The new dystopian era of pharmaceutical websites selling their own drugs

Would you like to prescribe yourself a prescription medication? No problem! Some of the largest pharmaceutical companies in the United States are conducting pilot projects through websites that essentially sell their drugs directly to consumers.

This unprecedented move ushers in a new dystopian era: pharmaceutical companies act as healthcare providers, eliminating the need for annoying doctor middlemen. This is what the pharmaceutical industry has always wanted: It has long viewed doctors as uncomfortable barriers between the company and their customers. Instead of bribing and persuading doctors to please prescribe our drug, companies can now sell their drugs directly to the consumers who want them, regardless of whether those consumers need, know about, or will benefit from those drugs.

Lilly’s website, launched in January, sells weight loss, diabetes and migraine medications, but its focus is on weight loss medications. On August 27, Pfizer launched its PfizerForAll portal to sell Paxlovid for Covid-19 and Zavzpret (Zavegepant), an intranasal migraine drug. The website also promotes the use of vaccines.

Pharma’s one-stop shopping websites encourage patients to click a button for an immediate consultation with a prescriber who will recommend a medication, which can then be ordered through the website. It solves a patient’s problem of “seeing a doctor to find someone to write to them about what they think is a solution to their health problem,” Lilly CEO Dave Ricks told Yahoo Finance.

It’s no coincidence that Pfizer, Lilly, Amgen, and AbbVie all offer anti-CGRP migraine medications on their direct-to-consumer portals; These drugs don’t work well enough to be popular with real doctors. We wonder if the telehealth companies that work with these pharmaceutical companies are telling migraine sufferers that these drugs are little better than placebos; They are less effective than cheap, generic triptans and take longer to work, leaving patients in pain for longer. But at least they’re expensive, up to $125 per pill.

Avoiding the use of a family doctor is a good corporate move when a company is promoting a mediocre drug.

The drugs marketed on these websites generally require marketing. Pfizer’s Paxlovid, for example, was once hailed as a game-changer in the treatment of Covid-19, but sales of the drug fell sharply after it became clear that only a small group of high-risk people were benefiting. Recent studies show that paxlovid does not relieve symptoms more than placebo, and that one in five patients becomes infectious again (with or without symptoms) after completing treatment. And paxlovid can dangerously increase the levels of other medications a patient is taking. Whether or not someone with Covid should take this medication should require a thoughtful discussion with a primary care physician who knows the patient, not some moonlighter in a white coat who has never examined or even seen this patient before.

On the same day that Pfizer announced its portal, Lilly announced that the popular weight-loss drug Zepbound would be available in cheaper bottles that require the user to draw the drug into a syringe. The discounted drug appears to compete with websites that sell compounded tirzepatide (the generic name for Lilly’s drug Zepbound).

Although patients are billed as saving money when their insurers don’t cover weight-loss medications, the dosages available are not cheap and may be ineffective. LillyDirect will only sell the 2.5 mg dose of Zepbound (a starter dose) and the 5 mg monthly dose, which will cost $549, compared to about $1,000 for the Zepbound pens, which also available in doses of up to 15 mg.

Patients with migraines or Covid or who want to lose five pounds to look better in clothes should not self-prescribe medication and that is exactly what is happening on these portals. Of course, this is a cooperative prescriber from a supposedly independent provider of cooperative prescribers. But the thin camouflage of a white coat cannot hide the fact that working for a company tied to a drug manufacturer and prescribing the same drug to almost everyone is not a doctor’s job. If nine out of ten prescriptions are filled for the drug manufactured by the company whose website the customer clicked on, that company is simply dealing in drugs.

Adriane Fugh-Berman, MD, directs PharmedOut, a research and education project focused on inappropriate pharmaceutical marketing practices, at Georgetown University Medical Center, where she also co-directs the Health and Public Interest MS program. Judy Butler, MS, is a Senior Research Fellow at PharmedOut.