John Pastor, PharmD, President of Fairview Pharmacy Services

Summary

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Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Guest: Dr. John Pastor, PharmD, President of Fairview Pharmacy Services
Host: Laura Dardo
Date: January 31, 2026

This episode features Dr. John Pastor, President of Fairview Pharmacy Services, who discusses Fairview’s core philosophies, the recent expansion and innovations in their pharmacy operations, ongoing challenges in the industry, and his vision for the future. He shares leadership insights, details about facility transformation, and broader perspectives on pharmacy's evolving role within healthcare systems.

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Key Discussion Points & Insights

1. Background and Philosophies at Fairview Pharmacy

• Dr. Pastor introduces himself as a pharmacist with over 30 years of experience, primarily hospital-based but also now in ambulatory care.
• Fairview is a large Minnesota-based nonprofit health system: 10 hospitals, 60 clinics, 34,000 employees, 1.2 million patients.
• Pharmacy Philosophy: More than just prescription fulfillment; pharmacy is integrated into the entire healthcare journey for patients.
  • “We're a vital part of how our patients experience healthcare.” — John Pastor [00:45]

2. Major Initiative: Relocation and Expansion of Central Pharmacy Facility

• Fairview Pharmacy doubled in size over the last 5-10 years, necessitating a major facility upgrade.
• Undertook a multi-year project relocating to a new 150,000 sq. ft. pharmacy shared services facility in Shoreview, MN.
  • All core central pharmacy teams consolidated in the new site.
  • Facility supports 26 retail locations, specialty pharmacy serving all 50 states (16,000 patients), home infusion pharmacy (3,000 patients), and 10 hospitals.
  • Over 200,000 prescriptions filled monthly.
  • “Frankly, it was a four- or five-year project in whole from start to we got the final team moved.” — John Pastor [03:33]

3. Lessons Learned from the Expansion (Advice for Peers)

• Admits this was a new-scale project and sought advice from national peers.
• Integrated best practices from other health systems into new designs, particularly in:
  • Infusion Center: 16 specialized suites for adults, adolescents, and pediatrics, each tailored for specific patient needs.
  • Technology: Invested in state-of-the-art, often first-in-US-market pharmacy technology for safety and efficiency.
  • “One of the things on our list that they don't teach you in pharmacy school: how to do a big project like this.” — John Pastor [04:25]

4. Priorities and Headwinds for 2026

• Industry Growth: Pharmacy is now an $800B+ industry (trending toward $1T), with specialty pharmacy as a key driver.
• Access Challenges: Major closures of pharmacies nationwide (chains and independents); nearly 45% of pharmacies in Minnesota have closed since 2013.
  • Patients in rural and urban areas may have limited pharmacy options.
• External Pressures:
  • Federal legislation and policy changes.
  • Manufacturer restrictions and 340B program uncertainty.
  • Workforce shortages and persistent supply chain/drug shortages.
  • Healthcare costs rising faster than reimbursement.
  • “Pharmacies across the country continue to close at an alarming rate... patients living… with significant access issues.” — John Pastor [06:50]

5. Strategic Planning Amid Uncertainty

• Stays proactive about legislative and market shifts; strong emphasis on a responsive, well-informed team.
  • “Staying abreast of what's happening around us... making sure we have all the right members on our team engaged.” — John Pastor [09:11]
• Drug shortages can shift daily, requiring nimble responses and teamwork.

6. Leadership and the Challenge of Complexity

• The pharmacy business has grown dramatically in complexity, making adaptability and teamwork more vital.
  • “The hardest thing... is being able to respond in a timely way to external changes... the business has become very complex compared to how it was when I started.” — John Pastor [10:12]

7. Growth Opportunities and New Ventures

• Strong belief that health systems should strive to retain and care for their own patients through integrated pharmacy services.
• Launch of Fairview Pharmacy Solutions (2025): New enterprise to help other health systems replicate Fairview’s successes and retain patients.
  • “Our goal there is to help other health systems do a lot of the things that we've done over the last 25 years and optimize their care delivery.” — John Pastor [11:38]

8. Philosophy of Shared Success

• Emphasis on collaboration and shared progress for better patient outcomes.
  • “When we can all serve patients better, we all do better, and that's our goal.” — John Pastor [12:27]

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Notable Quotes & Memorable Moments

• "We're a vital part of how our patients experience healthcare." — John Pastor [00:45]
• “One of the things on our list that they don't teach you in pharmacy school: how to do a big project like this.” — John Pastor [04:25]
• “Pharmacies across the country continue to close at an alarming rate... patients living… with significant access issues.” — John Pastor [06:50]
• "Staying abreast of what's happening around us... making sure we have all the right members on our team engaged." — John Pastor [09:11]
• “The hardest thing... is being able to respond in a timely way to external changes... the business has become very complex compared to how it was when I started.” — John Pastor [10:12]
• “Our goal there is to help other health systems do a lot of the things that we've done over the last 25 years and optimize their care delivery.” — John Pastor [11:38]
• “When we can all serve patients better, we all do better, and that's our goal.” — John Pastor [12:27]

