Pharmaceutical company Eli Lilly just launched its own telehealth website where patients can access physician appointments and the prescription drug tirzepatide (Mounjaro and Zepbound) for weight loss. The new LillyDirect platform also offers free home-delivery service, but it will not provide discounts on tirzepatide. As described in a news story in People, Mounjaro is approved to treat type 2 diabetes, and Zepbound is approved to treat obesity, each with a list price of more than $1,000 for a 1-month supply. Few insurers are currently covering tirzepatide. The manufacturer says patients will still be required to meet with a physician regularly through video chat while using the drug.
Ethics come into question: “There has always been a legal separation of pharmaceutical manufacturing, prescribing, and dispensing to avoid conflict of interest and assure the patient gets the most appropriate meds for their medical need. The ability to now get meds directly by telemedicine from the manufacturer, bypassing the entire medical delivery infrastructure, breaks every historic ethical norm ever known to physicians,” says Alan Ayers, President of Experity Consulting and Senior Editor of JUCM. “In addition to the slippery slope of ‘what’s next,’ there should be concerns that obesity and diabetes, for which Mounjaro is indicated, are highly correlated with other co-morbidities and chronic health risks that require a more comprehensive history and physical exam, established in primary care, than is typically within telemedicine’s capabilities.”