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1rem

 podcast episode, UpScriptHealth founder and CEO Peter Ax discusses:

The impact of tariffs on the pharmaceutical industry, highlighting branded and generics medications

How tariffs could lead to strategic supply chain changes, including potential US manufacturing shifts

How digital health platforms can help potentially offset tariff impacts

The importance of telehealth in ensuring medication availability

Strategic partnerships between digital health platforms and pharma companies to improve patient care and access

Podcasts

Peter Ax, founder & CEO of UpScriptHealth, discusses the impact of tariffs on the pharmaceutical industry and how digital health platforms could potentially help offset them.

Tariffs and Drug Prices: Understanding the Impact on Pharmaceuticals

In this episode of the Pharmaceutical Executive podcast, Bill Grambley, CEO of AllazoHealth, explores:

How AI can potentially revolutionize patient engagement and adherence

Utilizing patient-level data and predictive modeling

How AI can identify individual needs and preferences

The importance of ethical considerations and data privacy when leveraging AI in healthcare

Bill Grambley, CEO of AllazoHealth, delves into the potential of AI to revolutionize patient engagement and adherence.

Revolutionizing Patient Adherence: Leveraging AI for Personalized Engagement

The recent shift in Health Economics and Outcomes Research functions across major pharmaceutical companies highlights a lack of understanding of its value. 

HEOR: From Proving Product Value to Proving Its Own Worth

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses ethical considerations surrounding AI use in medication access, and how the industry can ensure that these technologies are used responsibly and equitably.

Ethical Considerations for AI Use in Medication Access

 video interview, Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses "The 2025 Medication Access Report." She highlights gaps in data-sharing and cross-functional collaboration as major bottlenecks that cause delays, rework, and increased patient burden. Chiang shares that only 3% of patients utilize support programs due to a lack of awareness. A large majority of the report's respondents plan to expand funding for patient support programs within the next 5 years due to large number of new therapies expected to come to market.

Pharmaceutical Executive: With the rapid advancement of AI, what are the ethical considerations surrounding its use in medication access, and how can the industry ensure that these technologies are used responsibly and equitably?


Ethical considerations with the use of any technology tool that is going to replace human decision making is something that we are quite focused on as an organization. We believe in responsibility and that AI should only be a complementary tool until we are very confident in the fair and unbiased nature of the AI and the diverse data sets that it’s pulling from.

For today and the near future, we believe the best position for AI is where technology enhances clinical support. The human component of care continues to be the most important element of making sure that the right clinical decisions are made for patients. We want to make sure that AI is used to support, not replace. The human touch in healthcare should persist in the most relevant clinical support services going forward.

We also believe in the protection of private information. Building those diverse data sets while maintaining patient privacy is a critical element to consider as an industry. While thinking about patient privacy, we also must think about transparency in decision making. A patient should know how a decision was made relative to their care. They should fully understand and be able to ask questions about how the process solicited this type of support for them.

The ability to protect privacy and maintain transparency in the decision-making process for patients is a critical factor that the industry needs to think about.

Videos

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses ethical considerations surrounding AI use in medication access and how the industry can ensure that these technologies are used responsibly and equitably.

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, addresses patient and prescriber expectations for digital health tools.

Balancing Technological & Human Support in Medication Access

Pharmaceutical Executive: The report addresses patient and prescriber expectations for digital health tools. How do you see the balance between technology, including AI, and human support evolving in the context of medication access?


 AI has to bring a fair and unbiased approach when it comes to medication access. The emerging use of AI, which is taking decisions out of the hands of humans and clinicians, is not ideal. It needs to strike the balance of support-not-replace. The same is true for technology and balancing the need for easy, quick digital tools that support patients finding information faster and getting education when they need it most with the need to speak to a human and have more clarity.

The utility of a digital tool when you’re overwhelmed, ill, and don’t have a good support system is where a paradox comes into play.

How do we provide the just-in-time tools for patients with some digital sophistication, while still recognizing that there is going to continue to be a significant need for patients to seek help through a variety of channels? That’s where patient support program engagement comes in. You are able to balance tools for patients who want to use them with patients who want to speak to humans.

