When patient support was introduced two decades ago it was more about reactive services for brands facing closed formularies than the patients themselves. As a result, this “support” has only reached a tiny proportion of patients and left prescribers burdened with administrative tasks while brands lose ROI.

However, today, direct-to-patient (DTP) programs are redefining the manufacturer’s access operating model. They are not mere add-ons. They are a new infrastructure. One that is measurable, scalable, and defensible under both policy and consumer scrutiny.

When done right, this new infrastructure changes the balance sheet of the prescription journey. Instead of simply counting how many patients start therapy for selected brands, manufacturers can quantify how efficiently, transparently, and sustainably a patient moves from awareness to refills across an entire portfolio.

The DTP balance sheet measures access, friction, and trust.

Increased access

Legacy systems often result in delays from signature to first prescription fill––leading to physician and patient frustration and the risk of worsening outcomes. A particular pain point is prior authorization (PA). More than nine in 10 physicians say PA delays patients’ accessing necessary care and eight in 10 say PA results in their patients abandoning a recommended course of treatment.¹

DTP compresses that timeline to days, or even hours, by integrating benefit verification, affordability routing, and fulfillment visibility into a unified platform. Validating prescriptions upfront prevents incomplete or incorrect submissions from reaching payers. This eliminates common points of friction, leads to faster PA cycles, and increases dispense rates by 50%.²

The benefits also extend far beyond first-fill––every percentage point increase at these early-stage compounds through refills, adherence, and long-term brand equity. For example, an integrated DTP model can deliver refill success one and a half times higher than the national average.³

A further benefit is that, because DTP frameworks operate across insurance, cash-pay options, and copay assistance, access is no longer defined by payer restrictions alone. Instead, access is defined by patient readiness. This allows us to act when motivation is highest, meet people where they are, and help them achieve their desired health outcomes.

Decreased friction

Traditional hubs are manual and capital intensive. Handoffs, data silos, and delays increase drop-off risk and put formulary access at risk. DTP frameworks do not just absorb this friction––they eliminate it.

Instead of relying on manual fax loops and opaque call trees, API-driven orchestration provides verified, timestamped steps which any stakeholder can audit. This results in fewer surprises for patients, fewer callbacks for providers, and fewer black boxes for manufacturers. This in turn accelerates time-to-therapy, helps reduce abandonment, decreases service-cost-per-start, and automatically strengthens compliance and documentation.

That last point is crucial in the era of Most-Favored Nation (MFN) drug pricing and the Inflation Reduction Act (IRA). Today, traceability is as valuable as the increase in prescriptions filled.

Decreasing friction is not just about operational hygiene, it also provides vital risk mitigation and reputational insurance.

Trust earned

Legacy patient support was not designed to deliver a modern consumer-grade experience. Patients today want fast access, transparent pricing, and proactive support. Every time they hit an unnecessary administrative hurdle, face delays, or end up paying too much for their medication, we risk lowering trust.

Yet this is what is happening every day. Up to 67% of patients with a chronic condition fail to get new prescriptions filled within a year because of issues with PA, embedded step therapy, and formulary controls.⁴ Nearly half of adults in the US say it is difficult to afford healthcare costs.⁵ With trust paramount in healthcare, there is also increasing scrutiny from governments over not just affordability but also transparency in the prescription journey.⁶

Fundamentally, every transaction is a test of belief. Consumers want to know––will this brand make it easy and affordable for me to access my medication? DTP programs answer this question by providing clear, trusted information on cost, channel, and status. By automatically implementing billing efficiencies they make medication more accessible and affordable for patients. This technology-enabled approach is reinforced with human support to convert frustration with a broken system into confidence in a frictionless prescription journey.

The effects of this increased trust are cumulative. As patient satisfaction and understanding rise, call volumes decrease and persistence increases. Customer satisfaction scores for a DTP platform are more than 90% compared to 77% industry wide.⁷ Higher satisfaction is, in turn, associated with better compliance and improved persistence.⁸

This increased trust also builds the foundation for next-generation real-world evidence. When patients trust the system, they are more likely to consent to share data. This leads to richer insights and shorter cycle times.

Transparency pays dividends not once but twice––in both enhanced experience and enriched evidence.

Conclusion

Early adopters are already seeing that DTP is not a campaign. It is a capability and should be treated as core infrastructure governed by clear service level agreements, built on open data standards and measured with the same rigor as commercial sales.

The DTP balance sheet includes fill rate, days on therapy, persistence, patient satisfaction, and audit readiness. Each of these metrics helps to tell the same story––when access increases, friction decreases and improves trust. This allows us to move forward together to unify the prescription journey from provider to patient.

DTP rebalances the pharmaceutical economy towards the patient. What began as support in name only, is now crucial to retain competitiveness. The future will belong to brands that make every step in the prescription journey as frictionless, direct, and transparent as it can be.

Sources

1. AMA. July 18, 2024. Exhausted by prior auth, many patients abandon care: AMA survey.
2. IQVIA Institute Report. April 30, 2025. Understanding the Use of Medicines in the U.S. 2025.
3. IQVIA PBL. June 2023 – May 2025. Persistence of commercially insured patients taking chronic medications at month 3.
4. IQVIA. July 29, 2025. The Impact of Formulary Controls on Commercially Insured Patients in Five Chronic Therapeutic Areas.
5. KFF. October 8, 2025. Health Care Costs and Affordability
6. The White House. September 9, 2025. Memorandum for the Secretary of Health and Human Services the Commissioner of Food and Drugs.
7. American Customer Satisfaction Index. 2024. Drugstores Satisfaction Benchmark.
8. Barbosa CD et al. January 13, 2012. A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence.