What will pharmacists actually spend their time doing in 2035?
That question matters more than whether pharmacy will have better automation, more artificial intelligence, or new technology. Those tools are almost certain to change the profession. The bigger question is what happens to the pharmacist when they do.
On November 3, ASHP previewed PAI 2035: A Framework for Pharmacy Enterprise Transformation, the next evolution of its long-running Practice Advancement Initiative. The framework focuses on comprehensive medication management, expanded pharmacist and pharmacy technician roles, AI-enabled practice, value-based care, technology and innovation, public health, and stronger financial performance across the pharmacy enterprise.
At first glance, that sounds like another professional roadmap.
Look closer, though, and a much bigger idea appears.
Technology is taking on more operational work. Pharmacy technicians are assuming more advanced responsibilities. AI is becoming capable of processing information, identifying patients who need attention, supporting decisions, and improving workflows.
If those trends continue, pharmacists cannot simply spend the next decade doing today’s job more efficiently.
They have to move toward work that requires more judgment, accountability, strategy, and responsibility for medication outcomes.
In other words, the future pharmacist moves up the value chain.
Pharmacy has already moved much further than it sometimes feels
It is easy to talk about the future of pharmacy as though the profession has barely changed.
The data tell a different story.
ASHP reports that pharmacists now routinely provide direct patient care at the bedside in more than two-thirds of hospitals. More than 70% of health systems have pharmacists integrated into ambulatory care clinics. Meanwhile, automated dispensing systems have become common in nearly 90% of hospitals.
Pharmacy technicians have also taken on more advanced responsibilities. That shift has allowed pharmacists in many organizations to spend more time on medication management and patient care.
These changes did not happen overnight.
ASHP launched the original Practice Advancement Initiative in 2010. PAI 2030 later created 59 recommendations across patient-centered care, pharmacist education and training, technology and data science, pharmacy technician roles, and leadership in medication use and safety.
Many ideas that once sounded aspirational have since become normal in parts of health-system pharmacy.
Pharmacists participate in transitions of care. Ambulatory pharmacists help manage chronic disease. Specialty pharmacy has grown inside health systems. Telepharmacy and remote care have expanded. Pharmacy departments use more automation, analytics, and advanced technicians.
PAI 2035 starts from that new baseline.
The question is no longer simply whether pharmacists should do more.
It is what pharmacists should own next.
Automation changes the job only if the profession allows the job to change
Pharmacy has a complicated relationship with automation.
Technology has already transformed medication distribution. Automated dispensing cabinets, robotics, centralized fulfillment, barcode systems, clinical decision support, and electronic prescribing now handle work that once required far more manual effort.
AI is likely to accelerate that transition.
ASHP’s 2026 Summit on Pharmacy Workforce Transformation in the Age of AI focused specifically on how artificial intelligence could reshape pharmacy roles, responsibilities, workflows, competencies, and business functions. Importantly, ASHP framed the goal as using AI to strengthen human expertise rather than simply replace it.
That distinction matters.
If AI helps review large volumes of information, the pharmacist should not simply use the saved time to process more of the same work.
If automation reduces technical tasks, pharmacists should not spend the next decade protecting every task that technology can perform safely.
The opportunity is to move toward work where pharmacist judgment matters more.
That could include identifying which patients need intervention, evaluating complicated medication regimens, managing high-risk therapies, interpreting evidence, overseeing medication systems, designing care pathways, governing clinical technology, or determining how an organization should manage medication spending.
Technology creates the capacity.
The profession still has to decide what to do with it.
Technicians moving forward should allow pharmacists to move forward too
The same principle applies to pharmacy technicians.
PAI has long emphasized expanding technician roles. ASHP’s current recommendations support technicians taking greater responsibility for technical and operational functions when training, regulation, and organizational systems allow it.
That is not simply a technician workforce story.
It is a pharmacist workforce story.
If appropriately trained technicians manage more operational work, pharmacists gain an opportunity to spend more time on responsibilities that require their education and judgment.
The profession should therefore avoid measuring progress only by how many new tasks pharmacists accumulate.
A better question is whether pharmacists are shifting toward higher-value work.
Consider medication reconciliation. A pharmacy team may use technicians, automation, data systems, and pharmacists together. Technology can gather information. A trained technician may help build the medication history.
The pharmacist’s value comes from interpreting what the information means.
