If you run a hospital pharmacy or manage medicine procurement for an oncology unit, you already know that sourcing specialty cancer medicines is nothing like ordering paracetamol or antibiotics. A patient waiting for their next cycle of a targeted therapy cannot wait two weeks because a shipment got delayed, a cold chain broke down somewhere, or a distributor ran out of stock without warning.
This guide is written for procurement managers, hospital pharmacists, and oncology administrators who want a clearer picture of how specialty medicine
How to Source Specialty Cancer Medicines in India — A Practical Guide for Oncology Centres and Hospital Pharmacies 1
sourcing works in India in 2026 — what to look for in a distributor, what
questions to ask, and where things most commonly go wrong.
Why Specialty Oncology Medicines Are a Different Animal
Most medicines that flow through India’s pharmaceutical supply chain are forgiving. They sit at room temperature, come in large volumes, and usually have generic alternatives if one brand runs out.
Specialty oncology medicines operate under completely different constraints. Many need unbroken cold storage between 2°C and 8°C from manufacturer warehouse to hospital pharmacy. A single temperature excursion — a
refrigerator malfunction, a poorly insulated delivery vehicle, a few hours sitting on a loading dock — can compromise a vial of a monoclonal antibody or an ADC without anyone realising it. You won’t always be able to tell by looking at it.
Then there’s availability. Many of these medicines — targeted therapies, immunotherapies, radioligand therapies — are manufactured in limited global quantities. When stock tightens, it tightens everywhere simultaneously. A distributor who holds buffer stock and has strong relationships with authorised import channels is genuinely valuable here, not just a convenience.
And finally, the regulatory dimension. Specialty medicines imported into India must come through properly licensed channels under the Drugs and Cosmetics Act. Medicines sourced outside authorised supply chains — however they’re presented — carry real risks around authenticity, storage history, and legal liability for the prescribing institution.
What to Actually Look for in a Specialty Distributor
These are the questions worth asking before you establish a supply
relationship:
Do they hold the correct drug licences?
A legitimate pharmaceutical distributor in India must hold a valid wholesale drug licence. For cold chain biologics, radioactive medicines like Pivikto (Lutetium-177 PSMA), or controlled substances, additional licences or
approvals may be required. Ask to see these documents. A distributor who hesitates at this question is already telling you something.
How to Source Specialty Cancer Medicines in India — A Practical Guide for Oncology Centres and Hospital Pharmacies 2
Are they sourcing from authorised channels?
There’s a meaningful difference between a distributor who procures from manufacturer-authorised channels and one who sources from wherever stock is available. For originator branded medicines — AstraZeneca, Novartis, Pfizer, Roche, Sanofi — the manufacturer controls the authorised distribution chain tightly. If a distributor can’t tell you clearly where their stock originates, that’s a red flag.
How do they actually handle cold chain?
Ask specifically about storage infrastructure — cold room capacity,
temperature monitoring systems, backup power. Ask how they deliver cold chain medicines. Do they use validated insulated packaging? Do they provide temperature logs with every shipment? These answers tell you very quickly whether cold chain is something they take seriously or only talk about.
Products like Imfinzi (Durvalumab), Dupixent (Dupilumab), Enhertu
(Trastuzumab Deruxtecan), and Rafinlar (Dabrafenib) all require refrigeration — there is zero margin for error.
Can they maintain consistent supply?
For medicines patients take continuously — daily targeted therapy tablets, monthly injections, adjuvant endocrine therapy — supply consistency is not optional. Ask about buffer stock practices, typical restock lead times, and what their process is when a product is in short supply nationally. Running out of Tagrisso (Osimertinib) mid-cycle for an EGFR-mutated NSCLC patient is not just an inconvenience — it is a clinical problem.
Do they understand what they’re distributing?
This genuinely separates specialty distributors from general wholesalers. A distributor who understands that Rafinlar (Dabrafenib) and Meqsel (Trametinib) must always be ordered together as a combination regimen, that Imfinzi and Imjudo are both needed for the STRIDE protocol in HCC, that Pivikto requires nuclear medicine facility coordination — this distributor is a partner. One who treats these as interchangeable line items in a catalogue is a liability.
Common Problems Oncology Teams Run Into
The same issues come up repeatedly when speaking with oncology
pharmacists and procurement teams across India:
How to Source Specialty Cancer Medicines in India — A Practical Guide for Oncology Centres and Hospital Pharmacies 3
Last-minute stock shortages mid-cycle. A patient is three cycles into
treatment and the medicine is suddenly unavailable. The distributor didn’t anticipate demand, didn’t hold buffer stock, or simply doesn’t prioritise
consistent supply. Clinically disruptive and distressing for patients.
