Insight
This spring at Asembia’s AXS26 Summit, leaders across specialty pharmacy and biopharma converged on a shared reality that growth is no longer limited by innovation itself. It’s limited by whether patients can start therapy without unnecessary delays. New therapies continue to scale and become more complex, leaving the distance between a prescription being written and a patient beginning treatment as a highly fragile point in the system.
In recent years, and highlighted on the AXS26 show floor, access and affordability are no longer being framed as administrative tasks. They are positioned as infrastructure across the healthcare landscape. And like any infrastructure, when it falters, everything downstream feels the impact. Below are the insights that resonated most with attendees as we look to the future of access and affordability.
AXS26 clearly showed that brand performance increasingly hinges on whether access systems can navigate real world complexity including, coverage variability, documentation demands and patient cost exposure, often all at once. Oncology continues to remain a good use case. Even brief delays in benefits investigation or prior authorization can derail therapy starts altogether. While prior authorization is often a well-known visible friction point, the deeper challenge can be unclear requirements, repeat submissions and slow handoffs that stretch initiation timelines and stall momentum for both patients and providers. As a result, starting and staying on therapy is no longer viewed through an efficiency lens alone. It has become a determinant of consistency and growth, placing new weight on access solutions that are embedded in workflows, connected across stakeholders and designed to support more consistent therapy initiation, not just process transactions. See how CoverMyMeds is leading the way, here, with our new expanded Specialty Access and Affordability Solutions.
GLP‑1s dominated attention yet again, but not just because of demand. They exposed a structural weakness. As volume surges, coverage rules continue to vary widely, and affordability needs to be visible earlier and more often for patients. Traditional access paths, like phone and fax, have strained under the increased load. One key learning from AXS26 highlighted that when access models aren’t designed for scale, fragmentation fills the gap. For future launches, access strategies that succeed will integrate scale from the start and leverage partners with established networks and deep health plan and PBM connectivity in addition to insights that supports patients staying on therapy.
Interest in AI has shifted away from pilot programs towards real solutions that integrate and drive results. The question is no longer whether AI is part of the equation, but whether it changes outcomes patients and providers feel. The most compelling use cases were embedded directly into workflows, improving prior authorization submission quality, reducing back‑and‑forth, and accelerating decisions without adding another layer to navigate. In specialty care, everything starts with reliability, especially for clinicians who live inside these workflows every day. AI and automation only work when they are transparent and well-governed. Done right, AI can support access processes while operating within established clinical and administrative oversight frameworks. Done wrong, it introduces risk, erodes trust, and adds friction at the exact moment patients need clarity and speed.
Next‑generation therapies represent the upper bound of access complexity. High cost, narrow eligibility, site‑of‑care constraints, and one‑time dosing leave little tolerance for delay. In many cases, missed initiation windows can’t be recovered. What distinguishes these therapies isn’t novelty, it’s precision. Eligibility verification, benefits confirmation, authorization, and patient financial clarity must align almost simultaneously. At AXS26, there was broad agreement that gross-to-net (GTN) access must be designed into launch planning from day one. It can’t be retrofitted after friction appears. Connected, auditable infrastructure has become essential, no longer optional.
AXS26 demonstrated that access and affordability aren’t inherent obstacles to brand growth; when the challenges are met, they enable it. As innovation accelerates, biopharma must prioritize partners with an automated infrastructure to manage access complexity end‑to‑end, helping support a more connected transition from prescription to treatment initiation.
CoverMyMeds strengthens the access landscape, so that innovation doesn't stall in the moments it matters most. To learn more, watch our Innovation Roundtable for a deeper discussion on how our access readiness is shaping the market.
