Summary

As of August 26, 2026, there are 192 drug shortages according to the American Society of Health-System Pharmacists (ASHP). This is up slightly from 187 on May 20.

Drug shortages have been lasting longer and longer of late. In 2025, the average length of a drug shortage was 5.3 years while it was 4.3 years in 2024. In 2019, the average length was about 2 years.

What drugs are currently in shortage?

Some drugs that went into shortage in July and August include:

1. Tocilizumab-aazg injection, which treats moderate to severe rheumatoid arthritis
2. Calcitriol injection, which prevents and treats low calcium levels in people with kidney disease
3. Adalimumab-ryvk subcutaneous injection, which treats the symptoms of and prevents the progression of moderate to severe rheumatoid arthritis
4. Iodixanol injection, which is used to help find or diagnose problems in the brain, heart, head, blood vessels, kidney, bladder, and other body parts
5. Methohexital injection, which causes drowsiness before and after a procedure
6. Rifampin injection, which is used with other medicines to treat tuberculosis infections in many parts of the body
7. Pegfilgrastim-bmez injection, which is used to treat neutropenia caused by cancer medications
8. Terbutaline sulfate injection, which is used to prevent bronchospasm in people age 12 and up with asthma, bronchitis, emphysema, and other lung diseases
9. Sufentanil injection, which is used to relieve pain during and after surgery or other medical procedures
10. Pentostatin injection, which is used to treat hairy cell leukemia
11. Tuberculin intradermal injection, which is used to help diagnose tuberculosis in people at increased risk of developing active disease
12. Iopamidol injection, which is a contrast agent used in procedures like CT scans and x-rays

Additionally, many drugs are being discontinued. The number of discontinuations went up 60% to 170 in 2025 from 106 in 2024. That is the highest level of discontinued drugs since 2019. The reasons for discontinuation vary. Reyvow™ (lasmiditan), a migraine medicine, was discontinued early this year. The reasons for the discontinuation include post-marketing requirements, changes in the migraine treatment market, and availability of other therapies. Vizimpro® (dacomitinib), which treats metastatic non-small cell lung cancer, has been discontinued because oncologists preferred other drugs. Emtriva® (emtricitabine), an antiretroviral used to treat HIV, was discontinued in June because combination therapies have been replacing single agents.

What drug classes remain in shortage?

Data shows that medicines for the central nervous system have the most active shortages. This is followed by antimicrobial medicines in second place. Chemotherapy and hormonal agents are tied for third with the most shortages. Controlled substances make up 16% of current shortages. Contrast agents that are used for CTs and MRIs make up 10% of new shortages this year.

Additionally, several generic chemotherapy drugs are in shortage, including ifosfamide, carboplastin, cisplatin, and  oxaliplatin. Cisplatin and carboplatin are often prescribed for patients with ovarian, bladder, breast, lung, and other cancers. Ifosfamide treats various cancers like sarcomas, lymphomas, and testicular cancer.

In June 2026, hospital fill rates were 66% for cisplatin and 37% for ifosfamide. A fill rate under 80% is considered problematic. Some doses of ifosfamide are expected to become available this month while other doses are expected to become available in October.  In the meantime, doctors have sometimes had to make decisions about who gets ifosfamide and who does not. Various reasons are behind these particular shortages including supply issues, shipping delays, manufacturing issues, and corporate decisions.

Pediatric hospitals are also experiencing drug shortages. These hospitals face 25% more shortages than other facilities.

Two medications to treat Pompe disease, a genetic glycogen storage disease, recently went into shortage because of manufacturing and quality control issues. The two drugs are Myozyme® and Nexviazyme®.

Shortages for menopause medicines have also become an issue this year. According to a recent study, use of hormone therapy went from 1.7% in January 2017 to 3.6% in April 2026. More women have been  requesting these medications after a black box warning label for medicines containing estrogen was removed in late 2025.

Some shortages have been going on for long periods of time. About 13 drugs have been in shortage since 2015, one drug since 2016, and seven drugs since 2017, according to ASHP. Additionally, 19 drugs have been in shortage since 2022 and 35 since 2023.

How are local and world events impacting drug shortages?

In April 2026, the White House announced a tariff framework for certain patented imported medications and some active pharmaceutical ingredients (APIs). In July 2026, the White House announced tariffs on generics. These tariffs became effective on August 1, starting at 0% for two years, 100% for one year, and 200% from then on. Branded drugs generally have enough margin to absorb the costs. But generic manufacturers operate on thin margins. There are concerns that some generic medications could become unprofitable to produce and get taken off the market.

The U.S. conflict with Iran disrupted two critical pharmaceutical logistics corridors this year,  the Strait of Hormuz and major Gulf air cargo hubs. This drove up shipping costs and transit times for ingredients moving from India and other manufacturing hubs. These events show how exposed the generic drug supply chain is to disruptions in transit, even when domestic manufacturing isn’t directly affected.

