The Best Ideas for Transforming Pharmacy Operations in 2025
To thrive in 2025, pharmacies must embrace technology, becoming more data driven and patient centric; optimize operations; diversify services; and navigate regulatory challenges.
By Will Lockwood | PTMR Senior Editor
2025 will shape up to be a year of significant change and opportunity for pharmacies. As we look ahead, we take the temperature of the market with a survey of key pharmacy technology vendors to pinpoint where pharmacies can look to find innovative ways to optimize their operations, enhance patient care, and adapt to new challenges. From embracing technology to diversifying services and navigating PBM (pharmacy benefit managers) and regulatory challenges, here are some of the best ideas for pharmacies exploring various strategies to thrive in this dynamic environment.
Focus on Pharmacy Operations
2025 will find pharmacies continuing the search for the most efficient ways to manage the prescription-dispensing process. PrimeRx CEO Ketan Mehta lists several areas where pharmacies can improve workflow efficiency, including integrating e-prescribing, medication synchronization, and advanced inventory management.
Alexander Miguel, chief clinical and product officer at Outcomes, reports that the company is making a push in three critical areas in 2025. “Pharmacies need to focus on technology that can improve operational efficiency while enabling them to focus on clinical care,” says Miguel. “We are helping pharmacies accomplish this objective through three key technology deployments: an AI-driven, PMS [pharmacy management system] integrated pill counting solution with auto-verification capability; a clinical-first integrated pharmacy experience; and digital patient engagement solutions to drive patients back into the pharmacy and streamline the delivery of clinical care.”
The National Community Pharmacists Association’s (NCPA) Lisa Schwartz, senior director of professional affairs, sees promise in e-prescribing, where she is looking for stakeholders to move forward with capabilities that improve the pharmacy workflow. “EHRs [electronic health records] that use structured and codified SIG help pharmacies expedite new prescriptions and refill authorizations,” explains Schwartz. She acknowledges that there are still bumps that need to be smoothed out, however. For example, the CancelRx message — which allows clinicians to electronically communicate medication discontinuation orders to pharmacies — can still lead to issues, particularly in the case of cancel messages for expired prescriptions or ones that never had refills. “If the goal is to alert pharmacy staff to a discontinued medication, the noise of meaningless cancel messages needs to stop,” says Schwartz. “Looking ahead a bit to the next version of the e-prescribing standard, the ability to request or send transfers electronically will transform that task.”
PrimeRx‘s Mehta also believes it will be a year for pharmacies to consider the role of cloud-based pharmacy management systems for enhancing operational efficiencies. “We introduced PrimeRx CLOUD in 2024,” says Mehta, “with the goal of improving data accessibility and integrating compliance tools, both of which enable pharmacies to focus more on patient care and less on administrative burdens. The cloud also ensures real-time access to data and the flexibility to operate from any location securely.”
René Bloemke, director of product management at Managed Health Care Associates, has worked with pharmacy customers to identify and address common pain points that can lead pharmacies to fall short of maximum efficiency — for example, formulary changes, transition fills, and expired prior authorizations. “By leveraging technology to optimize clean claims,” says Bloemke, “we believe we can help pharmacies streamline processes, avoid rejected claims, and ensure patients receive their medications more quickly, all designed to give the pharmacy owner peace of mind. We are committed to helping pharmacies mitigate these disruptions and reduce the time required to fill prescriptions.” For example, notes Bloemke, Managed Health Care Associates‘ Net-Rx division pharmacy advisors report that implementing formulary checks has the potential to assist pharmacies in making timesaving decisions regarding drug coverage.
Stepping away from the dispensing workflow, NCPA’s Lisa Schwartz is always happy to see pharmacies adopt technology that makes them a pleasant and efficient workplace. “Examples are online appointment scheduling, tools to build HIPAA-compliant forms, employee scheduling tools, and secure messaging,” says Schwartz.
Mobile Convenience and Delivery Services in Pharmacy
Pharmacy operations will benefit from a focus on the increasing demand for convenience in a world shaped by the services tech giants have made us accustomed to, notes Datascan President Kevin Minassian.
“We live in the Amazon Prime or Netflix world today and are surrounded by convenience,” says Minassian. “That is what you need to offer your patients. Your patients want to be able to jump onto an app, see their profiles, queue up medications, or have them set to auto refill. Ideally, they want them delivered or to be able to receive a notification, show up, and walk out with their medications and other everyday popular items in a quick and efficient manner. The more work you make them do, the more likely they are to leave you for a competitor or shop on Amazon, Mark Cuban Cost Plus, or some mail-order pharmacy.”
