Legal & Regulatory

Traceability

Trade & Brand Protection

Brand & Product Security

Business and Finance

Containers & Shippers

Devices

Software

Cold Chain

Commercial Channels

Artificial Intelligence

Digitalization

Real World Data

Data & Technology

Manufacturing & Packaging

Supply Chain

Logistics & Transportation

Commercialization

Pricing

Trade & Channel

Market Access

Opinion

Adherence

HUB Services

Patient Assistance Programs

Patient Support

News

Pharma Pulse

Academy

Publications

Partner Perspectives

Webcasts

Resources

Conferences

Conference Coverage

Conference Listing

Events

Videos

Podcasts

Editorial Podcasts

Subscribe

Business strategies and top news in the biotech / biopharma industry, including market access, supply chain distribution and more.

About Us

Advertise

Editorial

Contact Us

Do Not Sell My Personal Information

Privacy Policy

Terms and Conditions

Pharmaceutical Commerce

Instagram

Facebook

LinkedIn

Threads

Soundcloud

Spotlight

Digital Editions

Security

Topics

Data and Technology

Legal and Regulatory

Supply Chain Logistics

1rem

Articles

Latest 10-year BLS projection sees moderate growth in US employment—except for ‘top executives’

Long-Term Pharma Employment: Better Than You Think

Conventional training of sales forces is being complemented by executive-level training for corporate compliance

Training Executives for Marketing Compliance

People on the Move-April

Distance-learning modules lead to a “Certificate of Professional Competency”

CMR Institute Offers New Sales-Rep Training

People on the Move-March

Stable economics and growing healthcare concerns make Brazil one of the top emerging markets, with a current growth rate >20%

Entering the Brazilian Pharmaceutical Market

 interview, Renier Brentjens, MD, PhD, deputy director and chair of medicine at the Roswell Park Comprehensive Cancer Center, discusses:

How he has seen the field evolve since its inception, and what excites him most about its future

How the Roswell Park expansion helps improve patient access to CAR T-cell therapy

The key safety concerns associated with CAR T-cell therapy, along with how Roswell Park aims to mitigate potential risks

How Roswell Park is working to make CAR T-cell therapy more widely available

The steps needed to be taken at the regulatory and healthcare policy levels in order to support the broader adoption of CAR T-cell therapy

Renier Brentjens, MD, PhD outlines the evolution of the space, while offering ways to boost patient access to these treatments. 

Embarking on the CAR-T Journey

 interview, Brandon Newman, Xevant’s CEO and founder, explores:

The implications of the Inflation Reduction Act’s price negotiation provisions, and how these could result in ripple effects across the healthcare system

The role that pharmacy benefit managers (PBMs) and other intermediaries' play when it comes to determining drug costs, and how spread pricing is involved

How Xevant helps improve drug cost transparency efforts

Strategies for affordability Newman would offer the pharma industry that can be implemented immediately

Brandon Newman joins The Pharmaceutical Commerce Podcast to discuss the evolving role of PBMs, including the importance of drug price transparency. 

A Further Examination of Pharmacy Benefit Managers

A survey study takes a closer look into which medications patients would like to have deprescribed, along with the reasons and factors influencing that decision.

Reducing Polypharmacy in Older Adults

The Carlsbad plant is expected to accelerate both the development and commercialization of cell therapies. 

Thermo Fisher Scientific Unveils Advanced Therapies Collaboration Center 

Access USA converges in Philadelphia to explore new—and needed—solutions to boost patient outcomes.

Conference Connect: Progressing Patient Assistance 

A panel discussion uncovers ways to deliver personalized therapy ops in a timely fashion.

LogiPharma Europe 2025: Complex Novel Modality Preparation

The key strategies for reducing or eliminating post-prescription abandonment.

From Prescription to Patient: Four Ways to Increase Speed to Therapy 

Will Moving Drug Production to the United States Help or Hurt Patients?

