Asked where direct-to-patient goes from here, Parkinson points to specialty medicine as the next frontier. Specialty drugs account for more than half of drug spend even though just 2% of patients use them, and Parkinson says that concentration of cost and friction is exactly where direct-to-patient delivers its biggest return. He expects platforms may stop defaulting to cash pay and instead route specialty patients through whichever path, cash or insurance, is cheapest and fastest to access. That routing logic, he said, is also where cash and insurance stop running on separate tracks. The upshot, Parkinson says, is an industry moving past pilot mode: more brands launching hybrid direct-to-patient and insurance models from the start, translating into faster adoption, faster first fills and stronger persistency.