Decision to extend Pharmacy Services

20 May 2026

Medicines Decision

What we’re doing

Health New Zealand and Pharmac are pleased to announce that from 2 June 2026 the range of funded medicines community pharmacies can provide directly to people in their communities will be expanded to include:

Treatment for scabies
Oral rehydration for children
Pain and fever management for children
Treatment of headlice
Treatment for conjunctivitis for children
Treatment for uncomplicated urinary tract infections
The emergency contraceptive pill

To support this change, Health New Zealand will fund consultations provided by community pharmacies for eligible people, and Pharmaceutical Schedule will be amended to allow Direct Provision by Pharmacists in accordance with their pharmacy agreement.

What does this mean for people and community pharmacies

Health New Zealand and Pharmac understand the important role that pharmacists have in providing timely healthcare to people in New Zealand and the barriers that many people face in accessing appropriate care and treatment.

To support the role of community pharmacists as a first point of contact for those seeking clinical care, from 2 June 2026 community pharmacies will be able to supply an extended range of funded medicines to eligible people without a prescription. Pharmacies that choose to offer this service will be part funded by Health New Zealand to provide consultations and service. Users may be required to pay a consultation fee.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 15 April 2026. We would like to thank the people and organisations that took the time to respond to the consultation and for the valuable feedback they provided. The feedback we received was overwhelmingly supportive of the proposal and the benefit that it will provide to New Zealanders.

Respondents also shared other medicines that they would like to be added to the extended pharmacy services programme. We have kept a record of these and will consider them as part of any future changes.

No changes have been made to the proposal following consultation.

Who we think will be most interested

Pharmacists
Māori Pharmacists Association
Pacific Pharmacists Association
Pharmaceutical suppliers and wholesalers
Primary care providers
GPs and Primary Health Organisations
Health professionals who work with infants and young people
Health Professional Bodies
Wellchild Tamariki Ora providers
Social services
Early childhood education/care providers
Schools
Community Services Card holders and their families/whanau
Parents and Guardians of people under 14

Detail about this decision

Treatments included

A note will be added to Section B of the Pharmaceutical Schedule from 2 June 2026 to allow pharmacies to supply the following currently funded medicines directly to the following groups of people without a prescription when providing an (Integrated Community Pharmacy Services Agreement (ICPSA) Extended Pharmacy Service.

The following medicines will also continue to be funded via a prescription for the same populations as they are now. Pharmac is not making any changes to funded eligibility.

Treatment	Eligible population for pharmacy service provision
Acute analgesia and fever management Paracetamol 120 mg/5 mL oral liquid Paracetamol 250 mg per 5 ml oral liquid Paracetamol 500 mg tablets Ibuprofen 20 mg per ml oral liquid	People under 14 years old
Acute oral rehydration Powder for oral solution (Electral) Solution with electrolytes (2 x 500 ml) (Pedialyte)	People under 14 years old
Acute bacterial conjunctivitis Chloramphenicol 0.5% eye drops Chloramphenicol 1% eye ointment	People older than two years and under 14 years old
Headlice treatment Dimethicone 4% lotion	People under 14 years old and their whānau.
Scabies treatment Permethrin 5% lotion	People under 14 years old and their whānau.
Emergency Contraception* Levonorgestrel 1.5 mg tablet	Women under 25 years old
Acute uncomplicated urinary tract infection Nitrofurantoin 100 mg capsules Trimethoprim 300 mg tablets	Women aged 16 to 65 years old

Treatment

Eligible population for pharmacy service provision

Acute analgesia and fever management

Paracetamol 120 mg/5 mL oral liquid
Paracetamol 250 mg per 5 ml oral liquid
Paracetamol 500 mg tablets
Ibuprofen 20 mg per ml oral liquid

People under 14 years old

Acute oral rehydration

Powder for oral solution (Electral)
Solution with electrolytes (2 x 500 ml) (Pedialyte)

People under 14 years old

Acute bacterial conjunctivitis

Chloramphenicol 0.5% eye drops
Chloramphenicol 1% eye ointment

People older than two years and under 14 years old

Headlice treatment

Dimethicone 4% lotion

People under 14 years old

and their whānau.

