Many pharmacies could stop opening in the evenings and weekends in the new year after owners voted for collective action for the first time.
The National Pharmacy Association (NPA) said members do not want to cut services but have “no option” if the government does not increase funding.
Some could also stop deliveries, consultations and emergency contraception if a deal cannot be reached.
The amount pharmacies are paid for medicines they supply for the NHS is fixed by the government.
The NPA said this has not increased for 10 years.
Around 700 pharmacies have shut in England over the last two years and 1,250 in the last decade.
Pharmacies are contracted for 40 hours per week – but most open for 50 hours on average, according to the NPA.
More than 3,300 independent pharmacies took part in its vote (a 64% turnout) and 97.8% said they were willing to shorten their hours.
Over 96% also voted to potentially pull out of services such as addiction support, stop-smoking services and emergency contraception.
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NPA chairman Nick Kaye said: “Pharmacy owners are not a radical bunch, we have never proposed action like this before, but after a decade of underfunding and record closures, something simply has got to give.”
He said anger had “intensified exponentially by the budget”, with the hike in employers’ national insurance contributions and a national living wage increase pushing “even more pharmacies to the brink”.
Head of the Independent Pharmacies Association Dr Leyla Hannbeck said the national insurance increase would cost pharmacies £12,000 a year extra.
“The government must urgently raise pharmacy funding to prevent further closures of community pharmacies,” said Dr Hannbeck.
“We are awaiting a settlement and the results of that settlement will determine the next steps.”
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GPs in England also voted for collective action earlier this year in a row over new contracts.
The British Medical Association (BMA) issued a list of 10 actions for surgeries to consider, including capping the number of patients to 25 a day and refusing to carry out some work.
GPs’ funding increase for 2024/25 was 1.9% – and 99% rejected it in the BMA vote.
