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1rem

 podcast episode, UpScriptHealth founder and CEO Peter Ax discusses:

The impact of tariffs on the pharmaceutical industry, highlighting branded and generics medications

How tariffs could lead to strategic supply chain changes, including potential US manufacturing shifts

How digital health platforms can help potentially offset tariff impacts

The importance of telehealth in ensuring medication availability

Strategic partnerships between digital health platforms and pharma companies to improve patient care and access

Podcasts

Peter Ax, founder & CEO of UpScriptHealth, discusses the impact of tariffs on the pharmaceutical industry and how digital health platforms could potentially help offset them.

Tariffs and Drug Prices: Understanding the Impact on Pharmaceuticals

In this episode of the Pharmaceutical Executive podcast, Bill Grambley, CEO of AllazoHealth, explores:

How AI can potentially revolutionize patient engagement and adherence

Utilizing patient-level data and predictive modeling

How AI can identify individual needs and preferences

The importance of ethical considerations and data privacy when leveraging AI in healthcare

Bill Grambley, CEO of AllazoHealth, delves into the potential of AI to revolutionize patient engagement and adherence.

Revolutionizing Patient Adherence: Leveraging AI for Personalized Engagement

Key trends in healthcare communication to build trust between healthcare providers and their patients.

The Evolution of Healthcare Communication: Bridging the HCP-Patient Divide

In this Q&A, Organon's Chief Communications Officer, Becky Edwards discusses how much social media and influencers sway decisions about birth control methods, potential consequences of these misinformed choices, and more.

Social Media's Influence on Young Women's Reproductive Decisions

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, addresses patient and prescriber expectations for digital health tools.

Balancing Technological & Human Support in Medication Access

 video interview, Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses "The 2025 Medication Access Report." She highlights gaps in data-sharing and cross-functional collaboration as major bottlenecks that cause delays, rework, and increased patient burden. Chiang shares that only 3% of patients utilize support programs due to a lack of awareness. A large majority of the report's respondents plan to expand funding for patient support programs within the next 5 years due to large number of new therapies expected to come to market.

Pharmaceutical Executive: The report addresses patient and prescriber expectations for digital health tools. How do you see the balance between technology, including AI, and human support evolving in the context of medication access?


 AI has to bring a fair and unbiased approach when it comes to medication access. The emerging use of AI, which is taking decisions out of the hands of humans and clinicians, is not ideal. It needs to strike the balance of support-not-replace. The same is true for technology and balancing the need for easy, quick digital tools that support patients finding information faster and getting education when they need it most with the need to speak to a human and have more clarity.

The utility of a digital tool when you’re overwhelmed, ill, and don’t have a good support system is where a paradox comes into play.

How do we provide the just-in-time tools for patients with some digital sophistication, while still recognizing that there is going to continue to be a significant need for patients to seek help through a variety of channels? That’s where patient support program engagement comes in. You are able to balance tools for patients who want to use them with patients who want to speak to humans.

Restrictive programs are something I would caution pharma against. There’s not only one way to do things, and there are efficient ways to have human interaction. The industry really needs to look at that. How can we ensure that the right patient gets the right resource? AI can help us understand that fragmentation and the dimensionalization. When there’s complexity with a patient population, AI could begin the journey and know when to pass things to humans.

We need to strike that balance between using AI and identifying when a patient needs to talk to a human.

If you’ve used chatbots and other AI tools that exist today, there’s a point when you refine as much as you possible can and you’re still unsatisfied. We need to have excellent identification through AI of where the journey begins and ends. The technology can only get us so far and we need to offer patients the flexibility to receive the support they need in the manner in which they feel is best for them.

The fair and unbiased approach is going to require significant and diverse data sets. AI is only as good as the information it’s feeding from, so we need to make sure that we as an industry are looking at fair and unbiased data sets that we are making decisions from. Patients and providers also deserve to know how decisions are being made on their behalf. As an industry, that is going to be a challenge to us. Ensuring that we are protecting the privacy of the patient throughout that journey is paramount.

There’s great hope for AI in the ability to get patients to the support they need faster. There is work for the industry to do, however, in creating those fair and unbiased data sets.

Videos

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, discusses how the industry leverages data and technology to identify and address affordability issues before they become a barrier to patient access.

Proactively Identifying & Addressing Affordability Issues with Predictive Analytics

Pharmaceutical Executive: How can the industry leverage data and technology to proactively identify and address affordability issues before they become a barrier to patient access? What role does predictive analytics play in this?


