Oct. 25, 2019

Pharmacy Industry Medical Affairs | Anne Arvizu, PharmD, FASCP, PCC

Pharmacy Industry Medical Affairs | Anne Arvizu, PharmD, FASCP, PCC
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Anne Arvizu, PharmD, FASCP, PCC, is a global consultant and to fortune 500 biotech companies, and a successful entrepreneur in Miami, FL.

The companies she builds & affiliations she keeps all share a common focus of promoting productivity, health & life balance in the lives of entrepreneurial women executives.

In 2002, Anne founded RxER Communications Corp., a management consulting firm partnering with biotech companies that require operational capabilities build within Medical Affairs.

Anne is a premier Medical Information expert and sought after keynote speaker that brings 22 years of pharmaceutical medical affairs and operations globalization expertise to the table.

In 2018 RxER launched its proprietary executive coaching model and business framework, Corecentryx®, and the Corepreneur® podcast concept was born. ​

Anne also gives back to her community, currently serving as Chair of the YMCA Board of Directors in her local area.

For more information visit www.rxercommunications.com

Thank you for tuning in to The Business of Pharmacy Podcast™. If you found this episode informative, don't forget to subscribe for more in-depth conversations with pharmacy business leaders every Monday. For additional resources and updates, visit www.bizofpharmpod.com. Together, let's navigate the ever-evolving world of pharmacy business.

Transcript

This transcript was generated automatically. Its accuracy may vary.

[00:00:12] Mike Koelzer, Host: Hello, Ann. Well, hello, Mike. Thanks for joining us. Oh 

[00:00:16] Anne Arvizu, PharmD: my gosh. Thanks for inviting me. And for 

[00:00:18] Mike Koelzer, Host: those that don't know, you give us your name, tell the listeners what's hot in your 

[00:00:23] Anne Arvizu, PharmD: life. Oh, what? Isn't thanks, Mike. Really appreciate the invitation. So I'm Dr. Ann RV zoo. I'm Pharm D. I'm the founder of RCR communications Corp.

  1. Well say it is a top global consulting firm, specializing in global medical affairs, shared services, capabilities, build and operations for rare disease focused companies. And, um, I'm going into 22 years in the pharmaceutical industry when I was a pharmacist back when I had, uh, I was a, I was a tech and then an intern and.

A pharmacist in both hospital and community pharmacy. And while I was still in pharmacy school, I just decided I'm gonna get into the pharmaceutical industry. I really wanted a business and I wanted to learn business. Um, if I would've stayed in either facet of pharmacy, whether it's hospital or, or community, I would've wanted to be on the business side of it.

I would've wanted to be in. You know, in corporate and it just is what I think my DNA was all about. It's what I am, it comes naturally to me. So entrepreneurship came very naturally to me as well. And, um, back in 2002, I started, uh, RCR communications because I wanted to do what my tagline said, which is provide the right drug to the right patient at the right time through drug information.

Back then we called it drug information. Now. Mostly in the industry, it's called medical information. Um, but then there's other operational functions within medical affairs and I've been a global leader to those. So I've worked for companies like GlaxoSmithKline, Baxter Baxalta and, um, For example with Balta.

I was the global head of medical information. So I had a team in four regions, um, and it was fantastic, but I also, when, you know, I've gone back and forth in the pharmaceutical industry and out with RCR communication. So it's been because my husband is in the same industry, um, and he's a physician in the same industry and we do basically the same thing with just a different come from different takeaway.

But within medical affairs, RCR having my own company has been great for me to go in or out of the industry and not miss a beat. Um, whether I'm outside with RCR communication, I'm supporting the industry or I'm inside the industry and I'm leading a big group. You know, I think the biggest takeaway is having not only business skills, but the pharmacy knowledge that you have, uh, knowledge of medics, you know, medical and, and the products, but, but also, um, This entrepreneurial skill set as well.

So I love the whole thing. I love being the leader of my company. 

[00:02:58] Mike Koelzer, Host: Okay. Now wait a minute, Anne. I'm we ERs aren't as aren't as quick as you guys are down there. So slow this down for me a second. Okay. So when I hear medical affairs dumb that down for me. Okay. Are you a conduit between the drug company and the.

Doctors, and you're trying to merge that information to make it understandable. Or am I way 

[00:03:26] Anne Arvizu, PharmD: off you are right on you are right on. So what are the functions? Okay. So let's take it up even a higher step. And that is in the pharmaceutical industry. I would say there's three major buckets of. What people do there is sales marketing.

We would call that commercial. Okay. Then there is, uh, research and development. And then in many companies, a separate part, or sometimes it's part of research and development lies. Another group called medical affairs and medical affairs over the past, I would say decade. And before that, because I've been in medical affairs a long time, medical affairs is kind of like compliance.

Police force if you will, for the company mm-hmm. So they're the ones that keep the company compliant and keep the company focused on the patient because who better than medical, who are healthcare professionals and providers, physicians, pharmacists, and many PhDs as well that have, um, really a clinical focus and background that have maybe worked in hospitals in the past.

Uh, this is. This is the concept of, you know, when after the, uh, a product has been researched and it's been used in a population it's ready to go for market right now. Now it's finally coming out to the market. So doctors are gonna prescribe those products and then pharmacists are going to dispense those products in some cases, in some cases, not because depending on if it's a therapy or if it's a drug product, et cetera, um, gene therapies, it's something that maybe as a pharmacist, we wouldn't hear.

For example, and there's some really neat therapies coming down the pike with, with genetic, um, potential to cure disease. That's really a big passion of mine and also to diagnose rare diseases, which is a huge passion of RCR as well. So, going back to your original question. Yeah. Just to finish up. Yes.

At that point, there are different pieces of medical affairs, such as medical information. Medical communications publication strategy. So if you were gonna go to a journal like Jamma yeah. Who writes those publications, who puts them together, who spearheads? What is the process and the strategy around here's the data that's come out.

How are we going to create and present it in the most fair, balanced way? And that is all driven through the. And a lot of people don't know where this article is being written. Who's it being written in collaboration with mostly it's with the key opinion leaders and the thought leaders out there who are prescribing and working with those patients.

So it's a total partnership in collaboration between medical affairs and. The key thought leaders, physicians out there that are working with their patients. And then to your earlier point, we are also dispensing. So medical information would be I'm dispensing that information in a way that if a physician was gonna call my office and speak to someone on my team, and let's just say they had a oncology product that, that oncology specialist on the phone, generally a pharm D would know more about that product than any other product.

