Blog | 6/24/2025

DTP for the Win: Another Opportunity to Fix Age Old Issues

By Jeff Abraham

Direct-to-Patient (DTP) models may offer pharmaceutical companies a potential pathway to adapt to MFN pricing while enhancing the patient experience. In practice, these models may combine telehealth consultations, digital prescribing, and home delivery, allowing patients to access medications directly through manufacturer-run platforms. In bypassing traditional intermediaries, including potentially PBMs and specialty pharmacies, manufacturers could potentially enhance patient access and care delivery, while providing patient with a more affordable and economical pathway than through the traditional and existing pathways. For some highly competitive drug classes—such as insulin, anticoagulants, and anti-TNFs—where PBM rebates can range from 30% to 80%, MFN pricing may largely replace those rebates, resulting in a relatively modest impact on net price for the manufacturer. However, for products that do not currently offer substantial rebates, MFN pricing could significantly compress margins, making alternative models like DTP increasingly important as a strategic lever.

Examples of direct-to-patient engagement are already taking shape. LillyDirect, launched by Eli Lilly in early 2024, connects patients with virtual care providers and ships selected medications—such as Zepbound for weight loss—directly to patients through partnerships with Amazon Pharmacy and other fulfillment providers. Similarly, Pfizer’s PfizerForAll platform enables patients to consult clinicians online and receive treatments like Nurtec or Paxlovid delivered to their door. Most recently, Roche announced they are exploring the direct-to-patient option as a way to “take out these people in the middle”. The Swiss pharma giant is exploring the option for drugs like Ocrevus.

These efforts mirror a broader industry shift seen in platforms like Hims & Hers, which have long integrated telehealth and pharmacy services to deliver care directly to consumers. While such models streamline access and enhance transparency, they have also drawn attention from policymakers raising concerns about potential conflicts in prescribing. The new class of pharmacies Is also starting to raise concerns with the federal legislature. Senators Elizabeth Warren of Massachusetts and Senator Bernie Sanders of Vermont, are troubled by the combination of biopharma affiliated pharmacies, telehealth, and physicians. The concern is that the combination of the three will lead to unnecessary prescriptions for patients who might otherwise not require medication and therefore an increase in federal spending. To support their concerns, a recent investigation illuminated the following,