 The ability to be proactive in identifying and addressing those gaps requires a centralized data system and a greater ecosystem. The ability to leverage data requires that data to be comprehensive. Predictive analytics will run on strong data models, and in order to have those, you need a seamless experience.

How do we capture data along the patient journey, and how do we ensure that predictive analytics will help us analyze that data? It all starts with the ability to streamline the data. If we don’t begin to bring data sources together in real and important ways, we will not be able to properly allocate our resources and spending in pharma. There will be some forecasting and assumptions, but with some real-world data (RWD) integrated.

Think about the addition of an integrated data model with RWD and what that could do for better predictive analytics. Our assumptions would be lowered, and our predictions would be better. We would have optimized predictability for where the funding needs to be directed.

The second piece of that is you have better clinical outcomes if you can identify in advance. You will not have patients walking away from their prescriptions, which continues to be a challenge. We are also seeing significant increases in claims denials. About 73% of claims are denied. What do we do when claims come back denied?

With predictive analytics, there are affordability and co-pay types of expansion. There’s also focus and energy around overturning claim denials. How do we ensure that the claim was denied for righteous reasons? The ability to have all of the data integrated and run it through predictive analytics alongside RWD would help us improve clinical outcomes. Those patients will not be denied medication that they need and rightfully deserve.

Doing all of this more efficiently will remove costs from the ecosystem. There is significant fragmentation in all of the processes. To bring all of that data together to understand the market access for a single brand launch, bio-pharmas must piece together all of that information. Bringing data together and using predictive analytics with strong data models will help these companies do so more efficiently. It will take costs out of the system and speed patients onto the right medications. Healthcare providers will also spend less time waiting for the patient to get approved.

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds identifies innovative strategies and solutions for addressing the rising cost of medications and improving patient access.

Strategies to Address Rising Medication Costs & Improve Patient Access

Pharmaceutical Executive: Beyond traditional copay assistance programs, what innovative solutions or strategies does the report show are emerging to address the rising cost of medications and improve patient access?


 Beyond traditional copay programs, innovating in this area is going to be critical in the next few years. The challenge is to rethink the journey. We need to see patients in more dimensions than we’re seeing them today. We need to see more than just their ability to pay. There are more things that are critical drivers of adherence and access to medication that should be considered along the patient journey.

We are big advocates for a comprehensive view of the patient, expanding that view, and then bringing that into the data. For folks that are bringing and designing projects and financial support programs, this means figuring out how to design those dimensions in to ensure that we’re not just looking at pure affordability. This means going beyond asking if they have coverage and what their copay is. Expanding beyond that is one of the most critical elements to evolving the state of patient affordability programs.

The way to do that is in the design. Traditional co-pay programs only look at two dimensions: do you have a copay and can you afford to pay. We have to look at a couple of different elements. Using patient education as an example, we can educate patients to self-advocate and declare the challenges they might be experiencing in a community. The ability for a person who’s living on their own to pay for a taxi to take them to receive their medication at a distant clinic impacts whether they even consider taking the medication.

How can we look at all of the dimensions of a patient and plan those assessments into program design to ensure adherence from the beginning? We think of adherence as perpetually being on the medication and living well. A lot of the work in the past 5 years has been around structing adherence support programs for patients who have agreed to go on a prescription and have no affordability issues.

Addressing adherence issues at the very beginning is a change to that paradigm. We’re moving off of the linear patient journey and looking at dimensionalizing the patient experience. How do we plan forward and proactively identify those gaps? What algorithms can we use with predicative analytics to look at a patient’s profile and show what a support program looks like that has the best chances of that patient getting, staying on, and doing well with medication? What levers do we need to play with in a support program to ensure that the patient’s holistic needs are managed? This includes educating them, managing travel concerns, and pre-planning all of that.

The journey doesn’t look like a straight line. We need to constantly review if the patient’s needs have changed as their journey improves or time passes. Are there ways to intervene early using predictive analytics? Should we intervene with certain types of patients on certain dimensions early in their healthcare journey to have the best outcomes? This is the important element in designing patient support programs. We’re going to spend the money, but how do we do that differently going forward?

The other element is bringing the concept of digital healthcare forward so that patients have digital solutions and tools at their fingertips. Patients today can do all of their other needs on their phones. This is the mobile phone culture which we talk about quite extensively in the report. However, a patient who’s experiencing illness can’t pick up their phone to search for help with their questions or find affordability options. They don’t have tools to monitor where they should be in their healthcare journey. There is an overwhelming appetite for innovative tools.

