Unlocking What’s Next: Supporting Therapy Starts in a Fragmented Access Journey

Access has historically been measured by whether a prescription could get through the system. Increasingly, it’s being measured by whether a patient can start therapy without delay. For years, conversations about patient access have focused on individual barriers ranging from prior authorization requirements and affordability concerns, to pharmacy fulfillment challenges and reimbursement complexity. But patients don’t encounter these barriers as separate issues. They experience them as one connected journey, where each point of friction can compound the next and make starting therapy more difficult than it needs to be.

As utilization management evolves, financial pressures mount and therapy pathways become more complex, biopharma companies are being asked to answer, “What happens after a prescription is written, and what determines whether a patient ultimately starts therapy?”

That question was at the forefront of a recent fireside chat I had with my colleagues Tate Williams, Senior Director of Product Management and Dimple Patel, PharmD, Senior Director of Product Management at CoverMyMeds. Together, we explored how the evolving access and affordability landscape is reshaping the experiences of patients, providers, pharmacies and biopharma, and why a more connected approach is becoming increasingly important.

Our discussion covered a range of topics from growing affordability pressures and gross-to-net (GTN) considerations, to the critical role pharmacy engagement and data play in supporting therapy initiation. While the challenges facing the industry continue to evolve, one theme surfaced throughout: a meaningful opportunity to improve therapy starts comes from strengthening the connections between the people, processes and insights that shape the patient journey.

Here are three observations that stayed with me after the conversation.

1. Access and Affordability Are Increasingly Part of the Same Conversation

An important point in the discussion centered on the growing relationship between access strategy, patient affordability and commercial performance. As market dynamics evolve, organizations are under increasing pressure to balance patient support investments with broader business goals, including the need to manage gross-to-net (GTN) performance. At the same time, affordability challenges continue to influence whether patients ultimately start therapy. This creates a more complex operating environment where access, affordability and commercial strategy can no longer be viewed as separate workstreams. Understanding how financial barriers impact patient behavior has become critical for improving therapy starts, optimizing support programs and creating sustainable pathways to access.

2. The Pharmacy Counter Remains a Pivotal Moment in the Patient Journey

While many access conversations focus on interactions that occur earlier in the process, patients often make their final treatment decision at the pharmacy counter. Research from CoverMyMeds highlights that nearly half of patients abandon therapy when out-of-pocket costs exceed $125.^[0] Even when coverage has been secured and clinical decisions have been made, affordability can become the determining factor in whether treatment begins. That reality reinforces the need for support programs that work together rather than independently. Affordability resources, pharmacy interventions and access programs can operate more efficiently when they are connected to broader provider and patient workflows, helping ensure support reaches patients at the moment decisions are being made.

3. Data Is Becoming the Connective Tissue of Access Strategies

For biopharma, the issue is not a lack of data. It’s that too much of the most useful intelligence is still trapped in separate moments: a prior authorization outcome, a copay decision, a pharmacy transaction, a patient support interaction. Each one says something important about where access is working, where it’s lagging and where investment may or may not be changing patient behavior. The opportunity now is to connect those signals in a way that gives commercial and access teams a better view of what happens between prescription and therapy start. With the right technology, analytics and responsible use of AI, biopharma organizations can begin to see patterns sooner, understand which barriers are most likely to delay or derail initiation, and make smarter decisions about where to focus resources. That kind of visibility matters not just for the patient’s experience, but for therapy adoption, operational efficiency and the overall economics of access.

Looking Ahead

What stayed with me as the conversation wrapped was how much the access discussion has shifted. Prior authorization, affordability, patient support and pharmacy engagement may be managed across industry stakeholders, but patients view them as one process. If one part breaks down, the whole journey can slow. That’s why connection matters now more than ever. Biopharma companies need a better line of sight into what happens after a prescription is written, where patients are getting stuck and which interventions are making a measurable difference. The biopharma teams that build that view will be better equipped to move beyond individual access fixes and help more patients start, continue and benefit from the therapies prescribed to them.

Watch the full conversation.