Pfizer to Sell Drugs Online to Consumers, Bypassing Doctors and Pharmacies

This article originally appeared on The Defender and was republished with permission.

Guest post by Brenda Baletti, Ph.D.

Pfizer is developing a direct-to-consumer platform to sell some of its drugs online, including Paxlovid and a migraine nasal spray, the Financial Times reported.

The move is the latest by Big Pharma to bypass primary care physicians and traditional pharmacies to sell drugs. It follows Eli Lilly’s launch in January of LillyDirect, which provides home delivery of diabetes, obesity and migraine medications.

Pfizer’s website will connect patients in the U.S. with independent telehealth consultants who can prescribe medications, and an online pharmacy partner will fill and ship prescriptions. The drugmaker plans to have the website up before the end of the year.

Pfizer will sell Paxlovid, Lucira, a COVID-19 and flu test, and the drugmaker’s recently approved nasal spray Zavzpret and other migraine medications on the site.

Pfizer planning on selling Paxlovid online via a telehealth doctor.
44 severe drug interactions, toxic to the liver and kidneys, contains an HIV drug with a black box warning, poorly tolerated due to metallic taste, 20% incidence of rebound infection, $1400.
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— Mary Talley Bowden MD (@MdBreathe) May 8, 2024

Last year, Pfizer launched a collaboration with Ada Health, a digital health symptom-checker company, that offers a platform for people to self-diagnose their symptoms by inputting them into Ada’s artificial intelligence (AI) app. The app also connects users with physicians to prescribe medications and allows them to track their symptoms over time.

With funding from Pfizer, Ada created a self-assessment tool for people to identify if they are at high risk of developing severe COVID-19. If they are, it connects them with a healthcare provider within two hours and facilitates same-day prescription pick-up at a local pharmacy.

In that case, the provider and pharmacy were both referred to third-party sites. The new platform would pull all of these things together, Pfizer told the Financial Times.

Telehealth services have sprung up over the past few years for weight-loss drugs, psychiatric medications and other issues like hair loss, erectile dysfunction and skin care.

“Drugmakers have kept in their lane, though, developing and manufacturing medicines without getting into the business of connecting patients to physicians and delivering products to their homes,” according to Fierce Pharma, until this year.

When Lilly launched its platform earlier this year, the American College of Physicians raised concerns about the move.

“The American College of Physicians (ACP) is concerned by the development of websites that enable patients to order prescription medications directly from the drugmaker,” Dr. Omar T. Atiq, the organization’s president, said.

“While information on in-person care is available, this direct-to-consumer approach is primarily oriented around the use of telehealth services to prescribe a drugmaker’s products,” he added.

The organization advocated for an established and valid physician relationship for telemedicine to take place responsibly.

“These direct-to-consumer services have the potential to leave patients confused and misinformed about medications,” Atiq said. “While efforts to remove barriers to care are important, they should not devalue the proven benefits of the patient-physician relationship.”

LillyDirect provides access to new weight-loss drug

Eli Lilly launched its direct-to-consumer platform in January, providing access to its new weight-loss drug Zepbound, an injectable glucagon-like peptide 1 (GLP-1) agonist medication similar to Novo Nordisk’s blockbuster drugs Ozempic and Wegovy.

The active ingredient in Lilly’s weight-loss drug is tirzepatide, the same as in its diabetes drug Mounjaro, but Zepbound is approved for weight loss.

The U.S. Food and Drug Administration (FDA) approved Zepbound in November 2023, just two months before Eli Lilly launched the platform.

LillyDirect allows patients to access the medicines by filling out a form on the website. They are connected to independent health providers, which the company says “can complement a patient’s current doctor or be an alternative to in-patient care in some cases,” WebMD reported.

Lilly uses the websites Truepill and Amazon Pharmacy as its drug distributors.

Lilly’s CEO David Ricks said the platform is geared toward helping patients with chronic issues navigate the complex U.S. healthcare system. “With LillyDirect, our goal is to relieve some of those burdens by simplifying the patient experience to help improve outcomes.”