The API Innovation Center (APIIC), founded in 2021 in St. Louis, is a nonprofit corporation and public benefit organization backed by research and dedicated to ensuring a stable, U.S.-based supply of APIs to strengthen national health security. Earlier this year, APIIC released a white paper that discussed a way  to secure the generic drug supply chain in the United States. In the paper, APIIC’s National Fragility Index (NFI)  was proposed. The NFI is designed to quantify supply chain risk and determine where the most vulnerabilities are. The NFI scores medications on factors like geographic concentration and purchasing behaviors with the goal of giving manufacturers, procurement teams, and policymakers insight into the market and where diversification or investment could help. The goal is to prevent shortages before they start.

Drug shortage outlook for rest of 2026

Several factors may affect drug supply through the fourth quarter of 2026. Coordinated action among manufacturers, healthcare providers, and government remains key to managing drug shortages. Shortage trends change from quarter to quarter, so staying informed going into the fourth quarter is important.

The July 2026 generics tariff framework is still working through the supply chain. Continued disruption through the Strait of Hormuz and Gulf air cargo corridors could keep transit times and shipping costs high for API imports. This could especially affect generic sterile injectables and oncology drugs. New shortages and long-term supply gaps show that the supply system can be fragile.

Coordinated action among manufacturers, healthcare providers, and government remains central to managing drug shortages. Shortage trends shift from quarter to quarter, so staying informed going into the fourth quarter of the year is important.

VytlOne actively monitors drug shortages and proactively identifies alternatives to reduce patient impact.

 VytlOne uses AI responsibly and ethically in support of our editorial work. AI tools may assist with idea generation, outlining, drafting, and editing across a range of materials. All content – regardless of whether AI assists in its creation – is reviewed by marketing, clinical, and legal teams and governed by our editorial standards.

By Joel Wright, President, Pharmacy Services, VytlOne

Summary

Most health systems capture only a fraction of the 340B savings they are eligible for. The gap hides in eligibility screening, contract pharmacy management, and split billing, where manual processes and legacy tools miss cases that a modern 340B program would catch. Specialty pharmacy usually holds the largest uncaptured opportunity. The savings are rarely lost to carelessness. They are lost to a lack of visibility.

Expectations vs. reality

Ask most health system CEOs and CFOs how they think about pharmacy, and you will usually get one of two answers: it is a clinical department, or it is a cost center to manage carefully. Both are true as far as they go. But they miss the bigger picture.

Pharmacy, particularly 340B and specialty pharmacy, is one of the largest untapped revenue engines most systems have.

That is not a knock on anyone running these programs. The people managing 340B and specialty pharmacy today are capable, careful, and stretched thin. The real issue is that eligibility screening, manufacturer restrictions, contract pharmacy complexity, and split billing have grown far more complicated than the manual processes and legacy tools most systems still rely on.

It is not a talent gap. It is a tools gap.

How much 340B revenue are most health systems missing?

The 340B program represents billions in savings for eligible health systems, yet the average system captures only a fraction of what it is entitled to. In hundreds of gap analyses, we have found meaningful uncaptured savings in nearly every one we have run. The question usually is not whether the gap exists. It is how large it turns out to be.

Specialty pharmacy is where that gap, and the dollars, tend to concentrate. Complex therapies, oncology, rare disease, and transplants, are exactly where eligible patients slip through manual screening, and a well-run specialty pharmacy program at a 340B hospital can generate up to six times more revenue per prescription than a retail program. Most C-suites haven’t had that number put in front of them plainly. It deserves to be.

What closing the 340B gap looks like in practice

One system we work with, an 800-bed multi-campus health system, recognized $25 million in net new profit in its first year working with us. We are now tracking toward $50 million as we expand into additional service lines and pharmacy operations. That is not a hypothetical upside. It is what happens when a health system gets the visibility and infrastructure to capture what the program was always supposed to provide.

Closing that gap is the focus of our 340B optimization work, where the goal is simple: capture what the program was designed to deliver, and keep capturing it as the rules shift.

A financial shift worth your attention

The 340B rebate model pilot scheduled to take effect January 1, 2027 is a shift that belongs on your balance sheet, not off to the side in pharmacy. It is still moving, drawing active litigation and competing legislation, so the details may change. What does not change is the direction: more scrutiny, more complexity, and less room for a program you set up once and left alone.

Most executives have not had a real conversation yet about what it means for their organization. Not because they are not paying attention, but because so much else is competing for that attention right now.

Manufacturer restrictions, regulatory changes, and contract pharmacy rules are all moving at once. Systems that set up their 340B program once and left it alone are often surprised, years later, by how much savings quietly eroded.

Why the 340B gap is usually a data problem

When a pharmacy director says the program is performing well and the CFO is not so sure, that is rarely a disagreement about pharmacy. It is a visibility problem because no one has had the tools to see it clearly. The same visibility gap shows up across the system, which is why AI-driven pharmacy analytics has become a priority for health system leadership. Health systems fight hard for every dollar of payer reimbursement, then leave 340B savings unclaimed on the other side of the ledger, not out of carelessness, but because no one has had the tools to see it clearly. Recognizing $5 million a year in savings for a 500-bed hospital has leaders feeling good about the program. Learning it should be $19 to $22 million annually puts it in a different light. “Performing well” has to be measured against the potential to be meaningful.