Restrictive programs are something I would caution pharma against. There’s not only one way to do things, and there are efficient ways to have human interaction. The industry really needs to look at that. How can we ensure that the right patient gets the right resource? AI can help us understand that fragmentation and the dimensionalization. When there’s complexity with a patient population, AI could begin the journey and know when to pass things to humans.

We need to strike that balance between using AI and identifying when a patient needs to talk to a human.

If you’ve used chatbots and other AI tools that exist today, there’s a point when you refine as much as you possible can and you’re still unsatisfied. We need to have excellent identification through AI of where the journey begins and ends. The technology can only get us so far and we need to offer patients the flexibility to receive the support they need in the manner in which they feel is best for them.

The fair and unbiased approach is going to require significant and diverse data sets. AI is only as good as the information it’s feeding from, so we need to make sure that we as an industry are looking at fair and unbiased data sets that we are making decisions from. Patients and providers also deserve to know how decisions are being made on their behalf. As an industry, that is going to be a challenge to us. Ensuring that we are protecting the privacy of the patient throughout that journey is paramount.

There’s great hope for AI in the ability to get patients to the support they need faster. There is work for the industry to do, however, in creating those fair and unbiased data sets.

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses how the industry leverages data and technology to identify and address affordability issues before they become a barrier to patient access.

Proactively Identifying & Addressing Affordability Issues with Predictive Analytics

Pharmaceutical Executive: How can the industry leverage data and technology to proactively identify and address affordability issues before they become a barrier to patient access? What role does predictive analytics play in this?


 The ability to be proactive in identifying and addressing those gaps requires a centralized data system and a greater ecosystem. The ability to leverage data requires that data to be comprehensive. Predictive analytics will run on strong data models, and in order to have those, you need a seamless experience.

How do we capture data along the patient journey, and how do we ensure that predictive analytics will help us analyze that data? It all starts with the ability to streamline the data. If we don’t begin to bring data sources together in real and important ways, we will not be able to properly allocate our resources and spending in pharma. There will be some forecasting and assumptions, but with some real-world data (RWD) integrated.

Think about the addition of an integrated data model with RWD and what that could do for better predictive analytics. Our assumptions would be lowered, and our predictions would be better. We would have optimized predictability for where the funding needs to be directed.

The second piece of that is you have better clinical outcomes if you can identify in advance. You will not have patients walking away from their prescriptions, which continues to be a challenge. We are also seeing significant increases in claims denials. About 73% of claims are denied. What do we do when claims come back denied?

With predictive analytics, there are affordability and co-pay types of expansion. There’s also focus and energy around overturning claim denials. How do we ensure that the claim was denied for righteous reasons? The ability to have all of the data integrated and run it through predictive analytics alongside RWD would help us improve clinical outcomes. Those patients will not be denied medication that they need and rightfully deserve.

Doing all of this more efficiently will remove costs from the ecosystem. There is significant fragmentation in all of the processes. To bring all of that data together to understand the market access for a single brand launch, bio-pharmas must piece together all of that information. Bringing data together and using predictive analytics with strong data models will help these companies do so more efficiently. It will take costs out of the system and speed patients onto the right medications. Healthcare providers will also spend less time waiting for the patient to get approved.

Kimberley Chiang, vice president of biopharma commercial solutions, CoverMyMeds, highlights gaps in data sharing and cross-functional collaboration as major bottlenecks that are causing delays, rework, and increased patient burden.

The 2025 Medication Access Report: Biggest Bottlenecks for Patients

 video interview, Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses "The 2025 Medication Access Report.

 She highlights gaps in data-sharing and cross-functional collaboration as major bottlenecks that cause delays, rework, and increased patient burden. Chiang shares that only 3% of patients utilize support programs due to a lack of awareness. A large majority of the report's respondents plan to expand funding for patient support programs within the next 5 years due to large number of new therapies expected to come to market. The report emphasizes the need for interoperability to streamline data and improve patient outcomes.

Pharmaceutical Executive: "The 2025 Medication Access Report" highlights significant fragmentation due to gaps in data-sharing and cross-functional collaboration. Can you elaborate on the most critical areas where these gaps are causing the biggest bottlenecks for patients? Specifically, what are the tangible effects you've observed on patient timelines and outcomes?


