Pharmacy leaders say AI is reshaping health system strategy

For years, the gap between writing a prescription and getting a patient to the medication was treated as part of the process. Pharmacy leaders are now working to close that gap with artificial intelligence because, as one leader put it, waiting even one more moment is no longer tolerable.

That shift has lifted pharmacy into a more central strategic role in healthcare. As health systems try to grow, free up capacity and ease margin pressure at the same time, pharmacy sits at the intersection of all three. Chief pharmacy officers are increasingly involved in the decisions that shape a system’s future, including financial performance, workforce planning and technology adoption.

Three pharmacy leaders recently discussed that changing role: Dr. Deborah Simonson, vice president and chief pharmacy officer of Ochsner Health; Marjorie Lazarre, PharmD, associate chief pharmacy officer of Yale New Haven Health; and Lisa Stump, MS, chief digital information officer at Mount Sinai Health System, who began her career as a clinical pharmacist and director of pharmacy. Sri Somasundaram, co-founder and CEO of Latent, also offered perspective on the shift.

Dr. Lazarre said the pressure on leaders is growing as the wider healthcare environment changes. She pointed to shifting insurance dynamics, affordability concerns and the scale of medication spending in the U.S. The source cited overall pharmaceutical expenditures rising nearly 13% in 2025 to more than $915 billion, driven mainly by utilization. Hospital drug expenses rose 13.6% in 2025, according to the American Hospital Association, while academic medical centers saw drug expenses climb more than 20% in a single year.

Somasundaram said the problem is not just one of staffing. In his view, medicine has advanced faster than the systems used to deliver it. The information needed to get one patient onto one medication is scattered across multiple systems, he said, and no one holds the full picture. He described that as a data problem, not something a hospital can solve simply by hiring more people, and not something general-purpose AI can fix on its own. He said it takes a platform built around the full patient journey and the way pharmacy work actually happens.

For pharmacy leaders, that gap is also an opening. Dr. Lazarre called it a real and present opportunity for leaders to step up. She said pharmacy teams already have, and can do more.

The financial case for pharmacy has changed dramatically. Chief pharmacy officers remember when a costly hospital medication might run about $40 a dose, then later when some therapies moved toward $100,000 per dose. Now they are seeing medications priced in the millions. At that scale, pharmacy becomes a board-level issue.

But the same forces that drove spending also created a new role for specialty pharmacy. The department historically seen as a cost center is now able to generate revenue. Dr. Lazarre said pharmacy began as a cost center, and specialty drugs changed that. Specialty pharmacy has altered the dimension of the department by allowing it to become a revenue generator, she said, and that responsibility is taken seriously.

That change also affects how her team thinks about patient access. Dr. Lazarre said the team now weighs financial toxicity alongside clinical toxicity, because a treatment a patient cannot afford is not meaningful therapy. She described it as unacceptable to tell someone what medication they should take and then leave them unable to obtain it. Access, she said, must be real. Her patients, she noted, are often forced to choose between health and food, or rent and tuition, because of medication costs.

At Ochsner, that mindset helped build the specialty pharmacy business. Dr. Simonson said leaders need to think several years ahead in order to move an organization forward. In 2012, she brought executives a view of the coming growth in oral chemotherapy, which is dispensed as a pill and taken at home. A missed fill could mean a missed cure, so the idea was framed around patient care. The system approved a pilot for one drug, and the specialty pharmacy operation grew from there. The source said it is now a significant contributor to Ochsner’s performance.

Workforce pressure is now adding urgency. Ms. Stump said the healthcare workforce is under strain because the population is aging, more therapies are reaching the market and those therapies are often more complex. At the same time, many clinical disciplines are plateauing or shrinking. She said the result is an imbalance: more people need more services, but fewer people are available to provide them.

Dr. Lazarre, who teaches residents and students, was blunt about the pipeline. She said the field is out of time, with shortages that have existed for more than a decade and are not being resolved by incoming classes.

That is part of why AI is no longer being treated as a future idea in pharmacy. Leaders are using it to manage work that has overwhelmed teams, especially tasks like reconciling patient records with payer rules, benefit designs and clinical criteria. Those tasks were never just a staffing problem, they were also an information problem.

Ms. Stump gave a simple example. In a hospital with 900 patients, identifying the small number who would most benefit from pharmacist attention on a given day is like finding a needle in a haystack. Her team stopped doing that by hand and began using data to surface and prioritize the right patients, so they could receive the right level of care faster.

The source said enterprise AI platforms built specifically for pharmacy are becoming critical infrastructure in more departments. Mount Sinai, Ochsner and Yale New Haven are using AI to pull patient history from the electronic health record and outside records, compare it with payer coverage criteria and assemble the documentation a pharmacist then reviews and submits. Work that once took hours of digging and phone calls can now be reduced to minutes.

Prior authorization has been a major proving ground. Dr. Lazarre said the process can make it hard to review notes and documentation quickly, especially when insurance carriers have separate requirements that may not appear in the record. She called the period between prescription and pill the last mile. The source said patients can take about 21 days nationally to cross that distance, and in some cases 30 days.

At Yale New Haven Health, prior authorization turnaround times now average about three days, according to the source. Dr. Lazarre said anything that shortens that timeline can improve access, adherence and education. She said the technology has helped her team do all three.

The same approach has also helped another $13 billion health system absorb a more than 40% increase in prior authorization volume between 2023 and 2025, along with a 90% increase in mail-order volume, without slowing turnaround times or adding the seven full-time employees that growth would otherwise have required.

Dr. Simonson said the appeal of AI is speed in a place where delays have only gotten worse. She said she needs data but cannot find it quickly enough, which is why she is excited about AI. At Ochsner, she said, AI has cut the time she spends searching for information by as much as 80%. She said the best part is that people can focus on the work only they can do, while AI handles the work they do not need to do.

At Mount Sinai, Ms. Stump said a pharmacy team aimed to double its revenue and did so without proportional hiring after using AI to remove administrative work between patients and medications. She said the result improved patient care, reduced cognitive burden for the care team and strengthened the enterprise’s financial performance.

None of the leaders described AI as a replacement for people. The source was cut off before providing further details on that point, so additional context was not reported.