 CEO of Theratechnologies, explains how Theratechnologies' operations have been impacted by recent US tariffs on Canadian goods, especially concerning the manufacturing and supply chain for its HIV therapy, EGRIFTA SV. The active ingredients used in EGRIFTA SV come from the US, travel to Canada for additional processing, and then return to the US for final assembly. As a result, the company faces tariffs on both the raw materials and parts of the manufacturing process that cross the US-Canada border. While the tariffs will increase costs, the company benefits slightly since the tariffs are applied to raw materials and intermediate steps, rather than the fully finished product, which would have resulted in a higher cost increase.

Theratechnologies is currently assessing the full impact of these tariffs on its supply chain, including effects on insurers, governments, and patients. Despite these challenges, the company remains committed to ensuring timely delivery of its therapies to patients, managing the increased costs as best as possible.

Levesgque also comments on the forecasted obstacles regarding the availability of specialty medicines for US patients; making the decision to reshore manufacturing processes; and much more.

Note: The FDA approved the company’s supplemental Biologics License Application (sBLA) for the F8 formulation of tesamorelin for injection on March 25. The new formulation will be commercialized under the tradename EGRIFTA WR and is expected to EGRIFTA SV.

What obstacles do you foresee regarding the availability of specialty medicines for US patients—as a result of supply chain challenges—and how can biopharma companies address these issues?

If you're manufacturing, you're really upstream, and you are looking for your first, contract development and manufacturing organization (CDMO). In light of this situation, now, you're going to try to get a CDMO that operates in the US, but if you're currently manufacturing elsewhere, this transition cannot happen on a dime. We're talking about years, we're not talking about months. There won't be any short-term solutions, and unfortunately, tariffs will apply and will will probably have an impact on the value of medicines. There's no other way.

Is the solution 100% to actually use a CDMO in the US? It could be, but again, I'm intrigued by the effect that it's going to have on pricing, and I think it will be a negative for us patients.

In the third part of his video interview with Pharma Commerce Editor Nicholas Saraceno, Paul Levesque, CEO of Theratechnologies, explains what the mindset be for companies who are just starting the reshoring process.

Why Patient Empowerment is Key  

 executive director at the Otsuka Patient Assistance Foundation, discusses two key sessions: "Establishing and Transitioning to a Foundation" and "Empowering Patients to Take Control of Their Healthcare." The first session focuses on the important aspects of transitioning to a foundation, emphasizing the risks associated with regulations and the need for robust patient support programs. The second session highlights the importance of guiding patients through their healthcare journey by removing barriers and enhancing their health literacy, helping them make informed health choices.

Thorpe outlines three critical factors when creating an independent patient assistance program (PAP) foundation: risk tolerance, conflict of interest, and funding stability. These factors are essential to ensure the successful operation and long-term sustainability of the foundation. She also stresses the importance of maintaining clear separation between the foundation and its core business operations, focusing on good stewardship and well-defined guidelines.

Thorpe emphasizes the significance of patient empowerment, noting that most patients struggle with understanding healthcare terms and concepts, with many having low health literacy. Empowering patients by improving their understanding of healthcare options is vital to help them make better health decisions.

Regarding digital innovation, Thorpe explains that while digital tools are crucial for patient engagement and literacy, they must be simple and engaging. Given the overwhelming digital landscape patients face, it’s important to create experiences that are easy to navigate and actively keep patients engaged, as prolonged use can be challenging. Simplifying digital interactions helps avoid patient fatigue and ensures long-term engagement.

How can foundations ensure that they maintain strong patient support while operating separately from their core businesses?

 In general, foundations should really have separation, and that separation is really focused in on two factors. Number one, good stewardship, and building cohesive guardrails and guidelines that offset those parameters for both the manufacturer as well as the foundation.

 Empowering patients is really important because patients do not understand healthcare in general. Nine out of 10 patients do not understand simple healthcare terms. Thirty-three percent of our population reads at a third-grade level, so health literacy is very important when building patient assistance programs, because we really want the patient to embrace their health journey and make good health choices. Without that education and that knowledge, they are at a disadvantage, and we want to broaden their awareness and their understanding so that they can engage in their health journey.

What role does digital innovation play in enhancing patient engagement and healthcare literacy?