The lack of cross-functional collaboration in our industry adds fragmentation, and the seamlessness of the flow of data and the patient experience is impacted. Whenever we impact seamlessness, we impact the data that is arriving to help us make decisions or anticipate gaps in patient care. It causes delays, rework, and for the burden to fall on the patient to piece together all the elements to find the best way to cover some of the barriers that they’re experiencing in their own healthcare ecosystem.

The industry needs a cohesive and efficient approach that takes cost out of the system and adds data at the right time to help HCPs make the right decisions. We need to get out of our silos because we’re still in our own way. The lack of a clear view drives delays, creates barriers, and doesn’t look at the holistic needs of the patient.

For example, pharmacies and providers see certain needs, and pharma is paying for patient support programs to provide other needs for patients. However, we’re not talking to each other, and that’s where the challenge lies. If we’re looking for the best outcomes for patients and the urgency to get them the medications they need quickly and efficiently with all the education and support for the patient journey, we need to improve integration.

The second element is the knowledge gap. Forty-six percent and 52% of providers don’t know what’s out there for patients. They may be able to identify a gap, but they don’t know where to go to fill that gap. Therefore, the pieces still don’t get put together in that puzzle for the patient and causes delays in looking up what’s available for that patient in their community.

The knowledge gap worsens the delay and puts the burden back on the patient to put together the pieces of their healthcare ecosystem themselves.

The pharma industry is committed to increasing the funding for patient-support programs. But if patients don’t know about them, the utilization stays at about 3%. The majority of the biopharma customers we talked to said that in 5 years, they plan to expand support and funding for these programs. That’s based on the fact that important new therapies are coming to market in the next 5 years and 75% of them have increased complexity because they’re in the specialty realm.

Complexity drives gaps and needs. If we don’t bring this ecosystem together and have data sharing across the portfolio to reduce fragmentation, we are going to continue to see delays which effectively reduce outcomes for patients.

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, highlights gaps in data sharing and cross-functional collaboration as major bottlenecks that are causing delays, rework, and increased patient burden.

Peter Ax, Founder & CEO of UpScriptHealth, describes how his company's recent partnership with Pfizer is impacting drug access.

Insights on UpScriptHealth’s Recent Pfizer Partnership & Its Impact on Drug Access

 Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, discusses the impact of tariffs on the pharmaceutical industry, highlighting that tariffs will initially affect pharmaceutical companies, particularly those dealing with branded medications and generics. He notes that tariffs could lead to strategic supply chain changes, including potential US manufacturing shifts. Digital health platforms like UpScriptHealth aim to reduce friction and costs in healthcare, potentially offsetting tariff impacts. Ax emphasizes the importance of telehealth in ensuring medication availability and the strategic partnerships between digital health platforms and pharma companies to improve patient care and access. He also praises Pfizer's approach to delivering comprehensive care rather than just selling medications.

Can you share insights on how your recently partnership with Pfizer is helping to navigate current challenges in drug pricing and delivery, and how it might be relevant in a scenario with increased tariffs?

I can't speak for Pfizer, but I can tell you my view is that Pfizer has made a strategic decision to be a part of the solution for the problems in healthcare. It's not about selling a medication specifically to a patient, or it’s a lot about delivering care that that they can help solve the patient's problem. And that might mean that the patient is prescribed their drug. It might mean that the patient is prescribed 10 other drugs, but they're going to provide a mechanism that patients can access care and receive great treatment. And if you think about PfizerForAll, they're not focused in on the brand strategy down below where you're kind of looking at specific medications. They're focused on ‘Let's treat migraine headaches’, ‘Let's treat respiratory illnesses, including COVID’, ‘Let's treat whatever category of disease they want to treat’, and let's just be sure that we're helping patients get great access to care. I give Pfizer enormous credit for their approach to this, to this problem.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, describes how his company's recent partnership with Pfizer is impacting drug access.

Peter Ax, Founder & CEO of UpScriptHealth, explores ways that digital health platforms can assist pharma companies seeking to maintain accessibility and manage cost pressures. 

Digital Health Platforms as Strategic Partners for Pharma Companies

How can digital health platforms become strategic partners for pharma companies seeking to maintain accessibility and manage cost pressures?

