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In a previous article, our team highlighted the strengths and limitations of the Pharma work unit (UO) in the accounting reprocessing of hospital pharmacies in France (PUIs). The aim of this study is to highlight the benefits and limitations of the UO in the context of inter-establishment pharmaceutical cooperation and the deployment of clinical pharmacy activities (CPAs). This is a retrospective observational study based on data from an external audit report from 2019 (unpublished), annual activity reports of the PUIs studied from 2019 to 2023, and hospitalization data from 2021 to 2023. These data were analyzed using SPSS software (v.29.0.1). In 2019, the data collected during an audit commissioned by hospital management revealed that the budgeted number of beds and places relative to paramedical staff was three times higher at the PUI of the Centre hospitalier Fondation Vallée (CHFV) compared to that of the PUI of the Groupe hospitalier Paul Guiraud (GHPG). However, the activity data indicated that the hospital pharmacy at the GHPG was 5 to 100 times more active. As a result, the UO was 26 times higher at the GHPG, while medical and paramedical human resources expenses relative to the UO were almost 2 times lower. Between 2021 and 2023, despite common management, the two PUIs, initially located across three sites, were consolidated into two PUIs on two sites. During this period, we observed a decrease in the Pharma UO (-4%), along with a fall in the number of beds (-24%) and a decrease in full-time hospitalization days (-10%). To explain this discrepancy between the evolution of the UO and that of hospitalization, it is necessary to consider all the weighted activities of the PUI and the deployment of CPAs. The number of shared activities between the two PUIs decreased (overall dispensing activity decreased due to a reduction in facility capacity). However, weighted clinical pharmacy activities increased by 16%, and their share in the UO grew by 19%. This growth can be attributed to the redeployment of clinical pharmacists (CPs) to care units that had remained operational but had previously lacked CP coverage. The intensification of CP presence in these care units led to an increase in requests for pharmaceutical interventions, as well as an innovative initiative assigning a CP to ambulatory units. In the case of inter-establishment pharmaceutical cooperation, the UO serves as an indicator that helps assess the impact of organizational restructuring and provides useful guidance for decisions regarding the merger/closure of a PUI. Finally, with regard to CPAs, it is important to clarify their role in the context of new processes, where activities vary depending on patients, care pathways, and treatments, and where coordination is necessary between traditional professions and emerging roles, such as advanced practice nurses or peer supporters.