 Digital technology is, of course, extremely important across all entities. We're really engaged with the digital innovation. With regard to foundations in patient support, understanding the patient journey is key. Digital innovation may or may not work for the patients that we serve. When you do have digital innovation, keep it engaging with what the patient is doing, what the patient is experiencing in their health journey, and then keep it simple. We want simplicity when we're talking to our patients. They are so engaged with all these digital components, that it's almost overwhelming, and so we want it engaging and simple. Keep it active. One of the biggest things is the boredom that happens—patients engage for a little bit, but not for a long term. And so, how do you keep it engaging, and how do you keep patients active in utilizing the digital tools?

In the final part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Rachel Thorpe, executive director at the Otsuka Patient Assistance Foundation, emphasizes the importance of the separation of core business and foundation, the value of patient empowerment, and the impact of digital innovation. 

Latest Conference Coverage

PAP 2025: Why Patient Empowerment is Key  

Where Does Healthcare Price Transparency Stand Today?

Turquoise Health’s SVP of market solutions

 describes how the recent executive order on healthcare price transparency aims to make pricing in the healthcare industry more accessible and understandable for patients. This initiative is a continuation of efforts by both the Trump and Biden administrations, with the goal of improving transparency around hospital and payer reimbursement rates. The central idea is to require all hospitals and insurance companies to publicly disclose their contractual reimbursement rates, meaning patients will have clearer insights into what insurers pay hospitals for services.

Historically, these prices were not transparent, making it difficult for patients to understand the actual costs of healthcare. While earlier laws introduced in 2019 improved pricing transparency, there have been enforcement challenges. The new executive order seeks to address these issues by ensuring hospitals and payers comply with transparency requirements. A key update in the order is the inclusion of prescription drug prices, which had previously been excluded from transparency rules.

The broader impact of this order is to make healthcare pricing as transparent and predictable as other consumer services, like booking a flight or a haircut. Although the system is not fully realized yet, this executive order lays the foundation for a future where patients can easily access upfront pricing before seeking healthcare services. This transparency is expected to simplify the decision-making process for patients, ultimately fostering a more informed and competitive healthcare environment.

O’Dell also comments on the biggest challenges healthcare organizations currently face in terms of price transparency; where the healthcare industry currently stand in terms of compliance with price transparency regulations; specific strategies Turquoise Health provides in order to help healthcare providers navigate and meet the new price transparency requirements; and much more.

Where does the healthcare industry currently stand in terms of compliance with price transparency regulations, and what steps need to be taken to achieve full compliance?

There's been a lot of evolution over the course of the last four years, so when these regulations came out, only 20% to 30% of hospitals were complying, and I really think they hoped this is going to go away. “We don't want to publish our rates. I hope this just falls by the wayside.” Lo and behold, the Biden administration comes in and starts enforcing it and says you actually have to publish your rates.

We saw a huge uptick in compliance over the course of the last four years, and now, 95-plus-percent of hospitals publish a machine-readable file. You'll see that sometimes called an MRF. What that means is that is just the standard format that they publish their rates in. Ninety percent of all payers also do the same thing. We see good compliance in that the files are out there. They're saying, “we've complied, here's the file.”

The area where I think there's room for improvement is what is in the actual file. We saw a huge improvement come in July of 2024, where hospitals had to start publishing their exact drug rates, the units of the drug, how they got reimbursed—they had to do it in a standard format, so the quality of the file improved immensely. Just because you have a file out there doesn't mean it's very useful. Over time, they've added new regulations to say we're going to enforce this and we're going to make it more standard. That's exactly, what this executive order is trying to do. It's saying we're going to enforce it, we're going to make it more standard. If you're one of those 5% that's not doing it, you're going to get a letter. If you're not doing it in the standard way that we published, you're going to get a letter. Perhaps most importantly, if you are a prescription drug payer or a prescription drug provider, it's time to start publishing your rates too. There's a term that I think is kind of a boring term when you say it, but will become very important to this, which is called historical net price. And that's what we don't have for drugs today, and that's what I think that the executive order is trying to bring out.

