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Delving Beyond the Shelving Podcast Episode #2: Private Equity and PBMs

Learning Objectives

After completing this application-based continuing education activity, pharmacists and pharmacy technicians will be able to:

·       Recall outcomes of previous private equity investment
·       Discuss what factors led to the topple of the Walgreens empire
·       Dissect the effects of the current healthcare payor system on patients and pharmacies
·       Develop a plan for potential legislation change

      Cute cartoon pill bottles on shelves with the words Delving Beyond The Shelving

       Release Date

      Release Date: June 20, 2026

      Expiration Date: June 20, 2029

      Course Fee

      FREE

      There is no funding for this CE.

      ACPE UANs

      Pharmacist: 0009-0000-26-038-H04-P

      Pharmacy Technician: 0009-0000-26-038-H04-T

      Session Codes

      Pharmacist: 26POD38-MRQ75

      Pharmacy Technician: 26POD38-RQM57

      Accreditation Hours

      0.5 hours of CE

      Accreditation Statements

      The University of Connecticut School of Pharmacy and Pharmaceutical Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE UAN 0009-0000-26-038-H04-P/T will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

       

      Disclosure of Discussions of Off-label and Investigational Drug Use

      The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy and Pharmaceutical Sciences or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

      Faculty

      Dylan Decandia PharmD

      Freelance Medical Writer, Franklyn’s Pharmacy

      Ho-Ho-Kus, NJ

       

      Faculty Disclosure

      In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy and Pharmaceutical Sciences requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

      Dylan Decandia PharmD has no relationships with ineligible companies.

       

      Dylan Decandia, PharmD discusses topics in the pharmacy world with a new guest each episode. Catch the next episode on Spotify or Apple Podcasts.

      DELVING BEYOND THE SHELVING PODCAST EPISODE 2

      Pharmacist Post Test (for viewing only)

      Delving Beyond the Shelving Episode #2: Private Equity and PBMs
      Posttest 26-038
      Pharmacists and Pharmacy Technicians

      1. Which of the following companies has Sycamore Partners invested in?
      a. CVS Caremark
      b. Playa Bowls
      c. Abercrombie and Fitch

      *

      2. Public scrutiny for private equity firms is often associated with which of the following practices?
      a. Cutthroat business practices leading to strenuous and substandard working conditions
      b. Lack of funding leading to unsatisfactory hiring practices and poorly staffed retailers
      c. Private equity firms ignore SEC regulations leading to audits and employee-related lawsuits

      *

      3. Walgreens failed to invest in what type of business, leading to its downfall. What type of business was it?
      a. Primary care clinics
      b. Pharmacy benefit manager
      c. Pharmacy manufacturers

      *

      4. Walgreen’s investment in what company set them back billions of dollars?
      a. Caremark
      b. VillageMD
      c. Aetna

      *

      5. Which of the following is a consequence of the current pharmacy payor system?
      a. Mass pharmacy closures across the country
      b. Decreased drug pricing for patients
      c. Formulary incorporating most available medications

      *

      6. Which of the following is an example of potential positive reform to the pharmacy payor system?
      a. Keeping the current system and modeling successful pharmacies
      b. Developing reasonable dispensing and service reimbursement
      c. Lower reimbursement rates to save taxpayer money

      *

      7. What action can individual pharmacists perform to impact legislative changes?
      a. Make time at work to tell prescribers that things are not going well
      b. Contact local legislators and explain how PBMs affect your pharmacy
      c. Call PBM pharmacy service lines and provide example of corporate greed

      *

      8. Which statement is most closely related to current changes in pharmacy PBM legislation?
      a. Legislation is rapidly changing; the system will change for the better soon
      b. State governments are laying the groundwork to challenge PBMs
      c. The federal government is targeting some PBMs in Congressional hearings

      Pharmacy Technician Post Test (for viewing only)

      Delving Beyond the Shelving Episode #2: Private Equity and PBMs
      Posttest 26-038
      Pharmacists and Pharmacy Technicians

      1. Which of the following companies has Sycamore Partners invested in?
      a. CVS Caremark
      b. Playa Bowls
      c. Abercrombie and Fitch

      *

      2. Public scrutiny for private equity firms is often associated with which of the following practices?
      a. Cutthroat business practices leading to strenuous and substandard working conditions
      b. Lack of funding leading to unsatisfactory hiring practices and poorly staffed retailers
      c. Private equity firms ignore SEC regulations leading to audits and employee-related lawsuits

      *

      3. Walgreens failed to invest in what type of business, leading to its downfall. What type of business was it?
      a. Primary care clinics
      b. Pharmacy benefit manager
      c. Pharmacy manufacturers

      *

      4. Walgreen’s investment in what company set them back billions of dollars?
      a. Caremark
      b. VillageMD
      c. Aetna

      *

      5. Which of the following is a consequence of the current pharmacy payor system?
      a. Mass pharmacy closures across the country
      b. Decreased drug pricing for patients
      c. Formulary incorporating most available medications

