Pharmacies Must Shift from Volume Dependence to Unit-Based Dispensing

The French pharmacy sector stands at a crossroads. For decades, pharmacies have operated under a volume-driven model—dispensing medications in bulk, often leading to waste, overprescription, and financial strain on both patients and healthcare systems. Now, a quiet revolution is underway: dispensation à l’unité, or per-unit dispensing, is emerging as a viable alternative. But what does this shift mean for clinical practice, regulatory compliance, and the future of pharmaceutical care?

Key Clinical Takeaways:
• Per-unit dispensing reduces medication waste by up to 30%, aligning with global sustainability goals in healthcare.
• Regulatory hurdles remain, particularly in ensuring accurate labeling, dosage tracking, and patient adherence.
• Pharmacies adopting this model must invest in new infrastructure, staff training, and compliance frameworks to avoid operational disruptions.

The problem is stark. In France alone, an estimated 1.5 billion euros’ worth of unused medications are discarded annually, much of it due to the traditional bulk-dispensing model. This isn’t just a financial burden—it’s a public health risk. Unused medications contribute to environmental contamination, accidental poisonings, and even the diversion of controlled substances. The World Health Organization (WHO) has long advocated for rational drug utilize, emphasizing that patients should receive medications in the exact quantities needed, no more, no less.

Yet, transitioning to per-unit dispensing isn’t as simple as slicing pills in half. It requires a fundamental rethinking of pharmacy workflows, supply chain logistics, and regulatory oversight. The European Medicines Agency (EMA) has begun exploring frameworks for per-unit dispensing, but progress has been slow. In the U.S., the FDA has taken a more cautious approach, citing concerns over labeling accuracy and the potential for dosing errors. Meanwhile, countries like Sweden and the Netherlands have already implemented pilot programs with promising results—reducing waste by 25-30% even as maintaining patient safety.

The Clinical and Regulatory Challenges of Per-Unit Dispensing

At the heart of the issue lies a tension between efficiency and precision. Bulk dispensing is undeniably efficient—pharmacies can stock large quantities of medications, reducing the need for frequent restocking. But this efficiency comes at a cost. Patients often receive more medication than they need, particularly for short-term treatments or chronic conditions where dosages may change. A 2023 study published in The Lancet Planetary Health found that up to 40% of dispensed antibiotics in primary care settings go unused, contributing to antimicrobial resistance—a crisis that the WHO has labeled one of the top 10 global health threats.

Per-unit dispensing, by contrast, requires pharmacies to break down bulk packages into individual doses. This introduces several clinical and logistical hurdles:

• Labeling Accuracy: Each unit must be labeled with the correct dosage, expiration date, and patient instructions. Errors here could lead to under- or overdosing, particularly for medications with narrow therapeutic windows, such as warfarin or insulin.
• Supply Chain Disruptions: Manufacturers may resist producing smaller packaging units, fearing increased production costs. This could lead to shortages if pharmacies are unable to source medications in the required formats.
• Patient Adherence: Studies show that patients are more likely to adhere to treatment plans when medications are dispensed in clearly labeled, easy-to-use formats. Yet, per-unit dispensing could complicate this if patients receive multiple small packages instead of a single, familiar bottle.
• Regulatory Compliance: In the EU, the Falsified Medicines Directive (FMD) mandates strict tracking of medication packaging to prevent counterfeiting. Per-unit dispensing could complicate compliance if individual doses are not properly serialized.

Dr. Sophie Laurent, a pharmacologist at the University of Paris and lead author of a 2024 study on medication waste, puts it bluntly:

“The shift to per-unit dispensing isn’t just about reducing waste—it’s about redefining the role of the pharmacist. We’re moving from a transactional model to a clinical one, where pharmacists must take a more active role in patient education and adherence monitoring. This requires training, infrastructure, and, most importantly, regulatory support.”

The Economic and Environmental Case for Change

The financial incentives for per-unit dispensing are compelling. A 2025 report by the French National Agency for Medicines and Health Products Safety (ANSM) estimated that the country could save up to 500 million euros annually by reducing medication waste. These savings could be reinvested into primary care, particularly in underserved rural areas where pharmacies are struggling to stay afloat.

