Health-System Pharmacy Purchasing and Drug Shortages

Look for "purchasing" in the ASHP Midyear 2026 program and you'll barely find it. Out of more than 200 education sessions in Orlando on December 6–9, none is about drug procurement as such. The only listing with "purchasing" in its title is a vendor-sponsored, non-CE breakfast. Read the program for what health-system pharmacy leaders are wrestling with, though, and buying decisions turn up everywhere: in the shortage sessions, the 340B sessions, the finance track and the debates about AI.

The pattern matters if you run health-system pharmacy purchasing or own a pharmacy budget. Purchasing is no longer a back-office task that sits under operations. It's now where drug shortages, 340B rules, the cost of high-priced therapies and data strategy all meet. Here are the four themes we see in this year's program, and the sessions that cover them.

1. Shortages: from firefighting to triage

This year's shortage sessions start from the idea that you can't defend every product equally, so you have to decide in advance which ones get your effort.

ASHP's Prioritizing Essential Medicines for Drug Shortage Intervention (Tue., Dec. 8, 8:00 a.m.) asks pharmacists to score each drug on two things: how critical it is to patient care, and how exposed it is to supply-chain disruption. Ranking by both, rather than either one alone, tells you where to spend your effort. Expect a similar logic to show up in shortage committee charters. Who it's for: pharmacists, technicians and pharmacy leaders; intermediate level. Best fit: buyers and shortage committee leads.

Two other sessions build on that idea:

• The Scarcity Dilemma (Wed., Dec. 9, 2:00 p.m.) brings ethics committees into severe-shortage decisions. Allocation is now treated as a clinical and ethical call, not just a buyer's problem. Who it's for: pharmacists, technicians and pharmacy leaders; advanced level. Best fit: pharmacy directors and shortage or ethics committee members.
• Advancing 503B Harmonization (Wed., Dec. 9, 2:00 p.m.) looks at what product catalogs from 503B outsourcing facilities (FDA-registered compounders) need to contain so buyers can evaluate and source alternatives quickly in a shortage. It treats speed in a shortage as a data-quality problem. Who it's for: pharmacists and technicians; general interest. Best fit: buyers and sterile compounding managers.

The takeaway for purchasing teams: drug shortage management is only as fast as the information behind it. Teams that can see on-hand quantities, how fast stock is being used and alternate sources in one place get to make these calls. Teams that can't end up reacting to them.

2. The 340B purchasing model may be rewritten

For purchasing teams, the session with the most at stake is 340B Developments Impacting Hospital and Pharmacy Practice (Tue., Dec. 8, 4:00 p.m.), led by 340B Health. Who it's for: pharmacists, technicians and pharmacy leaders; intermediate level. Best fit: 340B program managers, buyers and pharmacy directors. Its learning objectives ask attendees to plan for three changes:

• Back-end rebates. The 340B discount could move from the point of purchase to a rebate paid after the fact.
• Contract pharmacies. Manufacturers keep adding restrictions on 340B drugs dispensed through contract pharmacies.
• Medicare drug prices. Reimbursement is changing for 340B drugs that are subject to Inflation Reduction Act negotiated prices.

The rebate question matters most to buyers. Today a 340B purchase is priced when you place the order. Under a rebate model, you'd pay more up front and wait for money back, which means tracking claims, reconciling rebates and covering cash-flow gaps. How you choose between 340B, GPO and WAC accounts, compare primary wholesaler prices and check 340B compliance would all have to change with it.

The program also covers the basics. 340B Update: Using 340B Program Savings to Support Patients (Mon., Dec. 7, 4:00 p.m.), led by Apexus, covers how to report savings. Who it's for: pharmacists, technicians and pharmacy leaders; general interest. Best fit: 340B program managers and compliance staff. 340B University runs as a free, full-day pre-meeting workshop on Sunday, Dec. 6, with separate registration. Who it's for: open to all 340B stakeholders, CE for pharmacists and technicians. Best fit: buyers and staff new to 340B.

3. Supply chain becomes a leadership discipline

One session treats pharmacy supply chain as a career track with defined skills. Building Pharmacy Supply Chain (PSC) Leadership: A Validated Framework to Guide Training (Wed., Dec. 9, 4:00 p.m.) presents five consensus-derived areas of supply chain practice. It also shows where leaders say they need more training. Expect the framework to shape job descriptions and residency rotations. Who it's for: pharmacists, technicians and pharmacy leaders; general interest. Best fit: supply chain managers, buyers and the directors who hire them.

ASHP also files that session under "Leadership in Medication Use & Safety" on its new Practice Advancement Initiative (PAI) programming page. Midyear is where ASHP launches the PAI revision, its long-range framework for pharmacy practice. Building the Future: Driving Change in Pharmacy Practice Beyond PAI 2030 (Tue., Dec. 8, 9:30 a.m.) presents the updated recommendations. Whether supply chain earns a place in that framework is worth watching. Who it's for: pharmacists, technicians and pharmacy leaders; general interest. Best fit: pharmacy directors and anyone setting department strategy.

The finance sessions point the same way:

• From Once Upon a Time to Happily Ever After: The Pharmacy Revenue Cycle Story (Sun., Dec. 6, 1:00 p.m.) looks at charge capture and denials, and at how pharmacy and finance teams can work together on them. Who it's for: pharmacists, technicians and pharmacy leaders; intermediate. Best fit: pharmacy business and finance managers.
• Formulary Fidelity (Tue., Dec. 8, 2:00 p.m.) covers how the cost and complexity of high-priced, advanced therapies now shape formulary decisions. Who it's for: pharmacists and pharmacy leaders; intermediate. Best fit: formulary and P&T pharmacists.
• Balancing the Pharmacy Budget (Tue., Dec. 8, 2:00 p.m.) uses reports on high-cost drugs to find substitution opportunities that lower total cost of care. Who it's for: pharmacists and pharmacy leaders; intermediate. Best fit: population health and pharmacy finance leads.
• Turning Medication Waste Into Revenue (Sun., Dec. 6, 12:30 p.m.) shows how technicians recover money by documenting and billing for drug waste. Who it's for: pharmacists and technicians; general interest. Best fit: technician supervisors and revenue integrity staff.

A few of the five-minute talks inside this year's pearls sessions hit the same nerve:

• Specialty Pharmacy Pearls 2026 (Tue., Dec. 8, 8:30 a.m.) includes "Part B Without the Pain: Optimizing Billing" (Tufts Medicine) and "Switch Smarter: A Practical Workflow for Biosimilar Transitions" (WVU Medicine). Who it's for: pharmacists and technicians; general interest. Best fit: specialty pharmacy managers and buyers handling biosimilar contracts.
• Community Pharmacy Pearls 2026 (Tue., Dec. 8, 2:00 p.m.) includes "Different Name, Same Game: Making Biosimilars Work" (Regional One Health). Who it's for: pharmacists and technicians; general interest. Best fit: outpatient and retail pharmacy managers.

Across these sessions, pharmacy cost containment is treated as work leaders manage actively, not an overhead line. That puts purchasing data alongside clinical data in the conversation with the C-suite.

4. Data decides who can act

AI is the loudest topic at Midyear, and it gets its own section in the featured program. In the operations sessions, though, the real subject is integrating data that already exists.

• Controlled Substance Analytics (Tue., Dec. 8, 3:30 p.m.) shows how Johns Hopkins pulled together data from automated dispensing cabinets, inventory and purchasing systems, the EHR and a diversion-monitoring tool into dashboards. Most of the analytics were built in-house. Who it's for: pharmacists and technicians; general interest. Best fit: operations managers and diversion or analytics leads.
• Management Pearls 2026 (Tue., Dec. 8, 10:00 a.m.) includes a short case from Bon Secours Mercy Health on using data analytics to improve inventory turns and GPO contract compliance, plus a talk from Geisinger titled "Million-Dollar Doses." Who it's for: pharmacists and technicians; general interest. Best fit: pharmacy managers and buyers
• Pharmacy AI Readiness: Build, Buy, Govern, & Educate (Mon., Dec. 7, 4:00 p.m.) gives leaders a scorecard for choosing between building and buying, based on workflow fit, integration effort, staffing and time to impact. Who it's for: pharmacists, technicians and pharmacy leaders; intermediate. Best fit: directors and informatics leads evaluating vendors.
• Pillars of Preparedness (Tue., Dec. 8, 10:00 a.m.) asks how the pharmacy keeps running when systems are down for a long time. Who it's for: pharmacists, technicians and pharmacy leaders; general interest. Best fit: operations managers and emergency preparedness leads.

Two more sessions look at the data problem from the product-identity side:

• Revising the National Drug Code and Drug Label Barcode Requirements (Tue., Dec. 8, 3:30 p.m.), planned with the FDA, covers the final rule the agency published in March 2026. The rule moves the NDC (National Drug Code) to 12 digits and updates barcode labeling. Purchasing catalogs, contract pricing and inventory records built on today's 10-digit NDC will likely all need a transition plan. Who it's for: pharmacists and technicians; intermediate. Best fit: buyers, informatics staff and whoever maintains the drug item master.
• Informatics Pearls 2026 (Wed., Dec. 9, 2:00 p.m.) includes three five-minute talks on operations data. MemorialCare covers fixing default NDC selection with machine learning ("Garbage In, Default Out"). Houston Methodist covers inventory categories beyond fast and slow movers. UCSF Health presents an efficiency benchmark for automated dispensing cabinets. Who it's for: pharmacists and technicians; general interest. Best fit: informatics and operations analysts.

AI forecasting won't help much if purchasing, inventory and usage data are spread across systems that don't connect. The groundwork for useful AI is the same as for good purchasing: data from every vendor, contract and site that can be trusted and checked.

Sessions to put on your schedule

Times are Eastern; check the ASHP conference program for rooms.

ASHP audience is who ASHP accredits the session for; "leaders" means its Certified Pharmacy Executive Leader (CPEL) credit. ASHP has no buyer category, so Best fit is our own read on who will get the most from each session.

Tuesday, Dec. 8 has the most of these sessions. Several time slots double or triple up (Monday 4:00, Tuesday 2:00 and 3:30, Wednesday 2:00), so split them across your team.

One tip for building your schedule: ASHP's agenda has no purchasing or supply chain filter. Most of these sessions sit under the broad "Administrative/Financial/HR" topic, and the five-minute pearls talks only surface through keyword search. Try "procurement," "contract compliance," "inventory," "340B" and "NDC."

The bottom line

Purchasing doesn't have a track of its own at Midyear 2026, but it's part of nearly every hard question on the program: which shortages to defend, how 340B pricing will work next year, which high-cost therapies the budget can absorb, how many purchases stay on GPO contract, and whether the data behind those decisions holds up.

If those questions are on your list, come talk with us at SureCost, Booth #663. We'd like to hear how your team is preparing, and we'll show you how health-system pharmacies are bringing 340B, WAC and GPO purchasing, inventory and shortage data together in one place.

Sources

• ASHP Midyear 2026 conference program (session descriptions and schedule)
• ASHP Midyear 2026 featured programming
• ASHP Midyear 2026 pre-meeting workshops
• ASHP Midyear 2026 exhibitor directory