Strategies to Address Rising Medication Costs & Improve Patient Access

In this Pharmaceutical Executive 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: 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?
Kimberley Chiang: 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.