Strategic Spend: Partnership is the only choice for pharmacy and supply chain leaders in health systems

Health systems are operating in an era where disruption is constant. Persistent drug and product shortages, geopolitical instability, tariffs, reimbursement reform, and accelerating financial pressure have fundamentally altered how institutions must operate. Pharmacy and supply chain now jointly influence not only cost, but access, quality, and revenue performance. In this environment, historical models in which pharmacy and supply chain functioned independently—even if they appear to be doing so in an optimal fashion—will no longer support the enduring viability of the health organization or its ability to achieve patient care access and quality goals.

The evolution of supply chain and pharmacy

For decades, pharmacy and supply chain evolved along parallel tracks. Each optimized within its own lane—formulary management on one side, sourcing and logistics on the other.

But that model breaks down in today’s environment, given the overlap of challenges and responsibilities facing both entities, including supply interruptions from natural disasters, manufacturer shutdowns, and quality concerns—all of which now also occur alongside sustained headwinds such as:

• Site-neutral payment policies and margin compression
• Freight and geopolitical routing disruptions
• Vertical consolidation among manufacturers, distributors, and payers
• Increasing private equity influence
• Tariffs and trade policy uncertainty
• Federal policy shifts, including Medicare drug price negotiation

A breakdown of individual and shared responsibilities

To address these challenges in a way that promotes financial sustainability while keeping patient care at the forefront, leaders must embrace a more coordinated, system-wide approach. Modern healthcare requires:

• Shared governance over clinical and non-clinical spend
• Common financial language around price, quantity, and mix
• Coordinated responses to shortages and disruptions
• Unified engagement with manufacturers spanning multiple product categories

The field has evolved from transactional purchasing to strategic enterprise management. Today, decisions around formulary, sourcing, contracting, and utilization have immediate effects across cost, revenue, and access.

A framework for health system leaders

Successful organizations do not rely on rigid rules. Instead, they convene the right stakeholders—pharmacy, supply chain, finance, compliance, and clinical leaders—and work backward from a single question: What is best for the patient and the organization?

Health systems seeking stronger pharmacy–supply chain alignment should focus on:

1. Shared governance: Establish joint forums for decisions affecting clinical and non-clinical spend.
2. Common analytics: Use shared tools to analyze price, quantity, and mix across categories.
3. Role clarity: Align responsibilities with core expertise while maintaining shared accountability.
4. Operational integration: Plan major initiatives—new therapies, service expansions, technology implementations—together from the outset.
5. Relationship building: Invest in trust, communication, and mutual understanding at both leadership and frontline levels.

The days when pharmacy and supply chain could operate as parallel silos are over. In today’s healthcare environment, collaboration is not a courtesy—it’s a requirement. Organizations that align pharmacy’s clinical insight with supply chain’s sourcing and operational expertise are better positioned to withstand disruption, manage cost, protect revenue, and ensure patient access.

For chief pharmacy officers and chief supply chain officers alike, the message is clear: The strongest systems are built on shared strategy and accountability and a relentless focus on the mission they serve together.

Lessons from the field

Insights from a Vizient Member Networks C-Suite Exchange featuring leaders from East Alabama Health and NewYork-Presbyterian illustrates why the continuous strategic partnership between pharmacy and supply chain is critical and highlights how health systems can operationalize that partnership.