Senators fault Lilly and Pfizer telehealth platforms over prescribing patterns

Four senators released findings on July 17, 2025 from a nine-month investigation into the direct-to-consumer telehealth platforms run by Eli Lilly and Pfizer, saying the sites may steer patients toward the companies' own medicines ^[1][2].

The report is titled "Big Pharma's New Sales Scheme: Expanding Patient Access or a Virtual Pill Mill?" Sens. Dick Durbin (D-Ill.), Peter Welch (D-Vt.), Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) began the inquiry in October 2024 with letters to Lilly and Pfizer about LillyDirect and PfizerForAll, then expanded it in March 2025 to five contracted telehealth partners ^[2]. Both companies have maintained that their platforms do not incentivize doctors to prescribe their own medications ^[2].

What the investigation found

Patients routed to a telehealth visit through the platforms were prescribed a medication 85% of the time through PfizerForAll and 74% of the time through LillyDirect, according to the findings ^[2]. In one case, more than 500 of the 620 LillyDirect patients who saw a provider through the telehealth partner 9amHealth were prescribed a medication — about 83% — compared with 39% of 9amHealth's overall patient population ^[2].

LillyDirect users who saw a doctor contracted by 9amHealth were six times as likely to be prescribed a Lilly product as another brand-name medicine, the report said. Two-thirds of prescriptions written by doctors tied to another partner, Form Health, were for Lilly drugs ^[2].

The senators used the federal Open Payments database to identify providers working for Lilly's telehealth partners who have received payments from the company. They noted that research links industry payments to doctors with more prescribing of that company's products, but did not report those providers' prescribing rates ^[2].

The report also described searching for obesity care near the U.S. Capitol through LillyDirect's tool for finding in-person care, which is facilitated by HealthGrades. Four of the six closest doctors had received payments from Eli Lilly, the senators said. Searching HealthGrades directly, they said none of the 10 providers listed by LillyDirect appeared among the top 500 results ^[2].

Questions about how visits work

Appointments do not always require video, the report said, "meaning providers may be prescribing Pfizer and Eli Lilly drugs without laying eyes on a patient," and most virtual visits rely on a patient questionnaire rather than full medical records ^[2]. At least two telehealth services — LillyDirect-contracted Cove and former Pfizer partner Populus — let patients preselect the drug they want before meeting with a provider ^[2].

The report pointed to earlier findings by the Department of Health and Human Services' Office of the Inspector General, which has identified limited patient interaction, limited access to medical records and "a directive to prescribe a preselected item, regardless of clinical appropriateness" as fraudulent features of kickback schemes ^[2]. It also said neither company offers "overt" incentives to prescribers. The report does not conclude that a violation occurred, and no enforcement action has been announced ^[2].

Warren said the companies "continue to use shady tactics to squeeze patients and line its own pockets," while Durbin said the findings "shine a light on potential conflicts of interest and inappropriate prescribing that can balloon health care spending and lead to inferior care for patients" ^[2].

Why it matters for patients

The findings do not change what any drug costs or who can get a prescription. They do raise a question patients may not think to ask: when a prescription comes from a telehealth visit arranged by a drugmaker's website, who is paying the prescriber, and what that prescriber writes most often ^[2]. The report says some telehealth companies share clinician names with their pharma partners or list them online, and some tell clinicians when a patient arrived through LillyDirect or PfizerForAll ^[2].

The investigation does not specify which drugs were prescribed, so it is not established whether any particular medicine, including GLP-1 treatments, was involved at higher rates. It also does not name individual clinicians as wrongdoers. The senators' concern is structural: that a platform built by a drugmaker can shape what a patient asks for and what a prescriber orders, which they argue can increase spending for federal health programs ^[2].

What happens next

The senators did not say what their next steps will be, though their statements suggested they will push to limit drugmakers' influence over prescribing ^[2]. No legislation, regulation or enforcement case tied to the report has been announced.