Still, the Australian model isn’t just different — it gives pharmacists far more room to move.
A system built on independence
In a podcast for NCPA, Twomey spoke about community pharmacy structures in Australia. Every pharmacy in Australia is independently owned. There are no chains. Ownership is restricted to registered pharmacists, and new pharmacies can’t simply open anywhere. They must meet strict location rules, designed to prevent “pharmacy deserts”.
The result is unusual by global standards: 96% of Australian’s in Capital Cities live within 2.5km a community pharmacy. And in 332 towns across Australia community pharmacies are the only healthcare destination.
In the US, large portions of the population still lack local access — and corporate closures can wipe out entire towns’ primary care safety nets overnight.
Listen
Coming to you from #NCPA2025, host John Beckner and co-host Ed Cohen talk with Trent Twomey, BPharm, national president of the Pharmacy Guild of Australia, about how pharmacy operates differently in Australia compared to the U.S., and the central role community pharmacy plays in supporting patients.Automation frees up pharmacists to care
Dispensing looks different, too. Australia uses original‑pack dispensing, not manual pill counting. That shift has allowed widespread automation, which Twomey says has been a game‑changer.
It means pharmacists spend more time with patients, not stuck in the dispensary. That’s helped them deliver more care, at a time when the health system needs them the most.
A widening gap in primary care
Both countries are battling a shrinking GP workforce. In Australia, only one in seven medical graduates now choose general practice.
That shortage is having a ripple effect across the system. Australians are waiting three weeks for GP appointments, if they can afford to get one at all. Preventive care is slipping. Emergency departments are filling with patients who needed help far earlier.
Twomey’s message was clear: this is exactly where community pharmacy can step in.
A larger scope — because the system demands it
Australia has expanded pharmacists’ scope to help fill the primary care gap. Community pharmacies are now delivering more clinical services, supported by faster technology and closer geographical access.
The US is pushing for similar changes, but progress is slower — and often blocked by PBM reimbursement models that still treat pharmacists as product suppliers, not clinical providers.
Twomey didn’t shy away from that contrast. Pharmacy in Australia is regulated differently, funded differently and valued differently — and those settings allow pharmacists to practise at the top of their scope.
A shared future
Despite the differences, both countries are trying to solve the same problem: how to give communities reliable access to care when traditional models can no longer cope.
Australia’s experience shows what’s possible when community pharmacy is treated as core health infrastructure, not retail space. And if the conversations in New Orleans are anything to go by, US pharmacists are ready to make that case too.
