Eli Lilly launches home delivery of obesity drug Zepbound, warns on cosmetic use

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Eli Lilly & Co. on Thursday announced the launch of new digital health services that could help smooth patient access to the obesity drug Zepbound and other medications — but also warned against the use of some of its most-popular drugs for cosmetic weight loss.

The drugmaker’s new LillyDirect platform — designed for U.S. patients with obesity, migraines and diabetes — will offer access to independent healthcare providers and home delivery of certain Lilly
LLY,
+0.69%

drugs, including Zepbound, insulins such as Humalog and Humulin, and the migraine drug Emgality, through third-party dispensing services.

The platform’s online pharmacy will automatically apply savings-card discounts for people who qualify and will ship medicines free of charge, Lilly said in a release. LillyDirect will also help people connect with independent telehealth providers who can complement a patient’s current primary care or be an alternative to in-person care for certain conditions, the company said.

The new program arrives after Zepbound received U.S. regulatory approval in November, and will compete with a growing range of telehealth services that cater to people with obesity, including Ro and a new program from WeightWatchers
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-12.30%
.

While drugmakers have long offered patient-assistance programs and other services that can ease access to their drugs, “rarely has it been as coordinated an effort to stuff it all together” in a single package like LillyDirect, said Antonio Ciaccia, CEO of drug-pricing research nonprofit 46brooklyn Research. The service is believed to be the first from a major branded drugmaker to offer direct dispensing by mail of popular brand-name drugs through arrangements with pharmacies, Lilly said in a statement to MarketWatch.

If successful, Lilly’s approach will likely inspire other drugmakers to launch copycat services, Ciaccia said.

Lilly is launching the program as employers and insurers are increasingly concerned about the cost of new anti-obesity medications like Zepbound, causing many health plans to control utilization through prior authorization or other requirements.

“Payers are hesitant to open up coverage unless companies like Lilly pay big rebates back to them for that coverage,” Ciaccia said, and pharmacies also often lose money when dispensing the drugs as reimbursements fall short of their costs. Lilly’s new program is building a more-direct pathway that may help work around some of those roadblocks, Ciaccia said.

Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and a professor of medicine at Harvard Medical School, called the new service “a great move on Lilly’s part” because there are not enough obesity-medicine centers or specialists in the U.S. Apovian has done consulting work for Form Health, one of the telehealth providers involved in Lilly’s program.

But the program also raises potential conflict-of-interest concerns, Ciaccia noted. For telemedicine providers who focus on prescribing certain types of medicines, he said, “their business model is predicated on the patient successfully getting what they arrived for.”

Lilly said that the program will connect patients with independent telehealth providers who are identified based on prioritization of patient safety, robust medical practices and other factors. The drugmaker does not receive any compensation from third-party providers for referrals, and Lilly does not incentivize the providers to promote Lilly products, the company said in a statement to MarketWatch. “Lilly is not suggesting consumers seeking care through a provider listed on LillyDirect will be prescribed a Lilly treatment,” according to the company.

Even as it looks to ease patient access to Zepbound and other medications, Lilly sounded an alarm on how some of its most popular drugs are widely used. “Mounjaro and Zepbound are indicated for the treatment of serious diseases; they are not approved for — and should not be used for — cosmetic weight loss,” the company said in an open letter Thursday.

Lilly also warned of safety risks around using tirzepatide, the active ingredient in Mounjaro and Zepbound, that is produced by compounding pharmacies, which mix ingredients to make customized drugs based on specific prescriptions. The company said it is “extremely concerned” that some compounded tirzepatide it has tested contained high levels of impurities and in at least one case “was actually nothing more than sugar alcohol.”

The company said it has filed lawsuits against some medical spas, wellness centers, and compounding pharmacies making or selling products purporting to contain tirzepatide, as well as importers and distributors of those products.

Future updates to the LillyDirect program may include services designed to help patients adhere to their medicines, Lilly said. Questions persist about whether patients can stick to the latest generation of anti-obesity medications in the long term, given side effects such as nausea and vomiting.

The new program differentiates Lilly’s metabolic-drug business from Novo Nordisk’s
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+4.12%

Wegovy, which hit the market well before Zepbound but has faced supply challenges, BMO Capital Markets analyst Evan David Seigerman wrote in a note Thursday.

Lilly shares gained 0.5% Thursday and are up more than 70% over the past 12 months, while the S&P 500
SPX
has gained 22%.

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