If you have more than 60 days and expect to need at least 200 medals, full custom medals are worth considering. They give you more freedom to create a medal that is unique to the race and may also provide a lower per-unit cost at higher quantities.
Keep in mind that the 55 to 60 day production timeline begins after artwork approval and payment, not when you first contact MSH Medals. Starting earlier gives you more time for design, revisions, approvals, and economical shipping options.