Reducing delays from specialty cost uncertainty

When people don't have cost and coverage clarity for a specialty medication, they may delay care before treatment even starts. Unanswered cost questions can slow progress, even before treatment starts. 

Uncertainty is widespread. Most insured adults report low confidence navigating their health plan, and few know care costs in advance. When these gaps surface early, even appropriate treatments can stall. 

In specialty care, consequences are pronounced: nearly 40% of specialty prescriptions are never filled, with high out‑of‑pocket costs cited as a primary driver of abandonment prior to start of therapy. Early affordability uncertainty keeps patients from starting medication. 

Therapy initiation is a fragile moment 

Therapy initiation is a fragile moment in the specialty journey. Patients may be newly diagnosed or progressing to advanced treatment, while providers navigate benefit design, prior authorization requirements, and administrative steps under significant time pressure. 

Unresolved cost and coverage questions at this stage quickly become barriers. Cost pressures influence care decisions, and even short delays can create extra follow-ups or cause patients to pause before starting therapy. 

In these moments, access challenges are often driven less by clinical decision making and more by unanswered financial questions. 

Why delayed affordability support slows specialty therapy starts

Affordability is often addressed after a medication is prescribed, when progress has slowed or the patient risks not starting therapy. Support becomes “catch-up” work, extra calls and steps to sort coverage and costs, adding burden and extending delays. 

Health plans and pharmacy benefit managers negotiate lower prices and reduce medical costs, but those savings don’t always translate to clearer experiences for patients. Out-of-pocket spending continues to rise, especially for specialty therapies.

When affordability support comes too late, after uncertainty has already stalled momentum, it can increase the risk that patients pause or never start therapy, rather than helping them move forward. 

Earlier visibility changes the access equation 

Earlier visibility into cost and coverage fundamentally changes engagement at therapy initiation. 

Consumers rank predictable out‑of‑pocket costs as critically important, especially for prescription drugs.¹ There is broad public support for health care price transparency to manage costs and feel informed.

Transparent, upfront insight into coverage and costs increases confidence. Fewer surprises mean fewer delays and smoother progression to therapy. In specialty care, transparency and predictability are often as important as affordability itself. 

From reactive support to embedded financial navigation 

Addressing affordability earlier means helping patients before cost and coverage questions slow starting therapy, not trying to catch up after a prescription is already at risk.

Accredo® Specialty Pharmacy integrates financial navigation into the start of therapy for select medications, using a co-branded digital experience with TailorMed. Eligible patients get real-time information about available copay assistance, understand costs sooner, and enroll in support programs at the start of their treatment journey. 

What this looks like in practice: When an eligible specialty prescription is received, patients use the Accredo app or web to view copay matches and enroll through a guided flow. For certain contracted programs, Express Enroll enables a quick, 1–2 click enrollment. Accredo also uses outreach to support consent and self-enrollment. 

By the numbers:

Improving affordability visibility and access 

• 70–80% reduction in application time²
  Faster enrollment helps patients understand available financial support sooner, reducing delays at therapy initiation.
• 500+ self‑enrollments (through 4/30/2026)²
  More patients are engaging directly with affordability support through streamlined digital experiences.
• ~150 medications enabled for digital copay program matching and enrollment²
  Expanding access to early affordability guidance across specialty therapies. 

Why this matters: When affordability is clarified early, patients are more likely to start their medication, reducing delays and avoidable drop-off. 

What this means for access, medication adherence, and continuity of care

Reducing uncertainty earlier does more than speed up therapy initiation—it helps patients move forward with confidence. When patients know costs and support options, they’re more likely to begin therapy without delay. Providers benefit from streamlined workflows, fewer follow-ups, and reduced administrative burden. Over time, clearer expectations support stronger adherence and continuity of care. 

Access is not only about whether a therapy is prescribed, it is about whether patients have the clarity they need to start that therapy.

Learn how Accredo Specialty Pharmacy is helping address affordability earlier in the specialty journey to support faster therapy starts, improve the patient experience, and strengthen continuity of care.