5 Trends Set to Impact Patient Access to Prescription Therapy in 2024
The pharmaceutical industry finds itself at the crossroads of innovative treatments and technological advancements redefining how patients access prescribed therapy. However, this tremendous innovation has also presented unique challenges in securing patient affordability and access to therapy. These five key trends should be considered and will influence how manufacturers should think about shaping their services programs heading into 2024.
1) Patients are struggling with affordability challenges
Patients continue to worry about affording their healthcare. A recent KFF consumer survey found that in the past year, 4 out of 10 insured adults skipped or delayed some care due to cost, and 1 out of 6 had trouble paying medical bills. In 2022 alone, out-of-pocket costs led to the abandonment of 94 million prescriptions. Unsurprisingly, as we move into the 2024 election year, 80% of voters expect the presidential candidates to address the affordability of healthcare, and 64% want to hear about prescription drug costs.
According to a Deloitte survey, life sciences companies are acutely aware of these affordability concerns and expect the economy and inflation to influence their strategies in 2024. Biopharmaceutical companies have stepped up their efforts to support patients, spending over $80B during the last five years to help offset OOP costs for commercially insured patients.
In 2024, manufacturers should continue to analyze patient access program design and consider the subsequent financial implications to ensure that they sustainably support affordability while effectively managing their gross-to-net (GTN) performance to sustain the long-term viability of their branded therapies.
2) A fragmented healthcare experience persists
Fragmented healthcare is a persistent problem that negatively affects patient outcomes and experience, particularly for patients with chronic conditions. Consumers want to be able to navigate the prescription journey quickly and conveniently, but what they typically get is a disjointed, cumbersome, and frustrating experience. This problem is compounded by the fact that healthcare providers, pharmacies, and payers mainly operate in silos resulting in limited transparency for patients.
Pharmaceutical manufacturers can be part of the solution. By partnering with a technology-enabled hub providers that offer the integrated, streamlined experience across the prescription journey that consumers expect, brand teams can set the stage for successful, modern patient access services in 2024.
3) Digital innovations in healthcare continue to evolve
Digital technologies powered by generative AI are exploding across industries. The global generative AI market in healthcare is expected to reach $21.74 billion by 2032. However, according to a McKinsey analysis, pharmaceutical companies are substantially lagging when it comes to adopting digital technologies to transform their business models.
In 2024, life science manufacturers should undertake commercialization practices that increase patient access to their branded therapies and offer sustainable value in a complex drug channel. With advanced digital technologies, brand teams can:
Utilize digital channels to engage stakeholders
Leverage real-time data to make informed decisions
Monitor gross-to-net impact
Implement integrated commercialization strategies
4) Payer cost controls are growing
MGMA’s recent Annual Regulatory Burden Survey finds that medical practices face ongoing – and growing – burdens associated with payer cost controls. Respondents overwhelmingly noted increasing prior authorization (PA) requirements, patient access delays, and high administrative burdens:
89% of respondents rated PA as very or extremely burdensome
97% said their patients had experienced care delays or denials due to PA requirements
92% have hired or redistributed staff to keep up with increasing PA requests
Considering that PBM organizations anticipate using price negotiations and UM tools to reduce spending by consumers and plan sponsors by more than $1 trillion through 2029, it’s safe to say these price control tactics will continue to challenge patient access to branded retail therapies.
Many pharma companies already invest considerably in rebate programs, value-based contracting, and patient hubs for their specialty therapies. Moving forward, it’s critical for brand teams not to overlook the high-impact – and cost-effective – strategy of investing in digital technology to reduce the administrative burden of PAs.
5) Employers want transparency
Survey data from Business Group on Health shows that the rising cost of prescription drugs is a prevalent concern for employers. In 2022, prescriptions accounted for almost a quarter of employers’ healthcare costs, with specialty medications accounting for over 50%. Going into 2024, employers are particularly concerned about high-cost drugs in the pipeline and identify transparency as a tool to help contain costs and improve quality. They strongly support engagement platforms, enabling employees to make more educated healthcare decisions and better navigate their care.
This trend presents a tremendous opportunity for pharmaceutical manufacturers to enhance transparency with patient access platforms that:
Help employees navigate the complicated prescription journey
Make it easier for employees to access and afford prescribed treatment
Give employees options for how to engage and receive communications
Provide more visibility into prescription status
Stay ahead of the curve
In this ever-evolving landscape, staying ahead of the curve is not just a strategic choice – it’s essential to thrive in a highly competitive marketplace. The manufacturers that can navigate these trends strategically and proactively will be well-positioned to optimize patient access and drive the success of their branded therapies.
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