Hub-and-spoke dispensing models for community pharmacies in Europe

This article explores experiences in Europe with models of "hub-and-spoke" dispensing for community pharmacies. It finds that one of the most common forms of this type of model is automated "multi-dose dispensing" for older people who take multiple medicines, either in nursing homes or at home. Although now firmly established in the Nordic countries and the Netherlands, evidence on outcomes and costs is limited and does not allow firm conclusions. There is some indication that multi-dose dispensing might reduce overall drug use and improve treatment adherence, but would increase inappropriate drug use and result in fewer changes in drug treatment. Evidence on cost implications is missing so far.