Becker’s asked pharmacy executives from hospitals and health systems, along with academic medical centers and universities across the U.S. to share which alternative revenue streams will define survival by 2030.
The 10 executives featured in this article are all speaking at the Becker’s Healthcare 3rd Annual Fall Chief Pharmacy Officer Summit, from November 4 – 6, 2026 at the Swissotel Chicago.
To learn more about this event, click here.
If you would like to join as a reviewer, contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: Which alternative revenue streams will define survival by 2030?
Shabnam Gaskari, PharmD. Chief Pharmacy Officer and Vice President of Clinical Services at Stanford Medicine Children’s Health (Palo Alto, Calif.): By 2030, pharmacy survival hinges on evolving from a traditional, dispensing-centered revenue model to an enterprise strategy focused on clinical, operational, and financial growth. Diversified revenue streams, including specialty pharmacy and various infusion services, are essential for sustainable development by expanding care access in outpatient settings. Stanford Medicine Children’s Health is actively aligning its pharmacy strategy with emerging trends in biologics and precision treatments, positioning pharmacy as a central component in managing the continuum of care. Critical to this is solving accessibility challenges for specialty prescriptions and integrating pharmacy with broader clinical and research efforts to ensure new therapies reach pediatric patients effectively and efficiently.
Kevin W. Chamberlin, PharmD. Associate Vice President and Chief Pharmacy Officer of UConn Health (Farmington, Conn.): Initial reaction to that question:
- Optimizing reimbursement for pharmacist cognitive services, not just revenue gained off margin of drug dispensing
- Expansion of ambulatory pharmacy/pharmacist presence and scope, with creative strategies on how to measure the ‘soft’ dollars associated with pharmacist impact at the patient level in those spaces
- Pharmacist-based patient visits staggered between physician visits to increase continuity of care, patient ‘touches’ for high-risk diagnoses and patients, and opening up schedule opportunities for the physician
- Streamlined distribution models that do not lose the patient-centric focus of pharmacy care tenets of patient first, always accessible healthcare provider
- Mobile pharmacy services that meet the patient (and their needs) where they are at: mobile infusion strategies (home, unhoused encampments, event, etc.)
Ronnah Alexander. Chief Pharmacy Officer of Regional Health Care Affiliates, Health First Community Health Center (Providence, Ky.): In my opinion, we need to focus on disease states that are in our communities but are under diagnosed and treated. For instance, Hepatitis C and HIV are now being tested more aggressively in our area and this is making early treatment possible while also helping us to sustain in difficult times. In addition, in Kentucky, we recently passed legislation that allows for pharmacist’s services to be billable. Currently, pharmacists are a valued member of our multi-collaborative teams, impacting outcomes of patients throughout the state, but many of those services being provided have historically not been reimbursable. However, the revenues from the 340B program have largely paid for these specialty services. As the 340B program gets squeezed and some of the revenue starts to dwindle, this is an opportunity for the clinical expertise of the medication specialists to remain where they need to be, in patient care.
Larry Lindenbaum, MD. Vice President of Perioperative, Fairview Health System; Associate Professor and Division Director Department of Anesthesiology at University of Minnesota (Minneapolis): The dispensing margin that sustained pharmacy for decades is being compressed from multiple directions simultaneously: CMS negotiated drug pricing under the IRA, the TrumpRx direct-to-consumer portal bypassing traditional pharmacy channels, and PBM reform under the Consolidated Appropriations Act of 2026 eliminating spread pricing and utilization-based rebates in Medicare Part D. Chief Pharmacy Officers who anchor their financial models to product-based reimbursement will find themselves managing a structurally declining business by 2028. The pharmacies that survive and grow will be those that pivot aggressively toward medical-benefit and clinical-service revenue, including pharmacist-led chronic disease management, point-of-care testing, pharmacogenomics, and infusion services billed under Medicare Part B and commercial medical plans. Specialty pharmacy and 340B optimization remain high-margin opportunities, but both face increasing audit scrutiny and regulatory tightening that demand sophisticated compliance infrastructure. Supply chain volatility and persistent drug shortages are creating openings for health-system pharmacies to invest in compounding capabilities and centralized preparation services that serve as both cost-avoidance and revenue-generation mechanisms. Technology integration, particularly AI-driven inventory management, predictive analytics for formulary optimization, massive recovery through automated 340B optimization and real time claims reconciliation and automation of clinical documentation, will separate operationally resilient organizations from those absorbing margin erosion passively. The CPOs who will define the next era of pharmacy are those treating their departments not as cost centers dependent on drug distribution, but as clinical revenue engines embedded in value-based care delivery.
Fatimah Muhammad. Director of 340B Pharmaceutical Services, Specialty Pharmacy, Drug Replacement, and ADM Pharmaceutical Services at Saint Peter’s University Hospital (New Brunswick, N.J.): By 2030, pharmacy will not survive on dispensing economics alone, and organizations that remain anchored to that model will fall behind. The next era of pharmacy revenue will be defined by control of the patient journey, ownership of data, and the ability to influence access across the continuum of care. Specialty pharmacy will continue to be a cornerstone, but only for health systems that fully integrate it into clinical strategy rather than operate it as a siloed service.
From where I sit, the real opportunity is in how effectively organizations capture and retain value across the patient lifecycle, particularly in referral management, leakage prevention, and longitudinal medication management. Pharmacy is uniquely positioned to become a revenue generating clinical platform, driving outcomes in ambulatory care, chronic disease management, and value-based models where performance determines reimbursement.