      *

      6. Which of the following is an example of potential positive reform to the pharmacy payor system?
      a. Keeping the current system and modeling successful pharmacies
      b. Developing reasonable dispensing and service reimbursement
      c. Lower reimbursement rates to save taxpayer money

      *

      7. What action can individual pharmacists perform to impact legislative changes?
      a. Make time at work to tell prescribers that things are not going well
      b. Contact local legislators and explain how PBMs affect your pharmacy
      c. Call PBM pharmacy service lines and provide example of corporate greed

      *

      8. Which statement is most closely related to current changes in pharmacy PBM legislation?
      a. Legislation is rapidly changing; the system will change for the better soon
      b. State governments are laying the groundwork to challenge PBMs
      c. The federal government is targeting some PBMs in Congressional hearings

      References

      Full List of References

      1#. Walgreens Shareholders Approve $10 Billion Private Equity Buyout. Yahoo Finance. July 11, 2025. Accessed July 15, 2025.
      https://finance.yahoo.com/news/walgreens-private-10-billion-deal-225338615.html?guccounter=1

      2#. Sycamore Partners Acquires 51% Interest in Mast Global Fashions. Sycamore Partners. November 3, 2011. Accessed July 15, 2025. https://www.sycamorepartners.com/news/article/25

      3#. Private Equity Funds. United States Securities and Exchange Commission. Accessed July 16, 2025.
      https://www.investor.gov/introduction-investing/investing-basics/investment-products/private-investment-funds/private-equity

      4#. What Private Equity Firms Are and How They Operate. ProPublica. August 3, 2025. Accessed July 16, 2025. https://www.propublica.org/article/what-is-private-equity

      5#. 10 Top Private Equity Firms by Total Equity. Investopedia. Updated July 16, 2025. Accessed July 17, 2025. https://www.investopedia.com/articles/markets/011116/worlds-top-10-private-equity-firms-apo-bx.asp
      6#. Why Is Private Equity Gaining Popularity? Forbes. May 9, 2024. Accessed July 17, 2025.
      https://www.forbes.com/councils/forbesfinancecouncil/2024/05/09/why-is-private-equity-gaining-popularity/

      8#. Walgreens Boots Alliance, Inc. (WBA). Yahoo Finance. Accessed July 17, 2025. https://finance.yahoo.com/quote/WBA/

      9#. Walgreens Boots Alliance Enters into Definitive Agreement to Be Acquired by Sycamore Partners. Walgreens Boots Alliance. March 6, 2025. Accessed July 15, 2025.
      https://investor.walgreensbootsalliance.com/news-releases/news-release-details/walgreens-boots-alliance-enters-definitive-agreement-be-acquired

      10#. Walgreens Shareholders Approve $10 Billion Private Equity Buyout. Forbes. July 11, 2025. Accessed July 15, 2025.
      https://www.forbes.com/sites/brucejapsen/2025/07/11/walgreens-shareholders-approve-10-billion-private-equity-buyout/

      11#. Walgreens Boots Alliance Accelerates VillageMD Investment and Large-Scale Rollout of Primary Care Clinics. Walgreens Boot Alliance. Accessed July 18, 2025.
      https://www.walgreensbootsalliance.com/news-media/press-releases/2021/walgreens-boots-alliance-accelerates-villagemd-investment-and-large

      12#. How Walgreens went from pharmacy behemoth to distressed retailer. Reuters. March 7, 2025. Accessed July 15, 2025.
      https://www.reuters.com/business/healthcare-pharmaceuticals/walgreens-pharmacy-behemoth-distressed-retailer-2025-03-07/

      13#. Walgreens Net Worth 2010-2025 | WBA. Macrotrends. Accessed July 16, 2025.
      https://www.macrotrends.net/stocks/charts/WBA/walgreens/net-worth

      14#. Walgreens narrows profit outlook for 2024, takes $6B hit in Q2 from VillageMD investment. Fierce Healthcare. March 28, 2024. Accessed July 19, 2025.
      https://www.fiercehealthcare.com/retail/walgreens-takes-6b-hit-q2-villagemd-investment#:~:text=Walgreens'%20VillageMD%20bought%20the%20urgent,through%20over%207%2C400%20provider%20locations.

      15#. Private Equity Labor Scorecard. Private Equity Stakeholder Project. November 2023. Accessed July 17, 2025. https://pestakeholder.org/pe-labor-scorecard/

      16#. The risks of a private equity takeover of Walgreens. Private Equity Stakeholder Project. March 7, 2025. Accessed July 17, 2025. https://pestakeholder.org/news/the-risks-of-a-private-equity-takeover-of-walgreens/

      17#. Understanding Drug Tiers. Patient Advocate Foundation. Accessed July 18, 2025.

