In this article, Lindsay shares a pharmacist’s firsthand perspective on the growing complexity of patient access and the limitations of traditional pharmacy models. She argues that emerging Direct-to-Patient (DTP) strategies can reshape the care experience by addressing longstanding inefficiencies, enhancing transparency, and simplifying therapy initiation for both patients and providers.
Visit EVERSANA DIRECT Commercialization | EVERSANA to learn more about EVERSANA’s Direct-to-Patient solution.
Read on for Lindsay’s insights.
Rewriting the Access Script: A Pharmacist’s View on the Rise of Direct-to-Patient
By Lindsay Reel, VP, Pharmacy Practice & Specialty Solutions, EVERSANA
Why the Traditional Model No Longer Works
The traditional pharmacy model has too many hands in the process—Pharmacy Benefit Managers (PBMs), Hubs, wholesalers, insurers, PBM-affiliated pharmacies—all adding friction between the patient and their prescribed therapy. Patients wait weeks for prior authorizations (PAs) to process. Coverage denials lead to therapy or pharmacy switches. Formularies dictate treatment, not providers.
Meanwhile, Hubs are often cumbersome, offering little visibility and inconsistent, fragmented support. What used to be a straight path from prescription to therapy has become a maze.
As someone deeply invested in improving patient health outcomes, I’ve had numerous conversations with patients, healthcare providers (HCPs), and pharmaceutical manufacturers who echo that these barriers can significantly impede access, affordability, and adherence.
The Current Role of PBMs and Barriers to Transparency and Growth
Pharmacy Benefit Managers have not been transparent about pricing negotiations or formulary management, leading to inefficiencies and financial losses for manufacturers. Duplicate discounts, ineligible rebate claims, and convoluted pricing structures create revenue leakage and undermine trust between manufacturers and PBMs, mainly impacting patients and their ability to access treatments.
Vertical integration between PBMs, insurers, and pharmacies has also raised concerns about conflicts of interest and anti-competitive practices, further complicating pricing transparency. While regulatory scrutiny is increasing, manufacturers cannot afford to wait for policy changes to address these challenges. Instead, they must proactively explore new strategies that offer direct, transparent pathways for patients.
Industry & Government Pressures Demand New Ways to Empower Patients
The pharmaceutical industry is also facing its own challenges in the current landscape. Pressures from government pricing regulations create a need for new solutions. One opportunity is to adopt Direct-to-Patient (DTP) and Direct-to-Consumer (DTC) models.
These models allow pharma companies to bypass intermediaries like Pharmacy Benefit Managers (PBMs) and wholesalers, reducing costs and improving efficiency. By offering competitive pricing directly to consumers, companies can enhance accessibility and build stronger customer relationships. This approach addresses pricing pressures and meets the growing consumer preference for direct purchasing, creating a more transparent and streamlined supply chain.
With patients expecting more convenience, information, and engagement, Direct-to-Patient (DTP) models have emerged as a game-changing approach to meet these demands. They offer faster access to therapy and cut out the middlemen.
A Unique Perspective: Pharmacy + Telehealth
Having led both high-growth pharmacy operations and telehealth programs, I’ve witnessed firsthand how patient expectations and access models are rapidly evolving. Patients want speed, visibility, and personalized support. They want to access care on their own time—with clear guidance, real-time updates, and a frictionless path forward.
But there is a misconception of what DTP is. It isn’t simply home delivery—it’s a reimagined, fully connected model that gives manufacturers control over the access journey while creating a seamless, personalized experience for patients.
Direct-to-Patient isn’t synonymous with telehealth, either. It’s an ecosystem of patient choice where an HCP interaction can be virtual or in person, on-demand or scheduled, during standard business hours or a weekend. The ideal DTP model offers high visibility, customization, on-demand fulfillment, and a better experience for both patients and providers.
For providers, DTP simplifies their role. There’s no paperwork backlog or prolonged back-and-forth with a call center or Hub. Once the prescription is written, the digital pharmacy handles the rest, verifying benefits, facilitating affordability, managing fulfillment, and supporting adherence—all while providing real-time data and insights to the manufacturer.
This isn’t just a new distribution method—it’s a smarter, faster, patient-first ecosystem.
The Future is Direct—and Personal
We are entering a new era of commercialization. DTP is not a niche solution—it’s the future of how brands will engage, support, and retain patients. It’s faster, more transparent, and built for the real-world in which patients live. It allows manufacturers to directly understand patient coverage, choice, and adherence to their products.
As pharmacists and healthcare innovators, we must lead this change. The technology is here, as is the demand. And the opportunity to transform patient access—for good—is right in front of us. Learn more about EVERSANA’s unique Direct-to-Patient Model: EVERSANA DIRECT Commercialization | EVERSANA.
Sponsored guest posts are bylined articles that are screened by Drug Channels to ensure a topical relevance to our exclusive audience. The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish a guest post on Drug Channels, please contact Paula Fein (paula@DrugChannels.net).
No comments:
Post a Comment