drug manufacturer Eli Lilly announced a new website Thursday that will allow patients to obtain a prescription for weight-loss medications through a telehealth provider, a move the company says will improve access to extremely popular and effective medications, including its drug recently approved, Zepbound.
The new website, called LillyDirect, joins a growing list of platforms like Weight Watchers and Ro that offer weight-loss medications via telehealth, but it’s the first of its kind from a pharmaceutical company.
It comes less than two months after the Food and Drug Administration approved Lilly’s weight-loss drug Zepbound. The drug is the latest entrant into the field of the powerful (and expensive) class of drugs called GLP-1 agonists, which 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 websites,” said Lilly CEO David Ricks. “It really hasn’t been an option that’s been provided before” for prescription medications.
Ricks said the new platform will make it easier for patients to access medications, eliminating the need to go to the doctor to get a prescription and then to the pharmacy to fill it. Patients prescribed Zepbound will be eligible for Lilly’s home prescription delivery service.
However, there will be no price discounts on any of the drugs through the website, which, at a list price of more than $1,000 for a monthly supply and often not covered by insurance, puts them out of reach for most Americans. Patients will still need to meet the criteria for weight-loss medications, which are intended for long-term use, not rapid weight loss.
Some experts, however, expressed concern about the platform and raised questions about Lilly’s financial motives.
“What fuels my skepticism is that the stakes are so high,” said Arthur Caplan, chief of the division of medical ethics at New York University Langone Medical Center in New York City.
Other companies also offer weight loss prescriptions via telemedicine, but It’s not a pharmaceutical company with its own weight-loss drug, Caplan said.
“There is a lot of money that will go into these injectables,” he said. “That 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 physicians 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 who are prescribed a weight-loss drug will meet by video with a doctor on an ongoing basis, usually once a month.
Doctors will work independently and can prescribe any FDA-approved weight loss medication; will not be required to prescribe Lilly’s Zepbound.
But only those prescribed Zepbound will be eligible for Lilly’s home prescription delivery service, Ricks said.
Telehealth for weight loss medications
With dozens of telehealth services already offering prescriptions, LillyDirect faces plenty of competition. It’s unclear what percentage of patients get their weight loss medications or any medications via telehealth, but the platforms can be vital for people who live too far from a doctor.
“These are populations that are underserved minorities living in rural areas away from urban areas,” said Dr. Saurabh Chandra, director of telehealth at the University of Mississippi Medical Center Telehealth Center, who has no ties to either. both. Lilly or Form Health. “Approximately 18% to 20% of the population lives in rural areas.”
On top of that, there is a shortage of primary care doctors, he said. “If you combine the two, there is now a lack of access to health care for these populations.”
Still, not all experts are convinced that a telehealth provider backed by a major pharmaceutical company is the best approach.
“It feels like 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 ties to Lilly or Form Health.
Lilly said the online platform is only intended for people who currently meet the criteria for a weight-loss drug in the U.S.: people with a BMI of at least 30 or a BMI of at least 27 with at least a weight-related medical condition.
Form Health doctors will have complete discretion over who they prescribe medications to or whether a weight loss medication is right for a patient. The medications can have side effects including nausea, vomiting, and diarrhea.
Richardson, CEO of Form Health, said the telehealth company has multiple layers of protection to ensure that doctors only see patients who meet the criteria for weight-loss medications. That includes verifying the patient’s medical information and making sure her driver’s license fits her height and appearance. The company will also send a scale to the patient’s home.
Making sure the right patients receive medications is “an important aspect of what we do,” Richardson said. “It’s important not only for the patient’s health, but also for the system.” Preventing people from obtaining weight-loss drugs fraudulently means there is more supply for people who need them, she said.
Another question is how a telehealth platform specific to weight loss medications will be used in addition to primary care.
Chandra said she is concerned about the possibility of a “fragmentation of care,” where people use the platform to get their weight-loss medications but continue to see their other provider in person for other medications.
That poses a risk, he said, of possible drug interactions if providers are unaware of the different medications a patient is taking.
“Many of the patients don’t know what medications they are taking,” Chandra said. “A lot of times they don’t know what the side effects are or what the adverse effects may 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 supply of Zepbound will be able to keep up with what is expected to be extremely high demand. Semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy, has been in short supply since March 2022 amid the drugs’ growing popularity.
Ricks said supply of Zepbound is not a concern for Lilly, regardless of whether people get it at a local pharmacy or at LillyDirect.
“That doesn’t change the amount of supply available, but it can make it easier for people to connect with the medicine they want and need,” the Lilly CEO said.
Lilly also offers a similar telehealth prescription and delivery service for some of its migraine and diabetes medications.