Historical net price just means, what is the actual price of the product after you give discounts and rebates? I won't try to explain it, but the drug value chain is incredibly complex. There're lots of middlemen, per se, and each middleman is taking a little bit of the drug price. They're saying, I'll take a little rebate, or I'll take a little discount along the way.

Historical net price is effectively just a complicated word to say, you set a sticker price on a drug, but what did it actually get bought for by the doctor's office who's going to put it into the patient? So that difference is historical net price, and what your historical net price is can be than what my historical net price is, so you might be getting a different contract discount rebate than I am, and that's still to this day, completely invisible. It’s very difficult to make prices public or to help a consumer understand what they're going to pay for something if we have no idea what the drug price is that the PBM, pharmacy, or payer are going to pay or get reimbursed for something.

In the third part of his video interview with Pharma Commerce Editor Nicholas Saraceno, Chris O’Dell, provides an update on where the healthcare industry currently stands in terms of compliance with price transparency regulations, and what steps need to be taken to achieve full compliance.

Building a Thriving Culture

, Kimberly Westrich, MD, chief strategy offer at the National Pharmaceutical Council, describes how in response to rising healthcare costs, employers have turned to high-deductible health plans and higher out-of-pocket (OOP) expenses, causing patients to pay more for healthcare. To help alleviate this financial burden, manufacturers offer copay assistance programs, which are aimed at improving medication adherence and preventing disease progression. However, insurers have introduced cost-shifting programs such as copay accumulators, maximizers, and alternative funding programs (AFPs) to manage these costs.

Copay accumulators redirect the value of copay assistance to the insurance plan instead of counting it toward the patient's OOP max or deductible. This means that patients face surprise copay costs once the copay assistance runs out, essentially "double dipping" as the plan captures the benefit without applying it to the patient's financial responsibility.

Copay maximizers also shift assistance from the patient to the plan but manipulate the patient's copay to extract the maximum benefit from the copay assistance. While the copay assistance helps with a specific medication, it doesn't count toward the patient's deductible or OOP max for other expenses, leaving the patient responsible for other costs.

Alternative funding programs (AFPs) are more complex. In these programs, certain specialty medications are removed from insurance coverage, and patients must enroll in an AFP. They work with a third-party vendor to obtain the medication, often through manufacturer assistance, charity programs, or international pharmacies. While the AFP may provide the medication, it can be a slow and confusing process, and patients may not qualify, leaving them to pay out of pocket or forgo the medication. These cost-shifting strategies aim to manage healthcare expenses but can create additional financial and logistical challenges for patients.

Westrich also comments on how these accumulators, maximizers, and alternative AFPs are impacting patients, manufacturers, and healthcare ecosystems; sessions that have caught her eye; and much more.

What other sessions have caught your eye at Hub and Specialty Pharmacy Models East?

Unfortunately, I wasn't able to be here for the entire conference. I really wish that I could have been, but I did have the fortune to attend the session—which was immediately before my session—and Dolores and Amanda from EMD Serono talked about their thriving culture.

This is the kind of session that you might not expect to sit in at a conference like this. I personally really enjoyed it. I have multiple hats at the National Pharmaceutical Council (NPC), and while one of my hats is looking at the employer-sponsored insurance world and doing policy relevant research, one of my other hats is related to culture, and I oversee our culture initiative at NPC.

Last year, we were chosen as a great place to work, and that's been really important and exciting to me, so in this particular session with Dolores and Amanda, I was really interested in hearing about the things that they've been doing to deliberately have an open culture, a culture that has shared values and cultural curiosity. It was really interesting for me to hear how another organization approaches it, to have that overlaid with this particular conference, because they also wove in some information about their PAP program and how all of this fits together, so I really enjoyed hearing that.

 anniversary last year, and I believe that one of the reasons that we are so successful—we have such longevity as an organization—is the focus that we put on our culture. I'm excited to take some of what I heard from Amanda and Dolores back to the office with me, and share some of their ideas with my colleagues and see how we continue to raise the bar—as Amanda and Dolores said today—on excellence.

In the final part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Kimberly Westrich, chief strategy officer at the National Pharmaceutical Council, comments on another presentation that has caught her eye at the conference. 

