This story appears in the September–October 2026 issue of Dispense Times.
A Dispense Times Magazine Q&A
Community pharmacy is in the middle of a transition few could have predicted five years ago — away from being purely a medicine-delivery channel and toward becoming a true point of care. Few people have a better vantage point on that shift than Kristalyn Weaver, who leads the National Alliance of State Pharmacy Associations (NASPA). Dispense Times sat down with Weaver to talk about PBM reform, state-level scope-of-practice wins, and why she believes the next few years will define the profession for a generation.
Dispense Times: Before we get into policy, tell us a bit about your background. How did you end up leading NASPA?
Weaver: I actually come from a family of community pharmacy owners, so this world isn’t abstract to me — I grew up in it. What I realized pretty early on was that the part I loved most wasn’t the clinical side alone, it was the people’s side: the relationships, the trust, the advocacy that has to happen to protect that kind of practice. That’s what pushed me to pursue a law degree alongside my PharmD. Having both gives me a somewhat unique vantage point for this role — I can look at a scope-of-practice fight or a PBM contract and understand it both as a pharmacist and as an attorney, which turns out to be exactly what this job demands.
Dispense Times: Let’s start with the basics. What does NASPA actually do for state pharmacy associations day to day?
Weaver: Our job is to strengthen the state associations so they can do their jobs better. That means fostering collaboration between states, sharing policy intelligence in real time, and getting people together frequently enough that we’re not all reinventing the wheel in fifty different places. If one state gets blindsided by a harmful policy, we want every other state association to hear about it immediately, not after it’s already spread.
At the core, state associations exist to defend pharmacy practice — scope of practice, payment reform, fair business practices. But we also spend a lot of time on something less visible: helping associations fix their own financial models. Dues and grants alone don’t cut it anymore, so we help them find new revenue streams that let them sustain the advocacy work long-term.
Dispense Times: PBM reform keeps coming up in every pharmacy conversation right now. Where does that fit into your priorities?
Weaver: It’s central. PBM reform is about making sure pharmacies actually get paid fairly for dispensing — that’s step one. Step two, which is just as important, is expanding the payment options available for the services pharmacists provide beyond dispensing. We can pass all the scope-of-practice laws we want, but if there’s no payment mechanism attached, nothing changes on the ground.
That’s why implementation is such a big focus for us right now — credentialing, insurance enrollment, contracting. Those unglamorous administrative pieces are exactly what determines whether a pharmacist can actually get paid for a new service or whether the law just sits on the books.
Dispense Times: How does federal legislation like the Main Street Pharmacy Access Act factor into that?
Weaver: That bill is about creating a real Medicare Part B payment pathway for pharmacists, within whatever scope of practice each state has already defined. We’re working closely with NCPA and the state associations to get ahead of it — advocating at the state level for expanded test-and-treat authority now, so that when the federal payment door opens, pharmacists in every state are actually positioned to walk through it.
Dispense Times: You’ve pointed to a handful of states — Idaho, Alaska, Iowa — as models. What are they doing differently?
Weaver: Those states use what’s called a standard-of-care regulatory model. Instead of a narrow, category-by-category list of what a pharmacist can and can’t prescribe, it lets pharmacists practice to the full extent of their training and judgment. It’s a fundamentally different philosophy — moving away from restrictive, protocol-specific laws toward trusting pharmacists as clinicians.
More states are moving in that direction, and I think that’s the right long-term trend. We hold those states up as examples specifically because they show what’s possible when the regulatory framework matches how pharmacists are actually trained.
Dispense Times: What does the future of community pharmacy look like if this all goes right?
Weaver: Honestly, it looks a lot like the past — pharmacists returning to something closer to the old apothecary role. Managing minor conditions, working alongside patients on chronic disease management, being a real first stop for care rather than just a pickup window. Community pharmacy is positioned to become the primary access point for a lot of patients, especially in areas where other providers are scarce.
But that vision doesn’t happen on its own. It requires grassroots engagement — pharmacists showing up at their state legislatures, literally wearing their white coats, so lawmakers see the human face behind the policy debate.
Dispense Times: You mentioned Tennessee specifically as a case study. What happened there?
Weaver: The Tennessee Pharmacists Association just won a significant PBM reform victory, and it happened because members showed up. Strong participation, visible presence at the statehouse — that’s what let them overcome opposition that was very well-funded. It’s proof that grassroots effort can still beat money in these fights, but only if pharmacists actually engage. Membership, PAC contributions, legislative visits — all of it matters more than people realize.
Dispense Times: Summer feels like a quiet season for legislation. Is it actually quiet for state associations?
Weaver: Not at all — it’s one of the busiest planning windows of the year. Most legislative sessions are inactive, but that’s exactly when state associations are holding annual meetings, reconnecting with members, and building momentum for the 2027 bills. It’s also when we’re helping states work through the ACIP vaccine recommendation changes, making sure pharmacist vaccination authority is squared away before flu season hits. My advice to any pharmacist reading this: connect with your state association now. Don’t wait until session starts.
Dispense Times: Zooming out — how do you characterize where the profession is right now?
Weaver: We’ve been through five genuinely unprecedented years. I won’t sugarcoat that. But I also see real pathways for growth — the Rural Health Transformation programs, the federal legislation moving through Congress, the state-level wins we’ve already banked. The profession is shifting from a medicine-delivery model to a service-delivery model, and that transition is hard. It’s messy. We’re in the messy middle of it right now.
But if state associations keep sharing best practices, if pharmacists keep showing up, and if we stay unified instead of fragmented, I think community pharmacy comes out the other side of this stronger and more viable than it’s been in a long time.
Dispense Times: Any final message for pharmacists reading this?
Weaver: Get involved with your state association. Renew your membership, show up to the annual meeting, show up at the statehouse. This is a moment where individual engagement genuinely moves the needle — we’ve seen it happen in Tennessee, and we’ll need it to happen everywhere else too.
