Insourced, outsourced, or hybrid hub model?

With no one-size-fits-all approach, this recent expert panel offers insights and advice on what they see for the hub model of the future.

At the early-year Hubs East https://informaconnect.com/hub-specialty-pharmacy/ conference, panelists discussed “Hub Model Playbook: Navigating Insourced, Outsourced, and Mixed Models.”

Diana Villanova, executive director of patient support services at Catalyst Pharmaceuticals, told the audience, “I look at the drug development pipeline, and I see the focus on specialty meds and even gene therapies. The needs of our patient support programs are getting more and more complex so that we can support our patients.” Diana Villanova, executive director of patient support services at Catalyst Pharmaceutical

Catalyst, with therapies in the rare disease space, uses a hybrid model.

“We have an insourced, patient-focused slash FRM [field reimbursement manager] role that we call patient access liaison,” explained Villanova. “It’s great because those are the folks, they are the frontline with the patient. After our hub provider’s care coordinator gives them a welcome call, our folks will [also] give a welcome call, and they are there to help pull that through for reimbursement. But also, they stay on and work through titration challenges, side effect management.” Villanova noted this model works really well for the company.

Increasingly, companies are adopting hybrid approaches that combine elements of both models. Melissa Beatty, executive director of patient services at Zebra Therapeutics, observed, “I think that the trends are going in the direction that we’re going to have more and more hybrid models.

“I think historically hybrid was, you had your hub and then you had very distinct rules within your hub. And then you had separate and distinct rules within pharma, and that was the definition of hybrid,” Beatty continued. Melissa Beatty, executive director of patient services at Zebra Therapeutics

She elaborated on how the concept has evolved: “I think hybrid now is a much more complex environment, meaning that it’s about coordination ... It’s more of a process-oriented hybrid model than a roles and responsibilities model.

“I think those that are closest in connection with your customers are probably the best place to start. If you’re going to own something as a pharma biotech company, that person who interfaces with your customer the most is probably the person you want inside your shop. We know, as Diana pointed out about the complexity of reimbursement, that being connected to our sales force and others internally is critically important. That’s probably a good start.”

Best practices for selection and optimization

In a survey of industry professionals conducted by our events group in H2 2024, 40% outsourced all hub functions to a hub vendor(s); 12% outsourced most hub functions to a hub vendor(s); 24% outsourced some hub functions; 17% managed all hub functions internally but have outsourced some hub functions within the past three years; and only 5% manage all hub functions internally and have not outsourced any hub functions within the past three years.

These choices can easily characterize the single most critical factor in your model preference, the size of your company.

“We work for very different sized organizations,” said Beatty but added another important factor. “I think ownership structure is another thing we’ve talked about. Whether you are a publicly traded company or not that impacts your internal conversations. The other thing we see a lot nowadays is small startup biotech builds—building them to sell them. So what is the ultimate goal for your organization?”

Beatty added that right now there is a lot of flux, and there are no visible trends expected in the industry.

While choices are organizational specific, when evaluating which model works best, market access professionals should consider:

Strategic Planning: “Really think about having a thinking model so that you build your program for scalability and so that it supports the needs of your patient and your internal stakeholders,” Villanova advised.

Collaboration: “I’m a huge collaborator. When I’m building a program, I want collaboration from all of my internal stakeholders within my organization and help choosing my partner,” Villanova emphasized.

Advocacy Integration: “I would encourage all of those who are partners and vendors to think about how you incorporate advocacy into your business solutions,” suggested Beatty, highlighting the value of patient advocacy groups.

Flexibility: “Be flexible. Things are only going to get tougher in this industry,” Beatty added, emphasizing the importance of adaptability in an evolving landscape.

Learn more about hub models coming up at our Hubs and Specialty Pharmacy Models West event.

Quotes have been lightly edited for clarity.

Image header: Depositphotos@@ Elnur_