Mr. Tony O'Brien:

It probably is. The option of putting in place an intermediate distribution system is complicated by the very short shelf life of some of the products and the requirement for a continuous cold chain. Any time taken to send products to a central point for onward distribution would eat into the shelf life. Typically, and this is where the "just in time" aspect of the matter arises, most patients who are in receipt of high-tech drugs are doing so for a course of treatment, or even sometimes for continuous treatment. That means there is a capacity to plan. The variability comes in with the human factor. I refer to circumstances in which, without the knowledge of the supply system, an individual patient might make a last-minute decision to discontinue with the medication, or may be hospitalised and therefore unavailable to have it in the community, or may make the decision to change pharmacy. The cold chain implications which typically arise for all of these products mean that the option of transferring material between different pharmacies would be extremely complex and probably unsafe, even if it were allowed by regulation.