Patrick R. Coyle: Following the Patient to Understand the Economics

Connecting Patient Access and Business Performance

A patient receives a diagnosis. A treatment is available. A healthcare professional prescribes it. Yet several important steps may still remain before treatment begins.

Patrick R. Coyle has spent much of his career studying those steps and considering how organizations can better understand them. With more than two decades of experience across finance, operations, research and development, market access, specialty distribution and enterprise leadership, he brings a broad perspective to one of the life sciences sector's most important questions: how can organizations support appropriate patient access while building sustainable commercial models?

Coyle's perspective is both practical and constructive. He believes that the patient journey and an organization's financial performance can often provide complementary information. When treatment is delayed by authorization requirements, affordability concerns, enrollment procedures, pharmacy routing or other practical considerations, the effect may be felt by patients first. Over time, the organization may also observe a difference in treatment initiation, continuation or commercial performance.

This does not suggest that every access challenge has a simple financial explanation, or that every commercial outcome can be traced to one event. The life sciences environment is complex, highly regulated and influenced by many participants. Coyle's insight is that looking at patient experience and business performance together may give leaders a more complete understanding of that environment.

Creating a More Connected View

Life sciences organizations rely on many highly specialized functions and external partners. Market Access may focus on coverage. Patient Services may support enrollment and treatment initiation. Distribution partners may manage important aspects of fulfillment. Finance may evaluate the resulting commercial performance.

Each function contributes valuable expertise. Coyle believes organizations can gain additional insight when these perspectives are considered together. A connected view may help leaders better understand how patients move through the treatment journey and where further support, coordination or information could be beneficial.

Some transitions can be particularly difficult to observe. A patient may receive approval but require further assistance before beginning treatment. Another may complete an initial step but not continue to the next one. These situations do not necessarily indicate that anyone has acted incorrectly. They may simply reflect the complexity of a journey involving healthcare professionals, payers, service providers, pharmacies, patients and caregivers.

Coyle encourages Commercial, Market Access, Patient Services and Finance teams to examine this journey using shared definitions and aligned assumptions. His objective is not to assign criticism. It is to help professionals combine their expertise, clarify important transitions and develop a more complete understanding of the patient experience.

Following the Number Backward

Coyle began his career in financial operations and technology. He says this experience taught him that reported figures often reflect a series of operational decisions, processes and human actions. Looking beyond the final number can therefore reveal useful information about how an organization works.

He later held life sciences roles involving research support, product planning, commercialization and enterprise finance. Experiencing different stages of the therapy lifecycle gave him an appreciation for the many perspectives involved. Researchers, commercial teams, payers, finance professionals, healthcare providers and patients may each encounter the same therapy in a different context.

His international and cross-functional experience also reinforced the importance of context. Coverage requirements, treatment pathways, affordability considerations, distribution models and sites of care may differ considerably between markets. Coyle therefore sees value in approaches that can be adapted thoughtfully rather than applied uniformly.

Senior financial leadership gave him an opportunity to view the organization more broadly. Finance could explain what appeared in the numbers, but Coyle became increasingly interested in the events and decisions that preceded them. What occurred earlier in the treatment journey? What information could help teams understand the outcome more fully? What did the patient experience along the way?

These questions became central to his professional philosophy.

Learning from the Complete Patient Journey

Coyle recalls advisory work involving a specialty therapy with established coverage that was performing differently from internal expectations. Enrollment, dispensing, coverage and affordability information each provided part of the picture. When considered together, the information offered a clearer view of how patients progressed from one stage to another.

The example is intentionally generalized to respect confidentiality. It is not presented as a claim about an identifiable client, therapy or specific commercial result.

For Coyle, the experience demonstrated the value of examining transitions across the complete patient journey. An approved patient may still need guidance before treatment begins. A service provider may see only the portion of the journey within its responsibility. Finance may observe the eventual commercial outcome without having direct visibility into every earlier step.

Bringing these perspectives together can help an organization ask more informed questions. Coyle favors cross-functional review, clearly understood responsibilities and greater alignment around the information used by different teams. He also emphasizes appropriate caution when interpreting results. In a complex healthcare system, several factors may contribute to an outcome, and responsible leaders should distinguish a useful observation from independently established causation.

This balanced approach strengthens the value of his insight. It combines a desire for practical improvement with respect for evidence, confidentiality and the contribution of every professional involved.