This is the problem VytlAIQ was built to solve. Not a reporting layer bolted onto existing processes, but a platform built by people who have run these programs at scale and know exactly where the gaps hide. It does not replace your pharmacy team. It gives them the visibility and speed to stay ahead of an environment that manual processes were never built to handle. Using AI this way responsibly matters as much as using it at all, which is why we hold our 340B tools to the standards laid out in responsible AI in 340B.

The strongest 340B programs I have seen have one thing in common: the CFO and the pharmacy director are looking at the same numbers, in the same room, at the same time. That alignment is rarer than it should be, but when it happens, the results are not incremental.

How to know if your 340B program is capturing enough

Your pharmacy program is either funding your mission or quietly limiting it. There is not much middle ground. Within a reasonable range, we can usually tell you what a health system your size should be capturing from 340B, and what most systems your size actually capture. The gap between those two numbers is usually where the conversation gets interesting.

If you have not had that conversation yet, now is a good time to start. The environment is not getting simpler, and the systems that get ahead of it are the ones that stop treating pharmacy as a cost to manage and start treating it as the asset it is.

Key takeaways

• Most health systems capture only a fraction of the 340B savings they are eligible for. The gap is a tools problem, not a talent problem.
• Specialty pharmacy holds the largest uncaptured opportunity, up to six times more revenue per prescription than a retail program.
• The 340B rebate model change expected in January 2027 makes this a balance-sheet priority, not a back-office one.
• The core barrier is visibility. When the CFO and pharmacy director see the same numbers, the results are not incremental.

Frequently asked questions

How much 340B revenue do most health systems miss?

Most capture only a fraction of what they are eligible for. In hundreds of gap analyses, we have found meaningful uncaptured savings in nearly every one. For a 500-bed hospital, a program recognizing $5 million a year in savings should often be capturing $19 to $22 million. The uncaptured dollars concentrate in specialty pharmacy and in eligibility cases that manual screening misses.

Why do health systems leave 340B savings unclaimed?

Not through carelessness. Eligibility screening, manufacturer restrictions, contract pharmacy complexity, and split billing have outgrown the manual processes most systems still use. The savings are left on the table because teams have not had the tools to see them clearly.

How does specialty pharmacy affect 340B revenue?

Specialty pharmacy is where the largest uncaptured savings concentrate. Complex therapies in oncology, rare disease, and transplant are where eligible patients slip through manual screening, and a well-run specialty program at a 340B hospital can generate up to six times more revenue per prescription than a retail one.

Compare what a system of your size should be capturing against what it actually captures. That gap, sized through a 340B optimization review, is the clearest signal of whether a program is performing or just appearing to.

Learn more

Visit VytlAIQ to see what your 340B program should be capturing.

Joel Wright is a registered pharmacist and the President of Pharmacy Services at VytlOne. He has over 30 years of healthcare experience across retail operations, specialty pharmacy, managed pharmacy, health system and center pharmacy operations, and home infusion. Joel is dedicated to patient care, improving patient outcomes, and optimizing healthcare processes through innovation. 

How VytlAIQ turns pharmacy data into decisions

By Heather Brooks, Vice President, Pharmacy Services Products, VytlOne

How does AI improve pharmacy analytics for health systems? AI connects the data scattered across a health system’s pharmacy programs, from EMRs, third-party administrators, dispensing systems, and patient management platforms to 340B platforms, and normalizes it into one continuously updated view. That lets leaders see performance in real time, catch problems early, spot missed 340B and specialty opportunities, and make strategic decisions from clean data instead of manual reports. VytlAIQ is VytlOne’s AI-powered intelligence platform built to do exactly this for 340B, outpatient retail, specialty, and clinic-owned pharmacy programs.

Health system leaders overseeing 340B programs and outpatient pharmacy operations are managing some of the most complex, data-intensive work in healthcare. They are responsible for seeing that 340B savings flow back to the communities they serve, that outpatient retail and specialty pharmacies are retaining patients, and that clinic-owned pharmacy programs are reaching their full potential. The challenge has never been the availability of data. It has always been the ability to make sense of it quickly enough to act. VytlAIQ gives leaders real-time analytics, predictive insights, and decision-support tools built for exactly that complexity.

The five ways at a glance

• AI unifies data from every pharmacy system into one real-time view.
• AI catches performance signals early, while they are still easy to fix.
• AI surfaces missed 340B, retail, and specialty opportunities.
• AI flags patient leakage before a patient is lost.
• AI supports strategic decisions with clean, interpreted data.

1. AI brings all your pharmacy program data into one platform

Meaningful insight starts with complete data, and for health system pharmacy programs, that data lives in many places at once. A common frustration among pharmacy leaders is how long it takes to get a clear, reliable picture of program performance. Reports are often built manually, arrive on a lag, and require significant interpretation before they can inform a decision. Electronic medical records, third-party administrators, pharmacy dispensing systems, patient management platforms, and 340B platforms each hold a piece of the picture. Without a way to connect them, leaders make decisions on partial information or spend hours manually pulling data before analysis can begin.

VytlAIQ was built to solve that at the foundation. The platform ingests data from all of these source systems, normalizes it, and presents it through a single access point designed for health system pharmacy leadership. Rather than navigating multiple reports from multiple systems, leaders log into one platform and see a unified view of how their 340B, outpatient retail, and specialty pharmacy programs are performing. Because the data is consolidated and continuously updated, the dashboards reflect what is happening now, not what was happening when the last report ran. When something needs attention, it is visible. When programs are on track, that is visible too. The result is a leadership team that spends less time gathering data and more time acting on it.

