药房采购的未来：从采购职能到数据驱动战略
The Future of Pharmacy Procurement:From Purchasing Function to Data-Driven Strategy
Lauren Forni，药学博士，工商管理硕士，Bluesight临床战略高级总监随着药品价格飙升、短缺加剧以及政府规定的费用分摊受到质疑，医院系统药房采购正变得越来越令人担忧。药房领导者通常被期望在财务绩效、运营韧性和监管准备等关键成果上交付成果。
医疗系统——目前利润率徘徊在2%左右，现金储备骤降——正迫使药房支撑机构生存能力。不幸的是，太多药房组织缺乏交付所需的资源。
他们在各自孤岛中应对挑战，使用临时的电子表格和反射性做法，例如简单地“重新订购我们上次买的东西”。碎片化和低效率埋下了隐藏的陷阱，可能引发超支、药品供应紧急情况和意外的监管违规。即使是药品成本的小幅飙升也可能抹去一整年的利润。
药房的多方面职责
药房采购的挑战是多方面的。让我们关注三个核心职能：管理药品成本、避免灾难性短缺，以及确保获得联邦监管的340B团购折扣以改善患者护理。这些职能比表面上看起来更加相互交织。
每次药品采购都必须在采购成本、支付方报销、340B节省潜力和供应链稳定性之间取得平衡，这些变量是传统采购系统无法解决的。
假设您正在审查一项NDC变更，该变更每年可能节省数十万美元。这看起来像是一场胜利，直到您突然面临即将到来的供应中断。同样，如果报销未能跟上，较低的340B价格可能会危及预计利润率。
不幸的是，最危险的机构往往最不具备处理这些棘手决策的能力，无论是资源限制还是缺乏支持成功的解决方案。
然而，没有一个系统能够承受在相互关联的财务矩阵中继续做出孤立的采购决策。相反，采购必须演变为一种战略组织能力，考虑每项决策的操作、监管和财务影响。它必须实现统一决策主导力量一场完美风暴显著复杂化了药房采购。
药品价格正在上涨，预计今年将上涨3.35%至4%，主要受日益增长的高价疗法管线需求以及专科药物复杂性增加所驱动。对于药房来说，焦点已从简单的价格谈判转向总支出管理的生存级需求。
药品短缺已成为常态
而非例外。我们已经进入了一个持续稀缺的时代，活跃药品短缺总数在任何时候都创下超过270种药物的新纪录，近60%的当前短缺持续两年或更长时间。短缺充当隐藏的支出驱动因素，迫使系统采购昂贵的合同外替代品或昂贵的外包设施来填补空缺。从2019年到2024年，用于短缺管理的劳动小时和劳动成本增加了一倍多，显著增加了运营压力。
监管审查正在加强。
340B药品计划长期作为安全网提供者的财务基石，使他们能够扩大稀缺的联邦资源并为服务不足的人群扩展护理。随着340B采购的市场价值超过800亿美元，一项将前期折扣转为后端报销的提议引入了前所未有的现金流波动可能性。医疗系统可能被要求预付药品的全部费用，有时在等待制造商返利期间临时药品支出飙升500%至5,000%。
每项采购决策都伴随着权衡。条块分割造成了“决策鞭打”——一个反应性救火的循环，消耗劳动小时并削弱机构韧性。
将所有这些职能——药品支出、短缺和340B作为一个整体进行全面管理——将有利于运营和财务绩效。医疗保健系统需要购买、构建或创建获取统一决策能力的路线图。
进入药房智能
新的药房智能平台正在帮助将采购从交易性购买职能转变为数据驱动战略。通过整合供应链可见性、合同分析和预测性短缺洞察，药房领导者正在改进采购决策、控制采购成本，并在药品供应链中建立更大的韧性。
药品支出管理计划首次提供合同和发票的100%可见性，识别主要和二级批发商之间的最优定价选项，同时管理复杂的340B返利比较并提供短缺风险洞察。其意图是绝不将节省留在桌面上。
药品短缺技术充当早期预警系统，预测供应
中断。它还提供按站点“库存天数”计数的可见性，自动更新，给机构时间在必要时准备替代品。通过将这些预测信号直接整合到采购工作流程中，采购可以防止切换到即将从市场消失的“低成本”药物，在制造商独家来源药物价格上涨生效之前预见到，并提前规划预测到的短缺。
340B合规技术提供100%交易审计，将合规从追溯性“快照”转变为连续、实时的过程，确保每项索赔都是可审计和可辩护的。它提供持续合规监控和全面返利防御。
一些公司使用其340B合规技术使顾问能够进行类似于340B监管机构卫生资源与服务管理局（HRSA）所下令的“模拟审计”，为他们提供整体合规性的单一时间快照。作为替代方案，专门为340B合规团队设计的解决方案允许在其实340B计划的全部范围内进行持续合规监控。
统一决策赋予药房团队自信行动的能力。他们不再需要在最便宜的药物和最可靠的药物之间做出选择。相反，他们获得了一个单一事实来源，在每笔交易中平衡价格、可用性和审计准备。
在这个微薄利润和持续波动的时代，这种连接方法确保您的药房既保持临床准备，又成为其运营所在的医疗系统的财务生命线。
关于Lauren Forni，药学博士
Lauren Forni，药学博士，工商管理硕士，是Bluesight的临床战略高级总监，她与医疗系统领导者合作，现代化药物管理、加强转移监督，并将复杂的监管和运营挑战转化为可扩展的、数据驱动的解决方案。作为布里格姆妇女福克纳医院的前药房助理主任，她带来了涵盖制药供应链优化和340B计划管理的 frontline 运营洞察，以制定行业战略。她还是Diversion Collective的联合创始人，这是一个多学科协作组织，旨在通过共享专业知识和实际应用提升医疗保健组织衡量、管理和减轻转移风险的方式。
Lauren Forni, PharmD, MBA, Sr. Director of Clinical Strategy, Bluesight
