From Access to Outcomes: The Changing Role of HUBs | NASP Specialty Pharmacy Podcast

On this episode of the NASP Podcast, Sheila Arquette, President & CEO of NASP, sits down with Narlyn Lopes and Megan Winebrenner of CenterWell Specialty Pharmacy to talk about how modern hub models have grown well past basic access support; they're now built to deliver a coordinated, personalized experience across the whole specialty medication journey. The conversation digs into how better technology and closer collaboration are cutting down on delays and administrative burden, so patients can start therapy sooner and stay supported once they're on treatment.

• 0:05Speaker 00

  You are listening to the global network of podcasters dedicated to the pharmacy profession. Welcome to the pharmacy podcast network.

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  You're listening to the NASP Specialty Pharmacy Podcast, a collaboration between the National Association of Specialty Pharmacy and the Pharmacy Podcast Network. Each episode dives deep into trends, challenges, innovations, and patient-centric practices shaping the future of this dynamic and rapidly evolving industry. Whether you're a pharmacist or healthcare provider, patient advocate, or industry leader, you'll hear expert insights, real-world evidence, and thought-provoking discussion that highlights all that makes specialty pharmacy special.

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  In support of NASP's mission to empower specialty pharmacy stakeholders to advance the standard of patient care, NASP supports a free-market healthcare system in which all specialty pharmacies compete on the same fair and level playing field, because that is in the best interest of the patients we collectively serve. NASP is committed to working with all stakeholders and policymakers to ensure that all patients have access to the life-saving medications they need and the high-touch patient care and support services they deserve from the pharmacy of their choosing.

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  Hello, my name is Sheila Arquette, and I am the President and CEO of the National Association of Specialty Pharmacy. I am delighted to welcome my special guests from Centerwell Pharmacy, Narlyn Lopes, and Megan Winebrenner to this episode of the NASP Podcast. Narlyn Lopes is Vice President of Pharmacy Hub Operations at Centerwell, where she leads strategic initiatives focused on optimizing hub services, enhancing patient access, and driving operational excellence across the specialty pharmacy ecosystem. With more than 20 years of experience spanning specialty pharmacy, life sciences, patient support services, and healthcare technology, she has built a career leading growth, innovation,

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  and transformation in complex healthcare environments. Prior to joining Centerwell, Narlyn held executive leadership roles at Optum Insight, where she oversaw portfolios spanning real-world evidence, clinical trial solutions, and analytics. She also held leadership positions at AssistRx and Walgreen Specialty Pharmacy, where she helped advance hub and specialty pharmacy solutions that improve patient access, engagement, and outcomes. Megan Winebrenner, PharmDCSP, is a Clinical Pharmacy Lead on the Clinical Strategy Team at Centerwell Specialty Pharmacy, where she leads initiatives focused on specialty,

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  pipeline forecasting, clinical strategy, and innovative programs designed to enhance patient outcomes. With more than a decade of specialty pharmacy experience, Megan brings expertise spanning clinical operations, rare disease management, specialty drug strategy, and patient-centered program development. Her work centers on aligning clinical innovation, operational excellence, and emerging therapies to improve care for patients with complex conditions and support the future of specialty pharmacy. Narlyn and Megan, thanks so much for joining me today.

• 3:32Speaker 04

  Thanks for having us. Yes, thank you so much.

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  So Narlyn, for listeners who may be less familiar with the concept, how would you define a patient services hub? And then what role does it play in helping patients access and stay on therapy?

• 3:47Speaker 04

  Well, Sheila, this will probably be my favorite question. It's my version of Hub 101. At its core, a patient services hub will run support programs, which are typically funded by the pharmaceutical manufacturer, to help patients, providers, pharmacies, and insurers navigate the process of medication access, affordability, and adherence. They do this because, as we know, these are critical milestones in the patient journey for improving health outcomes. The three of us here know that understanding specialty pharmacy is knowing that our medications come with additional steps before a patient can start treatment.

