Pharmacists can drive change through education, engagement, legislation, and persistent efforts.
Community pharmacy is facing significant challenges, including declining reimbursement rates, staffing shortages, and the lack of compensation for many clinical services pharmacists provide.1,2 These challenges threaten not only the sustainability of community pharmacies but also patient access to care.1,2
Advocacy is one of the most powerful tools pharmacists have to influence change.3 Although legislative victories often receive the most attention, meaningful advocacy occurs every day across the country in pharmacies, communities, and professional organizations. Below are several ways pharmacists can become effective advocates for their profession and their patients.
Understanding payer and pharmacy benefit manager (PBM) contracts can help pharmacists identify reimbursement challenges and advocate for policies that promote fair and sustainable payment models.1 In the reality of low operational cost reimbursements and other financial pressures, many pharmacies are forced to close.1 Michael Murphy, PhD, MBA, an assistant professor of clinical pharmacy at The Ohio State University College of Pharmacy, reports their ongoing research shows that from 2022 to 2024, more than 7000 pharmacies closed nationwide, with approximately 2800 of these closures being in 2024 alone.4
One of the most pressing challenges facing community pharmacies is the frequency of prescriptions reimbursed below acquisition cost or below the cost of dispensing.1 Carefully documenting these losses and utilizing available appeal processes helps create the data needed to demonstrate the scope of the problem to policymakers, professional organizations, and other stakeholders.
Not only will involvement in organizations allow for professional growth, network expansion, and continuing education opportunities, but it can also support pharmacy advocacy efforts. For example, the National Community Pharmacists Association and American Pharmacists Association have entire pages on their websites dedicated to advocacy.5,6 These websites, among others, explain key advocacy issues, provide numerous resources, and describe how to get involved in these advocacy efforts.5,6
It is important to know the current state of active bills and how they may affect our profession. Understanding proposed legislation, its potential impact, and the reasons previous bills succeeded or failed allows pharmacists to engage in more informed and effective advocacy efforts.7,8
Meet with your representatives in person, and have an elevator pitch ready. Specifically mention the proposed bills, what they discuss, what it means for you, and how you should vote. Personal stories and specific examples of patients being impacted can help your message stand out among the many issues legislators encounter each day.7,8
If you are unable to arrange an in-person meeting with your local and/or state representatives, you can still send emails and make phone calls. This can still impact how a representative views the legislation and, in turn, affects their voting.7,8
Advocacy extends beyond policymakers, and patients are often unaware of the financial and operational challenges affecting their local pharmacies. Fair Jones, PharmD, an independent community pharmacy owner in Mississippi, uses social media to educate patients and communities about reimbursement losses, operating with below-cost dispensing, how this affects her patients, legislative developments, threats to pharmacy access, ways to advocate for community pharmacy, and more. By increasing awareness of the challenges facing community pharmacies, pharmacists can empower each other, their patients, and communities to become advocates for preserving access to local community pharmacy services.8
Mary-Wyatt Pettigrew Crow, PharmD, graduated from the University of Mississippi School of Pharmacy in 2024, and she completed her PGY-1 community-based pharmacy residency at the University of Mississippi on the Oxford Campus in June of 2026. During her time as a resident, Crow’s passion for community pharmacy continued to grow, especially throughout her time researching the potential economic impact that independent community pharmacies may have on the state of Mississippi.
Advocacy is not limited to legislative sessions or organized advocacy days. It is an ongoing responsibility that requires consistent engagement, education, and persistence.7-9 Whether documenting reimbursement challenges, participating in professional organizations, communicating with legislators, or educating patients, every effort contributes to advancing the profession.
The future of community pharmacy will be shaped by those willing to speak up, share their experiences, and advocate for meaningful change.1,8,9 By remaining engaged and persistent, pharmacists can help ensure that community pharmacies continue to serve as accessible and essential health care destinations for patients.
