Preparing for Blizzard Season: How to Turn 2026 Benefit Disruptions Into Strategic Wins

Pharma teams are skilled forecasters. They know that as the end of the year approaches, benefit transitions create the perfect storm—deductibles reset, formularies shift, and prior authorizations start over. It’s what many call “blizzard season” for hub services and co-pay program enrollments, and it’s coming at you quickly. 

The good news? There are steps you can take to prevent patient abandonment of treatment during coverage transitions. In a recent MM+M webinar sponsored by Timely by DrFirst, panelists discussed how proactive strategies and technology that reaches providers and patients upstream can help pharma brands not only manage these disruptions but turn them into opportunities to strengthen access and adherence. 

The discussion featured Chad Maeder, Senior Director of Patient Experience Strategy at Otsuka Precision Health, and Caleb Dunn, PharmD, Director of Product Management at DrFirst, and was moderated by Colin Banas, M.D., M.H.A., Chief Medical Officer at DrFirst.

Here are four key takeaways that brand, market access, and patient support teams can act on now: 

1. Make Cost Conversations Easier at the Point of Prescribing

Real-time prescription benefit (RTPB) checks have moved from “nice to have” to “must have.” Price transparency is most effective when it allows prescribers to see exactly what a patient will pay based on their current plan, deductible, and formulary status. 

“It’s all about actionability,” said Dunn. “We’re giving providers and patients the clearest possible view of out-of-pocket costs right when it matters most—before the patient walks out of the office.” 

Removing barriers upstream helps address access problems, but patients also need resources that cater to the complexity of the medication and their individual circumstances. Real-time price transparency also makes patients more likely to fill prescriptions the first time, without delays that can affect brand access and speed-to-therapy metrics. Technology allows stakeholders to support patients when the cost creates a barrier, pre-emptively identifying gaps in coverage and offering co-pay cards or coupons. 

2. Get the Prescription to the Right Pharmacy the First Time

Many specialty medications can only be dispensed by specific pharmacies. When providers can identify the right pharmacy upfront, it prevents costly prescription rework that causes delays—a major barrier to access. 

“When prescribers know exactly who can dispense a drug, that cognitive load disappears,” Dunn said. 

For specialty brands with limited distribution networks, intelligent pharmacy selection ensures prescriptions get to the correct dispensing pharmacy without delay. This can reduce time-to-fill and therapy abandonment. Pharma teams can take this even further by using technology to proactively educate prescribers on preferred pharmacy channels. Eliminating guesswork before the prescription is sent means fewer problems to fix after the fact and educating patients about pharmacy selection sets up expectations that specialty pharmacy orders are managed differently from those filled at retailers. 

3. Simplify the Prior Authorization Process to Prevent Delays

Some prior authorizations can be avoided, but electronic prior authorization (ePA) accelerates those that cannot. Bringing it into the prescribing process saves time for clinicians and patients alike. 

“When prior authorizations are initiated within the workflow, they go through faster,” Maeder said. “It’s about timing and integration.” 

Prior authorization is often where momentum is lost—and that delay can be the difference between a patient starting therapy or walking away. Brand teams can partner with companies to analyze payer level data and prior authorization hurdles to collaboratively help physicians and patients with navigating the complexities.  

4. Engage Patients Digitally and Immediately

Within minutes of a prescription being written, patients receive a text message on behalf of their physician that connects them to a secure web page where they can see brand-specific educational resources and support options, understand what it will cost, and take next steps. 

This is what Timely has provided for Otsuka, Maeder said. 

“The beauty of this is how early in the process it happens,” he added. “That’s where we need to be—early, proactive, and personalized.” 

Engaging patients not long after a prescription is written is critical, and more impactful when it comes from a trusted source—the provider. With a more than 80% engagement rate, this window is when patients are most motivated to act and when pharma brands have a unique chance to deliver value. Whether it’s delivering financial assistance, setting expectations around fulfillment time, or reinforcing the importance of a prescribed therapy, that early connection builds trust and drives adherence.  

Using an automated real-time engagement model that is integrated directly into the provider's workflow takes the emphasis off follow-up calls days later. Pharma teams create engagement programs that actually stick when patients get copay cards, guided support program enrollment, or behavioral nudges via text. 

Why It Matters for Pharma 

In a crowded market, patient experience can differentiate your brand. As Maeder put it, “If a person has a good experience, they’re not just a user. They become an advocate.” 

This kind of advocacy builds loyalty, but it also fuels adherence, brand performance, and provider confidence. When patients have a smooth experience—when they understand their out-of-pocket costs, know where to pick up their medications, and feel supported by their providers—your brand becomes the one that’s easier to start and easier to stay on. 

• For brand teams, this is your opportunity to stand out by making it easier for patients to start and stay on therapy.  

• For market access teams, reducing abandonment during transitions shows that your payer strategy and hub services are aligned and effective. It builds trust with plans and providers alike. 

• For patient support teams, digital engagement early and throughout the medication journey closes gaps in care and delivers a clear ROI for your program. 

“An engaged patient leads to better outcomes and a happier provider,” Dr. Banas said. When patient experience becomes part of your access and brand strategy, it stops being a reactive fix and starts becoming a strategic advantage. 

Start Now—Before the Storm Hits 

The 2026 “blizzard season” isn’t just a metaphor—it’s a known disruption with serious consequences for patients and for brands that don’t plan ahead. But for those that do, it’s a strategic opportunity. 

“It’s time to assess the gaps for your patients and your brands,” said Dr. Banas. “Let’s find those quick wins together.”

Ready to learn more about navigating 2026 benefit disruptions?

Watch the full webinar recording to hear about implementation strategies, real-world case studies, and actionable solutions for pharma teams.