Pharma’s Direct-to-Patient Push: Navigating Trump’s Drug Price pressure & the Rise of Sotyktu,Wegovy,and Zepbound
The pharmaceutical landscape is undergoing a significant shift,driven by a combination of escalating drug costs,political pressure,and innovative distribution models. Companies like Bristol Myers Squibb (BMS), Eli Lilly, and Novo Nordisk are increasingly exploring direct-to-patient (DTP) sales, a strategy gaining momentum as they navigate the complexities of pharmacy benefit managers (PBMs) and President Trump’s aggressive drug pricing policies.
Sotyktu’s Success & BMS’s DTP Strategy
BMS is seeing strong results with its psoriasis treatment, Sotyktu. In the first half of this year, the drug generated $126 million in revenue – a nearly 30% increase year-over-year. This success is fueling BMS’s investment in “BMS Patient Connect,” a platform designed to sell medications directly to consumers.
The company plans to expand this model to other drugs where it’s appropriate, offering a streamlined experience for patients and potentially greater control over pricing and distribution. This move signals a broader industry trend toward bypassing customary intermediaries.
Circumventing PBMs & Lowering Costs: Lilly, Novo Nordisk Lead the Way
Last year, Eli Lilly and Novo Nordisk pioneered DTP platforms for their popular obesity medications, Wegovy and Zepbound. These platforms offer discounted prices to cash-paying patients.
Initially,this was seen as a strategic maneuver to:
* Reduce reliance on PBMs: PBMs have long been criticized for contributing to high drug prices.
* Protect market share: Preventing the growth of compounded versions of in-demand drugs like Wegovy and Zepbound.
However,the DTP approach is also aligning with President Trump’s stated goal of lowering prescription drug costs for all Americans.
Trump’s “Most Favored Nation” Policy & Pharma’s Response
In May, President Trump signed an executive order mandating “most favored nation” (MFN) pricing for drugs sold in the U.S. This policy aims to tie U.S. drug prices to the lower prices paid in other developed countries.
Further guidance came in July through letters sent to 17 pharmaceutical companies, outlining expectations for MFN pricing for Medicaid patients and new drug launches. Crucially,trump offered a potential workaround: allowing drugmakers to sell high-volume prescriptions directly to patients,provided those prices don’t exceed those offered elsewhere.
This creates a compelling incentive for companies to embrace DTP models. The deadline for companies to respond to Trump’s policy is rapidly approaching – September 29th.
A Familiar Plan Revisited: The HHS pilot Program
The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) recently submitted a drug pricing pilot program to the Office of Management and Budget. Sources indicate this plan closely resembles the MFN proposal from Trump’s first term.
That original plan, which proposed testing MFN pricing for 50 drugs under Medicare Part B, faced legal challenges and was ultimately rescinded by the Biden administration. Its potential revival suggests a renewed push for significant drug price reform.
What dose this mean for you?
as a patient, you may soon have more options for accessing medications at lower costs, potentially through direct-from-manufacturer programs. However, navigating these changes and understanding your insurance coverage will be crucial.
Looking Ahead:
The pharmaceutical industry is at a crossroads. The convergence of DTP strategies, political pressure, and evolving regulations promises a dynamic and potentially transformative period for drug pricing and access.
Photo by Bristol Myers Squibb
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