The continuing row over pay in the health service could cause further problems for nondispensing GPs after a union said it will consider balloting members on industrial action.
The Unite section of Amicus, which represents pharmacists, is angry at government plans to offer a staged pay increase.
It is too early to say what form any action may take, but other unions have threatened to disrupt services over issues such as working hours.
Kevin Coyne, Unite head of health, said: "Unite alongside other health unions met with NHS employers in an attempt to reach an agreement on the pay of NHS workers in England.
"The employers have refused to offer any more money than the 2% imposed by the government, which overrode the Pay Review Body's recommendation of 2.5%.
"We will meet with our senior NHS representatives shortly and we will recommend they reject the offer and hold a consultative ballot on industrial action.
"NHS workers in Scotland, Wales and Northern Ireland will all receive pay increases in line with the Pay Review Body's recommendation of 2.5%.
"It is unacceptable that workers in England should be treated differently and contrary to the Pay Review Body's recommendation."
As well as pharmacists, the union represents 100,000 theatre nurses, estates and maintenance workers, health visitors, chaplains, mental health practitioners, health care scientists, and sexual health advisors.