And. They're gonna give you the answers you need, whether that's an on-label answer or an off-label answer, meaning it's pure, transparent sharing of information. And you know, what an off-label uh, use is. But for those who don't, that would be something that's not on the label. Um, but maybe a physician's using it in that manner.

Or maybe it's being studied in that manner. So therefore it's being used in that manner. So what data exists on that as well, and, you know, coming clean with all of that, whether it's good or bad, because it goes back to what is the right drug? Is this the right drug for you? And are we keeping our patients first?

[00:07:12] Mike Koelzer, Host: So I'm gonna, I'm gonna be a little bit stereotypical here. So you've got the smarty-pants chemists that make the drug, but they're not necessarily good at communication. we're gonna put them in with, you know, some of us pharmacists or, the, the stereotypical Dilbert with engineers and things like that.

[00:07:37] Anne Arvizu, PharmD: Yes. 

[00:07:37] Mike Koelzer, Host: So you got that side, then you've got pretty. Cheerleaders that were hired from college to be the sales people who years ago they were maybe more pharmacists and so on, but now it's more of a beauty pageant. Now I'm just, you don't have to agree with all this. I'm just saying that I'm just saying this in my head.

Yeah. So we've got 

[00:07:59] Anne Arvizu, PharmD: It's what people think you're right. 

[00:08:01] Mike Koelzer, Host: So we've got these two sides and you're the person in the middle that makes that all 

come together. 

[00:08:07] Anne Arvizu, PharmD: We're the team in the middle that does kind of make that all together. 

So if you would, you know, stereotype that down. Yes. Um, there is research and development there creating the drug.

I was in research and development for six years. So I've been able to take molecules literally from research and development to the market. After, after running global publications plans, global research, um, initiative. Uh, clinical studies and then bringing it to the medical affair side. Um, we are, we are the ones that will disseminate that information when it comes out in a, in a clean and thoughtful manner that it's good for the patient.

You can create patient materials. You could also create mostly for healthcare professionals. So some, some companies won't. Um, it depends on the product, but it's patients and caregivers that just have a lot of questions as well. Right. Um, I'm on something and I had a question where, where would I call?

Because I know that there's medical information. I probably wouldn't go back to my doctor. I would call the, the, the company directly. I would look at the label and, and say, if I had my question, let's answer it directly from the source. They know more than anything about that product, cuz they've created it.

Um, but yes, and, and in parallel, With the field sales team is a facet of medical affairs called the field medical team. Hmm. And those are pharm D and MDs. Sometimes nurses sometimes, um, PhDs. It depends on the company and, and what they're doing, but that field medical team would be able to maybe do lunch and learn at a hospital, or they're working with those top therapists, uh, to get them, you know, in, in.

In partnership because maybe some of those top treaters are saying, Hey, have you thought about this? Yeah. Right. So research, a lot of times is driven like an ISS, uh, investigator sponsored studies or some people call them, um, ISTs investigator sponsored trials. Those are where an investigator, a physician who's maybe a key opinion leader, a thought leader in his field or her field, uh, decides I'd really like to study this because there's no data on it.

Gotcha. And. Grants can be provided by the company. If, if they go to that particular company or group of companies, sometimes there, there could be an initiative through, um, a. Like a, uh, an association, if you will, uh, FDA provides grants as well for something that's unresearched and they're escalating the grants that come through for rare diseases as well.

I just recently just heard that from an FDA contact. 

[00:10:43] Mike Koelzer, Host: So you mentioned these kinds of different lanes of the, of the, um, affairs and is one of those lanes then would one of them be. Branding, like deciding like, okay, we've got this drug that is going to help urinary incontinence. And is part of your guys' branding that even though men and women and, and children and adults, you know, seniors have this, we're gonna decide to hit the 40 to 60 year old women and show them laughing at a family reunion.

You know, like those ads always do with that kind of stuff. Mm-hmm are you 

[00:11:14] Anne Arvizu, PharmD: branding that we don't do any branding or marketing? Anything there's, there's a, there's, there's a, there's a nice clean line between commercial and medical and it needs to stay that way. Gotcha. What we do, however, if you kind of touch on something else, is that, you know, going back to, to what we, who is the right person to receive that product, um, if a new indication is warranted for a particular.

Um, subset or age group, et cetera, that would differentiate the label or add to the label later on. Then, then it's the science part that would say let's do that study or let's give a grant for that study. And then it's the science generating that, um, that would be added to the label later or would advance the, um, The use of that particular 

[00:12:07] Mike Koelzer, Host: molecule.

So then you're kind of the go-between on the medical side, and then there's also marketing and there's probably also finance and so on. Yes. But you're more of that go between on the medical side. Correct. That sounds like something I couldn't do. 

[00:12:22] Anne Arvizu, PharmD: why 

[00:12:23] Mike Koelzer, Host: laziness and, um, And lack of knowledge, I guess.

And you can't BS 

[00:12:30] Anne Arvizu, PharmD: your way through it. No, you can't be there, you, you become an expert in your field, right? Right. You really become the top and, and you know that there's board certifications, there is no training that can prepare you for being an expert. I remember years ago when I was at, uh, it was Smith Kline beach and was my very first company and I.

Um, I had written a protocol that was going to be studied in 10 countries and I didn't even have a passport. And my team asked me, my boss asked me, okay, we're going to London next week. And I said, well, I would probably need a passport. They were like, you don't have a passport. I'm like a 28 year old pharmacist.

No, I've been studying. Right. So, so, uh, they sent me to the embassy. I got my passport overnight and within 10 days, Um, gonna speak to a room of 800 physicians. Wow. And present the protocol. So I was so nervous and I remember him and he was, you know, a Harvard educated physician. And he was saying, " I'm so nervous.

I said, Clarence, when I, when I present, I'm gonna point to you and you're gonna give the answer. That's what's gonna happen. When they ask me questions, I'm really nervous. You're gonna answer them. And then he looked at me and he said, Anne, who wrote the. And I said, well, I did. And who did the pharmacokinetics studies and the statistics and who worked with the other writers?

I said, well, I did. Oh, so you're the expert. Oh, geez. Hmm. So people asked the questions and I answered them. Yeah. Every single one. And, he just laughed at me after that. And that was my first year in the industry. It was like a learning curve that was straight up a mountain . 

[00:14:02] Mike Koelzer, Host: Oh yeah. That, that, that slaps your right in the face.