Minassian believes that making interactions with your pharmacy easy and convenient is the best way to keep giving patients reasons to stay loyal to you.
Pharmacy Services Diversification
Michael Ansel, chief growth officer at Managed Health Care Associates, sees expanded services as critical in the coming year. “By broadening the scope of services, pharmacies can tap into new revenue streams and better serve their communities,” says Ansel. “For instance, a trend we are seeing is pharmacies expanding their work into the long-term care [LTC] community setting by offering lab work or setting up infusion capabilities through the buildout of clean rooms. Since the majority of specialty medications being approved by the FDA are injectable and infusible drugs, the ability to perform onsite administration will be a growing trend.”
Pharmacies can implement the lab services in-house or outsource them. Either way this offers new avenues for raising the service level offered to LTC facilities, notes Ansel. “Lab services allow pharmacies to utilize the facility for lab draws by training the facility’s nursing assistants or students to reduce labor costs, return lab results quickly, and through a collaborative care agreement with the facility’s medical director, even prescribe specific medications such as antibiotics,” he says.
Ansel ticks off a list of benefits from lab services: This approach not only expands revenue but also lowers the cost of care, reduces the risk of falls or injuries by allowing residents to remain in the facility, and avoids the spread of disease. Additionally, it enables pharmacists to operate at the top of their license, with the eventual goal of achieving provider status by CMS (Centers for Medicare & Medicaid Services) and securing higher reimbursement rates.
PrimeRx’s Mehta suggests expanding patient services such as medication therapy management (MTM) and using customer service tools to help your pharmacy stand out in terms of patient care and adherence. “Our PrimeRx Enterprise platform will focus on integrated compliance tools and improved clinical service offerings,” he says.
Datascan’s Minassian suggests retail pharmacies explore long-term care opportunities due to higher reimbursements and consistent business. “Make sure your vendor can support LTC in their pharmacy management software,” he says. He is also one of the promoters of pharmacies adding compounding as a differentiator from chain pharmacies and a way to lower the number of PBM-reimbursed prescriptions. “Compounding is typically cash based,” Minassian notes, “with strong margins.”
The opportunities for pharmacists to expand revenue and profits in 2025 will require a balancing act, though, in the view of Alexander Miguel from Outcomes. According to Miguel, pharmacies will find success by embracing and performing clinical services while maintaining their prescription volumes. “This is why it is key for pharmacists to invest in solutions that automate fulfillment duties so that they can dedicate time to clinical work without incremental overhead investment,” says Miguel. “Clinical revenue will materialize in several ways. More than ever, payers are investing in medication adherence education services and pharmacists are at the forefront of the adherence conversation. Additionally, with CMS’ expansion of the comprehensive medication review [CMR] eligibility requirements, there will be a need for more CMR delivery. Finally, pharma manufacturers are also focused on the pharmacist being a main point of engagement for their patients. By putting the pharmacist at the center of the care delivery model, a fundamental shift is taking shape, transforming the pharmacy from dispensing to care delivery.”
Managed Health Care Associates‘ René Bloemke sees cause for optimism when it comes to services. “We have seen some pharmacies experience success by expanding their role and offering patient care services directly in the communities they serve,” she says, “and achieving provider status from CMS will certainly bolster these efforts.”
Combatting the PBM Influence and Other Risks to Pharmacy Operations
Multiple sources emphasize that the significant threat to pharmacy revenue and profits posed by pharmacy benefit managers (PBMs) will not let up in 2025. NCPA’s Lisa Schwartz specifically mentions “predatory PBM reimbursement” as a major concern, and points to recent media coverage of this issue, including a major story in The New York Times that reported that PBMs underpay independent pharmacies.
While an increasing awareness outside of pharmacy of PBM practices is very important, Schwartz is also of the view that it is crucial for long-term financial stability for pharmacies to continue to be strong advocates for policy changes to address the negative influence of PBMs. Still, 2025 will be another year that requires pharmacies to play at least some defense against PBM practices. “Pharmacists and pharmacy staff will benefit immensely from software applications that make dispensing and clinical workflows — and the documentation of either — more seamless,” says Schwartz. “Knowing that PBMs are anxious to roll out the NCPDP Telecommunication service transactions, pharmacies need systems that are ready for service billing via Rx claim or X12 837 formats.”
Terry Dean, director of product operations and execution at SoftWriters, also sees significant pressure from PBMs in the year to come. “PBMs and large healthcare entities increasingly integrate vertically,” notes Dean, “controlling more of the medication distribution chain. This consolidation can limit independent pharmacies’ negotiating power, reduce reimbursement rates, and divert patients toward in-network pharmacies within the larger entities.”
