In October the Consultant and Specialty Pharmacists of Michigan held its annual Board of Directors elections. CSPM is excited to welcome Ruth Opdycke, Randolph Regal and Zachary Mueller to the board for 2025. In addition, former chair and president Matthew McTaggart was elected to another three-year term. Manjula Jayabalan was chosen as the section president in 2024 and will lead the board as chair in 2025. Rema Farran serves as the president for 2025 and will become chair in 2026.

About Our New Board Members

Ruth Opdycke joined RxBenefits, headquartered in Birmingham, Alabama, in late 2021 where she currently holds the position of principal advisor and is responsible for optimization of RxBenefits’ utilization management programs for over three million members. Before joining RxBenefits, she was the director of pharmacy strategy at Cigna. Prior to Cigna, she ran a consulting company providing services to employer groups, brokers, BCBS organizations and regional health plans. Opdycke is a graduate of the University of Michigan where she earned a Doctor of Pharmacy (1986), Master of Science (1988) and Ambulatory Care Fellowship (1990). She has been a member of Michigan Pharmacists Association for 38 years and is also a member of the American Pharmacists Association and Academy of Managed Care Pharmacy. Opdycke resides in Livonia.

Randolph E. Regal has been employed with the University of Michigan for the past 27 years, where he holds the positions of clinical pharmacy specialist and clinical associate professor of pharmacy in adult internal medicine and gastroenterology. He has also been an independent long-term care pharmacy consultant for over 35 years. He is a 1984 graduate of University of Michigan, where he earned Bachelor of Science and Doctor of Pharmacy degrees. He currently has over 40 peer review publications and teaches classes in geriatrics, research design methodology/medical writing and hepatology at the College of Pharmacy. Regal has been a member of MPA for the past three years and was a member of ACCP for nearly 25 years prior to that. He currently resides in Plymouth.

Zachary R. Mueller has been employed with Walgreens since 2014. Starting as a pharmacy technician, Mueller currently holds the position of pharmacy manager in a specialty pharmacy located in Detroit. Mueller is a 2020 Pharm.D. graduate from Wayne State University, where he also did his undergraduate studies. Mueller served as

the 2020-2021 MPA Executive Fellow. He currently resides in Macomb.

Medicare Part D and the IRA: Changes Impacting 2025

By Leena Jamaleddin, Pharm.D., PGY-1 managed care resident, Priority Health

Overview of the Inflation Reduction Act (IRA)

The IRA represents a transformative shift in the landscape of Medicare, aiming to enhance affordability and access to health care for millions of Americans. Set to take effect in 2025, the IRA introduces significant reforms designed to reduce the financial burden of prescription drugs on Medicare beneficiaries. These changes are set to improve clinical outcomes, promote greater equity and enhance cost-effectiveness within the health care community. As the health care system continues to evolve, the IRA stands as a pivotal step toward a more sustainable and accessible future for Medicare.

Key Changes in 2025

• Out-of-Pocket Cap for Medicare Part D: Starting Jan. 1, 2025, Medicare Part D will introduce a $2,000 annual cap on out-of-pocket expenses for prescription drugs. Once a beneficiary reaches this limit, they will enter the catastrophic phase, where they will not incur any further out-of-pocket costs for covered medications for the remainder of the calendar year.
• Elimination of the Coverage Gap (Donut Hole): The "donut hole" in Medicare Part D coverage will be fully eliminated. This phase, where beneficiaries historically faced higher out-of-pocket costs after reaching their initial coverage limit, will no longer exist.
• Medicare Drug Price Negotiation: Medicare will gain the ability to directly negotiate prices for certain high-cost drugs with manufacturers. This provision targets medications that lack generic or biosimilar competition and account for significant Medicare spending.
• Insulin Cost Cap: Insulin costs for Medicare beneficiaries will be capped at $35 per month, a provision that applies to both insulin prescriptions covered under Medicare Part D and insulin used in durable medical equipment pumps under Part B.
• Expansion of the Low-Income Subsidy Program (Extra Help): The IRA expands eligibility for the Extra Help Program, which assists individuals with limited income and resources in paying for premiums, deductibles, and copayments. More beneficiaries will qualify for the full benefits of this program, reducing their overall prescription drug costs and improving access to necessary treatments.
• Medicare Prescription Payment Plan: The Medicare Prescription Payment Plan will offer beneficiaries the option to spread out their out-of-pocket drug costs over the plan year. Instead of paying the full cost upfront at the pharmacy, members can opt to pay $0 at the point of sale and receive a monthly bill for their prescription costs. This flexibility provides beneficiaries with immediate affordability and allows for more predictable expense management throughout the year.

