2026 is shaping up to be another pivotal year for the pharmacy industry. From new technologies and treatments to ongoing economic challenges and policy shifts, the pace of change shows no sign of slowing.
These developments affect more than just day-to-day operations. They are influencing access to care, workforce stability, and the financial sustainability of health systems and pharmacy organizations alike. They also raise new questions around growth and how your products and solutions must align with this year’s challenges and opportunities.
So, whether you’re a pharmacy leader prioritizing clinical and operational goals, a stakeholder within a health system evaluating risk, or a marketing professional trying to understand where the market is heading, understanding these trends will be valuable.
This blog will cover four major trends we at Definitive Healthcare feel are impacting the pharmacy industry the most in 2026:
- AI will remain an imperative for pharmacy
- The pharmacy workforce shortage will persist
- Drug costs will continue to climb
- Policy shifts and the 340B landscape will introduce new challenges
AI will remain an imperative for pharmacy
Successful pharmacy leaders have recognized AI’s game-changing potential for years. Its omnipresence at major healthcare conferences, in vendor roadmaps, and across executive discussions reflects that reality. That won’t change in 2026.
What is changing is how leaders think about adoption.
Pharmacy executives broadly agree that AI, predictive analytics, and large language models are key if organizations want to remain competitive. At the same time, however, rushed or poorly governed implementations can introduce clinical risk, regulatory exposure, and operational disruption. It’s clear that implementing AI technologies won’t be slowing down anytime soon, but leaders are acknowledging that adoption needs to be more tactical and cautious.
The emphasis in 2026 will be on using AI where it performs best today, while laying the groundwork for deeper clinical integration over time. Right now, AI delivers the most value when automating administrative or operational workflows. Typically, these include tasks where automation can reduce manual effort and free up pharmacists and technicians to focus on work more deserving of their time.
True transformation, however, will depend on how pharmacy leaders and technology innovators integrate AI into the clinical and medical worlds. In 2026 and beyond, we expect AI to play a growing role in areas such as building supply chain resilience, reducing waste, improving the medication reconciliation process, and supporting (not replacing!) pharmacists’ clinical judgment.
For pharmacy leaders, the challenge won’t be finding places to use AI. It will be deciding where it adds real value, how to implement it safely, and how to ensure that technology enhances rather than complicates clinical care.
The pharmacy workforce shortage will persist
Workforce shortages remain one of the most persistent challenges facing the healthcare industry, and the pharmacy sector is no exception. Nationwide staffing gaps continue to strain pharmacy operations, slow service delivery, and, in some cases, threaten patient access to timely and safe care.
The problem is centered around the pharmacy technician position. Despite being the backbone of safe, efficient medication management across health systems, technician roles are experiencing some of the highest vacancy and turnover rates in the industry. In fact, according to the American Society of Health-System Pharmacists, technician turnover rate is greater than 20% and vacancy rates are as high as 40%.
When technician positions go unfilled, the impact can be immediately apparent. Hospitals must pay overtime to remaining pharmacy technicians or have other pharmacists fill the gap, both options that are more expensive than keeping technicians in the first place. And when other personnel step in for support, their own responsibilities don’t simply disappear. Clinical services could be delayed, and the added strain contributes to burnout, medical errors, and reduced capacity to expand services.
In 2026, successful pharmacies and health systems will need to rethink how they attract and retain technician talent. Recruiting alone is not enough. Leaders must invest in training, career development, and compensation strategies that reflect the growing scope and complexity of the work technicians perform.
Raising technician salaries may be a necessary step, not simply as a retention tactic, but because their roles have become more complex. Many technicians now support medication history collection, supply chain management, infusion services, and specialty pharmacy coordination.
By investing in people, health systems can begin to stabilize their pharmacy workforce. But equally important is creating a supportive work environment. Clear career pathways, manageable workloads, and access to technology that reduces repetitive tasks can significantly improve job satisfaction and retention.
Drug costs will continue to climb
As I’m sure you’re well aware, the cost of care in the U.S. has risen steadily over the past several years, driven by inflation, supply chain challenges, higher labor and materials costs, tariffs, and the growing prevalence of high-cost therapies.
Already in 2026, manufacturers have raised prices for more than 870 drugs, despite recent federal efforts like the Most Favored Nation (MFN) drug pricing agreements intended to curb certain costs. The rising cost of prescription drugs is expected to remain one of the defining financial challenges for the healthcare system this year. Pharmacy leaders, employers, and manufacturers alike will need to balance rising costs while maintaining patient access and adherence to the medications they need.
