Many of the specialty medications used to treat complex, chronic conditions are delivered through limited distribution. Limited distribution drugs (LDD) are therapies only made available to a small number of pharmacies—and though there are reasons for these limitations, they sometimes make it difficult for patients to access medications as needed.

This article covers what limited distribution drugs are, why limitations exist, and how pharmacies can access manufacturer networks.

Understanding Limitations in Specialty Drug Distribution

According to the 2019 State of Specialty Pharmacy Report, nearly 85 percent of manufacturers manage some or all products through a limited distribution model. 

Why do so many drug manufacturers limit distribution of lifesaving medications? There are many benefits to limiting drug distribution within specialty pharmacy networks, including greater control and oversight from manufacturers.

Because limited distribution allows for closer patient relationships with prescribers and pharmacists, patients are typically more adherent to prescribed medications and more likely to have optimal treatment outcomes. This includes avoided or early-detected adverse events which can often lead to hospitalization or a patient to stop taking their medication. Limiting the size of specialty networks allows for greater oversight and quality, ensuring that only highly trained clinical staff are dispensing medications and supporting patients.

Additionally, limiting the size of a network ensures greater consistency and less variability of care. Here’s how an experienced pharmacist explained the issue:

“Drug manufacturers may have the ability to produce a limited supply of drugs to assure every patient who begins therapy will be able to have continued access to the drug; however, the number of pharmacies in the distribution network is limited to specialty pharmacies.

Limited access can be viewed as minimizing the competition, but the clinical benefits to the patient and accuracy of data collection and analysis is a benefit that counters this argument. A limited network can be beneficial to the manufacturer, the physician, the payer, patient and pharmacy, as every one of these entities must coordinate their efforts to get a patient set up correctly from the start of therapy.”

Accessing Limited Networks: How Pharmacies are Selected

Manufacturers identify specialty pharmacies that have the highest standards for clinical excellence, patient education, treatment monitoring, and customer support. There are several key criteria considered by drug manufacturers when selecting specialty pharmacies for limited distribution networks, such as:

• Clinical expertise, which is determined by everything from years of experience and number of patients served to background distributing similar therapies and manufacturer relationships
• Disease-state-focused care coordinators to support patients
• National accreditation to ensure proper storage and handling
• Medication adherence tools and support services
• Financial assistance/prior authorization services
• Advanced clinical, dispensing, inventory, and sales data
• Payer access and established relationships

How Avella is Leading in Limited Drug Distribution

Avella has been selected as a limited distribution partner by several leading manufacturers based on decades of industry experience, high-touch patient services, extensive payer coverage, and strong relationships with prescribers. As a result, Avella dispenses more than 65 limited distribution drugs, the majority of which are in oncology, including those that are most difficult for patients to attain.

Learn more about the wide range of limited distribution drugs Avella offers to patients treating complex conditions in our whitepaper: Limiting Distribution, Unlimited Potential