What is 340B, and is it Right for ME?

Learn the essentials of 340B pharmacy and how this program supports access to affordable medications for underserved communities. This episode simplifies key concepts, explains how 340B works, and offers practical guidance for pharmacists just getting started. Tune in to build your confidence and take the first step toward understanding the impact of 340B in your practice!
 
HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact

GUEST
Amanda Gaddy, R.Ph.
Co-Founder, COO
Secure340B

Pharmacists, REDEEM YOUR CPE HERE!
CPE is available to Health Mart franchise members only
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CPE INFORMATION
 Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Explain the purpose and structure of the 340B Drug Pricing Program, including its role in expanding access to affordable medications.
2. Identify key responsibilities and considerations for pharmacists participating in 340B programs, including compliance and operational basics.

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-020-H04-P
Initial release date: 2/3/2025
Expiration date: 2/3/2026
Additional CPE details can be found here.

Transcript

Jen Moulton

Hi, Health Mart pharmacists from your education partner, CE Impact. This is Game Changers, and each week we have a conversation on a hot clinical topic that will keep you current in practice and position you as a resource for prescribers and patients. Thanks for listening in.

Josh Kinsey

[00.00.05]

Welcome to the GameChangers Clinical Conversations podcast. I'm your host, Josh Kinsey, and as always, I'm excited about our conversation today. The 340 B Drug Pricing program offers a unique opportunity for healthcare organizations to expand access to affordable medications for underserved communities. In this episode, we'll break down the key steps to implementing a successful 340B pharmacy. Explore the challenges involved and discuss how pharmacists can maximize the program's impact while ensuring compliance and sustainability. And it's so great to have my good friend Amanda Gaddy as our guest expert for this episode. Welcome, Amanda. Thanks so much for joining me today. 

Amanda Gaddy

[00.00.46]

 Hey, Josh, it's so good to be here. 

Josh Kinsey

[00.00.48]

 Yeah. So Amanda and I, I was trying to think, actually this morning, I think we're going on two decades of knowing each other. Isn't that wild? It's so fun. Wild, wild. Um. So. Yeah, Amanda and I have a long history together, and. And when I was in Georgia, um, and was very active in the state association there, Georgia Pharmacy Association. And I've known Amanda, like I said, for over 20 years now. So, so excited that we're able to collaborate on different things throughout our careers. And I'm just really thrilled to have you on our podcast today. So for those of our learners that haven't known you for 20 plus years, uh, go ahead and tell us a little about yourself, Amanda, maybe your current roles and, uh, what you do and why you're really passionate about today's topic. 

Amanda Gaddy

[00.01.31]

Absolutely. So I've known you for about 20 years, but I've been a pharmacist for 30 years, and I cannot believe it. It's just it's wild. Um, I've had a lot of different opportunities. Currently, I, um, I'm the co-founder of a company called Secure 340B, and we help, um, pharmacies and pharmacies contract with um covered entities, hospitals, clinics, um, to help those patients have access to their medications. Um, I also still work with the pharmacy association, Georgia Pharmacy Association, the Academy of Independent Pharmacy, where I serve as my role as director of clinical services. But I basically do whatever the members need. 

Josh Kinsey

[00.02.10]

 Yep. Awesome. That's great. Yeah. Amanda has a long, um, storied career with GBA, and, um. Yeah, just super excited to to have you on for today. So, um, thanks again for taking time out of your busy schedule. We appreciate it. All right, so let's jump into the topic. Uh, I want to just kind of set the stage. I always like to do a foundational reset, just to make sure that all of our learners are on the same page. And we all understand kind of what the topic is for today. So just give us a quick overview of 340 being what what is it? What is its purpose kind of the history, where did it come from. And just just a brief overview for us, if you don't mind.

Amanda Gaddy

[00.02.46]

 Sure. So 340 B is a drug pricing program. It was established in 1992. So a while ago, um, by Congress. So it's not funded by taxpayers or anything like that. Basically, it requires drug manufacturers that are participating in the Medicaid rebate program to provide discounts to certain coverage. Well, we call them covered entities for certain hospitals and clinics, um, those that provide services to the most vulnerable patient populations. Um, and the intent really is for them to use the savings and the revenue to provide more access to medications, to provide services, and also to offset some of the losses that they, um, that they have with treating these this patient population. 

