The Apothecary Dispatch

"The task of medicine is to promote health, to prevent disease, to treat the sick when prevention has broken down, and to rehabilitate the people after they have been cured." — William Osler

"You have power over your mind, not outside events. Realize this, and you will find strength." — Marcus Aurelius

The first oral GLP-1 is officially here — and pharmacists need to be ready.

The FDA approved Foundayo (orforglipron) on April 1, making it the first oral GLP-1 receptor agonist that can be taken any time of day, without food or water restrictions. Developed by Eli Lilly, it marks a significant departure from existing options like semaglutide, which require fasting protocols. With oral convenience removing one of the biggest adherence barriers, expect a surge in new patient conversations at the counter. Counseling on realistic expectations, GI side effects, and lifestyle context will be essential from day one.

Independent pharmacists took their fight directly to Capitol Hill.

This week, hundreds of independent pharmacy advocates descended on Washington as part of the NCPA's annual Congressional Fly-In. Their message was pointed: while Congress passed Medicare Part D contract term reforms earlier this year, PBM practices in Medicaid, Tricare, and the Federal Employee Health Benefit Program remain largely unchecked. The advocacy push signals that PBM reform is far from finished — and independent pharmacies are making sure their representatives hear it in person.

Pharmacists are expanding vaccine access — but billing barriers are holding them back.

A new report highlights a persistent tension in pharmacy immunization services: pharmacists are positioned and willing to expand vaccine access, but inconsistent payer policies and uneven reimbursement are limiting the reach of those services nationwide. The issue is particularly acute in underserved communities where the pharmacy is often the most accessible point of care. Advocacy groups are pushing for standardized billing frameworks, but progress remains slow.

Foundayo (orforglipron) — Approved April 1, 2026 Eli Lilly's oral GLP-1 for obesity and overweight adults with weight-related conditions. The key differentiator: no fasting requirement, no timing restrictions. Watch for formulary placement decisions in the coming weeks and prepare for patient questions about how it compares to injectable options.

Awiqli (insulin icodec-abae) — Approved March 26, 2026 The first and only once-weekly basal insulin for adults with type 2 diabetes. For patients struggling with daily injection adherence, this could be a meaningful clinical option. Counseling points around dose timing, hypoglycemia risk, and the adjustment period from daily regimens will be important early on.

Xanax XR Recall — Class II Viatris Specialty LLC has recalled one lot of Xanax XR 3mg (60-count bottles) after the product failed dissolution specifications — meaning the medication may not dissolve or release as intended, potentially affecting efficacy. The lot was distributed nationally between August 2024 and May 2025. Class II classification indicates possible temporary adverse consequences. Check your inventory and advise affected patients accordingly.

When a new drug approval hits — run this three-step prep before the calls start.

When a drug like Foundayo gets approved, the questions don't wait. Patients see news headlines before their providers do, and the first call often lands at your counter. Here's a simple prep routine worth building:

First, pull the FDA approval summary and read the indication, contraindications, and key counseling points — not the full monograph, just the highlights. Five minutes. Second, check whether your major PBMs have issued any early formulary guidance or PA criteria. It often appears within days of approval. Third, draft three sentences you'd say to a patient asking about it cold — what it is, who it's for, and what they should discuss with their prescriber. Knowing your answer before the question arrives is the difference between a smooth conversation and a scrambled one. The best pharmacists aren't just informed. They're prepared.

Most pharmacists know AI is coming. Almost none are using it yet.

A 2026 pharmacy trends report from TELUS Health puts a striking number on the table: 47% of pharmacists name AI integration as the most significant driver of change in the profession — yet only 3% report using AI tools on a regular basis. The gap between awareness and adoption is wide. The barriers cited most often are unreliable outputs and system integration challenges. But the interest is real — pharmacists ranked workflow automation in dispensing, drug interaction screening, and billing optimization as the top three areas where AI tools could make a meaningful difference. The picture that emerges is of a profession that sees the wave coming and is waiting to see which tools are actually worth their trust. That's not resistance. That's discernment. We'll keep watching.

There is a passage early in Jim Murphy's Inner Excellence that has stayed with me. He writes about the difference between those who pursue greatness out of fear — fear of failure, fear of being found out — and those who pursue it out of love. Love of the craft. Love of the people they serve. Love of becoming. He argues that the ones who last, the ones who find something close to peace in their work, are almost always the ones operating from that second place.

I thought about that a lot building this newsletter. Pharmacy is a profession under pressure right now. But every pharmacist I have ever admired has carried something quiet beneath the noise — a genuine care for the person on the other side of the counter. That's not a small thing. That might be everything.

We'll see you next Monday.

— The Apothecary Dispatch News, Notes & Remedies from the World of Pharmacy