Beyond GLP-1s: Competing In The Era Of Consumerized Therapeutics

By Mariko O’Neill, Erik Nordkamp, and Chris Plance

GLP-1s didn’t just change how patients lose weight. They changed how pharma must sell.

GLP-1 receptor agonists were supposed to be a diabetes treatment. Instead, they became the first pharmaceutical product to be commercialized simultaneously as a clinical intervention and lifestyle choice. That convergence has done more than reshape the obesity market. It has revealed that the commercial model most pharmaceutical companies have relied on for decades — physician-centric, payer-mediated, and built around clinical data superiority — is no longer the only game in town.

The implications reach far beyond weight loss. What GLP-1s have set in motion is a structural shift in how patient-consumers access, pay for, and remain on therapy. The companies that understand this are already building for it. Too many others are copying a website and calling it a strategy.

The Shift No One Was Ready For

For most of pharma’s modern history, the path to market has followed a familiar logic: develop the molecule, prove efficacy in clinical trials, secure reimbursement, and market to physicians who would then prescribe it. The patient was the beneficiary of this system, but rarely the decision-maker.

GLP-1s broke that model. Because obesity sits at the intersection of sickness, wellness, and personal identity, demand didn’t wait for the traditional infrastructure to catch up. Patient-consumers, increasingly informed about the long-term health consequences of obesity and willing to pay for solutions on their own terms, bypassed the traditional system entirely. They sourced prescriptions through telehealth, where adoption surged during the COVID-19 pandemic. They bypassed primary care physicians entirely. And when branded supply fell short, compounders stepped in to meet demand at price points the market was willing to bear. Roughly $200 a month, as it turned out.

But it was not just how patients paid that changed. It was what they expected: seamless digital experiences, transparent pricing, and control over their own treatment decisions. The traditional gatekeepers, including the referral, the prior authorization, and the pharmacy benefit manager, were not just inconvenient. They were obstacles. Capital markets noticed. Eli Lilly briefly became the first healthcare company to reach a $1 trillion market cap, driven in significant part by the scale of consumer demand for GLP-1 therapies. It was a repricing of what happens when pharma gets consumerization right and of the growth opportunities it unlocks beyond a single therapeutic category.

Gaining The Advantage

For example, Eli Lilly’s LillyDirect platform is the case study everyone cites, but most analyses focus on the wrong part of it. The digital storefront is impressive, but it isn’t the strategic advantage. The real story is what sits underneath: a consumer pathway built almost entirely through third-party partnerships. Prescription fulfillment runs through partners like TruePill and Amazon, without the operational risk of owning the pharmacy, the logistics, or the last-mile delivery.

More critically, Lilly is experimenting with the use of digital solutions to improve retention. Through its collaboration with WellDoc, a digital therapeutics company with dozens of FDA clearances and extensive patents in predictive behavioral modeling, the Lilly Health app can deliver coaching, lifestyle nudges, and clinical support data directly to prescribers.

This matters because the patient journey in this market is not linear. Retention infrastructure must account for that reality, not assume a straight line from first fill to lifetime adherence. In a market where a single fill is table stakes, but three or four fills a year is the revenue model; retention is where the value compounds. When Lilly’s oral GLP-1 launches at scale, this infrastructure won’t just be a nice-to-have. It will be the operating system.

The Mindset Shift

Pharmaceutical companies have spent decades training their commercial organizations to see every launch through the physician’s eyes: What does the prescriber need to know? What does the clinical data say relative to the competition? How do we secure formulary access?  

In a consumer-driven market, those questions still matter, but they are no longer sufficient. The patient-consumer may not prioritize whether your molecule delivers 20% weight loss versus 18%. They care about whether they have to inject themselves weekly or take a pill. They care about whether they lose muscle mass along with fat, and what the quality of that weight loss looks like on the other side. They care about side effects, cost, and convenience. And increasingly, they walk into the doctor’s office, having already decided what they want. The physician is no longer the primary decision-maker, and, for a growing share of patient-consumers, not even the starting point. The segmentation that matters now is based on consumer motivation — whether that is cosmetic transformation, healthy aging, prevention, or quality of life — and each segment requires fundamentally different channels, messaging, and engagement.

