Let’s Be DIRECT: We Have an Access and Affordability Problem to Solve

Today’s guest post comes from Mark Thierer, Chief Executive Officer of EVERSANA.

Mark explains how combining direct-to-patient and direct-to-payer strategies can improve transparency, streamline access, and better align key stakeholders. He introduces EVERSANA DIRECT, the company’s new approach to market access.

To learn more, visit eversana.com/DIRECT.

Read on for Mark’s insights.

Let’s Be DIRECT: We Have an Access and Affordability Problem to Solve
By Mark Thierer, Chief Executive Officer, EVERSANA

The pharmaceutical industry is at an inflection point. Rising costs, opaque pricing and fragmented care are straining every part of the healthcare ecosystem. Patients, payers, pharma, providers, and pharmacies are all feeling the pain of misaligned incentives in a system that is harder to navigate than it should be. There is a dire need for new thinking—not for fixing old processes. While direct-to-patient (DTP) may be the latest buzzworthy term, it is not a silver bullet, and we already see the need to go beyond it.

That’s why we led the merger of EVERSANA and Waltz Health to bring together two organizations committed to rewiring the system for better access and affordability. Now, as a single combined entity, our company is in a unique position at a very urgent time. We have proprietary patient and payer technology platforms, combined with patient hub, marketing, field deployment, pricing, and channel management services, to reimagine modern market access through a brand-new model. We are calling it: EVERSANA DIRECT or more cleverly DTP²—bringing together Direct-to-Patient and Direct-to-Payer models to create a truly new, consistent, transparent, and reliable way for therapies to reach patients.

EVERSANA DIRECT Empowers Payers Through Modernized PBM Functions

Traditionally seen as intermediaries, Pharmacy Benefit Managers (PBMs) can become strategic enablers of affordability, access, and outcomes—especially when payers also adopt direct-to-payer models.

Payers can now:

• Plan and budget with confidence: With upfront and transparent pricing through direct-to-payer solutions, payers can forecast drug spend accurately, manage benefit design with precision, and eliminate unpredictable and often misaligned rebate structures. This clarity enables more reliable budgeting and long-term sustainability in managing pharmacy benefits.
• Expand affordable access: By integrating directly with pharmaceutical manufacturers and digital pharmacy networks, payers can offer members broader access to clinically appropriate, life-changing medications—especially high-value therapies like GLP-1s—at lower and more predictable costs.
• Align incentives for better outcomes: Direct connections between payers, providers, and manufacturers reduce administrative friction and ensure that all stakeholders are working toward the same goals: timely therapy starts, adherence, and improved health outcomes.
• Simplify benefit administration: Leveraging digital platforms and AI-driven tools reduces operational burden, streamlines formulary management, and enables dynamic pricing strategies that support affordability—without compromising access or quality of care.
• Ensure a seamless experience: Keeping members informed and supported throughout their prescription journey from initial script fill through subsequent refills and renewals improves their overall experience.

EVERSANA DIRECT Empowers Pharma Through New Channels

We have bridged pharma with payers, providers, and patients in an entirely new way by providing choices when it comes to modern market access via channels that best fit the product and patient population profiles. By combining a direct-to-payer digital channel with a traditional direct-to-patient model, we align stakeholder incentives and streamline therapy delivery to ensure patients receive timely, affordable, and clinically appropriate treatments. By integrating digital experiences, AI tools, and upfront pricing, this approach not only reduces abandonment rates but also enhances system-wide efficiency and stands out as a transformative solution poised to improve outcomes across the entire care continuum.

Pharma manufacturers can now:

• Increase access: By focusing on both coverage and speed to therapy, we can ensure that more patients receive the treatments they need in a timely manner. This approach not only broadens the reach of healthcare services but also accelerates the process of getting therapy to those who need it most.
• Improve gross-to-net ratio: Protecting manufacturer value and reducing inefficiencies are both crucial for maintaining the financial health of pharmaceutical companies. By streamlining processes and eliminating waste, we can improve the gross-to-net ratio, ensuring that manufacturers retain more of their revenue.
• Accelerate pull-through: Leveraging end-to-end patient services, EVERSANA drives awareness, improves access to HCPs, reduces pharmacy abandonment, and increases adherence. With a hyperfocus on providing seamless and frictionless patient experiences, EVERSANA removes many of the barriers patients face when finding a doctor, getting a timely diagnosis, receiving their initial treatments, and staying on therapy.

In today’s pharma landscape, market access is the problem to solve—and with the combined capabilities of EVERSANA and Waltz Health technology, we can solve it. By combining direct-to-patient access models with direct-to-payer technology, we are reimagining the pharmaceutical access ecosystem to address patient experience, costs, transparency, and care coordination. Payers, pharma, and—most importantly—patients ultimately win.

To learn more, visit eversana.com/DIRECT.

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