Pharmacy leaders say the future of the profession will not hinge on any single technology or policy change, but on whether the workforce, financial model and care delivery structure evolve fast enough to keep up.
During a panel at Becker’s Spring Chief Pharmacy Officer Summit, leaders across health systems pointed to a set of pressures already reshaping pharmacy today — from AI adoption and labor shortages to reimbursement shifts — and how those forces could determine what the field looks like a decade from now.
A workforce gap that’s already here
One of the most immediate challenges is workforce capacity. Several leaders said demand is already outpacing available staff, forcing organizations to rethink how work gets done.
“There is not enough workforce to meet the needs of what I have today, let alone what I’m going to have in 2035,” Kristen Kruszewski, PharmD, chief pharmacy officer at Cone Health in Greensboro, N.C., said.
That gap is accelerating interest in automation and AI — not as a long-term strategy but as a near-term necessity. Leaders said the question is how effectively teams are prepared to use them.
“AI is coming whether you like it or not,” Ping Du, PharmD, vice president of pharmacy at Baylor Scott & White Health in Dallas, said. “It’s not AI going to replace your job — it’s the people who utilize AI who will replace your job.”
Leaders described early use cases in areas such as prior authorization, where AI-assisted tools are cutting processing time from minutes to seconds. At the same time, some leaders said the growing use of automation is creating new operational dynamics — including what Dr. Du described as a “battle of the bots,” as health systems deploy AI to accelerate approvals while payers use similar tools to automate denials and downcoding.
That reality is pushing pharmacy leaders to think beyond individual tools and toward more coordinated strategies, particularly as workflows become increasingly interconnected across clinical, operational and financial domains.
“I need a platform that can do it all,” Dr. Kruszewski said. “I don’t want to have to go here for this piece, here for someplace else.”
Still, leaders said technology alone will not close the gap. Without parallel investment in training and workflow redesign, automation risks creating new inefficiencies rather than solving existing ones — particularly in organizations where staff are not yet comfortable using these tools.
The role of the pharmacist is shifting
As technology takes on more administrative work, leaders said the role of the pharmacist is being redefined with a growing emphasis on clinical decision-making and accountability for outcomes.
At New Orleans-based Ochsner Medical Center, that includes embedding pharmacists into care teams and expanding their role in population health and clinical strategy, supported by investments in data and decision support tools.
“Technology matters, but practice authority, trust and accountability matter even more,” said Director of Pharmacy Lisa Boothby, PharmD.
Leaders said that shift is also tied to burnout. When highly trained staff are focused on repetitive tasks, it creates inefficiency and dissatisfaction.
Others said the shift also requires rethinking how pharmacy teams are structured from the ground up — particularly in environments where staffing is limited.
“How do we rebuild from scratch?” said Siggi Raizada, PharmD, director of pharmacy at Franklin, Tenn.-based Community Health Systems. “How do we build programs that make sure those positions are sustained?”
But preparing for that shift requires changes in how pharmacists are trained — something leaders said has not kept pace with the demands of the role.
In addition to clinical expertise, pharmacists are increasingly expected to understand financial performance, reimbursement and system-level operations. But many are not exposed to those concepts until they move into leadership roles.
“I can’t have someone who goes from a staff pharmacist to a manager and the first time they’re seeing a budget is when they become a manager,” Dr. Kruszewski said.
Others pointed to the need for more structured training in emerging technologies, particularly as AI becomes more embedded in daily workflows. Dr. Du warned that without that training, the advantage will shift quickly to those who can effectively use AI.
Financial pressure is reshaping strategy
Alongside workforce and role changes, leaders said financial pressure will play a major role in shaping pharmacy’s future.
Changes tied to the Inflation Reduction Act, along with broader reimbursement dynamics, are forcing organizations to rethink how pharmacy is structured and funded.
At Cone Health, leaders are restructuring how pharmacy is represented within the finance function — elevating it as a standalone focus area by creating a dedicated pharmacy finance leader, Dr. Kruszewski said.
That shift is also changing how organizations plan. At Cone Health, leaders are moving away from traditional three- to five-year forecasts in favor of shorter planning cycles — closer to six to 12 months — to respond more quickly to changing reimbursement conditions.
For others, the impact is showing up at the point of care. Dr. Du said smaller community pharmacies and retail chains are already pulling back from dispensing certain drugs due to unfavorable reimbursement, pushing more volume toward health systems and increasing operational strain.
Regardless of the pressure, leaders returned to a consistent theme: the organizations that succeed in 2035 will be the ones that adapt early.
“If we want a seat at the table, we’ve got to be able to speak the language of the people at that table,” Dr. Kruszewski said.
“The future of pharmacy will be intentionally built,” Dr. Boothby added.
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