A comparative analysis of the roles and use of evidence in pharmacy policy in Australia

Pharmacists have important roles in consumers’ access to medicines and healthcare. Pharmacy policy advocates have recognised that evidence is important but often insufficient for policy change to support expanded roles of pharmacists, but there has been minimal exploration of why this is the case. To characterise, classify, and describe the types of knowledge that were considered and used in these two pharmacy policy issues in Australia: codeine up-scheduling and pharmacist-administered vaccinations. Using documentary data and semi-structured interviews, we identified the research-based, practical, and political knowledge used in these policy processes, drawing on Head’s ‘three lenses of evidence-based policy’. We used a ‘programmatic approach’ to analyse how evidence is used in policymaking, where the use and framing of evidence is considered in light of policy actors’ institutional roles and goals. Practical knowledge demonstrating pharmacists’ ability to conduct clinical activities and political knowledge of institutional processes and acceptability were used for both issues; however, research evidence was more identifiable in up-scheduling. Evidence was prioritised and used differently depending on stakeholders’ goals. Our analysis offers insights for the Australian pharmacy sector advocating for policies to benefit individual and public health. Although medicines regulation and pharmacy practice are phenomena that exist globally, institutional and policymaking contexts differ by country. The pharmacy sector needs to consider these contexts to effectively engage policymakers and optimise evidence use in developing and implementing desired policies.