Doesn't it? It was fun. Wow. Love it. All right. So my brother. Owns a branding consulting out in California. And once in a while, he'll come in for a drug company and probably take that lane that I was talking about in the, in the marketing side. Are you doing the same then coming in? Is that where your consulting comes in just as they hired him in as marketing?

Are they bringing you? Maybe with a similar thing, like doing this, why don't they use their own it's 

[00:14:36] Anne Arvizu, PharmD: it's sometimes a bridge and sometimes a stop gap solution and sometimes, uh, a need nece, a necessity to either revamp or revitalize current operations. Someone screwed up 

[00:14:49] Mike Koelzer, Host: in the company and they bring you in to save it, not 

[00:14:51] Anne Arvizu, PharmD: necessarily, but it could be, it could also be that there's a divestiture or a merger or an acquisition or something is happening.

There's change or something's coming down the pipeline and they can't scale that fast and they need help. They're okay if 

[00:15:07] Mike Koelzer, Host: they have one drug, but not three that they just merged into. Exactly. 

[00:15:11] Anne Arvizu, PharmD: Exactly. And sometimes it could be it. Really the expertise for capabilities build consulting at a high level.

I'm brought in by the C-suite by the chief medical officer or by the head of, um, medical affairs, usually a vice president. Um, in the last two or three companies, it's been the chief medical officer that they call me. They know about me. Uh, it's just been 22 years in the industry. Right. Do something long enough and you'll, you'll get known for it.

If you, if you just keep your niche down, we talked about that earlier. Mm-hmm um, and when they bring me in, uh, just for an example, uh, a last client brought me in because, uh, and my team and because they didn't have a medical affairs team on board yet, they had a couple of the functions. They had started the field medical team, but they had no one to lead that field medical team.

They had no medical information, no medical communications, no plan for, um, doing business cases, no SOPs, no basis of, um, business cases. When you do a slide deck for senior management. So the chief medical officer needs to go to the CEO and ask for money, ask for budget, ask for headcount. And they need that business case to justify why that headcount is necessary.

Just like in any organization. Yeah. Right. And you wanna justify that it's so easy these days to justify sales because you know that there's a return on investment. Yeah. Right. They, 

[00:16:34] Mike Koelzer, Host: it's easier to see it 

[00:16:35] Anne Arvizu, PharmD: happening. Yes, but you can't see the return on value necessarily that medical affairs have. I think one of the key drivers of that is that medical affairs is what is the wave of the future for the pharmaceutical industry?

Um, you've heard that in my podcast and that's gonna be the feature of my podcast, but the predicted model is that patients are out there online, just. Prescribers are, and they're watching and they want to see integrity. They want to see, um, pure data come out. They want to see that we're all in this together, that we're transparently sharing our data and our medical information.

And so the value is, is there. So that's why I'm brought in. 

[00:17:15] Mike Koelzer, Host: We all know that the patient, once you're on a medicine is like, People become experts quickly on a medicine. You know, even as a pharmacist, it's like someone will come in and they'll say, yeah, my doctor says I've got this and I've never heard of it before.

You know? And, and I pretend like I do by kind of nodding and, but, um, but, but then they, you know, they know it deep, you know, just from that information, Johnson and Johnson was in the news a couple days ago. They got hit with. Half billion dollar lawsuit. And one of the complaints was that the judge said they were naughty because they had brought out studies to the doctors and so on, and it wasn't clear.

They didn't make it clear to them. Doctors that were behind those studies. And it sounds to me like, kinda like you mentioned people they're, they're smarter now. They wanna know where, because let's say this was 10 years ago right now. It seems like they wanna know where things are coming from. Who's doing it?

It's just a smarter world right now. And it kind of sounds like that's right down your alley of, of making. Smoother than a company like that might have done 10 or 15 years 

[00:18:31] Anne Arvizu, PharmD: ago. Absolutely. Well, whether it's a sponsorship of a trial or of a publication that all needs to be documented. And then the other side of it is if there's.

Medical information or if there's something that a tip sheet or an educational program or something that it's really the job of medical affairs to teach on all facets and all parts of the data. So there's, you know, there's that we have to have open sharing of information. So as long as you reference that, Correctly.

It's not necessarily just the FDA, but it's the office of inspector general. It's the OIG that monitors that and can run a company. If you know, something's found that's not fully transparent or fully, uh, documented, referenced properly. 

[00:19:21] Mike Koelzer, Host: I reference everything, but yes, all of mine just say Wikipedia at the bottom.

All right. So in and out, what did you mean by that Ann? What did you mean by, in and out? You can come in and out. Does that simply mean that as a consultant that you can jump in at times, and then jump out of a company when you were saying that you can, um, You know, come in and out of stuff.

What did you mean by that? 

[00:19:48] Anne Arvizu, PharmD: So if, if a company needs me for a stop gap solution or our company for a stop gap solution, I was contacted today. Someone, um, wanted some medical writing and they said, do you do that? And I said, well, you know, had, had you known me back then when, when I was on the board of the American medical writers association, you would know that the answer is yes.

And, um, so, but right now I'm not gonna do that writing, but I have people on my team that would, and so right now I just need to do a quick assessment. Statement of work and see if, you know, we win that bid. Um, so that's fun and that might be just, they need this little chunk of work done. And if they know, like, and trust you, and you've done a great job, which I, you know, we try to fulfill everything at the highest level of integrity as right.

Any company would want to do it. I think that comes with being a pharmacist as well, right? Yeah. It's like it's in our, it's our it's in our collective DNA that we are, we watch every little detail and. Yeah, that's an in and out, but also in and out for a large consulting agreement where, Hey, this is the year we build and we need you to kind of put your hat on as our, you know, temporary VP, if you will.

Sure. And so I do that or, or just monitor the team or get our SOPs going. Can you write all the job descriptions? We did all that this year with one client and it's fun. It's really fun. And. There's that in and out, but also going back in and out of the industry, I'm so involved in the industry that there's probably not a couple of weeks that don't go by that I'm getting a job offer for something.

No, I see. I'm just not willing to move again or relocate again. So, 

[00:21:26] Mike Koelzer, Host: So in other words, you would switch from a consultant to then actually becoming an employee of a place for a while. And why, why would 

[00:21:35] Anne Arvizu, PharmD: you do that? I did for a while, because there was for example with Baxter and Balta, my husband was gonna be moving across the country to Chicago and we said, fine, we're gonna keep our home in Florida, but we'll try this whole thing.

