Patient Support Program Consulting for Pharma
Most manufacturers fund patient support generously and cannot say what it returns. The programmes work, the people in them are capable, and nobody can produce a number that connects the spend to the therapy a patient actually started. The Customer Excellence AGENCY rebuilds patient support as an operating model with a measure attached to it.
The problem is rarely the programmes and almost always the seams between them
A typical flagship brand publishes between three and seven separate affordability and support routes, rising to nine once the government programmes it refers patients to are counted. Each one of them is well built and does the job it was designed to do. A copay card absorbs cost at the counter, a hub opens benefits investigations, an assistance programme covers the uninsured, a nurse educator answers the phone, a foundation relationship catches the people the others miss. Every component has an owner who can defend it.
What almost never has an owner is the compound. In October 2026 I audited the published patient support pages of eight flagship brands from eight different manufacturers, across immunology, oncology, cardiometabolic disease and obesity, and counted the routes a patient can take. Every brand in the set published several routes, and not one published a tool that resolves which route is hers. In every case that function exists, it is staffed, and it runs as a telephone number.
That matters commercially rather than only experientially. A call centre is sized to call volume rather than to prescription volume, so its capacity is set by how many people ring rather than by how many people were prescribed. It runs during business hours, which are the hours a working patient is also at work. It produces almost no structured data, because what a case manager resolves in four minutes tends to be recorded as an enrollment in whichever programme the call ended in. The patient who read five sets of eligibility conditions, could not determine which applied to her, and closed the tab appears in no programme's denominator and no call log. She appears later as an abandoned prescription with no attributable cause, where the loss is almost always read as a price problem.
What a patient support operating model review establishes
The engagement begins by moving the denominator. Most patient support reporting counts enrollments, which measures the people who found their way in. A Realization Rate anchored at the prescription counts everybody the commercial system earned, including the patients no programme ever saw, which is exactly the population the current numbers are structurally unable to observe.
From there the work is diagnostic and it runs against data a company already holds. Rejection rates arrive as claims data. Abandonment at the counter is visible through hub and specialty pharmacy partners. Refill behaviour sits in dispensing data most brands already buy. The one stage nobody can see from the outside is the patient who collected a prescription and never started therapy. That population is reachable through the support programme and the field organization, both of which are in contact with people the claims cannot observe. A brand that measured even three of those four stages would know more about its own realized value than the published literature can tell anyone.
The review then tests the experience itself against a published standard rather than against opinion. The Consumer-Grade specification is a closed set of six conditions, and in the audits I have run, four of them commonly fail on assets a company owns outright with no payer, pharmacy or prescriber in the way.
- Recognition fails when the system does not know who she is even while she is signed in elsewhere on the same property.
- Coherence fails when the routes are presented as a list rather than as a path, and several of them lead to different domains.
- Effort fails when the sorting work has been transferred to the person with the least information and the most at stake.
- Resolution fails when nothing on the page closes the question and the only thing that does is a call she has to initiate.
None of those four is expensive to fix relative to what they cost. All four are invisible to a programme level scorecard, which is why they persist inside organizations that are investing seriously in patient support.
How the engagement runs, and what you hold at the end of it
Patient support sits inside the three commercial priorities this practice works across, and the engagement draws on all three. The diagnostic belongs to brand performance, because the loss it finds shows up in a brand's realized revenue rather than in a service metric. The intervention work belongs to field performance, because the frontline encounters these barriers long before any dashboard records them. The durability belongs to the customer excellence enterprise, which is where a capability stops being a project and becomes a way the organization works.
The work follows three phases, each of which leaves something behind. Reframe is a data driven diagnostic run against existing commercial data, establishing where value is leaking between the prescription and sustained therapy and sizing the Customer Value at Risk in the brands that matter most. Mobilize is the first direct engagement with the organization, combining a baseline field survey with acute interventions on the barriers that are costing the most now. Operationalize converts that baseline into continuous signal collection and embeds barrier workflows into permanent ways of working, so the capability survives the engagement rather than leaving with it.
What a client holds afterward is a measured Realization Rate for the brands in scope and a stage by stage account of where the loss occurs and who owns each stage. Alongside those sit a routing design for the patient who cannot currently tell which door is hers, and an operating model in which post-script value has a name attached to it above brand level. None of that is a report, since a report stops producing the day it is delivered. It is a set of measures and workflows that sit inside the commercial system and keep producing after the work ends.
Who does the work
The Customer Excellence AGENCY is led by Wayne Simmons, who led global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse, and designed the customer experience delivery system for a major manufacturer's direct to patient platform. He is the author of The Customer Excellence Enterprise (Wiley, 2024) and founding faculty of the MS in Customer Experience Management at Michigan State University's Broad College of Business. Earlier in his career he inherited a well resourced customer experience programme anchored in survey scores, judged it commercially inert, and dismantled it in order to rebuild the discipline around value realization and progression measurement. That decision is the origin of this practice and the reason its measures look the way they do.
Engagements are run player coach rather than deck and leave. The published research behind this page, including the eight manufacturer audit and the Realization Rate measurement work, is open and can be checked before you ever speak to anyone.
Where to start
The first conversation is diagnostic and costs nothing. Useful preparation is a single question you can answer internally beforehand. For the brand that matters most to your business this year, how many of the prescriptions written for it last quarter reached a patient, and who in the organization is accountable for the gap between those two numbers. If the answer involves three functions and no name, the problem described on this page is already operating inside your company and is currently being recorded as an access problem.
Related reading: the eight manufacturer audit in full, why nobody in the industry can currently compute a Realization Rate, the six classes of access barrier and their six different owners and what actually drives prescription abandonment. To start a conversation, write to wsimmons@cxedna.com.
