Health care reform is causing sweeping changes in patient care within the United States, and managed health care and universal access to health ting in care are resulting in profound changes in the practice of pharmacy. The impact of factors associated with cost containment as the increasing role of both private and federal third party payers, increased emphasis on ambulatory care and outpatient surgery clinics, discriminatory pricing by drug companies, pharmacy automation and computerization, and the use of pharmacy must rapidly adapt to the changing health care environment. Changes in curricula over the past 25 years will be reviewed, and projected curricular changes will be presented which reflect decrease in the number of hospitalized patients with a shift to intermediate and ambulatory care settings, the decreased compounding function of pharmacists, the emphasis on seamless team health care, the increased role of pharmacists as therapeutic consultants and drug information specialists, and managed health care and health care economics. Greater educational emphasis will be placed on pathophysiology, therapeutics, health care systems and economics, communication skills, patient counseling, drug information management, patient physical assessment, and ethics with less emphasis on physicochemical and analytical laboratory-based courses. Keywords : Health care reform, pharmaceutical care, clinical pharmacy, curriculum revision, outcome objectives