Contribution of the community pharmacist workforce to primary care through the lens of medicines classification: comparison of Aotearoa New Zealand and Australia.

Introduction Optimal use of the workforce in primary care is critical due to increasing complexity and demand resulting from multi-morbidity in ageing populations. Improving public access to medicines by making them available via a pharmacist without prescription can support self-care while ensuring oversight by a health professional. Aim The aim of this paper was to identify and explore key differences between New Zealand and Australia in medicines classified nationally for pharmacist-only non-prescription supply. Methods Medicines legally classified to allow sale by a pharmacist without a prescription were identified and compared between the two countries as of 1 February 2024. Based on consensus among the research team, notable differences were subjected to qualitative consideration about how medicines classification may be used to extend the role of pharmacists in primary care. Results Overall, New Zealand has a less restrictive approach to classification than Australia providing New Zealanders increased access to medicines via a pharmacist in two key therapeutic areas: sexual and reproductive health and infection. Oral contraceptives, sildenafil, antibiotics for urinary tract infection and two COVID-19 antivirals were classified for supply without prescription via pharmacists in New Zealand but not nationally in Australia, although some alternative legislative mechanisms are emerging at state level. Discussion Medicines classification has an ongoing role in enabling pharmacist contribution to primary care. Medicines classification needs to be considered alongside commissioning of services and other policy to facilitate integration of community pharmacy-provided care within the wider primary care environment. Digital tools supporting information sharing, collaboration and communication are key.