Financially Supported Roles for Pharmacists in International Settings

Abstract

A May 2025 workshop convened by the National Academies of Sciences, Engineering, and Medicine examined the sustainability of the pharmacy profession amid pharmacy closures, workforce strain, and misaligned reimbursement in the United States (US). Its discussion of financially supported pharmacist roles focused on US models and identified a gap in attention to international payment structures. This article examines how pharmacists are paid across international health systems, using a framework of who pays for care, who owns delivery infrastructure, who provides services, and who decides coverage and reimbursement. Cases from the United Kingdom, Germany, Canada, South Korea, Nigeria, and Singapore illustrate how financing and governance arrangements shape pharmacist roles. Across the cases, reimbursement embedded in system financing, standardized service definitions, and alignment between scope of practice and payment were common features where pharmacist services had been incorporated into routine care. The analysis identifies considerations for advancing financially viable pharmacist services in the US.