As healthcare evolves and increases in complexity, the Chief Pharmacy Officer role expands. Not only are the executive’s responsibilities multiplying, but a different mindset is required—one that embraces experimentation and innovation, thoughtfully assumes risk, and advances access, quality, and long-term sustainability for the health system. In today’s environment of significant financial pressure, this also requires strategic stewardship of resources in service of patient care.
Today’s CPO is a bigger, more robust, and more important role. No one knows this better than leading Chief Pharmacy Officers who are experiencing change and challenge on a daily basis. For this article, I spoke extensively with four executives who are impactful leaders within their enterprises and respected executives among their industry peers. They include:
- Philip Almeter, PharmD, MBA, Chief Pharmacy Officer University of Kentucky HealthCare
- Will Carroll, PharmD, FACHE, Chief Pharmacy Officer, Sutter Health
- Jordan Dow, PharmD, MS, FASHP, FACHE, Chief Pharmacy Officer at Froedtert & Medical College of Wisconsin
- Darren Evans, PharmD, MPH, MHA, FACHE, Vice President, Operations and System Pharmacy Services, Phoebe Putney Health System
Allow me to express since appreciation to Drs. Almeter, Carroll, Dow, and Evans for guiding the insights that follow.
How the Role Is Evolving: The Shift Toward Strategy
The CPO role has evolved dramatically over the past decade, transitioning from a primarily operational focus on medication distribution and management (mostly in acute care) to a strategic leadership position influencing enterprise-wide performance—to being “at the table,” as Evans says. Historically, outpatient pharmacy was an afterthought, but with the rapid growth in ambulatory and home-based care models, today it is a priority, he adds. The lion’s share of pharmacy activity now occurs in outpatient settings, requiring CPOs to drive value, access, and sustainability while aligning with payer expectations and emerging care delivery trends.
Modern CPOs, all three leaders emphasized, operate at the intersection of clinical care, supply chain, market dynamics, and financial performance. They are no longer measured solely by cost savings but by their ability to demonstrate value, sustainability, and financial impact in support of patient care. Shifts in USP compounding standards, payer complexities, specialty pharmacy expansion, and evolving 340B program requirements all factor into this evolution, as have EHR/EMR and other technology integrations.
Today’s CPO is a solution-oriented strategist, accountable in part for patient quality, safety, and financial outcomes. They influence decisions on high-alert medications, sepsis management, and length of stay while building business cases for executive leadership. Today’s health systems “really want Pharmacy to be part of the care continuum,” Dow says, requiring intentional integration and strategic oversight to meet organizational goals in a rapidly changing landscape.
And, given the complexity of the business of pharmacy today, CPOs need to “translate” their expertise into language that their executive peers can understand, Carroll says. They have to clearly communicate the “message of pharmacy.”
Ways that the CPO is “at the table” more than in the past include:
- Enterprise Strategic Leadership: CPOs now influence system-wide decisions, ensuring pharmacy is integrated into clinical governance and financial strategy across the health system.
- Financial Stewardship and Sustainability: They drive revenue growth by managing high-cost therapies, building business cases, and shifting pharmacy from a cost center to a value-generating clinical and operational partner.
- Specialty Pharmacy and Advanced Therapies: CPOs lead efforts to implement specialty pharmacy services and prepare for complex treatments like cell and gene therapy, requiring care redesign and payer alignment.
- Supply Chain Innovation: They are tasked with creating centralized distribution models and reducing reliance on external vendors to improve efficiency and control costs.
- Strategic Partnerships: CPOs forge partnerships that enhance accreditation, unlock access to limited-distribution drugs, and optimize operations to boost patient volumes and revenue.
Leadership Qualities
The shift toward strategy is requiring CPOs to exhibit qualities they may not have been trained for or relied upon in the past.
- Business acumen, something not taught in pharmacy school, is critical, Evans says. Such expertise also includes adopting a leader’s mindset and caring for employees and their professional development as well as taking an enterprise-wide view of challenges.
- Resilience and adaptability are important as well, he notes, which can be difficult for pharmacists who tend to be “by the book”.
- Collaborativeness is a requisite trait for CPOs today, Almeter believes. Clinical, financial, and supply chain functions all overlap with pharmacy and present areas for partnering. “If you’re not diversifying your portfolio, you’re missing out,” he says.
- People skills and emotional intelligence are critical, Carroll says, with today’s CPO engaging with colleagues of all ages and walks of life. One way he connects with peers, for instance, is by leading a book club.