Scabies treatment

Permethrin 5% lotion

People under 14 years old

and their whānau.

Emergency Contraception*

Levonorgestrel 1.5 mg tablet

Women under 25 years old

Acute uncomplicated urinary tract infection

Nitrofurantoin 100 mg capsules
Trimethoprim 300 mg tablets

Women aged 16 to 65 years old

*Funded supply of the emergency contraceptive pill can already be provided directly by pharmacists to people of all ages who need it. There will be no change to these arrangements or its listing on the Pharmaceutical Schedule. However, from 2 June 2026, Health NZ will also fund pharmacies to provide the consultation required to supply the emergency contraceptive pill to women aged under 25 years.

Funding for pharmacy services

Health NZ will part-fund the consultation between pharmacists and eligible service users.

An Extended Pharmacy Service consultation fee, to be paid by the service user may also apply, which would be reduced if the person is a Community Services Card holder.

Health New Zealand is working with the pharmacy sector to finalise funding arrangements for consultations and any consultation fees that may be charged to service users.

Prescription copayments may still be payable, unless the Service User is exempt(external link), for medicines supplied as part of an Extended Pharmacy Service.

Our response to what you told us

We’re really grateful for the time people took to respond to this consultation. A summary of the main themes raised in feedback, our responses to the feedback received, and changes we have made after listening to you are available on our notification webpage.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.