Companies that cannot make this mindset shift will find themselves perpetually one step behind. They will launch consumer-facing platforms that feel like digital versions of a physician sales aid. They will build eight-week regulatory review cycles around marketing content that needs to respond to a cultural moment in eight hours. They will try to own every layer of the value chain internally, rather than partnering with organizations that already know how to acquire, convert, and retain consumers at scale.

A Playbook, Not A One-Off

The temptation for the industry is to treat GLP-1 consumerization as an anomaly, a unique product in a unique category that created a unique moment. Some companies would prefer it to be a one-off. But their organizational habits, not their ambition, are what will keep them from seeing beyond it.

The structural conditions that created this market, including patient willingness to pay out of pocket for outcomes tied to identity and quality of life, digital channels that make direct access frictionless, and a regulatory environment slowly adapting to remote prescribing, are not confined to obesity. They could emerge in any therapeutic area where clinical need intersects with personal aspiration, healthy aging, or quality of life. NAD+, built almost entirely outside traditional pharma and representing a multi-billion-dollar segment of the anti-aging market, is one early indicator. The rapid growth of cash-pay aesthetics through Med Spas is another. But the more fundamental point is that every pharmaceutical company with a diversified portfolio should be asking the question: which of our products could be next?

Companies that recognize this have a window to act. The ones best positioned may not be those that launched GLP-1s first. Consumerized therapeutics require a hybrid commercial model: the innovation engine of a new product launch combined with the retail, volume-driven mechanics of a consumer brand. That combination is rare in pharma today.

Companies able to capture or rebuild these consumer health capabilities will have an edge. The next phase of pharma commercialization requires extending beyond traditional launch excellence to fully embrace retail consumer commercialization.

The Prototype, Not The Exception

The GLP-1 market did not create consumerization in pharma. It made it visible. It proved that patient-consumers will pay, that digital channels will scale, that partners can deliver what manufacturers cannot build alone, and that the companies willing to rethink their commercial model from the top, starting with how they see the patient-consumer, will capture value that the traditional model leaves on the table.

The question for every pharmaceutical company is no longer whether this applies to their portfolio. It is whether they will be ready when it does.

About The Authors:

Mariko O’Neill is an experienced business transformation consultant, with over 20 years of experience in change management, business design and IT strategy in the life sciences industry. Mariko has been with PA Consulting since 2001 and specializes in advising pharma companies and innovative biotech firms on large-scale transformation programs. She is an active supporter of PA’s learning academy and its inclusion and diversity network. O’Neill has a master’s degree in history from the University of Oxford.

Erik Nordkamp is a health and life sciences expert at PA Consulting. Erik has over 25 years of experience in senior roles at major pharmaceutical companies, where he has led teams in strategy, business change, and operations, including CEO of General Medicines at Arcera, Chief Commercial Officer at Mundipharma, Managing Director at Pfizer UK and Senior Director Transformation & Lean Six Sigma at Eli Lilly. In addition to this, he led the ABPI as its President during the Brexit negotiations and was a Non-executive Director for Kings College London Trust. At PA, Erik works with pharmaceutical companies to shape growth plans, strengthen operations, and turn bold ideas into practical solutions that benefit patients.

Chris Plance is a U.S. healthcare pathway architect, with a focus on how new therapeutics and digital health innovations make it into complex care markets. He works at the intersection of payment models, value-based care, delivery systems, and commercial channels, helping organizations understand the incentive and operational realities that determine whether innovation scales safely. His work has contributed to some of the first billing codes available for AI-based healthcare solutions, and he has supported clients in building the clinical, economic, and workflow evidence required for national adoption. He applies the same lens to fast-moving categories like GLP-1s, where decentralized channels and consumer-driven demand are reshaping the pharmaceutical value chain. He holds a BS in Computer Engineering from the University of Pittsburgh and an Executive MBA from Rutgers University.