2. AI turns data signals into early action

In health system pharmacy, the difference between a manageable issue and a major operational problem often comes down to timing. By the time a downward trend appears in a monthly report, the window for easy correction has usually passed. VytlAIQ closes that gap by identifying signals in the data early, while there is still time to act without disruption.

The platform continuously monitors performance indicators across all pharmacy program types, looking for patterns that precede problems rather than documenting them after the fact. A gradual decline in 340B-eligible prescription capture, a slowdown in specialty therapy starts, or a dip in refill adherence at a clinic-owned location are all conditions VytlAIQ can surface before they register as a trend leadership has to explain. When those signals appear, the platform brings them forward with enough context to understand what is happening, where, and what options exist to address it.

That early visibility changes how leadership teams operate. Rather than reacting to performance problems after the fact, they are positioned to make small, targeted adjustments that keep programs on track. Over time, that shift from reactive to proactive management has a meaningful impact on program performance, patient retention, and the financial health of the programs the health system depends on.

3. AI surfaces pharmacy program opportunities you’re missing

Health systems often do not know what they are missing until the data is organized to show them. VytlAIQ uses predictive analytics to identify underutilized opportunities across all three program types: 340B-eligible prescriptions that are not being captured, patients who miss the chance to fill at the health system retail pharmacy, and specialty therapy candidates being referred out of network.

For example, a health system may have a strong oncology program but route specialty patients to an external partner by default rather than capturing them in its own specialty pharmacy. VytlAIQ can identify that pattern, quantify the financial and clinical impact, and help leadership make the case for an operational change. These are not hypothetical opportunities. They are real gaps that exist in most health system pharmacy programs and are difficult to see without the right analytical lens.

4. AI spots patient leakage before it becomes a loss

Patient leakage occurs when a patient fills a prescription outside the health system’s pharmacy network. It is one of the most persistent and costly challenges pharmacy leaders face, and historically, identifying it required manual data pulls and retrospective analysis that arrived too late to act on.

VytlAIQ changes that by continuously analyzing patient prescription activity across 340B, outpatient retail, and specialty programs, identifying patterns that signal leakage risk before a patient is lost. For example, a patient discharged from a health system clinic who has not filled a follow-up prescription within an expected window can be flagged automatically, giving the care and pharmacy team a chance to re-engage. For 340B programs specifically, every prescription that leaves the network is a missed opportunity to capture savings that fund critical patient services.

5. AI supports better decisions about your pharmacy programs’ future

The most valuable use of AI in health system pharmacy is not describing what has happened. It is helping leadership decide what comes next. VytlAIQ combines historical performance data, predictive modeling, and the ability to ask the platform a direct question, giving leaders the context to think strategically about their programs. For 340B leaders, that means assessment and planning supported by visibility into program compliance, savings generation, eligible prescription capture rates, and change risk modeling. For outpatient retail and specialty programs, it means fill rates, patient leakage, adherence benchmarks, and revenue performance, plus the unique attributes affecting each.

Whether a health system is evaluating whether to expand its retail pharmacy reach, change its 340B program structure, or invest in specialty pharmacy growth, those decisions benefit from clean, organized, AI-interpreted data. VytlAIQ is designed to meet health system leaders wherever they are, whether managing day-to-day operations or planning three years out.

The future of health system pharmacy is one where AI handles the complexity of data aggregation and pattern recognition, freeing health system, pharmacy, and operational leaders to focus on what only people can do: building relationships, driving strategy, and delivering better outcomes for patients.

Frequently asked questions

What is pharmacy analytics?

Pharmacy analytics is the practice of collecting and interpreting data across a health system’s pharmacy programs, including 340B, outpatient retail, specialty, and clinic-owned, to measure performance, catch risks early, and guide decisions. AI platforms like VytlAIQ consolidate that data into one real-time view.

How does AI help manage 340B programs?

AI connects 340B platform data with dispensing and patient records to track eligible prescription capture, savings generation, and compliance, and to flag leakage and missed capture before savings are lost.

What is patient leakage in health system pharmacy?

Patient leakage is when a patient fills a prescription outside the health system’s own pharmacy network. AI can flag leakage risk early, for example when a discharged patient has not filled a follow-up prescription, so teams can re-engage.

What is VytlAIQ?

VytlAIQ is VytlOne’s AI-powered pharmacy intelligence platform for health system leadership. It unifies data across 340B, outpatient retail, specialty, and clinic-owned pharmacy programs to deliver real-time analytics, predictive insights, and decision support.

See VytlAIQ in action

Health system pharmacy programs are sitting on data that could be driving better decisions today. VytlAIQ was built to unlock that potential across 340B, outpatient retail, specialty, and clinic-owned pharmacy programs in one integrated platform.

Request a demo and see how VytlAIQ gives health system pharmacy leadership the insight to move forward with confidence.

