An insider’s look at LillyDirect

[Music] You're listening to Pod Nosis, the pulse of the healthcare industry. I'm your host, Aila Ellison. GLP1s may dominate healthcare headlines, but for many patients, actually getting these medicines is still anything but simple. Between finding a provider, navigating insurance, and understanding out of pocket costs, the process can be overwhelming. On this episode of Pod Nosis, senior writer Anastasia Gliatkoskaya talks with Jen Maezer, senior vice president of Eli Lilly and companies Lilly Direct, the company's digital health platform that connects patients to telehealth services, pharmacy options, and treatments for obesity, diabetes, and migraine. Maezer explains why Lilly launched the platform before direct to consumer drug access became a political flashpoint, how Lilly Direct is changing expectations around convenience and price transparency, and why nearly half of news at bound prescriptions in the fourth quarter were filled through the platform. She also discusses criticism from lawmakers, the rise of self-pay options, and why Lilly believes platforms like Lilly Direct could push the broader healthcare system to work better for patients. Let's get into it. [Music] So, walk us through the idea behind Lilly Direct. What was it born out of? What was the goal? There were two primary reasons why we launched Lilly Direct. The first is our US healthcare system is very complex, and people have a difficult time navigating it, especially those with chronic disease. That was the first problem we wanted to solve. And the second is we've all come to rely on the ease and efficiency that comes through digital tools and our daily lives as consumers, and healthcare is in a lot of ways anything but easy and efficient. And we wanted to maximize opportunities with the rise of digitization. So, it was really our second problem to solve or opportunity. So, with Lilly Direct, our goal from the start was to improve the ease, convenience, and really accessibility of healthcare for people living with chronic conditions, particularly in the United States. So, whether it's connecting patients with independent and person or telehealth providers, helping people learn more about their conditions, especially those that are newly diagnosed, and honestly, even those that have been navigating a disease for some time, and getting prescribed medications delivered directly to your door. Lilly Direct helps make managing conditions like migraine, memory and thinking issues, sleep apnea, dermatology conditions, obesity, and diabetes, more manageable. And we're not just talking about offering people more options. Sometimes that's not always the best solution. We're really making healthcare simpler, more convenient, and built around the patient. And I think folks, my associate, Lilly Direct today, with kind of like Trump initiatives around consumer access and affordability when it comes to medications, but Lilly Direct actually predates some of these initiatives, right? Absolutely. We launched in January of 2024, officially launched. We were doing some piloting in 2023, but announced our official launch in January. Okay, great. So, can you talk a bit more about the care and navigation piece, and specifically how you're thinking about helping patients, no matter their condition, to sort through the complexity of the system we've been talking about? So, for us, I mean launching in January 2024, again, it was to solve for the complexity in the US healthcare system, leverage, digital tools that are available in our daily lives, and the goal, ultimately being help people cut through all that complexity to focus on what matters most, and that's better health. And when you think about the friction introduced throughout a person's health journey, it might be difficulty finding a doctor, finding one who's accepting new patients and scheduling appointments. It could be navigating insurance coverage and cost and affordability solutions, even accessing the medication itself at various pharmacies. And those were some of the problems for us that we were aiming to solve. And so in January 2024, when we launched Lilly Direct, we saw some early momentum, but shortly after, a great example of our continued evolution here was launching a self-pay option. And this, for us, was with obesity coverage or a lack thereof, for the obesity market, obesity as a chronic disease, which warrants medication coverage, like any other chronic disease, we saw that patients were struggling to access their prescribed medicine. And so by introducing a self-pay option, that giving people direct to consumer pricing, transparency, and how much they're going to pay for their prescribed Lilly medicine, it reflects the kind of innovation that we believe is necessary and how medicines for obesity management were then and now still are being delivered. And regarding the sort of the question you asked about care, this was really an opportunity again for people who do not have a care provider or in some circumstances have to drive, you know, 50 miles to get to their doctor. And then there are just, of course, those who are looking for more convenient options to access care. There's a number of hurdles that can get in the way of someone getting to diagnosis and treatment. This is one of the hurdles. And we were seeking to give consumers, patients, access to not just prescribed Lilly medicines, but access to other care resources, holistic health, well-being resources, nutritionist, as well as independent licensed healthcare providers that are seeing people, seeing patients in person and sort of your traditional brick and mortar, doctors offices, as well as those that can see patients virtually through telehealth platforms. And this just gives consumers, depending upon what it is they need to get to better health, giving them those solutions and services available at their fingertips through our Lilly Direct platform. And if that's accessing an independent care provider, we just wanted to make that available to consumers as a choice. So you're saying the platform kind of aggregates local or telehealth provider options that consumers have a streamlined way of finding providers near them or that might work for them. And then we should say Lilly Direct still requires a prescription for any of the