Josh Kinsey

[00.03.30]

 Yeah. Great. That's great. I know that this has been around even dating back to when I had my pharmacy. And I have to say, it was just it always was just that topic that I knew about, but I didn't really know about. So I'm I'm excited to learn more about it today from you, because I know that, um, you are an expert in this field for sure. So you mentioned covered entities. What are some of the other key stakeholders? When we're looking at a 340B program?

Amanda Gaddy

[00.03.56]

Yes. So going back to just 340B in general, you have to have a covered entity and that is the hospital or the clinic that qualifies. So there are certain, um, qualifications that have to be met for. So it can't just be any hospital. And so the covered entity can then work with a 340B administrator or a TPA. And that would be a company that helps decide which claims qualify for 340B, which patients or patients of that covered in C. And then we have contract pharmacies. So covered entities have the ability to basically use pharmacies that are in the community as agents for them. So with that being said, there has to be that third party administrator that kind of administers all of this. So what happens with the contract pharmacies? There are two things that you really need to think about. We've got the one piece of the puzzle where it increases access to medication for those patients. So if I'm uninsured and I go to a hospital, they could say, hey, here are the pharmacies that provide medications at little or no cost to you. Which is fantastic because without insurance, you know. And this actually happened to me working as a pharmacist. I had a patient come in and had some a prescription for insulin, and they couldn't afford it, and I had to turn them away. Had we been a contract pharmacy that could offer a backup, received that medication at little to no cost. So that's one piece of the puzzle is uninsured. The other piece of the puzzle for contract pharmacies is they will build claims like they always have been for patients who have insurance. So the prescription is adjudicated to their third party. They're paid based on their third party contract with that PBM. And they basically transfer the revenue they receive to that covered entity. So that's where the revenue is generated. They keep the small amount to cover their costs and what they're doing to service that patient. And then the 340 administrator would, um, administer or facilitate that product to be shipped back to the pharmacy. To replace what has already been received by that patient with 340B. So I think that's important to say. Okay, we've got the way that we're increasing access to medications, but we're also creating a way to to have revenue to come back to that covered entity so that they can provide extra services and offset some of those losses that they put in her. 

Josh Kinsey

[00.06.15]

 Yeah. Okay. That's great. My question has always been what are the what are the basics of eligibility? How do you know if you can do this as a pharmacy. And like how do you know if there's a covered entity out there that that you can partner with. So like how do we go about that for determining eligibility and and availability? 

Amanda Gaddy

[00.06.36]

 I guess that's a great question. So just being very clear the pharmacies never 340B eligible. So it would be a hospital or clinic. Um and then their eligibility depends on all kinds of different things. Um, there is a website that pharmacies can look up and it's um, I think it's 340BOPIS office.gov. Um, but if you look up 340B covered entity search. There's a way that you can actually go in and type in an address or name of a, of a facility or even a zip code, and you can see exactly which covered entities are in that area. It's not for everybody. I want to be very clear about that. This is. This is something where if, you know a pharmacy is filling prescriptions for a covered entity, it's worth having that conversation and always look at it as like, that patient is the same patient who's going to that hospital or clinic that's going to your pharmacy, right? We're talking about the same person. So how do we work together, um, to help that patient be more adherent? Um, and so when a pharmacy finds that there is an opportunity with a covered entity or vice versa, it could be a hospital that says, hey, we need to find a pharmacy or community where we sit in our prescriptions, too, because right now they're just going out and never, never land. You know, we're we're not really getting revenue back or making sure our patients have access. So everybody's sitting around a table and saying, how do we work together? Does this make sense? Let's do an analysis to see if we would have been a 340B contract pharmacy last quarter. You know what patients could have been impacted. How much revenue could be generated for that covered entity. Um and then go from there because again, it can be a way to. You know, even going back to finding out which patients may be like frequent flyers in the emergency room right there, plan for that. So to me, I think it's holistic. It's not just some people think it's like you just get handed an agreement, you sign it. Um, and all this stuff happens on the back end. But I really think it should be. We let's work together to help these patients be more adherent, less readmissions and very, um, you know, uh, possibly generate some of that revenue that can help that covered entities be viable. 

Josh Kinsey

[00.08.48]

 Yeah. No, that makes sense. That's really helpful to understand is that it's not really something that, I mean, a pharmacy can can initiate seeking out to see if there's an opportunity, but it's not really something that you can sit back and say, I'm definitely going to do this. Like you have to make sure there's a covered entity there they're willing to partner. And like everything has to align. So so you're right, it sounds like there has to be a lot of conversation on the back end before even knowing if this is a viable opportunity. 