Which medication should actually continue? Which discrepancy matters? Is the patient taking something unsafe? Does the regimen make sense after discharge? Who needs to know about the change?
That is a better use of a PharmD than spending time manually collecting information that another part of the system can gather safely.
Comprehensive medication management is a clue to where the profession is going
PAI 2035 places comprehensive medication management near the center of its vision.
That phrase can sound familiar, but the idea behind it is significant.
A pharmacist practicing at a higher level does not simply review whether one prescription is correct. The pharmacist looks across the entire medication strategy.
Does every medication have a purpose? Is each therapy effective? Is the regimen safe? Can the patient realistically use it? Are important monitoring needs being met? Could therapy become simpler or less expensive?
Now extend those questions across populations.
Which patients are at highest risk from medication problems? Where are preventable readmissions occurring? Which high-cost therapies need better management? Where are patients abandoning treatment because of access barriers?
The pharmacist begins moving from prescription-level oversight toward medication-system ownership.
ASHP’s existing PAI recommendations already call for pharmacists to share accountability for patient outcomes and population health. They also encourage pharmacy departments to analyze medication-use patterns, lead medication stewardship, support personalized therapy, and participate in financial stewardship.
PAI 2035 appears to push that direction further.
The future pharmacist may manage systems, not only medications
One of the most important shifts may be the level at which pharmacists create value.
Traditional pharmacy often focuses on one medication and one patient.
Future pharmacy increasingly operates at several levels at once.
A pharmacist may still make an individual therapy recommendation. However, another pharmacist could design a system that identifies 5,000 patients who need that same intervention.
Someone may oversee how AI evaluates medication orders across an entire health system. Another pharmacist may develop a strategy for introducing cell and gene therapies. A pharmacy leader could manage millions of dollars in specialty-drug spending or determine how a value-based contract should measure medication outcomes.
ASHP’s current PAI recommendations already call for pharmacy enterprises to develop expertise in finance, analytics, business management, informatics, payer relations, quality, and supply chain. They also recommend pharmacist executive leadership in enterprise-wide decisions involving medications and technology.
Those recommendations offer a clue about the pharmacist of 2035.
Medication knowledge remains the foundation.
The scale at which that knowledge gets applied becomes much larger.
AI creates a new pharmacist responsibility: deciding how AI should be used
Pharmacists sometimes discuss AI as a tool they will either use or compete against.
There is a third possibility.
Pharmacists can help govern it.
A health system cannot simply deploy an AI tool because it produces impressive answers. Someone has to determine whether the system is accurate, safe, useful, appropriately monitored, and suitable for the workflow.
Medication-related AI makes that responsibility especially important.
Imagine an algorithm that prioritizes patients for pharmacist intervention. Which variables should it use? What happens if the model consistently overlooks one population? How often should pharmacists override it? Who monitors whether the recommendations actually improve outcomes?
Another AI tool may summarize patient records. A different system could identify possible medication problems or predict adherence risk.
Every tool creates clinical and operational questions.
ASHP’s existing recommendations call for pharmacy involvement in advanced analytics, AI, emerging technologies, and standards governing AI use throughout the medication-use process.
Its 2026 AI summit also emphasized evidence-based, ethical, patient-centered implementation.
That creates a future role pharmacists may not have imagined during pharmacy school.
You may not need to build the algorithm.
You may need to decide whether healthcare should trust it.
Advanced therapies will push medication expertise in another direction
AI is not the only force changing pharmacy.
ASHP said earlier this year that the updated PAI framework also needed to account for ultra-high-cost drugs and advanced therapeutics.
That challenge is already visible.
Cell and gene therapies, precision medicines, specialty drugs, and other complex treatments can require far more than conventional dispensing.
Someone has to understand patient eligibility, evidence, storage and handling, access requirements, reimbursement, distribution, administration, monitoring, and long-term outcomes.
The more complicated the therapy becomes, the more valuable someone who understands the full medication system becomes.
A pharmacist in 2035 may therefore spend less time on routine product distribution and more time navigating increasingly complex therapies.
That pharmacist might work in specialty strategy, clinical operations, patient access, value-based contracting, advanced-therapy programs, medical affairs, or medication policy.
Again, the profession moves up the value chain.
Value-based care changes what pharmacy has to prove
Another major PAI 2035 theme is value-based care.
That could have enormous consequences.
