As the name suggests, the Medication Access Report (MAR) from CoverMyMeds studies obstacles that stand between patients and the medications they need to live healthier lives.
Heavy on data and insights, it outlines key reasons behind the barriers to medication access, as well as what it takes to solve for them.
The MAR is developed from 12 months of research in six phases, including more than 1,000 interviews and survey responses from patient, clinical and healthcare business stakeholders.
Here are 10 key insights from the 2025 edition, From Barriers to Bridges:
1. Medication access survey:
- 65% of patients surveyed experienced some kind of delay in accessing their medication.1
- 54% of patients are concerned about medication costs.1
- 94% of physicians say that the prior authorization process delays necessary patient care.2
- 73% of providers agree that claim denials are increasing.3
- 84% of pharmaceutical decision makers plan to increase their spending on access in the next five years.4
2. Current challenges:
Getting medication is no longer as simple as a trip to the pharmacy. Patients now must contend with soaring drug prices, intricate treatment plans, and complex health insurance policies—all amid a landscape continually shifting with medical innovation and evolving regulatory changes.
3. Technology advances could bring old barriers into new systems.
A fragmented healthcare system created many of today’s access barriers that compromise patient outcomes. Siloes exist throughout the patient journey. Escalating medication costs, regulatory changes, rapid therapeutic advances, and the integration of artificial intelligence (AI) might add more layers to an already complex ecosystem.
“[As an industry]…we’re potentially putting ourselves in a position where we create the same type of siloing and fragmentation in the digital realm. That is a big challenge with our physical healthcare system. So that’s what we have to fight against.” 4 – Greg Weidner, MD, One Medical
An example of the above:
4. Medical and pharmacy benefits used to have a clear delineation between prescription medication and medical treatments.
Coding structures and benefit designs were developed around that framework . However, therapies have rapidly evolved in both scale and complexity, blurring the lines between which are covered under the medical vs. pharmacy benefit.
5. Linear patient journey, meet multidimensional patient realities.
The patient journey is most often shown as a straight line, punctuated with transactions between patients and the healthcare system. However, patient care is no longer as simple as moving from point A to point B. Solutions that don’t account for today’s complexity are like offering landline phone access in a world of smartphone users
6. Adherence remains a challenge that must account for demographic and socioeconomic factors.
- Women are more likely than men to not take medication as prescribed due to cost.5
- Hispanic and Black adults are more likely than White adults to not take medication due to cost.5
- Adults with disabilities are more likely than adults without disabilities to not take medications as prescribed due to cost. 5
These factors, known as social determinants of health (“SDOH”) and environment, affect up to 80% of health outcomes.6
7. Reconsider the patient journey with a multi-dimensional approach.
Patients face unique and evolving challenges across access, affordability and adherence. These factors are deeply interconnected, requiring multidimensional solutions tailored to individual needs.
8. Fragmentation can be bridged by prioritizing interoperability between stakeholder systems.
To do this, a diverse set of solutions must be deployed that match the industry’s evolution and the lived realities of patients today.
- Prioritize data visibility and sharing
- Enhance collaboration with interoperable systems
- Pair human support with tech
9. Specialty pharmacies have become critical to the prior authorization and insurance processes.
Demanding more data-driven, automated solutions to provide personalized support, streamline care coordination and improve outcomes for patients with complex health conditions.
10. Too many patients (and providers) aren’t aware of patient support programs, how to use them or navigate the process.
- 59% of patients have little knowledge about the programs 7
- 42% of prescribers don’t know about them 7
As a chief medical officer for a large health system interviewed for the MAR put it: “Medication is the most powerful tool we have to keep our patients out of the hospital.”
So how to close the gaps in an ever-shifting healthcare landscape that still prevents too many patients from accessing its power? From any position within the healthcare ecosystem, collaboration and interoperability emerge as the most powerful tools.
Working together, stakeholders can break down barriers, guiding the evolution of healthcare into a system that is more accessible and effective.
RxSS and CoverMyMeds, both affiliates of McKesson Corporation, work in tandem to address challenges in medication access and affordability.
- CoverMyMeds Patient Survey, 2023.
- American Medical Association; “Health Insurance Denials, Delayed Care and Medication Access: How Prior Authorization Hurts Patients,” July 15, 2024.
- Nguyen, Kelly. “Healthcare Claim Denial Statistics: State of Claims Report 2024.” Healthcare Blog, October 7, 2024.
- Dinesh Kabaleeswaran, Jennifer Klarer. “From Pipeline to Patient: Understanding Barriers to Access in 2024 and Beyond.” Asembia Specialty Pharmacy Summit, May 1, 2024.
- Centers for Disease Control and Prevention. “Products – Data Briefs – Number 470.” June 2, 2023.
- World Health Organization. Health Topics, Social Determinants of Health
- Bulik, Beth Snyder. “Pharma’s’ Return on $5B Spent Yearly on Patient Support Programs? Only 3% Are Using Them: Survey.” Fierce Pharma, July 6, 2021.
