A Defining Moment for Health System Pharmacy: Advancing Competency, Policy, and Patient Need in 2026

To reach Dr Camejo or learn more, email MadelineCa@baptisthealth.net.

As we begin 2026, health system pharmacy enters a moment of real transformation. Therapeutic complexity is rising, public health needs are changing, scientific discovery is accelerating, and pharmacists are increasingly relied upon as essential sources of clinical judgment and operational consistency. Patients, clinicians, and health systems depend on pharmacists not only to dispense medications but also to interpret evolving evidence, anticipate risks, and design care processes that support better outcomes at scale.

This issue highlights several areas where the profession is already leading. The stewardship of glucagon-like peptide-1 (GLP-1) therapies, the management of acute migraine, new cardiovascular standards, improved identification of primary aldosteronism, and the safety considerations around biologics and immunomodulators all demonstrate how deeply pharmacists are embedded in the most complex corners of modern care. These topics reflect a broader truth: The influence of health system pharmacists now extends across nearly every major therapeutic area.

Regulatory and operational systems often lag current practices. Reviews of vaccine policy and state-level scope variation show that evidence often advances faster than the systems designed to support it. This misalignment contributes to variable access, fragmented implementation, and preventable gaps in care. Pharmacists could help address these gaps, but they need adequate authority, training, and infrastructure.

A Federal Milestone and What It Signals

One development this year deserves particular attention. For the first time, the American Pharmacists Association and Accreditation Council for Pharmacy Education have been written into US legislation as authorized providers of the US Drug Enforcement Administration–recognized training required for pharmacists who prescribe buprenorphine in states that permit it. This simple legislative change closes a long-standing training barrier and sends a clear message about the federal view of pharmacists as clinical partners in addressing national health challenges.¹

Although the update directly affects opioid use disorder care, its meaning is larger. It demonstrates federal willingness to recognize pharmacist competency, expand trusted training pathways, and incorporate pharmacy more fully into future models of prevention, chronic disease management, and primary care access. For health systems, it provides a foundation to strengthen medication-assisted treatment programs and support safer transitions across care settings.¹

Where Pharmacists Are Redefining Care

Pharmacists’ expanding responsibilities can be seen most clearly in clinical areas that demand careful, evidence-based decisions. Guiding the use of GLP-1 therapies has become increasingly important as these drugs are now used not only for diabetes but also for obesity and heart-related metabolic conditions. Today, pharmacists oversee starting and adjusting these medicines, watch for adverse effects, encourage patients to stick with treatment, help resolve supply problems, and offer advice on what to expect over the long term.²

Naloxone (Narcan; Emergent BioSolutions) counseling remains a critical touchpoint in overdose prevention. Pharmacists help patients, caregivers, and community partners understand administration, recognition of overdose, follow-up care, and the importance of linking to treatment rather than relying on rescue alone. Interactions between supplements and biologic therapies or disease-modifying antirheumatic drugs represent another growing area of risk. Pharmacists are often the first to identify combinations that may alter immune response, impair hepatic metabolism, or reduce therapeutic effect.^3,4

Pharmacists are also central to applying updated cardiology guidance. From lipid management and hypertension intensification to heart failure optimization and evaluation of endocrine-driven hypertension, pharmacists help standardize treatment and ensure guideline-directed therapy is carried out reliably across care teams.^5,6

Proof of Concept in Real Clinical Practice

Health system pharmacists have already demonstrated what is possible. Over the past decade, pharmacist-led programs in antimicrobial stewardship, medication reconciliation, heart failure management, chronic disease clinics, and now GLP-1 optimization have shown consistent and measurable improvements in safety, efficiency, and clinical outcomes. Variability narrows, adherence to evidence strengthens, and health systems perform better. These results are not just abstract. They are operating today in hospitals and clinics across the country. They make a strong case for expanding pharmacist involvement wherever care complexity is rising.

Doing More With Less, but With Greater Precision

Health systems continue to navigate workforce shortages, high costs, and increasing clinical demands. Simply asking teams to absorb more is not sustainable—the path forward requires precision and innovation. Technology is now essential to that equation. Artificial intelligence–supported clinical decision tools, risk stratification models, automated medication systems, and integrated communication platforms allow pharmacists to shift their time toward higher-value work, including direct patient support, therapy optimization, collaborative care, and prevention-focused services.

But technology alone is not enough. Progress depends on clear policy pathways and reimbursement structures that recognize the broad clinical value pharmacists provide. Pharmacists must lead these discussions in 2026.

2026: A Year to Lead, Not React

Federal recognition, therapeutic innovation, and operational pressures all point toward the same conclusion. Pharmacists are emerging as central architects of modern patient care, shaping how therapy is delivered and how health systems function. Our responsibility is to align policy with evidence, build scalable models of care, strengthen pharmacist involvement across every stage of the patient journey, and prepare teams for the decade ahead. A sustainable future cannot be left to hope. It requires deliberate action, strong professional advocacy, and a commitment to advancing our role in patient care.

As the profession continues to evolve, it is the insight, innovation, and leadership of health system pharmacists that will define the care models of tomorrow. This is not a year to react to change; this is a year to lead with conviction.

REFERENCES

1. APhA secures key congressional win allowing pharmacists to prescribe buprenorphine with specialized training. American Pharmacists Association. December 2, 2025. Accessed December 11, 2025. https://www.pharmacist.com/APhA-Press-Releases/apha-secures-key-congressional-win-allowing-pharmacists-to-prescribe-buprenorphine-with-specialized-training

2. Miller K, Carson E, Boothe K, Brown B. Implementation and evaluation of a pharmacist-led glucagon-like peptide-1 receptor agonist titration service in two primary care clinics. J Am Pharm Assoc (2003). 2025;65(3):102385. doi:10.1016/j.japh.2025.102385

3. Overdose prevention. CDC. Accessed December 11, 2025. https://www.cdc.gov/overdose-prevention/index.html

4. Dietary supplement fact sheets. National Institutes of Health Office of Dietary Supplements. Accessed December 11, 2025. https://ods.od.nih.gov/factsheets/list-all

5. Guidelines and clinical policy. American College of Cardiology. Accessed December 11, 2025. https://www.acc.org/guidelines

6. Primary Aldosteronism Foundation. Accessed December 11, 2025. https://www.primaryaldosteronism.org