Ukrainian Pharmacists Wary of Prescribing Rights, Nationwide Survey Finds

A nationwide survey of more than 1,000 Ukrainian pharmacists has revealed deep caution about granting prescribing rights to the profession, despite growing international momentum behind expanded pharmacy practice. The study, published in Pharmacia, surveyed 1,020 community pharmacists across Ukraine in 2025 and found that only about 14 percent supported implementing pharmacist prescribing, while more than 60 percent expressed negative or somewhat negative views. The findings arrive at a pivotal moment, as Ukraine undergoes sweeping healthcare reforms and aligns its pharmaceutical legislation with European Union standards.

The research team, led by investigators at Bogomolets National Medical University, set out to assess the awareness, attitudes, and readiness of pharmaceutical professionals regarding pharmacist prescribing. The timing is significant: Ukraine’s Law on Medicinal Products, adopted in July 2022, provides for the introduction of comprehensive pharmaceutical services in pharmacies from 2027 as a distinct professional activity. Against the backdrop of martial law, workforce shortages, and damaged medical infrastructure, the question of whether pharmacists could take on prescribing duties has moved from theoretical discussion to practical policy consideration.

Perhaps the most striking finding was the profession’s limited familiarity with the very concept it was being asked to evaluate. Only 9.0 percent of respondents reported being well informed about international pharmacist prescribing models, while 55.4 percent were entirely unfamiliar with the practice. This knowledge gap is not surprising given the current legal landscape: pharmacist prescribing is not an established professional function in Ukraine, so pharmacy students receive no specialized training in prescribing competencies. Familiarity with international models can only be acquired through independent learning or professional initiatives.

To give respondents a foundation for evaluation, the researchers introduced them to four models of pharmacist prescribing drawn from international experience. These ranged from collaborative prescribing under agreements with physicians, through restricted independent prescribing limited to specific conditions or medication lists, to full independent prescribing for both diagnosed and undiagnosed conditions. The models reflect a spectrum of professional autonomy seen across countries, from the United Kingdom and Switzerland, where independent prescribing is established, to Ireland and France, where protocol-based supply of selected medicines has recently been introduced.

When asked to rate these models, respondents revealed a clear pattern: support rose as professional autonomy decreased. Collaborative prescribing, in which pharmacists work under agreements with physicians, received the most favorable assessments, while full independent prescribing for undiagnosed conditions drew the strongest opposition. This gradient suggests that Ukrainian pharmacists envision a phased implementation path, beginning with team-based models and gradually expanding autonomy as regulatory and educational systems mature. The preference mirrors international experience, including Slovenia’s collaborative pilot programs and the United Kingdom’s staged evolution from supplementary to independent prescribing.

Despite the overall skepticism, respondents recognized meaningful potential benefits. Improved access to pharmacotherapy and reduced physician workload ranked highest among perceived advantages. These views align with a substantial body of international evidence. A cost-effectiveness analysis in the United States found that managing half of hypertension patients through pharmacist prescribing would save over $10,000 per person across a 30-year horizon, translating to roughly $1.13 trillion in population-level savings. Australian research in emergency departments showed that collaborative prescribing models reduced medication errors and improved documentation of adverse drug reactions.

The barriers identified by respondents were predominantly structural rather than attitudinal. The lack of a clear regulatory framework topped the list, followed by limited access to patient medical records, insufficient interprofessional collaboration, and concerns about professional liability. These concerns are well founded: expanding pharmacists’ clinical roles inevitably increases exposure to legal claims, and professional indemnity insurance has emerged internationally as a key protective mechanism. Respondents also emphasized the need for legal acts, clinical protocols, prescribing standards, and a defined list of medicines eligible for pharmacist prescribing as priority measures.

The survey also probed which medicines pharmacists believed could safely fall under their prescribing authority. Respondents favored lower-risk medicines with well-established safety profiles, particularly anti-inflammatory and analgesic drugs. Support dropped sharply for vaccines, immunobiologicals, and hormonal medicines, reflecting awareness of the higher clinical responsibility and more comprehensive patient assessment these categories demand. This cautious triage of therapeutic categories is consistent with the stepwise approaches adopted in Poland and Spain, where initial prescribing rights were limited to narrowly defined conditions.

Education emerged as perhaps the most formidable challenge. A striking 92.9 percent of respondents considered pharmacists’ existing knowledge insufficient or only partially sufficient for prescribing practice. Yet willingness to undergo specialized training was lukewarm: only about 30 percent expressed readiness to pursue such credentials, while 43.7 percent remained uncertain, likely because the regulatory framework, responsibilities, and practical conditions for applying new competencies remain undefined. When asked about preferred training formats, 42.4 percent favored workplace-based training under experienced professionals, ahead of continuing professional development courses and short-term certificate programs.

The study’s authors conclude that pharmacist prescribing in Ukraine should initially be introduced through collaborative or protocol-based models, with gradual expansion tied to regulatory, educational, and organizational readiness. The wartime context adds urgency: with physicians scarce, medical infrastructure destroyed in affected regions, and rural populations facing uneven access to care, expanding pharmacists’ roles could serve as a critical mechanism for maintaining continuity of treatment. Whether Ukraine’s pharmacy profession, currently cautious and under-informed, can be prepared for this transition will depend on sustained investment in postgraduate education, digital health infrastructure including electronic health records, and the legal architecture that defines professional responsibility.

Subject of Research: Pharmacist prescribing implementation in Ukraine

Article Title: Pharmacists’ perspectives on the implementation of pharmacist prescribing in Ukraine: a nationwide survey

Article References: Komarida, O., Kosyachenko, K., & Sakhnatska, N. (2026). Pharmacists’ perspectives on the implementation of pharmacist prescribing in Ukraine: a nationwide survey. Pharmacia, 73, Article e196917. https://doi.org/10.3897/pharmacia.73.e196917

Image Credits: AI Generated

DOI: 10.3897/pharmacia.73.e196917

Keywords: pharmacist prescribing, Ukraine, pharmacy practice, nationwide survey, professional autonomy, collaborative prescribing, healthcare reform, pharmaceutical education, regulatory framework, martial law, interprofessional collaboration, continuing professional development