With drug prices soaring, shortages intensifying, and government-mandated cost-sharing in question, hospital-system pharmacy procurement is becoming an increasingly fraught enterprise. Pharmacy leaders are routinely expected to deliver on critical outcomes, including financial performance, operational resilience, and regulatory readiness.
Health systems – with margins currently hovering around 2% and cash reserves plummeting – are pressuring pharmacies to shore up institutional viability. Unfortunately, too many pharmacy organizations lack the resources to deliver.
They tackle their challenges in silos with ad hoc spreadsheets and reflexive practices such as simply “reordering what we bought last time.” The fragmentation and inefficiency set hidden traps that can trigger overspending, drug-supply emergencies, and unintended regulatory violations. Even a minor spike in drug costs can erase a year’s worth of margin.
Pharmacies’ multifaceted duties
The challenges of pharmacy procurement are multifaceted. Let’s focus on three core functions: managing drug costs, avoiding catastrophic shortages, and securing federally regulated 340B group purchasing discounts to improve patient care. These functions are more intertwined than they appear on the surface.
Each drug purchase must balance acquisition costs, payor reimbursement, 340B savings potential, and supply chain stability, variables that traditional procurement systems cannot address.
Imagine you’re reviewing an NDC change that could save hundreds of thousands of dollars each year. It looks like a win until you’re suddenly hit with an upcoming supply disruption. Similarly, a lower 340B price can jeopardize projected margins if reimbursement fails to keep pace.
Unfortunately, the most endangered institutions tend to be the least equipped to handle these thorny decisions, whether it be resource limitations or lack of solutions to support success No system, however, can afford to continue making isolated purchasing decisions in an interconnected financial matrix. Instead, procurement must evolve into a strategic organizational capability that considers the operational, regulatory, and financial implications of every decision. It must enable unified decision-making Prevailing forces A perfect storm of forces has significantly complicated pharmacy procurement.
Drug prices are on the rise
and are projected to rise by 3.35% to 4% this year, driven largely by explosive demand for a growing pipeline of expensive therapies and the increasing complexity of specialty drugs. For pharmacies, the focus has shifted from simple price negotiation to a survival-level need for total spend management.