Heather Brooks is a pharmacist and the Vice President of Pharmacy Services Products at VytlOne. She has over 30 years of experience across retail pharmacy, hospital pharmacy, and pharmacy operations. As a pharmacist, Heather believes in AI as a partner in healthcare, working alongside professional judgment. As an operational leader, she’s focused on what that partnership makes possible: leaner processes, faster throughput, and better use of every dollar and every hour.

What is a pharmacy desert?

A pharmacy desert is an area where residents lack reasonable access to a local pharmacy. Usually, this means when residents must travel long distances (over 10 miles) to get to the closest pharmacy. Currently, over 48 million Americans live in pharmacy deserts, which equates to about one in every seven people. Rural residents, low-income communities, and communities of color are most at risk of living in a pharmacy desert.

Why does this matter?

Lack of access to pharmacies can have downstream effects, like poor medication adherence, problems managing chronic diseases, and less access to preventive care.

Pharmacy deserts by the numbers

• 48 million Americans (about one in seven) live in a pharmacy desert. (GoodRx)
• Over 10 miles to the nearest pharmacy is a common threshold that defines a desert. (Ohio State University College of Pharmacy)
• About one in three US pharmacies closed between 2010 and 2021. (USC Schaeffer Center / Health Affairs)
• Pharmacy counts fell in 41 states between 2018 and 2021. (USC Schaeffer Center)
• $5 million-plus was awarded by Oregon in July 2026 for prescription lockers, delivery, and telepharmacy. (Oregon Health Authority, via KBOI)

Pharmacy closures and bankruptcies

Pharmacies have been closing at an increasing rate over the past 15 years. According to research from the University of Southern California, about one in three pharmacies closed between 2010 and 2021. In 41 states, the number of pharmacies went down between 2018 and 2021. Among the pharmacy bankruptcies last year were Rite Aid and Partners Pharmacy Services.

What’s going on around the U.S.?

In Kapa’au, Hawaii, a rural town with a population of about 7,000, the only pharmacy for many miles recently closed. Prescriptions were transferred to a pharmacy in Waimea, about 20 miles away. Kapa’au’s population is primarily made up of residents over age 60, and many have trouble getting to Waimea.

In November 2025, in Gualala, California, the only pharmacy along 60 miles of coastline shut down. Now some residents must travel more than 90 minutes to get prescriptions.

In one neighborhood on the south side of Chicago, a drugstore recently closed, creating a pharmacy desert for those living in the area.

Are there options?

A recent article in AJMC suggested that hospital specialty pharmacies could help with the issues caused by pharmacy deserts. Sometimes hospital pharmacies are the last stable healthcare option in a community and can provide access when needed. They can provide comprehensive care and have experts overseeing medication management. And having a 340B program can increase access, services, and programs that could significantly help patients and their communities.

Learn more about how VytlOne’s 340B pharmacy programs expand access, services, and savings for the communities that need them most.

What should we keep an eye on?

In July 2026, the Oregon Health Authority gave the Pharmacy Foundation of Oregon over $5 million to bring secure prescription lockers, staffed prescription delivery, and telepharmacy services to certain communities in the state, like rural and frontier ones.

Frequently asked questions

What is a pharmacy desert?

A pharmacy desert is an area where residents lack reasonable access to a local pharmacy, usually defined as living more than 10 miles from the nearest one, or shorter distances in dense urban areas without a vehicle. About 48 million Americans, roughly one in seven, live in a pharmacy desert. Rural residents, low-income communities, and communities of color are most affected. The distance matters because it drives poorer medication adherence, harder chronic-disease management, and less access to preventive care.

How many Americans live in pharmacy deserts?

About 48 million Americans, roughly one in seven people, live in a pharmacy desert, according to GoodRx research. The burden is not spread evenly: rural residents, low-income communities, and communities of color are the most likely to lack a nearby pharmacy. The problem is growing as pharmacies close, which pushes more neighborhoods past the distance threshold that defines a desert.

Why are pharmacies closing?

Pharmacies have closed at an increasing rate over the past 15 years. University of Southern California research found that about one in three US pharmacies closed between 2010 and 2021, and the number of pharmacies fell in 41 states between 2018 and 2021. Recent bankruptcies, including Rite Aid, have added to the trend. Independent and lower-income-area pharmacies are especially vulnerable, which is a major driver of new pharmacy deserts.

How do pharmacy deserts affect health?

When people cannot easily reach a pharmacy, the downstream effects are significant: poorer medication adherence, harder management of chronic diseases like diabetes and high blood pressure, and reduced access to preventive services such as vaccinations and screenings. Older adults and people without reliable transportation are hit hardest, as recent closures in rural Hawaii and coastal California show, where some residents now travel an hour or more to fill a prescription.

How can pharmacy deserts be solved?

There is no single fix, but several approaches help. Hospital and health-system specialty pharmacies can serve as a stable access point, offering comprehensive care and expert medication management, and 340B programs can expand the services and access they provide. States are investing too: in July 2026, Oregon awarded more than $5 million for secure prescription lockers, staffed delivery, and telepharmacy in rural and frontier communities. Telepharmacy, delivery, and mapping tools that identify gaps all play a role.