The Inflation Reduction Act (IRA) is another specific challenge for pharmacies in the coming year, particularly its impact on revenue from negotiated drug prices. “The IRA has the potential to negatively impact revenues for pharmacies on the subset of negotiated drugs without proper tracking,” says Krystal Gaskill, director of operations at Net-Rx. “We are studying this closely, investigating any opportunities to assist pharmacies through technology.”
And overall, the trend will be for regulatory compliance to only continue growing more complex, according to SoftWriters’ Dean. “Evolving regulations regarding controlled substances, billing practices, and patient privacy require pharmacies to adapt continuously,” she says, “and often at a significant cost. Compliance with new policies can be resource intensive, and noncompliance risks penalties that impact revenue.”
The Fight for Pharmacy Revenue
There are other sources of potential strain on pharmacy revenue and profits in the coming year, notes PrimeRx’s Mehta. His list includes value-based care, with performance-based models possibly lowering payments; increased operating costs from rising labor, rent, new regulatory burdens, and technology expenses; shifting consumer behavior, such as the growing acceptance of telehealth and the ongoing risk for mail order to reduce foot traffic; supply chain issues that lead to drug shortages impacting sales; and specialty drugs with the risks they bring of high costs and low reimbursements.
As value-based care models grow, pharmacies must adapt to these payment structures, which are emphasizing patient outcomes over transaction volume, notes SoftWriters’ Dean. “Pharmacies continue to face cuts to reimbursement rates from payers, impacting profit margins, especially in LTC and specialty care,” says Dean. “To navigate these threats, pharmacies must leverage technology for efficiency, explore diversified services, and focus on patient-centric care to remain competitive. Key efforts include working with regulatory bodies to advocate for updated reimbursement models, especially for home health services, which expand pharmacies’ ability to serve patients in nontraditional settings. Additionally, vendors are introducing solutions that improve operational efficiencies, reduce costs, and ultimately enhance LTC pharmacies’ profit margins.”
The emergence of at-home healthcare is identified as another potential challenge, although its impact on different types of pharmacies remains uncertain. As this model evolves, it will be crucial for pharmacies to monitor its effects and adapt accordingly. “We just don’t know enough yet to understand the impact on various classes of trade within the pharmacy industry,” notes Managed Health Care Associates‘ Bloemke, “and how insurance companies will respond to this level of care. Again, we are watching this space closely to look for opportunities as the industry evolves.”
Mehta also offers suggestions for pharmacies to counteract these risks. For example, home and curbside delivery can attract and retain patients. Automating billing and inventory can help reduce costs. eCare plan integration can support pharmacy documentation of clinical services in real time to improve patient outcomes. Simplified and convenient payment options can offer value for customers with integrated payment processing for faster, more efficient transactions. And finally, real-time drug pricing and comparisons during purchasing can increase profitability. This is an area that Mehta’s company is actively addressing with a recently released offering. “We designed our PrimeRx MARKET platform to empower pharmacies with real-time drug price comparisons, helping them save on inventory costs and improve operational efficiency. These solutions ensure that pharmacies can better serve their patients while meeting the evolving challenges of the healthcare landscape in 2025.”
Analyzing Pharmacy Data Is Key
Harnessing data analytics will be a crucial strategy for success in the coming year, according to Managed Health Care Associates‘ Ansel. For example, strong data management and analysis can help pharmacies optimize supplier contracts. “Work with your group purchasing organization [GPO] to ensure you are optimizing not just your pharmaceutical spend,” suggests Ansel, “but also your spend on medical and business products and services, as well as contracted outsourcing solutions.” By doing so, notes Ansel, pharmacies can save time, reduce labor costs, and ensure they are getting the best value for their purchases, ultimately improving their bottom line.
Data also comes into play for claims reconciliation and reimbursement, which is another area that should be at the top of the list for pharmacies in 2025, according to Net-Rx’s Gaskill. “Knowing you received accurate payments and what is outstanding is foundational for a pharmacy’s cash flow,” she says. “Net-Rx strives to help pharmacy customers achieve up to 100% third-party reconciliation. In the coming year, our pharmacy customers will benefit from our new and improved reconciliation platform. This enhanced environment will allow us to release new solutions and reports, in a user-friendly and efficient ‘fewer clicks’ interface.”
