Pharmacist Salary in Missouri 2026,
$137,610 Median | BLS Data by City

Missouri pharmacists earn a median $137,610 a year, $66.16 an hour, per BLS OEWS May 2025, with the middle half between $127,920 and $158,120 and a full range of $107,530 to $166,840. That is 2.3% below the $140,910 national median, though Missouri's low cost base improves the real position.

Cape Girardeau at $141,250, then Kansas City at $139,460, Columbia at $139,430, St. Louis at $138,530 and Springfield at $134,990. Four of the five sit above the statewide median, which means the rural and small-town pharmacies outside the metros are what pull the state figure down.

Through the Missouri Board of Pharmacy at the Division of Professional Registration: a Doctor of Pharmacy degree from an accredited programme, the NAPLEX, the Missouri multistate pharmacy jurisprudence examination and supervised internship hours. Pharmacists licensed elsewhere may transfer by reciprocity but must still sit the Missouri jurisprudence examination.

Because a pharmacy cannot legally operate without a pharmacist on duty, and southeastern Missouri has fewer of them available. Cape Girardeau anchors a regional health system serving a wide rural catchment with no local pharmacy school pipeline, so employers there must raise the offer until someone accepts. St. Louis and Kansas City have deeper candidate pools — and both levy a 1% earnings tax that Cape Girardeau does not.

Missouri's graduated income tax tops out at 4.8%, favourable at this income compared with most states in this batch. Kansas City and St. Louis each levy a 1% earnings tax on anyone working inside the city, which at pharmacist earnings is a meaningful annual sum that outstate posts avoid entirely.

That geography beats the metro premium in this occupation. Cape Girardeau at $141,250 pays more than St. Louis at $138,530, avoids the 1% city earnings tax, and sits in a housing market a fraction of the cost. For a pharmacist willing to live in southeastern Missouri, that combination is worth far more than the several thousand dollars separating the metro figures — and the same logic applies across the rural Midwest markets in this batch.

The tenth percentile of $107,530 reflects part-time, relief and floating positions rather than a genuine entry salary for a full-time role. At the other end the band mixes hospital clinical specialists with retail managers earning a scarcity premium — two very different jobs arriving at similar numbers. And four of five metros sitting above the state median means the rural pharmacies pulling that median down are not visible anywhere on this page.

Residency for the clinical route, location for the retail one. A PGY1 and a PGY2 in oncology, critical care or infectious disease open the clinical specialist roles that reach the $158,120 seventy-fifth percentile, and Missouri's academic systems in St. Louis, Kansas City and Columbia run competitive programmes. On the retail side, the small-market scarcity premium — Cape Girardeau at $141,250 — is the fastest route above the median. Health system pharmacy leadership and specialty and infusion practice reach the $166,840 ninetieth percentile.