PharmD · Alabama
Collaborative Drug Therapy Management for Pharmacists in Alabama
Yes, a written agreement with a physician is required before you manage drug therapy. Alabama calls it a CDTM Agreement.
Represents Alabama's Collaborative Practice tier (Ala. Admin. Code r. 680-X-2-.44, enforceable since May 1, 2022), not base dispensing licensure. Jointly approved by the Board of Pharmacy and Board of Medical Examiners; permanently agreement-dependent with no independence pathway.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Agreement must specify duties performed, documentation/communication protocol, a quality-assurance plan, and (for drug-therapy CPAs) the authorized formulary; renewable every 2 years, amendments/termination reportable within 10 days (Ala. Admin. Code r. 680-X-2-.44).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Standard pharmacy ownership and permit rules
Materially more permissive than the healing-arts/APRN PC ownership regime governing PA/CRNP/CNM/CNS above.
Sources for the supervision rules (1)
- Ala. Admin. Code r. 680-X-2-.44 — Collaborative Pharmacy Practice
What a collaborating physician costs here
Typical monthly cost in Alabama
$500 – $600
Estimate for one Pharmacist. Standard-tier state.
About Alabama's rules
Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.
Other clinicians in Alabama: see the state overview.