medications, right? Absolutely. I mean, I think first and foremost, yes, it's an aggregator. These telehealth providers, and we leveraged from an in-person prescriber tool called health grades that's managed and ran completely independent of Lilly and Lilly Direct. And the same is true for the independent telehealth providers that are listed on our platform for a variety of chronic diseases. Again, we're talking obesity here, but also diabetes and memory and thinking issues and dermatology conditions. And again, it just gives consumers convenience and choice and how they want to access their care. Once someone comes to our platform and starts to explore these options, you completely leave our platform. And any decision made between you and your health care provider is completely independent and walled off and separated from Lilly. And if people may or may not get diagnosed, they may or may not get treated with a Lilly medicine. So completely disconnected as it should be, that relationship between a patient and provider should be completely independent. Now where our pharmacy fits in is for any licensed health care provider in the United States. Not just those that are accessible via our platform. And the company's company provider can send a prescription of a Lilly medicine that's being fulfilled by one of our independent third party pharmacy partners to the Lilly Direct pharmacy. And it's in that Lilly Direct pharmacy experience that consumers not only have the confidence that they're receiving authentic FDA approved Lilly medicine. They're also receiving transparent pricing access to all eligible savings programs that are available for that medicine that they qualify for. Getting that sort of digital connectivity that convenience of being able to engage with the pharmacy experience, pay for their medicines and choose to have the medication delivered to the location of their choice. That's that convenience price transparency and simplicity. That's that's the model people are very hungry for in a health care experience. And that's what we've created with Lilly Direct. A recent consumer survey by Phil, which helps farmers launch direct to consumer programs. I guess found that one of the most common reasons for not billing prescriptions include not knowing how much a drug will cost or simply that it's too expensive. Can you talk about how that contributes to Lilly Direct strategy? Absolutely. I mean, again, goes to the complexity of the health care system. And do you have insurance coverage? Do you have insurance? Maybe is the first. question for prescription drugs and if so does that particular plan that you're on or your employer, you opt it in, do you have coverage, and then of course you get into accumulators and maximizers. I know I'm talking likely to to an audience here that understand some of these complexities and for a consumer at the end of the day, they're navigating in most cases a chronic disease. They're looking for a path to better health. They've made a treatment decision with their healthcare provider that this is the next best solution to give them the best chance of better health. And then there is all this friction that's introduced throughout that point of treatment decision to really having the medication in my hands. And a lot of it is associated with the complexities around and surrounding cost and affordability. So for us, for Lily and bringing Lily direct to market, I mean our our one of our goals our mission is to help people that have been prescribed to Lily medicine. Get access to that Lily medicine as quickly as possible at the lowest possible out of pocket costs they are eligible for at every fill. We'll do the work in partnership with healthcare providers and pharmacies and insurance plans to ensure that patients are confident they're receiving transparent pricing information and and know what it is that their their their cost and affordability options are really try to again cut through all that complexity so that people can make decisions that are our best for them and their situation. We don't just support self-pay pricing although that is for us I think a very innovative model that we've seen I think really revolutionize the the way in which consumers are expecting to receive price transparency with their medications. But we also support insurance coverage and help help consumers and patients navigate their insurance plan and what their cost options are. And again, as I mentioned, ensure that if they're eligible for a savings card program that Lily is offering that that's applied at the point of check out said that they're maximizing all of the solutions that are available to them. Yeah, I think it's important that it's not mutually exclusive. So let's talk about GLP ones. I mean, it's I think something a lot of listeners are curious about and I think you guys have really interesting recent data on GLP one preferences out there in the market. Can you just run through some interesting data that you're collecting and what it seems to signal about where consumers are about GLP ones? I'm thinking about like the stat about like nearly half of New Zepp Bound starts in Q4 where Biobased and like what percentage of patients you see that having insurance coverage or dough like anything in that realm. I got you. So I mean, as you mentioned, we announced in with our Q4 earnings that nearly 50% of news that bound prescriptions were being fulfilled by the Lily Direct Pharmacy. I think this told us several things. Again, it mentions the the strong desire for price transparency. It speaks to the desire for people to have confidence they're receiving FDA-approved authentic medicine from the manufacturer. And I think it also speaks to the convenience factor. And even now with the self-pay pricing programs being more broadly available through other retail pharmacy channels, we still see a strong preference for the experience we are creating through Lily Direct. We're again a licensed healthcare provider, sense of prescription for let's say Zepbound or we just recently launched Foundao and that is now available and the the Lily Direct Pharmacy experience as well. Foundao is our oral GLP one indicated for chronic weight management. And these prescriptions come to Lily Direct Pharmacy and patients can benefit from the the convenience