Top Pharmacy Trends to Watch in 2025

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As we step into 2025, the pharmacy profession finds itself navigating a rapidly changing landscape. Challenges like pharmacy deserts, workforce development, supply chain issues, and PBM reform are reshaping the industry. How will we respond? 

There is no one-size-fits-all solution. Some advocates demand transformative changes, while others believe in a more measured approach. In this article, I’ll consider multiple perspectives to offer a balanced view of the trends shaping pharmacy today. 

Trend 1: Amid an increasing number of pharmacy closures, the health care system will need to definitively address pharmacy deserts. 

Problem
Thousands of pharmacies have closed their doors in recent years, particularly in rural and underserved areas that we call “pharmacy deserts.” These pharmacy closures are often driven by financial pressures, low reimbursement rates and the consolidation of pharmacy chains. Independent pharmacies, which often serve as lifelines in their communities, are especially at risk. A map of pharmacy closures in 2024, as compiled by pharmacist Benjamin Jolley

These closures exacerbate health disparities, as residents struggle to access medications and professional guidance. Communities without nearby pharmacies experience poorer health outcomes and an increased reliance on emergency services. 

Solutions
A range of opportunities exist to address pharmacy access challenges. 

  • Telepharmacy services can provide real-time access to pharmacists, ensuring that patients in underserved areas receive timely care. 
  • Digital pharmacy platforms and mail-order systems can be optimized to improve reliability and ease of use, thus enhancing patient experiences. 
  • Blending the development of new infrastructure with enhancements to existing services can cater to a broader spectrum of patient needs, striking a balance between innovation and practicality.

While these solutions can be opportunities to address systemic weaknesses in our health care infrastructure, they are not comprehensive. Mail-order services, for example, cannot adequately address urgent or acute medication needs. Fully addressing pharmacy deserts and their far-reaching impacts requires cooperation and collaboration from payers, lawmakers, regulatory agencies and the pharmacies themselves.

Trend 2: Declining pharmacy school enrollment will prompt changes to education, training, and work experiences for future pharmacists. 

Problem
Pharmacy education is at a crossroads. Pharmacy school enrollment is declining, driven by market oversaturation, uncertain job prospects, and general dissatisfaction with the workforce experience. 

Graph showing the disparity between available pharmacy jobs (13,400) and available new pharmacy graduates (8,000) in 2026.

Additionally, the traditional pharmacy education model is not keeping pace with the evolving health care landscape. Graduates are often unprepared for emerging roles in value-based care, leadership, and interprofessional collaboration. As seasoned pharmacists retire, we risk a workforce shortage at a time when the demand for clinical services is growing.

Solutions
The gap between pharmacy education and practice readiness is widening. It’s essential that we both reimagine pharmacy education and make pharmacy practice the fulfilling career its practitioners seek. Without adjustments, the profession will struggle to adapt to new health care paradigms, and patients will ultimately pay the price.

  • A reimagined pharmacy school curriculum should focus on emerging roles, leadership, value-based care and interprofessional collaboration. 
  • Scholarships and loan forgiveness programs can attract new graduates to underserved regions and specialties. 
  • Training should emphasize leadership, innovation and entrepreneurship, which can help ensure the next generation of pharmacists is prepared to meet evolving health care demands.
  • As automation reduces the demand for traditional roles like dispensing and inventory management, pharmacies can shift to equipping pharmacists with specialized skills like pharmacogenomics and health data analysis, allowing them to excel in niche roles. 
  • Pharmacists may look toward expanding their roles within health care, expanding into patient education, chronic disease management and preventive care in a way that allows them to directly engage with patients and improve outcomes, rather than simply dispense prescriptions. Such a focus can be achieved by utilizing advanced technologies to streamline repetitive tasks, freeing them up for more clinical and advisory roles. 

Although not a quick fix, pharmacy employers should commit to improving working conditions. Pharmacies across the country, especially major chains, suffer from inadequate staffing. This issue is a major stressor for their employees, especially alongside largely stagnant wages. And the problem needs to be addressed before it results in fewer providers to serve patients.

Trend 3: Patients and providers will seek resolutions to supply chain-related medication shortages that have, in recent years, had widespread impacts. 

Problem
The pharmaceutical supply chain faces unprecedented strain. 

