Deanna Horner's Five-Year Outlook for Direct-to-Patient Care

Direct-to-patient (DTP) programs are no longer confined to a handful of blockbuster launches. A September 2025 survey of pharma leaders by ixlayer and the Digital Health Coalition found that 73% were already running a DTP program or planned to launch one within the year, a figure that climbs to 94% once leaders exploring the option are included, and half expect DTP to become standard practice within five years.¹ The question increasingly isn't whether direct will matter, but where.

That's harder to answer than adoption curves suggest, because DTP's value looks different by disease. In specialty categories like oncology and rare disease, access alone can derail treatment before adherence becomes the issue: a systematic review found patient cost sharing above $100 was linked to abandonment rates as high as 75% for some specialty drugs, prior authorization denials affect 7% of all claims, and 37% of which end up being abandoned.² Chronic disease carries a different version of the same friction. Roughly half of patients on long-term chronic therapy don't adhere to it, a gap estimated to cost the US healthcare system between $100 billion and $290 billion annually.³

In the first and second installments of her interview with Pharmaceutical Commerce, Deanna Horner, executive vice president of Enterprise DIRECT Strategy at EVERSANA, explained why commercial pull and patient services are pulling manufacturers deeper into direct models, and how the real-time data they generate are reshaping resource allocation and lifecycle planning. In this third and final installment, Horner turns to where DTP goes from here. She notes a direct model is becoming the future of commercial infrastructure broadly, not a tactic tied to one drug class, but says early adoption will keep tracking therapeutic areas with high patient drop-off, like cardiometabolic, neurology, dermatology, and autoimmune disease first, followed by rare disease and oncology, where navigation, adherence support, and longitudinal re-engagement carry more weight. Her outlook has a ceiling, too. Categories where patients already move seamlessly through the traditional channel, like low-cost generics, are unlikely to become a DTP priority, she says.

Watch the first and second parts of Horner’s interview with PC:

1. What's Really Driving the Direct-to-Patient Boom?
2. How Real-Time DTP Data Are Rewriting Pharma's Commercial Playbook

References

1. ixlayer. "New ixlayer Survey Finds 73% of Pharma Leaders Are Running or Planning to Launch a DTP Program in the Next Year, and Half Say DTP Will Be Standard Practice Within Five Years." PR Newswire, Sept. 25, 2025. https://www.prnewswire.com/news-releases/new-ixlayer-survey-finds-73-of-pharma-leaders-are-running-or-planning-to-launch-a-dtp-program-in-the-next-year-and-half-say-dtp-will-be-standard-practice-within-five-years-302567022.html.
2. Weiser, Patricia. "Specialty Drugs: Higher Patient Cost Sharing and Prior Auths Linked to Abandoned Meds, Treatment Delays." Managed Healthcare Executive, May 17, 2023. https://www.managedhealthcareexecutive.com/view/specialty-drugs-higher-patient-cost-sharing-and-prior-auths-linked-to-abandoned-meds-treatment-delays.
3. Cutler, Rachelle Louise, Fernando Fernandez-Llimos, Michael Frommer, Charlie Benrimoj, and Victoria Garcia-Cardenas. "Economic Impact of Medication Non-Adherence by Disease Groups: A Systematic Review." BMJ Open, Jan. 21, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5780689/.