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  They may be insurance approvals, affordability programs, specialty pharmacy coordination, patient education, or the patients may need ongoing adherence support. The hub helps manage those activities and reduce friction throughout that patient journey. I'll give an example. Let's say a patient is prescribed a specialty medication for severe asthma. The hub will help verify insurance coverage, identify whether prior authorization is required, connect the patient with financial assistance programs, they'll coordinate with the specialty pharmacy, and provide ongoing support after therapy begins. Ultimately, their goal really is to support everyone in the care team for the benefit

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  of that patient, with a focus on prioritizing access and affordability for a complex process so patients can start therapy sooner, stay informed, and remain on that treatment longer.

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  So hubs have been around for quite some time, but the healthcare landscape has changed significantly. And Narlyn, how has the role of hub evolved over the years, and what factors have driven that evolution?

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  Yeah, great question. So if we go back several years, hubs are primarily focused on helping patients get through that access process. A lot of the work really just centered around benefits verification, prior authorization, finding that pharmacy, getting that fill as timely as possible. Interestingly enough, though, specialty medications have become more common, meaning the access and treatment process became much more complex. Patients weren't just looking for help getting access to therapy. They also needed education, affordability support, ongoing communication, and help navigating everything that happens after treatment.

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  At the same time, providers were, and honestly still, are dealing with increasingly administrative burden. The manufacturers wanted greater visibility into what was happening after a prescription was written. They wanted to understand were patients getting stuck, why therapy starts were delayed, and what barriers were preventing patients from staying on treatment. As a result, the role of the hub expanded. What started as an administrative support function evolved into a broader patient support ecosystem. So today's hubs help coordinate access, affordability, education, adherence, and patient engagement.

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  They also provide manufacturers with insights into the treatment experience. In many ways, hubs have evolved from simply helping patients start therapy, to helping patients stay on therapy, and helping providers and manufacturers better understand and improve that experience with data and insights.

• 7:25Speaker 03

  So despite all the progress that's been made, there are still significant barriers throughout the specialty medication journey. Megan, what are the biggest pain points for patients, providers, and manufacturers that today's hub models are trying to address?

• 7:39Speaker 04

  Yes, so even with all the advances we've seen in specialty pharmacy, there are still a lot of points along the journey where things can break down. First, from a patient perspective, one of the biggest challenges is navigating a complex process. Patients may be dealing with insurance challenges, they may be dealing with affordability concerns, they may be dealing with specialty pharmacy requirements, and then uncertainty about what happens next. So for someone who's just received a diagnosis, you know, when you take all of that together, this can be overwhelming.

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  Now, providers, they face a different challenge. They spend a tremendous amount of time on administrative tasks such as responding to payer requests, coordinating with pharmacies, and tracking down status updates. We all know these activities are important, right? But they can take away from patient care. Then you've got the manufacturers, and really, they're the ones who are ultimately investing in these support programs because they want to make sure and ensure that patients can successfully access therapy and achieve positive health outcomes through medication adherence.

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  And really, one of the biggest challenges for all of us in the care space, along with our patients, is understanding where patients are getting stuck in the process. For instance, is it an insurance issue? Maybe it's an affordability issue? Did the patient abandon the prescription? Did the provider run into administrative barriers? Historically, it hasn't always been easy to see where those breakdowns occur.

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  Another challenge, I think, is that multiple stakeholders are often involved in supporting the patient journey. So imagine that a patient receives approval for therapy, but they're contacted separately by, let's say, the provider's office, the hub, the specialty pharmacy, and an affordability program. Everyone here is trying to help, but the experience can become confusing rather quickly. Patients may not know who to call with questions, and providers can spend their valuable time responding to multiple requests from different parties.

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  So what today's hub models are really trying to do is to bring all of those pieces together. The goal isn't necessarily for the hub itself to do everything. It's to really better orchestrate the cure experience, right? So reduce the duplication, improve the coordination across all stakeholders, reduce friction for patients, lessen that administrative burden for providers, and provide manufacturers with greater visibility into where barriers exist. At the end of the day, you know, everyone has the same goal for the patient, and that's helping the right patient

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  get on the right therapy and stay on it. So hubs are designed to help make that process simpler, more connected, and more effective for everyone involved.

