Regional Distribution and Therapeutic Demand Patterns of DTP Pharmacies: The Challenge of Innovative Drug Accessibility and Urban–Rural Disparities in

By:DengYue International Business Division

Introduction: In the Era of Innovative Medicines, Why Are Patients Still Searching for Drugs?

Over the past decade, China's innovative pharmaceutical industry has experienced unprecedented growth.

From targeted therapies and PD-1/PD-L1 immunotherapies for cancer to orphan drugs, cell therapies, and gene therapies, an increasing number of advanced treatments have received regulatory approval and entered clinical practice. At the same time, China's National Reimbursement Drug List (NRDL) negotiations have expanded access to high-value innovative medicines, significantly improving overall drug accessibility.

However, for many patients, regulatory approval does not necessarily translate into timely access to treatment.

The same innovative medicine may already be available through hospital pharmacies and DTP pharmacies in major medical hubs such as Beijing and Shanghai, while patients in certain prefecture-level cities and county-level regions may still need to travel across cities or provinces to obtain it. Some patients face the frustrating reality of knowing that a medicine exists but being unable to access it locally.

This disparity reflects not only the evolution of China's pharmaceutical distribution system but also broader challenges in healthcare resource allocation during the era of innovative medicine.

Against this backdrop, DTP (Direct-to-Patient) pharmacies have emerged as a critical bridge connecting pharmaceutical companies, hospitals, healthcare payers, and patients. Their geographic distribution and therapeutic portfolios provide valuable insight into the current state of innovative drug accessibility in China.

DTP Pharmacies: Critical Infrastructure in the Innovative Medicine Era

DTP pharmacies first gained prominence alongside the rapid expansion of the oncology innovation market.

Unlike conventional retail pharmacies, which primarily focus on common prescription medications and over-the-counter (OTC) products, DTP pharmacies specialize in the distribution and management of innovative medicines, high-cost specialty drugs, and therapies for complex diseases.

Key characteristics include:

● Access to innovative medicines and specialty pharmaceuticals

● Professional pharmacist teams providing medication counseling

● Patient follow-up and treatment adherence management

● Cold-chain storage and transportation capabilities

● Integration with China's Dual-Channel reimbursement system

● Support for Patient Assistance Programs (PAPs)

For patients with cancer, rare diseases, autoimmune disorders, and those requiring long-term biologic therapies, DTP pharmacies are more than dispensing centers—they have become an integral part of the treatment management ecosystem.

As the number of NRDL-listed innovative medicines continues to expand and Dual-Channel policies become more widely implemented, DTP pharmacies have evolved into a vital endpoint for the commercialization and delivery of innovative therapies.

China's DTP Pharmacy Landscape: Why Are Resources Concentrated in Major Cities?

Although the number of DTP pharmacies continues to grow, their distribution remains highly uneven.

Cities such as Beijing, Shanghai, Guangzhou, Shenzhen, Hangzhou, and Chengdu account for a substantial proportion of China's DTP pharmacy resources, while many county-level regions remain underserved.

This imbalance is driven primarily by three factors.

Concentration of Healthcare Resources

Innovative medicines are predominantly used in the treatment of serious and complex diseases, including:

● Lung cancer

● Breast cancer

● Lymphoma

● Leukemia

● Multiple sclerosis (MS)

● Spinal muscular atrophy (SMA)

● Fabry disease

● Crohn's disease

● Psoriasis

Patients with these conditions are typically treated at tertiary hospitals, National Medical Centers, and Regional Medical Centers.

Because prescription generation is concentrated within these institutions, DTP pharmacies naturally develop around major hospitals, creating the well-known "hospital-adjacent pharmacy" model.

Market Expansion Strategies for Innovative Medicines

For pharmaceutical manufacturers, market penetration generally follows a phased expansion pathway:

Tier-1 metropolitan cities → Provincial capitals → Prefecture-level cities → County-level markets

This strategy aligns with both commercial considerations and healthcare resource distribution patterns.

Consequently, many innovative medicines initially become available in major metropolitan areas such as Beijing, Shanghai, and Guangzhou before gradually expanding into lower-tier markets.

This trend is particularly evident for:

● CAR-T cell therapies

● Gene therapies

● Ultra-orphan disease treatments

● Certain imported oncology innovations

These products often remain concentrated within a limited number of specialized treatment centers.

High Requirements for Cold-Chain Logistics and Professional Services

An increasing proportion of innovative therapies fall into categories such as:

● Monoclonal antibodies

● Bispecific antibodies

● Antibody-drug conjugates (ADCs)

● Cell therapy products

● Gene therapy products

These medicines require stringent handling conditions.

From temperature-controlled logistics and continuous monitoring to specialized pharmaceutical care, every stage of the supply chain demands significant investment.

As a result, DTP pharmacies with the necessary operational capabilities are more likely to be concentrated in major urban centers.

Regional Demand Variations: Different Markets Require Different Therapies

From a therapeutic perspective, China's regional markets exhibit distinct demand patterns.

Tier-1 Cities: Strongest Demand for Innovative Oncology Therapies

Beijing, Shanghai, Guangzhou, and Shenzhen host the country's most concentrated oncology treatment resources.

Demand is primarily focused on:

● EGFR-targeted therapies

● ALK inhibitors

● ROS1 inhibitors

● KRAS-targeted therapies

● PD-1/PD-L1 immunotherapies

● ADC therapies

● CAR-T-related treatment products

Patients in these cities generally demonstrate greater awareness of innovative medicines, stronger purchasing power, and broader access to commercial health insurance, making Tier-1 cities the most important markets for innovative therapies.

