As care continues to move beyond the hospital, pharmacy has become an increasingly important enterprise capability that influences patient access, financial performance and long-term growth. This evolution is driven not only by drug acquisition costs but also by utilization growth, reimbursement complexity, payer-driven site-of-care restrictions, specialty pharmacy access and advanced therapies.
“For health system leaders, projected inflation remains an important planning benchmark,” according to a new report from Vizient. “However, pharmacy spend is increasingly shaped by utilization, product mix, reimbursement and care delivery, requiring coordinated decision making across pharmacy, payer strategy, revenue cycle, non-acute operations: and clinical service lines.”
The report identified three trends that are shaping pharmacy strategy.
Expansion beyond acute care. Although acute care inflation remains comparatively stable, growth continues to shift toward ambulatory, specialty and complex therapies. This requires a pharmacy strategy to extend beyond inpatient drug cost management and into ambulatory operations, specialty pharmacy access, payer strategy, reimbursement performance and advanced therapy infrastructure.
High-growth therapies are reshaping pharmacy spending. Oncology represents the largest share of analyzed pharmacy purchases, followed closely by autoimmune and inflammatory conditions. Growth in GLP-1 therapies, biosimilars and cell and gene therapies demonstrates why organizations should plan for product mix, utilization growth, site of care, reimbursement and channel strategy — not projected price change alone — when developing pharmacy budgets and enterprise strategy.
Contracting, channel visibility and payer strategy strengthen enterprise performance. Contract products are projected to increase less than non-contract products, reinforcing the value of formulary alignment, aggregation and contract portfolio utilization where clinically appropriate. At the same time, high-cost therapies increasingly are flowing through specialty, retail, direct-purchase and limited-distribution channels. This requires stronger coordination across pharmacy, finance, revenue cycle, contracting, payer relations, specialty pharmacy and clinical service lines to ensure visibility.
The report recommended two moves to make now:
- Expansion beyond inpatient. Aligning pharmacy, payer strategy, revenue cycle and clinical operations into a connected enterprise model builds the capabilities needed to improve patient access, strengthen financial performance and sustain mission.
- Review data to create next steps. Use insights to prioritize the governance, operating models and enterprise capabilities needed to support future growth.
“As pharmacy continues to evolve beyond the hospital, organizations that align governance, strategy and operations across the enterprise will be better positioned to improve patient access, strengthen margins and support future growth,” the report said. “The opportunity is not simply to respond to changing market dynamics but to build the enterprise capabilities needed to deliver increasingly complex therapies across the continuum of care.”