      Understanding Drug Tiers

      18#. What Pharmacy Benefit Managers Do, and How They Contribute to Drug Spending. The Commonwealth Fund. March 17, 2025. Accessed July 18, 2025.
      https://www.commonwealthfund.org/publications/explainer/2025/mar/what-pharmacy-benefit-managers-do-how-they-contribute-drug-spending

      19#. Trends in Retail Prices of Prescription Drugs Widely Used by Older Americans, 2006 to 2020. AARP. January 2024. Accessed July 18, 2025. https://www.aarp.org/content/dam/aarp/ppi/topics/health/prescription-drugs/trends-in-retail-prices-of-prescription-drugs-widely-used-by-older-americans-2006-to-2020.doi.10.26419-2fppi.00219.001.pdf

      20#. Anderer S. Nearly 1 in 3 US Pharmacies Have Closed Since 2010, Widening Access Gaps. JAMA. February 4, 2025. Accessed July 17, 2025. doi: 10.1001/jama.2024.26875.

      21#. The Powerful Companies Driving Local Drugstores Out of Business. The New York Times. October 19, 2024. Accessed July 18, 2025. https://www.nytimes.com/2024/10/19/business/drugstores-closing-pbm-pharmacy.html#:~:text=This%20has%20been%20happening%20all,dozens%20of%20patients%20and%20pharmacists.

      22#. Annual Report 2025. Walgreens Boot Alliance. Accessed July 15, 2025. https://investor.walgreensbootsalliance.com/static-files/1dda9c7b-8315-4527-b4b3-c8cc6b4d7e09

      23#. The Real Reason Walgreens Collapsed. The Big News Letter. March 13, 2025. Accessed July 20, 2025. https://www.thebignewsletter.com/p/the-real-reason-walgreens-collapsed

      24#. SF 383 – Regulation of Pharmacy Benefit Managers (LSB1492SV.3). Legislative Service Agency. June 6, 2025. Accessed July 20, 2025. https://www.legis.iowa.gov/docs/publications/FN/1528921.pdf

      #25 Kicker: What it is, How it Works, and Types. Investopedia. Updated April 26, 2022. Accessed August 6, 2025.

      Delving Beyond the Shelving Podcast Episode #3: History, Recommendations, and Acetaminophen Controversy: A Pregnancy Review

      Learning Objectives

      After completing this application-based continuing education activity, pharmacists and pharmacy technicians will be able to:

      ·      EXPLAIN how historical events shaped the evaluation and labeling of medications used during pregnancy
      ·      IDENTIFY preconception interventions that may improve pregnancy outcomes
      ·      APPLY current evidence when counseling patients about medication use during pregnancy

          Cute cartoon pill bottles on shelves with the words Delving Beyond The Shelving

           Release Date

          Release Date: September 20, 2026

          Expiration Date: September 20, 2029

          Course Fee

          FREE

          There is no funding for this CE.

          ACPE UANs

          Pharmacist: 0009-0000-26-050-H01-P

          Pharmacy Technician: 0009-0000-26-050-H01-T

          Session Codes

          Pharmacist: 26POD45-PTX39

          Pharmacy Technician: 26POD45-XPT93

          Accreditation Hours

          0.5 hours of CE

          Accreditation Statements

          The University of Connecticut School of Pharmacy and Pharmaceutical Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE UAN 0009-0000-26-050-H01-P/T will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

           

          Disclosure of Discussions of Off-label and Investigational Drug Use

          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy and Pharmaceutical Sciences or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          Faculty

          Dylan Decandia PharmD

          Freelance Medical Writer, Franklyn’s Pharmacy

          Ho-Ho-Kus, NJ

           

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy and Pharmaceutical Sciences requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          Dylan Decandia PharmD has no relationships with ineligible companies.

           

          Dylan Decandia, PharmD discusses topics in the pharmacy world with a new guest each episode. Catch the next episode on Spotify or Apple Podcasts.

          DELVING BEYOND THE SHELVING PODCAST EPISODE 3

          Listen on an App

           

          logo for Spotify is a green circle with three curved lines shaped like a speaker Listen on Spotify

           

          Listen on ApplePodcasts COMING SOON

          Pharmacist Post Test (for viewing only)

          Delving Beyond the Shelving: Episode #3: History, Recommendations, and Acetaminophen Controversy: A Pregnancy Review

          26-050 Pharmacist post-test

           

          After completing this continuing education activity, pharmacists will be able to

          ·       EXPLAIN how historical events shaped the evaluation and labeling of medications used during pregnancy
          ·       IDENTIFY preconception interventions that may improve pregnancy outcomes
          ·       APPLY current evidence when counseling patients about medication use during pregnancy

           

          1. What drug, originally used as a non-barbiturate sedative, caused fetal abnormalities in over 10,000 newborns across Europe in the 1950s?

          A. Thalidomide

          B. Folate

          C. Warfarin

           

          *

           

          2. What is the name of the newly hired medical officer at the FDA, who helped prevent tragedy in newborns in the United States?

          A. Dr William McBride

          B. Dr Widukind Lenz

          C. Dr Frances Oldham Kelsey

           

          *

           

          3. What is the name of the amendment to the Food, Drug, and Cosmetic Act that improved safety and efficacy requirements following thalidomide incidents?

