Patient support programs (PSPs) provide services to support patients and caregivers across the treatment journey with the goal of improving outcomes and patient and consumer satisfaction. PSP capabilities are designed to improve the typically fragmented, confusing experiences patients encounter while starting and staying on therapy. But recent industry research found that in aggregate, 59% of patients were unaware of support for their treatment, and of those who were aware, only 3% were using that support. In addition, 19% of global consumers in ZS’s 2024 Future of Health report state difficulty in accessing medical care as the biggest barrier to high-quality healthcare. 

For patients, treatment regimens are becoming increasingly complex, and the growth of specialty pharmaceuticals has been accompanied by a burdensome and confusing path to start. Providers are challenged to estimate or understand how frustrated their patients may be feeling about their interactions; upwards of 84% of global healthcare providers (HCPs) in a recent ZS study claim patients rely on them to understand test results and other health metrics. We are also observing a generational shift where younger patients are more likely to feel dissatisfied with the healthcare ecosystem, with 62% of younger U.S. consumers stating, “I feel like the healthcare system doesn’t care about people like me.” PSPs are designed to address these challenges.

For HCPs and office staff, the administrative burden of benefits verification and prior authorization reduces the time and resources they can allocate to treating patients’ clinical needs. Our research shows how pervasive these challenges are, with 72% of global HCPs in a recent ZS study claiming spending more time with patients is important to improve the overall healthcare experience, and 74% of U.S. HCPs claiming an easier billing and insurance process will improve the overall healthcare experience.

The efforts of PSP teams, case managers and other personnel to improve the patient experience are hindered by antiquated workflows that remain highly manual, siloed and dependent on constantly changing coverage rules.

Given these challenges in healthcare delivery, there is a heightened focus on elevating PSP capabilities to drive a more compelling patient experience. We believe PSPs are at a major turning point.

Once pharma organizations recognize PSP capabilities as a key to improving patient adherence and outcomes, the common question is: Where to start? Many organizations jump straight to solutions, buying or building digital products and personalization tools. Our experience shows that lasting, significant impacts for businesses and patients require a comprehensive program perspective and focused, tangible efforts to modernize PSP capabilities. The ZS patient support programs transformation framework summarized in Figure 1 helps organizations plan based on the current maturity and success of their program across 12 dimensions.

In our experience, three pathways have helped life sciences organizations lead successful PSP transformation by prioritizing investments to elevate PSP capabilities and the patient experience.

All PSP investments should align to a patient-centric vision and strategy. Defining this vision—one that is impact-focused and patient-centric—regardless of the pathway, is a step that should mark the beginning of all PSP capability investments. 

Organizations leading through technology and analytics begin the PSP transformation journey by translating their vision for elevating the experience through technology and data capabilities. These organizations map out their PSP technology architecture to win in the future and systematically rally their business counterparts to see the business impact and upside of investing in these capabilities. While technology and data capabilities are typically seen as enablers of the experience, these organizations leverage digital technology platforms and integrated data sources as strategic levers to differentiate the patient experience.

Organizations selecting this technology and analytics-led transformation pathway should consider the following questions before beginning their transformation journey:

• Does your organizational vision and mission for patient experience benefit from advances in digital technology and data capabilities?
• Is your PSP technology architecture flexible and scalable or are you willing to develop a modular architecture that can be expanded over time to incorporate new technologies?
• Does your organization have the required capabilities and infrastructure or are you are ready to invest in these capabilities to act on first-party PHI data to generate insights?
• Are you willing to invest in data sources and develop advanced data science and analytics techniques?
• Do you have the right infrastructure and processes in place to integrate analytics and insights into patient engagement activities?

Organizations following this technology and analytics-led pathway should embrace these learnings and guiding principles:

Leverage the value of your own data. Capitalize on the value of first-party data and integrating data with second- and third-party sources to see a full view of the patient experience.

Plan data management capabilities for the long term, with unanticipated scale. Set up a PHI environment with capabilities to scale to successive brands and therapeutic areas; embrace the low marginal cost advantages that come from scaling technology platforms.

Start small with analytics use cases and execute pilots. Start with one or two use cases, execute prototypes to prove patient impact and pilot the capabilities in production. Trying to solve multiple use cases across multiple brands is often too intensive of a change. Rather, starting small and scaling at a sustainable pace can lead to greater and more lasting impacts.

Communicate impact measures actively across the business. Routinely share impact measures the PSP capabilities are having on patients and other stakeholders. This keeps the focus on driving impact and builds organizationwide momentum around the transformation.

Partner closely with marketing to have end-to-end impact on the patient journey. Become expert collaborators by forming cross-functional program teams that span brand, operations, medical and legal, marketing and patient services. As the PSP transformation scales, marketing is a key collaborator to embed new content and upstream (pre-prescription) engagement into the patient experience. 

