OBJECTIVES: According to osteoporosis guideline, bisphosphonates are the first choice of osteoporosis. Alternative treatments include raloxifene, calcitonin, teriparatide and the last one is least cost-effectiveness. There is strict national health insurance (NHI) payment rule for teriparatide in Taiwan. If the patient does not meet the NHI criteria, this reimbursement payment will be cut and hospital has to pay the fee (several times of NTD$15766). The objective study was to evaluate the pharmacist intervention to enhance the utilization of teriparatide and decrease reimbursement payment cut. METHODS: When physician prescribed teriparatide initially, the order would send to the regulation system and pharmacists had to review whether the patient met the criteria. If patient did not meet the criteria, pharmacists would inform the physician to change order at next clinic visit. Patient could receive teriparatide if pass the evaluation vice versa. The data collected from March 2010 to December 2011. RESULTS: The initial prescription number significantly decreased from 51 to 8 per month during March 2010 and December 2011. The NHI set new payment criteria resulted in the prescription rate declined, particularly after January 2011.  The cut in reimbursement fee of NTD$ 36,2618 in quarter one of 2010 reduced to zero in quarter three of 2011 since pharmacists intervened and reviewed the criteria via regulation system before prescribed. CONCLUSIONS: Pharmacists intervention enhanced the rational use of high cost of teriparatide and decreased reimbursement payment cut.Pharmacists intervention enhanced the rational use of high cost of teriparatide and decreased reimbursement payment cut.