Yangtze River Delta and Pearl River Delta: Rapid Expansion of Autoimmune Disease Treatments

Demand for therapies targeting autoimmune diseases has increased significantly in recent years.

Major disease areas include:

● Crohn's disease

● Ulcerative colitis

● Psoriasis

● Ankylosing spondylitis

● Rheumatoid arthritis

Commonly prescribed therapies include:

● Ustekinumab

● Secukinumab

● IL-23 inhibitors

● JAK inhibitors

Because these conditions require long-term disease management, DTP pharmacies increasingly play a role in patient education, adherence support, and ongoing follow-up services.

Central and Western Provincial Capitals: The Fastest-Growing Markets for Innovative Medicines

With the continued development of Regional Medical Centers, cities such as Chengdu, Chongqing, Wuhan, Xi'an, and Changsha are rapidly emerging as important pharmaceutical markets.

Patients who previously needed to travel to Beijing or Shanghai for advanced treatment can increasingly access innovative therapies closer to home.

Growth has been particularly strong in areas such as:

● Innovative oncology therapies

● Biologic agents

● Rare disease treatments

● High-cost specialty medicines

County-Level Markets: Chronic Disease Management Remains the Primary Demand

Compared with urban markets, county-level regions remain largely focused on chronic disease management, including:

● Diabetes

● Hypertension

● Coronary artery disease

● Chronic obstructive pulmonary disease (COPD)

● Osteoporosis

Penetration of innovative medicines remains relatively low.

This reflects not only disparities in healthcare infrastructure but also differences in patient awareness, affordability, prescribing habits, and pharmaceutical distribution networks.

Urban–Rural Medication Disparities: The Challenge Extends Beyond Drug Supply

Many people assume that urban–rural disparities stem solely from drug availability.

In reality, the challenge has evolved into a broader systemic issue.

Drug Accessibility Gaps

Patients in major cities often gain access to newly launched therapies relatively quickly.

In contrast, patients in underserved regions may face challenges such as:

● Local hospitals not stocking the medicine

● Limited access to nearby DTP pharmacies

● High costs associated with obtaining treatment outside their home region

These barriers are particularly significant for rare disease patients.

Diagnostic Capability Gaps

Innovative medicines often depend on precise diagnosis and patient stratification.

For example:

Targeted therapies for lung cancer require molecular and genomic testing.

Rare disease treatments depend on specialized diagnostic pathways.

Without adequate diagnostic capacity, even physically available medicines may fail to deliver meaningful clinical benefits.

Information Gaps

Many patients remain unaware that:

● A new medicine has already been approved

● The therapy has been included in the NRDL

● The medicine can be obtained through Dual-Channel pharmacies

● Patient Assistance Programs are available

In many cases, information barriers are even more difficult to overcome than physical access barriers.

The Dual-Channel Policy: A Key Mechanism for Expanding Access to Innovative Medicines

In recent years, China's Dual-Channel policy has become an important component of healthcare reform.

Under this mechanism, eligible patients can obtain reimbursable medicines through either hospitals or designated retail pharmacies, including DTP pharmacies, while maintaining access to health insurance reimbursement.

This approach effectively addresses the lengthy timelines often required for innovative medicines to enter hospital formularies.

For patients, it means:

Greater convenience and faster access to treatment.

For DTP pharmacies, it represents a transition from simple dispensing outlets to comprehensive innovative medicine service platforms.

As more innovative therapies are incorporated into the Dual-Channel system, patients in lower-tier markets are expected to gain greater access to advanced treatments.

How DengYueMed Helps Patients Overcome Regional Treatment Barriers

As patient challenges shift from "Does the medicine exist?" to "Where can I find it?", "What treatment options are available?" and "How can I obtain reliable information?", the importance of professional healthcare service platforms continues to grow.

Headquartered in Hong Kong, DengYueMed closely monitors global innovative medicine developments, China's evolving pharmaceutical landscape, and international healthcare resource integration.

To support patient needs, DengYueMed continuously tracks:

● Global innovative drug approvals and launches

● Advances in oncology treatment

● Updates in rare disease therapies

● DTP pharmacy coverage and availability

● Changes in reimbursement and Dual-Channel policies

● International healthcare resources and treatment information

For patients with cancer, rare diseases, and other complex conditions, timely access to accurate, transparent, and compliant information can play a critical role in treatment decision-making.

As a Hong Kong-based platform connecting patients with global healthcare resources, DengYueMed remains committed to helping individuals explore treatment options and reduce barriers created by information asymmetry.

Future Outlook: DTP Pharmacies Are Evolving from Drug Dispensing to Patient Management

Over the next five years, growth in the DTP sector will be driven not merely by the expansion of pharmacy networks, but by the ability to deliver comprehensive patient services.

Future competitive advantages will increasingly depend on:

● Professional pharmaceutical care capabilities

● Long-term patient management programs

● Digital follow-up and monitoring systems

● Healthcare reimbursement coordination

● Rare disease support infrastructure

● Innovative medicine education services

Organizations capable of supporting patients throughout the entire treatment journey will be best positioned for long-term success.

Conclusion

The geographic distribution of DTP pharmacies reflects broader disparities in healthcare resources and innovative medicine availability across China.

From Beijing and Shanghai to emerging county-level markets, from innovative oncology therapies to rare disease treatments, and from hospital pharmacies to Dual-Channel retail networks, China's pharmaceutical distribution system is undergoing profound transformation.

DengYueMed believes that the true measure of medical progress is not simply the number of innovative medicines approved, but whether those therapies can reach the patients who need them most—at the right time, through accessible channels, and at a sustainable cost.

Reducing urban–rural disparities, improving access to innovative medicines, and strengthening patient information support will remain critical priorities in the continued evolution of China's healthcare system.