title: Widening consumer access to medicines: a comparison of prescription to non-prescription medicine switch in Australia and New Zealand.
abstract: BACKGROUND
  Despite similarities in health systems and Trans-Tasman Harmonization of medicines scheduling, New Zealand is more active than Australia in 'switching' (reclassifying) medicines from prescription to non-prescription.
  
  
  OBJECTIVE
  To identify and compare enablers and barriers to switch in New Zealand and Australia.
  
  
  METHODS
  We conducted and analyzed 27 in-depth personal interviews with key participants in NZ and Australia and international participants previously located in Australia, and analyzed records of meetings considering switches (2000-2013). Analysis of both sets of data entailed a heuristic qualitative approach that embraced the lead researcher's knowledge and experience.
  
  
  RESULTS
  The key themes identified were conservatism and political influences in Australia, and an open attitude, proactivity and flexibility in NZ. Pharmacist-only medicine schedules and individuals holding a progressive attitude were proposed to facilitate switch in both countries. A pharmacy retail group drove many switches in NZ ('third-party switch'), unlike Australia. Barriers to switch in both countries included small market sizes, funding of prescription medicines and cost of doctor visits, and lack of market exclusivity. In Australia, advertising limitations for pharmacist-only medicines reportedly discouraged industry from submitting switch applications. Perceptions of pharmacy performance could help or hinder switches.
  
  
  CONCLUSIONS
  Committee and regulator openness to switch, and confidence in pharmacy appear to influence consumer access to medicines. The pharmacist-only medicine schedule in Australasia and the rise of third-party switch and flexibility in switch in NZ could be considered elsewhere to enable switch.
authors.affiliation: Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Gauld
authors.affiliation: School of Pharmacy, University of Auckland, Auckland, New Zealand; Griffith Health Institute, Griffith University, Brisbane, Australia.
authors.forename: Fiona S
authors.initials: FS
authors.lastname: Kelly
authors.affiliation: School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Australia.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Emmerton
authors.affiliation: Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Buetow
mesh_terms: D001315:Australia; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D057915:Drug Substitution / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009520:New Zealand; D004366:Nonprescription Drugs / Q000191:economics / Q000600:supply & distribution*; D010595:Pharmacists / Q000523:psychology; D011057:Politics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000191:economics / Q000600:supply & distribution*
chemical_list: D004366:Nonprescription Drugs; D055553:Prescription Drugs