The complexity of demands on Market Access teams has increased in recent years, between introducing innovative therapies targeting smaller populations and higher bars from Payers and PBMs.

Now, drug manufacturers are bucking up. According to the IQVIA Institute, the prescription abandonment rate has reached 27 percent, or $76 billion annually, in specialty drugs alone. This squandered revenue has led manufacturers to increase their focus on the complex, nuanced patient journey.

As a result, manufacturers are finally taking ownership of their patient journey technology stack. Their willingness to absorb painful system integration cycles have brought many to the conclusion that patient support services technologies should not and cannot be relegated to one-off patient-support vendors.

The lesson was learned the hard way, following a series of 2- to 3-year cycles in which manufacturers switched hub and copay service providers, requiring them to decouple their mission-critical systems from the vendor du jour and rewire with the new one.

In the years leading up to the COVID-19 pandemic, drug manufacturers went back and forth between in-sourcing and out-sourcing parts of their patient support operation. We expect a similar trend in 2023, albeit with a more technological focus. The in-sourcing will be driven by new patient journey categories (e.g. gene therapies), COVID’s impact on HCP and patient behaviors, and of course, by the proliferation of new software solutions.

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What will happen:

  1. In-sourcing the patient journey tech stack: Drug manufacturers will continue to bring their patient customer relationship management (CRM) software under their own roof. Manufacturers who had to rely on their hub’s CRM, for instance, are gradually transitioning the CRM in-house, often while maintaining the same contractor. Expect Salesforce to remain a dominant player.

  2. Patient Services teams will demand tech stack flexibility: With new types of therapies coming to market (e.g. gene therapies), manufacturers will accelerate their hunt for flexible technologies that can support a wide variety of use cases. Consider a family whose loved one was prescribed gene replacement therapy. They must identify a treatment center, then coordinate travel, post-procedure support, and other patient services. Paired with a friendly user experience, the right technology can ease the entire family’s logistical and emotional rollercoaster.

  3. Manufacturers will uninstall patient-support apps:  According to a 2021 survey by, 79 percent of users will abandon a transaction when they’re forced to download an app. This trend is reinforced when dealing with the sickest patients. [1] As one Pharma exec told us:  “A patient has stage-4 cancer and we are asking them to download an app?!?” Further, the app user experience is now readily available as a template for mobile Safari and Chrome. This liberates the manufacturer from the need to invest in app development, and enables them to focus on moments of value creation along the journey.

  4. Mobile is dead, long live mobile: In our study of 50 patient-facing brand sites, 82 percent of traffic came from mobile browsers as opposed to desktop. [2] Further, as Twilio quoted, SMS open rates remain sky-high. In short, patients and caregivers will continue to transact on mobile ― not just at the store, but also the doctor’s. [3] Drug manufacturers will have to be there. While apps have struggled, the bar has been raised for the patient’s browsing experience. Web 1.0 microsites with forms to fill out will struggle to “convert” users. Further, SMS-only interactions will be replaced by beautiful, templated interactive mobile experiences that do not require any coding.

  5. Increased patient journeys focus on “moments of value creation.” Value-creating moments along the patient journey can involve everything from activating copay cards, signing consent forms electronically, speaking to case managers, or tracking and receiving shipments. Today’s patient does not answer calls from unknown numbers, prefers texting to any other form of communication, and would dodge app downloads at all cost. Manufacturers must therefore accelerate the adoption of technologies to support specific transactions, or moments, that remove the biggest speed bumps for patients.

  6. API’s will un-silo the patient journey. As tools become patient-journey native and more interoperable, drug manufacturers will gradually replace the likes of DocuSign and Adobe signature forms with API-enabled native flows that are better tied to the adjacent steps in the patient journey: HCP referrals, copay card activation, etc.

  7. The digitization of ePrescriptions, and patient referral and enrollment forms will continue. We will still see anywhere from 40 to 80 percent of forms getting faxed by prescribers in 2023. This is not only a major efficiency opportunity for manufacturers and their software providers, but also an opportunity to shorten time to therapy through faster information collection and benefit verification cycles.

What will NOT yet happen in 2023:

  1. Artificial intelligence will not replace hub agents. Yes, AI is inching its way to patient services, most notably with Infinitus Systems replacing benefit verification calls with AI. However, our beloved patient services industry is still grappling with more basic functionalities. It will take time for the AI avalanche to materialize in our part of the world.

  2. Digital therapeutics and patient support technologies will not intermingle yet. While these two categories might look like siblings, they are in reality more like second cousins twice removed.  Given the regulatory hurdles, the different buying budgets and org-chart groups, drug manufacturers will continue to purchase digital therapeutics and patient support platforms from different vendors.

  3. “Digital” will not yet integrate fully into the pharma business and into the patient support services teams, who will often continue to “outsource” this know-how to a separate part of the organization. This will continue to be a missed opportunity to leverage digital as a core lever in the business, as well as to inch the culture towards digital innovation.

What we are most excited about
The most exciting news is that we are increasingly seeing manufacturers including technology interoperability requirements in their Hub and Copay RFPs.  This means that manufacturers are taking ownership of their patient journey technology stack, knowing that the sands will continue to shift.

[1] Khosla R. Market Study: Mobile Customer Experience Issues Highlight Use Cases for iOS App Clips. February 1, 2021. Online. Last accesses on January 16, 2023.
[2] Dudley D.The Age of the Desktop is Over. September 16, 2021. Online. Last accessed on January 16, 2023
[3] Higbee B. How to Maximize Your SMS Marketing ROI June 6, 2022. Online. Last accesses on January 16, 2023.

Featured image Photo by Behnam Norouzi on Unsplash

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