“Ya know we try to guess who you’re writing about, right?”

Guess away, friends. Guess away.

I can honestly say it’s never about any specific client. This <waves hands at the little business I’ve been building for nearly six years> is literally our son’s college fund. I ain’t messing with that.

Nope, I’m not spying on your inbox, nor do I possess any particular type of prescience. I’ve just been doing this for a while, and I pick up on patterns. I think we all do.

There’s a Hub/SP conference in San Diego next week that I would have liked to attend (fun fact: I spoke at it exactly ten years ago, when I was 33 weeks pregnant, and at a whopping five foot one, there was nowhere for the baby belly to go but out. It was getting tricky to reach the steering wheel, so I Amtrak’ed down from Camarillo), but I have a few ortho appointments for my shoulder, so I’ll be sitting this one out.

But if I were there, here are five things I’d be checking in with my Patient Support Peeps about:

1. Are you seeing HCPs leaning on SP rather than doing (and risking) buy-and-bill?

What I’m really asking: Does SP remove one of the practical constraints on how high a specialty drug price can go?

I’m hearing more HCPs say they don’t want to assume the acquisition cost and reimbursement risk of very expensive products. They want SP. I’m not talking about payer-mandated white bagging. I’m talking about provider preference.

With buy-and-bill, there’s a very practical constraint on price: somebody at the provider organization has to be willing to buy the product, carry the receivable, and take the risk that reimbursement works the way everyone thinks it will. SP takes that problem off the provider’s plate. The economics may get reshuffled through discounts, rebates, fees and other contracting.

I’m not suggesting SP is causing higher prices. But if we remove the provider’s willingness to finance the product as a practical constraint, does that give manufacturers more room to go higher on drug prices?

Somebody’s got to ask it. I suspect the net-price nerds will get up in my grill on this one, but I’m just sayin’ is all.

2. Is Patient Support moving back under Market Access?

After years of being built out as its own vertical...pendulum swinging?

Personally, I think in CGT, Patient Support should be its own functional area. For pretty much everything else, I think it should sit under Market Access.

But the hill I would die on?
FRMs should report under Patient Support.

I know, I know, I know. I hear the murmurs now.

Makes you rethink what the talent profile (and leveling) of that Patient Support leader should be, doesn’t it?

3. How far upstream can Patient Support go and still comfortably be considered non-promotional?

I wonder if there’s a little institutional memory being lost here.

There’s a generation of Patient Support folks who cut their teeth during the era of massive pharma settlements and Corporate Integrity Agreements (or were cut by them), when we got awfully deliberate about the lines between Sales, promotion and Patient Support.

“After the decision to prescribe...” has been tattooed on many a forehead. A lot of those folks have greyed out of Patient Support. Let the record show: I dye my hair.

Now I’m hearing versions of, “Why can’t Patient Support do that before the prescription is written?”

Maybe the better question is: What exactly are we trying to accomplish, and why did companies become so careful about this in the first place?

The industry did not invent all those walls for fun.

And some of the recent enforcement activity is a pretty good reminder of how quickly something called “support” or “services” can look very different once money, HCP behavior, specialty pharmacy arrangements or utilization enter the picture.

Veloxis is worth a read. So is EyePoint, although for a slightly different reason. The government's allegations there actually get awfully close to my first question about what happens when somebody takes provider acquisition risk off the table.

Everything old is new again?

4. If PAP scripts don’t count toward Sales incentive compensation, are we inadvertently creating two classes of Patients: those whose prescriptions “count” and those whose don’t?

There can be very good reasons not to compensate Sales on free drug. And PAP, bridge and other free-goods programs are not all the same thing. To be clear, I'm not arguing that Sales should be compensated on PAP volume.

But a Patient receiving free drug may still represent very real demand for the product. The HCP chose the therapy. The Patient wanted treatment. Access failed, coverage wasn’t there yet, or the Patient couldn’t afford their share after coverage. At launch in particular, payer coverage can lag actual clinical demand by quite a bit.