A fee-for-service or dispensing-oriented model rewards activity. A value-based model asks whether the activity improved something that matters.
Did medication management lower hospitalizations?
Did the pharmacist help control blood pressure?
Did better specialty-drug management reduce waste?
Did an intervention improve adherence?
Did a new care model reduce total healthcare spending?
Those questions require pharmacists to become comfortable with outcomes, economics, analytics, and measurement.
ASHP’s earlier PAI recommendations already called for payment models that recognize pharmacist value and align reimbursement with quality outcomes.
That sounds straightforward until you try to build the business case.
Pharmacy cannot simply say pharmacists provide value.
The profession increasingly has to quantify where that value appears.
That may require learning the language of quality metrics, healthcare finance, population health, pharmacoeconomics, reimbursement, and return on investment.
Those are not side skills for pharmacy leadership.
They may become core skills for proving why expanded pharmacist work deserves sustainable funding.
Financial performance belongs in the future-of-pharmacy conversation
One notable part of PAI 2035 is the inclusion of financial performance alongside patient care, workforce, technology, and public health.
That should not be viewed as separate from pharmacy practice.
A service that cannot support itself financially is difficult to scale.
A pharmacist may design an excellent chronic-care program. However, the organization still needs to know who will pay for it, how much it costs to deliver, whether it reduces another expense, and whether the model remains sustainable.
The same applies to specialty pharmacy, ambulatory care, remote monitoring, medication access, and advanced therapies.
Future pharmacy leaders will therefore need to understand both clinical value and economic value.
A PharmD who can explain why a therapy is clinically appropriate brings one type of expertise.
A PharmD who can also explain its budget impact, reimbursement pathway, operational requirements, and expected outcomes becomes useful in an entirely different way.
That combination can move pharmacists into strategy.
The pharmacist of 2035 may look less like a job title and more like a portfolio of capabilities
This is where the career implications become especially interesting.
There may not be one “future pharmacist.”
Different pharmacists will move toward different high-value functions.
One may become exceptional at complex medication management. Another could specialize in analytics and population health. Someone else may lead advanced-therapy operations.
Other pharmacists could work in digital health, AI governance, value-based care, specialty strategy, medication access, informatics, quality improvement, clinical research, or business leadership.
The common thread is judgment.
The jobs become less defined by performing one repetitive pharmacy workflow and more defined by solving medication-related problems that require specialized expertise.
That means pharmacists should think differently about career development.
Do not only ask which credential is next.
Ask which category of judgment you want an organization to trust you with.
The profession’s future depends on what pharmacists stop doing too
Career development usually focuses on adding skills.
The next decade may require subtraction as well.
Pharmacists should become comfortable asking whether a task still requires a pharmacist.
If a technician can perform it safely after appropriate training, should the pharmacist continue doing it?
If technology can automate it reliably, should the pharmacist spend time protecting that workflow?
If AI can summarize the information, should the pharmacist’s job be producing another summary or deciding what should happen because of it?
Those questions can feel uncomfortable because professional identity often becomes tied to familiar responsibilities.
However, professions advance when expertise moves toward the work that needs expertise most.
Pharmacists should protect judgment.
They do not need to protect every task.
Try the three-bucket exercise
There is a simple way to make PAI 2035 personal.
Look at your current workday and divide your responsibilities into three categories.
The first contains work that technology could eventually automate. The second includes work that another trained member of the pharmacy team could potentially perform. The third contains work that genuinely requires pharmacist judgment.
Be realistic.
Prescription processing may move increasingly toward automation and centralized systems. Data collection may become easier. Documentation may become partially automated. Some operational responsibilities may move toward technicians.
Now look closely at the third category.
What remains?
Perhaps it is managing a complicated medication regimen. Maybe it is making a difficult risk-benefit decision. It could involve interpreting evidence, resolving a high-risk medication problem, designing a workflow, communicating with another healthcare professional, or deciding how a patient should move through the medication system.
That is the category worth strengthening.
If automation and delegation shrink the first two buckets over the next decade, how are you becoming exceptional at the third?
That question may be more useful than trying to predict which exact pharmacy job will exist in 2035.
Students should prepare for a profession that may value different skills
This also has implications for pharmacy education.
A student graduating today could still be practicing in the 2060s.
Teaching that student only how current pharmacy workflows operate would be a mistake.
Future pharmacists will still need pharmacology, therapeutics, evidence evaluation, medication safety, and communication. Those foundations are not disappearing.
