One of the hottest trends in the pharmaceutical industry today is direct-to-consumer (DTC) sales and services.

Drugmakers are turning toward a new way to sell their products, gather user data, and save money by eliminating the intermediaries in the pharmaceutical supply chain, experts say. But that could come with some consequences, such as further siloing the healthcare system.

At the end of August, pharmaceutical giant Pfizer announced a new website called PfizerForAll, which provides information on common health issues like migraines or the flu and connects patients to telehealth services and prescription delivery services so they can get treatments and diagnostic tests delivered to their homes. Pfizer promotes some of its own therapies, including Paxlovid for Covid-19 and Nurtec for migraines, on the site.

That move came after rival pharmaceutical company Eli Lilly started LillyDirect in January, through which the company delivers prescriptions straight to patients. Eli Lilly also partnered with Amazon Pharmacy in March to deliver some of its medications to consumers’ doorsteps, including Ozempic competitor Zepbound, a GLP-1 weight loss drug.

So, why are Big Pharma companies going direct-to-consumer? According to Robin Glass, president of virtual care company Included Health, there are multiple advantages.

Keep reading here.—MA

Reminder! CMS Star Ratings come out in October—sooo in just a few weeks.

What is a Star Rating? It’s used to measure the quality of services received by Medicare members. This impacts the amount of reimbursement dollars health plans receive as a result.

To improve these ever-so-relevant Star Ratings, it’s crucial to ensure that patients are receiving the recommended preventive care.

To dig deeper into this pressing topic, LetsGetChecked’s e-book covers the hurdles health plans face in closing gaps in preventive care. It offers strategies and solutions (like LetsGetChecked’s at-home healthcare programs) for elevating a plan’s ability to achieve quality benchmarks and positive member outcomes.

Grab a free copy to learn more.

It may be getting colder outside, but contract negotiations between insurers and payers are heating up.

The latest standoff? Some UnitedHealthcare customers have been out of network with University of Florida (UF) Health since their contract expired on September 1, though negotiations are ongoing, according to a UF Health press release.

This came after Livonia, Michigan-based Trinity Health—a not-for-profit system that has 101 hospitals and 126 continuing care locations nationwide—failed to reach a contract by its July 1 deadline with United in California, Indiana, and Georgia. Members were left out of network for most of July before an agreement occurred, Stat reported.

Contract negotiations for Trinity Health of New England stretched into mid-August, with the system alleging unfair reimbursement had “pushed” it to a “breaking point” in a statement on the Trinity-run Health Comes First site.

Show me the money. One of the sticking points in these high-stakes tug-of-wars is payment. Both payers and providers agree new contracts should pay more for services, but they disagree on how much.

Keep reading here.—CC

The weight loss drug market isn’t going anywhere. In fact, GLP-1 use is about to get bigger.

A new report by financial research companies Morningstar and PitchBook projected that the GLP-1 market will hit $200 billion by 2031 and that 16 new obesity drugs could emerge within the next five years.

Karen Andersen, an equity strategist at Morningstar and an author of the report, estimated that the current market is about $50 billion. Pharma companies like Roche, Amgen, Pfizer, and AstraZeneca are among the contenders expected to release additional obesity drugs in the next three to four years.

Still, the analysts predicted that Ozempic, Wegovy, and Rybelsus (semaglutide) maker Novo Nordisk and Eli Lilly, which developed Zepbound and Mounjaro (tirzepatide), will maintain two-thirds of the market by 2031 due to their “first-mover advantages.” Other competitors are expected to take a combined $70 billion of the GLP-1 market, the study read.

Keep reading here.—CM