So if those Patients are excluded from the numbers that define commercial performance and compensation, are we getting a distorted picture of what’s actually happening?

And beyond the measurement issue, incentives are incentives. If one Patient’s prescription helps somebody hit goal and another Patient’s prescription doesn’t, I think it’s at least worth asking whether we end up creating two classes of Patients inside the commercial organization.

Not because anybody sat in a room and decided that.
But because money teaches people what counts.

5. Direct-to-Patient and cash pay are very sexy right now.

They are also not the same thing. And their use cases may be fairly limited, even if the number of Patients potentially affected is enormous.

I think some of our assumptions about who has “good insurance,” who has disposable income, and who is financially secure enough to pay cash are getting upended.

White-collar workers are increasingly worried about layoffs, AI displacement and the loss of employer-sponsored benefits. Meanwhile, some hourly and unionized workers have remarkably durable, collectively bargained coverage. The old proxies we use for who is “commercially insured,” financially secure, or a plausible cash-pay Patient may be getting less reliable.

Maybe these are five completely unrelated things.

Or maybe some of the lines we’ve spent years drawing around Patient Support, Market Access, distribution, promotion and reimbursement are getting a little...weird.

Is it me?

A note on AI use

I wrote this. I also used AI while editing it to pressure-test the thinking, the structure, the facts, and whether I was saying anything stupid or needlessly risky.

The opinions, examples, voice, and final decisions are mine.

Nobody is requiring me to tell you this. I just think it’s worth being transparent about how I use AI. It’s a very good editor and sparring partner. It does not replace judgment, experience, or the twenty-plus years I’ve spent working in hospitals and life sciences.

It’s the last Friday of summer vacation around here, and I’m spending it with my kiddo instead of writing something new. So I went back to one of the first pieces I wrote for The POOP. I wondered whether it had aged well. Unfortunately? Yeah. I think it has.

Pssssst, Manufacturers:
Bringing your Patient Support Program (PSP) operations in-house doesn’t excuse you from... y’know... actually managing the program operations.

On the flip side, I’ve seen Manufacturers go to the other extreme and treat their frontline people like widget-making machines on a factory assembly line. Somewhere, somehow, amidst all the Six Sigma and Lean methodologies, we lost our humanity. Ironic, given that we’re ostensibly trying to help people when they’re most vulnerable, i.e., when they are at their most human.

The funny thing is, I think both the “hands off” and “operational excellence” (both O and E capitalized, thank you very much) approaches are symptoms of the same problem:

A fundamental lack of respect for the actual work that people in Patient Support do. And let’s be clear: this work isn’t just administrative. It’s emotionally taxing, medically adjacent, and often the last thread connecting a Patient to the treatment they’re trying to access. It’s high-stakes, high empathy, and high burnout.

And unfortunately, <pause>
Hmmm.... am I really going to go there?
<deep breath>

I think it also suggests subtle (or not) sexism and racism in commercial Pharma and, I s’pose, US healthcare overall.

We tiptoe around the power dynamics. Or willingly ignore them when they work in our favor. And when we do that, we reinforce a pattern that keeps relational labor at the bottom of the hierarchy. Especially when women and people of color perform it. Pharma doesn’t just underfund these roles. It designs systems that treat them as disposable.

And if you’re a business leader reading this, wondering what it means for your Patient Support Program, here’s a place to start:

• Don’t call it in-house if it’s actually hands-off. If your internal team doesn’t have process maps, escalation protocols, or real leadership accountability, then congrats. You’ve built a program in name only.

• Audit who’s making the decisions AND who’s closest to the work.
  If your vendor selection process excludes the team managing daily operations, that’s not rigor. That’s a recipe for repeating the same mistakes with a shinier logo.