Impact on Beneficiaries

These changes collectively aim to make prescription drugs more affordable and accessible for Medicare beneficiaries. The $2,000 out-of-pocket cap and the elimination of the coverage gap will provide significant financial relief for those requiring high-cost or multiple medications. Additionally, the insulin cost cap and Medicare’s ability to negotiate drug prices will further reduce expenses, offering much-needed affordability for life-saving treatments. The expansion of the Extra Help program and introduction of the Medicare Prescription Payment Plan provide even more options to help beneficiaries manage their healthcare expenses effectively.

Considerations for Part D Plans

While the IRA’s changes bring substantial benefits for beneficiaries, they also shift financial responsibility to Medicare Part D plans.



Here is an example of what Coverage Phases looked like for 2024 vs. what they will look like in 2025:

To adapt, plans may implement strategies such as:

• Increasing member cost-sharing requirements: Adjustments to copayments and coinsurance may occur, particularly for high-cost drugs.
• Enhancing drug management strategies: Plans may expand the use of prior authorizations, step therapy, or formulary adjustments to ensure cost-effective medication use.
• Reevaluating supplemental benefits: Plans might reconsider the scope of additional benefits they offer, as they adjust to the new cost structures.

Conclusion

The IRA introduces transformative changes to Medicare in 2025, focusing on affordability, accessibility and sustainability. By capping out-of-pocket costs, eliminating the coverage gap and enabling Medicare to negotiate drug prices, the IRA aims to create a more equitable health care system for millions of beneficiaries. These reforms represent a significant step forward in addressing systemic challenges within Medicare and ensuring better access to critical treatments for patients.

Gov. Whitmer Signs MPA-Backed Bills Allowing Pharmacists

to Prescribe Contraception

LANSING – On Jan. 21, 2025, Gov. Gretchen Whitmer signed 16 bills that will expand reproductive freedom in Michigan, including a bill that allows pharmacists to directly prescribe and dispense contraceptives to patients. This package of bills ensures women can more easily access critical health care by lowering costs and cutting unnecessary red tape. These bills also bolster Gov. Whitmer’s commitment to advancing reproductive freedoms here in Michigan, giving more Michiganders the opportunity to control if, when, and how they choose to start their families. 

"Today, I’m signing common sense bills to further protect everyone’s fundamental freedom to make their own decisions about their own body,” Whitmer said in a press release. “These bills will save women time and money so they can access the birth control they need and cut unnecessary red tape that stands between people and their health care. Whether you’re getting ready to start a family or figuring out which contraceptive option is best for you, I’ll fight to make sure you have the freedom to make that choice. Together, let’s keep fighting like hell to protect reproductive rights.” 

House Bills 5435 and 5436, sponsored by state Reps. Stephanie A. Young, D-Detroit, and Kara Hope, D-Holt, expand contraceptive access in our state, giving thousands of Michiganders access to basic health care. The bills allow a pharmacist to directly prescribe birth control and require insurers to cover the contraceptives. Both bills were MPA-backed legislative priorities.

Currently, Michigan is experiencing a shortage of obstetricians and gynecologists (OB/GYNs), with one-third of Michigan’s 83 counties having no OB/GYNs at all. This shortage has negatively affected thousands of Michiganders, making it harder for them to access hormonal birth control.

