The Fragmentation Problem
Despite substantial investment and genuine intent, many first-generation DTP programs have struggled with a fundamental architectural challenge: fragmentation.
Today's DTP landscape is dominated by vendor assembly. Patients navigate separate portals for telehealth, fulfillment, and support. Each transition becomes a potential exit point. We've observed drop-off rates approaching 40% at critical handoff points, not because patients abandon therapy, but because the systems themselves create friction at every turn.
While often dismissed as minor operational inefficiencies, these are actually major architectural problems. The same issues that plagued legacy specialty pharmacy models (disconnected systems, limited visibility into patient behavior, inability to control the end-to-end experience) have been replicated in digital form.
For manufacturers, the consequences are clear: limited data ownership, no control over pricing optimization, and continued dependence on intermediaries that extract margin without delivering strategic value.
Understanding the DTP Spectrum
Direct-to-patient exists on a spectrum. On one end sits DTP (manufacturer-supported patient access programs) designed to work within the existing healthcare ecosystem, supporting insurance coverage and provider relationships. On the other end sits DTC (direct-to-consumer retail models) operating primarily as cash-pay retail channels.
What makes next-generation platforms transformative is the ability to support both seamlessly through dual-rail payment architecture. This gives manufacturers total control over pricing and inventory while allowing patients to pay using whichever route works best—whether that's insurance (pure DTP) or cash (pure DTC). The platform can even integrate with employer health plans to ensure cash payments count toward deductibles while maintaining benefit accumulation.
The architectural challenge transcends this spectrum. Whether a program leans toward DTP or DTC, fragmentation creates the same core problems for manufacturers: patient drop-off that limits market penetration, lack of actionable data to inform commercial strategy, and inability to optimize the experience in real time.
Why Manufacturer-First Matters
From the beginning, we designed our platform around a fundamental principle: manufacturers need infrastructure they control.
While many in the industry talk about being "patient-first," we believe the more strategic approach is manufacturer-first. This isn't semantics, it's a recognition that manufacturers are our customers, not patients. We operate B2B and B2B2C, not B2C or B2C2B.
This distinction matters because manufacturers make the strategic decisions about brand positioning, pricing, distribution, and long-term commercial strategy. Patients often don't pay—or don't pay the majority share—for their medications. What manufacturers need is a platform that gives them control over the entire patient journey, eliminates dependence on intermediaries, and provides the data visibility to inform commercial decisions.
How CaryHealth's Platform Delivers Control
Direct Control Over Pricing and Fulfillment
Our platform gives manufacturers what legacy specialty pharmacy and first-generation DTP programs cannot: direct control. We prioritize benefit verification, prior authorization support, and coverage optimization. But unlike legacy models that force manufacturers into rigid pathways dictated by PBMs, our dual-rail payment architecture gives manufacturers flexibility in how they serve different patient segments.
Manufacturers can leverage insurance when it provides the best value, offer cash options when that's more strategic, and dynamically adjust based on real-time data. This flexibility makes formulary placement less critical because manufacturers can manage patient costs directly while maintaining benefit accumulation.
Most importantly, manufacturers own the relationship and the data. They gain direct visibility into patient behavior, adherence patterns, and outcomes from the very first prescription—enabling continuous optimization of commercial strategy in ways that intermediary-dependent models cannot support.
Unified Infrastructure Without the Vendor Patchwork
Our platform eliminates the fragmentation that has limited both traditional specialty pharmacy and first-generation DTP programs. From initial education through prescription, fulfillment, and ongoing adherence support, manufacturers work with a single platform powered by our proprietary technology stack, not a patchwork of vendors they must coordinate.
Behind the scenes, sophisticated orchestration layers coordinate our nationally licensed pharmacy (operating in all 50 states), trusted telehealth partners, and AI-driven engagement systems. But manufacturers maintain control and visibility throughout. Real-time data flows into systems they access directly, enabling strategic decisions based on actual patient behavior rather than aggregated claims data received months after the fact.
Our integrated fulfillment is purpose-built for complex therapies. Specialized facilities integrate packaging automation with cold chain capabilities, eliminating the slow, manual steps required for temperature-controlled shipping. This makes fulfillment faster, more reliable, and more cost-effective than traditional distribution—while manufacturers maintain control over the entire process.
Configured for Your Therapeutic Area
We don't believe in one-size-fits-all DTP programs. Manufacturer needs and patient access barriers vary dramatically across therapeutic areas. The service configuration that optimizes market access for migraine medications differs fundamentally from what works for specialty oncology drugs or digital therapeutics.
Our platform enables manufacturers to configure service components based on the specific challenges their brands face. For conditions where finding experienced providers is the primary access barrier, we integrate comprehensive telehealth with specialist networks. For therapeutic areas where prior authorization complexity drives access failures, we optimize benefit verification and fulfillment processes. Manufacturers invest in high-value interventions specific to their brand's context, not generic services that dilute ROI.
AI-Driven Intelligence for Commercial Strategy
Traditional pharmaceutical distribution offers manufacturers virtually no visibility into patient behavior between prescription and fulfillment. Our platform creates end-to-end visibility from initial engagement through long-term adherence and transforms that visibility into strategic advantage.
Through our CaryConnect dashboard, manufacturers gain real-time insights into where patients disengage, which educational materials drive conversion, how different demographics respond to messaging, and which support interventions prevent treatment discontinuation. Our clinical sequencing engine and agentic automation layer leverage these insights to optimize every touchpoint continuously.
Every patient interaction generates insights that inform commercial strategy. Manufacturers can test messaging, optimize pricing strategies, refine service models, and measure program ROI based on actual performance data—not assumptions or delayed claims information. Programs evolve and improve based on real-world results that manufacturers control and access directly.
Compliance Built Into the Architecture
We build compliance into our architecture from inception. Telehealth integrations with external physician groups prevent patient steerage. Prescribers make clinical decisions without visibility into which channel patients used for access. Patient data flows through systems governed by explicit consent, with sensitive information protected behind appropriate controls.
These protections are prerequisites for sustainable programs that serve manufacturers within the boundaries that ensure integrity.
Proven Results Across Therapeutic Areas
Our platform isn't theoretical. We've deployed it successfully with global partners including Rejoyn for major depressive disorder with Otsuka Precision Health, SleepioRx for insomnia with Big Health, Parky for Parkinson's disease with H2O Therapeutics, and Mahana IBS for irritable bowel syndrome with Mahana Therapeutics.
The outcomes validate our manufacturer-first approach:
- 20% better patient conversion rates compared to legacy pharmacy models—translating directly to improved market penetration
- 30% higher adherence rates, maximizing therapy value and demonstrating that manufacturer control enables better long-term outcomes
- 24% faster speed to refill, reducing gaps in therapy that compromise both patient outcomes and manufacturer revenue
- 4.9 out of 5 average patient satisfaction rating, proving that what's good for manufacturers can also deliver superior patient experience
By eliminating the margin extracted by intermediaries and optimizing fulfillment operations, our platform improves gross-to-net economics while delivering better outcomes. When constructed correctly, manufacturers don't face trade-offs, they gain control, improve profitability, and expand market access through a single integrated platform.
