Guest Column | May 2, 2024

Building On Direct-To-Patient Marketing For Improved Access To Therapeutics

By Jenna Phillips, PA Consulting

Jenna Phillips_PA Consulting
Jenna Phillips

In January 2024, the US-based global pharmaceutical company Lilly announced the launch of LillyDirect, a direct-to-patient portal that enables some patients to access drugs including its novel weight loss drug Zepbound for as little as $25 per month, achieved in partnership with Amazon Pharmacy. In this model, the LillyDirect telehealth platform can supplement or serve as an alternative to in-patient care, operating similarly to other telehealth pharmacy-type offerings like Roman or Nurx. The key difference between Lilly’s model and other telehealth and tele-pharmacy offerings is that it distributes only Lilly’s products, though it does leverage a third-party telehealth service to achieve the care delivery.

Usage of telehealth services exploded due to restrictions on in-person care during the COVID-19 pandemic, increasing 63-fold for Medicare patients from 840,000 visits conducted using telehealth in 2019 to 52.7 million in 2020. While the growth of telehealth has slowed, its usage remains far above pre-pandemic levels, with an average of 22% of adults reporting use of telehealth in the last four weeks, in a survey conducted in 2023 by the U.S. Assistant Secretary for Planning and Evaluation.

The novel merger of a telehealth platform leveraged for prescription — where appropriate — of a specific therapy may raise red flags for some. It appears to excise local primary care providers who have greater familiarity with a patient’s longitudinal health record, as well as payers who can provide an important check on over-prescribing drugs with potentially harmful side effects. There is some concern that patients whose health does not warrant a prescription for a weight loss drug may lie to gain access to these drugs, a practice described in the New Yorker, among other publications, in 2023.

Setting aside patient health and industry transformation risks, the move toward direct-to-patient access to transformational therapeutics is exciting, particularly as the healthcare industry increasingly embraces models of shared decision-making and the concept of self-care proliferates among consumer healthcare brands. There is an important opportunity to expand this model to other chronic conditions like HIV prevention or maintenance, contraception, and various chronic dermatology conditions where therapeutic advancements are impacting many patients’ lives.

Now that Lilly has launched LillyDirect, the industry must await news of the results of the program in terms of company revenue, overall industry financials, patient health outcomes, health disparities and other important insights that will help industry stakeholders understand if and how the program is working. In the meantime, though, other therapeutics companies can consider how they can also take a leadership position by bringing their drugs directly to patients through their own telehealth platforms.

Three Questions To Consider Before Going Direct-To-Patient

Our experience standing up new platforms and delivery approaches with healthcare organizations of all stripes gives us insight into how the ambitious objective to bring therapeutics directly to patients can be achieved, with ample and rigorous planning to support effective implementation. We identified the top three questions that companies should consider before launching a novel direct-to-patient offer:

  • Is our product and/or therapeutic area the right fit for this service offering?

While the prospects of developing a novel access channel and working directly with patients is attractive to many companies, a direct-to-patient offer is not appropriate for all conditions. Due to the large scale of the investment in technology and other capabilities that will be required to succeed in this new channel, we foresee that the most successful organizations in this space will be in therapeutic areas with a large number of patients or potential patients. Weight loss and type 2 diabetes are strong contenders due to the prevalence of these conditions, and others like contraception, sexual health, dermatologic conditions, mental and behavioral health, to name a few, also have strong potential to achieve significant returns and patient impact. Rarer conditions or those that benefit from long-term close management with a single clinician or consistent team are perhaps better served through existing approaches.

  • Build or buy – what are our key capabilities and where do we need help?

For therapeutics companies, delivering telehealth and managing a direct-to-patients logistics business will require capabilities that are probably not native to the organization. Rather than trying to be all things to all people, these organizations should consider where and how they can leverage partnerships to achieve their objectives. For example, partnering with a reputable telehealth company can achieve both the required technology and access to licensed clinicians who can prescribe the medications and manage patient health. Similarly, rather than attempting to establish a nation-wide logistics network to distribute medications to patients, Lilly established a partnership with Amazon Pharmacy so patients can get their medications quickly through an existing channel of distribution. Companies should conduct a rigorous capabilities analysis to determine where their strengths lie and where they can use support from experts in other parts of the industry, be that technology, distribution, clinician support, manufacturing, or other key capabilities that may not be readily available internally.

  • Quality, governance and credibility – upon launch how will we be perceived?

Among industry observers who express concern about the LillyDirect model, the most common qualms relate to quality and continuity of care, as well as data governance and privacy. As companies pursue this direct-to-patient model, this concern should not be underestimated. For example, Lilly acknowledges that they may receive de-identified, aggregate data from the telehealth service providers via LillyDirect. While not uncommon, companies should ensure that they have a robust data governance approach to reassure patients and other stakeholders that the direct-to-patient platform delivers appropriate and high-quality care.

There is also a concern about industry credibility and the risk that a company appears to be self-dealing, delivering unneeded medication to patients who do not qualify for the prescription, but lie or obfuscate in other ways to get the prescription. Particularly in lifestyle diseases like obesity or diabetes, this risk needs to be mitigated to maintain the credibility of the therapeutic, the prescribing clinician, and the company overall. Lilly has an ongoing marketing campaign, Big Night, which includes the key message that weight management drugs are not intended for general weight loss. Collaborating closely with medical affairs teams and perhaps even engaging external medical stakeholders from specialty healthcare associations or reputable digital opinion leaders can demonstrate that the company takes concerns of credibility, governance, and best practices seriously.

Look Before You Launch

The integration of technology into healthcare delivery offers exciting and impactful opportunities for therapeutics companies to differentiate themselves and their products, as well as enhance the level of service and improve the experience of patients. While creating a novel healthcare delivery platform and approach is a major undertaking, companies that pursue rigorous upfront planning to determine product-market fit and a credible approach to delivery are likelier to achieve success financially and in patient health outcomes.

About The Author:

Jenna Phillips is a health and life sciences expert at PA Consulting.