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Increasing frustration among patients due to payer restrictions and limited access to medications has led to a growing trend in direct cash payments for prescriptions. Millennials and Gen Z, prioritizing convenience and speed over delays and rejections, are increasingly willing to pay out-of-pocket. Platforms like Mark Cuban Plus and GoodRx allow patients to find lower overall costs through cash payments compared to copays with insurance. Manufacturers are capitalizing on this trend by offering direct-to-patient channels, enhancing convenience and revenue, as demonstrated by Lilly Direct. Digital health tools like Push Health and Carbon Health enable immediate cash purchases of medications like Paxlovid, bypassing payer approval. Employers are becoming aware of the financial burdens of co-insurance/copayments and are incentivizing direct-to-patient channels to ease employee expenses. This shift reflects a broader move towards patient autonomy and streamlined access to certain retail drugs.