Hubs East 2025: Building a Thriving Culture

Pushing Back Against Cost-Shifting Programs

What aspect of your presentation would you have wanted to dive further into?

One thing that I really would have liked to have spent a little bit more time on is this idea of what can we all do to help push back against these programs. There's something that everyone can do, so for employers, I would call on employers to really assess the ethical and the legal considerations, and to really think about whether or not these cost-shifting programs are meeting their objectives, because I believe if they really take a careful look at the considerations, the research, the impact, they will land on the side of ‘no, these are not programs that we want to be implementing.’ That's what employers could be doing. In terms of health plans, I wish health plans wouldn't use these programs at all. If they are going to use them, they should be transparent, There should be a way for patients to know I'm enrolled in an accumulator program. I'm enrolled in a maximizer program. This is what that means. This is how it's going to impact me.

I call on health health plans to be transparent. Government regulators can issue that tri-agency guidance that we're waiting for, which I would hope would support the patient copay assistance, counting towards the patient cost sharing, that's been in limbo for a while. Patients need that rule to come out, and they need it to be enforced.

Then finally, researchers can continue to do the research to look at what the impact of these programs are. We do have some research showing the harm that can come to patients as the disease progresses, as they're waiting, along with the potential health inequities. The more research that we have that definitively shows to all of these stakeholders the harm that these programs can cause, then the more evidence and ammunition we all have to curtail or stop their use.

In the third part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Kimberly Westrich, chief strategy officer at the National Pharmaceutical Council, details the aspect of her presentation that she would have wanted to dive further into.

Hubs East 2025: Pushing Back Against Cost-Shifting Programs

A Change in Healthcare Education and Provider Awareness

, Colin Banas, MD, DrFirst’s chief medical officer, describes have many Americans face significant challenges in accessing GLP-1 drugs due to their high cost. Despite the growing popularity and usage of these medications, which were originally developed for diabetes treatment, the price remains largely unchanged. Even with insurance coverage, patients often encounter co-pays or out-of-pocket expenses upwards of $500 to $600, making the medications unaffordable for many. Research indicates that once out-of-pocket costs exceed $100, medication adherence drops dramatically, further limiting access.

Additionally, insurance companies frequently require patients to try other medications first, a process known as step therapy, which can delay access to GLP-1 drugs. The drugs' weight loss benefits have garnered attention, but insurance companies still primarily cover them for diabetes treatment, leaving individuals seeking them for weight loss without coverage options. Moreover, as ongoing research uncovers more potential benefits of GLP-1 drugs—such as their positive effects on cardiovascular disease, Alzheimer's, and chronic kidney disease—insurance policies have not yet adapted to these expanded uses. As a result, many Americans who could benefit from these drugs for conditions beyond diabetes find that coverage is not available.

Banas also comments on patients turning to direct-to consumer (DTC) platforms following insurance denials; rumors of DTC advertising being banned; and much more.

What are your thoughts on the rumors that RFK Jr. could potentially ban DTC advertising?

As a provider it might be mixed, but there's actually an interesting consequence of DTC ads, and it is conversation and it is education, meaning, as a provider, I am also exposed to what my patients are being exposed to. I see the advertisement at the Super Bowl, or the flyer in the magazine or the web page. A lot of these therapies, a lot of these drug classes, are brand new and accelerating so quickly that it is actually very hard to keep up.

In a roundabout way, if I see that, and if I'm bombarded with it as a provider, I actually take that as a cue to, ‘oh, I need to educate myself,’ not necessarily on that drug in particular, but on that therapy class. The reason is, ‘wow, there's something new that's out there. I should be on top of it,’ and, ‘oh, I think I'm going to get questions about this.’ I do think that's an interesting side effect of DTC.

The other thing I'll say about RFK—there are a lot of things on pause right now. There's a lot of trepidation, especially in the health IT world. What is going to happen with existing road maps, around interoperability, around some of the CMS initiatives that providers are participating in? I will say it does seem to be a tech-forward administration, and so I do think there's going to be advances—maybe even accelerations—in artificial intelligence, hopefully in interoperability, and the digitization of the medical record. Because a lot of these things can't be accomplished without data, and you can't get the data unless you're collecting it, aggregating it, and using it in an appropriate way.

