The status quo in the pharmaceutical supply chain has become untenable. For the past two decades, well-intentioned patient support services have helped a small proportion of new-to-brand patients navigate an irrational system which was never designed for them in the first place. Now, two powerful drivers are reshaping both expectations and economics in the biopharma market.

The first driver is policy. Most-favored nation (MFN) pricing is intensifying pressure on manufacturers to prove every dollar delivers value. The second driver is consumer expectations. Patients today demand speed, transparency, and choice in their pharmacy care to match the seamless digital experience they receive from other sectors. To meet these changing expectations, the market needs to move towards integrated direct-to-patient (DTP) models that combine technology, real-time data, and human support to meet people where they are.

Patient support services were an important step forward, but they should be viewed as a starting point rather than the end goal. DTP allows manufacturers to start more patients on therapy faster, keep them on therapy longer, optimize profitability, and see and control the entire prescription journey. Crucially, they also align manufacturer resources with patient outcomes, rather than intermediaries’ margins.

The impetus for change

For biopharma leaders who want to remain competitive in an MFN era, the question is not whether to expand brand support services, but how to redesign them for scale, efficiency, and trust.

Traditional pharmacy hubs are fragmented, with manual processes and slow approvals increasing drop-off risk. At the same time, uncoordinated outreach can lower adherence and erode prescriber confidence. Gross-to-net is dictated by the supply chain, forcing manufacturers into overlapping rebates, discounts, and 340B. Disparate data from multiple vendors and sources makes it hard to see the full patient journey or act quickly.

Manufacturers need more direct ownership of the prescription journey. This requires platforms which combine the best of digital and legacy hub models to provide real-time visibility and measurable outcomes for manufacturers, while also preserving patient choice, protecting provider autonomy, and removing friction from start to finish.

The prize for adopting such models is significant–expanded patient access, increased adherence, richer real-world data, improved patient satisfaction, and optimized gross-to-net.

A consistent patient-first layer

When talking about DTP, it is important to understand what it is and what it is not. DTP is not a cash-only storefront bolted onto a support program. It is a patient-first layer that allows every patient to see the price before they commit, choose how they get their medicine, and check their medication status in real time—whether the fill goes through insurance, manufacturer, assistance, or cash. It also offers human support when it matters to help everyone achieve their desired health outcomes. When it is done right, DTP turns brand intent into durable trust and demand.

DTP is also not a traditional hub rebranded. Traditional hubs rely on handoffs, manual processes, and fragmented systems, which slow approvals and increase drop-off risk. This, in turn, results in patients facing delays and higher costs, and providers shouldering extra work.

In contrast, DTP runs on an API-driven foundation anchored to a patient-consented longitudinal record. It is standardized, auditable, and allows manufacturers to measure what matters—promise-date accuracy, delivery time, refill rates, retention, days on therapy, and the satisfaction of both patients and prescribers. DTP platforms have been shown to deliver more medications within 24 hours, have higher dispense rates, and result in less abandonment.

Increased patient satisfaction and persistence

DTP benefits every member of the prescription ecosystem, from patients and providers to manufacturers and payers.

Imagine a system where, instead of facing delays and higher costs, patients are automatically routed to the most affordable path and can choose the fulfillment path which works for them— whether that is home delivery, a preferred local pharmacy, or a manufacturer program channel. Imagine a system where, instead of uncoordinated outreach, patients receive a personalized tech-plus-touch approach which combines AI tools with live pharmacist outreach.

DTP expands patient access and boosts affordability without adding work. It reduces therapy abandonment, improves customer satisfaction, and increases persistence. It also allows providers to keep full independence while shedding unnecessary administrative work.

In an era when policymakers want proof that every manufacturer dollar delivers value, DTP allows manufacturers to align resources with outcomes instead of intermediaries’ margins. With real-time visibility and localized insights into access, speed, and persistence, brand teams can proactively address barriers, optimize outreach and make faster, data-driven decisions that improve adherence and brand performance.

Instead of double discounts on the same prescription, resulting in loss of margins and failure to capture ROI, manufacturers can harness dynamic routing that balances affordability and margins, increasing gross-to-net performance without compromising patient experience.

For those payers and policymakers keen to see demonstration of value, DTP also provides greater transparency and less waste. Clear disclosures, real-time visibility, auditable routing, and standardized experiences reduce rework, increase the likelihood of commercial and patient access success, and help demonstrate that there is no steering.

The mandate and means to lead

Legacy patient support was built to navigate access hurdles, not deliver a modern consumer-grade experience which demonstrates value at every stage. In an MFN consumer-driven era, there is a clear imperative and mandate to challenge the status quo and adopt new ways of working. The future will belong to those willing to move beyond fragmented support services and take direct responsibility for the patient journey.

Instead of outsourcing what defines their brand, manufacturers need to deliver what the system hasn’t—clarity, choice, and momentum on the path to therapy. That is the true power move.

About the Author

Chip Parkinson is the CEO of Gifthealth, a digital pharmacy platform focused on accelerating patient access and innovation in pharmaceutical services.