Anderson's Exchange Pharmacy owner Don Anderson says he cannot accept a clause outlawing such charges in the proposed new district health board pharmacy services agreement, due to apply from March.
There had been minimal complaint from customers about his "risk-management fee", introduced in 2007, which added between 30c and $1.20 per prescription item to help pay for work not covered by the dispensing fee.
Nobody had gone without their medication as a result of the charge, which was introduced to cover such services as the correction of prescription errors.
He wants to substitute the clause with one allowing him to continue with his existing charging regime, only charging a specific fee for service if people refuse to pay his risk-management fee.
He said he expected he could be shut down over the issue, but Otago District Health Board planning and funding general manager David Chrisp said yesterday he was hopeful of talking to Mr Anderson and resolving the matter.
At this stage, however, "we do not find the changes he is proposing acceptable".
The contract was being sent out to pharmacists for signing after "national negotiation between DHB representatives and pharmacy representatives", he said.
At a meeting between Mr Chrisp and pharmacists earlier this week to discuss the new contract, Mr Anderson left the meeting when Mr Chrisp would not agree to set up a meeting on the issue with health board chief executive Brian Rousseau, board chairman Errol Millar and National list MP Michael Woodhouse.
Mr Anderson first took a stand on the issue in March 2007, when for several weeks he charged a fee of $5 a customer to raise awareness about the inadequacy of funding.
During one month he raised $650 for charity before introducing his current flat-fee regime.
Under the proposed agreement, pharmacists are able to charge individual patients a fee for a variety of services, including what it costs to have prescriptions corrected.
But they are forbidden from spreading the costs as Mr Anderson has been doing.
Mr Anderson points out that if he charged for some interventions it could cost some individual patients as much as $170.
There would be " fat chance" of getting that amount of money from a patient.
Even a relatively simple correction of a prescription might cost about $30.
He estimated that his across-the-board charge brought in around $20,000 a year, which allowed him to provide a "far superior service" to that required under the pharmacy services agreement.
New Zealand Pharmacy Guild chief executive Annabel Young said the issue was a national one and it was difficult to know how many pharmacists were applying extra charges across the board.
The guild considered pharmacists should be able to impose part charges when they did additional work.
Addressing an estimated 30% error rate in prescriptions would reduce the workload of pharmacists.
A major reason for the errors was that software used by some doctors was not up to date with changes in the schedule of subsidised drugs, she said.