• Define operational excellence in Patient terms, not just KPI dashboards. Speed is great. So is accuracy. But if your reps aren’t empowered to escalate, follow up, or troubleshoot with care, then you’re optimizing the wrong thing.

• Compensate experience. The woman who knows how to get a Patient approved after a denial isn’t “just a rep.” She’s knowledge, trust, and continuity. Treat her like it.

• And take a hard look at your attrition data. If the same job families consistently show high turnover, low pay, and little to no development, that’s not a coincidence. That’s a failure of investment.

These aren’t soft issues. They’re structural levers. If you’re not pulling them with intention, they will still be pulled. Just not in a direction that serves your Patients.

Walk through enough Patient Support call centers and Hub operations, and something becomes pretty obvious: the frontline workforce is disproportionately women and people of color. Doesn’t matter whether it’s in South San Francisco, Kansas, or South Florida. Very early on in my industry career (mind you, I was 40 and already had experience managing staff across multiple bargaining units in hospitals, but I was very new to “corporate America”), I was asked to counsel two teammates on their executive presence. I was even given a printout from, wait for it, Glamour magazine to share with them. I had just met these two women, and they seemed AOK to me. What was the “development opportunity”?

One had chunky caramel highlights that a senior director deemed “too much.” The other was considered very bright but didn’t “...demonstrate professional style.”

I looked at my boss, and in perhaps what was one of many career-limiting moves, I said, “You want me, a blue-eyed blonde who has been here a minute, to counsel two long-term employees, both of whom are women of color, on their hair?!?”

Dude. Yeah, no. Hard pass.

Fast forward many years, and I’m at an RFP onsite visit at a potential Hub services vendor. My group was invited to sit in part of a training class, all of whom were African American. The class had a nice mix of talents, including individuals who had worked in specialty pharmacies, health plans, and doctors’ offices. One young woman, in particular, was a former MA in a busy pediatrics practice. If I had been hiring, I would have snatched her up in a minute. She was sharp and had the right mindset for Patient Support work. The only thing she was missing for Pharma was a four-year degree.

We exit the class, and two folks from my team approach me.

“Maureen, OUR prescribers and Patients can’t be calling into people like that.”

Blink. Like what?
Oh, wait. I get it.
Well, no, I don’t. But I can see what’s going on here.

And then I couldn’t help but wonder, “Have y’all ever been in a doctor’s office? Who do you think works the front desk? Registration? Draws your blood?”

Are you uncomfortable with who is doing the work?

Or does it only become uncomfortable when they become part of your brand?

A theme I’ve encountered at every large Manufacturer I’ve worked with: When leaders talk about themselves, they’re sure to label themselves as strategists. They don’t “do tactics,” so they need to bring me in.

Listen, I don’t care whether you label me a strategist or a tactician. Initially, it used to bug me, as if there was something dismissive about understanding operations and execution. Then, my blue-collar chip on my shoulder shifted, and I realized that I bill what I bill, and as long as the checks don’t bounce and clients pay on time, it’s all good. Better than good. 😉

But if you’re internal to a Pharma manufacturer, you want to position yourself as strategic. Understanding “how the sausage is made” often works against you.

There’s another layer to this, too, one that shows up in who gets promoted.

When Manufacturers treat Patient Support as execution-only, they overlook a huge source of talent. Many of the women and people of color in these roles have deep system fluency, strong emotional intelligence, and an instinct for solving the kinds of problems that don’t appear on dashboards.

But instead of investing in their development, we treat them like throughput machines.
No wonder succession planning feels so hard.

Does your leadership pipeline lack representation?
I’m going to pause. Have you asked yourself the question?
Maybe it’s worth asking who you’ve already dismissed as “not strategic.”

“Fit” is often used as a neutral term, but it’s too frequently a proxy for whiteness, polish, pedigree, or proximity to power. It sounds benign, but it shapes who gets sponsored, who gets stretched, and who gets stuck.

And here’s where it gets personal.