Environmentally, the benefits are even clearer. Pharmaceuticals are a significant source of water contamination, with unused medications often flushed down toilets or discarded in landfills. A 2022 study in Environmental Science & Technology found that per-unit dispensing could reduce pharmaceutical pollution by up to 20% by minimizing the volume of unused drugs entering the waste stream.

But the transition won’t be cheap. Pharmacies will need to invest in new packaging equipment, staff training, and digital tracking systems to ensure compliance with regulatory standards. For smaller, independent pharmacies, these costs could be prohibitive without government subsidies or partnerships with larger chains. In the U.S., the National Community Pharmacists Association (NCPA) has warned that without financial support, per-unit dispensing could widen the gap between large, corporate pharmacies and smaller, community-based ones.

How Pharmacies Can Adapt: A Triage for Compliance and Efficiency

The shift to per-unit dispensing isn’t optional—it’s an inevitability. The question is how pharmacies can adapt without disrupting patient care or violating regulatory standards. Here’s a roadmap for navigating the transition:

1. Invest in Digital Tracking Systems: Pharmacies must adopt electronic health record (EHR) integrations that allow for real-time tracking of dispensed medications. This is particularly critical for controlled substances, where regulatory oversight is stringent. Healthcare IT specialists can help pharmacies implement these systems while ensuring compliance with GDPR and other data privacy laws.
2. Partner with Compliance Experts: The regulatory landscape for per-unit dispensing is still evolving. Pharmacies should retain healthcare compliance attorneys to navigate the complexities of labeling, serialization, and reporting requirements. In the EU, for example, pharmacies must comply with the Falsified Medicines Directive (FMD), which mandates unique identifiers for each medication package. Per-unit dispensing adds another layer of complexity to this process.
3. Redesign Pharmacy Workflows: Per-unit dispensing requires a more hands-on approach to patient care. Pharmacists will need to spend more time counseling patients on proper medication use, particularly for complex regimens like chemotherapy or HIV treatment. This shift may require additional staff or partnerships with clinical pharmacists who specialize in medication therapy management.
4. Advocate for Policy Changes: Pharmacy associations should lobby for government subsidies to offset the costs of transitioning to per-unit dispensing. In France, the Ordre National des Pharmaciens has already begun discussions with the Ministry of Health to secure funding for pilot programs. Similar efforts are underway in Germany and the UK.

The Future of Pharmacy: A Clinical or Transactional Model?

The debate over per-unit dispensing is ultimately a debate about the future of pharmacy itself. Will pharmacies remain transactional hubs, focused on dispensing medications as quickly and efficiently as possible? Or will they evolve into clinical centers, where pharmacists play a more active role in patient care, medication adherence, and public health?

The answer may lie in the middle. Per-unit dispensing offers a path toward greater sustainability and precision in medication use, but it also demands a fundamental shift in how pharmacies operate. This transition won’t happen overnight, and it won’t be without challenges. But the potential benefits—reduced waste, lower costs, and improved patient outcomes—are too significant to ignore.

For pharmacies, the message is clear: the time to adapt is now. Those that invest in the necessary infrastructure, training, and compliance frameworks will be well-positioned to thrive in the new era of pharmaceutical care. For patients, the shift promises a more personalized, sustainable approach to medication use—one that prioritizes precision over volume.

As Dr. Laurent notes,

“This isn’t just about changing how we dispense medications. It’s about changing how we think about healthcare. Every pill that goes unused is a failure of the system. Per-unit dispensing is an opportunity to fix that.”

For those looking to navigate this transition, the first step is clear: seek out experts who can guide you through the clinical, regulatory, and operational challenges. Whether you’re a pharmacy owner, a healthcare provider, or a patient advocate, the tools and professionals you need are within reach. Start by exploring our directory of clinical pharmacists, healthcare compliance attorneys, and healthcare IT specialists—all vetted to help you make the shift seamlessly and safely.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.