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As the lines blur between specialty and general medicine, pharma faces a critical inflection point. Primary care is increasingly tasked with initiating and managing complex therapies — once the sole domain of specialists — amid growing access barriers, staffing shortages and administrative burden. In this shifting landscape, the question isn’t if your patient support strategy must evolve, it’s how quickly.

At a recent roundtable, Kara Giannecchini, senior director of Haymarket Studio, sat down with Sarah Boyce, director, strategic operations and analytics, Syneos Health; Kelly Carter, associate VP, patient services, Amgen; Kim Plesnarski, VP strategic marketing, market access and patient support, Syneos Health; Sara Rubin, strategy lead, Spherico, powered by Syneos Health; and Michael Sarshad, managing director, commercial, Syneos Health, to explore what it takes to deliver adaptive, tech-enabled and human-centered patient support across both gen med and specialty.

A look at key market trends

Today’s healthcare environment is increasingly focused on specialty products, forcing pharma to rethink how they provide support to patients and healthcare providers (HCPs).

“Specialty drugs require a harder burden to achieve access; there are higher costs and they require more patient education to use,” Plesnarski said. “Primary care is not set up for that, specialists are. It’s important that we think about the support that we’re providing and how we do it at scale.”

In addition, the paradigm of care is shifting downward as patients reach out to their PCP instead of a specialist or utilize telemedicine in lieu of an in-office visit. “PCPs have to be well-versed in buy-and-bill products and understand how to get this prior authorization through or what the step edits for these medications are,” Sarshad explained. “Unfortunately, the patient is on the negative end of that spectrum because they’re not able to get their prescriptions either quickly enough or at all.” Research conducted by Syneos Health found that “72% of the time physicians will opt not to prescribe a medication because of the prior authorization burden,” he added.

Pharma needs to help alleviate the administrative burden and “find ways to embed into the HCP workflow wherever possible,” Carter emphasized. “We also have to think about how we engage with patients — whether that’s through AI agents, text or email — and make sure that we are speeding up that script fulfillment and meeting the customer truly where they are.”

In this increasingly complex landscape, brands can prioritize communication. “Support models are being redesigned for speed and empathy,” Rubin explained. “What we need to do is make sure that those patients receive clarity in their communication from the start of their treatment journey all the way through to the end of their journey.”

At Syneos Health, support models are customizable, personalized and modular, capable of working within a manufacturer’s ecosystem or as a standalone, Plesnarski said. “We combine the power of artificial intelligence (AI), data, insights and analytics, and this prompts our staff to do the next best action to support the patient and the provider, meeting them in their workflow, providing the right message at the right time,” she explained.

Disrupting responsibly with AI

The reality is “AI isn’t the future, it’s the present,” Boyce said. “We’re already interfacing with AI every day of our lives. You go to a search browser, type in any question and get a synopsis of the results from the websites without having to click on any of those websites.” In this scenario, the stakes for errors are low; however, that’s not the case with healthcare. “Pharma has to have a 0% error rate 100% of the time because we’re dealing with patients and patient data,” she emphasized.

According to Syneos Health research, “HCPs need to see 75 to 100% accuracy when it comes to administration or AI tools filling out forms for them,” Sarshad explained. “Anything less than that is almost like a flip of a coin, 50-50, that’s not going to build trust with the HCPs or staff to use AI in these processes moving forward.”

Clean data is essential to engendering trust. “When it comes to deploying technology safely and ethically, everything starts with the data. Has it been vetted? Is it ready to be used for the use cases and technology we have it defined for?” Boyce noted. “This is all about making sure that the outcomes for patients are accurate and expected.”

Staff training is necessary for successful AI deployment. “ [Staff] need to be providing feedback, making sure that [the AI] is learning, evolving and adapting,” Plesnarski added. “You’ll also need to have a team behind the scenes reviewing, listening and making sure your AI is not hallucinating, that it’s learning and it’s not learning the wrong things.”

Syneos Health is using technology to be more proactive with patient care. “We’re able to use technology to look at the data including claims and behavior to understand when a patient might face a problem before they actually do, and empower HCPs to provide that care before the patient even walks in the door,” Boyce explained.

In addition, AI can help streamline benefit verification, coach patients and personalize outreach. For example, “it’s offering services such as a non-dispensing pharmacy where HCPs essentially e-scribe directly to an eHub that takes it from there, engages with the patient through multiple modalities, whether that’s text, email or phone, to be able to expedite that script from prescription to fulfillment,” Carter said.

Rethinking deployment and response

With education, the industry will become more comfortable adopting AI for other use cases. “We’re going to get to a point where the HCP office has an AI tool and the payer has an AI tool,” Sarshad predicted. “The HCP office is going to use that AI tool to submit a pre-authorization; the AI tool from the payer is going to respond; and they’re going to have a conversation within milliseconds and give you a response, and that’s going to get drugs to patients much quicker.”

Technology is already opening up access to care. “With the advent of AI entering the workflow, things are happening faster, that’s freeing up more time and creating more demand for care,” Plesnarski said. “As things are speeding up, think about how you’re addressing the regulatory changes as well as reaching more patients.”

Within the specialty space, that speed “comes at high cost and complexity,” Carter added. “It’s even more important that a coverage determination provides the details that the HCP and the patient needs to make the appropriate decision to move forward on therapy.”

In this evolving healthcare environment with faster access, “personalized messages are incredibly important to make sure that the patient is receiving exactly what they need and how they need to receive it,” Rubin said.

Workflow changes will help HCPs and patients better navigate the complexity. “Technology is moving at a rapid pace and we need to be there with them,” Sarshad explained. “We need to rely on our strategic partners to move more quickly and be more agile. We need to learn to disrupt and disrupt responsibly.”

The care continuum is shifting fast. To keep pace, patient support must be reimagined for scale, speed and empathy. Now is the time to build adaptive, AI-powered, human-centered models that meet patients and providers where they are — and where they’re going. When patients and providers have clarity, treatments move forward faster — and the Syneos value and access team ensures communication drives that clarity every step.