What will separate leading organizations is their ability to translate data into action. The next generation of pharmacy revenue will not come from what we dispense, but from what we manage, influence, and retain across the patient journey. Real time visibility into eligibility, accumulation, and patient behavior will unlock new pathways for revenue and care delivery that do not exist today at scale. Programs like 340B will remain important, but their long-term value will depend on how intentionally they are used to expand access, fund clinical innovation, and strengthen community impact.
The organizations that lead in the next decade will not be asking how pharmacy supports the system. They will be building their system around pharmacy. Because ultimately, the future of pharmacy will not be defined by what we dispense, but by what we are trusted to manage across the patient journey.
Amy Jones, PharmD. Director of Pharmacy, Oncology, Infusion, IDS at University of Virginia Health System (Charlottesville): Pharmacy based infusion chairs or suites
Pharmacogenomic testing, monitoring, and treatment approach by pharmacists for oncology care
Quick and efficient availability of oncology and specialty infusion treatments as soon as they are on the market
Developing a method for clinic based nurse administered oncology and biotherapy care -with medication safety and billing/reimbursement.
Paul Green, PharmD. Director of Pharmacy Services at Westchester Medical Center (Valhalla, N.Y.): By 2030, the health systems that thrive will be the ones that build pharmacy revenue streams beyond traditional dispensing and treat pharmacy as a growth engine, not just a cost center. At WMCHealth, that means continuing to invest in areas where pharmacy is tightly connected to access, outcomes, and long-term system value, particularly specialty pharmacy, ambulatory clinical pharmacy services, infusion strategy, transitions of care, and disciplined 340B optimization. Specialty pharmacy and infusion will continue to matter because they sit at the intersection of patient access, clinical continuity, and margin, especially when health systems can keep patients connected to high-touch, clinically integrated pharmacy services. Ambulatory pharmacy will also become increasingly important as organizations expand clinical pharmacist involvement in chronic disease management, medication access, and longitudinal care models that improve quality and reduce total cost of care. We also see real opportunity in discharge programs and transitions of care, where stronger medication management can improve adherence, reduce avoidable readmissions, and support downstream retention within the health system. Underlying all of this is the same reality: pharmacy’s survival will depend on proving value in ways that are operational, clinical, and financial. The organizations that succeed will be the ones that align pharmacy strategy with broader system goals and build infrastructure that turns pharmacy from a support function into a strategic advantage.
Matthew Webber, PharmD. Director of Pharmacy Business at Novant Health (Winston-Salem, N.C.): I would push back on the framing of this question; health systems do not need alternative revenue streams to define survival in 2030. Health system pharmacies are not fighting for survival; they are fighting for market share, and the deck is stacked against them.
The same three companies processing 80% of U.S. prescription claims also own three of the five largest pharmacies in the country by dispensing revenue, competing directly with health systems for the patients they serve. Per the FTC, PBM-affiliated pharmacies have grown their share of the specialty drug segment from 54% in 2016 to 68% in 2023, and the playbook driving that growth is no secret: white and brown bagging mandates, expedited prior authorizations for PBM-owned pharmacies, and network exclusions engineered to eliminate competing pharmacies from the equation. The FTC’s interim staff reports found that PBM-affiliated pharmacies receive 80 to 90% higher reimbursement rates than unaffiliated pharmacies for similar drugs, generating over $7.3 billion in excess revenue between 2017 and 2022.
The opportunity for health systems isn’t to find alternative revenue streams; it’s to stop ceding existing ones by investing in specialty pharmacy capture, expanding ambulatory and community pharmacy footprint, and actively dismantling the steering practices that have eroded health system and independent pharmacy revenue for decades, contributing to pharmacy deserts across the country. Doing so allows health systems to continue serving the communities they call home, providing the human touch that is essential to patient care.
Nicole Copley, PharmD. Director of Pharmacy at Encompass Health Rehabilitation Institute of Libertyville (Ill.): I think this will start with Pharmacist advocacy first and foremost. I think the profession of Pharmacy has been pushed aside in many avenues and I think this is an opportunity for Pharmacists to demonstrate their value and reclaim their seat at the healthcare table.
We have such an array of healthcare opportunities from immunizations, medication therapy management (MTM), specialty pharmacy, and telehealth, just to name a few. The list is potentially endless.
I believe educating & empowering Pharmacists to move to these areas of practice will help as well. Many pharmacists feel stuck in one particular career path, but opening up more opportunities and more doors for Pharmacists will help more patients directly & improve patient-centered care. This will help not only keep Pharmacy alive, but allow it the opportunity to thrive.
Summer Abduqadir, PharmD. Pharmacy Compounding Specialist of Henry Ford Health (Detroit): I believe one of the most overlooked revenue opportunities is the reduction of medication waste through advanced inventory management. Currently, hundreds of millions to billions of dollars are lost annually due to poor medication inventory control and storage practices.
Pharmacies that invest in optimized, data-driven inventory systems will be able to significantly preserve and even expand their revenue margins. This includes models such as centralized inventory management, consolidated compounding services, and system-wide pharmacy service centers within health systems.
These centralized approaches reduce redundancy, improve medication availability, and strengthen procurement resilience. More importantly, they transform cost avoidance such as reducing expired medications and storage inconsistencies into measurable financial performance.
In this way, operational efficiency itself becomes a sustainable revenue stream, allowing pharmacies to reinvest in clinical services, expand access, and remain financially viable in an increasingly constrained reimbursement environment.
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