More pharma giants embrace direct-to-consumer sales
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Drugmakers are increasingly using telehealth platforms to sell their medicines directly to patients — and President Trump is pushing for more companies to get into the game.
Why it matters: Direct-to-consumer sales require only a few mouse clicks, often without the need to manage appointments or insurance forms. Online sales can also bypass pharmacy middlemen, in theory lowering prices and providing more transparency into what patients have to pay.
- But there are tradeoffs, like the prospect of overprescribing or manufacturers steering patients toward expensive name-brand drugs.
Driving the news: Trump on Thursday sent letters to the CEOs of 17 pharmaceutical companies, demanding they bring down U.S. prices within 60 days. The requirements include providing direct-to-consumer or direct-to-business drug purchasing models for certain products.
Several pharma giants have already committed to these models or are exploring them, in part driven by the surging popularity of GLP-1 drugs that are expensive and often not covered by insurance.
- Eli Lilly last year became the first pharmaceutical company to launch a direct-to-consumer health care platform for its diabetes, obesity, migraine and select other medications.
- Pfizer and Novo Nordisk have since launched their own direct sales models, and the CEO of Roche said last month that the company is considering something similar for U.S. patients.
- In the first quarter of this year, about 25% of new prescriptions for Lilly's weight-loss drug Zepbound were fulfilled through LillyDirect, per a spokesperson.
- Consumer health companies like Hims & Hers have also helped popularize the concept among patients.
How it works: Lilly's and Pfizer's DTC models start with virtual visits with independent practitioners working with telehealth platforms, who can — but are not obligated to — prescribe medicines in each company's program.
- Patients can then order medications directly from the company, and can often arrange to have them delivered to their homes.
- Some drugs on Lilly's DTC platform, including vials of Zepbound, are only available for patients who pay cash, which streamlines the process. Patients can use their commercial insurance for other drugs.
- Novo Nordisk's platform doesn't include the telehealth appointment but allows cash-paying patients who take GLP-1 drug Wegovy to have their prescription sent directly to the company. Patients can qualify for a lower price for the drug and home delivery.
The other side: Direct-to-consumer models run the risk of pushing drugs on patients who may not need them, Adam Brown, a physician and health care strategist, wrote in a September op-ed in MedPage Today.
- Pharmacy benefit managers, who serve as intermediaries between health plans and the manufacturers, also want to temper enthusiasm for the new systems and claim they can save more.
- "PBMs want lower prices on every drug for every patient, and direct to consumer channels may provide one more way for some patients to gain access to some medications," Greg Lopes, vice president of public affairs and communications for the Pharmaceutical Care Management Association, said in an email.
- "In most cases however, patients will spend less out of pocket and face fewer safety concerns when their medications are delivered through their prescription drug benefits at their pharmacies and with their doctors involved."
The intrigue: While Trump is pushing direct-to-consumer drug sales, Health Secretary Robert F. Kennedy Jr. has long been interested in limiting pharmaceutical companies' ability to advertise to consumers.
- Health and Human Services is "exploring ways to restore more rigorous oversight and improve the quality of information presented to American consumers who deserve nothing less than radical transparency," spokesperson Emily Hilliard told Axios.
- HHS did not directly answer questions about whether the two policy goals are in conflict. Trump's letters to drugmakers last week said his team, including Kennedy, "stand ready to implement these terms."