And it'll be for your sake. And the company reached out to me and they actually had, Hey, we have this global head. Uh, we, we, we think that you'd be able to really, um, Spearhead this position. And so, because it was a global head position and I'd be able to hire directors in four different regions. And I built a team of 30 people, all pharmacists and MDs within 18 months. I had a great challenge and it came in a personal time.

You know, I wanted to kind of hang up the RCR hat and not drive it so much. Yeah. Then I went through a personal health issue. So it was like, I just need to just do this thing. I'm moving to Chicago. It'd be better for me to go into the office and be with people than, yeah. You know, and get through this stuff.

So I, I did that 

[00:22:32] Mike Koelzer, Host: doing your own thing. I mean, pharmacy, I become spoiled because you get something going and eventually people come in, but for people that are not that you're literally pounding the pavement, but when you're doing that on your own, you know, you gotta, you gotta keep that fishing line out all the time.

Mm-hmm because you don't wanna rest on your laurels. I've got a, uh, brother-in-law in. Building business and he hates, you know, writing out proposals and things. because it's like dispensing everything out. Are you at the stage where you're just getting requests or do you have a, is there like a database where you're finding requests for proposals for other companies like yours and you're trying to win the business.

Do you have a little, little bit of. Still little 

[00:23:23] Anne Arvizu, PharmD: bit of both. So, um, we'll get into a situation where there's an RFP, a request, a request for proposals, and we'll be trying to win that bid or it's. Work comes to me and I don't take that lightly or for granted, for me, it's yeah. A blessing. And, and it's because you've been in the trenches for 22 years doing the same thing, and you're just known as an expert and yeah.

And so I've, I've never been without work. Um, that one time, when I went back into the industry, I knew that it was gonna be a temporary two year thing. Yeah. And I came out. Harder and stronger and ready to go. You know, so yeah, it was so good developmentally for me that, um, it also put me on a higher level game playing field.

So I think it's great to have, you know, even in the industry, whether I had on my team in the past a pharmacist who was maybe doing medical information, they might keep their. Paw in community pharmacy and work there one day a week because you wanna have the flexibility and career and that's something that's so great about pharmacy.

Yeah. I love being a pharmacist and I love that we have options. 

[00:24:32] Mike Koelzer, Host: Yeah. I didn't comment back on your comment about why you'd work. For a company. And that makes a ton of sense. And you kind of have access to the smorgasboard of people, of hiring and setting up things better than you could if you came in and had to always just recommend that you can actually actually do that.

So that's pretty cool. Are your RFPs a pain in the, in the rear or, or is it the building industry? I mean, you've gotta say how many nails you're using and how much would cost at this time. And that kind of stuff is. RFP is a, a huge deal 

[00:25:05] Anne Arvizu, PharmD: or not. I think they're okay because we've done it. So long and so well now, and we are so niche down.

Yeah. That it doesn't have to be reinventing the wheel. Yeah. And I think that's a huge if, if there's listeners out there, if there are listeners out there that are pharmacists that have their own businesses. Yeah. You know, it's always good to niche down and. then you're asked to do other things, right. Um, but you start with just, I'm just doing this.

Yeah. I stay in this hole and then it's like, well, do you do R and D and can you speak about this? And I get, you know, a keynote invitation or I get, uh, a job that's bigger than that. And, um, The other initiative, the other podcast that I mentioned to you before we started the call is about women's leadership.

And that's a subsection of what I do because you're recognized yeah. For something else, like right. Some of the calls, even a consulting call can turn into, oh gosh, I just wanna just. You know, kind of let my hair down on this call and someone just said, well, trust me. And it's a safe place to, for another leader, an executive woman to just say, oh my gosh, I'm tired.

right. How can, what can we do together to think about, um, organizational design? That would be a little leaner and happier for everyone all around. Yeah, 

[00:26:17] Mike Koelzer, Host: As school starts now, you're like the, um, third grade teacher that has got to use her lesson plan at least for three or four years. And then someone, you know, it's not like someone's gonna come and say, now you're moving to eighth grade, cuz that's a pain in the, you know, but then you gotta like reinvent it all again, you know?

Yeah. So you're staying with third grade, you know, for a while that's. I I noticed in your work history, I know you said that you had some time in retail and hospital, but it seemed that you jumped pretty quickly. Mm-hmm from like an internship mm-hmm right into this stuff. So you knew you were 

[00:26:54] Anne Arvizu, PharmD: going here, right?

I know now this is back to Mike in the day of the typewriter. Okay. So it wasn't easy. Point and click and send out 10 resumes. In a day, I went and drove door to door to Wyeth and Smith Kline. Beacham with my typed out resumes and little Manila envelopes to whom it may concern and humbled myself and got in and just decided this is where I belong.

And it was just knowing all through pharmacy school. I'm sure other people are like this too, you know, once you know a pharmacist, you know, like that, that pharmacist is probably related to other pharmacists. Sure. So my brother's a pharmacist. My niece is a pharmacist. My nephew's a pharmacist. My nephew's wife is a pharmacist.

You know, my other niece is a nurse, et cetera, et cetera. My sister-in-law is a nurse. My husband's a physician. It's like, we're all in this family. But, but, um, when you know where you're supposed to be, none of them had that knowing it's just, well, where I'm gonna get a job. Right. And mine. I'm getting into the industry and I'm gonna do whatever it takes to do that.

So I started off in, uh, at w I said, okay, I'm gonna do a temporary job. And that led to another temporary job at Smith Kline Beacham. And that was a, uh, document specialist in a clinical science setting. And within three months of that, I was a clinical scientist. And within four months of. After that I was writing that protocol.

I talked about earlier and within a year I was presenting, um, my protocol that I wrote then, that patients were enrolling in. So I took it very, very seriously. I loved it. When did you know 

[00:28:29] Mike Koelzer, Host: that was your. Drive was that like the, before pharmacy school or like into pharmacy school? You, you said, Hey, I'm 

[00:28:36] Anne Arvizu, PharmD: gonna do this part of it.

Yeah. In pharmacy school, uh, I went to Philadelphia college of pharmacy and science at the time, which is now us P and I think it was. My fourth or fifth year they brought in companies to like a job fair. Yeah. And just because of the location of, you know, central to Philadelphia, where there was wth and Merck and, um, Smith Kline, and, and some other companies AstraZeneca in that, in that area, they all came.