          A. Kefauver–Harris Amendments

          B. Durham-Humphrey Amendment

          C. Pure Food and Drug Act

           

          *

           

          4. Why are the new post-marketing surveillance systems preferred to the previous pregnancy categories classification?

          A. The new system added additional categories such as class F and Z to incorporate alternative outcomes from real life data acquired by the surveillance system

          B. The new system allows providers to make informed decisions based on real life data, whereas the old system was too rigid by forcing medications into categories

          C. The new system only collects data from real world exposures; the FDA is assessing this data before releasing it as guidelines to the public, so we cannot determine the benefits over the old system yet

           

          *

           

          5. What is the best way to describe acetaminophen's current role in therapy based on available studies?

          A. Acetaminophen is recommended in pregnant patients with high-grade fevers

          B. Acetaminophen is linked with neurological conditions in children such as ADHD and autism, so therapy is contraindicated in pregnant women

          C. Acetaminophen is associated with increased bleed risk in pregnant women, NSAID treatment for fevers is preferred

           

          *

           

          6. Which over the counter is contraindicated in pregnancy?

          A. NSAIDs

          B. Benadryl

          C. TUMS

           

          *

           

          7. What source, recommended by the CDC, is helpful to patients and healthcare professionals to review the effects of medications on pregnant patients?

          A. Instagram

          B. Mothertobaby

          C. Barbara from accounting

           

          *

           

          8. Which statement best describes the effects of discontinuing oral birth control on ovulation and pregnancy?

          A. Each patient is different, but generally the body returns to ovulation after 2 weeks. Patients can begin trying to conceive.

          B. The female body takes at least 3 months to return to ovulation after last dose for most birth controls. Patients are required to wait at least 3 months to prevent possible fetal abnormalities.

          C. A patient’s cycle may never be the same; oral birth control tablets have a long history of lifetime effects.

           

          *

           

          9. Birth defects like Spina bifida and anencephaly are associated with deficiency in which B-vitamin?

          A. B3: Niacin

          B. B7: Biotin

          C. B9: Folate

           

          *

           

          10. How does obesity impact the chances of conception for men and women patients?

          A. Obesity has no impact on conception for men and women; the main impacts are smoking and alcohol intake.

          B. Obesity has a positive impact for male patients; excess fat buildup around the scrotal area warms sperm in men, making it more mobile and fertile.

          C. Obesity has a negative impact for men and women; decreased fertility rates, reduced sperm counts, anovulatory infertility, and other side effects of obesity lead to worse pregnancy outcomes.

          Pharmacy Technician Post Test (for viewing only)

          Delving Beyond the Shelving: Episode #3: History, Recommendations, and Acetaminophen Controversy: A Pregnancy Review

          26-050 Pharmacy Technician Post-test

           

          After completing this continuing education activity, pharmacists will be able to

          ·       EXPLAIN how historical events shaped the evaluation and labeling of medications used during pregnancy

          ·       IDENTIFY preconception interventions that may improve pregnancy outcomes

          ·       APPLY current evidence when counseling patients about medication use during pregnancy

           

          1. What drug, originally used as a non-barbiturate sedative, caused fetal abnormalities in over 10,000 newborns across Europe in the 1950s?

          A. Thalidomide

          B. Folate

          C. Warfarin

          *

          2. What is the name of the newly hired medical officer at the FDA, who helped prevent tragedy in newborns in the United States?

          A. Dr William McBride

          B. Dr Widukind Lenz

          C. Dr Frances Oldham Kelsey

          *

          3. What is the name of the amendment to the Food, Drug, and Cosmetic Act that improved safety and efficacy requirements following thalidomide incidents?

          A. Kefauver–Harris Amendments

          B. Durham-Humphrey Amendment

          C. Pure Food and Drug Act

          *

          4. Why are the new post-marketing surveillance systems preferred to the previous pregnancy categories classification?

          A. The new system added additional categories such as class F and Z to incorporate alternative outcomes from real life data acquired by the surveillance system

          B. The new system allows providers to make informed decisions based on real life data, whereas the old system was too rigid by forcing medications into categories

          C. The new system only collects data from real world exposures; the FDA is assessing this data before releasing it as guidelines to the public, so we cannot determine the benefits over the old system yet

          *

          5. What is the best way to describe acetaminophen's current role in therapy based on available studies?

          A. Acetaminophen is recommended in pregnant patients with high-grade fevers

          B. Acetaminophen is linked with neurological conditions in children such as ADHD and autism, so therapy is contraindicated in pregnant women

          C. Acetaminophen is associated with increased bleed risk in pregnant women, NSAID treatment for fevers is preferred

          *

          6. Which over the counter is contraindicated in pregnancy?

          A. NSAIDs

          B. Benadryl

          C. TUMS

          *

          7. What source, recommended by the CDC, is helpful to patients and healthcare professionals to review the effects of medications on pregnant patients?

          A. Instagram

          B. Mothertobaby

          C. Barbara from accounting

          *

          8. Which statement best describes the effects of discontinuing oral birth control on ovulation and pregnancy?

          A. Each patient is different, but generally the body returns to ovulation after 2 weeks. Patients can begin trying to conceive.

