Julianna Kula, PharmD, BCOP | SVP, Oncology Clinical Solutions
For years, complex oncology therapies were assumed to belong almost exclusively in academic medical centers because complexity was thought to require institutional scale and infrastructure.
That assumption is increasingly outdated. Community practices are demonstrating faster decision-making, stronger operational ingenuity, and broader clinical readiness to deliver therapies once believed to require academic infrastructure.
Across radioligand therapies, bispecific antibodies (BsAbs), and select cellular therapy models, evidence from Precision AQ’s OncoGenius® Landscape 2025 Report points to the same conclusion: community practices are adopting new therapies more quickly, redesigning care models in real time, and expanding the operational foundation required to support complex treatment delivery.
Across 84 leading cancer organizations in the OncoGenius research, community practices stand out not only for speed but also for the operating model that enables rapid, confident decision-making.
73% of community practices integrate new products into EHR treatment plans within one to five weeks of approval, compared with 30% of institutions. Institutions are more likely to require six weeks or more, reflecting layered governance and cross‑departmental coordination.
This is not a trade‑off between rigor and speed. It reflects structural efficiency, smaller decision‑making bodies, clearer accountability, and governance models designed to support agility in real‑world oncology practice.
For biopharma teams, the growing role of community practices creates meaningful commercial opportunities and makes operational precision far more important at launch.
Community practices often represent the earliest real‑world access point following approval, particularly for therapies targeting defined patient populations or addressing high unmet need.
Agility leaves little room for error. Manufacturers can help community practices succeed by partnering early to build EHR order sets and test accuracy of prior authorization processes. If organizations move too fast without these steps, early use will be marked by frustration and avoidable barriers.
Radioligand therapies (RLTs) offer one of the clearest examples of how community practices are redefining readiness through workflow design, logistical adaptation, and targeted partnerships.
Precision AQ’s radiopharmaceutical commercialization research shows that many community practices operate without traditional nuclear medicine infrastructure. A significant proportion function without a dedicated hot lab, and therapies such as Lutathera and Pluvicto are frequently delivered in adapted patient rooms rather than specialized suites. To enable delivery, community practices most often rely on agile workflow adaptation and third‑party operational partnerships, not capital expansion.
Community practices are signaling a willingness to engage with RLTs, but readiness is increasingly defined less by physical infrastructure and more by the agility of workflows, logistics support, and confidence in execution.
Bispecific antibodies demonstrate how community practices are building the operational and clinical capabilities required to support therapies once considered beyond their scope.
BsAbs make capability expansion visible at the practice level. Their introduction requires community practices to strengthen infusion workflows, adverse-event monitoring, patient triage, and care coordination – practical changes that show how these organizations are extending their ability to manage greater clinical and operational complexity.
As a result, community practices can make faster, more pragmatic determinations about where BsAbs can be administered safely and when referral or alternative care settings are more appropriate.
Cellular therapies such as chimeric antigen receptor (CAR) T-cell therapy remain predominantly institution-based, but community practices are steadily broadening their role through earlier intervention and stronger continuity models.
Rather than viewing cellular therapy as categorically out of scope, some community practices are increasingly participating by earlier patient identification, coordination of referral pathways, and post‑infusion monitoring and continuity of care. Adoption remains limited, but complexity is no longer treated as an automatic exclusion criterion when agile participation models are possible.
Taken together, these findings point to a broader market shift: community practices are becoming a more consequential setting for the adoption of complex therapies than many stakeholders have recognized.
Manufacturers seeing the strongest early traction are prioritizing EHR treatment‑plan readiness alongside formulary access, delivering practical, workflow‑level guidance (particularly for RLTs and BsAbs), and segmenting community practices based on operational agility rather than outdated assumptions.
Community practices are distinguished by how quickly they act, how effectively they adapt, and how far they have extended their role in complex oncology care.
For manufacturers, the implication is clear: community practices should be treated as strategically important partners in the commercialization of complex therapies. Launch strategies that support execution at the workflow level will be best positioned to convert readiness into early success. Explore how OncoGenius can help uncover barriers to provider access for your life-changing products, with actionable insights into formularies, EHR treatment plans, and pathways for your products across leading U.S. cancer centers.