Pharmacies are becoming more data-savvy, according to Managed Health Care Associates’ Bloemke, and, as a result, better understand how essential it is to have not just a firm understanding of key performance indicators (KPIs), but also accurate benchmarking. “Understanding KPIs is one thing,” says Bloemke, “but knowing whether they are good or bad is another. Our pharmacy and data experts are researching ways to deliver baseline value metrics to help pharmacies make sound business decisions and monitor the overall health of their operations.”
AI’s Role in Pharmacy in 2025
Look for artificial intelligence (AI) to continue to be a major driver of advancements in 2025. Terry Dean from SoftWriters reports that the company is focused on advancing long-term care pharmacy operations through innovative software solutions in 2025 in three primary areas: AI, business intelligence (BI), and customer insights (CI). “These pillars hold immense potential to revolutionize pharmacy operations, decision-making, and patient care,” says Dean. “By integrating them, we deliver smarter solutions that create a more resilient and efficient healthcare environment.”
Dean notes that AI is starting to transform healthcare, and while its full potential is still being realized, it is already making significant strides in LTC pharmacies. “At SoftWriters, we are focused on leveraging AI to automate burdensome data entry workflows, such as order entry, to address our customers’ staffing and operational challenges,” she says. “This automation enhances efficiency and reduces human error.” Dean also expects to see AI tools provide insights that allow pharmacies to participate in value-based care models, aligning with the industry’s shift toward outcomes-based reimbursement.
SoftWriters is taking an active, collaborative approach to building out AI solutions. “By working with industry leaders through initiatives like the AI Mastermind Cohort,” says Dean, “we ensure our solutions meet the real-world needs of LTC pharmacies.”
Outcomes’ Alexander Miguel mentioned the company’s integrated, AI-driven pill-counting solution earlier, and this offers an excellent example of how AI is being deployed. “This pill-counting solution will drive dispensing efficiency even further, with optical character recognition enabling seamless document scanning and uploads to partner platforms to import clinical documentation,” he says, “as well as operational tasks like inventory management tracking. As we deploy auto verification, pharmacists will be able to read and verify prescription labels and other documents systematically against the PMS-entered data shared via this interface.”
In addition to automation, Terry Dean reports that SoftWriters actively pursues AI analytics as part of its BI solutions. The goal for BI is to transform data into actionable insights, empowering LTC pharmacies to make informed, data-driven decisions. “In 2025, BI will be crucial for pharmacies as they navigate complex regulations, cost pressures, and evolving patient needs,” says Dean. She provides a long list of benefits pharmacies can see from high-quality BI, including the ability to spot trends in prescription fill rates, medication errors, and patient feedback, offering a clear picture of areas for improvement.
“By leveraging these insights, pharmacies can boost customer satisfaction and streamline resources,” says Dean. “BI also uncovers growth opportunities, empowering pharmacies to expand services based on market demand or adapt to shifts in the industry. This will provide more important insights to our customers, helping them make more informed decisions and optimize their operations. This coming year, SoftWriters will integrate BI tools that enable pharmacies to track performance indicators, analyze historical data, and generate reports for strategic decision-making.”
Integrations and Interoperability in Pharmacy Technology
An area for optimism in 2025, according to NCPA’s Schwartz, will be improved interoperability between pharmacy systems and other healthcare providers. “We are hopeful that health information exchange will be transformative,” says Schwartz. “The Pharmacy HIT Collaborative and its member pharmacy organizations and associate members have done a lot of work to coordinate diverse opportunities and take down barriers. And now The Sequoia Project, which will be responsible for coordinating the rollout of Trusted Exchange Framework and Common Agreement (TEFCA), is launching a pharmacy interoperability workgroup as part of its Interoperability Matters initiative.” The Sequoia Project is notable, in Schwartz’s view, because it’s being organized outside the pharmacy community — with plenty of pharmacy practice stakeholders — to accelerate pharmacy health information exchange and access to health information networks.
In general, pharmacies should continue to see new technology offerings in the market, as existing and new vendors innovate. As always, these tools will be most valuable when they can be integrated within the technology suite. PrimeRx’s Mehta offers the example of a new integration that PrimeRx has rolled out to an app from a company called Hyphen, which he notes is already making waves by supporting the pharmacist’s role in value-based care. “This app empowers pharmacists by providing real-time insights to improve patient care and rewards them for their efforts,” says Mehta. ”We have over 150 pharmacies using PrimeRx software that are now also utilizing the app, and we are seeing that pharmacists can easily track patient education activities, improve medication adherence, and receive incentives for their services.”
