TL/DR –
The article discusses the importance of point-of-care engagement in healthcare. It highlights that despite significant investment in payer negotiations to achieve high coverage percentages, the lack of visibility at the point of prescribing often results in lower rates of conversion to prescription. The author also discusses the underutilization of copay programs, pointing out that in many top therapy areas, less than half of eligible prescriptions utilize this support, which does not drive prescriptions without activation.
Scrutinizing the Intersection of Market Access and Point-of-Care Engagement in Pharmaceuticals
Over the past year, the dialogue in this segment has largely revolved around the commercial aspect of market access, with special attention on hubs, affordability initiatives, and adherence infrastructure as key revenue drivers. Now, it’s time to dig into a related construct that bears fiscal ties with these but is often discussed separately: point-of-care engagement, which is when the actual prescribing decisions are made.
A Closer Look at the Disconnect between Investments and Prescribing Decisions
Pharma brands dedicate substantial resources in negotiating with payers to secure 75% to 90% coverage. Yet, this information is often absent at the point-of-care, leaving prescribers in the dark during the prescribing decision. This lack of visibility means that the invested resources do not necessarily translate to a prescription, despite the existence of a contract and coverage.
Simultaneously, brands fund copay programs to spur fills and adherence. However, in many top therapy areas, fewer than half of eligible prescriptions harness this support. As per recent data from IQVIA, in fields such as oncology, ophthalmology, dermatology, and antithrombotics, only 30% to 40% of prescriptions activate copay programs1. Diabetes copay utilization saw a 50% decline within a year. Despite the presence of such investment and support, without activation, it doesn’t boost the prescription.
Exploring the Impact on Pharma Revenue
Chris Dowd, Senior Vice President, Market Development at ConnectiveRx, conversed with Lisa Prowker, ConnectiveRx’s SVP of messaging operations to comprehend how point-of-care prescribing decisions impact the pharma industry’s revenue. Lisa is a recognized industry innovator and thought leader in the Electronic Health Record (EHR) and pharmacy healthcare provider (HCP) messaging network space.
Understanding the Visibility Issue
Lisa explains that the lack of visibility at the point of prescribing puts the investment at risk. She highlights that copay support is a strategic investment in access, and when prescribers and patients are unaware of its existence, the brand gets ruled out for affordability reasons before the support can be effective.
She points out that the industry spent roughly $23 billion on copay support last year. The point at which copay awareness is most crucial is typically when a medication is being prescribed or seriously being considered as the best clinical fit. If a prescriber or patient is unaware of the copay support at this juncture, that investment is never activated. This is not only a patient access problem but also an ROI problem.
Reframing Point-of-Care as a Strategic Lever
Chris and Lisa’s discussion delves into how point-of-care engagement can be seen as an aspect of revenue preservation, ensuring that investments made by brands, such as formulary wins, copay support, and hub services, are indeed utilized.
Today, CFOs and brand leads are expected to demonstrate a durable, traceable return on every dollar spent on patient support. This is particularly true under IRA (Inflation Reduction Act) cost constraints and increased payer pushback. The key question is no longer whether a brand offers help but if the help is being utilized.
Implementing Ethical Engagement at the Point of Prescribing
Chris and Lisa further discuss the implementation of transparency, rather than persuasion, at the point of prescribing. Lisa explains the importance of integrating copay support directly into the RTBC (Real-Time Benefit Check) workflow, where it provides the complete cost picture, allowing physicians to prescribe based on clinical judgment instead of financial conjecture.
Lisa suggests that in light of the decline in rep access, point-of-care has become a primary channel instead of a supporting one. She notes the power of relevance, with messaging tied to therapeutic context, patient characteristics, and the act of prescribing itself, as opposed to broad demographic assumptions.
Understanding the Impact of Absence at the Point of Care
Without presence at the point of care, brands face the risk of being excluded due to perceived high costs, leading to potential loss in revenue, outcomes, and trust. To overcome this, Lisa suggests commercial or access leaders should audit where decisions are currently being influenced, assess how affordability is communicated in the workflow, and include point-of-care as part of their strategic plan.
Acknowledging point-of-care as a strategic lever, not just a tactical add-on, can significantly increase a brand’s performance in first-fill and continued therapy.
About Chris Dowd
Chris Dowd is the Senior Vice President, Market Development, at ConnectiveRx. With a nearly three-decade-long career spanning leadership roles across Big Pharma, healthcare startups, and the patient support space, Dowd is a prominent industry voice in patient access and adherence.
Reference
1. Understanding the Use of Medicines in the US 2025. IQVIA. April 30, 2025. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/understanding-the-use-of-medicines-in-the-us-2025
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