RetinUp Podcast

Hosts:

John Kitchens, MD

Scott Krzywonos

Guest:

Shane Dixon, Vice President of Vision, Strategic Advancement & Business Development, Cencora Specialty GPO

Show Summary:

In this episode, John and Scott continue their coverage of the Cencora Vision Exchange meeting with an in-depth conversation about the economic, policy, and operational forces reshaping retina practices. The discussion opens with key takeaways from the meeting’s opening sessions, including a deep dive into drug pricing policy, the downstream impact of federal legislation on how retina practices are reimbursed for care, and the coding and billing changes showcased at the Cencora Vision Exchange meeting.

John then sits down with Shane Dixon, VP at Cencora Specialty GPO, to unpack what a Group Purchasing Organization actually does—and why its role has become increasingly critical. Drawing on his experience as a physician assistant, former Regeneron launch leader for Eylea, practice executive, private equity operator, and now GPO executive, Shane offers a rare, 360-degree view of how drugs move from manufacturer to patient, how contracts are structured, and how practices can survive tightening margins.

Topics Covered:

1. Key takeaways from the Cencora Vision Exchange meeting
2. Federal drug pricing policy and “Most Favored Nation” pricing
3. How government policy is reshaping retina drug economics
4. Coding and billing risk, including increased scrutiny of Modifier 25
5. CMS’s use of AI for claim detection, audits, and recovery
6. Declining surgical reimbursement and its impact on access to care
7. The collapse of the Good Days patient assistance fund and what replaces it
8. What a Group Purchasing Organization (GPO) is and how it works
9. How Cencora’s GPO leverages scale, segmentation, and contracts
10. Differences between private practice and large aggregators

Key Quotes:

1. “The way we get paid for drugs is going to fundamentally change—and it’s going to change fast.” — John Kitchens, MD
2. “We’re not just doing contracts. We’re helping practices think strategically about how they operate.” — Shane Dixon
3. “Documentation isn’t optional anymore. ‘I didn’t know’ is not going to cut it.” — John Kitchens, MD

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube

Hosts:

John Kitchens, MD; Scott Krzywonos

Guest:

Eric Besse, Vice President & General Manager, Besse Medical (a Cencora company)

Show Summary:

In this episode, Scott and John return from the Cencora Vision Exchange meeting in Dallas and sit down with Eric Besse, VP and General Manager of Besse Medical, to unpack the unseen infrastructure that keeps retina practices running. Eric shares how his family’s corner pharmacy grew into one of the most influential specialty distributors in the country and explains why drug distribution is far more than logistics — it’s practice support, financial stewardship, technology integration, and practice-level partnership.

The conversation spans everything from cold-chain handling and inventory management to sustainability and the future of practice support. For retina specialists, this is a rare, behind-the-curtain look at the systems that make allow retina practices to operate smoothly. 

Topics Covered:

• What the Cencora Vision Exchange meeting is and who attends
• The family origins of Besse Medical and its growth into a national distributor
• How Cencora and Besse Medical fit together
• Why distributors manage more than just shipping 
• Technology platforms such as CubixxMD and PODIS
• How drug distributors support retina workflows, billing, and compliance
• The importance of stable, long-tenured support teams for practices
• Cencora’s new recyclable, corrugated cold-chain packaging initiative

Key Quotes:

• “We don’t want to be viewed as a distributor that picks, packs, and ships product. We want to be more than that, and we push ourselves to be more than that.” — Eric Besse
• “If the soda fountain down the street puts two cherries on top, you put three. If they put three, you put four.” — Eric Besse, on his family’s philosophy of service
• “If I were starting a practice today, [Cencora] would be the first place I would turn to partner.” — John Kitchens, MD

Hosts:

John Kitchens, MD

Scott Krzywonos

Guest:

Alexander Gaffney, VP of Regulatory Policy & Intelligence, Agency IQ / POLITICO

Show Summary:

In this episode, Scott calls in from the Outer Banks to discuss two major clinical headlines before turning to federal policy. First up is the PRIMA retinal prosthesis, a wireless subretinal chip that helped patients with geographic atrophy regain partial reading vision. Then, Scott and John analyze the rapidly expanding — and often contradictory — body of research on GLP-1 receptor agonists and their links to retinal disease.

In the second half, they welcome Alexander Gaffney from POLITICO’s Agency IQ for a deep dive into how the ongoing government shutdown and widespread staff reductions are affecting the FDA’s ability to review and approve ophthalmic therapies. From PDUFA carry-over funds to workforce attrition, Alec explains why the true impact may not be the shutdown itself, but the backlog that follows.

