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News|Videos|July 30, 2026

What's Next for Direct-to-Patient?

Gifthealth's Chip Parkinson shares his outlook on direct-to-patient models in specialty, regulation and platform design heading into 2027.

Pharmaceutical Commerce continues its H1 Review/H2 Outlook series, checking in with industry voices on the predictions they made earlier this year. This installment features Chip Parkinson, CEO of Gifthealth, in the third and final installment of a three-part video interview, closing out the series.

Asked where direct-to-patient goes from here, Parkinson points to specialty medicine as the next frontier. Specialty drugs account for more than half of drug spend even though just 2% of patients use them, and Parkinson says that concentration of cost and friction is exactly where direct-to-patient delivers its biggest return. He expects platforms may stop defaulting to cash pay and instead route specialty patients through whichever path, cash or insurance, is cheapest and fastest to access.

That routing logic, he said, is also where cash and insurance stop running on separate tracks. Rather than the parallel cash-pay and insurance-pay journeys that exist today, Parkinson expects platforms to merge onto a single set of rails, with patients funneled automatically toward whichever option costs less.

Regulatory certainty is catching up too. Parkinson noted that the HHS Office of Inspector General, in the guidance it issued earlier this year, also asked for public feedback on a full safe harbor for direct-to-patient arrangements, not just an advisory bulletin. He expects that rulemaking could advance in 2027, giving manufacturers still sitting on the sidelines a firmer legal footing than they have now.

The upshot, Parkinson says, is an industry moving past pilot mode: more brands launching hybrid direct-to-patient and insurance models from the start, translating into faster adoption, faster first fills and stronger persistency.

Pharmaceutical Commerce asked Parkinson to unpack what these shifts mean heading into 2027.

Watch the first and second installments of his interview with PC:

  1. Chip Parkinson on Direct-to-Patient's Big Year
  2. Mid-Year Check-In: How Direct-to-Patient Momentum Is Accelerating

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