When I was a mother of a young child, I was told (more than once) that market access roles could wait.
Too much travel.
Too many payer meetings.
Too much time away.

And yet somehow, no one ever blinked when I flew multiple times per month…
To Raleigh.
Or Frisco (Texas).
Or Newark.
By myself. To throw on a headset for side-by-sides at a nurse call center, or hold a vendor’s feet to the fire during a copay QBR, or lead a Hub training for a line extension.
That travel didn’t “count.”
It was invisible. Because the work was invisible.

And so were the people doing it.

Here’s something I think about more than I probably should:

When I’m brought in to evaluate a Patient Support Program, whether outsourced, insourced, or somewhere in the messy middle, my final recommendations rarely surface anything the Patient Support team doesn’t already know. I might package it differently. I might connect some cross-functional dots. And sure, I put it in a polished slide deck.

But the insight? It’s already there. The people doing the work know exactly where the system breaks, what slows it down, and what would make it better.

So I keep wondering: why don’t senior leaders just ask them?

And if the answer is, “We can’t take them off the floor,” or “We can’t afford to pull them from throughput,” maybe that’s your signal. If the system relies on their nonstop labor but can’t make room for their voice, that’s not operational excellence. That’s avoidance.

If Pharma wants to be Patient-centric, why does it still marginalize the very people supporting those Patients?

Look at who’s doing the real work in your programs. Who gets asked what they think. Who gets invited into the room when decisions are made. Who gets developed. Who gets praised when things go right, and who gets blamed when they don’t.

And maybe, the next time someone tells you the Patient Support team isn’t “strategic,” ask yourself whether you’ve ever actually given them the chance to be.

Originally published in The POOP, April 2025

Strategic plans are getting tested. Senior leaders are asking their teams to plug numbers into sprawling, multi-tab Excel files. Budgets are being arm-wrestled into place.

And Patient Support leaders are trying to figure out what they are actually going to need next year, what they can defend, and what somebody else is going to decide they should live without.

Across completely unrelated manufacturers, therapeutic areas and brands, I keep getting versions of the same question:

How many people are we going to need?

One of the stranger things about consulting in Patient Support is how often completely different engagements start to rhyme. I can be working with manufacturers in different therapeutic areas, with different mechanisms of action, different brands and completely different access challenges, and still find myself thinking, didn’t I just have this conversation last week?

Lately, that conversation has been about capacity. Can you help us model this? At what volume do we need to add p…

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When you work in Patient Support long enough, you cannot help but notice patterns. One that I have always found quietly moving is the number of people in our field who have backgrounds in theology, divinity, ministry or worship music.

I offer this as an observation rather than an analysis. I have not conducted a survey, and I cannot tell you whether former theology students and church musicians are statistically overrepresented in Patient Support. I can only tell you that I have met enough of them over the years to notice.

At first, I thought it was simply an interesting coincidence. The more I thought about it, though, the more sense it made.

I have written before about how Patient Support can allow people to retain some sense of human decency and stewardship while still earning a comfortable living and supporting a family. We work inside a commercial industry, yes, but the substance of the work is often deeply human.

A person has been diagnosed with a serious illness. A physician has pr…

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Ness: “I have sworn to put this man away with any and all legal means at my disposal...”

Malone: “And then what are you prepared to do?”

— The Untouchables

“We don’t want to lose the personal connection with our Patients.”

“We want our case managers to feel like a friend to the Patient and their family.”

“AI can ruin that human touch that we work so hard to achieve.”

I’ve heard all of the above, and I agree with all of it. But you know what I also believe to be true? You’ve got to fight fire with fire.

Patient Support cannot protect the human touch while remaining technologically outmatched.

A case manager does not become more compassionate because she spends 25 minutes hunting for a payer policy, documenting a call, or checking seven screens for missing information. She simply has 25 fewer minutes to help the Patient, and quite possibly a growing desire to throw her laptop out the nearest window.

