Australia’s dispensing fees for medicines are estimated at about $3 billion annually, a figure Grattan says results from a lack of competition and backroom negotiations that benefit pharmacy owners at the expense of taxpayers and patients.

The Pharmacy Guild contends it has helped drive affordability, noting a January 2026 co-payment reduction to $25—the lowest level since 2004—and positioning itself as a steward of affordable medications.

Both Grattan and the Guild emphasize the essential role of community pharmacies in access to medicines and health services, while calling for expanded pharmacist roles and a nationally consistent prescribing framework.

Grattan urges an end to backroom deals and advocates for transparent, evidence-based government fee negotiations, with patient and pharmacist participation at the table if broader reforms are resisted.

Dispensing fees average about $9.24 per script, and Grattan argues these fees should be reset and set independently based on actual costs, criticizing current costs as obscured by guild-driven negotiations.

Australia’s regulatory framework allows discounts on medicines below the maximum co-payment, a practice Grattan says could deliver real savings to patients, citing about $319 million saved in 2025.

Grattan alleges the Pharmacy Guild wields substantial political influence as the main representative of pharmacy owners and through political donations, leading to governance that favors industry profits over public value.

Around 6,000 community pharmacies dispense 335 million prescriptions under the Pharmaceutical Benefits Scheme, with taxpayers covering about $3.8 billion, underscoring a perceived mismatch between costs, fees, and patient savings.