Pharmaceutical waste management represents a global issue. There is a significant gap in consumers’ education regarding the proper disposal of pharmaceutical waste. A significant amount of pharmaceutical waste is generated in health care facilities, including expired medicines, unused doses, and contaminated materials. Inadequate disposal of pharmaceutical waste can have effects on human health and on the environment. Managing pharmaceutical waste requires coordinated efforts from policymakers, health care providers, pharmaceutical manufacturers, waste management companies, and consumers. The purpose of this paper is to examine the current state of activities that may impact the efficiency of Romanian pharmacists in collecting and disposing of pharmaceutical waste, as well as the intentions of pharmacists/technicians to recycle this type of waste. Furthermore, this paper aims to identify institutional and behavioral barriers that affect effective waste management. This research was conducted using quantitative and qualitative research methods. An exploratory factor analysis was used to identify the elements of satisfaction and their attribution levels in the pharmaceutical industry. The statistical significance of the differences across different occupations regarding satisfaction with pharmacists’ activities to reduce waste at each stage was tested using an analysis of variance. Cross-tabulation and a Pearson’s chi-square test were used to analyze the relationship between occupational segments and intention regarding recycling and reusing pharma waste. This research was augmented using qualitative analysis based on the Delphi technique, focused on the barriers to waste management in the pharmaceutical sector. This study presents a general perspective on the current situation of pharmaceutical waste in Romania. The results indicate that the selection of appropriate pharmaceutical waste practices is primarily determined by the attitude of individuals and organizations, followed by regulatory, economic, and technical criteria. In developing sustainable pharmaceutical waste policies, this research provides practical implications for governments, organizations, and citizens. A comprehensive approach to overcoming barriers in pharmaceutical waste management was developed by combining institutional strategies that focus on organizational policies and infrastructure with behavioral strategies that target individuals and communities.