Lilly launches LillyDirect, the first direct-to-patient platform from a major drugmaker

Eli Lilly launched LillyDirect on Jan. 4, 2024, a website that combines a self-pay home-delivery pharmacy for select Lilly medicines, a list of independent telehealth providers, and a search tool for finding in-person clinicians ^[1]. It covers obesity, diabetes and migraine, and it is the first platform of its kind from a major drug manufacturer ^[2].

The obesity piece drew the most attention because it includes Zepbound (tirzepatide), which the FDA approved less than two months earlier ^[2]. Patients prescribed Zepbound become eligible for Lilly's at-home delivery service, and medicines shipped through the platform's third-party pharmacy partners ship free of charge, with Lilly savings card offers automatically applied for people who qualify ^[1][2]. Mounjaro, the tirzepatide product approved for type 2 diabetes, is not part of LillyDirect at launch, though CEO David Ricks told The Wall Street Journal it could be added later ^[3].

What the platform does and does not do

Lilly is not employing the telehealth clinicians. For weight-loss prescriptions, LillyDirect routes patients to Form Health, a telehealth company focused on obesity medicine; for diabetes, Lilly is working with 9amHealth ^[2][3]. Lilly's release states that treatment decisions "are made based on the independent medical judgment of the telehealth provider's care team," and that they may prescribe a medication or another course of treatment ^[1]. Ricks said Form Health and its physicians will not be compensated by Lilly for prescribing Zepbound, and that Form and 9amHealth clinicians will not know whether a patient arrived through LillyDirect ^[2][3]. A Lilly spokesperson told Becker's the company does not receive compensation from third-party providers for referrals and that providers "are not incentivized by Lilly to promote Lilly products" ^[3]. Form also prescribes competing drugs, including Novo Nordisk's Wegovy (semaglutide) ^[3].

Importantly, the site does not lower prices. NBC News reported there are no price discounts on medications through the website, and that the list price is more than $1,000 for a month's supply, often without insurance coverage ^[2]. Patients still must meet the clinical criteria for the drugs, which are meant for long-term use ^[2]. Form Health CEO Evan Richardson said patients prescribed a weight-loss drug typically meet by video with a doctor about once a month ^[2], and told The New York Times the company collects medical records, confirms patients meet criteria and coordinates with a patient's primary care team ^[3].

The objections

The American College of Physicians said on Jan. 5 that it "is concerned by the development of websites that enable patients to order prescription medications directly from the drugmaker," arguing the approach is "primarily oriented around the use of telehealth services to prescribe a drugmaker's products" and that responsible telemedicine requires an established, valid patient-physician relationship or consultation with a physician who has one ^[3].

Arthur Caplan, head of medical ethics at NYU Langone, said other companies already offer weight-loss prescriptions by telemedicine, but not a drug company selling its own weight-loss drug: "There's so much money that's going to move with these injectables. That creates at least the appearance of conflict of interest" ^[2]. Zeev Neuwirth, MD, asked Becker's what firewalls exist between Lilly and the small telehealth partners, saying the new channel should be "held to the same ethical, regulatory, clinical and safety standards as any other provider, with transparency" ^[3]. Andrew Krafston, MD, of Michigan Medicine told the Times, "I just find it a bit disingenuous to think that people are just going to get this totally neutral, balanced care" ^[3].

Other experts told Becker's the platform could ease access for people who struggle to see a specialist in person, and reduces the chance of receiving counterfeit or compounded versions the FDA has warned about ^[3]. On the same day it launched LillyDirect, Lilly published an open letter warning against "cosmetic use" of its weight-loss drugs ^[3].

Why it matters for patients

For people weighing GLP-1 treatment, LillyDirect changes the route, not the cost. Anyone using the obesity section would still pay self-pay prices unless their plan covers the drug, and NBC reported those prices remain above $1,000 a month at list ^[2]. The convenience is real: one path from an online visit to a shipped prescription ^[1][2]. The open question raised by ACP and the ethicists is whether a prescriber reached through a manufacturer's website is as likely to discuss non-Lilly options, non-drug approaches, or no treatment at all ^[3].

Also unresolved is continuity of care. Lilly frames the telehealth option as something that "could complement a patient's current primary care team or be an alternative to in-person care," while ACP argues prescribing should tie back to a clinician who knows the patient ^[1][3].

What happens next

Lilly said LillyDirect will be updated and expanded, with possible future additions including new products, partners and adherence programs ^[1]. Experts cited by Becker's expect other weight-loss drugmakers to launch similar platforms ^[3]. Whether regulators or medical boards respond to the ACP's concerns is not addressed in these sources.