The fast-evolving e-pharmacy has significantly transformed healthcare delivery, improving access, affordability, and medication availability (1). The COVID-19 pandemic accelerated the adoption of digital pharmacy services as patients sought online options due to limited access to traditional pharmacies (2, 3). While e-pharmacy offers numerous advantages, such as quicker access to medications and cost savings, concerns persist regarding patient safety, job security for pharmacists, regulatory oversight, and the risk of counterfeit drugs (4, 5). Community pharmacists, who traditionally provided medication counseling and chronic disease management, now face a changing landscape where digital technologies and automation redefine their roles (6, 7). Recent studies in Gulf Cooperation Council (GCC) countries have similarly reported evolving professional roles and regulatory challenges associated with digital pharmacy services (8, 9).

AI-driven e-pharmacy platforms have automated key pharmacy functions like prescription verification, medication dispensing, and adherence monitoring (10). Although these advancements enhance efficiency and reduce errors, they limit pharmacist-patient interactions, raising concerns about medication adherence and overall healthcare quality (11). Independent pharmacists struggle to compete with large e-pharmacy corporations that offer lower prices, home delivery, and promotional discounts, leading to decreased foot traffic and financial uncertainty for small pharmacies (12). Many small businesses risk closure without integrating digital services (13).

The upsurge of illegitimate online pharmacies increases patient safety risks (14). Studies indicate that an estimated 95% of online pharmacies operate illegally, dispensing prescription drugs without proper identification, thereby raising the rate of spurious and counterfeit medications (15, 16). These counterfeit drugs can have improper dosages or toxic ingredients, leading to serious health consequences, such as treatment failure and drug side effects (17, 18). The absence of pharmacist control in online sales increases the risk of self-medication and toxic drug interactions (19). In addition, it is challenging to regulate cross-border e-pharmacy platforms since many illegal online pharmacies are based in jurisdictions with ineffective regulatory systems, making it harder to guarantee drug authenticity and safety (20).

E-prescribing has become integral to modern pharmacy practice, allowing physicians to transmit prescriptions electronically (4). While this reduces errors from handwritten prescriptions, issues such as system incompatibility and delayed processing still affect patient care (21, 22).

Job security concerns persist as automation and AI technologies expand (23). Tools such as robotic dispensing and computerized counseling have replaced many routine pharmacy tasks (24). Independent owners also face growing financial risks competing with major e-pharmacy providers (25).

Despite these challenges, e-pharmacy offers new professional opportunities. Telepharmacy supports remote consultations and medication management in underserved areas (26). Emerging technologies such as AI-based adherence tracking and blockchain-enabled prescription validation enhance medication safety and efficiency (10, 27). Saudi Arabia’s Vision 2030 emphasizes digital transformation in healthcare, including the regulation and expansion of e-pharmacy (28). Comparable regional research from Qatar has shown that technology acceptance, regulatory trust, and professional concerns influence e-pharmacy adoption among consumers and healthcare providers (29). However, there remains limited research exploring how Saudi community pharmacists perceive this transformation. Clarifying their perspectives is vital to guide safe integration and maintain their role in patient care (30). Community pharmacists were chosen as the focus of this study because they represent the first point of patient contact and are most affected by online dispensing models.

Informed by the Technology Acceptance Model and socio-technical systems theory, this study considers how perceived usefulness, ease of use, organizational context, and professional role expectations shape pharmacists’ responses to digital pharmacy services.

This study explored whether community pharmacists in Saudi Arabia (specifically in the Aseer region) perceive e-pharmacies primarily as a threat to their professional roles or as an opportunity for growth.

This exploratory study specifically sought to address the following research questions: (1) What are community pharmacists’ attitudes toward e-pharmacy in terms of perceived threats and opportunities? (2) What challenges and barriers do community pharmacists associate with e-pharmacy adoption? (3) What professional and service-related opportunities do pharmacists perceive in relation to e-pharmacy? (4) Are pharmacists’ perceptions associated with demographic and professional characteristics?

The sudden rise of e-pharmacy has brought opportunities and challenges for community pharmacists, especially in the changing healthcare environment in Saudi Arabia (2). While digital technologies redefine pharmacy services, pharmacists need to balance new responsibilities with protecting their historical roles in patient care (33, 34). In this study, a noticeable proportion of pharmacists expressed practical concerns about e-pharmacy’s impact on workflow and patient interaction, reflecting broader issues tied to technological readiness. This research provides insights into how the emerging role of e-pharmacy is viewed by community pharmacists, whether as an innovative opportunity or a disruptive force that threatens their professional practice. Gaining insight into these views is key to crafting policies and strategies that reconcile technology with the need to maintain pharmacists’ critical role in medication safety and personalized patient care, particularly in relation to prescription validation, medication counseling, and error prevention in increasingly digital dispensing environments.

