Cencora’s Accelerate Pharmacy Solutions report finds health system pharmacies pursuing growth amid rising access and reimbursement pressures
CONSHOHOCKEN, Pa., [Oct. 7, 2026] – Cencora’s Accelerate Pharmacy Solutions, an integrated portfolio of pharmacy and supply chain solutions, today unveiled findings from its Pharmacy Outlook: Fall 2026 Edition revealing how health systems are prioritizing pharmacy growth while payer restrictions and enterprise coordination gaps continue to challenge patient access.
Released at the Accelerate Pharmacy Solutions Health Systems National Summit, the report draws on a survey of more than 110 health system pharmacy leaders to explore how pharmacy’s clinical, financial and operational priorities are becoming increasingly interconnected, and what that means for health systems planning their next phase of growth.
“Health system leaders are navigating significant financial and operational pressures while continuing to look for opportunities to expand access to care and strengthen performance,” said David Tinsley, Senior Vice President – Accelerate Pharmacy Solutions, Cencora. “The findings across every section of this report highlight that pharmacy decisions no longer stay inside pharmacy. The capabilities health systems are building – across specialty, infusion, cell and gene therapy, technology and more – cannot be fully realized within the pharmacy department alone. The health systems getting the most from pharmacy are the ones that treat its strategy as enterprise strategy."
The findings highlight how health system pharmacies are managing the intersection of financial pressure, access complexity and enterprise-wide readiness as their scope broadens and reveal actionable strategies for health systems to navigate a complex landscape:
- Health systems remain focused on growth, but leaders are applying greater financial discipline to determine which opportunities move first. More than half of respondents characterized their pharmacy strategy as growth-oriented, with improving pharmacy financial performance and revenue capture leading the growth roadmap (87%). Biosimilar adoption and formulary optimization follow closely (85%), with specialty pharmacy and infusion expansion each at 79%.
The findings point to the importance of ownership and operational structure to achieve these goals. Dedicated pharmacy billing and revenue-cycle staff was ranked by respondents as the most valuable approach for optimizing rebilling and revenue recovery, while data analytics for revenue optimization ranked first among broader pharmacy cash-flow priorities. - Expanded capabilities have not eliminated structural patient access barriers. Across therapeutic areas, report findings show patients whose specialty prescriptions stay within the health system begin therapy twice as fast. Yet 69% are still being dispensed through external pharmacies. The barriers most reported, payer network restrictions that route prescriptions outside the health system (77%) and payer approval requirements (74%), do not sit within a single program’s control. Closing the gap between capability and capture is a cross-service operating challenge running through referral management, site-of-care strategy and payer influence, which is why no one program can close it alone.
Infusion poses similar access barriers. Despite an uptick in respondents with a home infusion program (29% to 40% year-over-year), more than 20% of respondents cannot estimate how many of their infusion patients are being referred outside the health system – a visibility gap that can make it difficult for leaders to determine where patients ultimately receive care and how best to invest in alternate-site strategies. - Cell and gene therapy is becoming an enterprise priority before it is an enterprise capability. Despite a cell and gene therapy (CGT) pipeline that points to enormous potential, report findings show that many health systems do not yet have the enterprise-wide capabilities to support broader patient access. Although 100% of current CGT adopters report pharmacy plays some role, only 5% say pharmacy leads and manages the program – underscoring the cross-functional nature of CGT governance and the need for repeatable approaches to reimbursement, financial risk, governance and portfolio management across clinical service lines.
“Health systems have built the clinical and operational capabilities to care for specialty patients, but payer networks and manufacturer restrictions still determine whether they can reach them,” said Beth Riggio, Vice President & General Manager – Practice Management Solutions at Accelerate Pharmacy Solutions, Cencora. “With only one third of specialty patient prescriptions managed internally, the next phase of growth will depend less on adding pharmacy services and more on aligning payer strategy, provider relationships and patient access around the patients the health system already serves.”
For more information about how Accelerate Pharmacy Solutions is partnering with health systems to help build, grow and optimize their pharmacy and supply chain programs, and to read the full Pharmacy Outlook: Fall 2026, visit: cencora.com/resources/health-systems/pharmacy-outlook-report