Gross-to-Net as a Shared Operating Perspective

Gross-to-net generally describes the difference between a medicine's gross sales and the amount retained after applicable rebates, discounts, government pricing obligations, fees and other adjustments. Although Finance plays a central role in reporting and forecasting these figures, Coyle notes that the underlying economics can reflect decisions and activity across several functions.

Contracting may influence rebate economics. Channel design may shape distribution arrangements, fees and data visibility. Patient-support programs can assist eligible patients as they move toward treatment initiation. Payer policies, utilization requirements and changing patient circumstances can also contribute to the overall result.

Coyle sees an opportunity for relevant functions to share information, align assumptions and contribute their expertise through a regular operating cadence. Finance retains its important responsibility for financial reporting, while Commercial, Market Access, Trade, Patient Services and other appropriate teams help build a fuller understanding of the business environment.

The exact structure will naturally differ by organization, product and market. It should always reflect applicable legal, regulatory and compliance requirements. Coyle places compliance first and encourages leaders to evaluate financial decisions alongside their potential implications for appropriate patient access.

He also sees value in looking beyond aggregate measures. Overall coverage or blended financial figures are useful, but stage-by-stage information may offer additional context. Measures concerning enrollment, approval, initiation and continuation can help leaders better understand the journey, subject to data availability, patient privacy and appropriate governance.

A Thoughtful Sequence for Operational Improvement

Coyle summarizes his operational philosophy in four steps: simplify, standardize, automate and measure.

The sequence reflects a disciplined approach to change. Simplification helps teams understand the process. Standardization creates consistency. Automation can then support efficiency, while measurement helps the organization learn and improve over time.

His leadership experience during the early stages of the COVID-19 pandemic reinforced the importance of preparation and communication. Coyle says he participated in moving a corporate workforce to remote operations after considering connectivity, equipment and technology-support needs. He does not attribute a particular health outcome to the decision. Instead, he views the experience as an example of leaders responding carefully and responsibly during a period of uncertainty.

Remote work also highlighted the importance of purposeful human connection. Technology allowed operations to continue, while regular communication helped replace some of the spontaneous conversations that naturally occur in a shared workplace. Coyle says the experience deepened his appreciation for structured check-ins, accessible leadership and attention to employee wellbeing.

That perspective also informs his view of artificial intelligence. He sees meaningful potential in automating work that can be clearly defined and performed consistently. At the same time, he believes human judgment remains essential when information is incomplete or when decisions may materially affect patients. AI can support analysis, but accountable leadership, professional expertise, appropriate oversight and compliance remain fundamental.

Turning Experience into a Lasting Contribution

Coyle's current focus is on translating his experience into advisory methods and educational approaches that other professionals can apply. For him, the value of an idea is demonstrated not only by how clearly it can be explained, but also by whether teams can use it thoughtfully in their own organizations.

His aim is not to encourage people to repeat predetermined conclusions. Instead, he wants to help them ask constructive questions:

• What conditions need to be present for this strategy to work?

• What additional information could improve the decision?

• Which transition would benefit from clearer coordination?

• What other explanation should be considered?

This approach reflects intellectual openness. If new evidence does not support an initial hypothesis, Coyle believes the hypothesis should be reconsidered. In complex healthcare systems, learning and adapting are essential leadership capabilities.

His emphasis on curiosity, collaboration and evidence makes his perspective especially relevant. Rather than offering a universal formula, he provides leaders with a practical way to connect information that may otherwise be viewed separately.

Seeing the Journey as a Whole

Coyle's central insight is that patient access and commercial performance, while distinct, can often be better understood through the same treatment journey.

Organizations that examine that journey across functions may gain earlier and more useful insight into how their systems are operating. This can support more informed conversations, stronger coordination and a deeper appreciation of both patient experience and business performance.

For CEOs and senior leaders, the message is clear and constructive: follow the patient journey carefully, understand the economics responsibly and remain precise about what the available evidence can demonstrate.

Patrick R. Coyle's contribution lies in helping leaders see these perspectives together. His work offers a valuable framework for thoughtful discussion in an industry where patient needs, scientific progress, operational complexity and sustainable business performance are closely connected.

Note: This article is based primarily on information and professional perspectives provided by Patrick R. Coyle in written responses supplied for publication. References to previous work and advisory experience have been generalized to respect confidentiality and avoid identifying organizations, clients, products or other third parties. The article does not make clinical claims or provide medical, legal or investment advice. Statements concerning professional methods and industry practices reflect Coyle's views and experience.