And I just remember being Smit. And I think that's what I wanna do. So it was in my mind, I didn't even know what the roles were. I didn't, I wasn't able to articulate what we talked about earlier. The difference between commercial or marketing or research and development or medical affairs or anything that medical affairs did.

And it was still forming at the time. , but I just knew that was where I wanted to go. And no matter what I do, I'm either attached to this industry at the hip, um, serving it or in it and leading. And that's just such an honor. So I know it's a misunderstood industry. It's like tech mm-hmm tech, tech, and biotech.

Uh, pharma big pharma is misunderstood in terms of, Hey, there's some really dedicated. Smart people, um, caring about patients, you know, the, the term is patient centricity, putting it at the center of all you do, and making sure that diagnosis happens and that, uh, the, the cause of science is further there's over in rare disease.

There's over 7,000 rare diseases on planet earth today. And the majority of them are misdiagnosed mm-hmm or so it takes. Up to 12 to 17 years for, to receive a diagnosis. Right. And by the time that that patient receives a diagnosis, they're already well on the way to irreversible care. Yeah. Right. And so when there is some kind of a genetic marker or disorder, sometimes it's palliative care sometimes it's, but sometimes, you know, if, if FDA can help push through a new therapy that, um, it takes a long time to study a product or a therapy, genetically it takes.

A lot of information and a lot of team and a lot of money and a lot of time and effort. So research and development is not an easy thing and people don't understand it. These are not human Guinea pigs. This is people that. We're giving them a chance to receive a potential therapy that scientifically has been shown way before it ever enters their bloodstream or, you know, their mouth or yeah.

Their arm in a vein, whatever, before it ever enters their body, it's been tested and, and somewhat proven, um, It's giving them a chance at life and changing that life. So XLH is a prime example of that. Um, there's a company called Ultragen that's the company that my husband works for and creating gene therapy for patients around the world that have XLH and helping kids walk that otherwise wouldn't walk.

Right, right. Or right. This is really stuff that's worthwhile to me as, as with my heart, as a Pharmac. 

[00:31:53] Mike Koelzer, Host: Yeah, really? It's worthwhile when you look at it that well, when you look at it, that side and sometimes, um, in the industry, the big boys, really, no matter who you are can get kind of a bad rap.

Mm-hmm . What was your degree in your, your first degree in your international people, cultures and politics. Was that something you thought of before pharmacy and here's why I bring it up, Anne. Yeah. I'm gonna guess that you read books. You're a good writer. You're a good communicator. Obviously you're a good speaker.

And I think that I would put you in the top 5% of your pharmacy class with those kinds of skills. Do you think you were? 

[00:32:37] Anne Arvizu, PharmD: I, I was until in my very last year of pharmacy school, my mom died of cancer. Oh, Oh, I'm sorry. Hear that. And so I remember those pharmacology tests where I just filled in the blank with Mickey mouse and Donald duck.

And at the very end, you know, lost any form of honor and, um, And placement, but, uh, was able to make those, those, um, credits up with zero transfer in. So they didn't count to fix my GPA, but those, those grades after my mom died, that I had to go, uh, you know, to St. John's that summer in New York. And, um, those grades were straight A's so yes.

Nice. Like a hundred percent straight A's. But 

[00:33:20] Mike Koelzer, Host: besides being smart, though, you can read a lot of fiction, not 

[00:33:23] Anne Arvizu, PharmD: so much fiction. I should read a lot of books so you can see behind me, the listeners can't see it, but, um, just like you, I see a bookshelf behind your head too. That's 

[00:33:32] Mike Koelzer, Host: all. Uh, that's Nancy Drew and har Hardy boys back there, I think, but you're a good reader, but I mean, if I sat you down and your pharmacy class, all right, and said, everybody write a story or write.

This or that of whatever it is, you were gonna be in the top 5%. I'm not talking about pharmacy stuff, I'm talking about your writing skills. Yes. And your be, you were gonna be in that 

[00:33:57] Anne Arvizu, PharmD: top 5%, right? That I can, I can unabashedly say yes to, uh, my, my best friend from pharmacy school. And I was just together last week in Nashville and we were joking and laughing.

And you know how pharmacy school is with your besties? Mm-hmm that you just, you get through the entire school through laughter. Um, but. We used to laugh and joke when, when I had a paper to write and that paper was, do a three paragraph paper and it's due tomorrow. Yeah. And she had the same three paragraph paper due tomorrow, and I wrote 16 pages and she couldn't get past the third sentence.

And she's like, exactly, I'm never gonna get this done. And I was a prolific writer. I, so I'm writing a book right now and a book is a much more comfortable assignment for me than in fact they have to even tone me back and keep it in the outline and let's keep it crisp. And so my editors are working with me on that.

Uh, it's a fun process, so I've written, I've written textbooks, et cetera. And, um, you know, going back to your comment about international communications, nothing's been wasted, right? So I've, I've worked internationally, I've worked globally and people. Places cultures love. Was that before you thought of pharmacy?

It was because, um, originally when my mom, when we found out my mom had breast cancer, it was five years before she died. And I went into pharmacy school, uh, because it was. When I decided to do that, it was it, that was my heart. I was definitely a scientist. Um, okay. I had been a lifeguard and taken, you know, courses and all that for, for life saving and everything.

So you learn some anatomy and physiology and everything. So I knew that that was part of it, but I had graduated and my original plan was to go to law school and I stopped the process of that. When I found out that my mom. Breast cancer. And I was like, I'm not gonna move because my option was probably gonna be moving to either California or Dallas.

I was looking at SMU. I was looking at Pepperdine and I knew that I just needed to stay in the area. And my brother, of course, there's always a pharmacist in your life that says right. Go to pharmacy school. . Yeah. And so I think later I actually wrote a feature about that. That was featured at Smith Kline.

Beacham that shows nothing's wasted that here's, here's all my degrees. Here's what I know: nothing's wasted knowing international communications. It gave me a leg up to go where I needed to go and be a global leader. So that was fantastic. Things are wasted. 

[00:36:23] Mike Koelzer, Host: I, I actually was in the, um, for a year I went down to the Catholic seminary until they kicked me out.

That's awesome then. Um, awesome. Well, they didn't kick me out, but they should, 

[00:36:32] Anne Arvizu, PharmD: Well, not that part, but it's cool that you did something else. 

[00:36:35] Mike Koelzer, Host: Then I came, then I had some philosophy morphology. Then I came back. So I had about a year and a half of writing, reading, things like that. And I. I never, um, feel bad about that, of, of those kinds, you know, skills that I, that I learned, you know?

