In that situation that’s a niche filled perfectly by both panhaima and pneuma, it’s hard to justify a skill that has incredibly niche uses and only when synced below a level that a better skill fills the same nicheHonestly, I find Pepsis fairly useful in certain situations.
Do I need to do back-to-back AoE heals -- heal up for a raidwide, then heal after the raidwide -- in a window smaller than Ixochole's cooldown, and still need to move for a mechanic so that I don't die? I can E.Prognosis and weave Pepsis to crack the shield immediately for one, and use Ixochole for the other. Conversely, using just Prognosis for one of those two back-to-back heals is only 300 potency of heal (compared to the 450 total of an E.Prognosis + Pepsis), still costs me a GCD, and I've got to stay still long enough to channel the cast.
Pepsis is never my first choice, because yeah, it is sacrificing a GCD to get the shield on there in the first place to crack it; if I have other options available, Pepsis is probably not the most efficient choice. If I've got enough time for HoT to be sufficient to top off after that hypothetical raidwide, Physis II (especially to buff any AoE heals from my co-healer, if applicable) or Kerachole is probably good. If Holos is off cooldown for that back-to-back heal scenario, I'd probably favor doing Holos for the first one (and get that lovely mitigation on folks) and Ixochole for the second. Etc.
But I absolutely consider Pepsis a viable and useful option in my toolkit when healing, even if it's never going to be one of the first tools that I reach for in that kit.
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