However, digital solutions come with a bit of a paradox: more digital solutions mean less human touch. The industry is going to be challenged with striking that balance between putting efficient digital tools in the hands of the patients while also allowing for the human touch when it’s needed. That’s a balance that we need to strike, and it’s going to be a challenge that the industry is going to face. Eighty percent of patients say they prefer something digital, but how many are actually using digital tools when available?

What we need to monitor as we bring these brilliant, innovative solutions forward is the balance with the patient’s access to a human touch.

Kimberley Chiang, vice president of biopharma commercial solutions at CoverMyMeds, identifies innovative strategies and solutions for addressing the rising cost of medications and improving patient access.

Peter Ax, Founder & CEO of UpScriptHealth, describes how his company's recent partnership with Pfizer is impacting drug access.

Insights on UpScriptHealth’s Recent Pfizer Partnership & Its Impact on Drug Access

 Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, discusses the impact of tariffs on the pharmaceutical industry, highlighting that tariffs will initially affect pharmaceutical companies, particularly those dealing with branded medications and generics. He notes that tariffs could lead to strategic supply chain changes, including potential US manufacturing shifts. Digital health platforms like UpScriptHealth aim to reduce friction and costs in healthcare, potentially offsetting tariff impacts. Ax emphasizes the importance of telehealth in ensuring medication availability and the strategic partnerships between digital health platforms and pharma companies to improve patient care and access. He also praises Pfizer's approach to delivering comprehensive care rather than just selling medications.

Can you share insights on how your recently partnership with Pfizer is helping to navigate current challenges in drug pricing and delivery, and how it might be relevant in a scenario with increased tariffs?

I can't speak for Pfizer, but I can tell you my view is that Pfizer has made a strategic decision to be a part of the solution for the problems in healthcare. It's not about selling a medication specifically to a patient, or it’s a lot about delivering care that that they can help solve the patient's problem. And that might mean that the patient is prescribed their drug. It might mean that the patient is prescribed 10 other drugs, but they're going to provide a mechanism that patients can access care and receive great treatment. And if you think about PfizerForAll, they're not focused in on the brand strategy down below where you're kind of looking at specific medications. They're focused on ‘Let's treat migraine headaches’, ‘Let's treat respiratory illnesses, including COVID’, ‘Let's treat whatever category of disease they want to treat’, and let's just be sure that we're helping patients get great access to care. I give Pfizer enormous credit for their approach to this, to this problem.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, describes how his company's recent partnership with Pfizer is impacting drug access.

Peter Ax, Founder & CEO of UpScriptHealth, explores ways that digital health platforms can assist pharma companies seeking to maintain accessibility and manage cost pressures. 

Digital Health Platforms as Strategic Partners for Pharma Companies

How can digital health platforms become strategic partners for pharma companies seeking to maintain accessibility and manage cost pressures?

The light bulb has gone off in pharma, right? Every single pharma company we're aware of is we're in some level of discussion with about the platform that works for them, the direct to patient solution that works. And what we've seen is a massive shift from sort of simple prescribing of a medication when someone has a migraine headache, letting them try, letting that patient try a new medication, perhaps, or shifting them to a different medication, to what is a really complex ecosystem of healthcare. We're now involved in platforms for pharma companies where we will send patients to injection centers or to infusion care centers. And so the level of care and the complexity of the of the patient flow is really evolving to a to a much more complex world that's sort of digital health 2.0

For us, the way we think about it, and the way that really helps pharma, if you think about all the problems we have in the current model for the delivery of care, right? Patients can't get appointments very quickly. Patients don't know what that cost of appointment is going to be for them. They don't know what their co pay is. They don't know what insurance is going to cover. They don't know if it's in network out of network. They oftentimes don't know where the fulfillment is coming from, and whether or not there's a supply of the medication that they need or the treatment that they need. We can solve all those problems by working with our pharma partners.

So, when a pharma company decides to be on the UpScriptHealth platform, it's not just a simple discussion of, we're going to put a button on your website. Patients will click on that button and see a telehealth provider. It's a much more complicated discussion about what is the patient journey, and how do we really make that patient journey a good experience, a positive experience, literally changing the paradigm of healthcare. I think, by the way, that's why Pharma is so interested in these platforms, because they realize they have to help be an instigation for the changing of how healthcare is delivered.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, explores ways that digital health platforms can assist pharma companies seeking to maintain accessibility and manage cost pressures. 

Peter Ax, Founder & CEO of UpScriptHealth, explores how tariffs could affect the availability and accessibility of specific medications, particularly for patients relying on direct-to-patient telehealth.