Links of interest

• Pharmacy Deserts: An Update for 2026. VytlOne. February 16, 2026.
• Pharmacy Deserts in the United States: A Continuing Crisis. VytlOne. November 18, 2025.
• Too far to fill: The growing problem of pharmacy deserts in America. VytlOne. June 2, 2025.
• Pharmacy deserts: A growing problem in the U.S. VytlOne. December 2, 2024.
• Wittenauer, Rachel, et al. Locations and characteristics of pharmacy deserts in the United States: a geospatial study. Health Affairs Scholar. March 16, 2024.
• Murphy, Michael and Rodis, Jennifer. The growing crisis of pharmacy deserts. The Ohio State University College of Pharmacy. April 28, 2025.
• Our tool to help you identify pharmacy deserts across the country. National Community Pharmacists Association. April 16, 2026.

Why AI Won’t Replace Pharmacists

By Heather Brooks, Vice President, Pharmacy Services Products, VytlOne

Will AI replace pharmacists? No. In health system pharmacy, AI is augmenting the team, not replacing it. It takes on documentation, data gathering, and routine checks, while pharmacists, pharmacy technicians, and Prescription Access Liaisons (PALs) keep authority over clinical decisions, patient counseling, and care. What staff working alongside these tools describe is not replacement but relief: relief from documentation overload, from hours on hold with insurance companies, and from the mental weight of catching errors in a high-volume, high-stakes environment.

The concern is understandable. AI is moving fast, the headlines are loud, and no one wants to feel like their expertise is being automated away. But the professionals who work with AI day to day are not being pushed out. They are being freed up to do the work only a trained, caring human can do. Here are five ways AI is making that difference.

The five ways at a glance

• AI streamlines the prior authorization process for pharmacy staff.
• AI adds a second layer of error checking in high-volume dispensing.
• AI puts complete medication history at every role’s fingertips.
• AI supports clinical decisions with real-time evidence.
• AI reduces administrative burden so staff can focus on patients.

1. AI streamlines the prior authorization process for pharmacy staff

Prior authorizations (PAs) are one of the most time-consuming, frustrating parts of pharmacy work, and one of the most consequential for patients. A delayed PA can mean a delayed therapy start, a gap in critical medication, or a patient who walks away from care they need. This is especially true in health system specialty pharmacy, where PA volume is high. AI is changing the pace by pulling a patient’s medication history, diagnosis codes, clinical documentation, and payer-specific criteria into one place. That consolidation helps PALs, pharmacists, and pharmacy techs build stronger, faster PA submissions without the hours-long hunt across multiple systems.

How this works in practice

A patient arrives to pick up a newly prescribed specialty medication and learns their insurance requires a prior authorization before it can be dispensed. The PAL opens the workflow, and within minutes AI has surfaced the patient’s relevant diagnosis history, current medication list, prior therapy attempts, and the specific clinical criteria the payer requires, all without a phone call to track down records. The pharmacist reviewing the case uses that same medication history to confirm the new therapy is appropriate given what the patient already takes. The PA is submitted the same day. The patient, who expected a days-long wait, gets a call that afternoon with an update and leaves trusting the pharmacy team is in their corner.

2. AI reduces errors in high-volume dispensing

The dispensing environment in health system retail and specialty pharmacy is fast-moving and unforgiving. Medication errors, even small ones, can have serious consequences, and the cognitive load on dispensing pharmacists and pharmacy techs is significant. AI-assisted verification tools give those teams an additional layer of review that does not get tired, distracted, or have a bad day. By flagging potential drug interactions, dose discrepancies, or duplicate therapies before a medication leaves the pharmacy, AI acts as a reliable second check. The pharmacist’s judgment is not replaced. A supportive backstop helps catch what human eyes sometimes miss.

How this works in practice

A pharmacy tech is processing a high volume of prescriptions during a busy afternoon when a new order comes through for a patient already on a complex regimen. The tech prepares the medication and routes it for pharmacist verification. Before the dispensing pharmacist completes the check, the AI verification system flags a potential interaction between the new prescription and a medication the patient takes for a chronic condition, one filled at a different location that might not have been visible in the active queue. The pharmacist confirms the interaction is clinically significant and contacts the prescribing provider to discuss an alternative. The prescription is updated before it reaches the patient. What could have been a harmful outcome becomes a routine clinical intervention.

3. AI puts complete medication history at every role’s fingertips

A patient’s medication history is foundational to nearly every decision in health system pharmacy, and accessing it has historically been anything but simple. Information lives across systems, visits, and providers, and pulling a complete picture together takes time pharmacy staff often do not have. AI changes this by aggregating and presenting medication history in a structured, accessible format, and the benefit reaches every role on the team. When all roles share the same complete picture, handoffs are smoother, assessments are more thorough, and patients work with a team that knows their history.

How this works in practice

A patient is being discharged with a new prescription added during their inpatient stay. The pharmacist conducting discharge medication reconciliation needs to evaluate whether the new therapy is safe alongside the medications the patient took before admission, prescribed by specialists, a community pharmacy, and a mail-order service. Instead of piecing that history together from multiple portals and phone calls, the AI tool surfaces a consolidated medication list in seconds. The pharmacist identifies a duplication of therapy and resolves it before discharge. The patient goes home with the right medications, the right instructions, and a care team working from the same page.

