As patients wrestle with the steps to get their prescription medications, new research from healthcare consulting and technology company D2 Solutions finds that delays and confusion are impacting whether patients even start prescribed therapies. A survey of 1,000 U.S. adults age 25 and older found that 21% have delayed starting a medication, highlighting the impact of access challenges on medication starts.

Nearly half of respondents reported that their insurance required prior authorization for a prescription, and 22% said the process took longer than expected. These challenges contribute to a difficult experience at the start of therapy. Only 20% of patients described their most recent medication start as “strong,” while 47% reported negative emotions such as anxiety, confusion or feeling “in limbo.”

“Access challenges aren’t just paperwork hurdles; they lead to delays, uncertainty and missed opportunities to start therapy,” said Dean Erhardt, President and CEO of D2 Solutions. “When communication breaks down or processes stall, patients are more likely to disengage before treatment even begins. That has real implications for adherence and outcomes across the healthcare system.”

Access barriers are changing patient behavior

The survey data shows that obstacles to medication access can lead patients to delay, abandon or adjust their treatment:

• 21% delayed starting a prescribed medication due to confusion or access issues.
• 11% didn’t pick up their medication from the pharmacy.
• 12% skipped doses, and 8% stopped treatment earlier than planned.
• 11% asked their doctor about switching to a different medication.

Younger adults are particularly affected. Millennials were more than twice as likely as Baby Boomers to delay starting a medication and were also more likely to skip doses or stop treatment early.

Breakdowns in coordination and communication

The findings point to coordination challenges across the healthcare ecosystem. Patients rely on multiple stakeholders, including providers, pharmacies, insurers and support programs, yet many report navigating the process with limited guidance or visibility into next steps.

Patients cited barriers such as provider office delays, pharmacy issues and difficulty understanding next steps. Many respondents reported managing the process on their own, reinforcing the lack of consistent support during a critical point in the treatment journey.

• Communication gaps are widespread: 38% received little or no communication while waiting for their medication.
• Support programs remain underutilized: 46% were unaware of manufacturer support programs, and only 15% reported using one.

Implications for medication starts and adherence

The early stages of the medication journey, particularly access, approval and onboarding, represent a critical window for patient engagement. When that experience is delayed or unclear, patients are more likely to postpone treatment, skip doses or discontinue therapy.

As policymakers and industry leaders work to reform prior authorization requirements and reduce administrative burden, the findings suggest these efforts have yet to translate into a smoother experience for many patients starting therapy.

“Patient access gaps suggest that improving communication and coordination across stakeholders can help reduce delays and support patients in starting and staying on therapy as prescribed,” said Erhardt. “Access remains a serious barrier for many Americans. Improving medication starts is the key to accelerating patient access, improving adherence and driving better clinical outcomes.”

To learn about D2 Solutions’ consulting services and technology solutions, visit d2rx.com.