Potential Tariff Impact on Availability & Accessibility of Medications for Telehealth Patients

Beyond cost, how might tariffs affect the availability and accessibility of specific medications, particularly for patients relying on direct-to-patient telehealth?

If you think about the way direct-to-patient telehealth works, is we allow a consumer to go on the web and talk to a clinician right away, assuming they're prescribed some medication, then we have to somehow assure availability, or at least have some insight into availability.

One of the real benefits of our platform is that we're able to partner with pharmaceutical companies to be sure that we have supply available, or that they've partnered with a fulfillment partner that is assured to have supply available. In a lot of ways, we can solve kind of nuances in the market that makes supply difficult because of tariffs. Think about a pharma company that enlists engages with UpScript to develop a platform. We end up partnering with a fulfillment partner, and we can assure the supply through that fulfillment partner, because we're dealing with the manufacturer, and the manufacturer can help make sure that medications are accessible. So, in a lot of ways, telehealth can mitigate the impact of tariffs and the and the changes in supply that may occur.

I think only time will tell which medications it impacts and how it impacts, whether it impacts generic drugs more than it does branded drugs. There will, of course, be some level of impact, but it won't be across the board. It's going to be in different pockets, for example. It will be easier to get medication in New York City than it is in Des Moines, Iowa, for example, and so telehealth can help sort of mitigate those differences.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, explores how tariffs could affect the availability and accessibility of specific medications, particularly for patients relying on direct-to-patient telehealth.

Peter Ax, Founder & CEO of UpScriptHealth, addresses how tariffs will affect pharmaceutical costs and which drug categories will be most affected.

How Tariffs Will Drive Up Pharmaceutical Costs & Which Drug Categories Will Be Most Affected

Will tariffs drive up pharmaceutical costs? Are there particular types of tariffs or drug categories that would be more affected than others?

When you think about tariffs, you really have to think about how they impact micro markets. Let's, for example, think about there's generic medications and there's branded medications. And let's think about those as two micro markets for a minute. The branded medications, the cost of branded medications, comes from two things, right? It comes from raw materials, and it comes from labor. So, if the price of raw materials goes up, or increases in price for what we're importing in raw materials, certainly that's going to, on its face, impact the price of the development of that medication.

However, the fact that it's impacting the price that medication will not necessarily impact the price to the consumer, because think about all the intermediaries involved in healthcare. There's payers involved, there's PBMs involved, and because of that, what you will see is, let's say, an increase in pricing raw materials, increase in price in the manufacturer of that branded drug, and the person that's going to really bear the brunt of that is really the pharmaceutical company in the short run.

Now, in the long run, it impacts all consumers, but in the short run, it's really the pharmaceutical company, because they have to renegotiate contracts with their PBMs and renegotiate pricing. I mean, some of the contracts might have specific clauses that deal with tariffs as an issue, but most won't. There'll be a lagging effect on any price increase to individuals, and really, it's the pharmaceutical companies that will bear the brunt. The second piece of that analysis is the other micro market, generics. If you think about generics, a lot of the cost of manufacturing generic is really the raw material. So, tariffs may have a larger impact there.

Not only that, but the generics Marketplace is a thin margin marketplace, so you could even see perhaps a curtailment of some supply as manufacturers decide they're not going to manufacture certain drugs that require increasing prices and raw materials that they can't pass on to the consumer. So it really depends on how quickly they'll be able to pass that pricing onto the consumer. The other side of that argument is the consumer price for generics is so low that to go up 10 or 20% isn't really going to be a very dramatic number. So you may not see a large impact in the generic space at all, or you might see certain manufacturers deciding that they want don't want to be involved any longer in manufacturing certain drugs.

Now, having said that about the micro markets of tariff pricing, I think one of the bigger implications of tariff changes that will take place is in the boardroom. Because if you think about it, what sudden tariffs are doing is forcing companies to analyze their strategic supply chain, where's Where are their supplies coming from? What manufacturing do they need to bring into the United States? What manufacturing do they need to redevelop? Do they do they need to redeploy assets and resources? And those are board level discussions. So frankly, I think tariffs have an instantaneous effect on pricing, right, but they have a much longer-term effect impact on strategically. How is the supply chain going to evolve? How is where is manufacturing going to move? And if you're a board member of a major pharma company today, you've got to be asking yourself, ‘Is your company properly positioned to deal with supply issues when tariffs come and go?’, and it looks like tariffs might be in the sort of vernacular for the next at least the next four years, and probably longer.

In this Pharmaceutical Executive Video Interview, Peter Ax, Founder & CEO of UpScriptHealth, addresses how tariffs will affect pharmaceutical costs and which drug categories will be most affected.

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