Oncology Optimized
Limited Distribution
The NCODA-preferred distribution model, Oncology Optimized Limited Distribution (OOLD), excludes PBM-affiliated mail-order pharmacies and empowers medically integrated pharmacies (MIPs) to deliver timely, coordinated, patient-centered cancer care.
What is OOLD? ▶
Explore the Model
OOLD Tools
WHY OOLD
Coordinated patient care starts with where therapy is dispensed.
NCODA is committed to collaborating with all stakeholders to expand and demonstrate the value of the OOLD model. By prioritizing the medically integrated pharmacy (MIP) and in-practice care coordination, OOLD supports timely access to therapy and optimizes the patient experience.
Care Continuity
Keep the medically-integrated practice at the center of care.
Industry Standards
Set best practices manufacturers and payers can adopt.
Patient Access
Reduce delays getting patients onto critical oncology therapies.
NCODA Distribution Model Definitions
PREFERRED
OOLD
Manufacturer designates a broad, accessible network that includes medically-integrated dispensing pharmacies as preferred partners.
CAUTION
PBM Influenced
Pharmacy benefit managers steer access toward affiliated or owned pharmacies, often limiting practice-based dispensing.
OPEN
Open Distribution
Any qualified pharmacy meeting manufacturer requirements may dispense the therapy — the most accessible model.
RESTRICTED
Closed Distribution
A single specialty pharmacy or a very small, exclusive network controls all access to the product.
Represents the NCODA preferred model, where PBM affiliated mail order pharmacies are excluded, and MIPs and non-PBM affiliated pharmacies can dispense. This model enables coordinated, in-practice care and supports timely, patient-centered treatment.
NCODA is committed to continued education and advocacy to expand access to this approach wherever possible.
Includes one or two PBM-affiliated mail order pharmacies which include Optum, CVS Caremark, or Express Scripts. While not preferred, it is important to recognize manufacturers that are attempting to promote MIPs and limit access to PBM owned pharmacies.
*This distribution networks limit MIP involvement and introduce barriers to timely access and coordinated care, often through restrictive contracting or payer-driven steerage.
Medications widely available through retail, hospital and mail order pharmacies without restrictions. Includes Optum, CVS Caremark, and Express Scripts PBM-affiliated mail order pharmacies.
*These distribution networks limit MIP involvement and introduce barriers to timely access and coordinated care, often through restrictive contracting or payer-driven steerage.
Applies to medications with highly restricted networks, such as those requiring REMS or manufacturer-designated controls.
These models typically offer little to no flexibility in dispensing, often excluding MIPs altogether. This includes models with no MIP Access.
WITH THANKS TO
OOLD Initiative Supporting Partners
NCODA's OOLD tools and resources are made possible through the support of the following partners.
↓ Days
to therapy start
↑ Adherence
with integrated follow-up
1 Team
coordinating every step
SEE IT IN ACTION
How OOLD and the MIP model improve patient outcomes
When available, the medically integrated pharmacy should be the preferred option for dispensing prescribed therapies. Watch how this model improves access, adherence, and the overall patient experience.
01
OOLD Search Tool
Search by drug name to see its current distribution model classification — OOLD/Preferred, PBM Influenced, Open, or Closed — sourced directly from manufacturer policy.
02
MIP Search Tool
Find medically-integrated pharmacies by region and confirm which limited distribution products they're approved to dispense.
Distribution Search Resources
Tools to help oncology teams navigate oral anticancer medication distribution and find medically integrated pharmacies.
Redefining Oncology Distribution: Advancing Medically Integrated, Patient Centered Care Through Oncology Optimized Limited Distribution
The number of available anti-cancer medications has steadily increased over the past two decades, with oral medications playing a major role in the treatment of multiple tumor types.
Alongside this evolution, the medically integrated dispensing pharmacy (MIP) has become a best-in-class model for dispensing anti–cancer therapies while preserving a high standard of coordinated, patient centered care.
KEY TAKEAWAYS
Distribution model directly affects how quickly patients begin therapy.
Medically-integrated pharmacies are frequently excluded from closed networks.
OOLD/Preferred models correlate with stronger adherence outcomes.
Practices can use NCODA's search tools to advocate for network inclusion.
Read the White Paper
WHITE PAPER
OOLD Treatment
Discussion Guide
SPECIAL RECOGNITION
OOLD Supporting Partners
Manufacturer partners committed to improving distribution access for the medically-integrated oncology community.
AstraZeneca
Aveo
Azurity
Bayer
BeOne
Blueprint
Bristol Myers Squibb
Corcept
Cycle Pharma
Daiichi-Sankyo
Deciphera
Eli Lilly
EMD Serono
GlaxoSmithKline
GSK
Incyte
Ipsen
Janssen
Karyopharm
Kura
Merck
Novartis
NuvationBio
Pfizer
PharmaEssentia
Revolution Medicines
Rigel
Servier
Shorla
Sobi
Springworks
Stemline
Sumitomo Pharma
Syndax
Taiho
Takeda
TerSera
Versatem Oncology
GET INVOLVED
Help us build an optimized oncology distribution system
Explore the OOLD and MIP Search Tools, read the full report, and join NCODA's network of medically-integrated practices advancing patient-centered care.
Become a Member