Organizations pursuing the design and process pathway begin their PSP transformation by crafting a compelling, actionable vision and strategy that informs the design of their services and business processes. Organizations on this pathway adopt a holistic “experience as the product” approach—one where traditional commercial framings of success are replaced with patient-centric success factors—to rethink patient services as tools for experience transformation.

Organizations selecting this design and process transformation pathway should consider the following questions before beginning their transformation journey:

• Are you willing to rethink your partnership models to have better control over the design and delivery of services and processes?
• Are you willing to redesign business processes and handoffs to make the patient experience seamless across channels and journey phases?
• Are you willing to set up or improve your data environment to enable seamless data collection and data processing of digitized services?
• Do you have the right teams or partners who can design digitized services with modern user experience and user interface components for improved patient experiences? 

Organizations starting on this design and process pathway should embrace these learnings and guiding principles:

Design services with empathy and attention to patient needs. Services should be designed based on careful analysis of high-touch points for different patient personas and treatment journeys; do not assume you understand patient needs without first analyzing them.

Improve services through data collection of digital touch points. Leverage insights and feedback to inform program design and implementation, using digital technologies to enhance patient engagement and education. Determine how to deliver the right message at the right time through each channel.

Adopt a holistic “experience as a product” vision to transform PSP initiatives. Anchor strategic decisions in their anticipated impact on patient experiences and outcomes. Rally support around the vision by demonstrating with data how poor patient experiences can create poor commercial outcomes.

Define the right collaboration strategy. Build strong collaborative networks with external stakeholders, including patients, healthcare providers and payers. Put special focus on creating strategic partnerships with key stakeholders to establish clear lines of communication and feedback mechanisms. Leverage collaborative networks to inform program design and implementation.

Establish processes and mechanisms to automate PSP capabilities. Prioritize development of standardized and scalable business processes and procedures to ensure consistent and efficient delivery. Focus on optimizing program delivery processes, leverage automation and technology to streamline program implementation and develop strong quality assurance and control mechanisms to ensure program effectiveness and efficiency.

Organizations on the “ways of working” pathway begin their PSP transformation journey by establishing a purpose-driven, patient-centric culture across the organization with a “North Star” aligned with the PSP vision. Next, they create nimble, cross-functional teams and processes that leverage advanced infrastructure for internal knowledge sharing, communication and collaboration. These organizations invest in enabling their data-driven decision-making capabilities and continuously seek feedback to iterate and improve the delivery of patient services. 

Organizations selecting the “ways of working” transformation pathway should consider the following questions before beginning their transformation journey:

• Are you willing to reorganize the structure and governance of the PSP teams in alignment with the vision and capabilities of the PSP and enhance the patient experience?
• Is there a data-driven, patient-centric culture throughout the organization with accountability that starts with leadership? If not, are you willing to break the status quo to create one?
• Are you willing to implement processes and build new teams to enhance coordination across patient touch points to break down functional silos?
• Are you willing to invest in training people for roles and skill sets required for the new operating model within the organization?

Organizations starting on the “ways of working” pathway should consider the following lessons and guiding principles:

Identify current versus desired culture across the organization. Assess current cultural fit and readiness of the organization and determine what added characteristics are needed to achieve the vision of transforming to a patient-centric culture. Focus on organizational buy-in to enable the shift in a way that feels empowered rather than forced.

Adopt agile, unified and cross-functional ways of working. Move away from legacy corporate structures and embrace agility and a product mindset to tie strategy, execution, data and insights together to reflect the patient as clearly and as broadly as they do the brand.

Establish an empowered, patient-focused team to promote patient centricity. Create cross-functional, patient-centric teams with well-defined roles and responsibilities all aligned to deliver transformational patient experiences powered by advanced data-driven insights. Adapt to changes with a strong focus on innovation and automation to ensure quality and speed.

Develop a comprehensive and actionable stakeholder management plan. Design plans that capture elements of the transformation that are exciters for stakeholders, noting key barriers for stakeholder adoption. This plan should outline steps for communication and upskilling.

Each pathway can successfully guide organizations to elevate, innovate and transform their PSP capabilities, and each poses an opportunity for organizations to make a bold, sustained impact to improve the support experience for patients. In our experience, life sciences organizations can make tangible, sustained progress across these pathways by leading with a clear vision and embracing the opportunities ahead. Overall, we’ve seen success in each pathway. Whether the focus is on maximizing value from first-party data and scalable technology, streamlining partnerships and business processes or evolving to new ways of working across the organization, each can have a measurable impact on improving the patient experience.