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Timestamps for Major Topics

• 00:25 — Dr. Pastor’s background and Fairview overview
• 02:00 — Overview of the new pharmacy shared services facility
• 04:20 — Lessons learned and advice for others expanding pharmacy services
• 06:03 — Current and future priorities for Fairview Pharmacy/industry
• 08:22 — Planning and pivoting amid external pressures
• 10:10 — Biggest challenges for the coming year
• 11:08 — Growth opportunities and launch of Fairview Pharmacy Solutions
• 12:27 — Closing philosophy on collaboration and serving patients

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Tone and Closing Thoughts

The episode was marked by candor, humility, and a focus on teamwork and patient-centered care. Dr. Pastor offered both a strategic lens on the business of pharmacy and granular insights for other leaders navigating expansion, change, and industry headwinds. The conversation closed with optimism about collaboration and continual improvement in healthcare and pharmacy services.

Transcript

[A]

This is Laura Dardo with the Becker's Healthcare Podcast. I'm thrilled today to be joined by Dr. John Pastor, President of Fairview Pharmacy Services. John, it's a pleasure to have you on the podcast today.

[B]

Great. Thanks, Laura. I appreciate you having me.

[A]

Absolutely. Now I'm excited to dig in deeper with some of the cool things you've been up to at Fairview with pharmacy and, you know, get your perspective on the future. But before we dive in, can you tell me a little bit more about yourself and Fairview?

[B]

Sure. Happy to. So I'm a pharmacist by training, and I've got over 30 years of experience in various parts of pharmacy practice. I started my career more on the hospital side and spent the first 20, 25 years exclusively in that setting, and over the last five to 10 years have expanded more into the ambulatory side of our pharmacy business as well. And a little bit about Fairview. Fairview is a Minnesota based nonprofit health system, and we operate 10 hospitals and 60 clinics. We've got approximately 34,000 employees and serve 1.2 million patients. And our pharmacy philosophy in Fairview is it's really more than a place to just get your prescriptions filled. We're a vital part of how our patients experience healthcare. And so we're really proud to be part of that entire journey through healthcare that our patients have. And we've contributed to this care of our patients and the healing of our patients, really in this philosophy of how we deliver our pharmacy care for more than 25 years now.

[A]

That's amazing to hear. You know what a great service that you're providing to the community, especially looking at being able to make sure that the patients have timely care, access to prescriptions and filling them, and really elevating that whole experience within the healthcare journey. Now, when you look back at the last year or so, could you tell us a little bit more about the most important initiative you led? What did you do and what were the results?

[B]

Well, I think probably the single most important thing we did in the last year is we moved to a new location for our pharmacy shared services facility. So I can tell you a little bit about Fairview Pharmacy and whole. We provide a comprehensive suite of pharmacy services partly from the belief that we want our patients, if at all possible, to get all of their pharmacy care directly from us. So we operate 26 retail locations in our communities. We've got a specialty pharmacy that serves patients in all 50 states where we take care of about 16,000 patients. Right now, we've got a Home Infusion pharmacy, serving nearly 3,000 patients. And we also provide pharmacy services across the 10 hospitals I mentioned. So all in all, we're filling over 200,000 prescriptions per month for our patients. Now, our move that I just mentioned took place last fall. We started in October, and we actually completed just after the first of the year. But we relocated all of our core central pharmacy teams to this new location. It's a 150,000 square foot facility located in Shoreview, Minnesota, which is a northeast suburb of the Minneapolis St. Paul area. And the reason we had to do this relocation is we've nearly doubled in size over the last five to 10 years within Fairview Pharmacy. And we simply needed to upgrade our facility, both from a space standpoint as well as a technology standpoint to be able to better serve our patients. So that's really probably the biggest initiative that we've led in the last year. And frankly, it was a four or five year project in whole from start to we got the final team moved.

[A]

Wow, that's an incredible undertaking. And, you know, I can imagine it takes a lot of organization and planning and management. But then no matter what, you know, there are always lessons you learn along the way and pivots you have to make. So, you know, what were some of the things that, you know, you had to adjust to or surprises that you had during this process? Just be curious, especially for those who are thinking of going through something similar or needing to expand the space of their, for their pharmacy teams overall.

[B]

Well, honestly, I would say one of the initial things many of us on the pharmacy team recognized is, you know, we had not done a project of this scale ever. We call this, you know, one of the things on our list that they don't teach you in pharmacy school, you know, how to do a big project like this. So we spent a lot of time talking to our peers and colleagues across the country that had done similar projects, trying to learn from their experiences and take some of the best of the best things that they did and incorporate them into our spaces. And some of the things that we took away from that is in the design of our infusion center. We put together for our infusion suites, these specially designed bays for adult patients, adolescents and pediatric patients that sort of meet the unique needs of those patients in terms of decor and functionality in each of these 16 suites that we have on location. And we also did the same for our specialty and mail order pharmacy. In terms of technology, we went around and evaluated all the different types of technology that would improve both safety and efficiency and help automate many of our processes. And we have some of the, I'd call it sort of state of the art technology and some of the first installations in the US Market of some of this equipment. So I think it was really just kind of doing the research and drawing on the experience of some of our close colleagues and peers across the country.

