Mike shares key takeaways on patient access and affordability from CoverMyMeds’ 2025 Medication Access Report. He focuses on the systemic fragmentation that exists across payers, providers, and pharmacies. Mike explains how these silos delay treatment and lead to increased out-of-pocket costs.
To learn how a more connected, patient-centered solution can bridge silos and align clinical and financial realities, register for CoverMyMeds’ free June 12th webinar: Dimensionalization of the Patient Journey.
Read on for Mike’s insights.
From Barriers to Bridges: Rethinking Medication Access for 2025
By: Mike Cohn, Vice President, Network Operations, CoverMyMeds
Healthcare has always been complex, but today’s pace, scale and fragmentation have pushed the system to a breaking point. Improving medication access requires more than isolated fixes. It calls for a multi-dimensional, connected approach that reflects how intertwined these challenges really are.
A Growing Gap Between Drug Innovation and Access
Today, difficulty accessing medication is not the exception but the norm. In fact, data in our 2025 Medication Access Report highlights 65% of patients experienced delays filling their prescriptions. Of those, more than half cited cost as a key barrier (CoverMyMeds Patient Survey 2023).
However, this financial burden isn’t evenly shared. For example, individuals and families with moderate and stable incomes, often defined as “middle-class,” often earn too much to qualify for financial assistance but still face significant out-of-pocket expenses, and are particularly vulnerable to affordability challenges.
Additionally, the increasing utilization of specialty medications presents both opportunities and challenges for the healthcare system. While representing under 5% of total prescription volume, these innovative treatments now account for 56% of overall medication spend, a dramatic rise over the past decade. With 250 new therapies expected by 2028, that number will continue to rise.
Support Exists, But Patients Need Support Finding It
Help does exist to make medications more accessible and affordable, but most patients struggle to find available resources. Each year, pharmaceutical companies invest over $5 billion in patient support programs (PSPs) designed to ease the financial burden of treatment. Yet only 3% of patients engage with them. (Sohn, Adam, et al. “Making Patient Support EESI (EASY) Enhance, Empower, Simplify, Improve.” IQVIA, 12 July 2023)
A big part of the disconnect lies in how these programs are delivered. In a world where almost everything is available with a tap or a swipe, PSPs are often buried behind complex enrollment forms, unclear eligibility rules or disconnected provider workflows.
Patients ultimately need better connections to the people they trust. To improve utilization of PSPs, the programs need to be presented by the patient’s care team, ideally at the point of care, and accessible through clear, patient-friendly language. When prescribers, pharmacists and care navigators can easily access and activate support options, patients are far more likely to stay on therapy and achieve better health outcomes.
Breaking Down Silos
Access, affordability and adherence are deeply connected, and directly impact the well-being of the patients we serve. To improve the patient journey, we need to treat patients as whole people. That’s the heart of dimensionalization: approaching patient care in a way that reflects not just patients’ medical needs, but also their financial realities, social circumstances and the complexity of their care journeys.
This begins with breaking down silos across healthcare so information can flow more freely to improve care and reduce medication delays. It also means finding the right balance between automation and human connection. Technology can streamline workflows, but people still need human guidance—someone to explain the process, answer questions and guide them forward.
Even in the age of AI, human expertise remains crucial for ethical, effective, and patient-centered healthcare. It ensures that data-driven decisions and streamlined processes truly serve the patients behind the numbers. This is especially important in areas like prior authorization and payer processes, where compassion and clinical judgment are as important as efficiency. In addition, field reimbursement managers and clinical support personnel can also make digital solutions more accessible and can reach the people who need them most.
Building the Bridge Forward
We’ll dive deeper into these ideas during our upcoming webinar, Dimensionalization of the Patient Journey, on June 12. I’ll be joined by my colleagues, Miranda Delatore, Vice President of Product, Kristina Crockett, Vice President of Product, and Kimberley Chiang, Vice President of Biopharma Commercial Solutions to explore key takeaways from the 2025 Medication Access Report: From Barriers to Bridges.
The path from barriers to bridges begins with an objective look at where the system is falling short and a shared commitment to do better. It’s a complex topic, and our 2025 Medication Access Report goes well beyond what we’ve shared here—offering a deeper look at data, real patient experiences, and practical strategies that move patients from prescription to treatment with fewer delays and fewer barriers.
We invite you to register for our June 12 webinar, and more importantly, to join us in helping to shape what comes next.
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