SoftWriters’ Dean also weighs in on key integrations for 2025, noting that integrations between electronic medical record/electronic health record systems and pharmacy management systems will be vital for seamless pharmacy operations. “This integration streamlines workflows,” she says, “significantly reduces the need for manual data entry, and improves accuracy in order processing.” Additionally, Dean sees machine learning and AI-powered systems playing an increasingly prominent role in helping pharmacies verify orders for drug-to-drug interactions, perform allergy checks, and make patient-specific recommendations.
Alexander Miguel reports that Outcomes is focused on what he calls an integrated pharmacy experience. “This will be the first clinical-first pharmacy management system to allow pharmacists and technicians to access their clinical and prescription-filling workflows from one common sign-on interface,” says Miguel, “enabling pharmacies to manage their medication reviews, adherence services, and prescription fulfillment seamlessly. With our in-workflow statistics widget, pharmacies can see how many open prescription orders are pending, what status they are in, and their promised delivery time, all from their clinical workflow screens. Additionally, pharmacists can toggle back and forth between clinical and dispensing workflows with the touch of a button, saving critical pharmacists’ time.”
How Pharmacies Are Making Medicine Personal
Jennifer Hardesty, senior vice president of clinical strategy at Clarest Health, is also seeing that tight connections among systems will enable pharmacies to better personalize care for patients; deepen clinical review in a targeted, time-efficient manner; and build a truly patient-centered approach. “It’s our goal to provide personalized medication management at every step,” Hardesty says. “We are using technology to infuse humanity into our comprehensive pharmacy services.”
As an example, Hardesty points to the Clarest technology platform’s ability to ingest a variety of medical/pharmacy claims, long-term care pharmacy data, and patient-specific information over time. “As we work with patients longitudinally,” continues Hardesty, “we can harness this rich history in ongoing algorithmic analyses and evidence-based medicine standards to quickly identify significant issues like high-risk medications, drug interactions, or inappropriate therapy. Blending technology like this with the human touch results in a supportive environment that is customized by the patient’s specific needs.” Engaging the patient in their care, providing them education and tools, and engaging their primary care providers supports the coordination of care and promotion of the patient’s healthcare goals and improvement in their quality of life.
Hardesty emphasizes that pharmacies need to view medication management as an ongoing effort. “Support occurs longitudinally over time,” she says, “and with collaboration of the patient and their care providers.” And while the ability to influence patient adherence to therapy, and the ability to provide pharmacy support after transitions of care/post-acute care are highly impactful areas, Hardesty points out that they can also be very complicated. “Our current focus is caring for high-risk and complex patients in the home environment, and to offer providers and patients solutions that transcend a physical institution and can be customized to each patient’s needs,” she says. “Helping care for medically complex individuals and those who have just experienced a transition of care or are struggling to remain in their home is an area where medication management and pharmacy as a service can really make an impact in patient’s lives.”
Net-Rx’s Gaskill emphasizes that maintaining strong relationships with prescribers and medical staff is crucial, especially when managing complex patient groups cared for by large teams. “This can pose challenges in managing outreach programs,” says Gaskill. “At Net-Rx, we aim to provide pharmacies with insights to focus their provider relationship management efforts and quantify the value of those relationships in terms of volume and revenue.”
Understanding patient needs is at the core of effective pharmacy care, notes SoftWriters’ Dean. With that in mind the company will be making focused efforts to provide pharmacies with customer insights (CI) for enhanced patient care. “CI offers a way for pharmacies to continuously gather and interpret patient and caregiver feedback,” explains Dean, “which is critical for personalizing care and improving service quality. These insights play a vital role in helping pharmacies build trust with patients, ensuring they feel understood and valued. LTC pharmacies can better align services with patient expectations by leveraging these insights, driving satisfaction and retention. Through advanced technologies and data-driven strategies, pharmacies can streamline operations, improve decision-making, and deliver high-quality care. At SoftWriters, we’re committed to accelerating innovation in the industry, and we’re excited to support pharmacies on their journey to a more efficient, patient-focused future.”
Continued Technological Advancement
What’s clear is that pharmacies face a complex and dynamic landscape in 2025. Addressing the influence of PBMs, navigating the implications of the IRA, and adapting to new healthcare models will be crucial. Those pharmacies that are aggressive about embracing technological trends; that are able to make the shift toward a more data-driven, patient-centric, and efficient pharmacy model; and that deploy technology to mitigate reimbursement erosion will be best positioned to adapt in the changing healthcare landscape. By implementing the right strategies, pharmacies can create a more robust financial foundation for 2025 and beyond. PTMR