Four Things We Learned at the Inneo Alliance Pharmacy Forum

Last week, the Inneo Alliance gathered pharmacy leaders from a number of health systems to discuss and compare notes on what’s working, breaking, and emerging in today’s rapidly shifting pharmacy landscape.

Out of that discussion, four trends that will shape the future of pharmacy rose to the top.

Specialty Pharmacy as a Growth Strategy

Specialty pharmacy is no longer an add-on service. It is a central growth engine and margin strategy.

By streamlining the patient experience vis-a-vis prior authorization and delivery of high-cost specialty prescriptions, some health systems are seeing success in capturing pharmacy revenue that would normally head out the door.

Additionally, pharmacy programs that make the effort to provide point-of-care access to limited access drugs have been shown to make a major difference in driving significant growth.

Health Systems Are Reclaiming PBM Control

Several pharmacy leaders noted that they were steering their systems away from traditional, opaque PBM arrangements and towards greater internal control. In essence, these pharmacy departments are taking steps to design benefits that better support the real-world needs of their patient populations and, in doing so, are finding opportunities to reduce their own plan costs.

In at least one case, these changes have resulted in a double-digit per-member-per-month spend reduction.

AI Is Transforming Prior Authorization

The amount of time spent on prior authorization has long been a pain point, but a new slate of AI-powered tools are starting to show significant time savings. One health system reported cutting their time spent from 30-45 minutes down to about 5 minutes.

Another system has begun to leverage generative AI tools to write appeal letters significantly more quickly, cutting down a process that can potentially take over an hour down to a matter of minutes.

Thoughtful governance and human oversight still matter, and compliance looks different state-by-state, but pharmacy may be one of the most immediately practical and high-ROI applications of AI in healthcare today.

Integration & Technology Consolidation Are Accelerating

A number of the systems present discussed their reasoning behind transitioning to Epic Willow Ambulatory and consolidating under a unified Epic ecosystem .

Leaders described dismantling years of “Frankenstein” bolt-on systems in favor of integrated workflows that unify:

• Retail

• Specialty

• Home infusion

• Inventory

• Patient engagement

The ultimate goals of this move towards a streamlined software stack are to improve visibility, strengthen provider integration, increase capture rates, and reduce operational friction.

Interested in transforming your pharmacy operations?

Pharmacy is evolving from an operational department into an enterprise-level strategy function. The most successful pharmacy departments are proactively adjusting their strategy to lead from the front, rather than simply reacting to industry pressures.

If you’re interested in getting more out of your pharmacy department, the Inneo Alliance can help, reach out to our team of experts at alliance@inneo.health.