Pharmacy Is at the Center of Reform Research and Emerging Therapies

This issue of Pharmacy Practice in Focus: Health Systems explores several of the most pressing forces shaping pharmacy practice today, from rising prescription drug costs and workforce equity to the rapidly evolving science of obesity care. Through in-depth features and peer-reviewed research, it highlights the expanding role of pharmacists in navigating pharmacy benefit manager (PBM) reform, advancing mentorship and scholarship, and translating emerging therapies into safe, accessible, and patient-centered care.

The cover feature discusses how prescription drug spending continues to strain US health systems, and PBMs play a major role in how medications are priced, reimbursed, and accessed. As federal and state PBM reform efforts grow, health-system pharmacists are increasingly positioned to support solutions through formulary leadership, data analysis, contract evaluation, and advocacy to protect both affordability and patient care.

One of this issue’s peer-reviewed pieces highlights female authorship in pharmacy journals. Although the prevalence of female authorship in the 10 highest-impact pharmacy journals exceeds the representation of women in the pharmacy, medical, and pharmaceutical science workforces, a disparity still remains between first and senior female authorship, underlining concerns about career advancement and research progression. The authors’ findings show limited collaboration between female first and senior authors, suggesting missed mentorship opportunities, which can be a critical area for improvement.

The FDA approved an oral formulation of semaglutide (Wegovy; Novo Nordisk) at the end of 2025, offering the first oral glucagon-like peptide-1 option for chronic weight management with efficacy comparable to the weekly injection. Although both formulations share similar gastrointestinal adverse effects (AEs) and require gradual dose escalation, the pill has strict morning administration requirements to ensure absorption and uses much higher doses because less drug reaches the bloodstream orally. Pharmacists will be key in counseling patients on adherence, managing AEs, navigating cost and insurance barriers, and supporting safe transitions between injectable and oral formulations.

Together, these features underscore how pharmacists are positioned to lead through complexity—whether addressing drug pricing pressures, advancing equity in scholarship, or guiding patients through rapidly evolving therapeutic landscapes. As health care continues to shift, pharmacist-driven expertise, advocacy, and collaboration will remain essential to improving access, outcomes, and the future of the profession.