Topics Covered:

• PRIMA retinal implant: wireless innovation and its surgical challenges
• The trade-off between functional vision gains and expanded atrophy area
• GLP-1 receptor agonists: mixed data on AMD, DR, and DME risk
• FDA shutdown implications for ophthalmic trials and approvals
• The reduction in force across FDA divisions and its effect on review capacity
• How new leadership and the National Priority Voucher Program aim to modernize the agency
• Why backlogs could extend into 2026 for gene therapy and TKI programs

Key Quotes:

• “I’m less worried about the shutdown itself — I’m worried about what happens afterward.” — Alexander Gaffney
• “You might not be able to read or drive, but that peripheral vision is what lets you move through the world. Losing more of that matters.” — John Kitchens, MD
• “We don’t always know what we’ve lost — how much faster certain drugs might have reached patients.” — Scott Krzywonos

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

 RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube

Hosts:

Scott Krzywonos

John Kitchens, MD

Show Summary:

In this episode, Scott and John pick up where they left off — talking about the American Academy of Ophthalmology (AAO) meeting and how innovation is reshaping the field. They explore their favorite AAO host cities, the atmosphere of this year’s meeting, and the under-the-radar conversations shaping the future of retina.

Scott shares insights from iCelerator, his favorite ophthalmology meeting, which highlights how technology, AI, and macroeconomic forces are influencing eye care. The two discuss “oculomics” — using retinal data to understand systemic diseases — and the potential of multimodal AI systems that combine imaging, genetics, and longitudinal data.

John then breaks down the next wave of therapies: gene therapy, tyrosine kinase inhibitors (TKIs), and how FDA study design changes could reshape how new drugs are approved. The discussion dives into superiority studies, the logic of targeting diabetic retinopathy (DR) instead of diabetic macular edema (DME), and what these shifts mean for patients and clinicians.

They wrap with a preview of the Cencora (formerly AmerisourceBergen) meeting — a behind-the-scenes look at the often-overlooked but crucial role drug distributors play in retina care.

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

🎧 RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube

In the debut episode of RetinUp, Drs. Scott Krzywonos and John Kitchens introduce their vision for the show—unfiltered conversations between retina specialists that capture the hallway and after-hours discussions rarely heard on stage.

They kick off by recapping highlights from the AAO Annual Meeting, including the first-ever full eye transplant, updates on Alcon’s Unity vitrectomy system, the LumiThera photobiomodulation platform, and the coming wave of AREDS 3 vitamins.

The episode then turns to a one-on-one interview with Cedric Francois, founder and CEO of Apellis Pharmaceuticals, whose journey from surgeon to biotech innovator led to the creation of Syfovre, the first approved treatment for geographic atrophy. Francois shares how a chance encounter at the Macula Society set his career in motion, the origins of complement inhibition research, and what it means to lead a mission-driven biotech as both a scientist and physician.

• AAO 2024 highlights:
• The world’s first whole-eye transplant — and what it could mean for future nerve regeneration research.
• Alcon’s new Unity vitreoretinal platform — first major system since Constellation.
• The promise and controversy of photobiomodulation in dry AMD care.
• Previewing AREDS 3 — a reformulated vitamin blend with added B vitamins and lower zinc.
• Inside the Apellis Story:
• How a Belgian surgeon became a biotech CEO in Kentucky.
• The early experiments that led to complement inhibition research.
• The role of serendipity at the Macula Society—and how a single conversation led to Apellis’s first investment.
• Lessons learned from Potentia’s first molecule (POT-4/APL-1) to Syfovre (pegcetacoplan)
• The transition from Louisville to Boston’s biotech hub.
• Why physician-founders bring unique empathy—and accountability—to innovation.

From the first eye transplant to the first therapy for geographic atrophy, Episode 1 sets the tone for RetinUp— candid, curious, and clinically relevant. Drs. Krzywonos and Kitchens explore how preparation meets luck, and how visionaries like Cedric Francois turn bold ideas into breakthroughs for patients.

Hosts: Scott Krzywonos and John Kitchens, MD

Guest: Cedric Francois, MD, PhD (Apellis Pharmaceuticals)

Business Operations: Liz Hogan

Production & Marketing: Laura Brown

🎧 Listen to RetinUp wherever you get your podcasts, or visit RetinUp.com to subscribe to our newsletter.

Hosts: John Kitchens, MD & Scott Krzywonos

Duration: 2:15

Welcome to RetinUp—the podcast where retina science meets real-world insight. Hosted by Dr. John Kitchens and Scott Krzywonos, RetinUp brings together leading voices in ophthalmology to explore new data, breakthrough research, and the stories behind the science shaping the future of retina care.

In this short trailer, John and Scott introduce the RetinUp mission, what listeners can expect from upcoming episodes, and how the show will connect researchers, clinicians, and innovators across the retina community.

Stay connected with RetinUp for upcoming interviews, conference recaps, and clinical discussions.

📱 Subscribe on Apple Podcasts, Spotify, or wherever you listen.\

🌐 Learn more at retinup.com

💬 Follow the conversation on LinkedIn with #RetinUpPodcast

John Kitchens, MD is a vitreoretinal surgeon with decades of clinical and research experience.

Scott Krzywonos is an editor, educator, and longtime retina media producer. Together, they bring clarity, humor, and insight to every conversation.