Indonesia's large population, geographical fragmentation, decentralized health system and expanding universal health coverage create a complex environment for pharmacy practice and pharmaceutical policy. This manuscript reviews the Indonesian pharmaceutical landscape through the interconnected themes of medicine access, pharmaceutical care, antimicrobial stewardship, workforce capacity, procurement and supply-chain resilience, and pharmacy education. The review synthesizes evidence from the World Health Organization, Indonesia's Ministry of Health, the Indonesian Food and Drug Authority (BPOM), the International Pharmaceutical Federation and peer-reviewed studies. Evidence indicates substantial progress in pharmaceutical-system development, including the expansion of national health insurance, the development of national antimicrobial-resistance strategies, pharmacist-led public education, and growing attention to pharmaceutical care. However, persistent challenges remain. Recent assessments found procurement and pricing problems affecting medicine availability in facilities participating in the national insurance system, while shortages of selected medicines continue to create pressure on service delivery. Antimicrobial stewardship is another major challenge: BPOM surveillance reported high levels of antibiotic dispensing without prescriptions in pharmacies, although the proportion declined between 2021 and 2023. At the practice level, studies indicate that pharmacists in primary care can contribute to medication adherence, patient education and chronic-disease management, but the scope of pharmaceutical care remains uneven. Indonesia's archipelagic geography also produces disparities in workforce distribution, service capacity and access. The manuscript argues that strengthening pharmacy in Indonesia requires an integrated approach that combines regulatory enforcement with professional development, reliable medicine procurement, digital information systems, community engagement and expanded pharmacist participation in patient-centred care. The article concludes with a policy and research agenda focused on rational medicine use, antimicrobial stewardship, equitable access, workforce planning and outcome-oriented pharmaceutical care.
Keywords:Indonesia; pharmacy practice; pharmaceutical care; pharmacists; medicine access; antimicrobial resistance; antimicrobial stewardship; national health insurance; pharmaceutical supply chain; pharmacy education