JPHS 2016, 7; 129–139 ª 2016 Royal Pharmaceutical Society Received October 11, 2015 Accepted March 3, 2016 DOI 10.1111/jphs.12134 ISSN 1759-8885 Correspondence: Gholamhossein Mehralian, School of Pharmacy, Shahid Beheshti University of Medical Science, Vali-e Asr Avenue, Niayesh Junction, Tehran, Iran. E-mail: gmehralian@gmail.com Underlying factors influencing community pharmacies business in low- to medium-developed markets: a societal perspective Maryam Rangchian, Gholamhossein Mehralian, Jamshid Salamzadeh and Hossein Vatanpour Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran Abstract Objectives To identify (1) critical local factors affecting community pharmacy perfor- mance and (2) items that are important in assessing community pharmacy performance. Methods A cross-sectional survey based on the opinions of the pharmacists involved in managing a community pharmacy in Iran at least for 3 years by the time of the study was conducted, in 2014. The questionnaire was anonymous and self-administered and consisted of three parts, which constructed to address research questions. Descriptive and factor analysis were performed using SPSS (16.0.0). The size of the effect of each dimen- sion was investigated by LISREL (8.54). Key findings Based on the respondents’ opinions, product (0.89), leadership (0.86) and promotion (0.82) were the three most influencing intra-organisational dimensions, and price (0.37) was the least important one. Regard to extra-organisational factors, the high- est and lowest scores were obtained for participants (0.86) and regulatory issues (0.58) respectively. Among performance assessment items, clients’ results (0.76) and society results (0.22) set at the first and last priority respectively. Conclusions Authors believe that this study provides decision makers and researchers with a comprehensive collection of factors affecting the community pharmacy area, which after minor modifications based on local issues is applicable in countries that are similar to Iran with regard to the level of the reprofessionalisation of community pharmacies. Keywords 7Ps; community pharmacies; European Foundation for Quality Management; extra-organisational factors; intra-organisational factors; performance Introduction Community pharmacy profession has experienced some important milestones during its history. Al-Shaqha and Zairi have suggested three phases in the history of this profession: (1) compounding and dispensing; (2) clinical pharmacy and (3) pharmaceutical care. [1] In other words, this profession has shifted from a product-based paradigm to a care-based paradigm. [2] Despite available evidence confirming clinical and financial benefits of phar- macists’ interventions, [3–5] in some countries, the transition towards care-based paradigm has been slow. Not only does this lag prolong the ambiguity in the position of pharma- cies in health care, but also it causes some financial and nonfinancial damages to the society. Success in this transition needs a comprehensive sight about all factors affecting the area. Previous studies have mainly addressed factors influencing business in general and rarely have focused on factors affecting pharmacy in particular. Therefore, there is a gap for special investigations in the case of community pharmacies, as small enterprises that are highly involved in both the issues related to the health of the society and finan- cial challenges. Pharmacies deal with the market of pharmaceutical products, which is different from other markets in several aspects such as more intense regulations. [6] Research questions Facing the situation stated above, this study tries to provide researchers, practitioners and policy makers of this area with a primary platform of factors affecting community 129 Research Paper