Asembia’s AXS26 Summit just wrapped in Las Vegas, five days of the most concentrated specialty pharmacy intelligence in the industry. One statistic from the closing sessions reframed the entire AI conversation in a single number. And the specialty growth data that came out of the same week makes the opportunity undeniable.
The Number That Changes How You Think About AI
Although 69% of healthcare executives cite AI as a top priority for 2026, only 8.3% of healthcare enterprises have AI operating in production today, compared with 90% in professional services. Experts from Infinitus Systems and Optum Rx identified “pilot purgatory” as a major hurdle, where initiatives remain in perpetual evaluation due to unclear success criteria and inadequate data infrastructure.
Read that again slowly. Sixty-nine percent call it a top priority. Eight-point-three percent are doing it.
That gap is not a failure of vision. It is a failure of execution. And execution gaps in competitive markets create enormous advantages for whoever closes them first.
Professional services firms, legal, financial, consulting, operate AI in production at a 90% rate. Healthcare, the most administrative-burden-heavy industry in the economy, sits at 8.3%. Every pharmacy that moves from pilot to production while competitors stay in evaluation mode gains speed, accuracy, and margin the competition cannot quickly close.
Why the Gap Exists And Why It’s Solvable at the Pharmacy Level
Healthcare leaders who have successfully deployed AI identify three consistent barriers: unclear metrics for success, fragmented data systems that don’t communicate across platforms, and organizations that haven’t committed to the workflow redesign that AI-assisted operations require. The winners will be those who prove impact with governed data, deploy AI with safety nets and continuous monitoring, and treat workflow integration as the product itself, not model sophistication.
That sounds complex at the health system level. At the pharmacy level, it is simpler than it appears. The pharmacies navigating this well are not deploying enterprise AI platforms. They are picking one specific, repetitive workflow, prior authorization, refill processing, patient follow-up calls, defining a clear metric for success, deploying a tool built specifically for that workflow, measuring the result, and repeating.
Prior authorization automation is one of the highest leverage starting points. AI agents can handle the entire prior authorization process from initiation through follow-up, reducing care delays and freeing licensed staff to focus on clinical and patient-facing work. CMS has already tightened prior authorization timelines, payers must now make standard decisions within seven calendar days, down from fourteen, with expedited requests requiring a 72-hour response. Pharmacies running manual prior authorization workflows are not just slow, they are increasingly misaligned with the speed the regulatory environment now demands.
Infinitus Systems, which presented at AXS26, simultaneously launched Infinitus Studio, the first healthcare-specific no-code AI agent builder, enabling teams to design, test, and deploy AI agents 90% faster than manual approaches, with 40% greater accuracy. Early results from a healthcare intelligence platform show over a 93% success rate across all tasks.
The tools exist. The barrier to entry has dropped dramatically. The question is whether your pharmacy is in the 8.3% or the 91.7%.
The Specialty Growth Data That Makes AI Urgency Even Clearer
The AI deployment gap didn’t emerge in isolation. It sits directly on top of a specialty pharmacy market that is expanding in complexity and revenue opportunity at a pace that makes manual workflows increasingly untenable.
XiFin’s 2026 Specialty Pharmacy Transformation Outlook survey, released at AXS26, found that more than two-thirds of respondents, 68%, identified an expanded role for pharmacists in filling care gaps as the top growth opportunity. In the next 12 to 36 months, specialty pharmacies plan to expand into treatments for growth deficiency, pulmonary hypertension, infertility, hemophilia, immune deficiency, and cystic fibrosis. Revenue is following: 48% of respondents reported an increase in revenue as they expanded specialty offerings, up from 38% in 2025.
That 10-percentage-point jump in revenue reporting, from 38% to 48% in a single year, tells you the specialty clinical services model is generating real financial results for the pharmacies that commit to it. More pharmacists filling care gaps, in more therapy categories, with growing revenue to show for it.
The leading challenge holding back that growth: low medication reimbursement, followed closely by workload and time constraints.
Workload and time constraints. That is an operational problem, and operational problems have operational solutions. AI-assisted workflows, automated prior authorization, intelligent refill processing, AI-driven patient follow-up sequencing, exist specifically to compress the time your clinical team spends on administrative tasks so they can spend more time on the care gaps that generate value.
What AI Is Working on in Specialty Pharmacy Right Now
The AXS26 sessions went beyond the statistics to describe what production AI looks like in the specialty setting.
