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Medicines regulation and law

Wider hub-and-spoke dispensing expected in 2021

Exclusive: The Pharmaceutical Services Negotiating Committee has revealed hub-and-spoke plans after a report found an absence of cost-benefit cases of automated dispensing.

The UK government is expected to allow hub-and-spoke dispensing between different legal entities from early 2021, the Pharmaceutical Services Negotiating Committee (PSNC) has said.

The comments from Gordon Hockey, director of operations and support for the PSNC, made exclusively to The Pharmaceutical Journal on 26 February 2020, follow the publication of a National Pharmacy Association (NPA) report on 25 February 2020, which found an “absence of cost-benefit cases” for automated dispensing.

The NPA research found that “large-scale automated dispensing of original pack medicines to third-party pharmacies is not apparently operational in any global market”, and while it said there was an economic case to be made for introducing hub-and-spoke dispensing across different firms, “demonstrable cost-benefit cases have not been uncovered by this research, and many independent researchers also point towards the absence of hard economic evidence to support further investment”.

Gareth Jones, head of corporate affairs for the NPA, said the research “doesn’t mean there is no future for hub-and-spoke [dispensing]”, but he said ”it raises serious questions about the underlying case for investing in models that allow hub and spoke to operate between different companies”.

The Department of Health and Social Care introduced the Medicines and Medical Devices Bill to parliament on 13 February 2020, providing the primary legislation that will allow legally separate pharmacies to set up shared hub-and-spoke dispensing services following a second round of legislation. 

Commenting on the NPA research, Hockey said the government planned to introduce hub-and-spoke dispensing between different legal entities in “early [2021] through new legislation — the Medicines and Medical Devices Act — and has committed to agreeing with the PSNC which models will allow the whole community pharmacy sector to benefit fairly”.

He added that the PSNC “is collaborating with the NPA and other pharmacy organisations on how hub-and-spoke dispensing between different legal entities might work in practice” by learning from organisations already carrying out this type of dispensing “to ensure hub-and-spoke dispensing between legal entities is fair for all community pharmacy contractors”.

The Association of Independent Multiple Pharmacies (AIMp) launched a hub-and-spoke task and finish group in December 2019 to gather “the practical experience of our members who [already] operate central assembly processes” within their pharmacy companies.

Leyla Hannbeck, chief executive of AIMp, said: “Moving volume from branches to central assembly clearly frees up pharmacist time to provide additional services but it is unclear if those services can be delivered at a cost that allows a reasonable return for a professional service, given the low fee.”

Previous government proposals to introduce cross-firm hub-and-spoke dispensing in 2016 were shelved after pharmacy bodies expressed concern over the safety of the plans.

The concept was revived in July 2019 when the community pharmacy contract said the government would be pursuing “legislative change to allow all pharmacies to benefit from more efficient hub-and-spoke dispensing, enabling increased use of automation and all the benefits that that brings”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20207748

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