          B. The female body takes at least 3 months to return to ovulation after last dose for most birth controls. Patients are required to wait at least 3 months to prevent possible fetal abnormalities.

          C. A patient’s cycle may never be the same; oral birth control tablets have a long history of lifetime effects.

          *

          9. Birth defects like Spina bifida and anencephaly are associated with deficiency in which B-vitamin?

          A. B3: Niacin

          B. B7: Biotin

          C. B9: Folate

          *

          10. How does obesity impact the chances of conception for men and women patients?

          A. Obesity has no impact on conception for men and women; the main impacts are smoking and alcohol intake.

          B. Obesity has a positive impact for male patients; excess fat buildup around the scrotal area warms sperm in men, making it more mobile and fertile.

          C. Obesity has a negative impact for men and women; decreased fertility rates, reduced sperm counts, anovulatory infertility, and other side effects of obesity lead to worse pregnancy outcomes.

          References

          Full List of References

          1. Lenz W. A short history of thalidomide embryopathy. Teratology. 1988;38(3):203-215. doi:10.1002/tera.1420380303
          2. Mcbride WG. Thalidomide and Congenital Abnormalities. The Lancet. 1961;2:1358.Accessed July 15, 2026. https://softenon.nl/wp-content/uploads/2025/08/Brief-McBride_The-Lancet-19611216.pdf
          3. Vargesson N. Thalidomide-induced teratogenesis: history and mechanisms. Birth Defects Res C Embryo Today. 2015;105(2):140-156. doi:10.1002/bdrc.21096
          4. Kelsey FO. Thalidomide update: regulatory aspects. Teratology. 1988;38(3):221-226. doi:10.1002/tera.1420380305
          5. Her Refusal to Approve a Dangerous Drug Changed Medical History. 19th News. October 22, 2025. Accessed July 15, 2026. https://19thnews.org/2025/10/frances-oldham-kelsey-history-medical-drug-safety/
          6. Author of Thalidomide History Tells Drug’s Hidden Story. Yale Law School. October 30, 2023. Accessed July 15, 2025. https://law.yale.edu/yls-today/news/author-thalidomide-history-tells-drugs-hidden-story
          7. Frances Oldham Kelsey, FDA Scientist Who Kept Thalidomide Off U.S. Market, Dies at 101. The Washington Post. August 7, 2015. Accessed July 15, 2026. https://www.washingtonpost.com/national/health-science/frances-oldham-kelsey-heroine-of-thalidomide-tragedy-dies-at-101/2015/08/07/ae57335e-c5da-11df-94e1-c5afa35a9e59_story.html
          8. Roca C. An Evolution of Labeling Information for Pregnant Women: PLLR History and Background. U.S Food and Drug Administration. March 5, 2018. Accessed July 15, 2026. https://www.fda.gov/files/advisory%20committees/published/An-Evolution-of-Labeling-Information-for-Pregnant-Women--PLLR-History.pdf
          9. Greene JA, Podolsky SH. Reform, regulation, and pharmaceuticals--the Kefauver-Harris Amendments at 50. N Engl J Med. October 18, 2012. Accessed July 17, 2026. doi:10.1056/NEJMp1210007
          10. Folate (Folic Acid) -- Vitamin B9. Harvard School of Public Health The Nutrition Source. Updated March 2023. Accessed July 17, 2026. https://nutritionsource.hsph.harvard.edu/folic-acid/
          11. Finelli R, Mottola F, Agarwal A. Impact of Alcohol Consumption on Male Fertility Potential: A Narrative Review. Int J Environ Res Public Health. December 29, 2021. Accessed July 17, 2026. doi:10.3390/ijerph19010328
          12. Preconception Health. OASH Office on Women’s Health. Updated September 26, 2025. Accessed July 17, 2026. https://womenshealth.gov/pregnancy/you-get-pregnant/preconception-health
          13. Medicine and Pregnancy: An Overview. U.S. Centers for Disease Control and Prevention. September 22, 2025. Accessed July 17, 2026. https://www.cdc.gov/medicine-and-pregnancy/about/index.html
          14. FDA Responds to Evidence of Possible Association Between Autism and Acetaminophen Use During Pregnancy. U.S Food and Drug Administration. September 22, 2025. Accessed July 17, 2026. https://www.fda.gov/news-events/press-announcements/fda-responds-evidence-possible-association-between-autism-and-acetaminophen-use-during-pregnancy
          15. FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid. U.S Food and Drug Administration. Updated September 1, 2022. Accessed July 18, 2026. https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic
          16. Nicotine Replacement Therapy to Help You Quit Tobacco. American Cancer Society. Updated October 28, 2024. Accessed July 17, 2026. https://www.cancer.org/cancer/risk-prevention/tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html
          17. Pregnancy and Obesity: Know the Risks. Mayo Clinic. February 22, 2025. Accessed July 16, 2026. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409
          18. Obesity and Reproduction: A Committee Opinion. American Society for Reproductive Medicine. Accessed July 16, 2026. https://www.asrm.org/practice-guidance/practice-committee-documents/obesity-and-reproduction-a-committee-opinion-2021/
          19. Medicine and Pregnancy. U.S. Food and Drug Administration. Updated February 3, 2025. Accessed July 14, 2026. https://www.fda.gov/consumers/womens-health-topics/medicine-and-pregnancy
          20. Signs of Ovulation After Stopping the Pill. IVI Fertility. Accessed July 16, 2026. https://ivi-fertility.com/blog/signs-of-ovulation-after-stopping-the-pill/
          21. Getting Pregnant After Stopping Birth Control. New York Presbyterian Health Library. Updated February 27, 2026. Accessed July 18, 2026. https://www.nyp.org/healthlibrary/articles/getting-pregnant-after-stopping-birth-control
          22. Depo-Provera (Birth Control Shot). Cleveland Clinic. Updated April 7, 2025. Accessed July 16, 2026. https://my.clevelandclinic.org/health/drugs/4086-depo-provera-birth-control-shot
          23. Caffeine. Mothertobaby. Updated November 1, 2025. Accessed July 22, 2026. https://mothertobaby.org/fact-sheets/caffeine-pregnancy/
          24. Harvard’s Public Health Dean Was Paid $150,000 to Testify Tylenol Causes Autism. Harvard The Crimson. September 24, 2025. https://www.thecrimson.com/article/2025/9/24/autism-dean-public-health/
          25. Health Brief: Tylenol lawsuits roar back. The Washington Post. July 13, 2026. Accessed July 22, 2026. https://www.washingtonpost.com/wp-intelligence/health-brief/2026/07/13/health-brief-tylenol-lawsuits-roar-back/
          26. Tylenol lawsuits are asking the wrong question. The Washington Post. July 21, 2026. Accessed July 22, 2026. https://www.washingtonpost.com/opinions/2026/07/21/tylenol-lawsuits-are-asking-wrong-question-about-use-pregnancy/
          27. Niklewicz A. “The importance of vitamin B12 for individuals choosing plant-based diets.” European journal of nutrition vol. 62,3 (2023): 1551-1559. doi:10.1007/s00394-022-03025-4
          28. Weight Gain During Pregnancy. U.S. Centers for Disease Control and Prevention. May 15, 2024. Accessed August 10, 2026. https://www.cdc.gov/maternal-infant-health/pregnancy-weight/index.html
          29. Spilling the Beans: How Much Caffeine is Too Much? U.S Food and Drug Administration. Updated August 28, 2024. Accessed August 10, 2026. https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much
          30. About Alcohol Use During Pregnancy. U.S. Centers for Disease Control and Prevention. April 2, 2026. Accessed August 11, 2026. https://www.cdc.gov/alcohol-pregnancy/about/index.html
          31. Liew Z, Kioumourtzoglou MA, Roberts AL, O'Reilly ÉJ, Ascherio A, Weisskopf MG. Use of Negative Control Exposure Analysis to Evaluate Confounding: An Example of Acetaminophen Exposure and Attention-Deficit/Hyperactivity Disorder in Nurses' Health Study II. Am J Epidemiol. 2019;188(4):768-775.
          32. Ji Y, Azuine RE, Zhang Y, et al. Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. 2020;77(2):180-189. doi:10.1001/jamapsychiatry.2019.3259
          33. Ahlqvist V, Sjöqvist H, Dalman C. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. April 9, 2024. Accessed August 13, 2026. https://jamanetwork.com/journals/jama/fullarticle/2817406