Amanda Gaddy

[00.09.17]

So in really talking about it being a partnership. You know, I've had some talk to some pharmacies where they were basically, you know, given a contract, they signed it. They were losing a lot of money because it wasn't, you know, it wasn't beneficial. But just saying, hey, go back to that hospital clinic and explain what's going on. You know, it's it should be that partnership of like, let's work together in this community together to make this program the best it can be. 

Josh Kinsey

[00.09.42]

 Yeah. That's great. So now that we've kind of talked a little bit about the foundation of it, you know, it's kind of history where it came from. And a little bit about the eligibility. I know there's still so many nuances and it goes so much deeper. Um, but in our our short little podcast, we can only kind of scratch the surface. But I do want to talk about what are some of the opportunities. So like what are what would be reasons why we definitely want to try to see if this is if this is a viable opportunity for us. So what are some of those benefits that we would see in a pharmacy setting? 

Amanda Gaddy

[00.10.14]

 I think for one thing, it's just increasing access to medications again. What happens is that patient, like I was saying, that comes to the pharmacy with a prescription for insulin and they can't get it. Um, that to me is like number one, right? Um, and then going back to with pharmacies right now there. And this is more of a challenge. But right now they're being. You know, under reimbursed for a lot of their prescriptions, a lot of their you know, I remember when having a patient with diabetes was profitable for a pharmacy and now it's not. So if the program can be structured appropriately so the pharmacy can actually be profitable on those prescriptions, then they can in turn use that profit to put back into their the services they provide for their pharmacy firms that have been able to add, um, adherence programs, packaging. I mean, that stuff cost money that they're not getting paid for. 

Josh Kinsey

[00.11.05]

 Yeah. Nutrition counseling, bringing in a nutritionist for their diabetic patients. 

Amanda Gaddy

[00.11.10]

 Yeah, exactly. Um, and I really think and even like we had one pharmacy that was able to even get transportation or a car to do delivery. When I think about that small town of somebody bringing the medications to the patient, rather than having to, like, try to figure out how to get there. And, um, multiple times, you know, we're doing med sync. A lot of these pharmacies are doing med sync. Um, but my point of bringing that up is that's time and that's money. And so by being in a, in a program that could help generate some a fair amount for the pharmacy, they're able to continue to provide these services. 

Josh Kinsey

[00.11.45]

 Yeah. And let's be let's be honest, I mean, those patients who are having difficulties affording their medications, they likely have other issues, transportation issues, they have food insecurities. They you know, they're that's the population that is is more likely going to have those compounded issues as well. Because, you know, we're already saying that they they don't have good access, so they can't afford medication. So being able to provide delivery services or other nutritional services or, you know, other things in the pharmacy, it's that's definitely a benefit.

Amanda Gaddy

 So yeah. One other thing I wanted to add about that is pharmacies are now looking for that. They're doing they're becoming like community health workers and community health workers. That right. That's right. Yep. and then also just looking for those social determinants of health, right? Absolutely. You have like a pharmacy delivery person who's doing this and it's circling back to the covered entity in the hospital. We're full circle in it here. And so, um, but without, you know, a program that's structured so we have a win for the pharmacy, win for the covered entity, some of those services wouldn't be available. 

Josh Kinsey

[00.12.56]

 That's right, that's right. Exactly right. Yep. And, you know, that would further be a detriment to the community because those individuals would have decreased access to a lot of things. So yeah. Um, okay. So we've talked about some of the benefits. So what are some of the challenges. So like you said in the beginning, it's it's not super easy and it's not for everyone. Right. So we want to make sure that that it's well known what the challenges are and that people understand what it is they're getting into if they decide to go down the path of, you know, the 340B pricing program. So if you can maybe tell us some of those challenges and maybe what are some strategies that people use to to mitigate these challenges that they see? 

