State of Data in Copay and Patient Support Programs

An outreach call within 24 hours of an abandonment signal has an up to 40% conversion rate**. A dashboard that tracks leading indicators of potential drop-off can help teams identify where intervention may still change the outcome. By comparison, dashboards focused primarily on enrollment and abandonment tend to describe what has already occurred rather than where action may be needed next.

Despite technological advancements and the influence of machine learning, there continues to exist a disconnect*** between what data is being reported versus what data is needed to make decisions. Many of the dashboards teams utilize are created with leadership in mind, not the needs of the teams that use them every day.

It seems, however, that there is an attempt for many organizations to transition from historical reporting to real-time, actionable analytics. If in the past teams were measuring enrollments, claims processed and abandonment rates to understand what had already happened, today a myriad of data points allows them to predict friction and barriers to patient access. Patrick O’Neal, Vice President, Market Access at Millicent Pharma, believes that future-looking copay and patient programs should focus on “identifying barriers before they impact patients, whether that's affordability concerns, access restrictions or fulfillment delays."

On the other hand, Peter Avalos, VP Market Access and Pricing at Summit Therapeutics, notes the constantly evolving landscape – not just in terms of data, but regulation and policies such as the introduction of GLOBE, GUARD and GENEROUS. Staying on top of these changes can be challenging, particularly for smaller companies that are already spread thin. Peter recommends navigating this with the help of a policy expert that can guide teams on what the new rules mean for them, how to adjust their programs and how to prepare for the future.

For Hillary Gretton, Director, Data Strategy at Claritas Rx, the fix for fragmentation isn’t another patch. It’s a foundation that unifies specialty pharmacy, hub, and copay data into one consistent view of the patient, built by agreeing early on the true ‘must-haves’ and putting scalable processes in place rather than working around each gap as it appears.

Central to that approach is the difference between configuration and customization. Configuration lets each business unit adapt a shared platform to how it works, with its own thresholds, rules, workflows, and terminology, while the foundation stays intact. Customization rebuilds the foundation to mirror legacy habits, locking in outdated workarounds and adding complexity that compounds with every upgrade, integration, and training cycle.

Favoring configuration keeps the core simple and adaptable while preserving what truly differentiates each team. It also forces a useful question: why does this practice exist? Every variation that survives has a business reason behind it, not just history.

Peter Avalos, VP Market Access and Pricing at Summit Therapeutics, highlights that it is crucial to understand the story behind your insights and what that data is telling you. Working side-by-side with your vendor to prioritize activities around potential barriers to affordability and gaps in the programs can significantly improve your access strategy and your affordability plans.

One thing is clear: data is here to stay, and it has the potential to rewire the way copay and patient support programs operate. You know the potential challenges now, but what does it take to face these head-on? Find out the answers in the second piece of this series that identifies the most meaningful metrics and provides practical insights into shifting from reactive to proactive reporting.