Challenge
A mature brand from a top 5 pharma manufacturer faced rising risks of therapy switching and non-adherence due to the Medicare “donut hole” coverage gap. With an older patient population relying heavily on Medicare, out-of-pocket costs spiked unpredictably based on individual
medication spend. Providers lacked visibility into when patients would enter the gap, making it difficult to proactively offer financial support—often leading patients to consider lower-cost generics.