Make life easier in 2026 by learning to do more with less

Each new year arrives with a mix of uncertainty and determination, especially for professionals who manage essential services under shifting conditions.

Many leaders are already sensing that the months ahead may reshape long-standing assumptions about what their organizations can sustain.

The landscape appears poised for significant pressure, leaving teams to navigate unfamiliar constraints while trying to maintain high standards of care. Even so, the next chapter invites careful attention as it quietly signals how much adaptation will be required.

A changing policy landscape and a tightening financial outlook​

The passage of the “One Big Beautiful Bill Act” is expected to reshape health care access and financial stability across the country, placing enormous strain on hospitals and the patients who rely on them.

The legislation removes more than $1 trillion from health programs over the next decade, resulting in millions of people losing coverage and increasing uncompensated care by an estimated $278 billion.

Rural hospitals, Medicaid expansion states, and urban communities with underserved populations face the greatest risk of service cuts and closures.

Pharmacy leaders will likely be asked to limit capital spending, reduce workforce levels through attrition, and identify new revenue sources to stay afloat.

The shifting expectations placed on covered entities in the 340B program​

For health systems participating in the 340B program, 2026 brings several specific challenges that will shape both daily operations and long-term strategy.

A new pilot beginning January 1 allows certain manufacturers to move high-cost drugs from upfront discounts to rebate-based reimbursement, raising administrative costs and potentially shrinking savings.

Covered entities also worry that this model will expand rapidly, giving drug manufacturers and their third-party partners greater influence over compliance oversight.

Alongside this shift, many expect reduced contract pharmacy activity and heightened operational pressure for safety-net institutions.

Additional federal actions increase pressure on reimbursement and compliance​

CMS plans to conduct a survey of hospital drug acquisition costs that will inform OPPS rate setting for fiscal year 2027, and the anticipated cuts resemble those implemented in 2018.

Lower reimbursement for outpatient drug administration may weaken the financial foundation of safety-net providers that already serve a high proportion of underserved patients.

At the same time, HRSA appears to be approving more industry-requested audits, creating uncertainty for covered entities that are already monitoring tight resources.

Many leaders view this shift as an effective transfer of oversight responsibility to the pharmaceutical industry, deepening concerns about fairness and conflict of interest.

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Emerging priorities: CGT growth, workforce shortages, and AI integration​

Rapid expansion in cell and gene therapy (CGT) is transforming supply chain demands and long-term financial planning for health systems.

These therapies require coordinated involvement from multiple departments, making it crucial for pharmacy leaders to shape systemwide processes from the earliest planning stages.

Workforce shortages, especially among experienced pharmacy technicians, continue to limit operational capacity and require inventive approaches to recruitment, training, and retention.

At the same time, AI-assisted technologies are becoming increasingly important, offering potential support in indirect patient care tasks while requiring strong oversight to ensure safety and reliability.

Also read: 10 powerful New Year’s resolutions every senior should know for a happier, healthier year

Preparing for a demanding but potentially rewarding year​

Pharmacy leaders must anticipate a year defined by rising pressure, tighter margins, and increased administrative expectations, yet the work remains critical to overall system stability. The combined effects of policy changes, workforce challenges, and technological evolution will require a disciplined, forward-looking approach.

Many will need to balance immediate operational realities while planning for long-term sustainability in a rapidly evolving environment. Despite the obstacles, the year ahead may provide opportunities for innovation, resilience, and meaningful progress.

Read next:

• How seniors are finding new purpose with a simple New Year’s tradition
• The history behind January 1 as New Year’s Day

Key Takeaways

• The coming year is expected to bring significant pressure on health-system pharmacy through sweeping policy changes and shifting reimbursement structures.
• Leaders face new challenges within the 340B program, including rebate-based models and increased audit activity.
• Growing CGT programs, workforce shortages, and expanding AI tools will also shape decisions and operational planning.
• These developments emphasize the need for thoughtful strategy and adaptable leadership as 2026 approaches.

The pharmacy landscape is clearly moving into a period of tighter resources and higher expectations. Many leaders are already weighing how to maintain essential services while adapting to rapid external changes. The next year may test operational creativity, but it also offers chances to rethink long-standing systems in smarter ways. How do you think the health system pharmacy should prioritize its efforts in 2026? Share your thoughts in the comments below.