Pharmacy Leaders Set Priorities for Global Primary Care Integration

In an effort between the American Pharmacists Association (APhA), the Canadian Pharmacists Association, and the International Pharmaceutical Foundation (FIP), global pharmacy leaders officially announced their plans for integrating pharmacists in the primary care sector, according to an APhA release.¹

Within their plan, the organizations identified 4 factors as key for sustainable integration: workforce readiness, sustainable funding models, supportive regulatory frameworks, and interprofessional collaboration.

“Globally, pharmacists are taking on broader roles in primary health care, with evidence of their impact on chronic disease management, medication safety, transitions of care, and preventive health services,” Sandra Leal, PharmD, MPH, vice president of pharmacy professional relations at CVS Health and regular Drug Topics® contributor, said on LinkedIn upon the announcement.² “However, significant differences remain in how pharmacists are integrated into health systems and in the policy, workforce, and funding structures that support their roles.”

Workforce readiness begins with the rigorous educational path modern pharmacists undergo. Since 2000, all US pharmacy schools have transitioned to the PharmD degree as the sole professional standard, which includes extensive training in biomedical, pharmaceutical, and clinical sciences.^3,4

This extensive training typically surpasses that of nurse practitioners and physician assistants, equipping clinical pharmacists to step directly into daily clinical challenges.⁴

READ MORE: Pharmacists as the Center of Prescribing in US Health Care

Furthermore, approximately 30% of pharmacy graduates complete 1- to 2-year postgraduate residencies, and tens of thousands hold board certifications in specialized practice areas like ambulatory care, pharmacotherapy, or geriatrics. This deep clinical expertise enables pharmacists to accurately reconcile incomplete medication histories, manage high-risk drug monitoring, and optimize complex medication therapies.^3,4

By maximizing the clinical skills of these highly trained professionals, health care systems can deploy a severely underutilized asset to improve patient outcomes.^4,5

Breaking Through the Reimbursement Barriers

Despite their clinical capabilities, establishing sustainable funding models remains a primary bottleneck for integrating pharmacists into primary care teams. The primary financial hurdle stems from the fact that Medicare does not recognize pharmacists as health care providers of clinical services under Part B, which limits direct billing options and forces reliance on complex billing mechanisms like "incident-to" billing.^1,3,4

Although all 50 states allow collaborative practice agreements to delegate responsibilities such as initiating or adjusting medications, reimbursement laws vary drastically by state. Only a minority of states broadly require commercial plans and Medicaid to reimburse pharmacists as providers for clinical services.³

To bridge this gap, many clinics are utilizing emerging value-based care payment models. These alternative structures, which include care management fees and performance-based payments, provide alternative revenue streams that allow clinics to financially sustain pharmacists on primary care teams.

Navigating Regulation and the Battle Over “Scope Creep”

For clinical pharmacists to work to the full extent of their education, supportive regulatory frameworks are essential. Advocates have pushed for legislative reforms, most notably through the federal Equitable Community Access to Pharmacist Services Act (ECAPS)—later named the Main Street Pharmacy Access Act—which would establish a reimbursement mechanism for essential pharmacist clinical services under Medicare.^1,3,6

However, expanding the pharmacist's scope of practice has been met with political opposition. The American Medical Association has historically campaigned against what it characterizes as “scope creep,” raising concerns over patient safety through the integration of pharmacists.⁶

Yet, scientific evidence and real-world experience consistently demonstrate that pharmacist-led clinical services, such as administering vaccines or managing chronic diseases, do not compromise care quality or safety. International examples further validate this integration, as several countries and Canadian provinces have expanded pharmacist prescribing authority without sacrificing patient safety.

Far from trying to practice medicine, pharmacists seek to complement physicians to help resolve the critical primary care access crisis.⁶

Mitigating the Physician Shortage Through Collaboration

The ultimate goal of global integration is to foster interprofessional collaboration that addresses the severe physician shortage.^1,5

By 2036, the US alone could face a deficit of up to 40,000 primary care physicians, resulting in long wait times and delayed care. Integrating clinical pharmacists into primary care teams expands workforce capacity by freeing up physicians to focus on more complex clinical cases.^3-5

Studies show that an integrated clinical pharmacist can save a primary care physician an estimated 640 hours annually on medication management, which opens up nearly 2000 patient appointments per year and restores a sense of professional fulfillment to exhausted physicians.³

As health care systems continue to evolve, the consensus among global pharmacy leaders remains clear. Patients achieve better outcomes and health care systems grow stronger when clinical pharmacists are fully integrated as collaborative partners on the primary care team.¹

“Around the world, health care systems are looking to pharmacists to play a greater role in meeting patient needs and advancing primary care,” Michael Hogue, executive vice president and CEO of APhA, said in the news release. “Success depends not only on expanding scope but on preparing and supporting the workforce to deliver on that opportunity. When pharmacists and pharmacy teams have the resources and practice environments they need to thrive, patients gain better access to care, healthier outcomes, and a stronger health care system.”

READ MORE: Transforming Community Pharmacists Into Care Providers

REFERENCES

1. Global pharmacy leaders identify priorities for integrating pharmacists into primary health care. American Pharmacists Association. News Release. August 31, 2026. Accessed September 1, 2026. https://www.pharmacist.com/APhA-Press-Releases/global-pharmacy-leaders-identify-priorities-for-integrating-pharmacists-into-primary-health-care

2. Leal S. Globally, pharmacists are taking on broader roles in primary health care, with evidence of their impact on chronic disease management, medication safety, transitions of care and preventive health services. However, significant differences remain in how pharmacists are integrated into health systems and in the policy, workforce and funding structures that support their roles. LinkedIn. September 1, 2026. Accessed September 1, 2026. https://www.linkedin.com/posts/slealrx_apha-press-releases-share-7500553520958529536-idQV/

3. Smith M, Bodenheimer T, Robb K. Building the primary care workforce with pharmacist clinical services. Health Affairs. November 13, 2024. Accessed September 1, 2026. https://www.healthaffairs.org/content/forefront/building-primary-care-workforce-pharmacist-clinical-services

4. Teichman P, Wan S. How to integrate clinical pharmacists into primary care. FPM. 2021;28(3):12-17. https://www.aafp.org/fpm/2021/0500/p12

5. Pharmacists bridging the healthcare gap and filling the doctor shortage. DocStation. December 17, 2025. Accessed September 1, 2026. https://docstation.co/blog/pharmacists-bridging-the-healthcare-gap-and-filling-the-doctor-shortage

6. Covvey JR. Why can’t we be friends? The manufactured fear of pharmacist “scope creep.” JAPhA. 2023;64(1):43-46. doi:10.1016/j.japh.2023.11.003