Guide gives HR and benefits leaders a step-by-step roadmap to expand employee access to care and lower costs through local pharmacies.

With employer healthcare costs projected to rise approximately 9% in 2026 and access to care growing more uneven, American employers are searching for solutions that don't cut benefits or shift costs to workers. A new resource from the Health Action Alliance (HAA), commissioned by the National Association of Chain Drug Stores (NACDS), points to a solution that is already embedded in daily life for most Americans: local pharmacies - one of the most scalable and underutilized strategies available to employers today.

The new playbook - Beyond the Script: An Employer's Guide to Unlocking the Value of Pharmacy-Based Services - arrives as healthcare cost increases show no sign of slowing down and roughly 108 million Americans now live in areas with inadequate access to primary care, with nearly two-thirds of those shortage areas in rural regions. Against that backdrop, the guide highlights a striking disconnect: while 96.5% of Americans live within 10 miles of a pharmacy and employees visit pharmacies regularly - 57% visiting at least once a month - few employers are aware that pharmacies offer clinical services far beyond dispensing medications and administering vaccines.

Beyond vaccines, pharmacists provide preventive care and screening for chronic conditions like diabetes, high blood pressure, and high cholesterol; testing and treatment for common illnesses such as flu, COVID-19, and strep throat; medication therapy management; and ongoing chronic disease management - often at a lower cost than traditional care settings. Overall, return on investment for pharmacist-led healthcare services ranges from $1.29 to $18.50 for every $1 invested among non-hospitalized patients, with the greatest impact in high-cost, high-prevalence conditions such as diabetes, cardiovascular disease, and cancer.

"Employers need to control healthcare spending and close access gaps - without passing more costs on to workers," said NACDS President and CEO Steven C. Anderson, FASAE, CAE, IOM. "This employer playbook makes clear that pharmacy-based care is a proven, practical answer: accessible and affordable healthcare that keeps employees healthy and on the job. Pharmacies are already there, already trusted, and already capable of doing more - this guide gives employers the roadmap to make that happen."

The playbook outlines how HR and benefits leaders - particularly at self-funded and level-funded organizations - can integrate pharmacy-based services into existing health plan arrangements to help employers close access gaps, improve outcomes, and better manage total healthcare spend. It includes actionable guidance on adding clinical pharmacy services to medical benefits, educating employees on available services, building direct partnerships with local pharmacies, and tracking impact. The playbook also identifies policy changes - including payment for pharmacist services as recognized healthcare providers and expanded scope of practice - that would multiply these benefits at scale.

"Local pharmacies are more than just access points for medication. They have the potential to serve as frontline healthcare destinations," said Health Action Alliance Co-Founder and Co-CEO Stephen Massey. "Employers who recognize this and act on it will gain a meaningful advantage: healthier workforces, lower costs, and employees who feel supported. This guide is designed to make getting started as straightforward as possible."

Employee interest backs that case. Eighty-nine percent of U.S. employees hold a positive perception of pharmacy-based healthcare, 71% say more pharmacy-based services would improve their health, and 65% say those services would help them avoid missing work - a direct benefit to employer productivity that pairs with the broader cost savings the playbook documents.

The playbook's release was paired with an extensive employer outreach effort. NACDS and HAA partnered with the HR Certification Institute (HRCI) for a virtual employer briefing that drew more than 1,000 live attendees internationally - and the results were striking. Before the session began, only 42% of participants said they were familiar with the full range of services their local pharmacist could provide. By the end, 92% described themselves as familiar. Post-event survey results reinforced the demand: nearly 63% of respondents said most or all of the content presented was new to them, 95% called it relevant to their work, and 87% said they were now likely to explore pharmacy-based services as part of their benefits strategy.

The playbook builds on HAA's 2025 research report, commissioned by NACDS and featuring insights from pharmacy, population health, and business leaders. Together, the playbook and report are part of a suite of resources designed to help employers partner directly with pharmacies to make healthcare more affordable and accessible.

Designed as a step-by-step guide, the playbook walks employers through making the internal case, starting the conversation with carriers and brokers, building pharmacy partnerships, and measuring results - turning the opportunity into a practical next step.

Access the full playbook here.