EDITORIAL:
The APhA Annual Meeting
Inspirational, Educational, a Home Run, and an Error!
From the time I participated in my first APhA annual meeting in the 1960s, I was determined to participate in as many subsequent annual meetings as possible, and I have been fortunate in having done so. The excellent educational sessions, informative exhibit programs, social events, hallway discussions, and the establishment of what would become life-long friendships were valuable experiences that expanded my horizons and further increased my pride in my profession.
It will surprise many readers to learn that APhA annual meetings in the 1960s and before were the forums in which pharmacists who were active in most other national pharmacy organizations/groups (e.g., hospital pharmacists, faculty of colleges of pharmacy, members of boards of pharmacy) would also convene and participate in combined programs, as well as separate programs relevant to their specific responsibilities. Many of the current national pharmacy organizations (e.g., American Society of Consultant Pharmacists, American College of Clinical Pharmacy) had not yet been established.
The large increase in the number of pharmacists, the marked expansion of the number and type of practice roles for pharmacists, and the establishment of new national organizations of pharmacists with focused/specialty areas of practice have resulted in opportunities, experiences, and challenges in the 2020s that few would have even envisioned in the 1960s. Although a few smaller national pharmacy organizations/groups still hold their meetings in conjunction with the APhA annual meeting, for multiple reasons most national pharmacy organizations now hold their own separate meetings.
APhA2025
The APhA annual meeting was held in Nashville last month. The theme was Igniting Inspiration and motivational speakers, presentations about the Association's accomplishments, the exceptional services of Award recipients, and the discussions of new and innovative practice roles fulfilled this goal well.
As the umbrella national organization for all pharmacists, regardless of their type and site of employment, APhA has an added challenge in providing educational programming that will be of interest and value for pharmacists with very diverse responsibilities. The overall program not only met but exceeded expectations as attendees could select from dozens of diverse, relevant, and timely topics. A comment I heard from numerous pharmacists related to their difficulty in deciding between two or more programs that held a high level of interest for them but were held during the same time period. My presentation on new drugs was scheduled from 7:30 – 9 am on the Saturday of the program. As I reviewed the full meeting schedule, I noted that there were six other educational programs scheduled during the same time period as mine. Several long-time friends who traditionally have attended my annual presentation on new drugs had the courtesy to inform me that they would not be coming to my session this year because there was another program scheduled at the same time that would have greater value for them. Yes, I will quickly acknowledge that "New Drugs" is not an important topic for many pharmacists.
The exhibit program also contributes significantly to the educational value of the meeting, as do the hallway discussions with previous and new friends. These discussions are always stimulating regardless whether they concur with and reinforce opinions I hold, or what I learn from the perspectives of individuals whose views and opinions are different from my own.
The home run
Stephen W. Schondelmeyer, Pharm.D., Ph.D., is the 2025 recipient of the Remington Honor Medal. He is a Professor and Director of the PRIME Institute at the College of Pharmacy at the University of Minnesota. His distinguished career includes accomplishments in pharmacoeconomic and public policy research, as well as diverse and novel expertise and responsibilities across a wide spectrum of areas that involve relationships of pharmacy interests and issues with those of the entire healthcare system.
In my opinion, Steve's Remington Lecture was the "home run" of the APhA meeting. When it is published by APhA, it should be required reading for all pharmacists and student pharmacists. He reflected on the most important accomplishments and changes in the profession during the last 50 years – issues such as the repeal of anti-substitution laws and implementation of drug product selection laws, the expanded role of pharmacists in patient counseling and the requirement to offer counseling, the transition from the B.S. degree to Pharm.D. degree as the entry-level degree for licensure, and the substantial increase in residency and specialty opportunities for pharmacists. This review is very instructive for recent graduates and current student pharmacists with respect to the substantial changes that have been made over the last several decades. For those of us who observed and participated in the discussions and sometimes tense debates regarding these changes, these experiences are important reminders that substantial change can be achieved, of the lessons learned from the experiences that can be applied for future benefit, and the recognition of opportunities that were missed or ignored.
