The Weekly Dose: Cyclosporiasis Outbreak Grows, AI-Powered Refills Pilot, and New FDA Approvals in Alzheimer Disease

This week’s episode opens with a major update on the nationwide cyclosporiasis outbreak, which has now grown to more than 5000 cases across 31 states, with Michigan remaining the epicenter at over 3300 cases. For the first time, investigators have identified lettuce and salad greens as the leading suspected source, and officials are also examining a potential connection to Taco Bell locations, although no product or chain has been formally confirmed. Michigan health officials are advising consumers to choose whole heads of lettuce over bagged greens. Marilyn Bulloch, PharmD, BCPS, FCCM, an associate clinical professor in the Department of Pharmacy Practice at Auburn University Harrison College of Pharmacy in Tuscaloosa, Alabama, told Pharmacy Times that the delayed source identification is concerning, given the 1- to 2-week incubation period, and reinforced that pharmacists should encourage symptomatic patients to seek specific cyclosporiasis testing since routine stool cultures miss the parasite.

The episode then turns to a Utah pilot program allowing an artificial intelligence (AI) chatbot to authorize refills for certain chronic medications. Nilesh Desai, MBA, BS, RPh, CPPS, CPEL, chief pharmacy officer at the University of Miami Miller School of Medicine in Florida, told Pharmacy Times that although AI could meaningfully support refill management, it should function as clinical decision support rather than replace pharmacist and physician judgment on this important safety checkpoint.

The key opinion leader portion of the episode features Neil Markey, cofounder and CEO of Beckley Retreats, discussing what the recent psychedelic-focused executive order does—and doesn't—change for veterans. Markey clarified that ibogaine remains Schedule I and does not yet qualify under the Right to Try Act of 2017, given its unmet phase 1 safety requirements and known cardiac risks, whereas psilocybin is further along in development.

The policy roundup covers 3 FDA approvals: a new at-home starting dose for lecanemab-irmb (Leqembi; Eisai Inx) in early Alzheimer disease; full approval of selpercatinib (Retevmo; Eli Lilly and Company) for RET fusion–positive solid tumors; and approval of gedatolisib (Revtorpyk; Celcuity Inc) plus fulvestrant (Faslodex; AstraZeneca Pharmaceuticals LP) for hormone receptor–positive, HER2-negative metastatic breast cancer.

From foodborne outbreaks and AI-assisted care to breakthrough approvals in neurology and oncology, this week's stories reflect the many ways pharmacists continue to shape safe, informed patient care.