LillyDirect Offers Direct-to-Patient Weight Loss Drugs
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People with overweight and obesity have a new strategy for accessing weight loss medications: They can go directly to the manufacturer. Eli Lilly, the maker of the injectable drugs Mounjaro for type 2 diabetes and Zepbound for weight loss, launched its new website LillyDirect last week to connect patients with telehealth appointments and medication delivered straight to their home.
But the idea of a patient being diagnosed as overweight or obese and potentially being prescribed a weight loss medication online — all without an in-person doctor’s visit — has some healthcare providers concerned. It also remains to be seen if this will address the most pressing barriers to accessing these medications, like lack of insurance coverage, high out-of-pocket costs, and nationwide medication shortages.
“It will be interesting to see how LillyDirect addresses these barriers, whether it can do it comprehensively and safely, and if so, whether it decreases access to patients seeking care via traditional health services,” says William Yancy Jr., MD, a weight management specialist and the director of the Duke Lifestyle and Weight Management Center in Durham, North Carolina.
Although Eli Lilly is the first pharmaceutical company to offer online prescriptions, Ro and WeightWatchers both offer online clinics and prescription services for people seeking GLP-1 weight loss medications.
How LillyDirect Works
Patients seeking weight loss medications can access independent telehealth providers on LillyDirect.com that “could complement a patient’s current primary care team or be an alternative to in-person care for certain conditions,” says Lilly.
For people with overweight or obesity, Lilly has partnered with the company Form to provide telehealth appointments. To sign up, people pay a $199 “one-time onboarding fee.” As part of the enrollment process, Form requests patient medical records and a signed medical release so that information can be shared between the Form doctor and the patients’ primary care physician (PCP). The company requires that people be under the “active care” of a PCP.
Telehealth provider visits are billed to insurance and the patient is responsible for copays, deductibles, labs, and medications not covered by insurance, per the website.
Form doctors can prescribe Zepbound or any other weight loss medication approved by the U.S. Food and Drug Administration. Treatment decisions and prescribing practices are based on the independent medical judgment of the telehealth provider’s care team — they may prescribe a Lilly medication or another course of treatment, according to the company.
Prescriptions for Lilly medications are filled by LillyDirect Pharmacy Solutions and shipped directly to the patient at no extra charge. According to the company, discounts and savings card opportunities are automatically applied for patients who qualify.
Platform Offers Search Tool for In-Person Care
LillyDirect also has an independent search tool, provided by Healthgrades, that allows a patient to find healthcare professionals near them if they prefer in-person care.
This search tool is separate from any telehealth provider options available on LillyDirect, and treatment decisions and prescribing practices are made at the discretion of the provider’s care team, per the website. Providers located via this service may recommend a range of care options, including medications.
Some Doctors Worry About the Limitations of Prescribing Weight Loss Drugs During a Virtual Visit
For telemedicine services to take place responsibly, there should be an established and valid patient-physician relationship, or the care should happen in consultation with a physician who has an established relationship with the patient, said Omar T. Atiq, MD, president of American College of Physicians (ACP), in a statement.
“These direct-to-consumer services have the potential to leave patients confused and misinformed about medications. While efforts to remove barriers to care are important, they should not devalue the proven benefits of the patient-physician relationship,” said Dr. Atiq.
Along with lifestyle changes, medications can be an important part of treating overweight and obesity, says Fatima Syed, MD, a weight management specialist at Duke Lifestyle and Weight Management Center. “Being able to access medication is important, but it’s critical that it happens within the context of overall health along with conversations about lifestyle interventions,” says Dr. Syed.
Not only are in-person visits needed to get vital signs and a comprehensive physical exam, these appointments also allow a more personalized conversation, Syed says. “I think these things are very important in the management of any condition, including obesity,” says Syed.
“In-person visits may not be that critical to determine if weight loss medication is appropriate, but they are much more likely to allow detection of an underlying cause or a complication of weight gain,” says Dr. Yancy.
Medical Follow-Up Is Important for People on Weight Loss Drugs
Follow-up is another key aspect of care for people on a weight loss medication that could be hard to replicate virtually, says Syed.
For example, people with a history of hypertension who lose a significant amount of weight typically need to have their blood pressure-lowering medications tapered or discontinued, she says. “It’s important to do that so that the patient doesn’t get physical symptoms from having low blood pressure. Similarly, if a patient has diabetes and they start weight management medication, they may need to change some of their diabetic medication to prevent low blood sugars,” says Syed.
The doctor prescribing the weight loss medications would need to be aware of the patient’s overall health and medical history to adequately manage these issues, she says.
In-Person Visits and Virtual Visits Can Offer the ‘Best of Both Worlds’
Still, doctors say telehealth visits have a place in obesity treatment. “Our practice strives to see patients in-person for the initial visit and at least yearly thereafter to provide the best of both worlds. Virtual visits certainly increase patient convenience, especially for those who live a distance from providers, have mobility issues, or have caregiving responsibilities,” says Yancy.
The safety and effectiveness of weight loss treatments might be increased if virtual visits allow patients to check in with their doctors more often for education, monitoring, and support, Yancy says, “or they could be decreased if the convenience of virtual visits results in lower motivation and less accurate monitoring.”
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