[A]

That's helpful to understand. Thank you for digging a little bit deeper there. Now, looking ahead to 2026, what are some of your big priorities as well as headwinds that you're focused on?

[B]

Well, I'd say a couple of things. You know, pharmacy across the country has already developed into, you know, nearly a trillion dollar industry. I know it's over $800 billion now, and that number is expected to continue to climb, Specialty pharmacy being a large part of that. So we put a focus on just making sure we're developing the technology and the processes that we can continue to accommodate that increased growth and continue to meet our patient needs. One of the other things that comes to mind is just improving access to pharmacy care. This is a national problem that we've experienced quite a bit in Minnesota as well, too. But pharmacies across the country continue to close at an alarming rate, both the chain pharmacies as well as the independently owned pharmacies. In fact, in Minnesota, I think that number is nearly 44, 45% of pharmacies have closed since 2013. So we find that there's a number of patients living, you know, not just in rural areas, but even in urban areas that have significant access issues where they may have to drive a long ways to get pharmacy care and may find that the pharmacy that they do have access to has reduced hours to operate. So, you know, we're keeping that in mind as we're always evaluating our services and our ability to continue to serve our patients and those that live in our communities. And I think the final thing I'd add to that, Laura, is just what I'd call just the intense headwinds that come from the external forces right now. So, you know, all the federal legislation that's happening that impacts health care and pharmacy in general, all the manufacturer rules and restrictions that tie into the 340B program, workforce shortages, supply chain issues, including shortages which have not gotten better over the years, much to our disappointment, and then just the overall health care finances with rising costs and reimbursement rates that don't necessarily keep pace with that.

[A]

That absolutely makes a lot of sense. And you know, those things you, you just mentioned and looking at the 340B program works for shortages, supply chain issues, a lot of unknowns out there in kind of widening gaps that are challenging for the healthcare industry and access to care. And so, you know, how do you as a leader think about making sure you're planning for the future in the right way, not necessarily knowing 100% what it's going to look like, but being ready to pivot? I mean, are there things and contingency plans that you're making? If there are changes to the 340B program, what is the impact there? And how are you kind of shifting the way you look at your strategy on the pharmacy side?

[B]

Yeah. So basically you're asking, how do we polish our crystal ball up? I think that's a great question. I think just staying abreast of what's happening around us in terms of legislative changes, policy changes, making sure we have all the right members on our team engaged that can help monitor all those things and help us react and pivot our processes and things as we need to in order to respond to all the things that you just mentioned. And when you think about things like drug shortages, for example, drug shortages and drug supply issues are a daily sort of thing. They change day by day and sometimes multiple times within each day. So I think it's just highly highlights that it takes the team and the entire team to help us keep monitor of all that and be able to respond so we can best meet our patients needs.

[A]

I love that, you know, and it is really helpful to look at things that way and just keeping that patient front and center. What do you think the hardest thing that you'll have to do in the coming year will be?

[B]

Honestly, I think what we've just been talking about, just, you know, being able to respond in a timely way to, you know, kind of the external changes that come our way, whether they're regulatory or legislative or other. In my career, the pharmacy business has become very complex compared to how it was when I started. And again, it just, it makes me thankful for the incredible team of people we have within Fairview Pharmacy and across broader Fairview, you know, to help us address those challenges and make sure that we're there to help make health happen for our patients.

[A]

That's amazing to hear. And definitely, you know, like you said, things have become very complex in the healthcare space and especially in pharmacy. So when you look towards growth, where else do you see some opportunities in the next few years? What does that look like for you in Fairview Pharmacy?

[B]

Yeah, great question. I think the biggest opportunity is to be sure that our pharmacies across the country are doing what they can to care for their own patients. You know that our health systems are able to keep their own patients and provide all that pharmacy care for a seamless and hopefully less complex experience for the patients that they serve. One of the ways that we've tried to help address that, both locally and nationally, is we launched a new company within Fairview at the beginning of 2025 called Fairview Pharmacy Solutions that I serve as the chief operating officer for. And in our goal there is to help other health systems do a lot of the things that we've done over the last 25 years and optimize their care delivery, keep their patients within their health system and do the best they can to make a difference in that fashion.

[A]

Oh, that's fascinating. And so you're able to actually scale some of the things and share some of the things that have worked well with other organizations and hopefully bridge that success across the board. I think that sounds like a really great opportunity to continue to strengthen those times in broadening the influence that you have in the healthcare space.

[B]

No, I agree. I mean, that's our principle under which we operate is when we can all serve patients better, we all do better, and that's our goal.

[A]

Fantastic. I love it. John, thank you so much for joining on the podcast today. This has been a really fun and informative conversation, and so I'm excited about that and looking forward to seeing you as well. In April, I know you'll be Speaking at our 2026 Chief Pharmacy Officer Summit in Chicago, and it'll be amazing to kind of see you in person and continue this discussion and share some of those learnings in growth opportunities. So thank you, John.

[B]

Yeah, well, I look forward to that and I appreciate the opportunity to be with you today, Laura, so thank you.