"Michigan has many medical deserts, with an even greater number of communities without an OB/GYN primary care provider," said MPA member and Wayne State University professor of pharmacy practice Mary Beth O'Connell, who was a leading voice in pushing for the bills' passage. "Michigan’s unintended pregnancy rate was 50% in 2020. This legislation will help decrease these reproductive health deserts for essential contraception medications and help Michiganders prevent unintended pregnancies. We know that 67% to 82% of college students in Michigan from all races, ethnicities, religions and political affiliations – including both Republicans and Democrats – stated they would be interested in getting their birth control from a pharmacy. Ninety percent of college students and 74% of women felt this service would definitely or probably decrease their likelihood of having an unintended pregnancy. They felt the pharmacy service would be more convenient, save time and be easier for them."

Whitmer said the bills increase access to safe, affordable birth control and recognize pharmacists as important members of a woman’s health care team. Michigan Pharmacists Association staff and members worked with state legislators to pass the legislation.

“Today, we are breaking down barriers to reproductive health care access in Michigan. This new law makes it easier for individuals — especially those in underserved communities — to take charge of their health and their futures," Young said. "Access to contraceptives shouldn’t depend on where you live or whether you can get a doctor’s appointment. By expanding access, we are prioritizing equity, convenience and the well-being of our residents. I’m grateful to my colleagues and advocates for helping us deliver meaningful change for Michiganders.”  

“Contraception should be easily and safely accessible,” Hope added. “Now that these bills have been signed into law, barriers like geography and healthcare shortages are no longer obstacles to receiving contraceptive health care in Michigan. These new laws will make a meaningful change in the lives of Michiganders.” 

"Pharmacist-provided hormonal contraception is a necessary factor in increasing accessibility, particularly in areas with limited access to healthcare services,” said Eric Roath, MPA's director of government affairs. “It enhances women's health by further empowering them to take control over reproductive decisions using safe and effective medications. This is critical toward improving health outcomes and reducing unnecessary health care spending." 

NCAP Develops Substance Abuse Disorder Training Program

The North Carolina Association of Pharmacists has developed a comprehensive, one-time training program designed to give health care professionals a thorough understanding of preventing, detecting, and managing patients with substance use disorders. The program addresses prevention, treatment, and recovery, conceptualizing substance use disorder as a chronic brain disease affected by genetic, behavioral, cultural, and socioeconomic factors. The program will emphasize opioid use disorder (OUD) and is designed to equip participants with the information needed to treat and manage patients living with OUD effectively.

The target audience for this advanced-level training includes physicians, nurse practitioners/nurses, physician assistants, and pharmacists. Clinicians who see patients with addiction in primary care, emergency/urgent care, treatment centers, or general psychiatry settings.

Sign up now!

It's Time to Renew Your Membership

There are many benefits to renewing your membership with MPA, including:

• Direct access to experts who can answer law and practice questions
• Networking opportunities with pharmacy professionals, such as complimentary membership in our local county associations and practice sections
• Free and discounted CE opportunities such as the MPA Annual Convention & Exposition – the state’s largest pharmacy conference
• Being part of the collective voice advocating for the future of the profession
• Competitive home, auto and business insurance through MPA’s affiliated PSI Insurance Agency

MPA exists for and is effective because of its members. RENEW today to ensure that your benefits are secured and that MPA has the resources to move the mountains ahead for you, for the profession and for patients.

ACE 2025 Registration is OPEN!

Register now for the 2025 Annual Convention & Exposition! ACE 2025 is the premier pharmacy continuing education event in Michigan, taking place April 11-13, 2025, at the Grand Traverse Resort and Spa.

Sign up now and save with MPA's early bird registration rate, which is available until Feb 7. Member pharmacists who sign up by Feb. 7 can get $70 off their ACE rate! To view the full table of convention pricing, click here.

We encourage our members to make the 2025 ACE their "stay-cation" – golf, water activities and wineries are just a few things you can do in beautiful Traverse City. After you register for ACE 2025, be sure to book your room at the Grand Traverse Resort. MPA's room block is already more than half full, so act now! Click the booking link below or call 231-534-6001 to speak with a reservations agent. Attendees will receive the discounted rate if they mention the Michigan Pharmacists Association.

CSPM Website | Board of Directors

The Consultant Archives | MPA Website | Contact Us