Patient Support Programs Shift Toward In-House Models Amid Regulatory and Affordability Pressures — Guidehouse Inc.

Event summary

Guidehouse's 2026 Patient Support Programs Trends report highlights a 23-point decrease in third-party HUB service utilization as manufacturers insource more services.
Only 14% of respondents feel 'very prepared' to adapt affordability programs to the Inflation Reduction Act's policies, including Medicare price-setting and out-of-pocket spending caps.
65% of leaders say copay accumulator/maximizer programs are disruptive to the patient journey, creating operational bottlenecks.
AI and automation solutions for reimbursement support are seen as the most impactful services for improving patient and provider experiences.

The big picture

Guidehouse's report underscores the evolving landscape of patient support programs, driven by affordability challenges, regulatory shifts, and digital advancements. The move toward in-house models reflects a broader industry trend of manufacturers seeking greater control over the patient journey and data management. These changes are critical as companies navigate complex business environments and strive to improve access to treatment.

What we're watching

Regulatory Compliance: How pharmaceutical companies will adapt to the Inflation Reduction Act's policies, particularly Medicare price-setting and out-of-pocket spending caps.
Operational Efficiency: Whether the shift toward in-house HUB models will improve data control and patient journey management despite higher operational costs.
Technological Integration: The pace at which AI and automation solutions for reimbursement support will be adopted to streamline prior authorization and benefits verification processes.