'US-style medicine model' as big pharma dispensing of GLP-1s condemned

Doctors condemn Eli Lilly move to dispense GLP-1 medication Mounjaro direct to door In short: Eli Lilly's new online platform LillyDirect will dispense certain medicines, starting with Mounjaro, directly to a patient's door. Doctors and pharmacists have criticised the move, arguing it poses a risk to patient safety. Eli Lilly has defended the online platform, saying it does not circumvent pharmacists or GPs, and will improve affordability and convenience for patients. A move by a multi-billion-dollar global pharmaceutical company to bypass bricks and mortar pharmacies and deliver its GLP-1 medication Mounjaro directly to consumers' doors has been broadly condemned by doctors and pharmacists, who argue it poses a risk to patient safety. Eli Lilly has announced its new online platform LillyDirect will dispense certain medicines, starting with tirzepatide, an injectable GLP-1 agonist sold as Mounjaro, which is used to treat conditions like type 2 diabetes and obesity. Under the model, patients submit an e-script to LillyDirect from their doctor. The script is then directed to an online third-party pharmacist to dispense, before it is delivered to the patient's home. The pharmaceutical giant said the new platform allows patients to find competitive pricing without shopping around and does not replace the need for an independent doctor to prescribe the medication. But Royal Australian College of GPs (RACGP) President Michael Wright said GLP-1 agonists were powerful medications with serious side effects, and needed proper oversight and continuity of care. He said using online pharmacists to dispense the medication could remove a layer of protection for patients, noting many might already be using telehealth providers to access the e-script in the first place. "What concerns me about this model is that potentially they can be prescribed in some situations and delivered by someone who doesn't actually have full access to your whole record and I think that really creates risks for patients," Dr Wright said. The Pharmacy Guild of Australia and the Pharmaceutical Society of Australia said the model of care was "clinically inferior" and reduced opportunities for "face-to-face clinical interaction" where problems could be identified and addressed. "This proposal is a concern to every Australian who values an independent and patient-focused healthcare system," Pharmacy Guild President Trent Twomey said. "We should not allow the Americanisation of Australian healthcare." Eli Lilly advertising online doctors for prescriptions After protracted negotiations with the federal government, Eli Lilly announced in April it would not proceed with the Pharmaceutical Benefits Scheme (PBS) listing process, airing a cluster of grievances including that the price Australia was willing to pay for the drug was too low. As a result, Mounjaro can cost patients as much as $700 a month privately. Eli Lilly is bound by competition law and is unable to say how much cheaper the medication is when sold through its platform. However, social media users who have already begun using the service, which launched last week, have posted the medication costs as much as $50 less. LillyDirect launched in the US in 2024 where consumers are connected directly with telehealth providers to get their prescription. The Australian Eli Lilly website advertises two major telehealth providers including Juniper, which has previously been criticised by eating disorder experts for aggressive social media marketing of GLP-1 drugs. Dr Wright said GLP-1 drugs were not suitable for everyone such as those with a history of eating disorders, and came with serious side effects such as the potential risks of suicidal thoughts and behaviours. He also noted there had been serious consequences when telehealth providers were not able to access a patient's full history, such as the fatal overdose of a young woman in Melbourne, who convinced multiple telehealth providers she needed large qualities of her medication and stockpiled it. The case prompted the federal government to introduce sweeping changes to force prescribers to record all medicines-related information under a new national record. The Australian Health Practitioner Regulation Agency also recently vowed to crack down on reckless prescribing of drugs such as GLP-1s, arguing some telehealth practitioners had "departed from established professional standards." 'An interest in keeping people on the medicine' Barbara Mintzes from Sydney University's school of pharmacology said online distribution platforms run by pharmaceutical companies were problematic. "It's putting patients who are using a company's medicine directly in contact with the company that's marketing that medicine and they are a producer of pharmaceuticals, they're not a health care provider — that's quite a different role," Professor Mintzes said. "Lilly has an interest in keeping people on the medicine that is being prescribed." The company's experiment with a new distribution model comes as its revenue last quarter blew past estimates, increasing by 48 per cent. The growth was primarily driven by its injectable weight loss drugs Mounjaro and Zepbound. In a statement, a Lilly Australia spokesperson said the move would improve affordability and convenience for Australians, arguing Lilly Direct operated within existing regulatory frameworks. "Australian doctors prescribe the medicine, Australian pharmacists review and dispense prescriptions, and Australian healthcare, pharmacy, privacy and regulatory requirements apply at every stage," they said. "The LillyDirect platform does not circumvent the role of pharmacists. A registered Australian pharmacist reviews the prescription, dispenses the prescribed medicine and is available to provide advice and counselling to the patient."