By Todd Huseby
Ask most pharmacy executives what AI is for and
you’ll get a confident answer: cost reduction,
automation, throughput. They’re right … about yesterday. The organizations winning in 2026 and beyond
are asking something rather uncomfortable: What should the jobs even be? That question hasn’t landed
in most pharmacy C-suites yet. It needs to.
The Mental Model That Changes Everything
Here’s the idea that changes everything: A job is just a bundle of tasks. Not a title. Not an identity. Not a job description nobody has updated since 2011. Just things that need doing. For decades those bundles were stable enough that nobody questioned them. Then AI walked in and started pulling at the threads.
Microsoft’s 2025 Work Trend Index documents the result: Leading organizations are rebuilding workflows around humans and AI agents as a mixed team. Agents own the repetitive work. Humans own judgment, relationships and accountability. Microsoft calls these “frontier firms.” They exist today, mostly in tech and digital-native companies. Pharmacy is not among them.
AI is the most powerful productivity technology in a generation. Pharmacy’s ambition, so far, has been to process scripts slightly faster. That’s the equivalent of putting a Formula One engine in your car for a trip to the pharmacy and calling it a win. The technology is transformational, but our imagination for what to do with it hasn’t caught up.
The Most Valuable Asset You’re Not Using
Large pharmacy chains possess something data scientists describe as extraordinarily hard to obtain: billions of labeled, verified data points generated by licensed professionals making real decisions. Every verified prescription. Every overturned denial. Every patient whose health trajectory you’ve tracked across 20 years of fills. You didn’t build this dataset deliberately. It built itself, one transaction at a time while everyone was focused on getting through the day.
It is sitting in pharmacy operating systems right now, treated like an accounting ledger. Stored. Archived. Underused.
Third-party aggregators sell longitudinal dispensing data. But not yours, not with the clinical judgment and institutional context embedded in it. Yes, HIPAA shapes what you can build. But it doesn’t excuse not building anything. That proprietary data edge narrows as innovators find ways to collect alternative data.
The Promotions Nobody Has Offered Yet
Before we talk about new roles, let’s say the quiet part out loud.
Somewhere in your organization today, a pharmacist who graduated at the top of her class is spending four hours verifying that a computer recorded the right dose. A technician who could run a small business is doing data entry that a decent AI agent could handle. An adjudication specialist who chose health care to help people is losing arguments with insurance algorithms — again and again and again.
Call it what it is: the wrong people doing the wrong work, every single day. AI didn’t create it. But AI, built on the very data those professionals generated, is the first thing that can fix it.
Here are three sample promotions that could be offered when AI agents are on your teams:
A. Clinical Systems Designer: The pharmacist stops verifying one prescription at a time and becomes a Clinical Systems Designer, scaling her judgment across thousands
B. Orchestration Lead: The technician stops doing what software should handle and becomes an Orchestration Lead … making sure the whole human-agent system actually works
C. Access Strategist: The adjudication specialist stops losing arguments with algorithms and becomes an Access Strategist … working the insurance landscape upstream instead of fighting it downstream.
Those promotions are long overdue. And the people who deserve them are already inside your stores, waiting for someone to recognize the fit.
When Your Team Is Half Human, Half Agent
Here is something no pharmacy school taught and very few leadership development programs have caught up with yet: You are about to manage teams where some members are human and some are not.
And here is the part that should genuinely surprise you: Everyone will manage agents. Your newest technician included. Plan for that.
The mechanics will be new too. AI agents will need to be onboarded, evaluated, retrained when they drift, and retired when something better exists. Think of it as HR for digital workers, except the performance review is continuous and the termination is a software update.
The best pharmacy leaders of the next decade will think like conductors. Not “Did Sarah complete her tasks today?” but “Will the system (humans and agents together) produce the right outcomes?” Humans will bring judgment, empathy and accountability. Agents will bring speed, consistency and scale. The chains that learn to orchestrate both, and develop that discipline deliberately, will have an advantage that competitors will find genuinely difficult to replicate.
Four Questions Your C-Suite Should Be Asking
A few questions worth making the room uncomfortable at your next leadership off-site:
• You hold billions of verified prescriptions, resolved adjudications and longitudinal patient profiles. So what agents, exactly, are you training with that data?
• Payers are already constructing their own AI prior-auth platforms. Are you watching that happen or responding to it?
• Who owns the human-agent workflow in your organization? Someone needs to own the blueprint — the entire system of how humans and agents work together.
• When the best pharmacists and technicians start seeking roles that AI has made possible (and they will), will you have created those roles yet?
So What?
Pharmacy chains earned something that no tech company has managed to simply purchase: the trust of patients. People don’t deeply trust a platform … at least not like they trust a neighbor. Combined with proprietary clinical data, physical presence in thousands of communities and payor relationships built over generations, that trust is one of the most valuable strategic foundations in our health care system.
It is not, however, a permanent, durable advantage. It is a window. And windows, eventually, close.
The tech companies are watching. They’re patient, well capitalized, and professionally interested in pharmacy workflows in the same way that a pro chess player is interested in an undefended king.
You could go first. Or you could wait and see what they build.
Todd Huseby is a partner at Kearney, a 100-year-old global management consulting firm, and leads its pharmacy practice.
