Does Pharmacy Have an Identity Crisis? | TWIRx

On this episode of This Week in Pharmacy, we examine two major forces reshaping the profession: the unfinished business of pharmacist provider status and the legal landscape around direct-to-consumer pharmaceutical distribution. In part one, Erik Abel, PharmD, MBA, discusses his May 2026 analysis, “So Pharmacists Want to Be a Provider: Where the Profession Lost Its Way and Perhaps a Path to Get Back.” Abel argues that pharmacy’s provider-status challenge is not a lack of clinical evidence, but a lack of operational infrastructure: credentialing, payer contracting, revenue cycle management, interoperability, and scalable business models. In part two, Darshan Kulkarni, PharmD, Esq., joins the show to discuss direct-to-consumer pharmaceutical distribution, legal risk, regulatory scrutiny, telehealth-linked prescribing, manufacturer strategy, and what pharmacists need to understand as drug distribution moves closer to the patient. This week in pharmacy news, Pittsburgh-area pharmacies continue to face uneven access to Adderall and other ADHD medications, years after the FDA first identified shortages in 2022. Patients are still calling multiple pharmacies, switching medications, rationing doses, or going without treatment as availability varies by dosage, formulation, manufacturer, and wholesaler. Pharmacists are also using medication therapy management to protect older adults from preventable medication-related harm. MTM reviews can identify risky prescriptions and OTC products, including diphenhydramine, duplicate therapies, drug interactions, and long-term proton pump inhibitor use that may need reassessment. In 340B news, CVS Health is facing federal lawsuits from major health systems alleging CVS Specialty and WellPartner improperly retained approximately $250 million in savings that should have gone back to covered entities. The litigation adds pressure to debates over PBM integration, contract pharmacy arrangements, and 340B transparency. On Capitol Hill, lawmakers are pressing the Department of Defense to commit to annual audits of the TRICARE pharmacy contract as concerns continue around PBM conflicts of interest, reimbursement practices, network adequacy, and access for independent and community pharmacies.