Understanding Big Pharma: How Different Functions Work Together

Author: Mariam Hanna, PharmD, RPh

Views are my own and do not reflect my employer.

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The Part of Pharma I Never Understood in Pharmacy School

Before entering industry, I thought pharma functions operated mostly independently: Medical Affairs was Medical Affairs. Market Access was Market Access. PSS was PSS. Trade was Trade. And so on.

What I didn’t fully understand was how interconnected everything actually is, especially when it comes to getting a patient from prescription to therapy initiation.

It wasn’t until I joined industry as a post-doctoral fellow in Medical Affairs and Medical Strategy, and later transitioned into a role focused on Specialty Pharmacy and Payer Access within Patient Support Services (PSS), that I really started seeing the bigger picture.

And honestly, I realized this is something many pharmacy students are never taught.

 

Seeing Pharma Beyond Individual Roles

In pharmacy school, we often hear the names of different industry roles, but not necessarily:

• how teams interact

• what each function’s responsibilities are

• where responsibilities overlap

• how operational, medical, and patient access-related decisions affect one another

The more experience I gained, the more I realized pharma functions are deeply interconnected.

While working in Medical Affairs, I was exposed to:

• Medical strategy planning and execution

• Evidence generation

• HEOR and medical value outcomes

• HCP insights

• Cross-functional collaboration surrounding launch planning and patient access considerations

Later, transitioning into Specialty Pharmacy and Payer Access within PSS gave me visibility into an entirely different side of the patient journey:

• Coverage, prior authorizations, and reauthorizations

• Payer barriers and specialty pharmacy coordination

• HUB operations

• Nursing coordination

• Escalation management

• Time-to-therapy challenges

What stood out most to me was realizing how many teams are involved behind the scenes to support patient access.

What Changed My Perspective

 

Working within PSS further shifted my understanding of the healthcare ecosystem.

For the first time, I could clearly see how payers, specialty pharmacies, HUBs, field teams, access teams, and internal stakeholders all influence the patient experience in different ways.

I also began to see how operational issues, communication gaps, or payer restrictions can directly contribute to treatment delays.

That perspective changed the way I think about collaboration in pharma.

No single function operates in isolation, and no single team alone determines patient outcomes.

Why I Think This Matters for Students

I genuinely believe pharmacy students would benefit from earlier exposure to how pharma functions connect operationally and strategically.

Not because everyone should pursue industry, but because understanding the broader ecosystem helps make sense of how therapies ultimately reach patients.

It also helps students:

• explore career paths more intentionally

• understand how different functions contribute to patient care

• recognize that impactful work exists far beyond traditional roles

For me personally, one of the most interesting parts of working in industry has been learning how all of these moving pieces fit together end-to-end—from R&D and clinical development to regulatory approvals, Medical Affairs, pharmacovigilance and patient safety, market access and payer strategy, trade and distribution, Patient Support Services (PSS), specialty pharmacy coordination, therapy initiation, and ongoing patient support.

What has surprised me most so far is realizing how dependent each function is on the others for successful patient outcomes.

And honestly, I still feel like I’m learning something new every day.