However, they may also need greater fluency in analytics, AI, healthcare economics, informatics, population health, advanced therapeutics, and business.
ASHP’s PAI recommendations already encourage pharmacy education and training to cover reimbursement, payment, business management, health information technology, and other areas beyond traditional therapeutics.
PAI 2035 reinforces why those subjects matter.
The goal is not to turn every pharmacist into a programmer, financial analyst, or executive.
It is to make sure pharmacists can work effectively inside a healthcare system where those disciplines increasingly intersect with medication use.
Technology does not automatically elevate the profession
There is one important caution.
Automation alone will not create a better pharmacist job.
AI alone will not move pharmacists into more strategic work.
Expanded technician roles alone will not guarantee that pharmacists gain more meaningful responsibilities.
Healthcare organizations could use those changes simply to increase throughput.
That is why professional strategy matters.
If technology removes ten hours of routine work, pharmacy leaders have to decide what higher-value work replaces it.
Do pharmacists take greater responsibility for medication outcomes? Do they manage high-risk populations? Do they move into clinics? Do they help govern technology? Do they lead specialty strategy? Do they become more involved in population health and value-based care?
Those choices determine whether technology advances pharmacy practice or simply makes today’s model faster.
PAI 2035 appears to argue for transformation rather than acceleration.
The pharmacist should not merely process more.
The pharmacist should own more meaningful outcomes.
The future pharmacist moves toward the decisions that matter most
The strongest signal in PAI 2035 is not any single recommendation.
It is the direction of travel.
Pharmacists are becoming more involved in patient care. Technicians are expanding their responsibilities. Automation is taking on more operational work. AI is entering clinical and business workflows. Advanced therapies are becoming more complicated. Healthcare payment is slowly shifting toward outcomes.
Those forces all point toward the same question.
What work should require a pharmacist in 2035?
The answer is unlikely to be every task pharmacists perform today.
It may be the work where medication expertise changes a decision.
Which therapy should this patient receive?
Which patients need intervention?
How should this health system manage a $3 million therapy?
Should this AI recommendation be trusted?
How should an organization reduce medication-related hospitalizations?
What should the formulary cover?
How should a pharmacy service prove its financial value?
How should medication care be redesigned for an entire population?
That is a much bigger role than processing medication orders.
It also creates a more optimistic way to think about automation.
Technology does not have to shrink pharmacy.
It can create room for pharmacy to move upward.
The pharmacist of 2035 may spend less time performing tasks that technology or another trained team member can safely handle and more time making decisions that require clinical judgment, systems thinking, leadership, and accountability.
That is the real opportunity inside ASHP’s blueprint.
The future of pharmacy is not simply doing today’s job faster.
It is owning different work.
Resources & Citations
- American Society of Health-System Pharmacists. “PAI 2035 Establishes a Vision for the Next Decade of Pharmacy Practice.” November 3, 2026. ASHP’s preview of PAI 2035 describes a framework focused on patient care, workforce development, technology and innovation, public health, and financial performance, with emphasis on comprehensive medication management, expanded pharmacist and technician roles, AI-enabled practice, and value-based care.
- American Society of Health-System Pharmacists. “ASHP Summit on Pharmacy Workforce Transformation in the Age of AI.” Pharmacy Futures 2026. The summit examined how AI could change pharmacy responsibilities, competencies, workflows, clinical practice, operations, research, education, and business while emphasizing responsible implementation that strengthens human expertise.
- American Society of Health-System Pharmacists. “PAI Recommendations.” ASHP’s existing PAI 2030 recommendations include comprehensive medication management, expanded technician roles, AI and analytics, population health, medication stewardship, pharmacy financial management, informatics, payer relations, advanced technology, and payment models linked to quality and outcomes.
- American Society of Health-System Pharmacists. “PAI FAQs.” ASHP describes the Practice Advancement Initiative as a framework intended to transform pharmacist care by expanding pharmacist and technician roles, applying medication-safety technology, and increasing pharmacist leadership in medication use.
- American Society of Health-System Pharmacists. “Get Ready for the PAI 2030 Reboot.” March 11, 2026. ASHP explained that the next evolution of PAI needed to respond to disruptive forces including workforce pressures, artificial intelligence, ultra-high-cost drugs, advanced therapeutics, and changes in the business of healthcare.