The FDA approves Eli Lilly’s Zepbound, a weight loss drug similar to Ozempic and Wegovy.
Courtesy: Eli Lilly
Drugmaker Eli Lilly announced on Thursday a new website that will allow patients to get a weight loss drug prescription through a telehealth provider — a move, the company says, that will improve access to the extremely popular and effective drugs, including its recently approved drug, Zepbound.
The new website, called LillyDirect, joins a growing list of platforms like Weight Watchers and Ro offering weight loss drugs through telehealth, but is 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 pricy — class of medications 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 drugs.
Ricks said the new platform will make it easier for patients to access the drugs, cutting out the need to go to the doctor to get a prescription and then to a pharmacy to fill it. Patients who are prescribed Zepbound will be eligible for Lilly’s at-home prescription delivery service.
There won’t be price discounts for any of the medications through the website, however, which, at a list price of more than $1,000 for a month’s supply and often not covered by insurance, puts them out of reach for most Americans. Patients will still need to meet the criteria for the weight loss drugs, which are meant for long-term use, not quick weight loss.
Some experts, however, expressed concerns 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, the head of the division of medical ethics at NYU Langone Medical Center in New York City.
Other companies also offer weight loss prescriptions through telemedicine, but not a drug company with its own weight loss drug, Caplan said.
“There’s so much money that’s going to move with these injectables,” he said. “That creates at least the appearance of conflict of interest.”
Lilly itself isn’t providing the telehealth services. Instead, LillyDirect will connect patients with the telehealth provider Form Health, whose obesity medicine doctors will work with patients to determine whether a prescription is appropriate.
Neither Form Health nor its physicians will receive financial compensation for prescribing Lilly’s drug, Ricks said.
Evan Richardson, the CEO of Form Health, said that patients who are prescribed a weight loss drug will meet over video with a doctor on an ongoing basis, typically once a month.
The doctors will work independently and will 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 at-home prescription delivery service, Ricks said.
Telehealth for weight loss drugs
With dozens of telehealth services already offering prescriptions, LillyDirect faces a lot of competition. It’s not clear what percentage of patients get their weight loss drugs or any medication through telehealth, but the platforms can be vital for people who live too far away from a doctor.
“These are populations that are underserved minorities who are living in rural areas based away from urban areas,” said Dr. Saurabh Chandra, the chief telehealth officer at the Center for Telehealth at the University of Mississippi Medical Center, who has no ties to either Lilly or Form Health. “Approximately 18% to 20% of the population are living in rural areas.”
On top of that, there is a shortage of primary care physicians, he said. “You combine the two, now you have 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, a specialist in obesity medicine and the 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 one weight-related medical condition.
Form Health’s physicians will have full discretion over who they prescribe the medications to, or if a weight loss drug is the right fit for a patient. The drugs can come with side effects including nausea, vomiting and diarrhea.
Richardson, the Form Health CEO, said the telehealth company has multiple layers of protection to ensure that physicians are only serving patients who meet the criteria for weight loss drugs. That includes verifying the patient’s medical information and ensuring their driver’s license aligns with their height and appearance. The company will also send a scale to the patient’s home.
Making sure the right patients are getting the medications is “an important aspect of what we do,” Richardson said. “It’s important not just for patient health, but it’s also important for the system.” Preventing people from fraudulently getting weight loss drugs means there’s more supply for the people who need it, he said.
Another question is how a telehealth platform specifically for weight loss drugs will be used in addition to primary care.
Chandra said he worries about a potential for “fragmentation of care,” where people are using the platform to get their weight loss drugs, but still seeing their other in-person provider for other medications.
That poses a risk, he said, of potential drug-to-drug interactions, if providers are unaware of different medications a patient is taking.
“Many of the patients do not know themselves what medications they are on,” Chandra said. “Many times they don’t know what the side effects or what the adverse effects may be.”
Richardson said the Form Health doctors will review each patient’s medical records, including any existing medications that the patient is taking.
It remains to be seen whether Lilly’s supply of Zepbound will be able to keep up with what’s 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’ surging popularity.
Ricks said supply for Zepbound isn’t a concern for Lilly, regardless of whether people get it from a local pharmacy or LillyDirect.
“That doesn’t change the amount of supply available, but it may make it easier for people to connect to a 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 drugs.
