Despite being established for “at least 15 years”, the use of hub-and-spoke dispensing “remains very limited globally”, the National Pharmacy Association (NPA) said on Tuesday (February 25).

A review published by the organisation, which looked at both the UK and international experience of hub-and-spoke dispensing, found no “demonstrable cost-benefit cases” for using the model.

The data and evidence “does not clearly establish either an economic case or a health outcomes case for large-scale automation”, NPA head of corporate affairs Gareth Jones commented.

While this does not mean hub-and-spoke is without a future, it should give policymakers “pause for thought”, he added.

“It raises serious questions about the underlying case for investing in models that allow hub and spoke to operate between different companies,” Mr Jones said.

It is currently illegal for different pharmacy businesses to share a dispensing hub, meaning independent pharmacies are not able to operate them, although the government has said it will seek to change this legislation.

The NPA has called for the feasibility, economic factors and patient safety benefits of large-scale automation to be examined more closely. Although automation may improve accuracy, new elements added as part of the process could “introduce new risks”, the organisation claimed.

More “rigorous independent research” is needed to establish the benefits of large-scale dispensing, the 99-page review concluded.