Amanda Gaddy

[00.13.35]

 Well, I think one thing is just understanding the contract. Um, so you're presenting the pharmacy services agreement. What does it mean? You know, how many days do I have to to once I receive it? Um, payment for a PDM to pay the hospital or clinic. Um, what is my fee? So if I'm paid $1,000 for a prescription, what part of that am I keeping and giving to the hospital or clinic? Um, and then what would I've made on that same claim had it not been 300 TB? Um, you have to say, okay, here's what I'm making with 340 B. What would I've made on those claims? Have they not been 340 B and what is that difference? I need to make sure it's more because I've got a lot of, you know, services. I've got to manage inventory, which takes me to the second thing I talk about with, um, with one of the challenges is inventory. So pharmacy can have a good contract for their cover and their costs. Um, but if they're, you know. Let's say, fill in a prescription for three months or a medication for three months, and then they're having to buy that from their wholesaler and then they get it on 340 V two days later, and they've got double the amount that they need. And with margins being so tight in pharmacies right now, they can't afford to have a lot of extra medication in the refrigerator or on their shelf. And so inventory management and making sure that the pharmacy only keeps, you know, what they need is just it's so important 

Josh Kinsey

[00.14.58]

 key. Yeah. It's key. And you know, we have a lot of courses on inventory management and empowering members of your team to take on that and that responsibility and to really own that process because it is more than just make sure we have what we need on the shelf. It's it's make sure that we don't have excess of what we don't need and make sure that what we do have is going to stay in date by the time we need it again. And also, you know, to make sure that you're having it in the right time for your patients so that they're not having to wait or you're not having to make them come back and whatever. So I mean, inventory is just. It spans a whole lot of different challenges and issues within the pharmacy practice. So it doesn't doesn't surprise me that that's one of the things with this program as well. Um, what about, um, you mentioned some of the, um, I think when we were talking initially about doing this, this podcast and kind of some of the stuff, one of the things you mentioned to me and you had a really great example of, um, just like the cash flow and, and understanding that. So tell us a little bit about the challenges there and how we need to make sure that we're managing that appropriately as well. 

Amanda Gaddy

[00.16.05]

 Right. So with cash flow again, you know, the pharmacy is purchasing the purchasing the inventory upfront and then it is dispensed to the patient. And then those prescriptions are deemed 340B after the fact. So what typically happens is one of the 340 administrators, they get all the pharmacy data from one day. And then overnight they will test the claims and say, okay, this patient meets the definition. This prescription should be 340B, but let's say it's um, it's a quantity of 30 out of a bottle of nine. Okay. And then they're the pharmacy is billed or basically invoiced. They're already transferring revenue for that one prescription. If they don't reach the quantity of 90. They're not getting that product back. And so there was always a trip process. But you do have to be aware that there could be times where pharmacies could be billed for products or for claims before they get the product. Now there are there are two different models here. We've got one where pharmacies are billed regardless if they receive the product or not. And then one where they only are billed once they receive the product. And so that's also something important to know when you're signing

Josh Kinsey

[00.17.12]

Yeah. Like 

Amanda Gaddy

[00.17.14]

 which am I getting billed regardless or only when I receive the product. Mhm. Because that could cause a huge cash flow issue. Yeah. 

Josh Kinsey

[00.17.22]

 And you know we talk about cash flow because it's already an issue or a burden or a challenge because of how it works with the manufacturers or you know with the wholesalers and how we are purchasing that. Then, you know, it's usually a two week turnaround or whatever, and you don't often get your reimbursement back in time. And so making sure that you're managing that appropriately is already a challenge in pharmacies. And so, um, just understanding that there's another impact on that cash flow, if you're a part of a 340B pricing program. So yeah, 

Amanda Gaddy

[00.17.54]

 I think Josh hinted at about that is to it. This goes back to that pharmacy services agreement. But making sure there's sufficient time. I've seen I saw one, um, pharmacy service agreement and had like the that the payment was due within seven days. Okay. Like in the world of pharmacy, how often are pharmacies paid? Within seven days. So if I, when it's 6 or $7000, I don't I need time, you know before I get that, you know. Yeah. Hey before I pay it. Yeah. 

Josh Kinsey

[00.18.22]

 Absolutely. Absolutely. Yeah. Um, one of the other things we talked about, too, when we were we were discussing this, um, podcast before was, uh, this topic was, um, not being the the pharmacies, the contracted pharmacies need to not be afraid to have conversations with the covered entities and to talk about contract renegotiations. So maybe tell us a little bit about that. I know you had a good example of something where they thought they couldn't go back and renegotiate. And so it's important to understand again the the structure of the contract and everything. So you want to talk a little bit about those challenges

Amanda Gaddy

[00.18.55]

Yeah, absolutely. Especially for pharmacists who've been, you know, in the program for a long time. Some of these contracts are so outdated and just really again, understand, like, you know what, um, what am I making with 340B versus what would I make if I was not in the program. Mhm. And then going back to it's a partnership sitting down having an honest conversation and saying, hey look you know, the cost of defense is, you know, $12.40 or whatever it is today. Um, we're only we're making $10, so we're losing money. So we really want to still be a partner, but we would like to see if we can look at the numbers a little bit to make sure that we're at, you know, we're at covering our cost and we're able to make a little bit more so we can provide these extra services.