          Delving Beyond the Shelving Podcast Episode #4: Pharmacist Roles in Prescribing and Medication Management

          Learning Objectives

          After completing this application-based continuing education activity, pharmacists will be able to:

          RECALL the impact of pharmacists in clinical and prescribing roles
          IDENTIFY the differences between collaborative practice agreements and progressive types of pharmacist prescribing
          EXPLAIN how lessons from Alberta and Idaho may inform US pharmacy law

              Cute cartoon pill bottles on shelves with the words Delving Beyond The Shelving

               Release Date

              Release Date: November 10, 2026

              Expiration Date: November 10, 2029

              Course Fee

              FREE

              There is no funding for this CE.

              ACPE UANs

              Pharmacist: 0009-0000-26-068-H04-P

              Session Codes

              Pharmacist: 26POD68-VAQ49

              Accreditation Hours

              0.5 hours of CE

              Accreditation Statements

              The University of Connecticut School of Pharmacy and Pharmaceutical Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE UAN 0009-0000-26-068-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

               

              Disclosure of Discussions of Off-label and Investigational Drug Use

              The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy and Pharmaceutical Sciences or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

              Faculty

              Dylan Decandia PharmD

              Freelance Medical Writer, Franklyn’s Pharmacy

              Ho-Ho-Kus, NJ

               

              Faculty Disclosure

              In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy and Pharmaceutical Sciences requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

              Dylan Decandia PharmD has no relationships with ineligible companies.

