Once viewed as an experimental approach reserved for niche therapies, direct-to-consumer (DTC) prescription drug models are starting to become a strategic priority across the pharma industry. With expanding policy support, digital infrastructure, and patient demand, DTC models are driving one of the most significant shifts in modern-day healthcare. In a conversation with Pharmaceutical Executive, CaryHealth CEO Areo Nazari discussed the evolving access landscape and how the next wave of DTC initiatives could permanently alter the balance between innovation, patient experience, and policy reform.

Altering the provider-to-patient structure

The emergence of DTC pharmacy models has changed the long-standing power dynamic between manufacturers, providers, and intermediaries. Nazari notes the immediate effects DTC Rx had on redefining pricing leverage across the supply chain, saying, “It opens up the ability for the government to work directly with pharma companies and negotiate prices, which changes the entire pricing equation. It also gives pharma companies more leverage by allowing them to optimize pricing efficiency and cut out middlemen such as wholesalers or, in some cases, PBMs (pharmacy benefit managers).”

According to Nazari, that efficiency can translate into tangible benefits for patients, including lower costs, faster access, and a more direct connection to the manufacturer. “Patients now have the ability to interact directly with pharma companies, and that’s mutually beneficial,” he says. “It’s not applicable to every therapeutic area, but for chronic conditions and oral medications, it’s a real opportunity.”

Establishing safeguards

As direct-access programs gain traction, questions of data security, compliance, and patient privacy have taken center stage. Nazari emphasized the importance of neutral infrastructure partners in maintaining trust. The evolving regulatory framework, he adds, will require continuous collaboration between legal, compliance, and technology teams.

“Pharma obviously wants as much data as possible, and often for good reason, to benefit the patient," says Nazari.

“But,” he continued, “attorneys and compliance officers are always evaluating: What are the limits? What does the [business associate agreement] cover? How should these programs be structured? Ensuring it’s done in a compliant way will always be top of mind.”

The pharma sector is witnessing what Nazari describes as “a Netflix-like moment” for drug manufacturers.

“Much like in media, Netflix controls the content and now goes directly to consumers,” Nazari tells Pharm Exec. “We’re seeing the same in pharma, where companies own the molecules and now want to control the patient experience.”

Redefining the supply chain

Some of the most intriguing aspects of these new DTC initiatives stem from the breakdown of traditional silos between telehealth, pharmacy, and fulfillment.

“Historically, pharma programs were fragmented—you had one vendor for telehealth, another for pharmacy, and yet another for engagement,” says Nazari. “What we’re seeing now is the recognition that patients want a unified, seamless experience from start to finish.”

Automation, supported by generative artificial intelligence, is being tested in areas ranging from patient engagement to order fulfillment. Nazari describes it as a “cascade of automation” and says that’s occurring from the moment a prescription is received and through the entire process to when the order is shipped.

“The human touch remains where it matters most in clinical decision-making and pharmacist oversight. But everything else, front-end and back-end, is built for speed, accuracy, and scale,” he explains.

A fundamental shift

Nazari was asked whether direct access represents a temporary experiment or a lasting realignment. In his response, he made it clear that he views the shift to DTC as a fundamental change.

“There are pharmacy deserts emerging across the country, PBMs are under pressure, and digital ecosystems have matured,” he says. “Add government negotiation and employer partnerships, and you’ve got all the ingredients for a new era in pharma.”

Nazari also predicts that while not every therapeutic area will adopt the model, the acceleration of DTC Rx will be a defining feature of the industry’s evolution.

“Working directly with government or self-insured employers just makes sense,” he says. “The fewer intermediaries involved, the more efficient and transparent the process becomes.”

The future of DTC models

In the ever-evolving pharmaceutical landscape, Nazari sees DTC models not as a disruption, but as an adaptation or natural response to a market demanding transparency, convenience, and personalization.

“At the end of the day, it’s about meeting patients where they are,” he tells Pharm Exec. “Giving them options, whether that’s home delivery, same-day fulfillment, or pickup at their local pharmacy. The future of pharma will be defined by how well we customize the experience while keeping it compliant, connected, and centered on the patient.”