A pharmacist-led specialty pharmacy coaching model presented at AXS26 showed improved A1C control, fewer hospital visits, and lower total costs by expanding support beyond medications to include lifestyle needs, social determinants, and care coordination for high-risk patients. The program pairs patients with pharmacist coaches who personalize care based on the provider’s care plan. “Every patient is unique, and what’s great about the program is that we give coaches the bandwidth to really tailor care and listen to the patient story,” said Bill McElnea, vice president of population health at Shields Health Solutions. Both presenters said the program supports value-based care by combining pharmacy revenue with shared savings, helping make the model sustainable while improving patient outcomes.
That model, high-touch pharmacist coaching supported by efficient data and workflow tools, is exactly what AI enables at scale. The pharmacist’s time goes to the coaching, the clinical judgment, the patient relationship. AI handles the scheduling, the prior authorization queue, the refill outreach, the documentation.
In 2026, AI and automation are becoming the backbone that helps specialty pharmacies operate efficiently at scale, manage complex medication regimens, and deliver personalized patient care. Patients expect timely, customized service. Providers need real-time insights. Health systems measure success by both clinical outcomes and operational efficiency. Success belongs to organizations that treat workflow integration as the product, not to those chasing the most sophisticated model.
The Broader AXS26 Context: A Market Under Structural Pressure
The AI urgency at AXS26 didn’t exist in a vacuum. The summit addressed a specialty pharmacy market navigating significant structural headwinds simultaneously.
IRA Medicare price negotiation provisions are now operational, with negotiated prices for 10 drugs having taken effect January 1, 2026, and 15 more drugs selected for 2027. Payers are beginning to treat these negotiated prices as de facto reference points in commercial contracting. “What we’re seeing now is that payer utilization management is intensifying faster, more than policy language ever implied,” said Dee Chaudhary, principal of Commercial Strategy Consulting at Clarivate, during her AXS26 presentation.
Reimbursement pressure compresses margin. Margin compression demands operational efficiency. Operational efficiency at scale requires automation and AI. The logic chain is direct, and the specialty pharmacy organizations that follow it earliest will be the most resilient when the next round of pricing pressure arrives.
The One-Workflow Strategy That Gets You to Production
The pharmacies now operating in the 8.3% didn’t start with an enterprise transformation strategy. They started with a workflow.
Pick one. Right now. Here are the three highest leverage starting points for community and specialty pharmacies in 2026:
Prior authorization automation. This is the most time-intensive, error-prone, and delay-generating administrative workflow in pharmacy operations. AI tools designed specifically for prior authorization, Infinitus, Cover My Meds, and several EHR-integrated solutions, handle the initiation, follow-up, and documentation. Measure success by turnaround time reduction and denial rate before and after implementation.
Refill outreach and adherence follow-up. Automated patient outreach for refill due dates, missed pickups, and adherence gaps keeps patients on therapy and generates revenue without requiring pharmacist time. Measure success by refill adherence rates and gap-in-therapy rates for your highest-value specialty patients.
Clinical documentation and care gap reporting. AI scribing tools reduce the documentation burden for pharmacist-patient interactions. AI analytics platforms identify patients in your panel who have unmet care gaps, unrefilled specialty medications, missed monitoring labs, open prior authorizations, before they become clinical problems. Measure success by the number of care gaps closed per pharmacist per week.
The best 2026 AI investments will coalesce around use cases with clear return on investment and low clinical risk. Successful deployments will focus on optimizing workflows, prioritizing integration, and performing rigorous validation, not model sophistication.
Define your metric before you start. Measure it before, during, and after deployment. If it works, expand it to the next workflow. If it doesn’t, diagnose and adjust.
That is how you escape pilot purgatory. One workflow at a time. One measured result at a time.
Sources: Drug Topics (Recap: Day 3 of Asembia AXS26, May 2026), XiFin Press Release / Morningstar (XiFin Introduces Empower AI for Specialty Pharmacy at Asembia AXS26; 2026 Specialty Pharmacy Transformation Outlook Survey), AJMC (What Health Care Leaders Have Learned From Deploying AI, April 29, 2026), Managed Healthcare Executive (Specialty Pharmacy Coaching Model — AXS26 Session Coverage), Pharmaceutical Commerce (Asembia AXS26: What’s In Store For the Future of Specialty Pharmacy; How CGTs Are Reshaping Specialty Pharmacy), Infinitus Systems Press Release (Infinitus Studio Launch, April 23, 2026), UPMC Enterprises (Healthcare Innovation in 2026: From AI Buzz to Measurable Impact), ACL Digital (Enterprise AI in Healthcare 2026), Healthcare IT Today (AI and Automation in Healthcare — 2026 HIT Predictions)