The machines are already here

In Patient Support, the compliance and regulatory landscape often d…

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It’s the second week of July, which means your mid-year Patient Support review is probably on the calendar, being rescheduled for the third time, or quietly becoming an early Q3 review. No judgment.

Before the 70-slide deck arrives, decide what you need from the meeting. I go into these reviews with four questions:

1. Vendor Performance: Is the vendor meeting its contractual and operational obligations?

2. Manufacturer Behavior: Are the Manufacturer’s own teams following the agreed-upon process?

3. Program Design: Does the program still match reality?

4. Market Intelligence: What are Patients and HCP offices telling us?

Ask your vendor partners to send the deck as a pre-read one full business week before the meeting. Most agendas devote the bulk of the time to the vendor scorecard because those slides are relatively easy to assemble and comfortable to discuss. If the program is being managed well between reviews, the routine vendor ops slides should take 15 minutes, tops, to discuss. The other three qu…

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A lot of us work in Patient Support because we feel like it is one of the few places in pharma where we can still hold onto a little piece of our souls.

Aside from clinical research, Patient Support is where the work can still feel close to the Patient. Close to the person.

And… the money can be good.

Shockingly good, if you came from clinics, hospitals, social work, or public health.

It may not rival the biggest sales compensation numbers, but it definitely beats what many of us would make in the more obviously mission-driven parts of healthcare.

My annual take-home pay more than doubled when I went from working as a hospital administrator to a pharma Patient Support operations role.

About eighteen months after I started that biotech job, a physician leader whom I genuinely liked, and for whom I have tremendous respect, took me out to coffee.

He had recently been promoted into an executive leadership role at an academic medical center and was looking for a “right hand,” so to speak. Someone…

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Yes.

“Are they also hiring aggressively for field reimbursement?”

Also yes, and the contradiction starts to make sense once you look at where the money is moving.

This does not look like a simple reduction in Patient Support Program investment. It looks like a relocation of human expertise. Reimbursement knowledge is being treated as expensive when it sits inside the hub and valuable when it sits in the field.

Sometimes that is defensible. This is still a business. But let’s be honest about what is changing, what is being lost, and what has to be built next.

Certain hub-based roles are clearly under pressure: intake specialists, case managers, reimbursement specialists, and other front-line operational jobs. That work is being run through an efficiency lens, with manufacturers looking hard at workflow tools, automated benefits investigation, electronic prior authorization, AI-enabled workflows, portals, dashboards, and oth…

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Lately, I’ve noticed a thing.

Someone will send me, or post online, a slick little infographic, summary, carousel, or “helpful visual” that clearly had AI fingerprints on it. And I’ll think: huh, that looks familiar.

Sometimes it is based on something I wrote. Sometimes they credit me. Sometimes they mention me in passing, which is not quite the same thing. Sometimes they don’t. Either way, if I’m being honest, it rubs me the wrong way.

I don’t think most people are trying to be shady. I think they’re experimenting with the tools, trying to be helpful, trying to make complicated ideas easier to share.

But it still feels weird to see your own thinking come back to you as someone else’s “quick visual” or “helpful summary,” especially when the source gets fuzzy.

And I’ll be honest: having it happen several times in a short stretch has made me a little more timid about posting anything substantive about Patient Support.

Which is an uncomfortable thing to admit, because I understand the bargain.…

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I was chatting with someone the other day about their copay program, and they complained about the program expense. They might want to explore other partners or a new program administrator.

Last week, behind the paywall, I wrote about the gap between a Patient being eligible for copay support and actually getting helped at the pharmacy counter, and why that gap usually has more to do with broken workflows than Manufacturer intent.

This week, I’m looking at a different copay problem: what happens when the Manufacturer looks at the program, hates the cost, and starts wondering whether the vendor is the problem.

I probably shoot myself in the foot with this stance, but I’m a firm believer, trust me, rooted in lived professional experience, that changing vendors should be a last resort.

