Over the next three to five years, the chief pharmacy officer role is expected to expand well beyond operational oversight. Dispensing excellence and medication safety will remain foundational. But what will distinguish successful leaders in 2026 and beyond is enterprise-level influence — across finance, technology, workforce, supply chain and policy — paired with the ability to build teams that can execute in a volatile healthcare environment.
Across health systems, pharmacy leaders describe a role that is becoming more strategic, more financially accountable and more deeply embedded in organizational growth.
From cost center to growth engine
Several executives pointed to a clear shift: Pharmacy is no longer viewed solely as a cost center. It is increasingly seen as a financial risk hub and a strategic growth platform.
Madeline Camejo, PharmD, vice president of pharmacy services and chief pharmacy officer at Baptist Health South Florida in Coral Gables, said the role is evolving from operational oversight to enterprise-level strategy.
She said differentiation will come from governing total drug spend across care settings, transforming specialty and infusion services into margin drivers, building infrastructure to safely deliver advanced therapies and leveraging predictive analytics in contract negotiations. In her view, pharmacy will function as both a “risk control function and a strategic growth platform.”
Bonnie Levin, PharmD, vice president of pharmacy services at MedStar Health in Columbia, Md., sees a similar trajectory. Successful CPOs, she said, will serve as “enterprise-level strategists who leverage pharmacy as a growth engine, integrate AI and technology responsibly and strengthen workforce sustainability.”
Thomas Carey, PharmD, senior director of pharmacy services at UW Health Northern Illinois in Rockford, described the CPO as a critical C-suite leader managing one of the largest financial portfolios in a health system. What sets leaders apart, he said, is the ability to “create a bold strategic vision which incorporates technology, AI and a detailed road map to achieve success.”
Technology and AI as defining capabilities
Artificial intelligence surfaced repeatedly — not as hype, but as a practical differentiator.
Nilesh Desai, chief pharmacy officer at Louisville, Ky.-based Baptist Health, said AI will be central in the coming years.
“Artificial intelligence is going to be the key, finding the right use cases for positive outcomes,” he said, emphasizing the need for agility as regulations, technology and patient expectations shift.
Dr. Carey likewise stressed that future leaders cannot be risk-averse when it comes to innovation. A successful CPO, he said, must be “a passionate enterprise-wide change agent” who embeds technology and AI into the organization’s broader strategic vision.
John Armitstead, vice president of pharmacy services at Lee Health in Fort Myers, Fla., said leaders must master “a blend of strategic leadership, technology adoption, operational excellence, team member development, entrepreneurial partnership and patient-centered innovation,” integrating those capabilities into what he calls a High Value Pharmacy Enterprise.
Managing volatility: shortages and supply risk
Drug shortages and supply disruptions remain defining challenges — and strategic responsibilities.
Kelly Guza, PharmD, vice president of enterprise pharmacy at Geisinger in Danville, Pa., described a multilayered, systemwide strategy to monitor and mitigate shortages, including a centralized purchasing team and a dedicated procurement back-order specialist responsible for enterprisewide monitoring.
While those systems allow Geisinger to respond quickly once a shortage is identified, she noted that the work remains resource-intensive.
“Earlier visibility into emerging supply disruptions would further enhance our ability to plan proactively,” she said, pointing to the need for greater upstream transparency from manufacturers and regulators.
Dr. Levin also cited supply-chain risk as a core leadership responsibility, noting that financial expertise must be paired with the ability to navigate policy shifts and procurement instability without compromising medication quality and safety.
Policy influence and professional advocacy
As pharmacy’s scope expands, leaders said influence beyond hospital walls will become increasingly important.
Kuldip Patel, PharmD, senior associate chief pharmacy officer at Duke University Health System in Durham, N.C., said future leaders must engage in shaping state and national pharmacy policy.
They will need to “publicize and secure the ability to authorize and drive our profession’s strategic direction creatively,” he said, noting particular attention should be paid to scope-of-practice decisions.
Mr. Desai similarly emphasized collaboration and advocacy, adding that leaders must build strong relationships across the healthcare team and “prioritize the needs and experiences of their patients” while advancing innovative solutions amid mounting complexity.
Culture and talent as multipliers
Even as the CPO role becomes more financially and technologically complex, several leaders underscored a more human differentiator: team building.
Peter Paxos, director of operations in the pharmacy department at Mount Sinai Hospital in New York City, said success will hinge on hiring the right people and building a structure with clearly defined roles. Just as critical is fostering psychological safety.
Leaders must create “a culture of psychological safety, trust and innovation where that team thrives together and is held accountable for producing outstanding results,” he said.
Dr. Carey echoed that sentiment, arguing that a successful CPO must have “the skills to multiply the talents of individual team members” to achieve the organization’s strategic vision.
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