Pharmacists Want Prescribing Authority With Proper Training, Support

Pharmacists reported they possess a significant willingness, confidence, and readiness to become independent prescribers due to their unrivaled medication knowledge and patient relationships. However, they also agreed that further training is necessary to improve their skills and confidence regarding independent prescribing, according to a study in Exploratory Research in Clinical and Social Pharmacy.¹

“Pharmacists complete a doctoral program with a Doctor of Pharmacy degree, where they receive 4 years of clinical training. Many pharmacists continue their education by pursuing fellowships and residencies that further add to their clinical knowledge and training,” according to authors at Scripted.² “Despite this high level of education, pharmacists cannot simply prescribe medications independently at a federal level. There are different circumstances in which a pharmacist may prescribe, including standing orders, collaborative practice agreements, and pharmacists with provider status or broad prescriptive authority.”

The global pressure on health care systems is driving this evolution, as the world faces a projected shortfall of 10 million workforce employees by 2030.³

In Pakistan, where physicians are severely overburdened and primary care access is limited, pharmacists are increasingly viewed as a vital bridge between physicians and patients.¹

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These professionals believe their clinical expertise can reduce the strain on hospitals and provide timely treatment in underserved regions. This sentiment is echoed in the US, where 1 in 3 Americans lack a primary care provider and 90% of the population lives within 5 miles of a community pharmacy.^1,4

Despite the desire for autonomy growing, the path to implementation involves navigating complex regulatory models. Globally, 8 countries currently allow independent prescribing in community settings, typically following either a government protocol model or a standard of care framework.³

The protocol model limits pharmacists to specific medications for conditions like urinary tract infections or smoking cessation, whereas the standard of care model allows them to use professional judgment to manage any condition within their competence. Innovative states like Idaho have successfully transitioned to this standard of care model, drastically reducing rigid regulations to empower pharmacist-led innovation.^3,4

However, the requirement for additional training presents a significant point of debate. In the Pakistan study, pharmacists called for specialized 1-year training programs to build diagnostic confidence.¹

Conversely, evidence from the expansion of HIV pre-exposure prophylaxis prescribing in the US suggests that mandatory training can actually act as a burden, with the largest increases in medication uptake occurring in states that removed such requirements, as stated in AJPM Focus.⁵

This suggests that although education is vital, administrative hurdles must be carefully balanced to ensure they do not obstruct patient access.

Sustainable practice also hinges on overcoming economic and professional barriers. Many pharmacists cite the lack of federal provider status as a major hurdle, limiting their ability to be reimbursed for clinical services through programs like Medicare Part B.²

Beyond reimbursement, practitioners often face resistance from medical associations concerned about fragmented care or scope creep. To address these concerns, proponents argue for integrated communication systems that allow pharmacists to notify physicians of prescribing decisions, ensuring coordinated patient management.^3,4

The transition toward independent prescribing is seen as a way to improve health outcomes and reduce unnecessary emergency room costs. Although challenges such as staffing constraints and structural barriers persist, the consensus among pharmacists is that they are ready to practice at the top of their education.^2,4,5

By aligning modern laws with pharmacist capabilities, health care systems can foster a more responsive environment that prioritizes patient safety and direct access to care.⁴

“Pakistani pharmacists demonstrate a clear willingness, confidence, and readiness to assume the role of independent prescriber, backed by their medication expertise and patient-care commitment,” concluded the authors of the current study.¹ “There is clear demand for specialized, 1-year training programs to ultimately improve their skills and professional confidence.”

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REFERENCES

1. Qureshi SE, Ullah M, Ali A, et al. Exploring the readiness of Pakistani pharmacists to become independent prescribers: a qualitative study. Explor Res Clin Soc Pharm. July 1, 2026:100823. doi:10.1016/j.rcsop.2026.100823

2. A pharmacist’s guide to prescribing — CPAs, CLIA waivers, & more. Scripted. June 27, 2025. Accessed July 16, 2026. https://scripted.co/pharmacists-prescribing/

3. Mesbahi Z, Piquer-Martinez C, Benrimoj SI, et al. Pharmacists as independent prescribers in community pharmacy: a scoping review. Res Social Adm Pharm. 2024;21(3):142-153. doi:10.1016/j.sapharm.2024.12.008

4. Frost T, Richards M. 2025 policy strategies for full practice authority. Cicero Institute. August 20, 2025. Accessed July 16, 2026. https://ciceroinstitute.org/research/2025-policy-strategies-for-full-practice-authority/

5. Fayaz-Farkhad B. Expanding pharmacists' prescribing authority and medication uptake: evidence from pre-exposure prophylaxis. AJPM Focus. 2025 Aug 13;4(6):100415. doi: 10.1016/j.focus.2025.100415.