Feedback	Pharmac comment
Overall support for expanding Pharmacy Services
Almost all respondents supported the proposal to expand pharmacy services and increase the range of funded medicines able to be dispensed directly from pharmacies. Many respondents noted that the proposal was patient-centred, and the proposed treatments aligned with medications that pharmacists regularly provided and were confident making diagnoses. Respondents also noted that pharmacies were well integrated into New Zealand’s health sector and would be able to refer complex cases with unclear diagnoses to their colleagues including GPs. Respondents considered that the proposal recognised the clinical expertise of pharmacists as a key part of the health sector and could help pharmacies to remain viable businesses and attract new people to the profession.	We are pleased that respondents support the proposal and consider that it will add value to New Zealand’s health sector and support the people who need them to access medicines more easily.
Respondents, including members of the public considered that the proposal was essential for easing pressure being experienced across primary care and noted that pharmacies are widely available and accessible throughout the country, including rural locations and are well placed to act as initial provider of treatment for common conditions.	We are pleased that respondents support the proposal and consider that it will increase access to health services and support people to access medicines for common conditions more easily.
Conditions, in scope treatments and eligible populations
Overall respondents were strongly supportive of the conditions and range of medicines in scope of the proposal. Respondents supported that the proposal included scabies or headlice treatment for the whole family.	We are pleased that the range of conditions and associated medicines included in the proposal have been well received by respondents. It is intended that this proposal would allow community pharmacies to provide funded medicines for a range of common conditions and diagnoses directly to patients and help reduce the burden on primary care and improve medicine access.
Respondents considered that age limits should be removed from the funded consultations for items such as ECP, scabies and headlice as people of all ages including the elderly could benefit from easier access to funded medicines via their pharmacy.	We acknowledge people of all ages may require treatment for scabies and headlice and a wide range of people could benefit from funded consultation for the ECP; however, the decision has been made by Health NZ to prioritise available funding for pharmacy consultations to these groups. People who are whanau of a child with scabies or headlice would be able to receive funded treatment. Access to funded ECP tablets for people of all ages would continue to be available through community pharmacies.
Respondents considered that infants younger than 3 months should be excluded from pain management as this is a high-risk group and other testing may be required. Respondents noted that use of paracetamol in children in this age would be off label.	Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical best practice.
Respondents considered that UTIs in children or men should never be considered uncomplicated.	Trimethoprim and Nitrofurantoin can only be provided by a pharmacist to women aged 16–65 years with uncomplicated UTI, thereby excluding children and men.
A respondent considered paracetamol tablets should be limited to pack sizes of 30 available from pharmacies to minimise the risk of overdose.	Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical best practice including provision of an appropriate quantity of medicine for treatment.
Respondents noted the majority of infections in children are viral rather than bacterial and do not require treatment. It was noted that the inclusion of bacterial conjunctivitis in children raised concerns for antimicrobial stewardship and antimicrobial resistance.	Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical best practice. Pharmacists currently diagnose and treat the proposed conditions within their scope of practice. This initiative provides funding for these services.
Respondents noted some people may require more than one tablet for effective emergency contraception.	We understand that different doses of levonorgestrel are used clinically for ECP. Up to two ECP tablets per occasion are already funded. This would not change, and it would continue to be funded as it is now.
A respondent requested that the tablet form of ibuprofen should be included as part of the service as this may be more appropriate than liquid for older children.	Ibuprofen cannot be supplied by a pharmacist without a prescription unless it is supplied in the manufacturer’s original pack. There are currently no Pharmac‑funded pack sizes of ibuprofen that can be legally supplied by a pharmacist without a prescription. If a smaller pack size was to become funded in the future, this would be considered at that time.
Consideration of additional medicines to include in the future
Respondents suggested a range of additional medicines that could potentially be considered for inclusion in the service in future. These included treatments for allergies, minor skin infections and fungal conditions, common infections, gastrointestinal symptoms, respiratory conditions, women’s health, chronic condition continuation, and preventive care. Some respondents also suggested access to selected medical supplies to support service delivery.	Health NZ and Pharmac appreciate the effort of respondents to identify medicines that would be helpful to have access to via community pharmacy and will consider these treatments as part of any future expansions to the service.
Clinical safety concerns and appropriateness
A small number of respondents provided feedback that they consider community pharmacists are not appropriately qualified to accurately diagnose conditions and provide appropriate treatment. Respondents also noted that the proposal could incentivise pharmacies to provide unnecessary treatment.	Pharmacists currently diagnose and treat the proposed conditions within their scope of practice. This initiative provides funding for this care. Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical and ethical best practice. Pharmacists will be paid for an Extended Pharmacy Services consultation even if no treatment is supplied (e.g. where referral to another has occurred).
Some respondents considered that rather than making treatments more accessible via pharmacies, the funding should be redirected to improve access to GPs.	Health New Zealand is actively working on initiatives to improve access to GP care.