Two categories in particular continue to reshape pharmacy budgets: GLP-1 therapies and cell and gene treatments.
GLP-1 medications, initially developed for diabetes and now widely used for weight loss and chronic condition management, have seen rapid adoption. As indications expand and demand grows, employers and payers are under increasing pressure to balance access with affordability. Coverage decisions, utilization management, and patient engagement strategies are becoming more complex and more visible.
At the same time, the pipeline of cell and gene therapies continues to expand. These treatments offer transformative potential but come with ultra-high price tags and complex delivery requirements. Many employers and health systems still lack the infrastructure, reimbursement mechanisms, or financial protections needed to manage the risk associated with these therapies at scale.
For employers, the challenge in 2026 will be sustaining access to innovative treatments without destabilizing benefit budgets. Weight-loss medications and therapies for chronic disease management are particularly challenging, as they often involve large eligible populations and long-term use.
For pharmaceutical companies, incremental price increases remain a familiar and reliable lever for offsetting rising production, labor, and distribution costs. While manufacturers may offer selective concessions on highly visible or politically sensitive products, broader pricing relief may be unlikely in the near term.
Policy shifts and the 340B landscape will introduce new challenges
Policy changes taking effect in 2026 are adding new layers of complexity to pharmacy and health system financial strategy. For organizations that rely on the 340B Drug Pricing Program and public payor reimbursement, even small regulatory shifts can have big operational and financial consequences.
Pharmacy leaders will need to work more closely with finance, compliance, and executive teams to anticipate how these changes affect cash flow, eligibility, and long-term sustainability.
The 340B Rebate Model Pilot Program
One of the most significant challenges facing health systems is the potential shift toward a rebate model within the 340B program. Under this approach, hospitals would purchase drugs at full price and receive 340B savings after the fact rather than upfront at the point of sale.
If implemented, this change could alter cash flow dynamics and increase administrative complexity. Health systems might need to manage delayed reimbursement, track claims with greater precision, and ensure compliance across multiple data sources. For organizations operating on thin margins, the timing of these savings could create real financial strain.
It is important to note, however, that this situation is actively underway. As of the writing of this article, the HRSA’s Office of Pharmacy Affairs (OPA) has paused the implementation of the 340B Rebate Model Pilot Program. HHS is currently evaluating whether to reconsider or modify the approach. Given the potential implications for cash flow, compliance, and operational planning, pharmacy leaders should continue to monitor developments closely. This is an actively evolving situation, and this article will be updated as new guidance or decisions emerge.
Medicaid eligibility
New Medicaid eligibility rules and work requirements present another risk. Depending on the state and a hospital’s payor mix, these policies could potentially reduce the number of patients counted towards a facility's status as a Disproportionate Share Hospital (DSH), which in turn could jeopardize the organization’s eligibility for 340B participation.
The providers that serve as safety nets for their communities could be particularly at risk here. Leaders will have to do more with less money while their existing operational and financial burdens remain the same.
Medicare Maximum Fair Prices
Another aspect of Medicare’s drug price negotiation program is the implementation of Maximum Fair Prices (MFPs) established under the Inflation Reduction Act (IRA). This policy applies to select high-cost drugs without generic or biosimilar alternatives, such as Eliquis, Stelara, Xarelto, and more.
These drugs are subject to MFPs, meaning the negotiated price sets the ceiling for what Medicare beneficiaries (and Part D plans) will pay — and pharmacies may be reimbursed based on these new benchmarks rather than traditional pricing models. This shift requires pharmacies to rethink acquisition and reimbursement strategies, as well as benefit design considerations that impact patient access and pharmacy margins.
What these trends mean for pharmacy strategy
To make matters more complicated, AI adoption, workforce instability, rising drug costs, and shifting policies are not isolated challenges. Each one influences the others. Technology decisions affect staffing models. Drug pricing pressures reshape benefit design and patient access. Policy changes alter cash flow, eligibility, and long-term financial risk.
There are also even more pharmacy trends we couldn’t get to in this article. Read our analysis on how the traditional pharmacy benefit model (PBM) is changing or learn about how specialty pharmacies and IDNs are connected for more insights.
2026 is certainly posed to field unique challenges for pharmacy leaders and healthcare providers alike. However, reliable data and market intelligence can help you guide decisions for your organization before problems surface. With the right insights, you can better prioritize investments, properly align your teams, position pharmacy as a strategic asset, and shift gears toward proactive decision making.
If you’re preparing for the challenges and opportunities ahead, Definitive Healthcare can help. Book a demo to see how comprehensive healthcare data and market insights can support smarter pharmacy strategy in 2026 and beyond.
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