A hospital pharmacy differs from a retail pharmacy in almost every dimension — scale, variety of medicines stocked, regulatory requirements, and the nature of operations. If you're planning to set up a pharmacy within a hospital, nursing home, or clinic complex, understanding these differences is essential before you start.

Licencing Requirements for Hospital Pharmacies

Hospital pharmacies require:

• Form 20-B licence (for stocking over-the-counter medicines) and Form 21-B licence (for stocking prescription medicines) — same as retail but under a hospital entity
• B.Pharm or D.Pharm qualified pharmacist — typically more than one if the pharmacy dispenses 24/7
• Hospital pharmacies attached to hospitals above 30 beds require a dedicated pharmacy department under NABH accreditation if the hospital is NABH-accredited

Minimum Space and Infrastructure

Hospital Pharmacy Formulary

A hospital pharmacy doesn't stock everything — it stocks a defined formulary of approved medicines. The Pharmacy and Therapeutics Committee (PTC) approves which medicines are stocked. Key formulary principles:

• One or two approved brands per molecule — reduces complexity and negotiates better rates
• Emergency drugs always in stock — resuscitation medications, IV fluids, anaphylaxis kits
• Department-specific formularies — ICU, OT, Paediatrics each have essential lists

Dispensing Systems

Larger hospitals increasingly use unit-dose dispensing or ward-level stock systems. For smaller hospitals (30–100 beds):

• Centralised dispensing: All medicines dispensed from one pharmacy — efficient, lower wastage
• Floor stock system: Standard medicines kept on wards for immediate nurse access — requires strong control to prevent pilferage
• Indent system: Ward sends daily medicine indent to pharmacy — pharmacy prepares and sends — good audit trail