and price transparency available to them. And we are seeing already for both Zepbound. We've known this about the opportunity for commercial coverage with Zepbound, our auto-injector device and we support those patients as well and already seeing commercial coverage for Foundao. So for us, it's about meeting consumers where they are helping them to navigate again the options available to them. And Lily continuing to broaden its portfolio of medication options for chronic diseases, including obesity, so that people have choice and can work with their healthcare provider on the medication that's right for them. And then when it comes to point of treatment decision, have confidence that they have support from Lily Direct to ensure they are accessing again FDA-approved authentic medicine at the lowest out of pocket cost they are eligible for. You mentioned other other drugs that you already offer or considering offering. Can you talk about what your approach is to determining what you would like to add to the platform? We first reflect on what's what's the unmet need for consumers? Clearly there was significant unmet need around obesity management medications and lack of of coverage. Less than 20% of large employers were providing coverage for obesity management medication at the time that we launched Lily Direct and our self-pay program is one innovative solution in addressing that and we recently announced our direct to employer program to again help to address the gap in coverage. So for us, we look at what are the unmet needs for consumers and patients and where can we play a role in simplifying, streamlining the availability of services to consumers that can help them in learning more about their disease, access to well-being holistic health resources, independent healthcare providers, and then if prescribed a Lily medicine access to those medicines. And so as to which medications we add into our experience, we want to make sure that the experience we are providing to consumers is pinnacle is the best possible experience and Lily Direct, we've been at this now as running and operating and a pharmacy for about two years. It's a new space for us and we've learned a lot in that and we want to be very thoughtful about the medications that we continue to add but we're looking at all of those opportunities as you think about migraine diabetes, memory and health thinking as or excuse me memory and thinking issues, dermatological conditions, how can we ensure that we're providing end to end experiential support for people navigating those variety of chronic diseases and that's a part of our thought process. Can you talk about the partners that Lily Direct has such as Wal-Mart or other folks and like what's the process, what's the thinking behind those partnerships? We first and foremost look for partners that are mission aligned, those that are focused on helping people with chronic disease get better and have their best chance of better outcomes. And so the companies we work with play a critical role in helping patients who have chronic disease navigate a complex healthcare system and these partners help support very important parts of the patient journey. Again addressing the most common friction points along someone's health journey such as connecting people to independent care supporting fulfillment of prescribed medications. At the lowest out of pocket cost that someone is eligible for which does take a lot of work to identify what those options are and enabling ongoing engagement in someone's care journey. Again, going beyond the medicine to ensure people have access to well-being and holistic health resources that empower them to take control of their health journey. And so these partners help connect what can otherwise feel like a fragmented experience but through Lily Direct feels more coordinated for patients and over time we hope more and more personalized to where a patient is in their care journey. So for example you mentioned Wal-Mart as we launched the Zetbound single dose file in the Lily Direct Pharmacy it was at that time sort of a male order pharmacy experience only. And so the way to access the self-pay price for the Zetbound single dose file was to engage digitally with the checkout experience but then enter in an address where you want that medication delivered. And we noted that that doesn't meet every consumer where they are and their needs. Some take longer vacations, some live in a location where maybe having the medication sitting on their front door depending upon their working hours where they're going to get to their medication and time to put it in the fridge. There's a number of factors that people are contemplating. And so partnering with someone like Wal-Mart who again first and foremost is mission aligned and helping people get better. They are a nation wide footprint of retail pharmacies and in a lot of ways really in the neighborhoods and backyards of many of our consumers and offer consumers another way in which they can pick up their Zetbound single dose file at the transparent self-pay price that we were offering. And we saw a really really great uptake of that of that solution where people are choosing for a retail pickup option because it just meets them where they are. It meets the consumer where they are and how they want to engage in their health care. So that's a small example of looking at again, what are the unmet needs for patients? What are the gaps in the experience that we're providing for patients and which partners that are mission aligned can help us close those gaps? Yeah, that makes sense. So earlier you were talking about the importance of independence for for the providers who are listed on the Lilly Direct platform. I just wanted to mention that last year Lilly Direct was the subject of a congressional probe that accused the program of influencing Dr. Prescribing habits. Some of the data that they found was patients routed to a telehealth provider through Lilly Director given a prescription three-quarters of the time and they were prescribed Lilly drugs at a higher rate than other brands. I wonder if that's like intentional. Like does it make sense that providers listed on the Lilly platform are prescribing Lilly products? Can you just talk about like the separation there and some of the