The industry trend looks set to grow.

Timothy Mackey, Ph.D., professor of global health at the University of California, San Diego, told the Financial Times that Big Pharma is realizing that “the best way to convert customers is through patient portals where they can act as a consumer in medicine.”

Mackey said he believed other companies would follow Eli Lilly and Pfizer’s lead.

Pfizer’s direct-to-consumer sales follow troubled history of direct-to-consumer advertising

In 1997, the FDA relaxed the rules governing advertising for prescription drugs. Evidence shows that direct-to-consumer advertising (DTCA) by Big Pharma — legally allowed only in the U.S. and New Zealand — increases pharmaceutical sales.

That spending has been increasing in the “digital health” arena or “eDTCA.”

The majority of physicians agree that consumer advertising by Pharma does not provide balanced information and encourages patients to seek treatments they don’t need. It also increases the sale of prescription drugs for symptomatic treatment of chronic conditions, according to Dr. Matthew F. Hollon writing in The Journal of the American Medical Association.

Big Pharma’s advertising isn’t driven by interest in patient well-being, but by the company’s interest in profit, Hollon wrote.

“Driven by this financial interest, the domination of health-related communication by companies with drugs to sell will, by its very nature, lead to problems unless balanced by educational efforts geared to public rather than private good.”

Hollon said drugs shouldn’t be advertised to patients until they have been on the market for three years, because the safety can’t be known with certainty until it has been on the market for a while.

Eli Lilly and Pfizer both planned their platform launch to sell drugs directly to consumers within months of their new drugs receiving FDA approval.

The Financial Times reported that Pfizer experimented with direct-to-consumer marketing in 2011 for its statin Lipitor, to compete with generics as the drug came off-patent.

At the time, the company created discounts and incentives for patients and insurers to keep the drug’s price competitive for six months after the patent ended.

In anticipation of the patent ending in 2008, Pfizer also launched a massive, $258 million ad campaign to promote the drug. The ads featured Dr. Robert Jarvik, who is known for inventing the Jarvik-7 artificial heart. However, the ad made a series of false or misleading claims.

Pfizer misrepresented Jarvik as a cardiologist, although he has no medical license. One ad used a body double to show him engaged in energetic outdoor activities. The ads were the subject of a congressional investigation and Pfizer voluntarily ended the campaign.

That direct-to-consumer advertising scandal came a couple of years after the company was forced to stop advertising Celebrex, an anti-inflammatory drug developed for people who cannot take non-steroidal anti-inflammatory drugs (NSAIDs).

The drug carries serious cardiovascular risks and the company’s advertising — on which it spent $87.6 million in 2003 alone — contributed to increased sales of the drugs among people who did not need it.

It is estimated that the inappropriate use of the drug by people who can use traditional NSAIDs resulted in as many as 140,000 serious adverse events.

Pfizer resumed the marketing campaign just a few years later but included a warning on the drug.

CEO Albert Bourla has a history of strongly advocating for direct-to-consumer advertising. He argued in a U.S. Senate hearing earlier this year that direct-to-consumer advertising is “of significant educational importance.”

Pfizer’s new platform part of a post-COVID growth strategy

Bourla laid out Pfizer’s direct-to-consumer strategy as one of several strategic priorities for the coming year, saying he hopes to build investor confidence after the company’s earnings fell to $145 billion — less than half of its peak during the pandemic era in 2021, the Financial Times said.

Pfizer told investors last week it “delivered solid financial results” in the first quarter, even though its $14.9 billion reported profits represented a 19% year-over-year decrease, largely due to a decline in revenues from COVID-19 vaccines and treatments.

The company also reported its non-COVID-19-related product revenues increased 11%. It didn’t mention the direct-to-consumer plans in its first-quarter earnings announcement.

The news comes as Pfizer has taken a large post-pandemic hit, with a 41% decline in profits in 2023. It projects $58.5 to $61.5 billion in revenue in 2024.

Paxlovid costs $1,400 for a five-day dose. Lucira costs about $50 and the new drug Zavzpret is about $1,168 for a six-day dose.

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