Rising uncompensated care, escalating cybersecurity and climate risks, and major shifts in the 340B and pharmacy benefit manager landscapes are prompting health systems to rethink how they deliver and finance care, according to the American Society of Health-System Pharmacists’ forecast report.
Built on insights from nearly 300 pharmacy leaders, the report, released Dec. 9 at ASHP’s Midyear Clinical Meeting and Exhibition in Las Vegas, outlines trends expected to shape health system pharmacies over the next five years and offers strategic recommendations to support more nimble planning.
Here are five takeaways from the forecast:
1. Financial pressures are reshaping reimbursement and pharmacy benefit models. Surveyed leaders anticipate continued strain from uncompensated care, tighter reimbursement and potential changes to the 340B drug pricing program. Many expect health systems to explore creating their own pharmacy benefit managers or contracting with more transparent PBMs as scrutiny of traditional models increases.
2. Infusion services may shift as Medicare and 340B policies evolve. More than half of respondents said health systems will likely restructure hospital-based outpatient infusion care because of falling reimbursement and reduced margins tied to policy changes affecting medication administration.
3. Cybersecurity threats could disrupt medication access. Two-thirds of pharmacy leaders said a cyberattack could impede drug delivery across much of the U.S., underscoring concerns about reliance on digital infrastructure and the need for coordinated mitigation strategies with manufacturers and federal agencies.
4. Climate-related events pose growing risks to hospitals and supply chains. Nearly three-quarters of respondents expect weather-driven disruptions to health system operations, prompting calls for more resilient infrastructure, stronger continuity planning and integrating sustainability into core decision-making. A companion editorial from the American Journal of Health-System Pharmacy also highlights expanding environmental impacts on care delivery.
5. New therapies, digital transformation and safety innovations will require operational readiness. Leaders pointed to the need to prepare for the growth of GLP-1s, theranostics and other advanced therapeutics; ready the workforce for AI-enabled tools; and shift toward proactive safety strategies supported by predictive surveillance and human-factors engineering.
ASHP said pharmacy leaders are positioned to help health systems translate these trends into action.
Read the full report here.