In the final part of his video interview with Pharma Commerce Editor Nicholas Saraceno, Colin Banas, MD, DrFirst’s chief medical officer, shares his thoughts on the rumors that RFK Jr. could potentially ban DTC advertising.

Breaking Down the New Executive Order on Healthcare Price Transparency

Can you explain the key provisions of the recently released executive order on healthcare price transparency and how it will impact the healthcare industry?

These executive orders are about price transparency, and this is not a new concept for the Trump administration or for the Biden administration for that matter. This happens to be one of the few bipartisan things perhaps that's out there. In essence, what they want to do is make all hospitals and all payers make all of their contractual reimbursement rates public. Those are complicated terms if you're not in the industry, but it basically just means, what is your insurer, as a patient, pay to the hospital for the service that you received? As wild as this sounds, until these price transparency laws were out, none of that ever existed.

That was all a guessing game, and no one had any visibility into it. Over the course of the last four years, since the first version of these laws came out in 2019, we've seen a lot better prices, and we've seen a lot better data on these—what does the payer pay to the hospital?

Why are we talking today? Why does this new executive order even need to happen? It's because first they feel that the laws have not been enforced enough. They're saying, these are good laws, but we need to really make sure that hospitals and payers are doing this, and we're going to enforce it if they're not doing it. The second thing that comes through is drug prices. Hospitals and insurance companies had to make all their rates available, but somehow, the pharmacy benefit drugs, or prescription drugs—as they reference in this executive order—squeaked away and didn't have to comply with the regulations.

They're coming back and saying, we're going to enforce and we're going to make sure that drug prices are visible. What does this mean for the whole healthcare industry? I actually agree with what I think the government believes here, which is that it makes it easier for a patient to understand what they're going to pay for healthcare services before they go in. They use this term of “guaranteed upfront prices,” and that's their government speak for saying it's as easy to go get healthcare services and know what you're going to pay as it is to book a flight or go get a haircut or whatever example you want to use—that's what they're going for. We are not there yet, but these are the building blocks and foundation that they're using to get there.

In the first part of his video interview with Pharma Commerce Editor Nicholas Saraceno, Chris O’Dell, Turquoise Health’s SVP of market solutions, outlines the key provisions of the recently released executive order on healthcare price transparency.

Creating an Independent Patient Assistance Foundation 

What factors should be considered when creating an independent PAP foundation?

So with regard to how to transition a foundation, or if you're thinking about transitioning to an external foundation, there are three factors that you have to think through. One is risk tolerance—what the manufacturer’s risk tolerance is, what the future foundation’s risk tolerance is.

Secondly is conflict of interest. What are the some of the conflict of interests that are associated with the manufacturer and the foundation? And then, what is your funding stability? What is your long-term plan to sustain these programs indefinitely, or within the terms of the patient or product population?

In the second part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Rachel Thorpe, executive director at the Otsuka Patient Assistance Foundation, lays out the ways to begin transitioning a foundation. 

PAP 2025: Creating an Independent Patient Assistance Foundation 

How Various Programs Affect Patient Care and Health Equity

How are these accumulators, maximizers, and alternative funding programs impacting patients, manufacturers, and healthcare ecosystems, and how does this all tie into your presentation that you participated in?

These are having real impacts on patients, on employers, on the healthcare ecosystem. If we look at patients in particular, they are experiencing unexpected costs. They are experiencing negative health impacts when it comes to adherence and persistency concerns.

First of all, there's a huge lack of transparency surrounding these programs. Patients often do not even know that they're in one of these programs. They will be going to the pharmacy counter, and they will either get, in the case of an AFP, a surprise denial that they've got to navigate. With accumulators or maximizers, more often, they're getting their product covered, and all of a sudden, surprise, you have this financial obligation. And then what happens for many patients? There might be an adherence problem. They might not be able to afford their medication. They're confused. They're trying to navigate it. In a survey of patients who are enrolled in AFPs, they reported that there was a two-month delay in getting their medication, and during that two-month period, a quarter of those patients experienced worsening of their condition, disease progression. So that's real hardship that is occurring from these programs. 