               

              Dylan Decandia, PharmD discusses topics in the pharmacy world with a new guest each episode. Catch the next episode on Spotify or Apple Podcasts.

              DELVING BEYOND THE SHELVING PODCAST EPISODE 4

              Pharmacist Post Test (for viewing only)

              Delving Beyond the Shelving: Episode #4: Pharmacist Roles in Prescribing and Medication Management

              26-068 Pharmacist post-test

               

              After completing this continuing education activity, pharmacists will be able to

              • RECALL the impact of pharmacists in clinical and prescribing roles
              • IDENTIFY the differences between collaborative practice agreements and progressive types of pharmacist prescribing
              • EXPLAIN how lessons from Alberta and Idaho may inform US pharmacy law

               

                 

                *

                 

                1. A health system is evaluating a pharmacist-managed anticoagulation service. Which finding best demonstrates a clinical benefit consistent with the activity?

                A. A decrease in acquisition costs for the anticoagulants used by enrolled patients

                B. An increase in time within the therapeutic INR range among enrolled patients

                C. A decrease in prescription turnaround times for the anticoagulants dispensed to enrolled patients

                 

                *

                 

                2. Patients in a community face long waits for appointments to address medication needs. Which service best illustrates how pharmacist prescribing can help close this care gap?

                A. Providing timely pharmacist assessment and prescribing for eligible patients within authorized services

                B. Providing same-day medication delivery and refill reminders for patients with existing prescriptions

                C. Providing electronic renewal requests and appointment reminders for patients awaiting prescriber visits

                 

                *

                 

                3. A pharmacist and physician sign a formal agreement that defines when the pharmacist may adjust medication therapy. Which statement correctly identifies the source of the pharmacist’s prescribing authority in this arrangement?

                A. It derives from a statewide protocol issued by a state agency

                B. It derives from category-specific authority established through state pharmacy law

                C. It derives from a collaborative practice agreement with the participating prescriber

                 

                *

                 

                4. A state agency establishes predetermined screening and prescribing guidelines for a medication service. Pharmacists meeting its requirements may provide the service without obtaining an agreement with an individual prescriber. Which model does this describe?

                A. Prescribing under a statewide protocol with predetermined eligibility guidelines.

                B. Prescribing under a collaborative agreement with a participating prescriber.

                C. Prescribing under category-specific authority with broader clinical decision-making flexibility.

                 

                *

                 

                5. A US state wants pharmacists to use updated first-line therapies as evidence changes. Which policy approach best reflects the flexibility highlighted in the activity’s discussion of Alberta and Idaho?

                A. Authorize prescribing through a fixed list of specifically named medications

                B. Authorize prescribing through individual physician approval of each medication change

                C. Authorize prescribing through drug categories guided by current clinical evidence

                 

                *

                 

                6. A US policy group is considering broader pharmacist prescribing authority based on lessons from Alberta. Which safeguard best reflects the activity’s approach when a patient’s needs exceed a pharmacist’s demonstrated competence?

                A. Begin a short treatment trial before deciding whether specialist care is needed

                B. Refer the patient to an appropriate clinician or facility for further assessment

                C. Use a general treatment algorithm instead of arranging another clinician’s assessment

                 