  • Climate change and natural disasters disrupt production and distribution, causing shortages of essential medications. 
  • Funding cuts to manufacturer assistance programs limit access for low-income and uninsured patients. 
  • Over-reliance on a small number of international manufacturing hubs compounds these issues. 

Vulnerable populations bear the brunt of these impacts, with medication non-adherence and related poor health outcomes becoming increasingly common. The current system lacks the flexibility to respond effectively to sudden supply or funding crises.

Solutions
Supply chain disruptions, which are not unique to health care, often stem from short-term or temporary events. Addressing them requires a multi-faceted approach. 

  • Developing contingency plans and building resilient, localized manufacturing hubs can ensure the availability of critical medications during disruptions while also reducing our dependence on global hubs. 
  • Strengthening partnerships between pharmacies and manufacturers fosters collaboration, ensuring that responses to supply chain issues are both timely and effective.
  • We cannot discuss shortages without addressing wasted medications. Expanding medication recycling programs creates a sustainable way to safely redistribute good condition, unused medications. 

Trend 4: At a breaking point over their influence on prescription prices, PBMs will face real reforms – not just calls for it – in 2025.

Problem
Pharmacy benefit managers (PBMs), which evolved with the noble intentions of fairly negotiating prescription prices for health plans, have become a behemoth and a significant contributor to unclear and ever-rising drug costs for both patients and payers. Graph showing the share of prescriptions held by the three largest pharmacy benefit managers in the United States as compared to all others.

PBMs made many headlines in the last year as they came under fire for various practices, like spread pricing and retaining manufacturer rebates, that boost their profits while driving patient cost increases and slashing reimbursement for pharmacies. Numerous calls for reform, including new legislation, aim to reduce PBM control and enhance transparency, although none of it took hold in 2024.

Solutions
The vast majority of prescriptions in the United States today are managed by one of the three largest PBMs – Express Scripts, CVS Caremark and Optum RX. A system that has come to rely so heavily on these organizations cannot be reformed overnight. As we consider solutions, it’s important that we work to preserve the good, cost-saving practices that are part of this current structure, while also pursuing a system that is both more equitable and transparent for patients, providers and payers alike. 

  • Pharmacists can lead the charge by partnering with payers to gradually implement value-based contracts. These outcomes-focused models align financial incentives with health results. 
  • Patients, providers and payers should join together to advocate for equitable reimbursement policies to level the playing field for independent pharmacies, which currently suffer from lower reimbursement rates than major chains for the same medications. 
  • Lawmakers should continue to work on regulatory reforms that specifically target some of the practices that artificially inflate prescription costs, like spread pricing and rebate retention.

Where do we go from here?

The goal for 2025 can be summed up in our mission statement – to create a patients-first pharmacy future. But no one group can do it alone, and it might take some time. 

    • Pharmacies 
      • Embrace innovations like telepharmacy to address access gaps and help reach underserved populations. 
      • Consider adopting value-based service lines to reduce dependence on unreliable per-prescription reimbursements. 
    • Pharmacists 
      • Redefine your role by integrating into collaborative health care teams and advocating for leadership in value-based care models. 
      • Join together to establish standard safe practices, an effort that can benefit both current and future pharmacists. 
    • Patients 
      • Stay informed about your prescription prices. Speak up when something doesn’t seem right, ask about cash-pay discounts, and bring your experiences to your plan administrator. 
      • Seek out available resources, like rebate programs from drug manufacturers or membership pharmacies, if you find yourself under- or uninsured. 
      • If you live in a pharmacy desert (more than 10 miles from the nearest pharmacy), ask your pharmacist or plan administrator about available telepharmacy options. 
      • Develop a close relationship with your pharmacist as a health care partner for advice on medication side effects, adherence and alternative treatment options. 
    • Payers
      • Consider technology, like telepharmacy and medication delivery, to reduce the impact of pharmacy deserts.
      • Seek value-based models that align financial incentives with measurable health outcomes, rather than on the number of prescriptions dispensed. 

The pharmacy profession in 2025 faces significant challenges, but the paths forward are diverse and achievable. Collaboration across sectors – pharmacies, pharmacists, payers, and patients – will be critical to creating a pharmacy ecosystem that is equitable, efficient, and prepared for the future.

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