Newcastle and Hunter Valley Pharmacists Association president Luke Kelly said the Labor policy would most benefit middle- to high-income earners.
Mr Kelly said that "pensioners will generally have to pay more", as pharmacists will have to charge for the free services they provide such as medication packs, which help administer doses correctly.
He said these packs "cost about $20 a week to make".
Mr Kelly said pharmacies had received a fee from the government of about $12.99 for dispensing and handling a medicine on the PBS [Pharmaceutical Benefits Scheme], which included ordering, selling and storing the stock.
Under the two-for-one policy, he said "we'll still only get $12.99" - meaning revenue would be halved.
Mr Kelly said the loss of income could only be covered in two ways - "reducing staff and hours, and increasing prices for services and products".
He said this meant patients would "lose both ways", as they will have to pay more and face less accessible service.
He said "up to 510 jobs" in the Hunter could go.
The independently-owned My Village Pharmacy, which has stores at Whitebridge and Redhead, has urged the government to help it save jobs.
Mrs Felkai said the loss of revenue would "cut into our net profit, which we are using at the moment to pay our loans back to the bank".
A trio of women - including Mrs Felkai - have owned the two stores since last November.
Mrs Felkai said they had put their houses against their loans.
"To meet our loan repayments, we will have to reduce staff," she said.
"We might have to sell one of the pharmacies, but at a deficit because the values have dropped [due to the new policy].
"We'd be left out of pocket by about $400,000 each by selling one of the pharmacies."
Federal Health Minister Mark Butler said "60-day prescriptions mean Australians get twice the medication for the cost of a single prescription".
"This was first recommended in 2018 from the independent clinical experts at the Pharmaceutical Benefits Advisory Committee. It was never implemented by the former government, costing Australians hundreds of millions in lost savings," Mr Butler said.
"Everyone with a Medicare card taking one of these medicines will save up to $180 per year, per medicine. Concession card holders will save $43 per medicine.
"This will be good for their hip pocket and good for their health."
The government believes the policy will mean fewer trips to a GP for scripts, but expects those freed-up appointments will be used by other patients.
Ms Felkai said "it may not reduce GP appointments", particularly "if doctors don't write 12-month scripts with five repeats".
She added that her two pharmacies were different to corporate models, as "we're part of the community we're serving".
"That gives an added level of trust and care," she said.
"It's not uncommon for us to drop things to people's houses on our way home from work when they can't get out of their house, like if they're stuck at home with a sick toddler or bedbound.
"We've had lots of people with COVID who we dropped antivirals to."
She said the revenue gained for dispensing "pays for that".
"It cross subsidises these services we're providing. Maybe it shouldn't, but you can't rip that money away and expect us to take the brunt of that without coming to the table to help support us."
She supported the government cutting the price of medicine, but urged it to help pharmacies cover the cost of the services they now provide for free.
She also felt the new policy would create "unsafe workplaces" and "lead to errors" due to having fewer staff.
"When we're dealing with medicine, those errors are really risky."
She said patients "won't be able to see me directly because I'll be so busy managing the pharmacy".
"We want to explain all this to the government, but they won't engage with us."
The federal "60-day dispensing" policy applies to more than 300 common medicines and will be introduced in three stages over 12 months.
The policy has the support of groups including the Consumer Health Forum, Heart Foundation, Lung Foundation, Breast Cancer Network and doctors' associations.
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