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NPA urges competition watchdog to ‘look into’ hub-and-spoke dispensing

The NPA has called on the government’s competition watchdog to “look into” the hub-and-spoke dispensing model, to make sure it can exist without “undermining choice in the medicines supply chain and disadvantaging independent pharmacies”.

The National Pharmacy Association (NPA) said today (August 31) that it is urging the Department of Health and Social Care (DH) to ask the Competition and Markets Authority (CMA) to conduct a review into the matter.

Following the passing of the Medicines and Medical Devices Bill in February, the DH now has the power to change legislation to allow all community pharmacies to operate a hub-and-spoke dispensing model, regardless of whether they are part of a chain or an independent.

This also includes proposals to allow large pharmacy chains with automated hubs to charge smaller chains and independent pharmacies “prescription assembly services”. The NPA recommends that the DH seeks a market review before and after an inter-company hub-and-spoke model is implemented, it said.

However, any plans to roll out these changes must first be subject to a “full public consultation” before they come to pass.


“Unintended consequences” must be avoided


NPA vice chair Nick Kaye said: “If the government believes that hub-and-spoke dispensing is the future for pharmacy, it must do more to allow independents to engage with the model on a level playing field and to prevent unintended consequences.”

“This includes ensuring that pharmacies that do not have access to hub services, or choose not to use hub services, are not disadvantaged,” he added.

Mr Kaye pointed to the CMA as the “obvious place to start for scrutinising the matter and achieving a competitive environment that works for independents and the NHS”.

C+D understands that the CMA cannot speculate on what investigations it may or may not launch.

A DH spokesperson said: “We want community pharmacies to play a bigger role in the delivery of health and care, and the government is committed to holding a full public consultation on the possible extension of hub and spoke dispensing.

“We are working closely with pharmacies to address any concerns or issues to ensure this model works in the interests of patients and pharmacists, allowing pharmacists to undertake broader, more clinical roles.”


Five tests for “fair competition”


As well as calling for a review of the model, the NPA also proposed five tests for “maintaining fair competition and choice” within hub-and-spoke dispensing, adding that “there needs to be a dynamic and competitive market in which hubs compete on the basis of quality of service and price”.

The lobbying body is suggesting that all hubs must be registered and meet regulatory standards. Hubs should also be prevented from using their position to circumvent pharmacy “spokes” for commercial gains, the NPA stressed.

The body is also calling for hubs to subscribe to a common set of standards concerning their accountability by publishing “professional metrics” to help pharmacies select a potential provider. The NPA would also like any mechanism designed to prevent a pharmacy from switching provider to be prevented, it said.

The NPA also said it would like barriers to becoming a hub to be removed “so that any registered provider meeting standards can operate and compete in this market”. It admitted, however, that this would require an update to the Human Medicines Regulations 2012.


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