accusations from the congressional probe, the findings? Yeah, we are disappointed that certain congressional reports mischaracterize Lilly's intent in offering patient-focused resources on Lilly Direct. Again, Lilly Direct is a digital health platform that helps patients navigate a complex and cumbersome health care environment that can often delay and in some cases even prevent people from getting to better health outcomes. And Lilly Direct is offering patients educational materials, the option to connect with independent telehealth platforms or in-person care, convenient home delivery of FDA approved Lilly medicines if prescribed. And Lilly Direct does not steer or influence a physician's choice of medicine. Providers exercise their own clinical independent judgment when evaluating and treating patients. That includes both the independent telehealth partners that are listed on the Lilly Direct website. That also includes of course just traditional health care providers nationwide that consumer see every day. Any health care provider can send prescriptions to our Lilly Direct pharmacy and this ensures patients are accessing these options regardless of where they receive care. But I cannot underscore enough the independence of the of the telehealth providers and the health grades in person, physician options available. If you experience for yourself the Lilly Direct site, you go to Lilly Direct, you're looking for a care option. When you click you see that interstitial you are leaving the Lilly Direct site. And at this point, who you choose of those telehealth provider options to engage with, what occurs in that appointment with your independent licensed health care provider, decisions made about next steps in your treatment are completely independent. And we think that is paramount to continue to protect the independence of that patient health care provider relationship. We are here to help support the patient along the way and string they have access to those independent care options and to ensure prescribed Lilly Medicine that they are confident they're receiving FDA approved authentic medicine at the lowest out of pocket cost they are eligible for. Thank you. So let's talk about Trump RX. How is this initiative fitting into Lilly Direct? I believe Lilly Direct is one of the listed kind of resources on Trump RX website. You just talk about what that has meant for you guys and where do you see it going? Yeah, so for us, Trump RX serves as a portal to Lilly Direct. Trump RX is helping expand consumer access by creating another entry point for patients to connect to affordable authentic medicines. And we believe it builds on our broader approach of offering multiple pathways, whether through self pay or insurance to ensure patients get the treatments they need when they need them when prescribed by a licensed independent health care provider. And so ultimately, Lilly Direct and Trump RX is all about reducing barriers and giving patients more choice and flexibility and how they access their care. And looking to the future, like what where is a program like Lilly Direct going? Like is the goal to make every Lilly drug available through Lilly Direct? How do you see it fitting into the broader company strategy? We're excited about what we've accomplished and we're excited about the future of Lilly Direct and the opportunity to build out a global health platform that is helping people have their best chance of better health outcomes. And that includes access to independent care providers, certainly access to authentic medicines if prescribed by an independent licensed care provider, but importantly access to holistic health and well-being resources that go beyond the medicine, really empowering consumers to take control of their health journey because Lilly Direct is helping to cut through the complexities of not just the US health care system, but global health care systems and really helping people have the best chance of better health. I'm curious like in terms of thinking about traditional pharmacies, obviously you have pharmacy partners like Walmart. Do you think that a model like Lilly Direct and these partnerships with retail chains will make traditional pharmacies obsolete? Is that even a goal? How do you think about like the role that traditional community pharmacies play when we're talking about the importance of convenience and choice and affordability? Oh gosh no. I don't think it'll make it obsolete. I do think programs, platforms like Lilly Direct will and it is shaping consumer expectation of how they engage with and access their health care. And I think it's raising the bar for all of us, all of us that are in the sort of the healthcare stakeholder ecosystem, helping to ensure patients have the best chance of better outcomes. It's challenging all of us to think differently, innovate to ensure that we are bringing better care, better health options, better medicines, and better affordability solutions to consumers who need the most. So no, I don't see the traditional pharmacy model going away at all, but I do see it getting better. And I think that is wonderful for consumers and patients. For any of us who ourselves have navigated the US healthcare system as a patient ourselves are walking alongside loved ones. We see a lot, I'm sure from all of our respective seats on what we think can be better and our role in driving improvements, but it's something completely different to see it as a patient or to see it as a loved one of someone who is struggling to navigate not just their diagnosis and disease, but then meanwhile almost needing a PhD on how to navigate the US healthcare system. And so that's what I see happening. I think we're going to all get better because of platforms and improvements like Lily Direct and our Innovative Self-Pay Program. And it's going to take a partnership between the pharmaceutical manufacturer, the insurers, the pharmacies, healthcare providers to really make the experience better for consumers. Great. Well, it's an exciting time. Jen, thank you so much. Thank you. Thank you for listening to Podnosis. I'm Aila Ellison. You can find out more about this topic in our show notes at fearshealthcare.com. Look for podcasts. And don't forget to tune in every Wednesday morning to Podnosis, where healthcare is our beat.