Cold chain breaks that go undocumented. A biologic arrives at the pharmacy with no temperature log, or with an excursion that was never flagged. The pharmacy now has to make a judgment call on a product they can’t fully verify. With medicines like Simponi (Golimumab) or Fasenra (Benralizumab), this situation should never arise with a properly run distributor.
Procurement through informal channels. When a medicine isn’t easily
available through standard routes, procurement teams sometimes turn to grey market sources. Authenticity cannot be verified. Storage history is unknown. The institution assumes legal and clinical liability. The risk is rarely worth it.
Poor communication around delays. Supply delays happen. What matters is whether the distributor tells you early enough to make alternative arrangements — or whether you find out when the patient is already in the chair.
The Medicines That Require the Most Careful
Sourcing
Not all specialty oncology medicines carry equal sourcing complexity. These categories warrant the most rigorous distributor vetting:
Cold Chain Biologics
Monoclonal antibodies, bispecifics, and ADCs require refrigeration throughout the supply chain. This includes Imfinzi (Durvalumab), Imjudo (Tremelimumab), Dupixent (Dupilumab), Nucala (Mepolizumab), Fasenra (Benralizumab), Simponi (Golimumab), Enhertu (Trastuzumab Deruxtecan), and Trodelvy (Sacituzumab Govitecan). Temperature monitoring and validated packaging are non
negotiable when evaluating a distributor for any of these.
Radioligand Therapy
Pivikto (Lutetium Lu-177 Vipivotide Tetraxetan) is a radioactive medicine requiring supply coordination with AERB-licensed nuclear medicine facilities. Not only does the distributor need the correct wholesale licence — they need to understand the coordination required between manufacturer, radiopharmacy, and nuclear medicine centre for each individual dose. This is genuinely
How to Source Specialty Cancer Medicines in India — A Practical Guide for Oncology Centres and Hospital Pharmacies 4
specialised territory that most general pharmaceutical distributors are not equipped to handle.
Targeted Therapy Combinations That Must Be Ordered
Together
Several targeted therapies are only clinically meaningful when used in
combination — both components must be reliably available simultaneously. Rafinlar (Dabrafenib) and Meqsel (Trametinib) are the BRAF + MEK inhibitor combination for BRAF V600-mutated melanoma, NSCLC, and thyroid cancer — ordering one without the other is clinically inappropriate. Imfinzi and Imjudo are both required for the STRIDE regimen in unresectable HCC. A distributor stocking only one component of a mandatory combination is not a complete solution.
Rare Disease Medicines in Low Volumes
Medicines for rare conditions — Emblaveo (Emapalumab) for haemophagocytic lymphohistiocytosis, Sabril (Vigabatrin) for infantile spasms, Rilutek (Riluzole) for ALS, Tibsovo (Ivosidenib) for IDH1-mutated AML — are prescribed in very small volumes by highly specialised teams. Stock availability can be
intermittent. A distributor who actively manages stock for rare disease products is meaningfully different from one who orders on demand and hopes for the best.
Building a Reliable Supply Relationship
The best supply relationships in specialty oncology tend to share a few
consistent characteristics. The distributor knows your patient load well enough to anticipate demand. They communicate proactively about stock levels rather than reactively about shortages. They can supply both components of a combination regimen. Maintain cold chain documentation as a matter of routine, not only when asked.
For oncology centres managing a broad spectrum of cancers — from solid tumours to haematological malignancies to rare diseases — working with a distributor who carries a comprehensive specialty portfolio reduces the administrative burden of managing multiple narrow suppliers. One relationship for Tagrisso (EGFR-mutated NSCLC), Venclexta (Venetoclax) (CLL, AML), Tibsovo (IDH1-mutated AML), Imfinzi (NSCLC, BTC, SCLC), Pivikto (mCRPC),
How to Source Specialty Cancer Medicines in India — A Practical Guide for Oncology Centres and Hospital Pharmacies 5
and Anagrelide (essential thrombocythaemia) is more manageable than six separate supplier relationships.
Finally, communicate your upcoming treatment plans where possible. A
distributor who knows a patient is starting a new course of Dupixent next month, or that you’re planning to initiate Pivikto for a mCRPC patient, can plan stock accordingly. Surprises are bad for everyone in specialty medicine supply.
About A.K. Pharma
A.K. Pharma is a licensed medicine distributor in Delhi specialising in specialty medicines across oncology, immunology, endocrinology, and rare diseases. The portfolio covers over 60 products across 20+ therapeutic areas — from targeted therapies and immunotherapies to ADCs, hormonal treatments, biologics, and radioligand therapy. All products are sourced from authorised distribution channels, stored under manufacturer-recommended conditions including full cold chain for biologics, and supplied to hospitals, oncology centres, and pharmacies across India.
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