Yeah. As a lifeguard, this time of year, I was a lifeguard for five years, my friend Dan and I, and, uh, we were at this elite club and we're just some scroungy lifeguard, you know, but the last year, every year we had repaint the pool. And so the last year when we painted it, Dan and I made a emblem, I said, Dan and Mike, 1984 through 89.

Yes. And it was. And owed to, to the two of us, and then they filled it with water. So all these Richest people came in and they had to look at this like an emblem to their two, you know, their two lifeguards, you know, but, um, well, you're not only a lifeguard though. You're a master swimmer. 

[00:37:31] Anne Arvizu, PharmD: I was. How did you find that out?

That's not on my LinkedIn. That's 

[00:37:35] Mike Koelzer, Host: awesome. I got my way. Do you still do 

[00:37:37] Anne Arvizu, PharmD: that? Uh, I still swim. 

[00:37:40] Mike Koelzer, Host: That ties you 

into 

[00:37:40] Anne Arvizu, PharmD: the YMCa board. That's correct. I'm on the board of directors for the YMCA in my area. It's a multicenter Y in Pembroke Pines, Florida. And it's been an honor to be just, you know, raised up to be the chair.

I didn't realize for years I was a lifeguard with the Y and other organizations like a lake, et cetera. But, um, I never realized that the YMCA was a nonprofit organization and it's like, you didn't know that. So now I'm raising money. Because it fosters leadership, it fosters swim lessons for kids in the area.

It helps people that, you know, you're not gonna go to an LA fitness and they're gonna give you a break on your membership if you are right. Exactly a special needs person, or if you, uh, financially need it. So I love that about why. And I'm really happy to be the leader among leaders. We have VPs of Wells Fargo.

We have the CEO of Kendra's health, hospitals, and the people, you know, just. People of organizations, Starbucks, um, law firms. just amazing. Amazing. 

[00:38:46] Mike Koelzer, Host: I don't wanna toot my own horn Anne you might be the head of the board there, but I, I was a Guppy. 

[00:38:52] Anne Arvizu, PharmD: Oh, 

you were a Guppy. 

[00:38:54] Mike Koelzer, Host: I was a Guppy with the Y 

[00:38:55] Anne Arvizu, PharmD: That's awesome then there's Guppy and and minnow and shark 

[00:38:59] Mike Koelzer, Host: I think I became a minnow. I'm not sure if I ever made the, 

I'm not sure if I made the shark that was maybe in the mid-seventies when jaws came out or something, and I decided not to go that route. 

Fantastic. What would you do all day? If you could do anything in your business and was not tied down with any administration, unless you love the administration, what would you like to do all day ?

Your field, if you 

[00:39:25] Anne Arvizu, PharmD: could, what a great question. Um, there's a bigger issue that is on my heart and it's part of everything that we're planning, a creation of a new business growth model called CoreCentric and, uh, called Correo. And that. Really is going to the heart of someone who's corporate, but entrepreneurial.

So you could be in a corporation, but the journey from Corp entrepreneur, right. Being in that box with an outline, like, like my friend, Trisha, trying to, to fill in the blanks of an outline, it doesn't work right. When you're trying to write a composition, that's three paragraphs. It doesn't work in a linear business model.

When in corporations today, the bigger issue is that people are burned out. It is a global epidemic, but it is like a major epidemic in the us culture. Um, and in corporate America. So I would be teaching and talking nonstop about that. That's what my new podcast for entrepreneurs is gonna be about. And the CoreCentric business growth model is what is the center of all you.

What is what, and is that tied to your integrity? So if my main core values as a human are being walked into my corporate halls every day or into my pharmacy every day for that matter, am I aligned with my company's mission? And that is that. Resonating with my personal mission. So teaching and speaking about that is I think really my next step and freeing myself up from some of the administration to do so.

[00:40:55] Mike Koelzer, Host: Okay. So let me see if I got this. So is the, you've got a corporate executive and there. Entrepreneurial spirit is pushed down because of the golden handcuffs. It's just too big of a jump to go to the entrepreneur or, or, and are you talking actually, actually an entrepreneur or the entrepreneurial spirit that they can bring to the corporation?

[00:41:23] Anne Arvizu, PharmD: Yep. When, when you're, if you're moving from Corp entrepreneur, Mindset wise, you can think, okay, I'm not gonna stay in this corporate box anymore. And you can just be a rock at the business that you're doing in a corporation, but with an entrepreneurial mindset. So that's one set of skills. The other set of skills is the exit strategy.

That, Hey, I have this idea it's bigger than a job can be. Mm-hmm and I really wanna do this, but I shouldn't quit my day job. So it's funny that when I'm speaking at conferences, women will always come up to me afterwards. They make a line and they go, here's the bigger issue. You mentioned this.

We're doing too much, too fast all the time. We are exhausted and really you don't wanna be exhausted. You wanna be energized, right? Yeah. That's the E and core. Um, so just to leave a little, little snippet out there, but yeah, but to have an entrepreneurial mindset really means you're gonna do things better and faster wherever you are.

So whether that's starting your own business or being an entrepreneurial leader, I'm working with one client right now and their pace has been so fast. That it makes my head spin and I know exactly what they need to do next. Right. But it's like, whoa. It's like, I have to teach them to put the brakes on yeah.

With senior management, creating unrealistic goals for them or unrealistic expectations. And people don't know how to do that because it's like, you don't know what you don't know. So they, they, they might know their thing. Like they might know medical information and how to do 

[00:42:54] Mike Koelzer, Host: it. Is that a case of them being an entrepreneurial, but those above see what's happening and they just keep piling 

[00:43:00] Anne Arvizu, PharmD: more on.

Right. Right. But being able to kind of come back and communicate that, or create business cases, just like an entrepreneur, would have to be that inside because they're building a company with little to nothing. Given to them in their budgets. And then they have to ask for budgets, just like, as an entrepreneur, maybe we would ask for an investor or a shark.

[00:43:21] Mike Koelzer, Host: Yeah. Yeah, it's interesting on a smaller scale, my daughter is working for a tech company in town and then just decided to, um, get her real estate license, switched to another broker in town. And she accidentally got loose on LinkedIn . And so her boss had been talking to her and she's like, I don't really owe it to him to tell 'em the other, you know, 128 hours a week, you know, of where things were going.

And so what do you, what part do you hate about your day? gosh, relatively speaking. 

