Review of the 2025 Pharmacy Forecast: Implications for manufacturers

By Connie Marshall, Director, Expert Content, IPG Health, BSc Pharm, CDE

Health systems continue to face significant regulatory, reimbursement and operating pressures that challenge their ability to provide care for the patients and communities they serve. Key to navigating those pressures is informed strategic planning. The annual American Society of Health-System (ASHP)/ASHP Foundation Pharmacy Forecast can help guide the strategic planning process as health systems—and pharmacy leaders—strive to stay ahead of existing and future headwinds. Understanding potential external developments can help organizations better adapt to an ever-changing healthcare environment.

The Pharmacy Forecast identifies and contextualizes long-term trends likely to impact healthcare, health systems and the pharmacy profession in the coming years. Based on insights from a panel of pharmacy trend watchers, the report offers actionable recommendations to help health system leaders, departments and teams prepare for potential challenges and opportunities. It also serves as a valuable resource for manufacturers as they shape strategies to navigate evolving healthcare and pharmacy landscapes.

The 2025 Pharmacy Forecast Advisory Committee identified six rapidly evolving domains for closer examination. The two domains/chapters titled, "Stabilizing the pharmacy workforce" and "Navigating generative artificial intelligence: Opportunity and risk," build upon the 2024 Pharmacy Forecast to explore new dimensions in these dynamic areas. The remaining four domains/chapters are new and represent areas where significant evolution has impacted healthcare, health systems, healthcare policy and/or healthcare professionals.


Forecast 2025 domains

  • Business of healthcare: Challenges in health-system pharmacy
  • Addressing the gap in primary care
  • Navigating generative artificial intelligence: Opportunity and risk
  • Managing ultra-high-cost drugs
  • Whole person health
  • Stabilizing the pharmacy workforce
     

Below is a review of two domains that have particular significance for manufacturers working with health system pharmacies and pharmacists. Possible implications for manufacturers have been explored, with a focus on strategies to activate health system pharmacists and enhance the manufacturer-health system pharmacy partnership.

Managing ultra-high-cost drugs (UHCDs)

UHCDs, such as cell and gene therapies, are potentially life-altering treatments for orphan and rare diseases that often entail very high one-time costs. They are typically administered at specialized treatment centers (e.g. academic medical centers). While these therapies can offer a cure or durable symptomatic treatment, questions remain for health systems about how UHCDs will be paid for, managed and distributed.

When 269 forecast panelists (FPs) were surveyed regarding the future management of UHCDs, 58% indicated that the Centers for Medicare & Medicaid Services (CMS) will very or somewhat likely require pharmacist involvement in a cell and gene therapy center’s multidisciplinary team to meet accreditation standards. In addition, 70% indicated that cell and gene therapies would be very or somewhat likely to be managed by the pharmacy.

However, the forecast highlighted a clear gap in preparedness. Only 53% of FPs stated that their health system, pharmacy department, or staff would be ready to respond if the CMS required a pharmacist’s involvement in the future and only 50% stated they would be prepared to have cell and gene therapies managed by pharmacy.


How likely is it that the following will occur, by the year 2029, in the geographic region where you work?

The Centers for Medicare & Medicaid Services (CMS) will require cell and gene therapy centers to document the participation of a clinical pharmacist on their multidisciplinary tea to meet accreditation standards (as with solid organ transport programs). 

Bar chart showing likelihood responses: 11% very likely, 47% somewhat likely, 35% somewhat unlikely, 7% very unlikely.

While 58% answered it is likely that the CMS will require pharmacist involvement in a cell and gene therapy, only 53% of respondents are prepared to respond to this change.*

*Survey question on preparedness: "If the following occurs by the year 2029, how prepared is your health system, pharmacy department, or staff to respond?"

How likely is it that the following will occur, by the year 2029, in the geographic region where you work?

In health systems, cell and gene therapies will be managed by pharmacy (e.g., patient screening for therapy appropriateness, manage pre-medications, and provide outpatient clinic follow-up and monitoring). 

Bar chart showing likelihood responses: 18% very likely, 52% somewhat likely, 25% somewhat unlikely, 5% very unlikely.

