Becker's Hospital Review

50 PHARMACY Pharmacy leaders weigh experience over NAPLEX scores By Ella Jeffries H ospital and health system leaders say they are placing greater emphasis on real-world experience, clinical judgment and cultural fit when evaluating pharmacist candidates, while standardized exam scores play a minimal role in hiring decisions. e North American Pharmacist Licensure Examination, or NAPLEX, is required for pharmacist licensure in the U.S. and assesses baseline competence to practice. In 2025, the mean pass rate rose to 84.5%, up from 71.8% the previous year, according to data from the National Association of Boards of Pharmacy. At the same time, pharmacy recruitment is occurring amid broader workforce pressures. Health systems across the U.S. continue to report shortages of pharmacy technicians and experienced pharmacists, challenges leaders say are shaping staffing models, service expansion and long-term workforce planning. Pharmacists are also taking on expanding responsibilities in areas such as specialty pharmacy, ambulatory care and complex medication management, increasing the need for candidates who can navigate clinical and operational challenges in real time. As a result, many pharmacy leaders say hiring decisions increasingly focus on how pharmacists apply their knowledge in practice rather than how they perform on a standardized exam. Patrice Neveaux Dupart, PharmD, senior vice president of pharmacy and apothecary-in-chief at NewYork-Presbyterian Hospital in New York City, said she has rarely considered NAPLEX scores when evaluating candidates. "In my 20 years as a pharmacy leader, I have placed almost no weight on NAPLEX scores when evaluating pharmacists," Dr. Neveaux Dupart said. "I have never once asked to see a candidate's score, nor have I used it as a measure of their potential or their value to the profession." Instead, she said she focuses on qualities that signal how pharmacists will function in practice, particularly their ability to adapt, solve problems and contribute to patient care. "What matters far more to me is a person's experience, ingenuity, resilience and exposure to diverse areas of pharmacy practice," she said. Ryan Haumschild, PharmD, director of pharmacy at Emory University in Atlanta, said he prioritizes candidates who demonstrate strong clinical judgment, among other attributes. "When recruiting pharmacy team members, I look for several key characteristics: humility, experience, clinical acumen and the ability to problem solve," Dr. Haumschild said. While NAPLEX scores can reflect baseline knowledge, he said they play a only small role in hiring decisions. "NAPLEX scores can demonstrate foundational knowledge, but they carry relatively less overall weight compared to clinical experience, judgment and the ability to adapt and lead within a team," he said. Cultural fit and role-specific experience also can be key considerations during the hiring process. Donna Feild senior vice president and chief pharmacy officer at PeaceHealth in Vancouver, Wash., said her team focuses primarily on a candidate's experience and how they approach interview questions. "We do not normally ask for their NAPLEX scores," she said. "I place great value on experience relevant to the open position and how candidates answer interview questions. It is important that a candidate fits well with the mission and values of PeaceHealth." With health systems competing for experienced pharmacists and pharmacy roles continuing to expand, leaders say hiring decisions increasingly center on qualities that signal long-term success in clinical environments, including adaptability, collaboration and a commitment to improving patient care. n Vertical integration reshapes pharmacy, payer landscape By Ella Jeffries V ertical integration across insurers, pharmacy benefit managers, specialty pharmacies and healthcare providers continues to reshape the U.S. drug supply chain, according to a Drug Channels report released April 14. Here are four notes from the report: 1. Control across drug channels persists: Large healthcare companies are maintaining or expanding control across insurance, PBMs, specialty pharmacies and care delivery, influencing pricing, patient access and sites of care. 2. Hospitals gain share in specialty pharmacy: Health systems now account for nearly one- third of accredited specialty pharmacy locations, with growth tied to 340B policy changes and partnerships with PBM-owned platforms. 3. Deal activity signals continued expansion: Evernorth invested $3.5 billion in Shields Health Solutions and now owns 100% of CarepathRx, while UnitedHealth Group acquired CPS Solutions, expanding payer reach into provider-facing services. 4. Some firms begin to unwind strategies: Select companies are divesting assets or outsourcing operations, reflecting evolving market dynamics and increased regulatory scrutiny. n

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