[00:43:56] Anne Arvizu, PharmD: What do I hate about my day? I almost wanna say nothing good for you. I really love what I do. I get up and I'm jazzed. I'm ready to go on a Monday morning. You have to stop me and say it's dinner time. Um, I'm. I'm just happy. I'm a happy entrepreneur.

And, and I think for you to think that that's just part of me being a core entrepreneur. That's my name for it. It's like, I'm. Lit from the inside out. And I feel that way. And I'm not saying that if I didn't mean it. 

[00:44:27] Mike Koelzer, Host: Good for you. Thanks. Who are your business inspirations? If you were gonna read somebody or kind of excited when their next kind of general business book came out, what, what author would that be?

Be, 

[00:44:40] Anne Arvizu, PharmD: um, I've had some great mentors in my life and some that I've chosen, you know, years ago and some that I still choose in my life and I've been a mentor to a lot of people. And some of my mentors are, uh, Tony Robbins, S Levine, Ali brown, uh, Carrie Wilkerson. And, you know, I was just in Nashville with Carrie last week, we just recorded a podcast and, um, uh, Allie and I were together a couple times this year.

Great. Uh, I, I have been in and out. Tony Robbins, his, his stuff. Like I would say probably if he was bringing out another finance book or business mastery, um, because you, you know, as a business owner, you have to master every area of your business, right? That includes your finances. You have to master your money, your message.

And, and so all of them have been something different to me. So I think Allie will have a book coming out and I'm looking forward to it. I have my book coming out in tandem with them. So it's good. What's your book about? It will be about the, I don't know what the publisher will end up calling it entrepreneur, but it'll be the core.

It'll be good for you. Some, you know, whatever they call it at the time, they always say, let the publisher name it for you because they really know marketing. And so we'll maybe have to change some things with. Websites or whatever later on, but that's, you know, that's what one of my mentors said, just let it go.

I'm like, it's true. It's it's, it's like you take a village to, I suppose, to raise a message and a, a message. That's really gonna get up. My wife didn't let 

[00:46:03] Mike Koelzer, Host: me just name our kids up. 

[00:46:06] Anne Arvizu, PharmD: it's a joint effort. yeah. 

[00:46:08] Mike Koelzer, Host: Did you ever walk across the Kohl's for 

[00:46:09] Anne Arvizu, PharmD: Tony? I sure did. I'm a fire walk. 

[00:46:11] Mike Koelzer, Host: You. You know what they say?

Cause he got in trouble for that a couple years ago when it was too hot or something. Oh, but they say that they say that walking across Legos is worse. I bet. I read that. I read that in the, in the, in the, on the news a couple months ago they said that's actually, that's actually harder. What would you do?

and if you were not allowed to progress with any business ideas for a year mm-hmm and someone said, you, you have to take a sabbatical and you really can't improve yourself. I know there's, there's not a fine line because as you improve yourself as a person, you're improving your business self too. But what would you do if someone said, take a sabbatical 

[00:46:51] Anne Arvizu, PharmD: for a year?

I think it would be great advice. I'm thinking. Potentially. And of course it depends on the context at that moment. I don't know what I'd do with myself. 

[00:47:00] Mike Koelzer, Host: Yeah. What would you do for a year? That's 

[00:47:02] Anne Arvizu, PharmD: when I'm getting there? I think I would be a receiver, right? So it's an idea that you can't stop. I would probably journal.

I'd probably write and then I'd probably plan it all out so that when go time came again. It's ready. So a small version of that is taking a couple weeks off or taking, even in your business, a mini sabbatical and saying, let me take a month because you're gonna come back really fresh. So even though I went to work, for example, At Baxter and Balta for those 18 months, two years, that was a sabbatical for me, from my business, even though I was working full time.

Yeah. But like coming back, it was like, boom, like, yeah, the ideas just wanted, it was a trajectory that I couldn't stop. I've 

[00:47:48] Mike Koelzer, Host: always said it'd be cool to have like 26 jobs a year, like two weeks being a truck driver, two weeks building houses, you know, that'd be kind of cool. What do you mean by being a receiver?

Just waiting, waiting for inspiration. You. 

[00:47:59] Anne Arvizu, PharmD: Yeah, receptive to inspiration, to new thoughts, new ideas, uh, maybe a new way of expressing an idea. Right. Your particular niche can define, can define like they, everybody is out there with a message and we don't have to be me too, or copy anybody. Else's message.

Yeah. Right. The thoughts that are coming into your head, Mike, are just as strong and valid as the thoughts that are coming to mind. And there's a way that you can express it, that I would never be able to. So I feel that we should honor people's ideas. And when those ideas come, people. Especially entrepreneurs, real entrepreneurs hold themselves back from writing that book or creating that masterpiece or running that business the way they can really see it because of fear or doubt or self doubt or second guessing themselves.

So to be receptive means you need to get it. You need to pause. You need to get still and you need to listen. There is a higher voice inside. I don't know what, you know, you call that, but yeah, but I think we're in such a bombarded age of screens. Mm-hmm and messaging. Right. That if my website isn't as good as yours, I don't look at anything else.

I just don't care about other companies. Yeah. I don't believe in competition. I don't have a mindset of anything. Partnership and fluidity. And so part of that fluidity is, is being open, like a vessel to receive information and wherever that comes from, whether it's just a, the little light bulb idea, if that light, that light bulb hovering over your head, or maybe it's a good idea.

Maybe it's a Good idea. I don't know what people call it, but. It's real. And I think that I've just been a conduit of those types of ideas, and I have not been afraid to execute and put them to work. And that's what makes you successful, just doing it over and over and over. And if you don't, you know, succeed at first, you try again and you try again.

And then as John Maxwell says, after 20 years of really hard work, one day you'll be an overnight 

[00:50:01] Mike Koelzer, Host: success. Yeah, exactly, exactly. Because, and you don't know when you're. Use stuff. And I know that for example, Ann, you and I were talking before we went live here about, you know, the podcasting and mm-hmm you just don't know on, on a simple scale, you know, there might be something that I do by flipping a switch or learning what adapter to or something that if I didn't have that knowledge from a lot of failed attempts to do something years ago, I might have gotten stuck at that point now.

And it might have been another time to say, screw it. I'm not doing it, but you, you just never know. And that's more figurative of, of the things, the people you meet and the things you do and your failures and your things that you need to forgive yourself and forgive others. All of those God doesn't really waste incidences, everything.