Drug shortages are the norm
rather than the exception. We’ve entered an era of persistent scarcity, with the total number of active drug shortages reaching a new record high of over 270 medications at any given time and nearly 60% of current shortages persisting for two years or longer. Shortages act as a hidden spend driver, forcing systems to procure expensive off-contract alternatives or costly outsourcing facilities to fill the void. From 2019 to 2024, both labor hours and labor costs dedicated to shortage management more than doubled, significantly increasing operational strain.
Regulatory scrutiny is intensifying.
The 340B drug program has long served as a financial cornerstone of safety-net providers, enabling them to stretch scarce federal resources and expand care for underserved populations. As the market value of 340B purchases exceeds $80 billion, a proposal to shift up-front discounts to back-end reimbursements introduces the potential for unprecedented cash flow volatility. Health systems may be required to front the full cost of medication, sometimes seeing temporary drug spend spikes of 500% to 5,000% while waiting for manufacturers’ rebates.
Every procurement decision comes with a tradeoff. Compartmentalization creates “decision whiplash” – a cycle of reactive firefighting that drains labor hours and compromises institutional resilience.
Managing all these functions – drug spend, shortages, and 340B holistically as an integrated whole – will benefit operational and financial performance. Health care systems need to buy, build, or create a roadmap for acquiring unified decision-making capability.
Enter pharmacy intelligence
New pharmacy intelligence platforms are helping transform procurement from a transactional purchasing function to a data-driven strategy. By integrating supply chain visibility, contract analytics, and predictive shortage insights, pharmacy leaders are improving purchasing decisions, controlling acquisition costs, and building greater resilience into the medication supply chain.
Drug-spend management programs for the first time are providing 100% visibility into contracts and invoices, identifying optimal pricing options across primary and secondary wholesalers while managing complex 340B rebate comparisons and providing insights into shortage risk. The intent is to never leave savings on the table.
Drug-shortage technology acts as an early-warning system, forecasting supply
disruptions. It also offers visibility to site-by-site “days-on-hand” counts that automatically update, giving institutions time to prepare for substitutes if necessary. By integrating these predictive signals directly into the procurement workflow, procurement can prevent switching to “low-cost” drugs that are about to disappear from the market, anticipate manufacturer price increases on sole-source medications before they take effect, and plan ahead for predicted shortages.
340B compliance technology provides 100% transaction auditing, moving compliance from a retrospective “snapshot” to a continuous, real-time process, ensuring every claim is auditable and defensible. It offers continuous compliance monitoring and total rebate defense.
Some companies use their 340B compliance technology to enable consultants to conduct “mock audits” resembling those ordered by the Health Resources and Services Administration (HRSA), the 340B regulatory body, giving them a singular snapshot in time of overall compliance. As an alternative, a solution specifically designed for a 340B compliance team instead allows for continuous compliance monitoring across the entirety of their 340B program.
Unified decision-making empowers pharmacy teams to act with confidence. They no longer have to choose between the cheapest drug and the most reliable one. Instead, they gain a single source of truth that balances price, availability, and audit-readiness in every transaction.
In an era of thin margins and persistent volatility, this connected approach is the only way to ensure that your pharmacy remains both clinically prepared and a financial lifeline to the health system in which it operates.
About Lauren Forni, PharmD
Lauren Forni, PharmD, MBA, is Senior Director of Clinical Strategy at Bluesight, where she works with health system leaders to modernize medication management, strengthen diversion oversight, and translate complex regulatory and operational challenges into scalable, data-driven solutions. As a former Assistant Director of Pharmacy at Brigham and Women’s Faulkner Hospital, she brings frontline operational insight spanning pharmaceutical supply chain optimization and 340B program management to industry-wide strategy. She is also the co-founder of the Diversion Collective, a multidisciplinary collaborative designed to elevate how healthcare organizations measure, manage, and mitigate diversion risk through shared expertise and practical application.
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