systemic cracks and ongoing exploitation in pharmacy, with billions lost and public trust damaged.

?? Your turn: How can these abuses be prevented? Share your thoughts!

?? What do you think needs to change to prevent these kinds of abuses? Share your thoughts.

?? AI Shakes Up Pharmacy

Why It Matters: AI is already reshaping pharmacy workflows, enhancing efficiency, and tackling rising costs—without replacing clinical decision-making. Leaders at Becker's CPO Summit shared what’s next for AI in pharmacy.?

?? AI's Early Wins in Pharmacy

Where it’s making waves:

• Prior Authorization: Streamlines paperwork-heavy tasks. ??
• Clinical Support: Acts as a helpful assistant for routine decisions. ??
• Medication Adherence: Keeps patients on track with their meds. ????

Pharmacy leaders are clear: AI isn’t the "new boss"—it’s a powerful tool freeing up pharmacists to focus on higher-value work.

?? AI Tackles Costs and Outcomes

The challenge: Rising drug prices and the pressure to justify costs.

• What’s changing: AI analyzes cost-effectiveness and connects expenses to outcomes.
• Why it matters: As Andre Harvin, PharmD, of Cone Health says, "If we can't connect costs to outcomes, pharmacy will always face scrutiny."

Act Now: AI Is Pharmacy’s Future

What’s next: Leaders agree—explore AI today to stay ahead tomorrow.

?? Your turn: How do you see AI transforming your workflow? Reply to share—we may feature your insights in the next issue! ??

In a world where innovation moves faster than a pharmacist on a double shift, staying informed isn’t just smart—it’s essential. From the rise of AI in healthcare to the battles over drug pricing and access, the pharmacy profession is evolving at lightning speed.

Don’t miss the next edition of RxNews, where we’ll dive into the trends and challenges shaping your career and the industry at large.

Until then, stay curious, stay proactive, and keep pushing for the future you want to see! ??

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