The main objective of this research was to investigate community pharmacists’ attitudes towards e-pharmacy and determine whether it is perceived as a potential threat to their professional status or a chance for development within Saudi Arabia’s healthcare system. The research aimed to determine the main challenges, obstacles, and opportunities of e-pharmacy from the viewpoint of practicing community pharmacists. By assessing their sentiments towards online pharmacy services, the study sought to better understand how e-pharmacy influences pharmacists’ work, business viability, and patient services and insights that could inform policy and future strategies to help integrate e-pharmacy into Saudi Arabia. The findings highlight three overarching themes shaping these perceptions: technological readiness, shifts in professional identity, and wider systemic adaptation within community pharmacy practice, which mirror concerns and opportunities reported in recent Gulf Cooperation Council (GCC) literature on digital pharmacy services (8, 9).

The findings of this study indicate that e-pharmacy adoption in Saudi Arabia is met with a combination of enthusiasm and skepticism among community pharmacists. While many recognize the potential benefits of digital transformation, concerns regarding job security, regulatory oversight, and changes to traditional pharmacy roles persist (35, 36). These findings align with previous studies, which have highlighted similar concerns among pharmacists globally (35, 36). Comparable concerns have also been documented in GCC contexts, where regulatory clarity and professional role delineation remain evolving (8). Compared to international studies where e-prescribing is more established, Saudi pharmacists are still in the early stages of adaptation, with notable disparities in technology access and digital literacy (37). Moreover, concerns about medication errors due to system incompatibilities and auto-populated fields in e-prescribing software are consistent with findings from studies conducted in Europe and North America (38). Similar system-level and regulatory gaps have been reported in GCC settings, reinforcing the need for interoperable digital infrastructure and standardized oversight (9). These contextual differences may stem from varying levels of digital infrastructure maturity and regulatory enforcement, which influence how quickly pharmacists adapt to emerging technologies.

Attitudes towards e-pharmacies varied among respondents, with younger pharmacists and those working in urban settings demonstrating greater acceptance of digital pharmacy models (32). This aligns with the study by Jarva et al. (39), indicating that digital-native professionals are more receptive to health technology integration. However, experienced pharmacists voiced concerns over the reduction of pharmacist-patient interaction and the commodification of pharmacy services, an issue also noted in studies from Canada and the UK (40). Despite these concerns, there is an acknowledgment that e-pharmacies can enhance efficiency, particularly in prescription fulfillment and adherence monitoring (41). These findings are consistent with regional evidence from Qatar, where technology acceptance factors influenced adoption while professional concerns persisted (29). Interestingly, some demographic variables that might have been expected to influence attitudes, such as gender and location, did not show significant relationships in this study, suggesting that perceptions of e-pharmacy are shaped more by professional experience and role expectations than by personal characteristics. Although several associations reached statistical significance, most demonstrated small-to-moderate effect sizes, suggesting modest practical impact despite observable differences across demographic groups.

One of the greatest challenges identified in this study is the threat of job loss due to enhanced automation in pharmacy practice. The fear that e-pharmacies may cause diminished demand for conventional pharmacy jobs has been evidenced in previous studies (31). However, it has been evidenced that e-pharmacies never displace pharmacists’ needs but instead redefine their roles as validating digital scripts and maintaining medicine safety. Still, tech disparities and incompatible systems between prescribers and pharmacy sites remain the key hindrances to the free-flowing adoption of e-prescribing (21). Pharmacists also reported higher stress levels due to more time spent rectifying prescription mistakes resulting from limitations in digital systems, a challenge also identified in research on integrating e-prescriptions (42). These findings underscore the importance of protecting pharmacists’ professional scope while reallocating responsibilities toward clinical oversight, medication safety assurance, and patient education in digital workflows. These concerns reflect broader anxieties about professional identity as automation alters traditional responsibilities, reinforcing the need for structured digital training and clearer workflow standards.

Saudi Arabia’s Vision 2030 offers a window of opportunity for organized and sustainable e-pharmacy adoption (28). With digital health transformation as one of the initiative’s core pillars, the government can standardize and regulate e-pharmacy services while preserving the professional status of pharmacists (2). Telepharmacy and AI-controlled medication management systems may extend the reach of pharmacy services beyond the conventional setting, a model already successfully adopted in specific Western healthcare systems (43). In this context, community pharmacists may serve as digital gatekeepers, ensuring appropriate medication use, counseling continuity, and patient safety within hybrid e-pharmacy models. Regulatory strategies focusing on licensing, system interoperability, and AI governance will be essential to mitigate risks while enabling innovation (8). Nonetheless, interpreting these findings requires acknowledging limitations such as the cross-sectional design and the reliance on self-reported data, which may not fully capture evolving attitudes as digital systems continue to develop. Furthermore, as this study was conducted in the Aseer region, the findings should be interpreted as exploratory and may inform, rather than represent, broader national discussions on e-pharmacy integration. However, the success of such integration will be based on proper training of pharmacists and regulatory systems that ensure patient safety while encouraging innovation.