Respondents noted that of the conditions included in the scope of the proposal treating fever and providing oral rehydration for children could be challenging for pharmacists and underlying causes could be missed or misdiagnosed.	Pharmacists providing Extended Pharmacy Services would be required to comply with treatment‑specific legal requirements and established clinical best practice. Pharmacists currently diagnose and treat the proposed conditions within their scope of practice. This initiative provides funding for this care.
Respondents considered that it would be important to address risks associated with the programme including fragmentation of care, particularly if pharmacy and GP records aren’t linked, it was also noted that this could result in vulnerable populations who cannot already access GPs receiving lower quality, episodic rather than comprehensive care.	Pharmacists currently diagnose and treat the proposed conditions within their scope of practice. This initiative provides funding for this care. Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical best practice. This includes referral to general practice, urgent care or emergency care where appropriate. Health New Zealand is actively working on initiatives to improve access to GP care.
Implementation support and sustainability of the service
Respondents considered that a range of media including television advertising, radio and social media posts should be used to promote the availability of the service to the eligible populations and amongst pharmacies to encourage uptake and participation. Respondents considered that any messaging should support pharmacists as a useful first contact for people with common conditions.	Health NZ is developing a public messaging campaign to support implementation.
Respondents considered that adequate compensation, including for any follow up would be vital for the successful implementation of the programme and ensuring it is available consistently throughout the country, including rural locations. Respondents considered that reimbursement should be beyond covering the cost of the medicine and must account for increased labour costs and the need retain staff. Respondents also noted that this proposal comes at a time when the pharmacy sector is facing significant shortages and workforce pressures and reimbursement must be sufficient that pharmacies are incentivised to provide the service and are able to retain staff.	Health NZ is working with sector leaders and consumers to design the Extended Pharmacy Service, including funding arrangements for pharmacists. Once these have been agreed, they will be communicated to providers.
Community pharmacies noted the importance of training that is simple and accessible to support provision of the service.	We appreciate this feedback. Pharmacists currently diagnose and treat the proposed conditions within their scope of practice. This initiative provides funding for this care. No new service specific training would be required beyond existing treatment‑specific legal requirements and that required to maintain established clinical best practice.
Clinical editors of NZ Community HealthPathways noted general support for the proposal and recommended use of a Sepsis Screening and Action Tool to help mitigate the risk of associated with pain and fever diagnosis in children.	Thank you for the recommendation. Pharmacists diagnose and treat the proposed conditions within their scope of practice as existing practice. This initiative provides funding for this care. Pharmacists providing Extended Pharmacy Services will be required to comply with treatment‑specific legal requirements and established clinical best practice. This includes referral to general practice, urgent care or emergency care where appropriate.
The NZ Association of Optometrists considered that pharmacies being able to offer chloramphenicol could provide benefit to patients and proposed providing an information sheet with questions to support diagnosis of conjunctivitis.	We appreciate the offer to support the implementation of this proposal. We have shared this feedback with Health NZ so that it can be considered as part of the communications and implementation activities that are being planned.
Respondents considered that there would need to be clear referral and escalation pathways for pharmacists managing complicated cases and uncertain diagnoses.	Pharmacists providing Extended Pharmacy Services would be required to comply with treatment‑specific legal requirements and established clinical best practice, as they do now. This includes referral to general practice, urgent care or emergency care where appropriate.
Many respondents noted the need for integrated IT infrastructure to support implementation, which would allow data to be collected and care to be tracked between pharmacies and other primary care providers like GPs. Some respondents considered the programme available to support the 2023 Minor Ailments Scheme would be sufficient.	Providers would need to report on service provision to Health New Zealand. This data will support monitoring and evaluation of the Extended Pharmacy Services.
Respondents noted the importance of evaluation and feedback mechanisms including safeguards where people may have frequent reoccurrences of conditions.	Services provided will be monitored, evaluated and routinely audited by Health NZ. Pharmacists providing Extended Pharmacy Services would be required to comply with treatment‑specific legal requirements and established clinical best practice.
Any decisions to further widen access to more pharmacy only medications could have a significant impact on the medicines budget.	Any decisions to widen access to funded medicines would include careful consideration of the budget impact and would only be progressed if sufficient budget is available to support it.
Supply chain impacts
A supplier of one of the medicines raised concern about the possible uptake of the service and the impact this could have on the availability of supply.	Pharmac will share possible volume information with suppliers to help with their forecasting. Suppliers will continue to be responsible for ensuring they have sufficient stock to meet demand.
Respondents noted the importance of ensuring suppliers have sufficient stock to support the service. Respondents also considered that in the event of supply issues it would be important for pharmacists to be able to provide alternatives, including products that do not have Medsafe approval (Section 29).	Supply agreements are in place for each of the medicines included in this proposal, which set minimum stockholdings that are required to be held by the supplier. Pharmac’s supply agreements are intended to provide security of supply. Sections 29 and 29a of the Medicines Act 1981 identifies the health professionals that are authorised to prescribe medicines that are not approved by Medsafe. Currently this does not include pharmacists other than Pharmacist Prescribers. Changes to the Medicines Act have not been considered as part of this decision.