Most people I speak to about direct-to-patient in Pharma tend to frame it in fairly practical terms. It’s about access, distribution, reducing friction in the system - shortening the path between a product and the person who needs it.
And to be fair, that’s not wrong.
But the more I think about it, the more it feels like that framing only scratches the surface of what’s actually changing.
What I’m starting to believe is that direct-to-patient is a story that extends much further than access. It’s a story about experience, and about a kind of responsibility Pharma hasn’t historically had to carry so explicitly.
A lot of people see direct-to-patient as a way of cutting out the middle. Fewer intermediaries means more control over delivery, pricing, and support. In a complex healthcare ecosystem, those are serious considerations, and they deserve attention.
But once Pharma moves closer to the patient, even slightly, it stops being just a supply and operating model question. It becomes a question of how the journey actually feels - where it starts, how understandable it is and how much work the patient has to do to keep moving forward.
That’s a very different problem to solve.
I’ve seen a lot of discussion on LinkedIn about LillyDirect, PfizerForAll, or AZ Direct as new channels that sit alongside existing ones - another route into care.
Framed differently though, what we’re seeing are early attempts to redesign journeys that were never really designed intentionally in the first place.
This is not a slight on healthcare systems, more a call out that there was never any real intentionality to how our healthcare systems were built. Instead, they’ve evolved over time through the actions of many different stakeholders, each with their own goals and incentives, adding layers of complexity along the way. They’re simply a byproduct of how healthcare systems evolve.
So with this shift comes a huge opportunity for Pharma to get this right, but also a massive sense of responsibility.
In Pharma the dominant experience conversation right now still centres on communication. Are we delivering the right message, to the right person, at the right time?
What direct-to-patient changes is that experience is no longer just about what’s said. It’s about:
- How the system behaves.
- Whether steps connect or fragment.
- Whether people feel guided or passed along.
- Whether the complexity lives behind the scenes or lands squarely on the patient.
In that context, the shift is less about promotion and more about participation. Helping people move through testing, eligibility, treatment initiation, and monitoring in a way that feels joined up rather than episodic.
When the experience is poorly designed, patients end up doing the work. They chase information, they repeat themselves, they have to connect dots the system should already have connected for them. Direct-to-patient models expose that friction rather than hiding it behind intermediaries.
For healthcare more broadly, it points to new ecosystems forming around diagnostics, delivery, and outcomes that are more intentionally linked. That shift brings real tension around roles, incentives, and responsibility, but it also opens the door to care pathways that actually behave like pathways.
So most people ask whether Pharma should go direct, but the question I keep coming back to is different - if Pharma is going to step closer to the patient, are we prepared to embrace the accountability for designing truly patient-first experiences?
It’s a big responsibility but one I think we should take.