Pharmacist Eli Lilly announced on Thursday a new website that will allow patients to get a prescription for weight-loss drugs through a telehealth provider — a move the company says will improve access to the highly popular and effective drugs, including newly approved drug, Zepbound.
The new site, called LillyDirect, joins a growing list of platforms such as Weight Watchers and Ro which offers weight loss drugs via telehealth, but is the first of its kind from a pharmaceutical company.
It comes less than two months after the Approved by the Food and Drug Administration Lilly’s weight loss drug Zepbound. The drug is the latest entrant into the field of powerful – and expensive – class of drugs called GLP-1 agonistswhich includes Lilly’s Mounjaro as well as Novo Nordisk’s Ozempic and Wegovy.
“We’re used to buying consumer goods directly from manufacturers all the time on online sites,” said Lilly CEO David Ricks. “It really hasn’t been an option in the past” for prescription drugs.
Ricks said the new platform will make it easier for patients to access drugs, reducing the need to go to the doctor to get a prescription and then to a pharmacy to fill it. Patients prescribed Zepbound will be eligible for Lilly’s home prescription delivery service.
However, there will be no price discounts for any of the drugs through the website, which, at a list price of more than $1,000 for a month’s supply and often not covered by insurance, making them out of reach for most Americans. Patients will still have to meet the criteria for the weight-loss drugs, which are meant for long-term use, not quick weight loss.
Some experts, however, have raised concerns about the platform and raised questions about Lilly’s financial motivations.
“What fuels my skepticism is that the stakes are so high,” said Arthur Kaplan, chief of medical ethics at NYU Langone Medical Center in New York.
Other companies also offer telemedicine weight loss prescriptions, but not a pharmaceutical company with its own weight loss drug, Caplan said.
“There’s so much money going into these injectables,” he said. “This creates at least the appearance of a conflict of interest.”
Lilly itself does not provide telehealth services. Instead, LillyDirect will connect patients with telehealth provider Form Health, whose obesity doctors will work with patients to determine if a prescription is appropriate.
Neither Form Health nor its doctors will receive financial compensation for prescribing Lilly’s drug, Ricks said.
Evan Richardson, CEO of Form Health, said patients prescribed a weight-loss drug will meet via video with a doctor on an ongoing basis, usually once a month.
Doctors will work independently and be able to prescribe any FDA-approved weight-loss drug—they won’t be required to prescribe Lilly’s Zepbound.
But only those prescribed Zepbound will be eligible for Lilly’s home prescription delivery service, Ricks said.
With dozens of telehealth services already offering prescriptions, LillyDirect faces a lot of competition. It’s not clear what percentage of patients receive their weight-loss drugs or any medication via telehealth, but the platforms can be vital for people who live too far from a doctor.
“These are populations that are underserved minorities that live in rural areas that are far from urban areas,” said Dr. Saurabh Chandra, chief of telemedicine at the Center for Telehealth at the University of Mississippi Medical Center, who is not affiliated with either two. Lilly or Form Health. “About 18% to 20% of the population lives in rural areas.”
In addition, there is a shortage of primary care physicians, he said. “You put the two together, now you have a lack of access to health care for these populations.”
However, not all experts are convinced that a telehealth provider backed by a big pharmaceutical company is the best approach.
“I feel like I’m blurring the lines,” said Dr. Shauna Levy, an obesity medicine specialist and medical director of the Tulane Bariatric Center in New Orleans. Levy has no affiliation with Lilly or Form Health.
Lilly said the online platform is only for people who currently meet the criteria for a weight loss drug in the US: People with a BMI of at least 30 or a BMI of at least 27 with at least one weight-related medical condition.
Form Health physicians will have complete discretion to whom the drugs are prescribed, or whether a weight loss drug is right for a patient. Drugs may have side effects including nausea, vomiting and diarrhoea.
Richardson, the chief executive of Form Health, said the telehealth company has multiple layers of protection to ensure doctors only serve patients who qualify for weight-loss drugs. This includes verifying the patient’s medical information and ensuring their driver’s license aligns with their height and appearance. The company will also send scales to the patient’s home.
Making sure the right patients get the drugs is “an important aspect of what we do,” Richardson said. “It’s important not only for patient health, but it’s also important for the system.” Preventing people from fraudulently taking weight-loss drugs means there’s more supply for people who need it, he said.
Another question is how to use a telehealth platform specifically for weight loss drugs outside of primary care.
Chandra said he worries about a potential for “fragmentation of care,” where people use the platform to get their weight-loss drugs but still see the other provider for other drugs.
That carries a risk, he said, of potential drug-to-drug interactions if providers aren’t aware of different medications a patient is taking.
“Many of the patients themselves do not know what drugs they are taking,” Chandra said. “A lot of times they don’t know what the side effects are or what the adverse effects might be.”
Richardson said Form Health doctors will review each patient’s medical records, including any existing medications the patient is taking.
It remains to be seen whether Lilly’s Zepbound offering will be able to keep up with the expected extremely high demand. Semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy, was in shortage from March 2022 amid the growing popularity of drugs.
Ricks said the supply for Zepbound is not a concern for Lilly, regardless of whether people get it from a local pharmacy or from LillyDirect.
“This doesn’t change the amount of supply available, but it can make it easier for people to connect with a drug they want and need,” Lilly’s CEO said.
Lilly also offers a similar telehealth prescription and delivery service for some of its migraine and diabetes drugs.