Access teams celebrate the formulary decision; brand teams wait for the volume. The gap between the two is a sequence of steps where patients and prescribers drop away.
Reading the leaks
- Prior authorization and step edits stall starts at the plan and account level; the friction is visible in claims and hub data if they are read together.
- Specialty pharmacy fill is where many approved prescriptions are abandoned, often for reasons of cost or contact.
- Staying on therapy depends on support reaching at-risk patients early; enrollment counts say little about it.
Find the step where starts stall, then point pull-through, hub services and field effort at it. Market access, patient and medical.