PharmD · Maryland
Collaborative Drug Therapy Management for Pharmacists in Maryland
Yes, a written agreement with a physician is required before you manage drug therapy. Maryland calls it a Prescriber-Pharmacist Agreement.
Represents Maryland's optional prescriber-pharmacist Drug Therapy Management (DTM) agreement tier under COMAR 10.34.29, not ordinary pharmacist licensure — base dispensing needs no agreement. Requires a PharmD (or documented equivalent training) plus 1,000 hours of relevant clinical experience (or 320 hours in an approved structured program) and disease-state-specific credentialing; no independence pathway once entered.
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
As needed
COMAR 10.34.29.05 requires the pharmacist to notify the authorized prescriber within 48 hours (unless the agreement states otherwise) whenever the pharmacist modifies a dose/agent, detects an abnormal assessment result, or initiates drug therapy under a physician-pharmacist written protocol — an event-driven notification duty rather than a fixed recurring meeting.
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
Under a prescriber-pharmacist agreement the pharmacist may modify, continue or discontinue drug therapy and order labs under a written, disease-state-specific protocol (COMAR 10.34.29.02). This is delegated drug-therapy management, not independent DEA-registered controlled-substance prescribing, so controlled substances are shown as not allowed. Only a licensed physician-pharmacist protocol may additionally authorize initiating drug therapy; whether that extends to controlled substances is not settled.
Written agreement
Required
Only required if the pharmacist and an authorized prescriber (physician, podiatrist, or certified APRN with prescriptive authority) elect to engage in drug therapy management under a written protocol and prescriber-pharmacist agreement (COMAR 10.34.29) — a pharmacist's base license and general dispensing authority need no such agreement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement identified for Maryland pharmacy permits
Materially more permissive than the physician-only Professional Corporation regime governing PA/APRN entities above, if confirmed.
Sources for the supervision rules (2)
- COMAR 10.34.29 — Drug Therapy Management
- Md. Health Occupations Code §§ 12-6A-01 – 12-6A-10 — Drug Therapy Management (statutory authority for COMAR 10.34.29)
What a collaborating physician costs here
Typical monthly cost in Maryland
$500 – $600
Estimate for one Pharmacist. Standard-tier state.
About Maryland's rules
Maryland's APRN categories are not uniform: CRNPs and CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), CRNAs remain fully supervised with no prescriptive authority at all (Maryland is one of about 11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs; professional entities use physician-only professional corporations, so multi-disciplinary ownership questions remain open.
Other clinicians in Maryland: see the state overview.