APhA’s member-driven policy response on vertical integration

At APhA, our strength has always come from our members, and that principle guides everything we do. As the national professional association representing pharmacists, student pharmacists, and pharmacy technicians across all practice settings, APhA has a responsibility to listen carefully, engage openly, and advance policy positions that reflect the collective voice of the profession, and we are committed to upholding that responsibility in everything we do. Our credibility, our impact, and the trust our members place in us depend on it.

That commitment is especially important as policymakers across the country consider significant changes to the structure of the pharmaceutical supply chain, including proposals related to vertical integration and the pharmaceutical supply chain. These issues are complex, consequential, and evolving rapidly, and they demand thoughtful, inclusive engagement from the profession. Tough issues require APhA to create a space where everyone’s voice is heard and adopt a policy that reflects the diversity of our members’ views.

We want to update you on APhA’s progress toward developing a policy position on vertical integration and other key issues related to the pharmaceutical supply chain.

Principles posted for member input

Earlier this year, the APhA Board of Trustees developed and posted a draft of Principles on Pharmaceutical Supply Chain Policy to provide a high-level framework for evaluating legislative and regulatory proposals related to reimbursement, market structure, and patient access. These principles were intentionally grounded in long‑standing House of Delegates (HOD) policy, while offering flexibility to help guide advocacy in a rapidly changing environment.

Consistent with our member‑driven governance, the Board posted these principles for member feedback through April 10, 2026. We heard from pharmacists practicing in a wide variety of settings, as well as from other stakeholders, who shared perspectives, concerns, and recommendations. That engagement has been invaluable and reflects the diversity of thought and experience within our profession.

Role of the House of Delegates

At APhA, it is the HOD that establishes the official policy positions of the profession. Those positions, in turn, guide the work of APhA’s advocacy team at both the state and federal levels.

That distinction was front and center during the most recent HOD discussions at our Annual Meeting & Exposition in Los Angeles, related to vertical integration in the pharmaceutical supply chain. Delegates introduced an urgent new business item addressing the structural separation of PBMs and pharmacies, in the context of recent state laws that would prohibit vertically integrated entities from owning PBMs and pharmacies, laws that have already been enacted in some states.

Delegates expressed a variety of perspectives. Some spoke in support of the resolution and urged stronger action, while others raised concerns about potentially eliminating efficiencies associated with certain integrated models or unintentionally limiting the ability of new, pharmacist‑driven PBMs to enter the marketplace.

After substantive and thoughtful discussion, the House voted to withdraw the resolution and instead take a deliberate next step consistent with APhA’s long‑standing consensus‑building tradition.

A deliberative path forward

Rather than advancing language that had not yet achieved broad agreement, the House directed Mary Klein, PharmD, Speaker of the House, to appoint a special committee charged with refining and harmonizing policy language that can appropriately reflect the perspectives of APhA’s diverse membership.

That committee will bring forward proposed language for consideration by the full House through a special virtual session, allowing delegates to debate and vote on a final policy position. Once adopted, that policy will guide APhA’s advocacy efforts on this issue.

This approach underscores an essential truth about APhA: when the profession is facing complex and consequential issues, we take the time to get it right.

Opportunities for member engagement

In keeping with our commitment to transparency and inclusion, APhA members will have the opportunity to observe the upcoming House deliberations through a non‑voting virtual “gallery,” similar to the format used during the 2020 and 2021 virtual HOD sessions.

Details on how to join the virtual gallery will be shared as the session approaches. For now, I encourage members to save the date:

Special Virtual Session of the APhA House of Delegates
Wednesday, May 27
4:00 pm to 5:30 pm ET

Listening, Learning, and Leading Together

The conversation regarding vertical integration and the pharmaceutical supply chain is not simple, nor should it be. Members have expressed a wide range of views on competition, patient access, pharmacy sustainability, reimbursement fairness, and regulatory oversight, and all those perspectives deserve to be heard and thoughtfully considered.

What unites us is our shared commitment to patients and to the pharmacist–patient relationship. By engaging members, our HOD, and following a transparent, deliberative process, APhA is doing what we have always done best: advancing policy with our members, not ahead of them.

Thank you to everyone who has contributed feedback, participated in House deliberations, or plans to engage in the upcoming virtual session. Your voice, your experience, and your engagement matter, and will help shape the future of the profession for years to come.

For all of pharmacy.