According to Deloitte’s “2025 US Health Care Outlook” report, rising healthcare costs are the biggest challenge facing the healthcare system and are expected to continue in 2025. According to the report, U.S. health care spending is expected to reach a staggering $4.6 trillion by 2025, which means that patient demand for PAP/PSP financial assistance will continue to increase, and the pricing pressure on pharmaceutical companies will also be more severe.
The report surveyed 80 executives from large U.S. medical institutions and health plans (each with more than $500 million in revenue) from August to September 2024, and most of the executives believe that “2025 will be a period of transition for the healthcare industry, and regulatory uncertainty may impact their 2025 strategy”, with 65% of executives citing a growth strategy for their organization as a top priority in 2025, making it the industry’s most popular trend (Figure 2). In addition, 46% of executives believe that consumer affordability of the healthcare system is a major trend.
Looking ahead to 2025, there will also be a shift in Patient Assistance Programs (PAPs) and Patient Support Programs (PSPs), including changes in policy and regulations, technology, patient needs, and growing values such as health equity and human rights equality in healthcare.
PAP/PSP under the pressures of multiple healthcare transformations
In August 2022, the U.S. Congress passed the Inflation Reduction Act (IRA), which aims to curb inflation by reducing the federal government’s budget deficit, lowering prescription drug prices, and promoting clean energy. In the part of reducing prescription drug prices, Medicare is authorized to negotiate drug prices with pharmaceutical companies, thereby reducing drug spending, which directly affects the profit margins of pharmaceutical companies and forces them to rethink the operation model of PAP/PSP and the source of drug revenue. Restrictions on drug reimbursement by commercial insurers and the rise of high-deductible programs have also exacerbated the financial burden on patients, making them more dependent on PAP/PSP support.
Digital Transformation: Accelerating the Embrace of Technology
Deloitte’s report also highlights the critical role of digital technologies and generative AI development in healthcare, and predicts that the use of digital health tools will continue to increase in 2025, from online applications, electronic medical records, teleconsultations to mobile apps, digital tools that will not only improve efficiency, but also expand service coverage and reach more patients in need. Increasing patient acceptance of digital healthcare services is also driving PAPs/PSPs to accelerate their embrace of digital technologies.
However, digital transformation also brings new challenges, such as the problem of digital gaps. Despite the many benefits that digital technology brings, most patients may not be familiar with digital tools and are unable to take full advantage of digital services. Therefore, PAP/PSP needs to provide multi-channel service reach, including multiple online services, telephone services, face-to-face services, etc., to ensure that all patients can easily receive support.
Health equity: Bridging the gap and ensuring equality
Addressing health inequalities is an important issue in healthcare today. This means that PAP/PSPs must not only focus on access and affordability of medicines, but also actively bridge the gaps that vulnerable populations face in accessing health care and support. This requires PAP/PSPs to provide more flexible, on-demand, and population-specific solutions to ensure that all patients have equal access to the support they need, and to mainstream sophisticated and personalized PAP/PSP program design.
Personalized care: Data-driven, customized services
Personalized care and AI-assisted care are the future of healthcare. This means that PAP/PSP is no longer a single solution, but needs to be tailored to the patient’s specific situation. Data analytics plays a key role in this. By analyzing patients’ personal information, medical history, medication habits and other data, PAP/PSP can provide more accurate educational content, medication reminders, psychological support and other services, improve patients’ treatment compliance, and obtain better treatment results.
Innovative services: a competitive tool for pharmaceutical companies
In such a volatile environment, PAP/PSP innovative services have become a competitive tool for pharmaceutical companies in the market, and their investment in innovative services can not only improve the treatment effect and quality of life of patients, but also bring the following benefits to pharmaceutical companies:
- Enhance brand value and reputation: A high-quality PAP/PSP can build a good corporate image and build trust among patients and medical professionals.
- Increase patient loyalty: Superior PAP/PSP services can increase patient loyalty, ensuring that they continue to use the pharmaceutical company’s products.
- Expand market share: Innovative PAP/PSP can attract more patients and expand the market share of pharmaceutical companies.
- Collect real-world data: PAPs/PSPs can collect real-world data on patients, understand their drug experiences, and adjust products and services based on the results of the data.
- Build a competitive differentiator: Innovative PAPs/PSPs can be a competitive differentiator for pharmaceutical companies, helping them stand out from the crowd.
Data Insights: The Future of PAP/PSP
Deloitte’s report points to the growing importance of data analytics in healthcare, and this applies to the development of PAP/PSP. Through data analysis, PAP/PSP can:
- Understand your patients’ needs: Analyze your patients’ data to understand their preferences, behaviors, and pain points to provide more targeted services.
- Evaluate service effectiveness: Track the service effectiveness of PAP/PSP and adjust service policies based on data results to improve service efficiency.
- Identify potential risks: Analyze data to identify potential risks for a patient’s medications and take preventive measures.
- Optimize resource allocation: Improve resource utilization by allocating resources to where they are needed most through data analysis.
The innovative services of 2025 with the patient journey at their core, in response to regulatory changes, digital technology, patient needs, and concerns about health equity, have had a profound impact on the evolution of PAP/PSP. The pharmaceutical service industry must embrace these challenges, embracing innovation as a core competency and patient-centric management services to ensure that all patients have access to the medicines and support they need in different ways.
Sean, Managing Director, Patientsforce Health Integration Group
