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“I have spent more time with my patients in the past three months. Removing the 'transaction' approach to healthcare is amazing.”


The positive healthcare effects of universal fees-free prescriptions have been far better than expected.

Read our new survey report here

Better healthcare for all:  Community pharmacy staff on the effects of universal fees-free prescriptions

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The 2023 Community Pharmacy Election is approaching, and it's crucial for your favorite pharmacy. Here's the scoop:

Most parties support fees-free prescriptions for all Kiwis, but a few may use pharmacists for taxing when sick.

Some parties prioritize patients over profits by safeguarding non-pharmacist ownership of pharmacies. Others are unclear or didn't respond.

Your voice matters! Let's stay informed for the upcoming election!

Cruel and wasteful: the introduction of prescription fees for most NZers on 1 July 2024 

PAI statement July 2024

The prescription fee – a tax on sick people – costs lives and health. It means less primary healthcare for everybody in Aotearoa NZ – whether or not they have to pay for vital medicines.


It is equivalent to removing around 128 fulltime pharmacists from our communities, as prescription tax red tape makes admin assistants out of qualified health experts, taking them away from patients, resulting in fewer primary health services and less preventative care for everybody. The knock-on effects for health will be severe.


 Universal fees-free prescriptions were one of the most popular policies ever in Aotearoa NZ; they were wildly popular including among government supporters. And for good reason: universal fees-free prescriptions immediately and greatly improved community healthcare and wellbeing – they were effective and efficient.

But now, for people without exemption or financial resources (including minimum wage workers, facing a cost of living crisis) and/or with high health needs, the tax will act as a barrier to vital medicines, and put more people in avoidable pain, distress, and illness. It will create shame and anxiety for many patients – important healthcare relationships will be destroyed.

The academic research – from both Otago and Wellington - is clear: the tax means more preventable visits to our hospitals which are already at breaking point. People could die due to the stress of this policy on the health system, and it could be anyone, even those who can afford vital medicines, or who do not have to pay.

The Prescription Access Initiative calls on the government to immediately reverse this policy to avoid preventable death, illness, shame, conflict, anxiety and other distress.  [Download pdf]

Surgeon in Uniform

The co-payment is a barrier to health, which leads to diminishing wellbeing of New Zealanders.


"People not showing up to collect prescriptions, people only taking part of their prescription, people waiting until pay day, people asking about alternative options for their condition to avoid getting the prescription. This happens all the time, the cost of living is simply so high…people are having to choose to go without."


"The worse case I know of is a man who didn't pick up meds because of the price. He didn't tell anyone, even his whanau. Then one day he had a massive stroke."


"The main knock on effect of the prescription fee is that the patient has a negative experience with the New Zealand health system and is less likely to engage with doctors and pharmacists for their health needs, leading to worse health outcomes."


"Pharmac has negotiated a good price for medicines (and some are very expensive ones too) to be funded in Aotearoa, only to be declined by the patient because they can’t afford to pay the $5 fee for these medicines." 


In March 2023, the Independent Community Pharmacy Group (ICPG) and the Prescription Access Initiative (PAI) asked community pharmacists to share what they’d seen of the effects of the prescription fee on their own communities. A survey encouraged open-ended responses on: patient responses to unaffordable prescriptions; immediate and knock-on effects of the fee for the patient; effects on patients’ family members; effects on patients with medium and high incomes; and effects on the pharmacists themselves. The response was overwhelming – this report contains only a fraction of the deep worry, care, and frustration poured out by more than 150 pharmacists from all around the country (all quotes in the report are from community pharmacists). 

Pharmacist and Patient



Prescription Access Initiative (PAI) is a group of passionate pharmacists in Aotearoa New Zealand who care deeply for whānau and our communities. We believe that all people should be enabled and supported to reach the highest attainable standard of health and wellbeing. We work to empower all people to exercise choice, and have access to the highest-level-medicine-related care in Aotearoa.

Aotearoa New Zealand WITHOUT the co-payment: better, more equitable healthcare

The FreeMeds Study

Recent research by the University of Otago confirms that prescription fees are significantly increasing the number of people admitted to hospital – creating high levels of entirely unnecessary and preventable distress.


1055 people around New Zealand participated in the study. About half of the participants are Maori. Participants had health problems (diabetes, COPD, mental health). People were divided into two groups: one group the researcher paid the $5 co-payment for one year. The other group kept paying as usual.

For every 100 people who did not have to pay the co-payment

For every 100 people who did not have to pay the co-payment

For every 100 people who did not have to pay the co-payment

Based on the study results, if 10000 people like the study participants not having to pay the $5 co-payment, we might expect:

​1927 fewer people admitted to hospital

11785 less days in hospital each year

The cost of a day in hospital is about $1500.

For every 100 people who did not have to pay the co-payment

33 were admitted to hospital

They spent 208 days in hospital
including 13 days for COPD & 11 days for mental health problems

For every 100 people who had to pay the co-payment

41 were admitted to hospital

They spent 326 days in hospital
including 53 days for COPD & 21 days for mental health problems

A girl feeling sad

People are affected by the $5 co-payment 

"Kids first. Like if I have to wait for my script. I will wait for next week or next fortnight or whatever, so as long as the kids have you know, what they need"

"I couldn't pay another $35 prescription charges. It's just a wee bit too high for me. So I've had to sort of cut back on stuff, Like maybe take some medications every second day instead of every day. Yep."

"I've been on nothing, hardly anything for two weeks, just so that I could have my pills. So it's nothing for me to starve myself."

Thinking Man on Couch

The government should remove the patient co-payment on prescriptions for all subsidised medicines for all people of Aotearoa New Zealand to immediately improve health and wellbeing.

PAI is dedicated to promote access to prescription medicines and empowering people's freedom of choice. Our efforts are guided by our commitment to health equity for people of New Zealand.

Learn More about Our Work

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Ensuring that All Voices are Heard

Open Textbook in Library

On Medicine Access and Health Equity

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Those who Stand with Us


Help Us Succeed


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Learning Together

Talk About The Issue

 ⫸Tell Family, Friends, and Community

 ⫸ Discuss with Your Health Provider

⫸ Share on Social Media

Collaborate With Us

 ⫸Tell Us Your Co-payment Story

 ⫸ Work with Us to Help Your Community

⫸ Show Your Support 

Contact Your Local MP

 ⫸ Write to Your MP to Tell Them You Believe The Co-payment should be Removed


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