I know, I know. I could make my bread and butter on request for proposals (RFPs) and advising folks on vendor moves. But I don’t, and it’s not because I’m in the vendors’ back pocket. I’m not. I’m independent,…

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“Why don’t the drug companies want you to use their copay cards? Is it because they won’t make as much money?”

Usually, no.

But the answer is more annoying than that.

I was on a high school debate team. True story: I got rejected from the school’s speech team. Twice. So a renegade group of us formed our own parliamentary debate team, and to this day, I won’t bring a pen to a podium.

One thing debate drilled into me: evidence and inference are not the same thing. It’s a little like when statisticians say correlation does not equal causation.

Imagine this. Before you leave the office, your spouse texts you and asks you to swing by CVS/Walgreens/Drogers/wherever you pick up most of your family’s medicines. Your daughter’s medicine is ready. Cool.

You know that you’re going to have to pay something, because when you and your partner were making decisions about your family’s health insurance last fall, you intentionally chose a high-deductible health plan (HDHP), in no small part because your fa…

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If you are…

A former coworker who became a friend…

A client whose engagement ended many moons ago…

A vendor partner who was great to work with and/or got me out of a pickle…

Someone who sent me a kind DM or dropped a comment on a post way back when…

And you’ve got a quick question, I’m happy to make time for a call.

If we start swimming towards topics I think require an NDA, I’ll say as much and hit pause, but honestly? Most folks just want a sounding board for a few minutes.

Scratch that; I’m more of a Greek chorus.

I may not always agree with you. If you’re Creon and throwing shade at Antigone, I’m going to gently suggest you go have a think.

You know what the number one question I get asked is?

It’s some flavor of:

Someone, AKA new executive leadership, the sales team, or field reimbursement, hates our Hub. Are there any Hub providers we should consider switching to? Or do we just need to bite the bullet and bring everything in-house?

And folks hate my answer:

M…

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Sometimes I get asked, often by somebody in trade or field reimbursement, very sincerely, whether it really would cost that much more to bring the hub in-house.

And I will admit, even now, the question can still make me choke on my coffee a little.

It is a fair question. What catches me is how often people do not fully understand what they are actually asking.

Because when most people ask that question, what they usually mean is: would it really cost that much more than what we are paying the vendor now?

They are thinking about headcount. Salaries. Maybe a little bit of technology.

What I wish they’d ask:
Is the manufacturer built to run the operation they are describing?

What You Actually Have To Build

Yes, you will pay your own staff more than whatever portion of the vendor fee is currently allocated to labor. I benchmark salaries all the time, from intake and reimbursement specialists to case managers to nurse educators to field reimbursement managers.

Believe me, that part is not the issu…

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A few things from Day 1 of the Access USA conference are still rattling around in my head.

In more than one room, I heard manufacturers say they want their case managers to become friends with their Patients. Same with nurses. Friends.

This wasn’t casual language. It came up as part of the rationale for keeping Patient Support in-house rather than using a third party. But it was also used more broadly to explain how important trust and connection are to these programs in the first place.

I don’t want to miss that nuance.

I’m not interested in turning that into a fake binary. There are real reasons to keep things in-house. Control. Visibility. Ownership of operations, data, analytics. All true.

There are also real reasons to use vendors. Cost. Speed. The ability to scale when you need to.

People can argue that all day.

What I can’t get past is the word friendship.

Friends don’t operate inside a pharmaceutical or biotech manufacturer-funded program with business goals attached. That doesn’t mea…

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I love AI. That does not make me any less of a touchy-feely Patient Support person.

If you care about Patient experience, you should care deeply about where human effort is being spent well, where it is being wasted, and where technology can reduce friction without creating new risk.

Talented, compassionate people should not be burning their time listening to muzak while waiting on hold.

Sometimes we confuse white-glove with human-led and forget that a Patient-centered experience is not necessarily the one with the most live touch. It is the one that gets someone what they need with the least avoidable hassle.