• 11:16Speaker 03

  So we're hearing more about automation, digital engagement, personalized support, and data-driven decision-making. Narlin, what is driving those changes, and how are they reshaping expectations for what a hub should deliver?

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  Yeah, there is so much out there with automation and digital and all of this. So I definitely think there's several industry trends that are converging at the same time. First and foremost, patient expectations are changing. Consumers like us are accustomed to personalized digital experience in nearly every aspect of our lives. And they increasingly expect healthcare to offer the same convenience and transparency and, honestly, ease of access. For example, as we know, all of us can check the status of a package, schedule an appointment

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  with just a few clicks. And patients are now increasingly expecting that, that same level of transparency, that same level of convenience when trying to access and manage medications. But it's also now happening with complex medications. At the same time, as I highlighted earlier, provider offices are facing growing administrative demands, and they're looking for ways to simplify processes and reduce that manual work. The manufacturers, as we mentioned, are also seeking deeper insights into that patient journey. They really want to understand access barriers. They want to know program

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  performance, and they want to really understand where the patients are struggling. Technology's helping address many of those challenges. A task that once required multiple phone calls and faxes, and yes, I said faxes, can increasingly be completed through integrated digital workflows. Advances in automation, artificial intelligence, and data innovation make it possible to streamline routine activities, improve visibility across that treatment journey, and identify issues earlier than ever before. We're also seeing a shift from one-size-fits-all

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  support models to that personalized engagement. Some patients do prefer speaking with a care team member. Others are going to prefer a text message, or going to a mobile app, logging on to a portal, or digital reminders. The ability to offer support through multiple channels helps create a more flexible and patient-centered experience. Let's also not forget that manufacturer expectations are increasingly focused on patient outcomes. As a result, hubs must evaluate operating models that support outcomes-driven activities and processes rather than purely transactional services. This shift could significantly impact

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  technology strategies, how we look at workforce, hiring models, or even pricing frameworks across hub organizations. Understanding and adapting to this market evolution is critical. That'll help align with manufacturer needs and building an execution model that prioritizes patient outcomes throughout the patient journey, rather than focusing solely on transactional touchpoints. Ultimately, expectations for hubs are expanding, as everything I highlighted there. Solutions should not only support access, but also create a more personalized, transparent, outcomes-driven, and efficient experience throughout that entire treatment journey.

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  So list questions for both of you. As hub models continue to evolve, why is it important for organizations like Centerwell to understand the space, and how does that knowledge support broader pharmacy and patient care goals?

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  Sure, I'll start, Megan. So I think one of the reasons this is so important for Centerwell is that we have a front row seat to the specialty medication process. As a specialty pharmacy organization, we work closely with our providers, manufacturers, insurers, and our patients every day. That gives us firsthand visibility into where processes work well, and where opportunities still exist to really improve the experience. For us, understanding the evolution of these hub models isn't just about following industry trends. It's really about understanding how the healthcare ecosystem is changing, and

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  how stakeholders like us can work together more effectively to support our patients. We also recognize that specialty therapies continue to become more complex. As new treatments enter the market, the need for coordination, communication, and patient support is only going to increase. For us, staying informed about evolving hub capabilities helps us anticipate future needs and identify opportunities to better support patients and providers. But more importantly, it really allows us to bring a specialty pharmacy perspective to really important conversations about innovation and patient access. Megan, anything else that

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  you would like to add?

• 16:44Speaker 04

  Yeah, I think you touched on this really well, and I'd just add that from a specialty pharmacy perspective, understanding these evolving hub models helps us to better prepare for the future of patient care. You know, many of the therapies that we support today are highly specialized. They require extensive access support and often involve multiple stakeholders throughout the entire treatment journey. And so the more we understand how the hub programs are evolving, the better positioned we are to support patients as they begin,

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  and then also continue on therapy. It also helps us to identify opportunities to really align patient support services with the clinical and operational resources that are already within the specialty pharmacy. So rather than creating additional complexity, we really want to understand how different stakeholders can work together more effectively and efficiently. And as new therapies continue to emerge, having that visibility into evolving access models allows us to proactively prepare clinical programs, patient education resources,

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  and also support strategies that can help patients navigate treatment more successfully.

