ADA 2026: Pharmacist-Led Refill Authorization Reduces Provider Burden in Endocrinology,

Refill requests represent a substantial administrative burden for health care providers, especially in endocrinology practices where patients commonly require long-term management of chronic conditions such as diabetes, thyroid disorders, obesity, hypertension, and hyperlipidemia. In emerging data presented at the 2026 American Diabetes Association (ADA) Scientific Sessions, findings indicated that pharmacist-led refill authorization under a collaborative practice agreement (CPA) has the potential to significantly reduce the provider workload while enhancing medication safety and workflow efficiency.¹

Findings Show Reduced Provider Burden Through Pharmacist Integration

Researchers developed and implemented a pharmacist-managed refill workflow designed with the intention of streamlining prescription renewal requests for patients who receive chronic disease management. Adults 18 years and older with active prescriptions managed by endocrinology providers were eligible for pharmacist-led refill review, while patients initiating new therapies or requiring treatment modifications outside established protocols were excluded.¹

In order to evaluate the impact of the program, the data analyzed baseline electronic medical record data, including refill volume, turnaround time, and medication safety concerns. Following implementation of the pharmacist-led refill authorization process under CPA protocols, the pharmacy team completed 3,750 refill requests in 2025. According to the data, these requests were resolved without reaching providers' in-baskets, representing a substantial reduction in administrative workload.¹

In addition to improving workflow efficiency, pharmacists identified potential safety concerns during refill review, including overdue laboratory monitoring, drug-drug interactions, inappropriate dosing, and medication-related adverse effects.¹ In preliminary findings, it was suggested that pharmacist involvement enhanced patient safety through proactive monitoring while allowing providers to focus on more complex clinical responsibilities.

Background: Expanding the Role of Pharmacists Through CPAs

CPAs have increasingly been used to expand the pharmacist’s roles beyond medication dispensing and into direct patient care activities. Under a CPA, a pharmacist may be authorized to manage medication therapy according to established protocols, allowing them to perform tasks such as medication adjustments, laboratory monitoring, and refill authorization.²

Previous studies have demonstrated the benefits of pharmacist-managed refill programs across outpatient settings. In a federally qualified health center, pharmacists processed more than 1600 refill requests in a single year and identified numerous opportunities for intervention, including overdue appointments, laboratory monitoring needs, medication discrepancies, and drug therapy problems.³ Similarly, a pharmacist-managed refill clinic was associated with a reduction in physician refill request volume of up to 60%, while enabling pharmacists to intervene in nearly half of refill encounters reviewed.⁴

These findings support a growing body of data that demonstrates that pharmacist-led chronic disease management programs can improve care processes and help patients achieve therapeutic goals while supporting interdisciplinary care models.⁵

Implications for Clinical Practice and Pharmacy

The findings presented at ADA 2026 highlight how pharmacists can play a critical role in addressing one of the most persistent operational challenges facing specialty practices: managing high volumes of medication refill requests. Through leveraging CPA protocols, pharmacists can independently assess refill appropriateness, identify safety concerns, and ensure patients remain appropriately monitored without requiring direct provider involvement for every request.¹

The data presented notes that pharmacist-led refill management may also reduce the need for frequent communication between providers and pharmacists by creating standardized workflows and decision-making pathways. This may facilitate faster medication access for patients while improving overall clinic efficiency.¹

For pharmacists, this data underscores the value of practicing at the top of their license. Beyond dispensing medications, pharmacists are uniquely positioned to evaluate adherence, review laboratory monitoring requirements, identify medication-related problems, and support chronic disease management through team-based care.²^,⁵

As health systems continue seeking strategies to reduce administrative burden and improve patient access to care, pharmacist-led refill authorization programs may offer a scalable model for endocrinology and other outpatient specialties. The authors concluded that CPA-driven refill workflows not only improve efficiency but also create additional opportunities for medication optimization and patient safety monitoring, demonstrating the expanding value of pharmacists within multidisciplinary care teams.¹

REFERENCES

1. Fetzner J, Hatipoglu B, Bellini N. Pharmacist-Led Refill Authorization in Endocrinology: Advancing Patient Safety and Workflow Efficiency. Poster presented at: 2026 American Diabetes Association Scientific Sessions; June 5-8, 2026; New Orleans, LA. Accessed via the ADA 2026 Scientific Sessions platform.

2. Chelewski R, Rodriguez K, Peter M, Zuckerman A. Assessing Pharmacist Interventions at an Outpatient Renal Transplant Clinic Under a Collaborative Pharmacy Practice Agreement. J Pharm Pract. 2024;37(3):593-599. doi:10.1177/08971900221149544

3. Hurley-Kim K, Keyvani A, Ahmed R, Wong HW, McBane S. Pharmacist-Managed Refill Service Impacts on Clinician Workload and Medication Interventions in a Federally Qualified Health Center. J Prim Care Community Health. 2023;14:21501319231168716. doi:10.1177/21501319231168716

4. Nguyen, M., & Zare, M. (2015). Impact of a Clinical Pharmacist–Managed Medication Refill Clinic. Journal of Primary Care & Community Health, 6(3), 187–192. doi:10.1177/2150131915569068

5. Greer N, Bolduc J, Geurkink E, et al. Pharmacist-Led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared With Usual Care. Ann Intern Med. 2016;165(1):30-40. doi:10.7326/M15-3058.