Pharmaceutical Leaders Bring Patient Support Services In-House

The shift toward internal management comes as manufacturers face a complex regulatory landscape that threatens to disrupt traditional affordability models. Survey data reveals that only 14% of industry leaders feel fully prepared to navigate the requirements of the Inflation Reduction Act, including new Medicare price-setting protocols and Part D coverage redesigns. These policy pressures are compounded by the expansion of health plan copay accumulator and maximizer programs, which 65% of respondents identify as significant bottlenecks in the patient treatment journey.

Despite these challenges, the reliance on support programs remains high. Copay assistance continues to lead the sector at 80% utilization, followed by temporary affordability programs and dedicated account support. To streamline these efforts, executives are increasingly prioritizing AI-driven automation for reimbursement tasks like prior authorization and benefits verification. Douglas R. Martin, MD, Global Life Sciences Leader at Guidehouse, notes that the industry remains committed to patient access while working to adapt to a business environment defined by evolving regulations and the urgent need for more efficient, data-integrated patient services.