Introduction <p>To improve access to innovative medications, the Chinese government introduced a dual-channel policy, allowing community pharmacies to dispense innovative drugs listed in the National Reimbursement Drug List of the national healthcare security system. However, research on how community pharmacies interpret and respond to these policies remains limited.</p> Aim <p>To investigate community pharmacy manager/ pharmacist perceptions of and responses to the dual-channel policy, with a focus on improving accessibility and the rational use of innovative drugs for patients in China.</p> Method <p>A qualitative research design, involving semi-structured interviews, was conducted in Jiangsu Province, China. The interview guide was developed to address key domains relevant to community and licensed pharmacists. The participants were recruited through purposive and snowball sampling to ensure diverse perspectives. The interviews were audio-recorded, transcribed, and analyzed using the framework method. NVivo software was used for coding and theme development, until theoretical saturation was achieved.</p> Results <p>The participants viewed the dual-channel policy as an opportunity to expand business operations and enhance market competitiveness. However, they also identified several challenges, including space and storage constraints, regional inconsistencies in electronic prescription systems, limited influence on hospital prescription flows, selective partnerships with pharmaceutical companies, and elevated service expectations from patients. In response, pharmacies have implemented a range of hardware-focused strategies, such as upgrading service areas, integrating insurance billing systems, and developing patient management platforms, as well as soft competence strategies, including pharmacist training on innovative drugs and disease knowledge, interpretation of reimbursement policies, and emergency response preparedness.</p> Conclusion <p>This study demonstrates that participation in a dual-channel policy is widely perceived by community pharmacies as a strategic opportunity, despite the associated operational and systemic challenges. Proactive engagement with the policy not only strengthened their competitive positioning but also contributed to improved pharmaceutical services and patient care outcomes.</p>