OBJECTIVES: Reducing prescription co-payments have been established to improve access to medicine. However, we do not understand what people are willing to give up in other areas of their pharmacy experience in exchange for lower prescription co-payments. In New Zealand, free prescriptions have been offered by a few discount pharmacy groups since 2017, however in July 2023 they were removed by government for all New Zealanders and remain a point of debate. This paper aims to investigate New Zealanders’ preferences for community pharmacies to identify the relative importance of different pharmacy characteristics.

METHODS: Discrete choice experiments (DCEs) provide a method for quantifying preferences. To design the DCE, population representative focus groups were conducted and thematic analysis was used to develop themes into attributes. A partial factorial design of 12 choice tasks and demographic questions formed the full survey. The survey was pilot tested using a ‘think aloud’ approach ensuring it was manageable and interpreted as intended, then disseminated to 1000 participants representative of the New Zealand population. A multinomial logit model was created and used to estimate utility and marketshare.

RESULTS: The DCE featured six attributes; location, wait time, customer service, prescription co-payments, nearby businesses, and car parking. Attributes indicative of a low cost model, $0 prescription co-payments, longer wait times and less personal service, were combined and compared to a pharmacy with short wait times, personalised service but charging higher prescription co-payments while other attributes were held constant. Initial results suggest the low cost model to be preferred by a smaller share of the market than other pharmacy models.

CONCLUSIONS: This research provides evidence that free prescriptions might not be the most important factor to patients and focusing on improving other attributes may lead to greater increases in pharmacy utilization.