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Patient Behavior Insight Express
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Sep 25, 2025

Insight Express: Your FAST Insight

IQVIA experts explore a new industry hot topic in under two minutes
Insight Express Series 1: Patient Behavior | Abandonment

When patients face higher out-of-pocket costs, they are less likely to fill their prescriptions. This trend is consistent across all brands, therapeutic classes, and payer channels. If a patient does not fill a payer-approved prescription, it is considered abandoned. This behavior influences insurers' benefit designs, access contracts, and demand capture strategies, and is a key consideration for policymakers aiming to assist patients.

Insight Express Series 1: Patient Behavior | Adherence

As patients' out-of-pocket costs rise, their likelihood of continuing therapy in the first year (i.e., adherence) declines. This relationship holds across different diseases, products, and patient types. Factors such as competing therapies, patient demographics, support programs, and annual out-of-pocket caps, like Medicare Part D’s $2,000 max, all contribute to shaping patient adherence.

Insight Express Series 1: Patient Behavior | One and Done

Persistence measures how long a patient continues a prescription, while “One and Done” describes those who fill only once and do not return. This can stem from price concerns, side effects, other health issues, dosing, effectiveness, demographics, or insurance coverage. Securing the initial fill is costly, but ensuring patients continue therapy is essential for better outcomes and accurate forecasting. If patients stop treatment early, they miss the potential benefits of therapy.

Insight Express Series 1: Patient Behavior | Medicare Part D $2000 Cap

Big changes are coming to Medicare Part D. Following the removal of catastrophic phase cost-sharing in 2024, a new $2,000 annual out-of-pocket cap takes effect in 2025. This major policy shift has the potential to reshape patient behavior as the reduced financial burden are expected to reduce prescription abandonment, improve treatment initiation rates, and enhance long-term adherence.

Insight Express Series 1: Patient Behavior | Medicare Part D: Patients with $0 Copay

How is the $2,000 Medicare Part D cap that began this year reshaping speciality treatment access? Dive deeper into its impact on oncology with trends from recent years as changes from the Inflation Reduction Act took effect. Patients are seeing improved access, but the ripple effects matter for other key stakeholders, too.

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