5 Barriers to Patient Medication Access

Life sciences companies invest heavily in getting therapies to patients. But between the prescription decision at the point of care and therapy start, patients encounter barriers that can delay or derail access.

New survey data from Surescripts provides a detailed picture of what patients actually experience on the path from a prescription being written to a therapy start. The results make it clear that these barriers are very real—and they're driving consequential decisions including patients abandoning prescriptions, rationing medication or simply giving up.

Consider these findings: 

• 37% said a prescription took a long time to fill
• 31% cited back-and-forth with health plan, provider or pharmacy
• 26% reported a prior authorization delay or denial
• 20% were unable to get their prescription filled

For life sciences companies, these moments represent a patient who may never start, or stay on, therapy. Understanding where access breaks down is the first step toward fixing it.

The medication access experience

Here are five of the most pressing barriers to medication access patients identified, what they're currently doing to work around them and the solutions that can address these barriers at the point of care and within prescriber workflows.

1. Prescriptions take too long to fill

Thirty-seven percent of patients who experienced challenges reported that their prescription took a long time to fill. For many, this isn't just an inconvenience, it’s a gap in care that can have real health consequences.

What patients do now: They wait, they call and they follow up. And 31% reported back-and-forth with their health plan, provider or pharmacy just to get their prescription moving.

A better path forward: Much of this delay stems from information gaps between the prescriber, pharmacy and payer—especially when that information isn’t available at the point of care. Surescripts Real-Time Prescription Benefit delivers patient-specific benefit and cost information from the prescription benefit plan to prescribers at the point of care and within their prescribing workflow. And Surescripts Prior Authorization Automation automatically retrieves the required clinical information from the patient's EHR and sends it to the pharmacy benefit manager. When prior authorization requirements are met, the request can often be approved without human intervention—reducing delays and the need for follow-up calls. Together, these solutions can help reduce downstream bottlenecks and delays.

2. Prior authorization delays and denials

Twenty-nine percent of patients who filled a prescription in the past 12 months said they experienced delays due to prior authorization. That number rises to 36% among patients taking two or more prescription medications daily. Additionally, 13% of patients report their health actually worsened because of prior authorization delays.

What patients do now: They wait for the process to work itself out—or they don't. Some switch medications. And some abandon the prescription.

A better path forward: Prior authorization doesn't have to be a barrier. Prior Authorization Automation matches a patient's clinical data with the health plan's determination criteria at the time of prescribing to reach a clinically appropriate decision as quickly as possible, so patients can start treatment faster. A Surescripts analysis of new prescriptions sent in January 2026 found that prescriptions requiring prior authorization took a median of four days longer to fill than those without prior authorization requirements. Removing that delay through automation can help keep patients on the path to treatment. And for life sciences companies, faster prior authorization may help reduce delays that lead to patient abandonment—supporting faster time to therapy and reducing access friction.

3. Cost surprises late in the process

When asked about ways to reduce sticker shock associated with prescription medication costs, 20% of patients split or otherwise rationed medication, and 25% abandoned the prescription—citing that they simply could not afford their medication.

What patients do now: They get resourceful, but in ways that signal a broken system and carry real clinical risk.

A better path forward: Cost transparency needs to happen upstream, at the moment of prescribing. Real-Time Prescription Benefit gives prescribers access to patient-specific benefit information at the point of care and within their workflow—including out-of-pocket costs and therapeutic alternatives—directly from the patient's benefit plan. This enables informed cost conversations with patients before the prescription is ever sent. Only 26% of patients reported currently discussing medication costs with their provider at half or more of their visits. Delivering accurate, plan-specific pricing to prescribers and patients at the point of care can make these conversations more frequent and productive.

4. Difficulty accessing assistance programs

Nineteen percent of patients surveyed are enrolled in a copay assistance or patient access program from a pharmaceutical company to manage costs. But the path to enrollment is often obstructed. And many patients who would qualify don’t know about the programs that are available.

What patients do now: Patients who find assistance programs may choose to use them. But others turn to less effective strategies—with 24% switching to a different medication, which may or may not be the best clinical choice.

A better path forward: Surescripts Electronic Benefit Verification gives patient access programs the ability to verify a patient's benefit coverage and understand their out-of-pocket costs. When program staff can quickly verify benefit information, identify coverage gaps and see what a patient will actually pay, they can intervene before patients make decisions driven by cost alone. For life sciences companies investing in patient support programs, this capability can mean faster enrollment, more informed patient support interventions and fewer patients falling through the cracks.

Data brief

How Patient Access Technology Can Simplify the Patient Care Journey

5. A system that’s difficult to navigate

Nearly half, or 48%, of patients said they don't know who or what to trust for accurate information about prescription pricing. And that uncertainty has real consequences with patients delaying, skipping or abandoning medications they can’t predict the cost of.

What patients do now: They do their best—comparing prices, searching for discounts and asking their providers for help. But without clear and complete information at the right moments, even engaged patients may struggle.

A better path forward: The barriers above compound and create a system that feels overwhelming to patients. But when real-time benefit information flows to prescribers at the point of care, prior authorization resolves automatically within prescriber workflows and patient access programs have electronic tools to verify coverage and costs—the entire system is easier to navigate.

The data is clear. Patients are working too hard to navigate a complex system. Surescripts has the technology solutions to reduce that burden—helping to ensure that more patients start and stay on therapy.