Despite many years of innovation in specialty medicine, our approach to patient support has remained surprisingly static. We’ve digitized call centers, automated reminders, and built complex case management systems — yet specialty medication persistence rates often remain stubbornly low. In oncology, real-world studies show that fewer than 6 out of 10 patients remain on oral oncology medications after 12 months and adherence rates may fall below 50%. For patients who discontinue early, many do so within just the first few months, and the reasons are rarely clinical alone.
The Limits of a Standardized Model
Most patient support programs today operate from a common playbook: standardized onboarding, scheduled check-ins, pre-approved scripts, and predefined escalation pathways. While these processes ensure consistency, efficiency, and compliance, they are often unempathetic. We miss the nuance of why a patient disengages.
Adherence cannot be effectively supported by brute force (constant outreach, reminders, or education); it’s an outcome of motivation, confidence, and patient-contextualized assistance. Yet current programs are structured to react to events — a missed refill, a side effect report, an unreturned call — rather than anticipate them. Patients receive support that is technically correct but emotionally disconnected.
The result is a paradox: programs that look successful on dashboards but fail to shift real-world behavior.
From Reactive to Proactive
To change this, the industry must move from reactive to proactive. That begins with recognizing that adherence behaviors can be predicted and influenced when we understand the underlying drivers. Early side-effect experiences, changes in daily routine, emotional fatigue, and even subtle language cues in patient conversations all signal risk — but only if we’re listening for them.
A proactive model means using data not just to track adherence, but to anticipate it: integrating EMR, specialty pharmacy, and patient-reported information to identify patterns before discontinuation occurs. It means shifting from outreach frequency to outreach relevance, where outreach is personalized to the patient’s evolving needs, not their position in a workflow.
From Generic to Personalized
The next generation of patient support will treat adherence less like a metric and more like a behavior to be understood. That requires personalization at multiple levels — not just by disease or product, but by patient mindset, motivation, and lived experience.
Behavioral science provides a roadmap here. Patients respond when they feel seen and supported, not managed. Human interactions, informed by modern technologies that help identify risk and guide interventions, can be far more impactful than scripted calls or automated reminders. A conversation that connects their “big why” — the personal reason they’re staying on therapy — can be more powerful than any brochure or app notification.
Personalization also extends to care ecosystems. A pharmacist discussing side-effect strategies, a nurse reinforcing confidence in therapy, and a health coach addressing motivation all contribute uniquely. Yet these roles often operate in silos, disconnected by data and process.
From Fragmented to Collaborative
Reimagining patient support also means rethinking collaboration between pharma, providers, and data partners. Each holds a piece of the puzzle — behavioral insights, real-world evidence, and clinical experience — but these insights often remain trapped within organizational boundaries.
Creating shared visibility into what drives persistence will help align goals across the ecosystem: ensuring the right intervention reaches the right patient at the right time, informed by evidence, not assumption.
A Call to Reimagine
Patient support must evolve from standardized, reactive systems to personalized, proactive, and data-driven ecosystems. This isn’t just a technical transformation — it’s a philosophical one. It challenges us to measure success not by the number of calls made or resources distributed, but by the confidence, capability, and continuity we help patients build.
If we can make that shift, adherence will stop being a problem to manage — and start becoming an outcome we can truly design for.
