Pharmacies express discontent over Xigduo distribution

Sales of Xigduo transferred to AstraZeneca Korea… large wholesaler A secures pharmacy distribution rights

Non-trading pharmacies blocked from supply under wholesaler A’s policy

Wholesaler A: “Limited inventory… 80% of pharmacies covered through direct trade”

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As the distribution of a widely prescribed pharmaceutical product has shifted from a manufacturer-led model to a wholesaler-led model, supply blind spots have emerged, leaving pharmacies that do not have a direct contract with the wholesaler unable to secure the drug.

Pharmacies claim they are effectively forced to enter direct trading agreements with the specific distributors to receive products, facing unprecedented inconvenience.

The product in question is AstraZeneca's diabetes drug, Xigduo XR (metformin hydrochloride, dapagliflozin propanediol monohydrate).

Until last year, HK Inno.N was in charge of its sales and supply. However, as of January 1 this year, sales and supply were transferred to AstraZeneca Korea. In the process, a large domestic wholesaler (Wholesaler A) secured exclusive pharmacy distribution rights for the product.

The problem is that since Company A secured the pharmacy distribution rights, supply to other wholesalers became impossible. In other words, pharmacies can only receive the drug if they have a direct trading relationship with Wholesaler A.

One pharmacist said, “None of our four primary wholesalers can source the product from Wholesaler A, and it shows as out of stock across online wholesale platforms. For pharmacies like ours that do not have a direct trading relationship with Wholesaler A, securing inventory is impossible. It is unfair for a single wholesaler to effectively monopolize the sale and supply of a prescription drug.

The pharmacist added that the product should at least be made available to other wholesalers through secondary wholesale channels.

Another pharmacist noted, “When we checked why Xigduo XR was unavailable, we found that it could only be purchased through Wholesaler A. According to the sales representative, distribution to other wholesalers will only take place after distribution rights and inventory are fully reorganized.”

In response, Wholesaler A stated that the policy is unavoidable given current supply conditions, citing limited inventory as a key constraint.

A representative from Company A stated, “Due to limited market inventory, we are prioritizing supply to our contracted pharmacies. Secondary wholesale distribution is physically not feasible at this time.”

The official added, “We currently have trading relationships with approximately 80% of pharmacies nationwide. Pharmacies with direct trade agreements can secure inventory as long as they meet the minimum order requirement.”

However, this leaves around 20% of pharmacies facing significant hurdles, as initiating a new trading relationship requires meeting an initial minimum order threshold.

Critics point out that pharmacies with low order volumes or long-standing relationships with other primary wholesalers are unlikely to open a new account solely to secure Xigduo XR—particularly when doing so may require purchasing several million wons worth of products upfront to meet initial order requirements.