Another consideration that a lot of people aren't really thinking about is the impact on health equity. These programs have the potential to exacerbate already existing health inequities. Research has shown that non-white patients are more likely to be enrolled in a copay accumulator program than white patients, and these programs are often targeting specialty medications that are intended for chronic conditions that are very serious, and you're having situations where vulnerable populations are experiencing disruption in care, which then has ripple effects on their health.

Maybe they end up going to the hospital, and then there's costs elsewhere. So these programs are in a situation where they can be exacerbating the health inequities that are already existing in our program that we would really like to be focusing on and improving, and given the potential for the harm that these programs can bring to patients. one of the things that we also explored in our session is, what can you do if you've got a problem, you don't want to just talk about the problem, you want to bring some potential solutions to the problem.

There are several things that are being done at the policy level, and I'll talk about what's happening at the federal level and what's happening at the state level. We published a primer in 

 earlier this week that looks at copay accumulators and maximizers, and goes into this more deeply than I'm about to here. I'm going oversimplify what's happening at the federal level and then at the state level. All of these programs are centering around not letting the copay assistance that comes from the manufacturer count towards the patient's out of pocket costs.

In the second part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Kimberly Westrich, chief strategy officer at the National Pharmaceutical Council, describes how accumulators, maximizers, and AFPs are impacting patients, manufacturers, and healthcare ecosystems, and how that all ties into the presentation she participated in.

Hubs East 2025: How Various Programs Affect Patient Care and Health Equity

Reasons Behind the Rising Popularity of DTC Online Prescription Services

As also noted by the iPrescribe survey, what are the primary reasons why 52% of respondents choose DTC online prescription platforms?

At first, I was like, ‘wow, that's crazy.’ And then I was like, ‘oh no, that actually makes sense.’ There are a couple things that come to mind. I'm still an actively practicing physician, although not nearly as comfortable in the outpatient space as I am on the inpatient space. I was a hospitalist, but a lot of patients may not want to bring these things up with their doctors. For whatever reason, a lot of patients may feel—like I spoke about earlier—that they're not going to qualify for that particular therapy, or that they've been down this path with their doctor before, and the doctor is just simply not going to prescribe it. ‘I've tried this before. My doctor is a stickler for this sort of thing.’ 

There’s a little bit of, I don't want to say gaming the system, but finding your sweet spot for your providers, and sometimes, whether it's comfort, whether it's the ability to access your primary care doctor, which I mentioned before can take months sometimes. The third thing—until recently, and the survey actually bears this out, but if you had asked me these questions two years ago, I would have almost guaranteed you that primary care doctors, internists, family doctors, were not writing for GLP-1s. I can almost guarantee it because it was this new diabetic medication that was on the scene, and I'm telling you that as an internist myself, there's a certain ‘we're comfortable with insulin, we're comfortable with metformin and glipizide,’ and maybe some of the other SGL2 inhibitors. I'm sorry I'm using all this jargon, but some of these other medications.

Once you hit a certain threshold, you're like, ‘I need an endocrinologist. I need a specialist. This is out of my comfort zone.’ And as the data started coming in, folks had to get more and more comfortable with it. You actually see internists prescribing this at a higher rate, year-over-year. You even see OBGYNs writing for these particular drugs, because a lot of times, women are using their OBGYNs as their primary care doctors, but two years ago, that wasn't the case.

You can imagine there's this sort of—as the industry catches up, or as folks get more and more comfortable with this—maybe patients don't realize that their doctor is indeed comfortable with this medication, and so they go looking for alternative. Again, not overly surprised. They certainly make it easy. It is easy to do these things on these DTC platforms, intentionally so.

In the third part of his video interview with Pharma Commerce Editor Nicholas Saraceno, Colin Banas, MD, DrFirst’s chief medical officer, uncovers the main reasons why 52% of respondents choose DTC online prescription platforms.

Patient Support

Latest News

More News