Drone delivery: eight minutes instead of thirty-five

In March 2017 a drone took off in Lugano from the roof of the Ospedale Italiano and landed a few minutes later at the Ospedale Civico. On board: laboratory samples. Swiss Post, the Ticino hospital association EOC and the American manufacturer Matternet were involved; the Federal Office of Civil Aviation had granted approval. It was a Swiss first and, as the Post rightly wrote at the time, a pioneering achievement worldwide as well: the first regular drone transport for health care in the middle of a city.

Routes in Zurich and Bern followed. Between the university hospital and the Irchel university campus the drone needed around four minutes for two and a half kilometres, making it twice as fast as a courier on the road, independent of traffic. Altogether more than three thousand flights were flown.

Then came two crashes in 2019, one of them into Lake Zurich, a voluntary suspension, an independent expert report, technical improvements and resumption. And at the end of 2022 came the truly remarkable part: the Post handed the drone project over to Matternet. The reasoning was neither technical nor regulatory. Operations were cost-intensive and could not be run profitably in the medium term.

Remember that sentence. It is the most important information in this article.

What has long been flying elsewhere

While the profitability question won out in Switzerland, the rest of the world has flown on.

Zipline began in Rwanda with blood supplies for remote hospitals and today operates in several US states. The provider’s newer system no longer lands at all: the drone hovers and lowers the package on a winch, which makes landing sites unnecessary and enables deliveries to flats and office buildings. Health care providers such as Intermountain Health, OhioHealth and the Cleveland Clinic work with this model for prescription deliveries and laboratory samples.

In April 2022 an American pharmacy chain launched, together with the Alphabet subsidiary Wing, what it described as the first commercial drone delivery service in a major US metropolitan area, in the Dallas-Fort Worth region.

And since October 2023, Amazon Pharmacy has been delivering prescription medicines by drone in College Station, Texas — according to the company in sixty minutes or less, with a range of more than five hundred active substances and flight altitudes between roughly forty and one hundred and twenty metres.

The number of American operating permits for commercial drone operations has risen within a few years from a handful to several dozen. What was a pilot project in 2019 is infrastructure in 2026.

Why this is relevant for a Swiss pharmacy

The obvious reaction is: we are a small country with a dense pharmacy network, so why drones?

That answer is right for the city and wrong for the rest of the country. The technology becomes interesting not in Zurich but in a side valley where the last pharmacy closed three years ago and the next one is twenty-two kilometres away, in winter over a pass road. It becomes interesting for the emergency service at ten in the evening, when someone drives thirty-five minutes to fetch an antibiotic for a feverish child. It becomes interesting for supplying homes for the elderly and nursing homes in outlying regions, for laboratory samples in the opposite direction, for a forgotten pack of insulin on a Sunday.

The time saved is not the real argument. The real argument is availability where supply density is falling, without anyone having to open a branch.

The hard questions come before the vision

Anyone taking the subject seriously has to solve four problems, and none of them is a flying problem.

Dispensing is a legal act, not a transport. Dispensing a prescription-only medicine is tied to a professional, to a check of the prescription and to counselling. A package that sinks into a garden on a line fulfils none of that. The only conceivable model is therefore one in which the pharmaceutical service takes place beforehand, by video or telephone, documented, and the drone handles the physical transport alone. That can be regulated, but it is not regulated.

Identifying the receiving person. Who takes delivery, how is it checked who is really standing there, and what happens with substances that must not fall into the wrong hands? Narcotics are ruled out for the foreseeable future.

The cold chain and documentation. Temperature control, vibration, air pressure and humidity are no side issue with biologics and vaccines. Without an on-board data logger and complete documentation, such a delivery cannot be justified pharmaceutically.

And the rest is physics and money. Swiss weather with the bise, icing and fog, topography with narrow valleys, noise acceptance in residential areas, data protection with camera-carrying aircraft, plus the U-space airspaces defined by the Federal Office of Civil Aviation as a regulatory framework. And above all the question Swiss Post has already answered: what does a flight cost compared with a courier, and who pays for it?

What will realistically come first

Not delivery to the private individual. Rather what also worked in Lugano: closed traffic between professional locations.

Pharmacy to nursing home. Pharmacy to medical practice. Pharmacy to hospital and back with laboratory samples. Supplying an emergency depot in the valley from the regional pharmacy. These are defined routes with known recipients, trained staff at both ends, controlled landing points and a payer with whom one can negotiate. It is precisely in this segment that the sums are most likely to add up, because a courier driver for twenty-two kilometres of mountain road is not free either.

Delivery to the home will follow later, first for plannable long-term medication and not for emergencies.

A stopover in 2035

Let us picture it briefly. A regional pharmacy in a mountain area operates two landing points on municipal territory and three at care institutions. The order comes through the app, the pharmaceutical check happens in the pharmacy, the counselling by video, documented in the patient record. The drone takes off from the roof, flies an approved route, reports temperature and location in real time and hands over at a secured reception point where the nursing professional identifies themselves with their card. The laboratory sample flies back.

In this picture the pharmacy is no longer merely a place. It is a supply node with a radius of fifteen kilometres.

The real point

The technology is solved. Three thousand flights in Lugano, Zurich and Bern show that, as does an American everyday reality in which prescriptions arrive within sixty minutes.

What remains unsolved is profitability, dispensing law and the question of who owns this infrastructure. And that last question is the decisive one. Whoever controls the last mile controls the customer relationship. In the USA that position has been taken by an online retailer that happens also to run a pharmacy.