Removing Barriers Between Prescription and Therapy Start

Over the past decade, patient support hubs have strengthened specialty access, improving affordability coordination and accelerating therapy initiation. But as health systems consolidate, prior authorization remains a barrier, Alternative Funding Programs continue to grow, and benefit design becomes more fragmented, the market is asking what removes barriers between prescription and therapy start today.

Increasingly, the answer points toward access infrastructure embedded within care delivery — not operating adjacent to it. We are not fully there yet, but the direction is clear. Patient access is increasingly shaped at the point of care, inside the clinical and operational workflows of health systems, narrowing the line between strategy and care delivery.

Patient Access Is Converging at the Point of Care

Pharma is evolving beyond standalone call-center hubs toward models integrating access support directly into health system workflows. Early signs include EHR-integrated benefit verification and prior authorization workflows, point-of-prescription support that surfaces cost and coverage information while prescribing decisions are being made, health system embedded models across IDNs and specialty clinics, and hub-lite structures paired with digital-first orchestration.

This is not a replacement of the hub model — it is its next structural evolution, with the center of gravity moving closer to care delivery and the prescribing workflow itself.

The Prescription-to-Start Gap Is Operational

Friction often arises in the space between prescription and therapy start. Coverage may technically exist and clinical intent may be clear, but administrative complexity, documentation requirements, or affordability confusion can quietly slow momentum — friction that isn't always visible through traditional reporting. Point-of-prescription support matters because it surfaces cost and coverage information early, helping providers and patients understand the likely access pathway before the visit ends.

Precision Access Requires Workflow Visibility

Prior authorization and affordability complexity are no longer generalized challenges — they are plan-specific, channel-specific, and data-driven, from benefit variability to biomarker-driven coverage, site-of-care restrictions, and plan-aware copay design.

Broad deployment of uniform support resources is becoming inefficient. The market is moving toward precision access orchestration — aligning support to the specific friction points within a patient's coverage profile, which requires workflow proximity and real-time visibility.

Automation Makes Embedded Access Scalable

Embedding access infrastructure inside care delivery must scale economically. Automating prior authorization and reimbursement workflows, reducing manual documentation burden, and intelligently routing patients to the right affordability pathway are becoming foundational — streamlining benefit investigation and identifying risk of delay or abandonment earlier.

This shift lets access teams spend less time navigating paperwork and more time helping patients move forward with care. When access infrastructure operates inside the clinical workflow, barriers can be resolved before they turn into delays that affect therapy start and outcomes.

Turning Access Friction Into Therapy Starts

The competitive divide in specialty therapeutics will increasingly hinge on one question: is access operating adjacent to care, or embedded within it? Patient support is evolving from an external service layer to access infrastructure that helps remove barriers between prescription and treatment start. Pharma brands are still early in this journey and health systems are still defining preferred models, but the trajectory is visible.

Organizations that integrate point-of-prescription support, cost and coverage visibility, and workflow automation will be better positioned to turn access friction into therapy starts. In today's health system environment, patient access must operate inside the workflow — not downstream from it.

At Flora Health, our team supports that evolution by connecting access strategy to real-world health system workflows, with an emphasis on partnership, integration, and measurable impact across the prescription-to-start journey.

About the Author

Karina Castagna is Chief Growth Officer at Flora Health, where she leads growth strategy and patient access integration across health systems nationwide. With over two decades of experience across pharma and healthcare, Karina brings deep expertise in access strategy, commercialization, and patient support. Prior to Flora Health, she held senior leadership roles at Mercalis, OptimizeRx, and Amgen, and holds an MBA from the Wharton School at the University of Pennsylvania and a BA from Loyola Marymount University.