Consumers Write a New Prescription for Healthcare

U.S. healthcare is shifting toward consumer-led access and payment, creating a potentially large direct-to-consumer opportunity across biopharma and healthcare services.

• Health Savings Accounts created in 2003, high-deductible plans, the 2010 Affordable Care Act and COVID-19-era telehealth adoption progressively gave patients more control over healthcare choices and spending.
• The GLP-1 market provides the strongest proof of the model: obesity patients generated significant demand before insurers were ready to pay, and branded products supported roughly half of their volume through consumer-led access pathways.
• Morgan Stanley estimates that the direct-to-consumer cash-pay biopharma market could reach $26 billion at its peak, while large-cap drugmakers are increasingly introducing direct-to-consumer platforms.
• In an August 2026 AlphaWise survey, 25% of U.S. consumers had paid fully out of pocket for a healthcare service and 31% for a medicine or treatment during the previous year.
• Another 36% said they would be willing to pay entirely out of pocket for healthcare services, spending an average of $413 annually, with willingness highest among younger and upper-income consumers.

Takeaway: Investors should look for companies enabling transparent, convenient consumer choice in medicines, testing, pharmacy and care, while recognizing that macroeconomic conditions and the limits of cash-pay adoption could constrain the trend.