By Steve Anderson
For years, “the future of pharmacy” sounded like a distant concept. But that future has landed on our doorstep, demanding immediate, decisive action. America faces a mounting health crisis, and the influence of pharmacies and pharmacists has never been more critical. NACDS Total Store Expo stands as the industry’s central stage — a platform for retailers and suppliers to take the reins and define pharmacy’s role as the face of neighborhood health care.
What’s at stake
Public opinion research by NACDS, conducted over nearly two decades, consistently finds that Americans rank pharmacies and pharmacists as the most accessible health care destinations, and among the most trusted. With 90% of Americans living within five miles of a pharmacy, and with pharmacists’ expertise at the core, our industry delivers both convenience and quality. The public is asking for more — expanded health and wellness services and deeper engagement in their care.
But our nation’s health metrics tell a sobering story. Chronic disease rates continue to climb, and U.S. life expectancy has dropped in recent years. Preventable conditions like type 2 diabetes and cardiovascular disease take a heavy toll, especially in rural communities. The Centers for Disease Control and Prevention (CDC) reports that 129 million Americans live with a chronic disease, and 42% manage two or more. These burdens drive up health care spending while the U.S. lags behind other developed nations in prevention and outcomes.
At the same time, pharmacy access is slipping away at an alarming rate. At the start of this year, pharmacies were closing at a rate of 3.7 per day — with more than 5,800 closures since 2018, and 1,364 in 2024 alone. Over 800 ZIP codes now lack a pharmacy, pushing care further out of reach for millions. This loss threatens medication safety — pharmacists play a crucial role in preventing harmful drug interactions — and strips communities of proven interventions for chronic diseases such as diabetes, hypertension and heart disease. Without strong pharmacy access, Americans’ health will decline. But by fortifying our reliance on pharmacies, we can begin to reverse these trends.
NACDS TSE puts retailers and suppliers in control
The challenges facing pharmacy — and the communities that rely on us — fall into two camps: those we can tackle head on and those that require broader action, including government reforms and policies. NACDS Total Store Expo empowers retailers and suppliers to join forces on solutions within our grasp and unites the industry to advocate for the changes we need.
Henry Ford once observed, “Most people get ahead during the time that others waste.” NACDS Total Store Expo embodies that spirit, opening doors that simply can’t be ignored. The partnerships and deals forged at this event will drive business success for years, powered by thoughtful preparation, and by dynamic conversations at “Meet the Market,” in the Exhibit Hall, during networking events, and throughout the crucial follow-up in the weeks after.
Attendees should dive into the event’s robust programming, which addresses the issues that matter most for our industry’s competitiveness. For example, the conference will provide insights about maximizing current technology, automation and pharmacy technicians to support pharmacists in patient care.
Also, NACDS has long championed artificial intelligence (AI), ensuring members have every opportunity to explore its direct connection to success. Opportunities for AI to enhance pharmacy operations are being deployed or discussed — including implications for medication management; personalized patient care through predictive analytics; optimizing inventory control; streamlining administrative tasks; and further-elevating clinical decision making and patient outcomes.
Consistent with this proactive approach, 2025 NACDS Total Store Expo will deliver practical AI insights, including:
• Case studies showing AI’s proven results.
• Strategies for using AI to combat retail crime.
• Innovations in category management.
• Effective evaluation of AI solutions.
Keynote speaker Peter Diamandis, entrepreneur and founder of the XPRIZE Foundation, will challenge us to think even bigger about the potential of AI and broader technology to spark industry innovation.
Attendees also will gain tools to succeed in areas such as:
• Meeting consumer expectations for seamless, personalized experiences across digital and physical channels.
• Addressing the needs of family caregivers and older adults.
• Keeping pace with the latest advances in pharmacy-based testing and treatment.
• Leveraging pharmacy-employer partnerships to boost workforce wellness.
• Learning from athletes about collaboration, resilience and wellness in both business and life.
This powerhouse content offers a road map for those determined to win in a fast-changing environment.
The advocacy imperative: controlling the ‘uncontrollable’
While innovation and collaboration can address many challenges, some threats demand action from policy makers. NACDS Total Store Expo serves as a rallying point for the industry to unite behind NACDS’ advocacy for policies that support people in communities throughout the country and the pharmacies that serve them.
At the top of the list: reforming the practices of pharmacy benefit managers. PBM middlemen drive up drug costs, force pharmacy closures and make health care harder to reach. Congress stands closer than ever to enacting PBM reforms, with broad bipartisan support and more than 70% of American voters calling for action. NACDS’ current campaign urges Congress to Call the Vote and stop PBMs from putting pharmacies out of business. Every day of delay means higher costs for Americans and more pharmacy closures.
NACDS also recognizes the complex web of health care and pharmacy policy. A change in one area can ripple across the system, sometimes with unintended consequences. The association advocates for comprehensive, real-world solutions that:
• Deliver meaningful PBM reforms with positive impacts for Americans and pharmacies.
• Expand opportunities for pharmacy teams to provide services that improve health and efficiency.
• Prevent further commoditization of pharmacy, and ensure the profession’s value is recognized beyond dispensing medications.
NACDS positions pharmacies as essential partners in the administration’s pledge to Make America Healthy Again, highlighting the importance of pharmacist-led screenings and interventions for chronic disease. The association leads on innovative health and wellness strategies, including “food is medicine” and nutrition initiatives such as the NACDS Nourish My Health national public education campaign. Critical legislation, such as the Ensuring Community Access to Pharmacist Services Act, would finally establish needed billing mechanisms for pharmacy services in Medicare — a long overdue move that would empower seniors to access services allowed by states.
NACDS also is maintaining a proactive footing to shape policy on issues like “most favored nation” drug pricing, direct-to-consumer pharmaceutical sales, pharmaceutical tariffs and vaccine policy. These are issues on which pharmacies’ insights and experiences — from their position closest to the American patient — are essential for sound policy making.
One of the most important roles of NACDS is to serve as the industry’s grassroots advocacy connector — ensuring our collective voice remains strong and unified as we weigh in with the government on pressing issues. This work will be front-and-center at NACDS Total Store Expo.
A call to action
NACDS Total Store Expo arrives at a decisive moment. The challenges facing Americans and their pharmacies — rising chronic disease, shrinking access, shadowy PBM practices — are intertwined and demand immediate, coordinated action. The conference offers retailers and suppliers a unique opportunity to innovate, collaborate and advocate for the future of pharmacy as America’s trusted neighborhood health care hub.
By embracing technology, advancing public policy and uniting around common goals, our industry can secure better health outcomes and stronger communities nationwide. The time for academic debate is over. The future of pharmacy must be defined, secured and created today — and the future belongs to those who seize the moment at NACDS Total Store Expo.
Steve Anderson is president and chief executive officer of the National Association of Chain Drug Stores.