Steve proceeded to provide the following recommendations of areas/issues to which our profession should give the highest priority as we move forward:
- Choosing and using biosimilars;
- Specialty drugs (e.g., definition, distribution/access, cost);
- Pharmacogenomics;
- Drug shortages;
- Affordability of drug therapy ("financial toxicity");
- Fiduciary responsibility and the PBM market (e.g., drug pricing, economic competition, transparency, patient access to medications and pharmacists; "PBMs and drug companies are often compared to 19th-century 'robber barons' like the railroads and oil trusts who engaged in monopolistic practices that exploited the market while wielding immense political influence.");
- Corporate vs. individual professional responsibility.
In a subsequent communication with Lowell Anderson, a Remington Medalist and Past-President of APhA who served as Moderator of the Remington Lecture and dinner program, I noted that I considered Steve's presentation to be very important and impressive. Lowell responded: "Steve's seven points could be the agenda going forward," and I fully concur!
The error
The Opening General Session of the APhA meeting was the best attended of all of the events as hundreds of student pharmacists joined the combined session. The session included presentations by APhA leaders, a motivational speaker and the presentation of the 10 finalists and winner of the National Patient Counseling Competition (NPCC). The NPCC is a rigorous competition in which one student from each college of pharmacy participates. Students prepare very thoroughly and, when presented with a patient situation, are judged based on factors such as the accuracy, clarity, and comprehensiveness of the counseling/information they provide, as well as their communication skills in responding. It is an excellent program that emphasizes the importance of counseling in assuring optimal patient use of medications.
I was shocked to learn that CVS was the sponsor of the event and that a CVS pharmacist was announcing/presenting the 10 finalists and winner of the competition. The CVS pharmacist wanted the students and those in attendance to believe that CVS was committed to the provision of comprehensive patient counseling with the implication that this can be expected in CVS stores. Nothing could be farther from the truth! In most situations, the CVS version of "counseling" is the instruction from the cashier or technician to "sign here." Because of serious understaffing, management-imposed metrics and policies that are disincentives for communication with patients, and stressful workplace environments, CVS pharmacists have no communication at all with most patients. The situation is even worse for those patients who are mandated, tricked, or provided financial incentives to obtain their medications from a CVS mail-order pharmacy.
The "practice" of pharmacy in most CVS stores is the antithesis of the goals of the NPCC and the advocacy of APhA for pharmacists to practice at the "top of their license." At a time when some state legislatures and governors (e.g., Arkansas) are taking actions to prohibit permits to pharmacies owned by PBMs (CVS/Caremark being a primary example), and APhA is urging PBM reform at the federal level, how can APhA permit such a prominent and deceptive role for CVS at its annual meeting?
The CVS charade of counseling is just one way in which it is putting patients at risk and undermining the goals and the scope and quality of services of pharmacists. Other egregious actions include the following:
CVS, Caremark, and their related companies have done more to harm the profession of pharmacy than any other organization or situation.
They have engaged in anticompetitive practices, and provide inadequate compensation that makes it difficult for independent as well as some other chain pharmacies to financially survive.
Because of the stress and negativity of the workplace environment, they have caused more harm than any other organization or factor in reducing/destroying the potential interest of full- and part-time employees for pursuing an education and career in pharmacy. The reduction in the number of applications and enrollments is of great concern for colleges of pharmacy and should be for the entire profession.
The understaffing and stressful workplace experiences cause mental and physical health issues and moral injury for employees. Turnover is high and employees who don't have other options are at risk of termination if they are critical or even voice concerns. Current and previous employees are more critical of CVS than anyone else.
Errors are considered a cost of doing business. CVS has enough wealth to settle the hundreds of lawsuits filed against it by patients/families, government agencies (e.g., FTC, DEA) and other organizations, pharmacists that have been victimized, and former employees.
