Stepping Stones: Accessing Limited-Distribution Drugs 

Published 06/24/2019
by Jerry Buller

Gaining access to manufacturers distribution networks is key to accelerating health system specialty pharmacy growth. In my experience, gaining access requires a multi-faceted approach that leverages local and national relationships. If your program has yet to develop or execute a limiteddistribution drug (LDD) access strategy, I advise considering these steps to increase your success: 

  • Build a world-class program: For a manufacturer to entrust their product distribution to a health system specialty pharmacy provider, they must feel confident that pharmacy has all the capabilities of established “big box” specialty pharmacies. This includes call center, financial assistance, and cold-chain processes. Simply saying “nobody can care for our patients like we can” will ring hollow if you can’t demonstrate adequate infrastructure and data reporting capabilities.  
  • Start locally: Despite what some national networks claim, manufacturers still grant access on a system-by-system basis. They want to understand your health system’s patient population (volumes and disease mix) and care model to ensure you can support rapid therapy initiation, medication adherence, patient management, and outcomes reporting. With this in mind, take the time to build relationships with your targeted manufacturers’ local representatives and educate them on your approach. They can support your requests to the national product market teams.   
  • Think corporate: Your local efforts should be complemented by conversations at the corporate level with targeted manufacturers’ market access teams. These individuals ultimately grant access for specific health systems, so it’s important that they also understand your specialty pharmacy approach and outcomes. Industry conferences hosted by Asembia, CBI, and NASP provide good opportunities to interact with manufacturers. 
  • Leverage aggregators appropriately: Companies like Asembia and Excelera offer data aggregation services that can support access to certain manufacturer networks. Consider leveraging these companies, but remember membership does not guarantee network access since manufacturers make decisions on system-by-system basis. Aggregators can provide great value in data reporting once you have gained access to the manufacturer’s network. Like anything, be sure you understand the value they provide given the annual cost of membership.

A word of caution: some manufacturer networks remain closed or difficult to access even with accreditation or support from aggregators. That said, I have seen many manufacturers work with health systems that have embedded, in-clinic specialty pharmacy teams because they recognize the impact this approach has on adherence and patient outcomes. With that in mind, make sure you can support your care model and LDD approach with data, including a comparative data set, clinical trial, literature review, or published results from other health systems.

LDD access is achievable with a consistent, multi-faceted plan backed by the right data. If you have questions about LDD access or require a partner to support your program growth, please contact us. For advice on gaining access to payor networks, read our recent Stepping Stones blog on the topic here.