While 70% answered it is likely that cell and gene therapies will be managed by health system pharmacies, only 50% of respondents are prepared to respond to this change.*

*Survey question on preparedness: "If the following occurs by the year 2029, how prepared is your health system, pharmacy department, or staff to respond?"

Implications for manufacturers: To embrace an enhanced role in UHCD management, health system pharmacies will need to ensure staff have the appropriate clinical expertise to prepare complex therapies and manage their safe handling. Manufacturers can seize this partnership opportunity by helping pharmacy leaders develop training programs to equip health system pharmacists and technicians with the knowledge and skills to manage and administer UHCDs efficiently and safely. Providing infrastructure support by collaborating on the development of UHCD policies and standards may help manufacturers further strengthen the health system partnership.
 

Addressing the gap in primary care

A 2023 report by the federal Health Resources and Services Administration (HRSA) projected that by 2026 there will be a shortage of over 68,000 full-time primary care physicians, with the shortage disproportionately impacting those in non-urban areas. Approximately 75 million Americans already live in primary care “Health Workforce Shortage Areas.”

There is a vast amount of evidence to support expanding the role of pharmacists as one component of an overall solution to ease the primary care gap. When FPs were questioned regarding potential primary care roles for pharmacy, 58% responded that it was very or somewhat likely that pharmacists and pharmacy technicians will be integrated into 50% of health system–based primary care practices to improve the efficiency and job satisfaction of primary care providers. As well, 72% responded that it was very or somewhat likely that 50% of health systems will develop centralized, remote pharmacist clinical services.

Again, the forecast highlighted a gap in preparedness. Only 63% of FPs stated that their health system, pharmacy department, or staff would be ready to respond if pharmacists and pharmacy technicians were integrated into health system–based primary care practices. Confidence was higher with respect to being prepared for the development of centralized, remote pharmacist clinical services with 76% stating they would be prepared if health systems implemented such services to support primary care physicians.


How likely is it that the following will occur, by the year 2029, in the geographic region where you work?

Pharmacists and pharmacy technicians willl be integrated into 50% of health system-based primary care practices to improve the efficiency and job satisfaction of primary care providers.

Bar chart showing likelihood responses: 14% very likely, 44% somewhat likely, 33% somewhat unlikely, 9% very unlikely.

While 58% answered it is likely that pharmacists and pharmacy technicians will be integrated into 50% of health system-based primary care, only 63% of respondents are prepared to respond to that change.*

*Survey question on preparedness: "If the following occurs by the year 2029, how prepared is your health system, pharmacy department, or staff to respond?"

How likely is it that the following will occur, by the year 2029, in the geographic region where you work?

50% of health systems will develop centralized, remote pharmacist clinical services to provide support to primary care physicians.

Bar chart showing likelihood responses: 24% very likely, 48% somewhat likely, 24% somewhat unlikely, 4% very unlikely.

While 72% answered it is likely that 50% of health systems will develop centralized, remote pharmacist clinical services, 76% of respondents are prepared to respond to that change.*

*Survey question on preparedness: "If the following occurs by the year 2029, how prepared is your health system, pharmacy department, or staff to respond?"

Implications for manufacturers: Advancing the role of pharmacists in primary care has been shown to improve access, lower costs and reduce the burden on the primary care provider. As health system-based pharmacy practice continues to evolve, manufacturers should be prepared to engage differently with health system pharmacists. Increased primary care involvement means pharmacists should be viewed as potential brand advocates who can significantly influence patient care decisions. Manufacturers can leverage pharmacists to streamline and enhance the access experience for the health system and the patient. Manufacturers can empower health system pharmacists to embrace their expanding primary care role and optimize the brand experience through the provision of practice-specific and product-specific education and training.
 

Conclusion

For many health systems, the annual ASHP/ASHP Foundation Pharmacy Forecast is an essential companion to promote strategic thinking, discussion and planning. The new perspectives and emerging trends identified in the 2025 Pharmacy Forecast can prompt and guide proactive action by health system pharmacy leaders and pharmacists. Manufacturers can utilize the forecast to proactively identify opportunities to activate health system pharmacists as emerging influencers of brand awareness, engagement and adherence.

If you have any questions or would like to discuss this topic further, please contact hello@mosaic-mm.com.

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