Josh Kinsey

[00.19.37]

 Right. Right. And so renegotiation is on the table. I mean that's that's the key thing. Mhm. 

Amanda Gaddy

100%. Yeah. Oh and going back to the conversations with the covered entities right now there are 38∼39 manufacturers that have imposed restrictions where um they're only allowing one contract pharmacy. Um no. It's more restrictive for hospitals than like let's say FQHC’s. Um, but it's important to have those conversations with the covered entity to make sure that there aren't certain manufacturers that are being excluded. That should be included. Um, and we've seen that before. Um, there are I think it's eight states that have passed legislation that have, um, some of those states have basically enforce the ruling that you could have more than one contract pharmacy. And we've seen instances where the pricing has not been restored. So the manufacturer restriction can be a whole. Podcast on its own? Yeah for sure. But it is, I guess my point and my takeaway is it is very complex and complicated. But you have to know like which manufacturers should be qualifying. Are they qualifying? If they're not, you know, where is the holdup. Is it with the whole seller. Is it with, you know, where is it in the covered entity not submitting data. There's a lot. So that's a big deal right now with the manufacturer. 

Josh Kinsey

[00.20.59]

 It's a big challenge. And you know, again I think it goes back to fully understanding the contract that you have. And and, you know, not just taking it for what it is, but reading into it, making sure that you understand, asking questions, being collaborative with that covered entity and making sure that you are taking care of your business. So yeah. Yeah. Um, so we've talked a little bit about some of the benefits that come from the programs and the challenges that we see. What would be the first step? Let's say I had a pharmacy and I was like, I want to go down this path. I want to see if this is something that is a viable opportunity for me with the first step be to to get on the website that you mentioned and kind of dig around in the web and the zip code and the area and see if there see if there are covered entities there, and then reach out for conversation. Is that kind of how that goes or, or do you have to wait for the covered entity to come to you? 

Amanda Gaddy

[00.21.55]

 Absolutely not. So when you log into the website, it will actually show who the contact is with the covered entity. Got it. And that may be the person that you reach out to. But let's just say that you're in a small town and your friends with the the hospital pharmacist and your local pharmacy, you could even reach out to them and say, hey, who is it that I need to reach out to just to have a conversation? Another thing that's real important, I think, for clinics and for hospitals is. Just in general to understand like, what are these community pharmacies providing? Um, not even include 340B, but just having that conversation and say, hey, look, we're doing an adherence program. You know, we're doing compliance packaging and we're delivering. Um, and then let 340B just be part of that conversation of like, would it make sense for us to also do this numbers and see if it would make. Because like I said, it doesn't always make sense. It's not like, hey, go every pharmacy, go out and do this. It's gotta be the right. But if it is the right situation, then a community can really benefit. 

Josh Kinsey

[00.22.55]

 Yeah, yeah that makes sense. And so again conversation is key. And doing your due diligence of, you know, researching and making sure that that it does fit within your, your business model. Um, so what then for our learners out there, what are some of the if you are in a 340B program or if you do go down this path and it becomes a viable option, what are um, what's the important things that a pharmacist needs to be sure they're doing. I assume compliance, I assume documentation, but like if you can tell us just a little bit about like, what would be your role as the pharmacist who's who's overseeing this to make sure that you're getting paid right. You're getting the medications delivered right, that you are actually benefiting, that customers or your patients are actually benefiting as they should. So like what what would pharmacists need to do? 

