The Executive's Guide to Pharmacy Issues

Educational briefings for non-pharmacy leaders

While historically pharmacy may have been viewed as a cost center, today pharmacy services generate a significant portion of system revenues and are essential to the achievement of strategic system-level priorities. To better understand increasingly complex pharmacy issues and the critical role pharmacy plays in overall health system success, download our executive briefings on hot pharmacy topics.

We’ll continue to build our library, so stay tuned for more on telepharmacy, biosimilars, drug spending trends, and more, or contact us at with any requests.


pharmacy wholesalers

Wholesalers are an intermediary between health systems and manufacturers; they streamline relationships around purchasing and distributing pharmaceuticals and medical supplies. An evolving health care marketplace presents an opportunity for many health systems to reexamine their wholesaler agreements and ensure that they align with system goals.

This briefing provides an overview of the main functions of pharmaceutical wholesalers, including services provided to both drug manufacturers and health systems, and insights into key drivers of wholesaler profitability.

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Pharmacy Benchmarks

benefits and limitations of pharmacy benchmarks

Benchmarks can be a useful tool for identifying potential areas for performance improvement. However, benchmarks have significant limitations, and these limitations are especially pronounced in pharmacy.

This briefing examines the limitations and benefits of pharmacy benchmarks and provides recommendations for how to derive the most value from them.

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Drug Expenditures

Prescription drug expenditures are the fastest growing component of health care spending, putting pressure on health systems’ inpatient margins while also creating new revenue opportunities in the outpatient setting.

For most health systems grappling with accelerating drug spend, reducing unwarranted prescribing variation will offer the single biggest improvement opportunity. That said, there are several other near-term chances to reduce spending and grow revenues. It’s critical to understand—and use—available controls to manage spend, capture revenue, and position for growth.

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Drug Shortages

Over the past two decades, drug shortages have become commonplace. They affect basic necessities such as IV fluids and antibiotics, as well as life-saving drugs such as cardiovascular and anti-cancer agents. By one estimate, shortages cost US hospitals $446M annually—$230M generated by the need to purchase more expensive therapeutic substitutes, and $216M by increased labor costs. Additionally, shortages can have a profound and widespread effect on patient safety and outcomes and burnout.

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Infusion Centers

Infusion centers administer infused and injectable treatments. While most infusion patients are undergoing cancer treatment, infusion centers also treat other types of complex and chronic disease, such as rheumatoid arthritis, multiple sclerosis, and Crohn’s disease. Despite the importance of infusion centers in meeting critical community needs, numerous reimbursement and policy changes are threatening infusion centers' financial sustainability.

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USP 797 is one of six chapters on drug compounding standards. It sets guidelines for compounded sterile preparations (CSPs) such a dialysis solution or chemotherapy. The guidelines prevent microbial contaminations, excessive bacterial endotoxins, variability of intended strength, and use of ingredients of inappropriate quality.

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USP 800 sets guidelines and quality standards for healthcare personnel who handle hazardous drugs such as chemotherapy agents. The rule applies to all facilities that store, prepare, transport, and administer hazardous drugs, and should be reviewed as an addition, not a replacement for USP 797.

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