Community pharmacists say they are concerned about patient care as the rise of bigger discount pharmacies could force the closure of smaller businesses.
The latest data shows over the last few years the number of community pharmacies has been declining.
Since the return of the $5 prescription co-payment, community pharmacists said things were only getting worse, with discount retailers absorbing the fee and putting smaller pharmacies out of business.
When Muneel Dayal started working at Seddon Pharmacy in Pukekohe five years ago, there were just six pharmacies.
Now that figure has more than doubled with a 13th pharmacy - Chemist Warehouse - opening.
That was on top of three other discount pharmacies already in the town, Countdown pharmacy, Bargain Chemist and another Chemist Warehouse.
All 13 pharmacies were within about a 3km radius of each other.
"It's always a fear that is there hearing every single time the new pharmacy is coming in, you always get a little bit scared.
"A genuine worry of mine is what will happen to some of my patients if for whatever reason you know we need to close our doors like what's going to happen to them, like who's going to take care of them."
Dayal said the workforce was already stretched and the rising number of pharmacies popping up was exacerbating the issue.
"Having the number of pharmacies that you do, there's just simply not enough pharmacy staff to share around.
"I don't think in my whole time of ownership I have had adequate staffing."
Owner of Liddells Pharmacy in Pukekohe Bahareh Javadian said despite some owners willing to pay for locums, it was extremely difficult to find one and staff were working overtime to cover absences.
Since the government brought back the $5 prescription fee in July, they had noticed a new pattern emerging.
Their customers have been going to bigger bargain pharmacies to get their prescriptions, only to then come back to their pharmacy for advice.
"They feel embarrassed they ask us, and they say, 'I'm so sorry I didn't come to you because, you know, it's free there but the pharmacist was too busy to explain anything to me, ' or 'I asked the shopper staff, but they had no clue'."
Pharmacy giant Chemist Warehouse. Photo: 123RF
In order to offer free prescriptions, Javadian said they would have to let a third of their staff go.
They have been serving the community for 82 years and knew everyone by name.
But that was not enough to pay the bills.
"It's getting harder and harder every day and being honest yes, I fear for the future of our business, for the future of community pharmacy overall and patient care."
Karen De Roo from the Prescription Access Initiative Group said discount pharmacies could afford to absorb the prescription fee because they sold so many retail products.
But they were dealing with the same staffing shortages, and De Roo said rapidly opening stores was unsustainable.
"If you put aside the fact that they're trying to just take that market share, then we struggle to understand how it can be manageable for them as well."
In Australia, a pharmacy that wanted to fill prescriptions could not set up within 200m, 1.5km or 10km of an existing pharmacy depending on whether it was in a shopping centre, suburb, or town.
Community pharmacists were calling for similar regulations here, warning if nothing changes, the community bond that came from knowing every customer by name could be a thing of the past.
"We do risk the quality and quantity of that advice and services.
"It may not be clear yet or for some time, but if the current situation continues as it does, there may not be a way back to what we've got now and what we've had for so many years."
In a joint statement provided to Checkpoint Medsafe Group Manager Chris James and Te Whatu Ora Living Well Director Martin Hefford said "while there are no restrictions on the number of pharmacy licences that can be issued in any particular geographical area, community pharmacies in New Zealand must hold an Integrated Community Pharmacy Services Agreement (ICPSA) awarded by their local Health New Zealand region before they can provide funded services, such as medicines dispensing.
"Pharmacies are not guaranteed a contract, as regions must review applications against their guidelines for awarding pharmacy contracts.
"Any decisions around awarding contracts will need to follow a fair process under the Commerce Act. Under the contracts, pharmacies - particularly those in rural areas - may be able apply for support based on local need."
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