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  This question is also for both of you. If these next-generation hub models are successful, what does that mean in practical terms for patients, providers, manufacturers, and clinical outcomes?

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  Sure, I can start with this one, Narin. So if these next-generation hub models are successful, the impact should be both meaningful and measurable. For patients, success means fewer delays in starting therapy. It means clear communication throughout the entire process. It really, it means support that is tailored to their individual needs. The healthcare system often feels complicated, and successful hub models can help make that experience simpler and also easier to navigate. So, success might mean reducing a patient's time

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  to therapy from weeks to days, allowing them to start treatment sooner and then potentially improving clinical outcomes. It could also mean giving patients greater visibility into what's happening along the way, including clear information about costs, including next step, and also including the status of their therapy. So the more informed and supported patients feel, the easier it becomes for them to stay engaged in their own care. And for providers, success means reducing that administrative burden that we've mentioned before and improving visibility into the status of their patients.

• 19:57Speaker 04

  When providers spend less time managing logistics, they can spend more time focused on that patient care and clinical decision-making. Now, from a clinical standpoint, earlier treatment initiation and stronger adherence support can create opportunities for improved therapy persistence, better disease management, and ultimately, better patient outcomes. Narin, what were your thoughts on this question?

• 20:27Speaker 05

  I think, I mean, you've covered those so well. You know, from a manufacturer perspective, I think success means gaining just a clear understanding of what is happening across that therapy lifecycle. That, to me, includes visibility into where patients may encounter barriers, how quickly they're starting therapy, how effectively support programs are performing, and where improvements can be made. Those insights will really help them make more informed decisions and better support the patients who are relying on their therapies. Operationally, I really think success means creating processes that are efficient, they're scalable,

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  and they're easier for all stakeholders to navigate. Information moves seamlessly, administrative tasks are reduced, and organizations can focus resources where they can have the greatest impact. I think when done well, the result is faster therapy initiation, stronger patient engagement, like we've discussed, improved adherence, and just those outcomes, right? Better outcomes for our patients. That's really the promise of the next-generation hub model, creating a more coordinated and effective experience for everyone involved while keeping the patient at the center of the journey.

• 21:50Speaker 03

  So Narin, looking ahead three to five years, what do you think will differentiate the most successful hub models?

• 21:58Speaker 05

  Another great question, right? To bring it all together, I really think, looking three to five years, the most successful hub models will be the ones that evolve, right? They're evolving from providing services to becoming true orchestrators of the patient journey. Traditional hub models have done a really important job supporting foundational services like benefit verification, prior authorization, and patient onboarding. Those functions aren't going away. In fact, they're still super critical, but they'll increasingly become the baseline expectation. They're no longer a differentiator. What will set leading hub models apart

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  will be their ability to connect stakeholders across the healthcare ecosystem and create a more seamless experience for patients. That includes leveraging data and technology to provide greater transparency, identifying barriers earlier in the process, and enabling more proactive interventions throughout the patient experience. We'll also see a greater emphasis on integration. The hubs that can effectively connect manufacturers, providers, specialty pharmacies, payers, and care teams will be best positioned to improve efficiency and reduce the complexity that often exists in specialty medication access.

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  And we know that is not an easy thing. That is the complex thing to tackle, right? Ultimately, I think success will be measured by more than operational metrics. The leading hub models will be the ones that can demonstrate real value through faster access to therapy, improved patient engagement, stronger adherence, and better clinical outcomes. Those organizations will combine operational excellence with a patient-centered approach, creating benefits not only for those manufacturers and providers, but most importantly, for the patients we all serve.

• 24:00Speaker 03

  Thank you so much, Narin and Megan, for chatting with me and sharing this valuable information.

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  Thank you.

• 24:06Speaker 03

  Thank you. And as a reminder, NASP corporate members are invited to be my guest on one complimentary podcast per year. For more information about this or other NASP membership benefits and events, please feel free to reach out to [email protected] or visit our website at www.naspnet.org. Until next time, have a great day.