4. AI clinical decision support surfaces real-time evidence

Pharmacists apply an enormous breadth of knowledge in real time: dosing adjustments based on kidney or liver function, drug interaction management, therapeutic alternatives, and formulary considerations that change with each payer. Staying current with clinical guidelines while managing an active caseload is one of the most demanding parts of the role. AI tools that surface relevant clinical evidence, guideline summaries, and decision-support prompts at the point of care reduce that cognitive load without reducing the pharmacist’s authority. The pharmacist still makes the clinical decisions, now with better, faster access to the information that supports them.

How this works in practice

A pharmacist is consulted on a patient whose new prescription requires a dose adjustment due to reduced kidney function found in recent lab work. The pharmacist needs to determine the appropriate dose, confirm there are no additional interaction concerns given the patient’s other medications, and document the recommendation. The AI clinical decision-support tool surfaces the relevant dosing guidance, flags a secondary interaction that warrants monitoring, and pulls the current guideline supporting the adjustment. The pharmacist reviews, applies clinical judgment, and delivers a recommendation to the provider in a fraction of the usual time. The patient’s therapy starts safely and on time.

5. AI reduces administrative burden so staff can focus on patients

Ask anyone in health system pharmacy what they wish they had more time for, and the answer is almost always the patient. The work that drew most pharmacy professionals to the career, counseling someone on a new medication, advocating for access to a therapy, and building the relationship that makes a patient feel cared for, is also the work most likely to get crowded out by administrative demands. AI reclaims that time by streamlining documentation, triaging routine inquiries, and handling the repetitive workflows that quietly consume hours of the day.

How this works in practice

A patient arrives to pick up a new therapy with important instructions, potential side effects, and follow-up steps to understand before leaving. Normally the dispensing pharmacist is already behind, with prescriptions queued for verification, a phone ringing at the counter, and unfinished documentation from earlier. But because AI has handled documentation consolidation for new therapies and reduced manual research on several drug-drug interactions, the pharmacist’s queue is manageable. The pharmacist has the time and bandwidth to work with the patient and make sure they understand their new medication, building trust and improving adherence.

Where this is heading

Across all five areas, AI is moving from reactive to proactive. Prior authorization is heading toward real-time eligibility checks at the point of prescribing and automated status tracking, turning a days-long process into hours. Verification is moving toward predictive risk modeling and AI-enhanced imaging that catches labeling and selection errors under real-world conditions like glare, poor lighting, and awkward angles. Medication history tools are starting to flag gaps and missing records, not just aggregate what exists. Clinical decision support is becoming proactive, surfacing guideline updates and patients due for review before anyone asks. And documentation is increasingly handled by natural language processing that turns clinical interactions into structured notes with minimal staff input. The through-line is the same: AI takes the work that can be automated so pharmacy staff can spend their time where only a human can.

The bottom line

AI in health system retail and specialty pharmacy will not replace the expertise, judgment, and compassion that pharmacy professionals bring to their work. What it can do is take on the administrative tasks that drain those qualities, the documentation and the data gathering. For pharmacists, PALs, and pharmacy techs, the promise of AI is a more supported team, not a smaller one. It is a team where errors are caught before they reach a patient, prior authorizations move faster, and information is readily available, so patient care stays front and center and the daily administrative frustrations of pharmacy practice are muted.

Frequently asked questions

Will AI replace pharmacists?

No. AI augments pharmacists rather than replacing them. It handles documentation, data gathering, and routine checks, while pharmacists keep authority over clinical decisions, counseling, and patient care.

Will AI replace pharmacy technicians?

No. AI takes on repetitive workflows like record retrieval and verification support, which frees pharmacy technicians and Prescription Access Liaisons for higher-value work rather than eliminating their roles.

Will AI take over pharmacy?

The realistic near-term picture is augmentation, not takeover. AI catches errors, speeds prior authorizations, and reduces administrative load, while trained professionals make the judgment calls patient safety depends on.

How is AI used in health system pharmacy today?

AI is used to streamline prior authorizations, add a second layer of error checking in dispensing, consolidate medication history, surface clinical evidence at the point of care, and cut administrative burden so staff can focus on patients.

See how VytlAIQ supports health system pharmacy teams.

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Heather Brooks is a pharmacist and the Vice President of Pharmacy Services Products at VytlOne. She has over 30 years of experience across retail pharmacy, hospital pharmacy, and pharmacy operations. As a pharmacist, Heather believes in AI as a partner in healthcare, working alongside professional judgment. As an operational leader, she’s focused on what that partnership makes possible: leaner processes, faster throughput, and better use of every dollar and every hour.

By Heather Brooks, Vice President, Pharmacy Services Products, VytlOne

How is AI improving the specialty pharmacy patient journey? AI is helping health system specialty pharmacies make the medication journey simpler, faster, safer, and more affordable, improving medication access at every step. It flags affordability barriers early, speeds prior authorizations, closes refill gaps, coordinates care across clinic and payer, and surfaces safety risks sooner, with pharmacists and care teams reviewing every step. The strongest results come from AI working alongside integrated clinic and pharmacy care teams and the patient.

In health system outpatient retail and specialty pharmacy, the patient journey includes coverage checks, prior authorizations (PAs), medication therapy management, refills, delivery, and human support. Below are five ways AI is improving that journey.