This study has several strengths and limitations. One limitation is its limited generalizability, as it only included community pharmacists in Aseer, which may not represent pharmacists across all regions of Saudi Arabia, particularly areas with lower urban digital adoption. This regional focus may have influenced the findings by reflecting a population more exposed to technology-driven pharmacy services. The high proportion of respondents working in chain pharmacies (78%) may have influenced attitudes toward e-pharmacy, as chain pharmacies are typically more integrated with digital platforms and corporate technological infrastructure than independent pharmacies, potentially leading to more favorable perceptions of digital service adoption compared to smaller private pharmacies. Additionally, the reliance on self-reported data introduces potential bias, as participants’ responses may be influenced by personal knowledge and expectations regarding e-pharmacy. Social desirability bias may also have contributed to more favorable reporting of attitudes toward digital pharmacy services, particularly in the context of national digital transformation initiatives, as respondents may have felt inclined to align their views with perceived institutional or policy priorities. Moreover, the study does not assess actual patient outcomes, such as medication adherence, prescription errors, or patient satisfaction, which limits the ability to evaluate the clinical effectiveness of e-pharmacy services. The study also did not account for non-response bias or sample representativeness in terms of gender and years of experience, which are typical constraints in survey-based research, and may affect the external validity of the findings.

Despite these limitations, the study has notable strengths, including its focus on a timely and relevant topic that addresses the growing impact of e-pharmacy on community pharmacists. It is among the first quantitative studies from the Aseer region examining pharmacists’ adaptation to digital pharmacy services in the post–COVID-19 context. It employs quantitative analysis using chi-square and correlation tests, ensuring objective and data-driven insights. Furthermore, the study identifies key challenges and opportunities in digital pharmacy integration, offering valuable information for policymakers and healthcare stakeholders. Its relevance is further strengthened by its alignment with Saudi Arabia’s Vision 2030 digital health transformation efforts. By situating its findings alongside emerging GCC evidence on e-pharmacy regulation and adoption (8, 9, 29), the study contributes regionally relevant insights that may guide future regulatory and workforce planning initiatives. These findings can contribute to the development of regulations and strategies that enhance patient safety while supporting the evolving role of pharmacists in digital healthcare, particularly in the context of emerging digital service models and regulatory harmonization efforts across GCC countries.

Some recommendations have been put forward to make e-pharmacies work successfully in the healthcare system of Saudi Arabia. It is recommended that thorough training programs be established to improve pharmacists’ digital skills and familiarity with e-prescribing systems. Such programs should be incorporated into pharmacy education curricula and continuing professional development programs. It is further recommended that policymakers enforce standardized regulations to ensure the efficacy and safety of e-pharmacy platforms. Regulatory attention must be dedicated to reducing medication errors, stopping the sale of counterfeit medications, and assuring that e-prescribing supports clinical best practices. In addition, adopting a hybrid model of integrating classical pharmacy services and e-health innovations is recommended, as this would allow pharmacists to have the necessary roles of patient counseling and drug safety while using technology to improve efficiency and access. Future research should explore the long-term impact of e-pharmacy on pharmacists’ professional roles, workflow efficiency, and service delivery through longitudinal study designs that capture changes over time. Further studies incorporating patient-reported outcomes, such as satisfaction, medication adherence, and perceived quality of care, would provide a more comprehensive assessment of e-pharmacy effectiveness from the patient perspective. Comparative studies across the Gulf Cooperation Council (GCC) or Eastern Mediterranean Region (EMR) countries are also recommended to examine contextual similarities and differences in regulatory frameworks and professional adaptation. In addition, mixed-methods research combining quantitative surveys with qualitative interviews may offer deeper insights into pharmacists’ experiences, perceived risks, and coping strategies in digitally evolving pharmacy practice. Positioning these recommendations within the broader global movement toward pharmacy digitization may also support Saudi Arabia’s potential leadership in regional regulatory innovation.

E-pharmacies bring with them potential benefits and profound challenges in the developing healthcare sector of Saudi Arabia. The advantages of e-pharmacies, such as safer medications, increased patient access to medication, and enhanced efficiency, render them an appealing element in healthcare modernization. With the vision of shifting towards a digitally empowered healthcare sector under Vision 2030 in Saudi Arabia, e-pharmacies can be a key player in minimizing drug errors and streamlining pharmaceutical operations. However, the changing process is being taken with alarm by pharmacists who are worried about losing jobs through automation and the erosion of pharmacist-patient contact. Technology can replace manual tasks and enable pharmacists to provide patient care through telepharmacy, medication therapy management, and clinical decision support. The study’s findings also highlight emerging patterns such as variations in acceptance across age groups and recurring workflow inefficiencies that add new insight to the understanding of e-pharmacy readiness in the Saudi context. To maximize benefits and mitigate risks, policies should focus on training pharmacists, ensuring system interoperability, and implementing regulations. A balanced approach combining technological advancements with human elements of pharmacy practice is necessary for successful integration. As this study was limited to community pharmacists in the Aseer region, the findings should be interpreted as exploratory and may inform, rather than represent, broader national perspectives on e-pharmacy implementation in Saudi Arabia. Overall, this study provides one of the early empirical assessments of community pharmacists’ preparedness for digital pharmacy integration in Saudi Arabia, offering key directions for future nationwide investigations and comparative international research.