Independent Community Pharmacists and Pharmacy Owner Experiences and Perceptions of the South African 4-Tiered Dispensing Fee Structure: A Quantitative Cross-Sectional Study

At the point of medicine dispensing, consumers in South Africa are charged a dispensing fee for medicines bought in the private sector. However, almost two decades later, uncertainty about the dispensing fee persists, and few studies assess community pharmacists’ perceptions of the fee structure. A cross-sectional study was conducted between 5 December 2025 and 28 February 2026 using a validated self-administered survey. The study targeted independent community pharmacy owners and pharmacists. Data analysis included descriptive and inferential statistics using the Statistical Package for the Social Sciences software, version 30. A total of 146 respondents completed the survey, out of the required 226. There was overall disagreement (76%) that the dispensing fee structure was fair compensation for pharmacists’ services and that it reflected pharmacy operational costs (87.1%), with 50.4% of respondents reporting that medical aid schemes do not remunerate in accordance with the government’s four-tiered dispensing fee. The findings revealed no significant differences between perceptions of the current (2024) and proposed (2025) fees. The survey findings, based on participant responses, suggest that the current dispensing fee structure may be misaligned with actual operational costs. Geographic inequity, the dispensing volume assumptions underpinning the model’s design, and medical aid non-compliance may be among the structural factors shaping these perceptions.