A recap of Bluesight and Becker’s Healthcare’s webinar, featuring pharmacy leaders from Phoenix Children’s, Essentia Health, and VCU Health System.
For decades, hospital pharmacy purchasing teams have operated with a singular goal in mind: buy the cheapest drug that safely treats the patient. Generic substitution, GPO contracts, and formulary discipline were the levers. Cost savings were the scorecard.
Today, that model is no longer enough.
In a recent Becker’s Healthcare webinar co-hosted by Bluesight, three pharmacy leaders from across the country joined AJ Rivosecchi, Director of Product at Bluesight, to discuss what it actually takes to shift pharmacy from a cost containment function into a driver of organizational revenue – and what risks come with getting it wrong.
The panel featured Don Bladt, Director of Inpatient Pharmacy Operations at Phoenix Children’s; Sean Tingham, Director of Infusion Oncology and Research Services at Essentia Health; and Ryan Anderson, Pharmacy Manager of Supply Chain and Operations at VCU Health System.
Here are the key themes from the conversation.
The cultural shift: from “buy the cheapest” to “what’s the margin?”
The hardest part of this transition isn’t the data – it’s the muscle memory. Pharmacy teams have spent careers optimizing on acquisition cost. Asking “what’s the reimbursement on this drug?” isn’t yet a natural part of the purchasing workflow for most teams.
Don Bladt framed the solution simply: make margin data as easy to access as the price on a wholesale platform. “If that information is easy to find and easy to interpret,” he said, “then asking the question of what is this reimbursed at just becomes a natural part of that decision and not an added burden.”
Ryan Anderson echoed the point, noting that the transition requires moving from manual calculations to automated, real-time decision support. The goal isn’t to slow down purchasing; it’s to give teams the right information at the right moment.
A real-world example of what happens when reimbursement data is missing
Sean Tingham shared a live example that illustrated the stakes clearly. As a 340B institution, Essentia Health has outlying clinics that don’t qualify for 340B pricing. When purchasing teams selected a biosimilar based on 340B acquisition cost, they didn’t realize until after the fact that the reimbursement profile in the clinic setting – purchased through a specialty GPO – was putting the site underwater.
“It actually took retroactive data, unfortunately, to find that situation,” Sean said. “I would have preferred a more proactive stance.”
The result: Essentia is now implementing what Sean called a “bidirectional biosimilar strategy” where they maintain different formulary selections for different sites of care based on margin, not just acquisition cost. “This was a situation where we thought the best purchasing opportunity was based on 340B data. We soon found the reimbursement information really put us in some hot water.”
The broader lesson: identical clinical decisions can carry very different financial outcomes depending on site of care, payer mix, and purchasing channel. And without reimbursement data embedded into the workflow, teams don’t find out until it’s too late.
Is pharmacy a cost center or a revenue center?
The panel tackled this question, and the answers were nuanced.
Ryan Anderson argued that pharmacy is neither purely one nor the other: “Pharmacy is now a critical driver of income rather than just the traditional place of controlling operational expenses. There’s no cost center or revenue center. It’s kind of a mix of both.”
Don Bladt was more direct: “I think our pharmacy is a revenue center. That’s just the way we’re being viewed.” He framed it as a dual mandate: generate revenue in high-growth areas like outpatient infusion and specialty pharmacy, while continuing to protect margin through cost discipline. “It doesn’t mean cost discipline becomes less important. It’s just that as pharmacy leaders, you really need to balance that cost management with a more strategic view of revenue growth.”
AJ offered a CFO-level frame that cut through the debate: “There’s three things you can do: decrease costs, increase revenue, decrease risk. Whether pharmacy is a revenue center or a cost center is almost inconsequential. Everyone in the health system is being looked at to try to help answer those three questions.”
The data problem: purchasing and reimbursement live in different silos
One of the most candid moments of the conversation came when the panelists discussed the structural barrier to margin-aware purchasing: the data needed to make these decisions has historically lived in completely separate systems, owned by completely separate teams.
“Pharmacy owns the purchasing data. Revenue cycle owns the reimbursement data. Finance owns the profitability view,” Ryan summarized. “How do we merge that into one unified team?”
Don was equally direct: “That answer is absolutely some blend that really doesn’t exist yet.” He described the challenge of aligning pharmacy, managed care, and finance — teams that have historically operated independently — around a shared dataset and a shared decision framework.
All three panelists converged on the same conclusion: the cross-functional team that needs to own these decisions doesn’t exist yet in most health systems, but building it is the next frontier. “None of us have the single full picture,” Don said.
What does good look like? Trusting claims-based data
When the discussion turned to claims-based reimbursement data (actual payer-level performance rather than directional ASP estimates) the panelists were consistent about what it would take for their teams to trust and act on it.
Don outlined the requirements: visibility into reimbursement by site of care, payer mix broken down rather than blended into a single average, and transparency into the inputs behind any number. “A single aggregate reimbursement figure could be misleading,” he said, “especially if it’s not connected to the specific context in which the drug will be used.”
Sean added that clinical credibility matters as much as data quality: the data needs to reflect “real life claims” rather than theoretical constructs. When those conditions are met, the data becomes actionable. Until then, it remains a directional estimate that’s hard to stake organizational decisions on.
The biggest risks, and the five-year view
The panelists closed with their honest assessments of where this is all headed and what could go wrong.
Sean flagged the complexity of making good decisions with more data, and pointed to AI as a necessary tool for interpreting it, “because the data we’re asking for is so robust, so comprehensive that are we gonna be able to, in a timely fashion, make the decisions we need to make with all that data?” He also cautioned against letting larger system-level decisions override site-specific nuances: a formulary optimized for a large academic center may not work for a small rural clinic.
Ryan named adaptability as the most important capability for the next five years: “You want something that has a rigid backbone of an idea, but then that ease of movement based on what payer structure looks like and what reimbursement looks like.”
Don issued a warning against losing sight of operational fundamentals: “Is this drug easy to compound? Do our technicians have the capability to get this drug to a patient? Am I going to give a four-hour infusion instead of a half-hour infusion and cut the number of patients I can run through my infusion center?” As margin data becomes more available, he cautioned, pharmacy teams can’t let financial optimization crowd out the operational realities that determine whether a formulary decision is actually executable.
His biggest wish: a simple, near-real-time way to use margin data to validate contract compliance with payers. “That would be a wonderful thing to have.”
Watch the full webinar
This recap captures the themes, but the full conversation goes deeper on biosimilar strategy, stakeholder alignment, executive reporting, and what the next five years could look like for pharmacy finance.
Stream the full Becker’s Healthcare webinar here.