Roundtable: Patient Services Leaders on the Pressures Shaping Hubs in 2026

Pharma's investment in hub and patient access support services has grown sharply alongside the specialty pipeline. The global market for these services, valued at approximately $3.55 billion in 2025, is projected to nearly triple to $10 billion by 2035 as stakeholders navigate an increasingly complex landscape of high-cost therapies, payer friction, and more.¹

The hub model is under pressure to evolve and hub transitions are accelerating. According to one survey, 45% of biopharma executives say they're considering consolidating hub vendors between 2026 and 2028, while 39% say they've felt leadership pressure to move at least some hub functions in-house, up from 28% in 2024.² What's driving that momentum, and what it means for patients already mid-journey, is a key question the industry faces right now.

Morbidity and mortality from medication non-adherence costs the US health system upward of $528 billion annually, and the stakes are especially high in specialty.³Across 99 novel medicines that launched between 2020 and 2024, an average of just 35% of first-year prescriptions were filled — 49% were rejected by payers and 17% were abandoned after payer approval, often due to high out-of-pocket costs.⁴ Even a brief gap in support can mean lost therapy and lost revenue.

At the same time, digital transformation and AI are reshaping how support is delivered, raising new questions about what hub functions manufacturers should own versus outsource and what the right operating model looks like in 2026.

To take stock of where the industry stands, Pharmaceutical Commerce spoke to four patient services experts to unpack the trends shaping hub services in 2026: what's driving transitions and how to protect patients mid-journey, what digital transformation actually looks like in practice, how to modernize without abandoning traditional channels, and how to choose the right operating model for this moment.

Those interviewed include:

• Aimee Bugosh, vice president, patient support services Two Labs Pharma
• Josh Marsh, vice president and general manager, Cardinal Health Sonexus
• Kristine McGaughey, vice president, implementation, ConnectiveRx
• Marci Peach, executive director of patient and access services, global pharmaceutical manufacturer

PC: Hub transitions are happening across the industry. What's driving that momentum and what does it mean for continuity of care?

Bugosh: Hub transitions are accelerating as manufacturers reassess their partners amid market disruption, rising cost pressures, and increasing expectations around patient experience and speed. Many are looking for more integrated, scalable models that can support complex therapies.

The challenge is that transitions often happen while patients are mid-therapy. Without a deliberate strategy, even minor disruptions can delay access or impact adherence. The most effective transitions are designed around continuity of care, with strong data migration, proactive communication, and overlap models that ensure patients experience a seamless journey—even when operations are changing behind the scenes.

Marsh: Hub transitions today are largely driven by compliance requirements, poor patient and provider experiences, and the need for more scalable, insight-driven models. Many manufacturers are reassessing whether their current partners can keep up with increasing complexity.

Continuity of care is the critical factor. A well-executed transition should be invisible to patients and providers, with no disruption to therapy or support. That requires rigorous upfront planning, parallel operations, and deep training so teams understand each patient’s journey before go-live.

When done right, a patient calling on day one is met by someone who already knows their case and can continue support seamlessly, often delivering a better experience from the start.

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References

1. Grand View Research. "Pharma Hub and Patient Access Support Service Market Size, Share & Trends Analysis Report, 2025-2033." Grand View Research, 2025, www.grandviewresearch.com/industry-analysis/pharma-hub-patient-access-support-service-market-report.
2. Cardinal Health. "2026 Patient Hub Outsourcing and Insourcing Trends." Cardinal Health, 2026, www.cardinalhealth.com/en/services/manufacturer/biopharmaceutical/patient-access-and-adherence/hub-evolution-reports/2026-patient-hub-outsourcing-and-insourcing-trends-infographic.html.
3. Klein, Dan. "Medication Non-Adherence: A Common and Costly Problem." PAN Foundation, 2 June 2020, www.panfoundation.org/medication-non-adherence/.
4. IQVIA Institute for Human Data Science. "U.S. Medicine Use Climbs Amid Continued Affordability and Access Challenges." IQVIA, June 2026, www.iqvia.com/blogs/2026/06/us-medicine-use-climbs-amid-continued-affordability-and-access-challenges.