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CMA must investigate hub and spoke dispensing to ensure ‘level playing field’, says NPA

hub and spoke

By Isabel Shaw
Reporter

31 Aug 2021

The National Pharmacy Association (NPA) has called on the competition watchdog to investigate the hub and spoke dispensing model in the UK, to ensure there is a ‘dynamic’ and ‘competitive’ market in place for pharmacies and other spokes.

The NPA has urged the Government to ask the Competition Market Authority (CMA) to ensure hubs can compete fairly on both quality of service and prices, so that independent pharmacies do not suffer, and medicine supply is not undermined or dominated.

The body has suggested five tests that the CMA can use to ensure competition is fair across the board. These include:

– That all hubs be registered pharmacies and meet all General Pharmaceutical Council (GPhC) and the Pharmaceutical Society of Northern Ireland (PSNI) standards.

– Hubs should stop using their ‘trusted position in the supply process to circumvent the relationship between the spoke and the patient’, such as a hub using patient dispensing data for commercial reasons or placing advertising material into packs of medicines.

– Current barriers to entry for a hub provider, such as the direct to pharmacy (DTP) and limited wholesaler schemes, must be removed so that any registered provider meeting standards can operate and compete in the market.

– A common set of standards should set out the accountabilities of a dispensing hub and data should be collected and published in order to assist the spoke in choosing a provider.

– Mechanisms currently in place that prevent pharmacies and spokes from switching hubs must be removed and a common set of standards should be created for hub providers to follow.

The NPA emphasised that in order to achieve these standards, the Human Medicines Regulations 2012 should be updated so all manufacturers are obliged by law to supply the reasonable needs of all registered holders of a wholesale dealer’s license or a registered pharmacy.

Nick Kaye, the vice-chair of the NPA, 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: ‘The Government should also ensure that manufacturer-controlled supply restrictions, which stifle competition along the supply chain, are swept away.

‘The CMA is an obvious place to start for scrutinising the matter and achieving a competitive environment that works for independents and the NHS.’


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