                References

                Full List of References

                D1#. Milestones in U.S. Food and Drug Law. U.S Food and Drug Administration. Accessed September 6, 2026. https://www.fda.gov/about-fda/fda-history/milestones-us-food-and-drug-law
                D2#. Durham-Humphrey Amendment of 1951: How the FDA Created the Prescription vs. OTC Drug Distinction. Casrai Standards. Updated July 30, 2026. Accessed September 6, 2026. https://casrai.org/guides/durham-humphrey-amendment-prescription-drug-regulation-history
                D3#. Physician Shortage. The American Medical Association. Accessed September 6, 2026. https://www.ama-assn.org/topics/physician-shortage
                D4#. The physician shortage will worsen—unless Congress acts now. The American Medical Association. Updated June 16, 2025. Accessed September 6, 2026. https://www.ama-assn.org/about/leadership/physician-shortage-will-worsen-unless-congress-acts-now
                D5#. New AAMC Report Shows Continuing Projected Physician Shortage. AAMC. March 21, 2024. Accessed September 17, 2026. https://www.aamc.org/news/press-releases/new-aamc-report-shows-continuing-projected-physician-shortage D6#. 2025 Survey of Physician Appointment Wait Times. AMN Healthcare. June 2, 2025. Accessed September 6, 2026. https://www.amnhealthcare.com/amn-insights/physician/whitepapers/2025-survey-of-physician-appointment-wait-times/
                D7#/D10#. Collaborative Practice Agreements and Pharmacists Patient Care Services. The American Pharmacist Association. Accessed September 6, 2026.
                https://www.aphafoundation.org/collaborative-practice-agreements
                D8#/D12#. Adams AJ. Pharmacist Prescriptive Authority: Lessons from Idaho. Pharmacy (Basel). 2020;8(3):112. Published July 8, 2020. doi:10.3390/pharmacy8030112
                D9#. Mahmoudjafari Z, Hough S. Expanding oncology pharmacist teams: Justifying the return on investment. J Oncol Pharm Pract. 2022;28(6):1381-1387. doi:10.1177/10781552221086292
                D11#. Collaborative Practice Agreements: Resources and More. National Alliance of State Pharmacy Association. June 8, 2017. Accessed September 6, 2026. https://naspa.us/resource/cpa/
                D13#. Pharmacists’ Authority to Initiate PrEP and PEP and Engage in Collaborative Practice Agreements. NASTAD. August 19, 2024. Accessed September 7, 2026.
                https://nastad.org/resources/pharmacists-authority-engage-collaborative-practice-agreements-and-initiate-prep-pep-and
                D14#. Pre-Exposure Prophylaxis (PrEP). Hiv.gov. Accessed September 7, 2026. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis
                D15#. Pharmacist-Prescribed Contraceptives. Guttmacher. Updated April 17, 2026. Accessed September 7, 2026. https://www.guttmacher.org/state-policy/explore/pharmacist-prescribed-contraceptives
                D16#. Over-the-Counter Access to Hormonal Contraception. American College of Obstetricians and Gynecologists. Updated October 2019. Accessed September 7, 2026. https://www.acog.org/en/Clinical/Clinical%20Guidance/Committee%20Opinion/Articles/2019/10/Over-the-Counter%20Access%20to%20Hormonal%20Contraception
                D17#. Current Contraceptive Status Among Women Aged 15–49: United States, 2017–2019. Centers for Disease Control and Prevention. October 2020. Accessed July 16, 2024. https://www.cdc.gov/nchs/data/databriefs/db388-H.pdf
                D18#. Pharmacist and Pharmacy Technician Vaccination Authority. National Alliance of State Pharmacy Association. January 3, 2025. Accessed September 6, 2026. https://naspa.us/resource/2024-pharmacist-immunization-authority/
                D19#. Le LM, Veettil SK, Donaldson D, et al. The impact of pharmacist involvement on immunization uptake and other outcomes: An updated systematic review and meta-analysis. J Am Pharm Assoc (2003). 2022;62(5):1499-1513.e16. doi:10.1016/j.japh.2022.06.008
                D20#. Teahan Á, Sharp M, Farragher A, Strawbridge J, Long J. Effectiveness and safety of pharmacist prescribing: a systematic review. BMJ Open. 2026;16(6):e112886. June 25, 2026. doi:10.1136/bmjopen-2025-112886
                D21#. Akintunde AO, Karaxhija A, Laaksonen R. Effects of pharmacist prescribing on health-related outcomes in secondary care compared with medical prescribing or no treatment: A systematic review. Res Social Adm Pharm. 2026;22(2):254-262. doi:10.1016/j.sapharm.2025.11.003
                D22#. 2024 Final Report: National Pharmacist Workforce Study. AACP. June 2025. Accessed September 16, 2026. https://www.aacp.org/sites/default/files/2025-06/2024-npws-final-report-5.27.25.pdf
                D23#. Pearson GJ. Evolution in the practice of pharmacy--not a revolution!. CMAJ. 2007;176(9):1295-1296. doi:10.1503/cmaj.070041
                D24#. Become a Pharmacist. Ontario Pharacist Association. Accessed September 7, 2026. https://www.opatoday.com/become-a-pharmacist/
                D25#. Additional prescribing authorization (APA). Alberta College of Pharmacy. Accessed September 7, 2026. https://abpharmacy.ca/regulated-members/registration/pharmacists/authorizations/additional-prescribing-authorization-apa/
                D26#. APhA secures key congressional win allowing pharmacists to prescribe buprenorphine with specialized training. The American Pharmacist Association. December 2, 2025. Accessed September 7, 2026. https://www.pharmacist.com/APhA-Press-Releases/apha-secures-key-congressional-win-allowing-pharmacists-to-prescribe-buprenorphine-with-specialized-training
                D27#. APhA's Initiating Buprenorphine Certificate Training Program. The American Pharmacist Association. Accessed September 7, 2026. https://www.pharmacist.com/Education/Certificate-Training-Programs/Buprenorphine
                D28#. Investigating pharmacists’ refusal to fill valid physician orders. The American Medical Association. December 18, 2025. Accessed September 1, 2026. https://www.ama-assn.org/practice-management/scope-practice/investigating-pharmacists-refusal-fill-valid-physician-orders
                D29#. Idaho 54-1734. PHARMACIST PRESCRIBING — GENERAL REQUIREMENTS. Idaho Statutes. Updated 2025. Accessed September 16, 2026. https://legislature.idaho.gov/statutesrules/idstat/Title54/T54CH17/SECT54-1734/
                D30#. Pharmacists to gain authority to therapeutically substitute controlled substances under new federal regulations. Canadian Pharmacists Association. Accessed September 21, 2026. https://www.pharmacists.ca/news-events/news/pharmacists-to-gain-authority-to-therapeutically-substitute-controlled-substances-under-new-federal-regulations/