Oncology Optimized Limited Distribution Table

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. 

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.