November 2025 • PharmaTimes Magazine • 22-23
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Shape shifters
High-touch, high-tech: how the US hub service model is shaping the future of patient support
The rise of specialty and rare and orphan disease treatments, along with the increasing importance of patient-centricity, are driving the growth and heightened focus on hub services within US pharmaceutical manufacturers.
Recognising that patients suffering with rare and orphan diseases have often faced a long and arduous journey to diagnosis, the industry goal is to deliver a high-touch, comprehensive service to support patients through access, affordability and adherence challenges.
Service status quo
Hub services are predicted to grow between 5%–10% over the next three to five years to serve the increasing US patient populations.
Today, the existing US hub service models, which include in-house, outsourced, hybrid and hub-lite, are customised based on the size of the population being served, nuances of the treatment, technology and expertise of the manufacturer.
They often rely on one or multiple third-party partners to meet all the needs of the programme.
Hub services might include:
- Enrolment and consent in the manufacturer’s support programme captured digitally or through traditional methods of fax or phone
- Benefit verification and coverage determination, both electronic and manual, by verifying directly with the payer
- Financial assistance coordination offered by the manufacturer includes copay, free goods, bridge and quick start
- Infusion centre or Centre of Excellence (COE) location and coordination to confirm referrals and scheduling, including travel arrangements and lodging when necessary
- A non-commercial dispensing pharmacy to distribute free goods to those who qualify
- Treatment barrier resolution and buy and bill medical benefit coverage through payer navigation, financial assistance education and site-of-care support
- Treatment navigation for patient support includes supplemental education, training, preparation, empathic support and ongoing patient check-ins to support adherence to treatment
- An HCP portal to streamline programme operations and reduce HCP offices’ administrative burden
- A Field Reimbursement Manager (FRM) portal enabling FRMs to educate providers on specific patient cases, monitor patient access progress and collaborate with internal programme operations.
Today, 65%–75% of manufacturers are outsourcing these services to Patient Services partners, with an average of 45% using multiple partners or third-party partnerships managed by an outsourced vendor.
Yet, despite this ongoing reliance on outsourced partners for services, manufacturers are voicing some dissatisfaction with the current state of affairs, and these concerns are likely to continue to drive the innovative change that is needed to improve patient affordability, access and adherence to treatment.
‘The ability to navigate and overcome payer restrictions requires considerable flexibility and field acumen within the programme’
Moving the needle
There are many components to consider when designing and implementing a patient support programme.
Payer landscape, technology to improve efficiencies, training of experienced talent for high-touch support and quality assurance truly set the tone for superior patient service.
When delivering a best-in-class patient experience, each component in patient support programmes can present its own set of hurdles, while each has the goal of positive improvements in patient data from enrolment through adherence.
For example, the impact of a single point of contact in a patient support programme is demonstrated in a programme where a treatment navigator was dedicated to support an individual patient.
By providing this single point of contact, the programme experienced improved drop-out rates before medication onset by as much as 15%, 11% decreased time between programme enrolment and first dose, and 10.3% improved discontinuation rates within 60 days.
Some top-level impacts to consider in improving hub service delivery include:
- Payer landscape – Manufacturers are delivering hub programmes in a US healthcare landscape where payers are continually in a state of flux due to federal policy shifts, pharmacy innovation and the increased emphasis on value-based care.
The ability to navigate and overcome payer restrictions requires considerable flexibility and field acumen within the programme. FRMs play a key role in this area, educating HCP offices on current programmes to achieve reimbursement and access for the patient, improving speed to therapy
Particularly concerning are interim findings from the PURE Payer Policy report where 67% of payers see greater site restrictions over the next three years, with preferences shifting more to the home and alternate site of care (ASOC) infusion centres not located in a physician office or hospital.
Close to 80% see more guard rails being put in place for prior authorisation (PA). As a result of these trends, it is not surprising that the need for field reimbursement specialists within the patient support programme is expected to grow in pace with hub programmes at 5%-10% over the next three to five years.
These shifts require patient support programmes to rely even more heavily on experienced talent and technology efficiencies in expediting PA approvals. Infusion-locator tools are also implemented to advise patients where they can receive treatment.
- Technology and real-time reporting – All of this programming requires a forward-thinking technology roadmap to deliver as close to real-time reporting as possible in order to enable effective and immediate programme adjustments as needed.
The technology to provide visibility to patients through digital communications, medication availability and payer requirements is critical to monitoring and improving the overall patient experience.
In addition, AI virtual agents, speech analytics and sentiment analysis for call summaries are being utilised to improve efficiencies, allowing human resources to be available to assist patients in navigating more complex challenges.
To measure patient support programme effectiveness, key performance indicators (KPIs) are established and monitored across such factors as patient enrolment, engagement and adherence to illustrate the critical drivers of patient support programme success.
The overall intricacies of hub design and delivery can be overwhelming, particularly considering the ever-increasing complexity of the healthcare landscape.
With the goal of having operational excellence to optimise the patient experience, manufacturers are honing their programmes. Many are examining the option to bring some functions in-house, recognising they still may lack the technology, experienced talent and bandwidth needed to offer all services effectively.
A vast majority are seeking a trusted partner who can offer patients an empathic single point of contact, operational excellence, and consultative and strategic account management to oversee their hub services.
All are looking to move the needle forward in providing high-touch hub services that truly make the patient journey easier, ultimately improving health outcomes.
Nareda Mills is Global President, Patient Solutions at Inizio Engage
PharmaTimes
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