That should not be controversial. I am not sure our industry always behaves like it agrees.

There is a lot of work inside Patient Support that is repetitive, administrative, and necessary, but not especially well-suited to human talent. There is also work that depends on judgment, explanation, trust, and context. That distinction matters more to me than the broad, blurry conversation…

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National Sales Meetings and Plan of Action meetings reveal what organizations actually prioritize.

Sales teams gather for multi-day workshops. They spend hours on mechanism of action, competitive positioning, objection handling, and territory strategy. Senior leadership makes appearances. The production value is high, the investment visible. This is where performance begins.

Patient Support training sits under the same roof, but it is rarely built with the same intentionality. Commercial learning and development timelines are structured around Sales and field execution. Patient Support content is often repurposed from those builds, adapted after the fact, or condensed to fit operational constraints. Scientific content is reduced at best, and often stripped down to process. I have heard more than one leader describe the material as needing to be simplified. Whether it is called sanitized or dumbed down, the effect is the same.

Even securing basic product training for Patient Support teams…

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Yup. Here’s what I think you should ask them.

My last piece on The POOP was ten questions you may want to ask a recruiter if they reach out about joining an emerging biotech. Let’s say you’re intrigued, you make it past preliminary screens, and all the nondisclosure agreements have been signed. I’m assuming you’ve already done some legwork on the disease state and how competitive (or not) the therapeutic area is.

Here are ten more questions I’d be prepared to ask if you’re in final interviews (note: this is informational/educational only and should not be construed as career coaching or advice).

You’ll notice I’m not starting with tactics like which hub vendors they’ve evaluated, whether they’re leaning on copay programs, or whether they plan to “solve” access through enhanced specialty pharmacy services. Those are downstream decisions.

If you’re an ops person reading this and bristling, I see you. Tactics matter. They’re the difference b…

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To be clear, I’m not shopping. I took the call because the therapeutic area was compelling with high unmet need, and honestly it’s a useful temperature check for comp, equity, long-term incentives, and org structure. Clients ask me about team structure and compensation all the time.

(A quick note: this originally appeared as a series of posts on LinkedIn. The response surprised me. There are too many Patient Support leaders who are hurting and don’t have much room to say it out loud at work.)

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Every January, the life sciences industry heads to San Francisco for the J.P. Morgan Healthcare Conference. Investors, bankers, executives, and dealmakers gather to tell a story about what’s coming next.

You know the drill.

Pipelines look great.
Narratives are tight.
Markets are big.
Confidence is high.

And one thing you almost never see on stage is Patient Support. Or Patients.

People sometimes read that as a statement. If it’s not at JPM, it must not be strategic. It must not really matter. It must live somewhere below the line.

That’s not quite right.

Everyone in that room understands what JPM is. It’s not an operating review. It’s a signaling venue. That’s table stakes.

Some distance between decisions and consequences is unavoidable. That’s how capital markets function. You can’t wait for perfect information before you invest, price, or build.

But there’s a difference between not knowing yet and choosing not to look too closely.

Patient Support is often where that choice becomes visible.

The m…

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Yet the function most responsible for whether Patients start and stay on therapy is still treated as a downstream service cost.

That is not a cultural inconsistency.

It is a valuation error.

By valuation, I do not mean sentiment or spend. I mean where authority and risk actually sit in the commercial model. The problem is not respect or visibility. It is value.

Patient Support is not positioned as commercial infrastructure. It is positioned as remediation. Internally, it is often reduced to “the Hub.” Convenient shorthand, maybe. But inaccurate.

Patient Support is the operating layer that translates commercial assumptions into reality. Field reimbursement and access support. Benefits verification and prior authorization execution. Copay and financial assistance programs. Patient Assistance Programs (PAPs). Nurse educator and onboarding services. Adherence enablement. Data feedback loops. Vendor performance management.

Not just the Hub, bu…

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