The five ways at a glance

• Affordability support becomes proactive instead of reactive.
• Prior authorization moves from fax-and-wait to a guided, faster submission.
• Refills and reminders close adherence gaps before they form.
• Care feels coordinated across clinic, pharmacy, and payer.
• Safety risks are flagged earlier, with humans in the loop.

1. AI makes medication affordability proactive

One of the biggest patient stressors is cost uncertainty, particularly for specialty therapies where copays can be high and assistance programs are complex. That same specialty complexity is where the 340B revenue most health systems miss tends to concentrate. In strong health system models, affordability support is already core to the care experience: identifying copay assistance, coordinating financial support, and setting expectations early. AI makes that support faster and more consistent by flagging likely affordability barriers, prioritizing who needs help first, and prompting the right assistance pathways at the right moment, before a patient abandons therapy.

How this works in practice

Marisol arrives at the pharmacy counter expecting a routine pickup. The initial copay is far higher than she expected. Instead of being told to check back, the pharmacy has proactively come up with two options: an assistance pathway and a clinically appropriate alternative to discuss with the clinic. The result is not that AI saved the day, but less panic, fewer delays, and a plan that supports her access to medication.

2. AI speeds prior authorization in specialty pharmacy

For specialty pharmacy patients, delays in prior authorization mean delays in therapy. PAs can take several days and sometimes longer, which is why time to therapy shows up as a top metric in specialty pharmacy performance. AI helps by drafting payer questionnaire responses, extracting relevant clinical evidence, and reducing the time staff spend rekeying information. AI can reduce work time per authorization from as much as 25 minutes to about five minutes, and submissions can go in about a day earlier.

How this works in practice

Darryl is prescribed a new, high-cost injectable after a flare-up. Historically, starting this drug takes weeks. VytlOne’s Prescription Access Liaisons can use AI-assisted drafting of the PA, shortening the time between prescribed and in hand. The pharmacist reviews for accuracy, and the request goes out sooner. The patient sees the care plan moving forward instead of stuck in paperwork.

3. AI closes refill gaps and improves medication adherence

Nonadherence often is not dramatic. It is small gaps: a refill missed during a busy week, a pickup delayed, a message forgotten. Digital reminders and nudges, especially text-based ones, are patient-friendly, scalable ways to reduce refill gaps, one of several medication adherence solutions AI makes smarter. AI makes this smarter by timing outreach based on behavior patterns, channel preference, and risk signals rather than a fixed day 28 text, and it does so without burying pharmacy staff in manual calls.

How this works in practice

Sam manages diabetes medications, blood pressure medications, and a statin, along with work and family. An AI-supported refill program notices a refill gap forming, sends a gentle nudge, and offers a quick deliver-or-pickup option. Sam stays on track without spending 30 minutes on hold.

4. AI coordinates care across clinic, pharmacy, and payer

Patients often experience the system as fragmented: the clinic says one thing, the payer says another, and the pharmacy is left translating. VytlOne’s health system specialty pharmacy models emphasize coordination by embedding Prescription Access Liaisons in provider offices, which allows for consistent updates and fewer dropped handoffs. AI improves coordination by acting like a workflow air traffic controller: routing tasks, flagging missing information, and keeping statuses visible so the next best action is obvious to the team, the same shift toward action that AI-driven pharmacy analytics brings to health system leadership. That visibility and orchestration turns a chaotic journey into a predictable one.

How this works in practice

The prescriber tells Nina the pharmacy will have her prescription ready. Instead of arriving to learn the prescription must be changed to the insurance formulary product, Nina gets predictable updates: benefits verified, PA submitted or alternates discussed with the prescriber, assistance in progress, delivery scheduled. Her journey from prescriber to medication in hand is handled with white-glove service.

5. AI flags medication safety risks earlier, with humans in the loop

Medication safety is not just dispensing accuracy. It also includes duplicate therapies, wrong-dose risks, and missed clinical signals. AI can flag potential problems early, and the critical design point is human review, which allows for proactive discussions among the prescriber, pharmacist, and patient.

How this works in practice

George has a medication change after a hospitalization. The system flags a possible duplication risk with a home medication. The pharmacist confirms with George that he has the duplicate at home, and the final regimen accounts for it while avoiding duplicative therapy. George feels someone is paying attention, and his confidence in his care team rises.

Where this is heading

Across all five areas, AI is shifting specialty pharmacy from reactive to anticipatory. Expect affordability support to move closer to real time, predicting cost barriers before a prescription is finalized. Prior authorization is trending toward proactive readiness, with AI predicting friction and helping teams build the approval packet upfront. Refill support is becoming anticipatory, catching insurance changes and shipment constraints before they become emergencies. Coordination is getting more structured, and safety is moving toward continuous medication surveillance that points pharmacists to the highest risk first.

A better experience, because the basics work better

Health system outpatient retail and specialty pharmacies are already positioned differently: closer to the clinic, connected to the care plan, and built to support medication access end to end. Used well, AI strengthens this model. Cost conversations happen earlier, authorizations move with fewer delays, refills do not slip into gaps, and safety risks are flagged sooner. The patient journey becomes more predictable and supported, and pharmacy teams get more time back for counseling and problem-solving instead of paperwork.