U.S. consumers are increasingly taking the lead in how they access and pay for healthcare, creating potential opportunities across biopharma and healthcare services.

Author

Erin Wright, Healthcare Services Analyst

Key Takeaways

Patients are gaining more control over their care, testing and medicines—in addition to payment approaches—in part due to policy changes and new technology.

The GLP-1 market has shown that branded prescription medicines can drive substantial volume through consumer-led access pathways.

The direct-to-consumer cash-pay opportunity in biopharma could reach $26 billion at its peak.

A Morgan Stanley AlphaWise survey found that 36% of U.S. consumers would be willing to pay entirely out of pocket for healthcare services, spending an average $413 a year.

In the complex and costly U.S. healthcare system, patients are no longer just heeding drug ads to “Ask Your Doctor”—they’re going straight to the source.

Policy changes and technological advances have given consumers more ways to directly choose the healthcare products and services that best suit their needs—including care, testing and medicines—as well as how they pay for them.

The healthcare industry is adapting to this trend, potentially creating new opportunities for investors. In biopharma alone, the total direct-to-consumer cash-pay market could reach $26 billion at its peak. Eyeing that opportunity, many large-cap biopharma companies now offer direct-to-consumer platforms.

How Policy and Market Practices Evolved

Healthcare consumerism took root with the creation of Health Savings Accounts (HSAs) in 2003, followed by the growth of high-deductible health plans (HDHPs). These changes gave consumers more control over healthcare spending—but also shifted more of the costs and decisions to them.

The 2010 Affordable Care Act (ACA) reinforced that shift by creating insurance marketplaces and strengthening consumer protections. Comparison shopping and standardized benefit information became central to buying insurance.

Beyond policy, efforts to make healthcare more convenient, accessible and consumer-friendly have also played a role. Digitization, for example, has helped engage more consumers.

The COVID-19 pandemic accelerated telehealth adoption and showed that much of healthcare could happen outside traditional facilities. Finally, wearables, direct-to-consumer diagnostics, cash-pay testing and direct-primary-care models let consumers monitor their health and seek care on their own.

GLP-1s Demonstrate the Direct-to-Consumer Model

Traditionally, drug manufacturers marketed their products to physicians and consumers, but the transaction itself still ran through many intermediaries. That is starting to change.

Patients can now identify a treatment they want, find a price that fits their budget, obtain a prescription digitally and fill it through a manufacturer-selected pharmacy or fulfillment partner.

Consumers are not necessarily stepping outside the healthcare system. Rather, they’re taking healthcare into their own hands—and gaining greater control over their health journey.

The GLP-1 market offered the first large-scale proof that this direct-to-consumer model can work. Patients’ desire to treat obesity generated substantial demand before insurers were ready to pay for it. What matters is not just that patients are willing to pay cash for an obesity medicine, but that a branded prescription product could support roughly half of its volume through a consumer-led access pathway.

That shifts the question for the biopharma industry: It’s no longer whether direct access can work, but where else it can unlock demand that the reimbursement system isn’t meeting today.

Healthcare services are evolving as well:

Payers are aligning more closely with consumer choice.

Direct-to-consumer pharmacy models can expand medication access and transparency.

Emerging consumer-enablement technologies, such as apps for screenings, patient support and home delivery,can facilitate access within existing systems.

Consumers Are Willing to Pay Out of Pocket

In an August 2026 Morgan Stanley AlphaWise survey of U.S. consumers, 25% of respondents said they had paid fully out of pocket for at least one healthcare service in the past year, and 31% had done so for a medicine or treatment.

The survey also suggests that 36% of consumers would be willing to pay entirely out of pocket for healthcare services, spending an average of $413 per year. Willingness to pay is significantly higher among younger and upper-income consumers.

Healthcare consumerism, however, is not simply about shifting more costs to cash-pay models. It’s about an emerging system in which consumers increasingly choose among coverage options, control healthcare spending, access their own data and initiate care directly.

There are limits to how far this shift can go, along with macroeconomic sensitivities and other risks. Still, models that emphasize transparency and choice are likely to play a growing role.

Consumers are not necessarily stepping outside the healthcare system. Rather, they’re taking healthcare into their own hands—and gaining greater control over their health journey.

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