Aim. To study the specifics of making managerial decisions in pharmaceutical institutions (PhI) taking into account the peculiarities of their organizational culture (OC).Results. The researches were conducted using scientific methods – questionnaires, sample observations, focus groups, expert assessments, involvement of competent experts and modeling have clarified in the framework of the OC PhI the basic requirements for the competences of the specialists of pharmacy (SPh), which are necessary for the adoption of management decisions . These include: timeliness, reasonableness, efficiency, consistency, efficiency, authority, situationality, flexibility, consistency and compliance with the management hierarchy. It has been established that the SF decision-making process should be focused on the awareness of the situation and the necessary final result taking into account the specifics of the OC. The requirements for the SPh, which make management decisions taking into account the specifics of the Federal Law, are outlined. Thus, the SPh, when making managerial decisions, should first of all be able to use professional knowledge and skills, to observe timelines, to have the desire to make positive decisions, in particular to have knowledge of the basics of management science. At the same time, when making managerial decisions in the conditions of OC PhI, risks can not be completely avoided due to the flow of individual SPhs that carry it out. According to the opinion of respondents, such managerial decisions should be weighed and conscious, but the specifics of the SPh activities allow the SPh to have certain intuition and impulsiveness in making decisions in an uncertain situation. Studies have shown that in the conditions of the OC PhI should pay considerable attention to the preparation of an order to execute a management decision by the staff of the Federal Reserve. Respondents indicate that in such an order the answers to the questions (to the extent of significance) should be answered: the purpose, time, performance and terms, methods and means, place, performers. However, the risks remain and most often they are related to the lack of clear formulation of the management decisions, not taking into account all the factors of influence for implementation, the adoption of decisions with insufficient information about the nature of the problem is not consistent with the performers. Therefore, conditions have been studied that should facilitate the successful implementation of management decisions in the Federal Law. Among these conditions are the allocation: the use of reliable information and its completeness, the existence of standard operating procedures for all types of work, a sufficient number of qualified executives, the observance of technology management processes, proper workflow in the implementation of management decisions. Studies have shown that the SPh, as subjects of making managerial decisions in the context of the OC PhI, should be aware of the advantages and disadvantages of different options for their adoption in general (American, German, Japanese, Ukrainian schools) and thus be able to construct their most appropriate procedure specifically in therefore, or another PhI. To successfully solve this problem, we have proposed an optimal version of the procedure for the preparation and adoption of management decisions in the Federal Law, taking into account the specifics of the OC. It combines ten consistently related actions, from understanding the task, studying and evaluating the situation and circumstances, to implementing a solution and feedback on obtaining results.Conclusions. According to the results of the researches, the aspects of making managerial decisions within the specifics of the OC PhI were clarified. On this basis, the optimal version of the procedure of preparing and taking management decisions is proposed, taking into account the results of personal research of their aspects in the Federal Law.