Limited Distribution Networks (LDNs) delay patient access to crucial medications.

As the controversy around LDNs continue, some have argued that LDNs stifle competition in the generic and biosimilar drug industries, ultimately impacting patient outcome and increasing cost(1).

A recent retrospective study(2) compares the rates and times to dalfampridine access for multiple sclerosis patients before and after a health-system specialty pharmacy was allowed access in the LDN.

Established by the manufacturer, LDNs are believed to facilitate effective allocation of a drug by tightly managing the supply chain to minimize drug shortages and reduce the amount of unused product in the supply chain. Yet, the role of LDNs in patient care has been controversial from inception.

The study shows the shortcomings of an LDN model such as treatment delays, decreased medication adherence, and increased inefficiencies.

It also shows the benefits of pharmacists in shortening therapy access and suggests that the removal of LDNs can help integrated specialty pharmacists monitor and counsel medications better to promote high adherence and persistence to therapy.

This study adds to the growing body of evidence that is instructive to benefits managers to be cognizant of the intended and unintended consequences of benefit design changes. Axum programs are diligently focused on aligning the interests of sponsors and patients.