Amanda Gaddy

Well, I want to touch on the compliance part for a little bit because the compliance is really, um, the covered entity is responsible for compliance. And they use the 340 administrators to, to administer that. So the pharmacy is not really in charge of going, oh, this claim should be 340B. This one's not. Now they still have to abide by all the rules of PBMs and that audit piece. Sure. Um, as far as like um a 340B audit. Um, but with that being said, um, what they really need to know is, again, going back to financial impact. With my dispensing fee. What am I? What is my takeaway? Versus what would I make on these same claims if I'm not in the program? That's number one. Number two is what about my inventory? I can have a good program, you know, where I'm, you know, may make a little bit more proclaim. But if I've got extra inventory on my shelves, then that is a negative. So there's got to be work done with inventory as far as managing that inventory, sending back over stock and really, really knowing. And I'll give you an example. Let's say that I go back to insulin. Let's say I just I'm invoiced for ten vials of insulin, meaning that whatever revenue I received, I passed through the covered entity dispensing fee. But I've only received three vials back. That's a problem. That would be a way of going. Okay. We need to work with the 340 administrator, the covered entity, and to see why. Because that going back to the cash flow. That can be huge cash flow. Right? Problem. Yeah, I support revenue, but I'm not receiving the product. So I would say that, um, those two things are are really important. And then also just the communication with the covered entity, you know, how do we work together? What else can we do together? You know, I remember the community healthcare workers and. Yeah, absolutely. Or just just adherence programs or, you know, really focusing on those patients who need, you know, they can't steer them there. Right? But they can also say, hey, if you have problems with transportation or if you need delivery or you need packaging, here's an option for you. Mhm. Um, yeah. Really keeping that that patient who the same patient there is coming to the pharmacy at the center. 

Josh Kinsey

[00.26.06]

 Yeah, absolutely. Yeah that's great. Um, so one of the things that I've heard over and over is the inventory management, and it makes so much sense to that. You're just the example you just shared where it's like, not only do you have to manage to make sure that you don't have too much and whatever and blah, blah, blah, but you have to be checking what's coming in compared to what you should be having coming in, you know. So it's important again, that inventory management is such a huge piece of it. Because if you if you miss out on those seven vials of insulin, that's, that's major, you know, for, for small operations. So, um, yeah, absolutely. Um, this is so enlightening. I feel like there's so many, so many things that even I've learned and I've, I've heard about, you know, 340B for for years and years and years, but I just never really felt like I had a true grasp of understanding of it. So this has been super helpful for me. I hope I hope the same for learners. Um, I always like to as we wrap up. Well, first of all, is there anything that you really think that we should know that we didn't get to talk about, uh, before we wrap up with our time? Or is there something that you're like, I was itching to tell you this, but I didn't get to anything there. 

Amanda Gaddy

[00.27.19]

 There's so much more I could share with you, but good hot topics for sure. 

Josh Kinsey

[00.27.20]

 Okay, perfect. Well, what? Always like to do before I wrap up, the episode is just kind of circle back to what's the game changer? So if you can just kind of give us a quick summary, a recap of what's the game changer here is, is the game changer? The actual three for TV program is the game changer. You're determining whether or not you're eligible. Like you know that it whether or not you there's a contracted entity that that is available to work with you. So what's the game changer here? What Star Farms does take home? 

Amanda Gaddy

[00.27.51]

 Well, my thing is and 340B really can be a game changer in a good way. In a bad way. Um, and I'll be honest about that. So, you know, if it's structured correctly, the lion's share of the revenue is going to the covered entity. The pharmacy is making a little bit more to help provide, you know them, provide more services. It could be a huge game changer, especially with today's, um, brand reimbursements that are really not very good. but then it can also be a game changer in a negative way. If a pharmacy has an agreement, they don't know what they're signing. Um, they're getting paid less than what it costs for them to fill a prescription. Um, and they get a cash flow issue, you know. So that's really is to me, the game changer is if you're going to do it, know what you're doing, and be very clear of the impact from a financial standpoint as well as an inventory standpoint. 

Speaker 2

[00.28.42]

 That's such good advice. I love that. I don't think I've ever had a guest tell me that the game changer could be negative, but that it makes. So it makes so much sense because, I mean, that we would want to stay away from it in that sense. So, um, that's really great. Thanks so much. Well, Amanda, this has been a pleasure as always. It's always great to see you. And thanks again for taking time out of your busy schedule to share what you are clearly, obviously passionate about and also an expert in. Um, so thank you again. Really, really great pleasure to have you here. 

Amanda Gaddy

[00.29.14]

 Well, thank you for the opportunity. And you know, I love pharmacy. So happy. 

Josh Kinsey

[00.29.18]

 Absolutely. Absolutely. As always, have a great week and keep learning. I can't wait to dig into another game changing topic with you all again next week. 

Jen Moulton

and that's it for this week. Be sure to log in to Health Mart University to claim your CE credit for this episode. As always, have a great week and keep learning. We'll talk to you next week.