Alum Maria Lopez fights for underserved communities

Juggling multiple roles as a pharmacist specialist clinician while advocating for underserved patients in the heart of San Francisco’s Latino/a/x community has put alum Maria Lopez, PharmD, on what she calls “the last frontier of pharmacy.”

Lopez, who grew up in a rural farmworker town in California and was the first generation in her family to attend college, is now a volunteer faculty member at UCSF. She purchased the Mission Wellness specialty care pharmacy in 2005, and rebranded the 45-year-old clinic to focus on handling complex therapies.

Under her leadership, Mission Wellness became the first standalone community pharmacy in California to implement hepatitis C point-of-care testing and One-Stop PrEP (pre-exposure prophylaxis for HIV). In recent pandemic years, Lopez added COVID-19 treatment and prevention to her expertise, and her pharmacy was one of a handful of sites in California to be awarded a COVID-19 Test-to-Treat equity grant by the California Department of Public Health (CDPH). She continues to lead the way for community pharmacies, providing affordable specialized care to vulnerable populations.

“Clinical pharmacy is really the backbone of the care we provide in the community,” Lopez said. “The pandemic highlighted what community pharmacists can do in terms of providing testing, vaccines, and therapeutics, but the industry is now at an inflection point.”

Lopez’ pharmacy won a major legal advocacy battle involving the role of PBMs, or pharmacy benefit managers—a group of companies that serve as the brokers between insurance companies, pharmacies, and drug manufacturers.

An arbitrator ruled in favor of Mission Wellness’ assertion of breach-of-contract by CVS Caremark. And because the woman-owned business won a multimillion-dollar judgment against the Goliath PBM, which failed to back up its claims that Lopez’ pharmacy didn’t follow adherence metrics, the case has taken on significance for public health generally.

In a rare move, the judge unsealed court records for the active case, which surrounds controversial direct and indirect remuneration (DIR) fees that have been soaring, resulting in higher prices for patients and jeopardizing the viability of pharmacies as businesses.

“Over the last 15 years, the pharmacy benefit managers have grown significantly,” Lopez said. “There has been a lot of growth and change in the business, and a need for pharmacists in the community setting to have touchpoints with patients, because we know that pharmacists can impact the care of a patient in a positive way if we are involved in the medication process and interventions.”

It’s all part of what Lopez describes as her calling, to increase access for Latinos and African Americans disproportionately affected by serious illnesses requiring specialized medications. The DIR win for Mission Wellness was fought on behalf of vulnerable HIV patients in a part of the city known to be a “pharmacy desert,” because larger chain pharmacies will not operate there.

Lopez has dedicated herself to the need for more detailed and compassionate care in these communities, where many patients are below the poverty line, ever since she started focusing on public health as a student leader at UCSF.

It was during her term as president of Chicanos in Health Education (now known as the Chicanx Latinx Campus Association) that she began spending time at Mission Neighborhood Health Center, a clinic she still works with closely. She is also a consultant with getSFcba, a capacity-building assistance program hosted at the SFDPH Center for Learning and Innovation (CLI). The organization’s mission is to foster a culture of learning and innovation within SFDPH, and to share local expertise with regional, national, and global partners.

Lopez’ leadership is also evident in her testimony to CA state legislature to fight for passage of bills that increase scope of practice for pharmacists. Her most recent victory saw the passage of a bill that will pave the way for California to reimburse pharmacists for their services.

“Community pharmacy is an untapped area for recognition and respect,” she said.

Lopez said in a previous UCSF alumni profile that she never thought she’d become a pharmacist or businesswoman. She says UCSF provided vital opportunities for leadership growth, and that trajectory continues in her lectures, which center on the future of the pharmacy industry. She is also on the board of the Pharmacy Alumni Association, as Diversity, Equity, and Inclusion (DEI) advisor.

“My relationship with UCSF has been very collaborative, and that’s the relationship I’ve had in the community,” Lopez said. “The pharmacy industry is at a crux, for example with pharmacists that are on strike [against chain pharmacies like Walgreens and CVS]. Insurance companies are very powerful, but this chapter’s not over yet.”