Pharmacists Overview

Pharmacists are trained professionals who dispense prescription medications and counsel patients on the safe and appropriate use of medications. They may also conduct health and wellness screenings, provide immunizations, oversee the ordering of medications and provide advice on healthy lifestyles. Pharmacists can work in pharmacies in a variety of settings, including retail clinics, general merchandise stores, grocery stores, hospitals and other health care facilities, among others.

Pharmacists must have advanced education and hold a doctor of pharmacy degree. They must also be licensed, which requires passing the North American Pharmacist Licensure Exam (NAPLEX) and, in most states, the Multistate Pharmacy Jurisprudence Exam (MPJE). Pharmacists who administer vaccinations and immunizations must also be certified in most states. As of May 2019, there are more than 311,000 licensed pharmacists working in the U.S.

Pharmacists may enter into collaborative practice agreements with other health care providers, such as physicians and nurse practitioners. These collaborations can increase care coordination and access to more services and providers. For example, providers can delegate tasks to pharmacists such as chronic care management and medication refill authorization. Allowing pharmacists to prescribe certain medications is a growing trend among states seeking to increase access to important medications.

The maps on the right show a comparison of all states and territories for the following three policy areas:

1. Prescription adaptation.
2. Prescription of hormonal contraceptives.
3. Prescription of tobacco cessation aids.

Choose a tab to explore different options. For more detailed information, please click on a state or territory.

Prescription adaptation can be defined as pharmacists modifying medication regimens from the original prescriber to improve a patient’s health outcome, either independently or in collaboration with the original prescriber (e.g., physician, nurse practitioner). This can include modifying the quantity of a prescription (e.g., changing a 30-day supply to a 60-day supply) or switching a patient to a different medication that has the same effect as the previously prescribed drug (i.e., therapeutic substitution).

The adaptation cannot change the type of medication or the outcome that the original prescriber intended. Some states have used this as a way to help patients in rural areas to alleviate unnecessary travel to the doctor’s office to modify a prescription.

Prescription of hormonal contraceptives refers to a pharmacist’s authority to prescribe contraceptives without having a collaborative practice agreement in place. In these states, patients do not need to see a doctor to receive a prescription for hormonal contraceptives. A pharmacist may ask a patient to complete a screening before prescribing to ensure the patient is the right candidate for the type of contraceptive requested. A pharmacist may also be required to complete specialized training before prescribing contraceptives, depending on the laws and regulations in the state.

Prescription of tobacco cessation aids refers to a pharmacist’s authority to prescribe tobacco, smoking or nicotine cessation aids without having a collaborative practice agreement in place. Pharmacists may be required to complete tobacco cessation education and outline steps for patient screening and cessation intervention components before being granted independent prescribing authority. After screening patients, pharmacists can determine the appropriate tobacco cessation aid and counsel the patient on how to use the product correctly.