A diversified, Fortune-50 payer-provider’s specialty pharmacy sought to reverse lagging first-fill prescription conversion and elevate its new-patient experience (NPE) while sharpening affordability support at scale. Growth stakes were material, with leadership citing a nine-figure revenue risk if trends persisted.

The Challenge

The client relied on a friction-full patient onboarding model that constrained proactive digital outreach and slowed time-to-therapy. Affordability conversations often occurred later in the journey, obscuring perceived value and lowering re-enrollment. Meanwhile, leading rivals were accelerating patient access with streamlined, multi-channel outreach and end-to-end digital pathways.

Our Approach

We built a blinded, evidence-based benchmark of specialty pharmacy NPE and affordability practices — spanning national retail-anchored, PBM-aligned, and oncology-focused peers — then mapped each step against the client’s workflows to isolate conversion bottlenecks.

Our team combined executive-level expert interviews with client SME working sessions, process maps, and digital flow audits to translate outside-in practices into pragmatic design choices (e.g., consent language, trigger logic, call approach, digital hand-offs). We stress-tested feasibility, sequencing, and risk with operations, legal, and CX leads to lock a near-term roadmap.

Our Impact

Leadership adopted three transformative moves to positively shift the new patient experience with their specialty pharmacy. Based on our work, this revised approach is expected to lift first-fill conversion by around five percentage points and unlock a path to eight-figure, potentially low nine-figure, revenue impact, while reducing patient burden and time-to-therapy.