The direct delivery of medicines by public healthcare facilities (Local health authorities, hospitals) is being discussed in Italy: the article considers opportunities and drawbacks of the different options (delivery through health facilities or through specific agreements with public and private community pharmacies) with respect to the characteristics of medicinal products and the needs of patients. The authors of the Italian Medicines Agency (AIFA) identify the main issues to be considered for a possible shift of some drugs from direct delivery to that on behalf, and which mainly concern drugs that must in any case be administered in hospital (see drugs for intravenous use or usable only in hospitals); drugs whose dispensing requires special precautions regarding confidentiality or for which dispensing by the staff of a health facility can improve patient adherence to therapy; innovative drugs monitored through registers.