GoodRx, Eli Lilly launch direct-to-employer models that reduce reliance on PBMs

Over the last few years, the pharmaceutical industry has gone all in on direct-to-consumer (DTC) cash-pay sales for drugs that widely lack health insurance coverage.

Now, pharma is taking it to the next level by going direct to employer.

Eli Lilly launched its Employer Connect platform on March 5, which gives employers their choice of 15+ independent program administrators and pharmacies where they can access its GLP-1 Zepbound Kwikpen for a reduced price of $449 for all doses. A press release touts it as an option offering “greater cost predictability and transparency.”

In related news, GoodRx, one of Employer Connect’s program administrators, announced its own expansion into the employer market on Feb. 24: GoodRx Employer Direct. Though GoodRx is initially focusing on GLP-1s, this new approach is related to a wider change in how healthcare is delivered and paid for, Julia Croxen, VP of strategy consulting at venture fund and advisory firm Rock Health, told Healthcare Brew.

“It makes sense as an evolution of the direct-to-patient or direct-to-consumer model,” she said.

The deets. Within GoodRx’s Employer Direct, employers can buy branded medications at manufacturer-sponsored prices. Employers can then pay down GoodRx’s price to lower the out-of-pocket cost their employee pays at the pharmacy counter.

It’s meant to add to, not replace, traditional insurance by making it easier for an employer to offer a brand-name drug even if it’s not covered by the employer’s insurance plan, according to a release.

GLP-1s were a natural area to start this program with because there’s high employee demand but low coverage, Laura Jensen, chief commercial officer at GoodRx, told Healthcare Brew. KFF’s 2025 employer health benefits survey found just one in five employers with 200+ workers cover GLP-1s for weight loss. Some may be holding off on covering the drugs in part due to cost.

“We’re doing this now because the technology exists, the appetite from the pharmaceutical industry exists, and the supply chain is really no longer serving the user experience,” Jensen said. 

The big picture. GoodRx launched this program amid wide-scale discontent from employers and patients about the pharmaceutical supply chain.

Many public calls for reform have centered on pharmaceutical benefit managers (PBMs), the intermediaries that negotiate drug prices between manufacturers and insurance plans. These negotiations have historically been done in secret, and there’s been concern that not all the rebates are directly passed to consumers.

Alternative PBMs advertising more transparency have been embraced by pharma companies like Lilly, which recently switched from CVS’s Caremark (one of the Big 3) to the smaller Rightway.

Programs like GoodRx Employer Direct are another way for employers to access drug discounts that aren’t available through the traditional PBM model, Croxen said.

“There is anticipated to be greater transparency and ability to determine and project what the cost would be to the employer in these [new] models,” she said.

The Trump administration’s “most-favored-nation” pricing initiative—a May 2025 executive order aimed at bringing US pharma prices down to the lower costs paid in other countries—also helped bring about this model by encouraging drug manufacturers to offer their drugs at cash prices directly to consumers without going through insurance, Jensen said.

GoodRx and Lilly are partners of the admin-created DTC market TrumpRx, a major part of the federal government’s initiative. Pharma’s DTC offerings have also expanded beyond TrumpRx through partnerships with companies like Amazon.

Getting out the crystal ball. In the future, GoodRx may expand this program to drugs that aren’t often covered by traditional health plans in other areas, such as fertility or migraines, Jensen added.

Croxen said she’s also keeping her eye on what other companies involved with TrumpRx get up to.

“I would be interested in monitoring other pharmaceutical companies with direct-to-patient platforms, or who are involved or planning to be involved in TrumpRx, to see if they take a similar [direct-to-employer] approach,” Croxen said.