It takes a village to launch a DTP program. It takes a group leading it to scale one.

Aaron Uydess
11 minutes ago
4 min read

Where direct-to-patient(DTP) belongs on the org chart, and why the answer is a condition, not a function.

Getting a direct-to-patient (DTP) program live is one of the hardest things a commercial organization can do. It pulls in marketing, market access, patient services, data, analytics, IT, legal and regulatory, and asks all of them to operate in step with an agency of record, a media partner, a co-pay vendor, a telehealth provider and a pharmacy. It takes every one of them. That is why so many companies treated the launch itself as the win.

Infographic showing US adults on direct prescription buying: 22% have used, 50% would use, 28% would not.

What happened next is the problem. Only 22% of US adults are very aware they can buy medications directly from a manufacturer, while 72% say they would be at least somewhat likely to do it. IQVIA counted 98 million new therapy prescriptions abandoned in 2023, and 44 million of those were abandoned at a cost under $10. The demand exists. The programs exist. The promotion does not.

A village can get a program live. It cannot grow one. That takes a point.

Who should lead DTP and under what condition

Team meeting around a long table with laptops, color swatches, and notebooks in a bright sunlit office.

Most of the internal debate is about who sits in the chair. That is the wrong fight. The threat is not on the org chart. It is 98 million abandoned prescriptions, 44 million of them already free to the patient.

The honest answer is not one function. It is one condition.

Market Access should own it when the only objective is price. A compliance or policy clock. A single brand. A defensive rationale. Success means a compliant, transparent cash price exists at all. That ownership is legitimate. It is also a stage.

Patient Services should own it when the only barrier sits after the prescription. Demand already exists and coverage is largely in place. The friction is prior authorization, benefits verification, training, adherence. Awareness spend would not change the outcome. This optimizes the middle of the funnel. It will never build a top of one.

Marketing should lead it when the objective is growth. A brand team when there is one product, a center of excellence when there is or will be a second. The distinction is scope, not skill. The capabilities are identical: promotion, omnichannel engagement, analytics, vendor management, optimization.

The argument by elimination

Here is why that third condition is DTP's future. Most brands already have a co-pay program, so something new is rarely needed. Most brands already have patient services. A DTP program does not always need its own pharmacy when a patient already has one they prefer. Almost every component is already in the organization, already funded, already staffed.

One component is missing, and one function can supply it. Marketing holds the budget, the promotional expertise and the mandate to optimize for scripts across the entire patient experience. Marketing, and especially the COEs that support them, know how to bring stakeholder groups together and read the patient experience across the silos. Put the program there and that group becomes the spine.

A spine gives a program two things it can get nowhere else. Everything the organization can bring travels forward through it. Everything the market says travels back. Without one you have functions that each work and a program that does not.

The shift is not building a store. It is connecting the assets you already paid for, and putting someone in charge of demand.

Avoid the DTP roundtable

Dark green slide with large white serif text about a program waiting two weeks for consensus and the patient.

Picture the whole thing as one spear. The spine is the shaft. The leader is the point. Market Access, Patient Services, Marketing, Data and Analytics, Legal and Regulatory are the weight behind it, and nothing lands without all of it moving together.

Which is why these programs cannot be run by committee. A steering committee can approve a DTP program. It cannot operate one. The decisions that determine whether it grows arrive faster than any roundtable meets: what to spend on awareness this month, which partner is underperforming, whether to move budget between channels on Tuesday's numbers. A program waiting two weeks for consensus optimizes at the speed of the calendar, not the speed of the patient.

So one leader carries the point, and everyone else lines up behind it with real weight. Market Access on price, cash strategy and payer conflict. Patient Services on reimbursement, hub support and co-pay, and where the program requires it, the dispensing and non-dispensing pharmacies. Marketing on demand. Data and Analytics on the signal. Legal and Regulatory on what is possible and how quickly.

A tip with no weight behind it is a stick. A shaft with no point is a pole. Neither one gets through anything.

That is not a diminished role for anyone. What each function gives up is not authority over its own domain. It is ownership of the whole program, and the spotlight that comes with it. That is the real friction, and pretending otherwise does not help the program.

What we are actually solving for

Underneath the org chart debate is a patient who waits two years for a diagnosis, does not know what a medicine costs, and abandons a prescription that would have worked. Fix that and the brand gets new patient starts, better lifetime value and a direct line to the patient it has never had. The company gets the data, the efficiency of one enterprise approach, and a channel the next launch can walk straight into. Those three outcomes are the same outcome.

That is the work we do. Kairos Meridian helps pharmaceutical companies build the spine: set the strategy, map the patient experience from end to end, bring the practices already working in market, and optimize performance once it is live, across marketing, market access, patient services, data, IT, legal and regulatory, and the partners who make the program run.

Most organizations have never mapped the full path a patient takes through their own program, so they cannot see whether they are losing people at awareness, at the prescriber, at the price, or at the refill. That map is where we start.

If you are looking to break through a ceiling of performance and take your DTP program to the next level, that is the conversation. It is short, and it is not a pitch.

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