Understanding Limited and Exclusive Networks: Considerations for pharmaceutical manufacturers new to the industry

As pharmaceutical innovation advances, especially in specialty medications, the distribution and management of these therapies become increasingly complex. Specialty medications, which often require specialized handling, administration, and patient support, need a distribution model that ensures patients receive the care they need while optimizing outcomes.

The distribution models highlighted in this article are limited and exclusive networks. For pharmaceutical manufacturers, understanding these networks in a specialty pharmacy is crucial to making informed decisions about the distribution of their therapies.

What are limited and exclusive networks?

Limited and exclusive networks refer to distribution models where only a select group of specialty pharmacies, or even a single specialty pharmacy, may dispense a particular specialty medication. This is different than an open distribution model, where any specialty pharmacy that meets certain criteria can dispense the therapy. The main goal of choosing a limited or exclusive network is to ensure patients receive specialized care focused on their condition's unique needs and prescribed therapy.

• Limited network: In a limited network, a small number of specialty pharmacies are selected to dispense a particular drug. The selection of a pharmacies is based on its ability to meet specific requirements set by the manufacturer, such as expertise in managing the type of therapy, ability to provide comprehensive patient support, and adherence to stringent storage and handling protocols, for example.
• Exclusive network: An exclusive network narrows the distribution further, where a single specialty pharmacy has exclusive rights to dispense a particular therapy. This model allows the manufacturer to be more involved with the distribution process, ensuring consistent patient care and optimizing the patient experience.

Choosing a limited or exclusive network

For pharmaceutical manufacturers, many factors such as optimizing patient outcomes and ensuring the proper use of specialty medications drive the decision to select a limited or exclusive network.

1. Specialized patient support and program management: Specialty pharmacies within these networks offer a level of patient support that is critical for the successful management of complex therapies. This includes services such as benefits review, prior authorization support, copay assistance program management, adherence monitoring, and comprehensive patient education. By choosing a limited or exclusive network, manufacturers can ensure that patients receive a high-level of care, leading to better adherence and outcomes.
2. Improved medication management: Specialty medications often require specific storage, handling, and administration protocols. Pharmacies in limited or exclusive networks are selected based on their ability to meet demanding requirements. This reduces the risk of compromised effectiveness, helping to ensure that medications are stored and handled properly and that patients receive the highest quality therapy every time.
3. Enhanced data collecting and reporting: Limited and exclusive networks allow manufacturers to gather more detailed information on medication use, patient adherence, and outcomes. This data is important for ongoing research and development, regulatory compliance, and proving the value of the therapy to payers and other stakeholders.
4. Cost management: By managing a therapy through a limited or exclusive network, manufacturers can better control the costs associated with the drug’s distribution and administration. This can include negotiating better pricing with network pharmacies and ensuring that patients receive the most cost-effective care without compromising quality.
5. Therapy integrity and consistency: With an exclusive or limited network, manufacturers can help ensure consistent patient experience across the distribution channel. This keeps the integrity of the brand and provides a uniform experience for patients, prescribers, and other health care providers in the ecosystem.

The right specialty pharmacy

Selecting the right specialty pharmacy is critical when considering a limited or exclusive network for the distribution of a specialty therapy. With its extensive experience in managing rare and complex conditions, Accredo by Evernorth offers pharmaceutical manufacturers the assurance their therapies are managed with the highest level of care and expertise.

Accredo’s condition-specific Therapeutic Resource Centers™ (TRC) consists of specialized pharmacists, field nurses, nutritionists, and other clinicians who understand the intricacies of the therapies and conditions they manage.

By working with a specialty pharmacy like Accredo, manufacturers can help ensure their therapies are delivered with the utmost care and precision, leading to better patient outcomes.

Explore more about specialty pharmacy networks

Understanding the nuances of limited and exclusive networks is essential for pharmaceutical manufacturers looking to optimize the distribution and management of their specialty therapies.

To learn more about how Accredo can support the success of your therapy pipeline through our specialized pharmacy services and network models, visit www.accredo.com/pharma/storage-and-distribution. Or download our latest white paper on advancing patient access to rare and gene therapies here.