--- title: "Oncology Optimized Limited Distribution" description: "The NCODA-preferred model for oncology care delivery, Oncology Optimized Limited Distribution, excludes PBM-affiliated mail-order pharmacies while allowing MIPs and non-PBM mail-order pharmacies to dispense. This approach promotes coordinated, in-practice care and ensures timely, patient-centered treatment." canonical: "/oncology-optimized-limited-distribution" published: 2026-09-17 keywords: ["oncology care", "Oncology Optimized Limited Distribution"] --- # Oncology Optimized Limited Distribution ## Hero 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. OOLD Tools Explore the Model What is OOLD? ▶ ## Story Intro 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. Patient Access Care Continuity Industry Standards Reduce delays getting patients onto critical oncology therapies. Keep the medically-integrated practice at the center of care. Set best practices manufacturers and payers can adopt. ## Distribution Models **Anchor Model** NCODA Distribution Model Definitions PREFERRED CAUTION OPEN RESTRICTED OOLD PBM Influenced Open Distribution Closed Distribution Manufacturer designates a broad, accessible network that includes medically-integrated dispensing pharmacies as preferred partners. Pharmacy benefit managers steer access toward affiliated or owned pharmacies, often limiting practice-based dispensing. Any qualified pharmacy meeting manufacturer requirements may dispense the therapy — the most accessible model. A single specialty pharmacy or a very small, exclusive network controls all access to the product. 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. 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 supportstimely, 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. 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. ## Partners WITH THANKS TO OOLD Initiative Supporting Partners NCODA's OOLD tools and resources are made possible through the support of the following partners. ## Story Moment — Video **Anchor Video** 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. **Video** ↓ Days to therapy start ↑ Adherence with integrated follow-up 1 Team coordinating every step ## Distribution Search Resources **OOLD Tools-Anchor** Distribution Search Resources Tools to help oncology teams navigate oral anticancer medication distribution and find medically integrated pharmacies. **NCODA OOLD DEMO** 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. [Search OOLD Table →](https://ncoda.org/oold-table/) 02 MIP Search Tool Find medically-integrated pharmacies by region and confirm which limited distribution products they're approved to dispense. [Search MIPs →](https://ncoda.org/mip-search/) ## Stat Callout 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. KEY TAKEAWAYS WHITE PAPER Redefining Oncology Distribution: Advancing Medically Integrated, Patient Centered Care Through Oncology Optimized Limited Distribution The number of availableanti-cancer medicationshas steadily increased over the past two decades,with oralmedicationsplaying a major role in the treatment of multiple tumor types. Alongsidethis evolution, themedicallyintegrateddispensingpharmacy (MIP) has becomea best-in-classmodel fordispensing anti–cancertherapies while preserving a high standard of coordinated, patient centered care. Read the White Paper OOLD Treatment Discussion Guide ### Content Name **Read More →** Type Showing 0-0 of 0 Assets ## Clone of Partners SPECIAL RECOGNITION OOLD Supporting Partners Manufacturer partners committed to improving distribution access for the medically-integrated oncology community. Kura Merck Novartis NuvationBio Pfizer PharmaEssentia Revolution Medicines Rigel Servier Shorla Sobi Springworks Stemline Sumitomo Pharma Syndax Taiho Takeda TerSera Versatem Oncology 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 ## ClosingCTA 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. 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