Retail and e-commerce giants are rapidly expanding their presence in pharmacy services, prompting new concerns among hospital and health system leaders about losing ground in patient access and workforce recruitment.
Amazon, for example, is significantly scaling its pharmacy footprint. The company plans to expand its same-day prescription delivery service to 4,500 U.S. cities and towns by the end of 2026 — adding nearly 2,000 new communities as it targets patients affected by pharmacy closures, staffing shortages and transportation barriers.
Walmart is taking a different approach, focusing heavily on its workforce. The retailer recently promoted 3,000 pharmacy technicians into pharmacy operations team lead roles while also increasing pay. Technician wages now average $22 per hour, with some earning as much as $40.50 depending on certification and location. The newly created team lead roles average $28 per hour, with potential earnings up to $42.
Other major players are making similar investments. Walgreens has said it will cover prerequisite coursework for employees pursuing a PharmD degree, and CVS Health recently opened a workforce development center in Texas aimed at training pharmacy technicians and other staff.
Together, these moves signal intensifying competition for both patients and talent. As retailers reshape expectations around convenience, compensation and delivery speed, hospital leaders say they are being pushed to rethink how pharmacy services are delivered — and how pharmacy teams are supported.
Nilesh Desai, chief pharmacy officer at Louisville, Ky.-based Baptist Health System, said health systems are already adapting.
“There will definitely be increased competition for both patient access and workforce recruitment,” Mr. Desai said. “We are actively investing in technology to improve patient access and convenience; we are also reviewing our compensation structures and professional development programs to ensure we remain competitive and continue to attract talent.”
While retail and e-commerce companies are leveraging scale and consumer convenience to gain ground, some health system leaders say hospitals retain key advantages — particularly on the clinical side.
David Young, vice president of pharmacy operations at Brockton, Mass.-based Signature Healthcare, said the competitive pressure from companies such as Amazon and Walmart is not insurmountable.
“The competitive pressure is real, and we take it seriously, but Signature Healthcare’s position is stronger than the headlines suggest,” he said. “Amazon and Walmart are formidable players, and their investments signal what pharmacy executives have long known: Pharmacy is a strategic battleground for patient access, loyalty and margin.”
In response, health systems are leaning into areas in which their model differs most. At Signature Healthcare, that includes deeper clinical integration and positioning pharmacy as a driver of value-based care performance rather than simply a dispensing function. The organization is also emphasizing its broader value proposition for pharmacy professionals — including culture, clinical autonomy and mission — alongside compensation.
Technology is another area of focus. Mr. Young said health systems are accelerating adoption of automation, digital adherence tools and interoperable systems designed to improve both patient and provider experiences.
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