- Entrepreneurial instincts are important as well, though “most CPOs are risk-averse,” says Dow. “You need to be willing to take risks.” He points to specialty pharmacies and infusion clinics as two areas for exploration and innovation. “You need to think several steps ahead,” Almeter adds. “The CPO needs to provide solutions.”
AI and Technology
Artificial intelligence and technology are reshaping the Chief Pharmacy Officer role, driving efficiency and enabling strategic decision-making. Dow notes it is being deployed as a resource multiplier, particularly in administrative functions. For example, CPOs are using AI tools to detect drug diversion and streamline prior authorization processes—tasks that previously required extensive manual review. These solutions have already delivered measurable efficiencies, freeing staff for higher-value work.”AI is here,” says Almeter of UK. The market is currently flooded with vendors, some better than others, he notes. “The sweet spot is to find AI solutions that are resource multipliers for the team to do more.”
As Sutter Health continues to advance AI capabilities across the enterprise, pharmacy is working to integrate these tools into its workflows, Carroll notes. Areas of early focus could include call bots, automated transcription technologies, and accuracy monitoring, alongside building thoughtful business cases to inform future investment.
Operational technology is also advancing rapidly. Robotics for sterile compounding, such as chemo preparation, enhance safety and quality while reducing exposure risks. Smart lockers for medication pickup represent innovative approaches to improve access for employees during off-hours, demonstrating how CPOs lead system-wide initiatives to modernize workflows.
Data analytics has become a cornerstone of pharmacy leadership. Dedicated analytics teams and platforms like Power BI enable CPOs to track trends, optimize biosimilar purchasing and management strategies, and support value-based care models. Ultimately, AI and advanced technologies position CPOs as strategic innovators, enabling them to integrate automation, analytics, and digital tools to improve efficiency, manage costs, and deliver better patient outcomes in a rapidly evolving healthcare landscape.
Advice for Tomorrow’s CPOs
Building upon their insights, Drs. Almeter, Carroll, Dow, and Evans offer advice for those to enter and advance into their profession.
- Maintain a growth mindset. Thinking outside the box is a prerequisite for the modern CPO role. Dedicate creative time to think beyond day-to-day operations and anticipate market shifts. Staying informed through diverse sources (reading, conferences, peer groups, etc.) enables leaders to anticipate and adapt before changes reach their organizations. “Leaders are readers,” emphasizes Almeter, who favors nonfiction books about inventors and great historical figures.
- Foster growth in others. Driving workforce development is critical for CPOs to succeed, from what Dow calls “front-end pipeline work” such as investment in local educational and apprentice programs to ongoing career development initiatives (including financial support) for more experienced staff. Supporting career mobility through cross-training and “bridge programs” for pharmacists and technicians reduces vacancies and fosters engagement.
- Get business training. While clinical and operational expertise can be developed through traditional pharmacy training, financial and analytical acumen often requires additional effort. “Go seek that skillset if you don’t have it,” Evans says, noting that many important skills can’t be learned on the job. Healthcare organizations are under financial pressure, making business literacy essential for survival and differentiation. “Lean into financial courses” and, if possible, pursue an MBA, Dow advises.
- Partner with technology. This may be easier for younger generations, but CPOs must dedicate time to understanding and integrating emerging tools and digital solutions into everything they do. This proactive approach positions them to lead innovation rather than react to disruption.
- Seek out mentors and confidants. Finding one or more dedicated mentors can accelerate success for a CPO, while trusted peers can serve as sounding boards and a support network. Don’t feel the need to go it alone in terms of career development and satisfaction.
- Cast a wide (geographic) net for advancement and new employment. Carroll notes that effective CPOs can do their work mostly or completely virtually as long as they have a strong work ethic, time management, and leadership skills. In a prior role he worked on-site for two weeks on off-site for two weeks each month.
Prescription for the Future
Pharmacy leaders in large health systems like Drs. Almeter, Carroll, Dow, and Evans face daunting challenges, including workforce shortages, cost containment, and specialty pharmacy integration. Yet there are significant opportunities. CPOs must leverage analytics to demonstrate value, improve outcomes, and communicate impact across the C-suite, peers, and manufacturers. Expanding pharmacy services into new care continuums and incorporating value-based strategies will be key differentiators. Ultimately, successful CPOs must act as “enterprise strategists”, in Almeter’s words. Rather than reacting to industry pressures, they are executives who will proactively shape tomorrow’s solutions.