The light bulb has gone off in pharma, right? Every single pharma company we're aware of is we're in some level of discussion with about the platform that works for them, the direct to patient solution that works. And what we've seen is a massive shift from sort of simple prescribing of a medication when someone has a migraine headache, letting them try, letting that patient try a new medication, perhaps, or shifting them to a different medication, to what is a really complex ecosystem of healthcare. We're now involved in platforms for pharma companies where we will send patients to injection centers or to infusion care centers. And so the level of care and the complexity of the of the patient flow is really evolving to a to a much more complex world that's sort of digital health 2.0

For us, the way we think about it, and the way that really helps pharma, if you think about all the problems we have in the current model for the delivery of care, right? Patients can't get appointments very quickly. Patients don't know what that cost of appointment is going to be for them. They don't know what their co pay is. They don't know what insurance is going to cover. They don't know if it's in network out of network. They oftentimes don't know where the fulfillment is coming from, and whether or not there's a supply of the medication that they need or the treatment that they need. We can solve all those problems by working with our pharma partners.

So, when a pharma company decides to be on the UpScriptHealth platform, it's not just a simple discussion of, we're going to put a button on your website. Patients will click on that button and see a telehealth provider. It's a much more complicated discussion about what is the patient journey, and how do we really make that patient journey a good experience, a positive experience, literally changing the paradigm of healthcare. I think, by the way, that's why Pharma is so interested in these platforms, because they realize they have to help be an instigation for the changing of how healthcare is delivered.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, explores ways that digital health platforms can assist pharma companies seeking to maintain accessibility and manage cost pressures. 

Jen Butler, Chief Commercial Officer of Pleio, discusses the significant threat of misinformation to public health and how emotional appeal plays a part.

The Threat of Misinformation on Public Health

 video interview, Jen Butler, Chief Commercial Officer for Pleio, discussed the significant threat of misinformation to public health, citing a 2021 report by former Surgeon General Murthy. She highlighted that 70% of false news is shared more often than true news due to its emotional appeal. Butler emphasized the importance of verifying health information by directly contacting trusted sources like Cleveland Clinic, Mayo Clinic, and Kaiser Permanente. She also noted the role of pharma in supporting patient communities and the need for media and health literacy. Butler also suggested that peer-to-patient platforms can enhance patient engagement and adherence, particularly for chronic conditions.

What kind of threat is misinformation to public health?

I have to say, nowadays, it's a huge threat. Back in 2021, former Surgeon General Murthy published a report about confronting health misinformation, and this was four years ago. He acknowledged at that point, and this was coming off of COVID and the pandemic, and the role of misinformation and causing confusion and anxiety and growing mistrust with patients and the population, and the impact that that can have over public health efforts. He raised concern in this report about the changing information environment, and at the time, four years ago, he was really focusing on the social media outlets that we have in place, and the fact that engaging content isn't always it. I should say engaging content is really emotionally driven, and therefore there's opinions behind it. In this report, there is a reference to a study that 70% of false news is shared more often than true news because it has that appeal. And while this is not about fake news, I think that can lend itself to health information also, because it's really important for patients when they're feeling vulnerable to be able to find information and not question. And as you're questioning information, you start to get more anxious and overwhelmed about what's coming next.

Fast forward from where we were four years ago to today with the impact and prevalence of TikTok and AI and we've just ignited where former Surgeon General Murthy was starting with his view of this, of this surge of misinformation for patients. It's really tricky. It's too easy for patients to go into their feeds and start finding patients like them in their feeds or hearing influencers. And no matter what you Google or search for in these in the in these forums, you're going to find opinions, and that it's the tricky part is, it's comforting. It's comforting to see patients like yourself offering opinions. And I think there is a great wealth of awareness that can be raised, but information and validated information can't be trusted upon opinions, and I think that's where it's a slippery slope.

When you add in TikTok and AI — and AI again, shows amazing opportunity for information collection, information seekers, but we know that AI also has quote, unquote hallucinations that you don't know what information you're getting back is credible. So, it's wonderful to have access to all this information. I mean, at least patients aren't in the dark like we were maybe 10, 15, 20 years ago, but we also have to make sure that we know how to handle the information that's coming our way and be able to separate fact from opinion.

In this Pharmaceutical Executive video interview, Jen Butler, Chief Commercial Officer of Pleio, discusses the significant threat of misinformation to public health and how emotional appeal plays a part.

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