I think. Everything. Everything works out for the good somehow. What would you tell me? What would you tell a high schooler right now? Like a senior in high school, what would be your advice to them? Pick 

[00:51:05] Anne Arvizu, PharmD: something and then be persistent and then let it change when it needs to change. But pick something, right.

You can do so much with so many degrees. Our podcast today is a perfect example of that, right? Mike, you and I we're both wise swimmers. We are both podcasters. We're both pharmacists, we're both entrepreneurs and those are all different hats. Those are all different roles. Mm-hmm so that's the advice that we gave our son, Ian, and this is my youngest.

This is our, this is my stepson, Ian. He. He is just going into engineering. I'm like, just get through it, just get the degree, right? Yeah, because I see in him a natural gift and talent for teaching mm-hmm , that's his ability that's built into him from the time he was a kid. He'd be able to teach me how to play a video game.

That there's no other way I would've learned. Right. Because he's so. Patient. So I said, you'll get in and you might not be that math guy. So don't worry about the things that are not your strengths, but you'll get in and, and your strengths will lead you into a training position. Uh, you don't necessarily have to be an educator in the education system, yeah.

To use your teaching gift. So yeah, those abilities will just. Come and shine through, but do some self searching, pick something and then learn about yourself along the way. There's a lot of great personality tests and, and those things that can guide you. So one of those great tests that I would recommend to any high schoolers is a book from it's probably on the back shelf somewhere.

It's called do what you are. And I cannot remember the, the, I think, um, can't remember the, but do what you are. Look it up on personality tests, but any of them, the Meyers, Briggs. Yeah. All of those, those are. 

[00:52:42] Mike Koelzer, Host: Tools. Yeah. So, they pick something and it could be that they pick it and they move. And what it seems like you're saying is they might pick one of 10 different paths and that really doesn't.

Matter, because it's all gonna be it's, they're gonna be using all of it to fulfill themself, your proof of that with your, your different educational pass along the way. And 

[00:53:13] Anne Arvizu, PharmD: so on, they pick and then, and it moves and it morphs. And if you just let it be in the direction of your strengths and your persistent to where you wanna go.

Yeah. Right. Then it manifests. 

[00:53:25] Mike Koelzer, Host: Tell us a little bit more about your I'm just gonna call it a women thing. It's you know, , as soon as I hear it's for 

[00:53:30] Anne Arvizu, PharmD: women, I think that's fine. You just zone out. That's fine. It's not for me. 

[00:53:34] Mike Koelzer, Host: So , I just call it a woman thing, but just tell us a little bit about how it's feeling, how's it going?

And what are you excited about? Are you gonna try anything differently? The 

[00:53:42] Anne Arvizu, PharmD: Corlanor podcast and although many and probably most of my guests will be. There are men that I consider coroners. So in, in the book, that's about the colonial experience. Um, I have tons of examples too, so you can read the book.

Um, and the podcast is also really coming out, to say you are one of my mentors or you're someone I really wanna have a conversation with because you're a core entrepreneur. You are leading from the inside, out from a passion that is unquenched. And as a result, you've already built, you know, a multimillion dollar business out of it, or you've started something that is so big and so bold.

So for example, if you've heard of Jennifer Braa right, she's had a tremendous Ted talk. She's a patient advocate because she is a patient. So, Hey, why not just whip up a film and go to the Sundance film festival and win some awards. And, and play big. These are people who are playing big and it's because they are so driven to what they care about.

Just like RX Sierra, we're running down the halls of rare disease. Right. And, we wanna connect what we do in medical affairs with something higher and bigger. And that's that. Part of it is the Corlanor and the core centric business growth model that I created through RCR that was launched last year, it's a business model.

So it's got all the 10 parts of a business model. And I do that all the time, but it was like a light bulb moment. So. For example, there's a life balance wheel exercise where if I put a wheel in front of you, let's just say we draw a circle on a piece of paper. I'm gonna do this visually for people, a mental exercise and awareness so that you can see where you are in terms of where you wanna go.

So I have a goal, for example, let's just say I draw a circle on a piece of paper and one of them. One of the slices of pie that I draw, I draw maybe three or four lines in that slice of pie. Right? Like let's, let's look at it like a piece of pie. One of those pieces of pie maybe is my health. And let's just say, I wanna lose 30 pounds.

Mm-hmm and I know that putting that. Real pie in my mouth is not gonna help me lose those 30 pounds. Mm-hmm so I know better, but are my actions going to take me to where my goal says it is? Because most people make silly resolutions every January 1st, and then don't get there. Mm-hmm um, so, so this is a.

A temperature gauge or a tool that businesses can use to see every facet of their business. Mm-hmm but then you're the business owner or the business, you know? Yeah. Initiator, right. If you're in a corporation and you're the one that has to do that business. So if you're coming into work with your junk all day, right.

And, and maybe a bad one, okay. Relationships or you're dealing with a health issue or you're hurt because you're dealing with a special needs child or any of these really human examples that make us the employees or masters of our businesses. You have some alignment work to do. To make sure that you're still operating where you need to be at full capacity as a person.

And then that company gets the rest of you that are operating in alignment with their purposes. So, right. You're, you're a person of integrity, whether at work or home, and you're leading from within jazz Jews. Happy. Um, and, and ready to, you know, not judge yourself. So regardless of situation and circumstance, there's still a way to move through everything with joy and a good plan.

And that's what, uh, our business growth model's all about. So that's exciting. That's what the book's gonna be about too. 

[00:57:26] Mike Koelzer, Host: That is exciting. I like when joy hits the last word of it, , there's a lot of people running through things without, without joy. It seems so. That's, that's a cool, yeah, that's a cool way 

[00:57:35] Anne Arvizu, PharmD: to wrap that up.

I have a sticky note. You can see it, but our listeners can't and it's on my desk and it says on the bottom of, uh, you know, the sticky note, just a few things that I remind myself of daily mitigate stress and maximize 

[00:57:47] Mike Koelzer, Host: joy, mitigate stress and maximize joy. Yeah, that's good. Yep. 

[00:57:54] Anne Arvizu, PharmD: Thank you. All right, 

[00:57:55] Mike Koelzer, Host: Anne.

Nice talking to 

[00:57:57] Anne Arvizu, PharmD: you, Mike. Nice talking to you 

[00:57:59] Mike Koelzer, Host: too. Thanks Anne. I look forward to keeping in touch with you. Thank you, Mike. All right, we'll talk again soon.