For years, many centralized fulfillment operations have been designed and optimized around vial-based dispensing workflows. Today, changing prescription trends are prompting pharmacy leaders to rethink that approach.
Pharmacies are managing a growing mix of therapies that arrive in manufacturer’s packaging and are dispensed exactly as received. These “unit-of-use” medications, which include many injectable therapies, specialty drugs, and GLP-1 medications, are changing once-trusted operational realities.
For health systems, retail pharmacy chains, and other pharmacy organizations evaluating centralized fulfillment strategies, the question is not simply how to automate prescription filling, but how to build a centralized fulfillment model that can adapt to evolving medication formats, patient needs, and operational demands.
Why This Matters for Centralized Fulfillment
As the prescription mix evolves, pharmacies are managing medication workflows that cover more than simply traditional vial dispensing. These medications often arrive in prepackaged cartons, pens, kits, or other manufacturer-ready formats. While this can simplify the dispensing process in some ways, it introduces new operational complexity in inventory management, storage, order fulfillment, and distribution.
Traditional centralized fulfillment operations were largely designed to maximize efficiency for high-volume oral solid medications dispensed into vials. That model is important. However, fulfillment should support a much broader medication mix.
Industry data shows the specialty drug trend rose 11.1% last year, driven almost entirely by a 13.1% increase in utilization but offset by a 1.9% decrease in unit cost1 This illustrates an environment where pharmacy fulfillment models benefit from efficiently managing complex therapies. The challenge is that unit-of-use medications can introduce workflow requirements that differ from traditional vial-based medications and may need to be fulfilled manually. This manual workflow may require additional manual handling and operational resources.
Pharmacy leaders are becoming increasingly aware of the operational challenges associated with a changing prescription mix, particularly as more therapies introduce unique storage, handling, and fulfillment requirements.
For many health systems, these operational considerations increasingly influence strategic priorities around patient access, outpatient pharmacy growth, specialty expansion, and enterprise pharmacy performance.
The Rise of GLP-1 Medications Accelerates the Shift
The marketplace has seen a rapid growth of GLP-1 therapies used in diabetes and weight management2. However, unlike traditional oral medications, many GLP-1 products are dispensed as unit-of-use packages that also require cold chain storage. This often introduces the need for additional refrigerators, careful inventory controls, and fulfillment processes that differ substantially from vial-based and even ambient-boxed workflows.
As utilization rises, these medications could grow to represent a meaningful share of overall prescription volume despite following completely different fulfillment paths. This may cause many pharmacy organizations to reassess the assumptions that guided earlier centralized fulfillment investments.
As medication complexity increases, pharmacy leaders are not simply looking for automation. They are increasingly seeking greater visibility and control over inventory, fulfillment, and distribution workflows. That need is especially acute as pharmacies manage growing volumes of specialty and temperature-sensitive medications, where technician shortages, staff satisfaction, and labor-intensive refrigerated workflows can place additional strain on operations. Pharmacy leaders are increasingly seeking ways to reduce manual touchpoints and create more sustainable workflows for both patients and staff.
Flexibility May Become More Important Than Volume
In this changing landscape, flexibility is becoming increasingly important. As prescription mix and packaging formats evolve, pharmacy leaders should evaluate centralized fulfillment operations that can efficiently support a broad range of needs, from traditional vial prescriptions and unit-of-use medications to specialty therapies, refrigerated products, and emerging treatments with unique handling requirements.
Because formulary changes can occur rapidly, fulfillment infrastructure must be capable of adapting without requiring major operational redesigns every few years.
Organizations that build around a single medication format may find it more difficult to respond to future shifts in prescribing patterns.
Modern fulfillment strategies also depend on visibility across inventory & order management, compliance, and distribution workflows. As centralized fulfillment operations scale, the ability to connect information across systems becomes increasingly important.
Looking Beyond Today’s Prescription Mix
The medications driving prescription growth today may not be the same medications driving growth five years from now. New therapies, changing reimbursement models, and evolving patient needs will continue to reshape dispensing requirements.
For that reason, an important centralized fulfillment design question may no longer be: “How efficiently can we fill prescriptions today?”
Instead, leaders should ask: “Can our fulfillment model adapt to the medications and workflows of tomorrow?”
As formularies change and unit-of-use medications represent a larger share of prescription volume, there becomes an increasing demand for centralized fulfillment strategies that evolve beyond traditional dispensing models. Organization will need to evaluate future-state fulfillment strategies, the conversation increasingly extends beyond hardware and software. Pharmacy leaders are seeking data-driven partners that can support long-term growth, changing prescription demand, and evolving operational requirements.
1https://navitus.com/drug-trend-report/specialty-spend-what-this-years-results-reveal/
2https://www.managedhealthcareexecutive.com/view/iqvia-predicts-spending-on-obesity-drugs-could-reach-60-billion-by-2029-pbmi-2025
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