Substitute Economics and the Threat of Artificial Intelligence Providing Pharmaceutical Care

The accelerating adoption of artificial intelligence (AI), particularly large language models such as ChatGPT, has raised critical questions about the role of pharmacists and the potential for AI to substitute for human expertise in pharmaceutical care. Grounded in Porter's Five Forces framework-specifically the threat of substitutes-this commentary explores whether AI can adequately fulfill the complex and relational functions of pharmacists in delivering patient care. Drawing from foundational definitions of pharmaceutical care and economic theories of substitution, the paper examines both historical and emerging competitors to pharmacist-provided services, including physicians, nurses, and now AI-powered tools. Rather than assert a binary conclusion about AI's ability to replace pharmacists, this paper identifies conditions under which substitution may be more or less likely. Key factors include the nature of the pharmaceutical care service, patient preferences, the quality and accessibility of AI tools, and regulatory and institutional constraints. Using examples from practice and education, the commentary highlights areas where AI may function as a substitute-such as information delivery or curricular mapping-and others where human oversight remains essential. Ultimately, the question is not whether AI will serve as a substitute, but to what extent, under what circumstances, and with what implications for pharmacy educators. Preparing students for a professional environment augmented by AI requires a shift in educational strategies, with a focus on adaptability, data literacy, and meaningful integration of emerging technologies.