Laws and Rules Affecting Pharmacists’ Prescribing Privileges

Evolving compliance from obligation to opportunity

Pharmacy practice is continually changing from traditional dispensing to clinical and therapeutic services, including prescribing drugs for patients. The scope of pharmacy practice is expanding, and pharmacists should take advantage of the opportunities. Here, we will analyze several policies and regulations affecting prescribing rights of pharmacists that have changed in the first quarter of 2021.

The good news is that legislators and the Board of Pharmacies are increasingly changing laws and rules to expand the scope of pharmacy practice.  At Bula, we track these changes for you and present them concisely and clearly. We want pharmacists to know and exercise their prescribing rights, benefit their patients, and increasingly contribute to the overall healthcare system. Pharmacists deserve to use their skills fully and enjoy practicing pharmacy.

Use this document to learn what you can prescribe and if there is any extra training you need. We have linked the full texts of laws and rules affecting pharmacists’ prescribing privileges. Our policy analysts have summarized each one of them for your quick review.

High-Level Summary

The CDC has observed a rise in the cases of deaths caused by drug overdose since the pandemic started. They noted that ‘’over 81,000 drug overdose deaths occurred in the United States in the 12 months ending in May 2020, the highest number of overdose deaths ever recorded in a 12-month period’’ (CDC, 2020). Different states are responding to the crisis by expanding distribution, access and use of naloxone through pharmacies and other means.

Center for Disease Control and Prevention (2020). Overdose Deaths Accelerating During COVID-19. (Online) Available at: Overdose Deaths Accelerating During COVID-19 | CDC Online Newsroom | CDC (Accessed on April 30, 2021)

Trends We’re Observing Across States

Bula Intelligence is tracking sixty-four bills from the last three months which affect pharmacist prescribing rights and extend their scope of practice. These bills are from twenty eight out of fifty states.

What is Common Across States?

The extent of prescribing privileges differs between states. However, the classes of drugs pharmacists are typically allowed to prescribe are similar. For example, on February 8th, Michigan introduced SB155 to allow pharmacists to issue emergency insulin to a patient who has run out of refills independently.

Arkansas is in the Spotlight!


Arkansas has the most bills in process which affect pharmacist’s prescribing practice. Over the last three months, Arkansas has proposed five bills that affect prescribing privileges for pharmacists; HB1246, HB134, HB1069, HB1502, SB176. Two of them have been enacted (HB1134 & HB1069). The remaining three bills have passed the first chamber and are now in the second chamber of the legislative process.


HB1246 stands out because it requires the Board of Pharmacy to adopt a formulary of drugs that a pharmacist prescribes for the following conditions:

  •   Pharyngitis caused by streptococcus.
  •   Influenza
  •   Other conditions that can be screened utilizing the waved test under Clinical Laboratory Improvement Amendments of 1998.

On March 22nd, Governor Asa Hutchinson passed HB1069 to add oral contraceptives to the drugs under wide state protocol that allows pharmacists to initiate therapy, administer and dispense to patients.

Bills Most Likely to Pass

Rhode Island HB6047 and SB0589 are the most likely to pass bills. Although these bills are both in the first chambers, they propose to authorize pharmacists to prescribe and dispense tobacco cessation drugs to qualified patients. Most states have passed tobacco cessation prescribing as an extended scope of practice for pharmacists.


The first quarter of 2021 has seen significant movement on issues surrounding pharmacists’ prescribing rights.  Bula will continue to track these events closely to help you and your teams stay abreast of these changes.  We’ve created a summary table for your easy reference.