The increased awareness of the public about errors, restrictions, and other barriers/delays in obtaining needed medications because of CVS/Caremark policies is damaging to the respect for and reputation of our entire profession.
Student pharmacists attending the APhA meeting who have not been in a CVS store and/or have not otherwise learned about the above concerns are being provided a deceptive image and message based on its apparently welcomed role in an APhA program.
CVS has much to benefit from the appearance of a positive relationship/sponsorship with APhA. However, APhA risks damage to its credibility. My characterization of the situation as an "error" is an understatement. Even if there is disagreement with the extent of my criticism of CVS or my voicing my concerns, the leaders of APhA have to be aware of the issues and potential consequences I have identified. So why do they enable, or perhaps even solicit, a sponsorship with an organization like CVS?
I asked an APhA leader how much revenue the Association receives from CVS for its level of participation in the annual meeting but I have not yet received a response. I am hopeful that there will be a transparent and specific response. Otherwise questions and concerns only increase.
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EDITORIAL:
Congratulations to Carl's Drug Store in Greencastle, PA!
Two Centuries of Service to Greencastle and Representing our Profession!
There were many community drug stores/pharmacies/apothecaries in the United States before 1825, but none of them are still operating. Many of them served their communities for well more than 100 years before closing.
On April 27, 1825, Adam Carl opened Carl's Drug Store in Greencastle, PA. As it now celebrates the 200th anniversary of its founding, it is the oldest community pharmacy in the U.S. Adam Carl and his family owned and operated the Pharmacy for almost 150 years. In 1974 Pharmacist Frank Ervin purchased the Pharmacy from the great-grandson of the founder. Frank was one of my students at the Philadelphia College of Pharmacy and he has kept me well-informed of the continuing services, historical role, and recognition of the Pharmacy. Frank maintained and expanded the professional services and prominence of Carl's Drug Store for almost 40 years and, in 2013, sold it to Pharmacist Rodger Savage who owned it until 2023. In 2023, it was purchased by Pharmacist Wayne Myers, who with Pharmacists Shane Clugston and Grant Frey, and a capable team have maintained the tradition of excellent service and leadership for which the Pharmacy is well-known and respected in the Greencastle-Antrim community and beyond.
The longevity of Carl's Drug Store has not been without challenges including several relocations in "downtown" Greencastle (but without interruption of services), and the current financial pressures all independent pharmacies are experiencing. However, the commitment and perseverance of its ownership over two hundred years have earned these individuals and Carl's Drug Store a prominent position in the history of pharmacy. In observance of the Bicentennial anniversary, U.S. Rep. John Joyce has honored the pharmacy and its leadership with a submission to the Congressional Record, and PA state Rep. Chad Reichard also visited and honored the pharmacy. The Greencastle-Antrim community has had a long-standing tradition of recognizing an important part of local history in a celebration (Old Home Week) held every three years. A commemorative badge is prepared for each of these events and the celebration to be held in August will feature the bicentennial of Carl's Drug Store on the Old Home Week Badge. Pharmacist/owner Wayne Myers has responded:
"The Old Home Week Mission – honor the past, encourage the present and grow the future – perfectly sums up our goals as we make plans to celebrate the oldest, continuously running independent pharmacy in the United States. We thank both the committee and the community for your support of our family-owned pharmacy, and we can't wait to celebrate with you."
My visit
Greencastle is in south-central Pennsylvania just north of the border with Maryland and several miles from Interstate Route 81. My wife and I drove to the recent APhA annual meeting in Nashville with most of the travel being on I-81. During my presentation at the meeting, I noted the Bicentennial of Carl's Drug Store and its important contribution to the history and legacy of our profession, and continuing extension of the professional roles of pharmacists. We have visited Carl's on several previous occasions and on our trip home, we stopped for a brief visit. It was an inspiring source of continuing pride in our profession.
THANK YOU to Adam Carl and the pharmacists and team members, past and present, for what they continue to accomplish for their community and our profession!
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