Senators blast pharma-telehealth tie-ups in new report

In a new report, several senators highlighted the adverse impacts of the increasingly popular partnerships between pharmaceutical companies and direct-to-consumer, or DTC, telehealth companies, including the ability to inappropriately influence telehealth providers' prescriptions.

U.S. Sens. Dick Durbin (D-Ill.), Bernie Sanders (I-Vt.), Elizabeth Warren (D-Mass.) and Peter Welch (D-Vt.) released an investigative report examining the ties between pharmaceutical giants Pfizer and Eli Lilly and telehealth companies Populus, UpScriptHealth, Form Health, Cove and 9amHealth.

The partnerships seek to increase sales of high-cost medications amid the online GLP-1 boom, the report notes. The senators blasted the companies' "shady tactics" to influence medical care and boost profits. 

The report found that 74% of the 4,394 people using Eli Lilly's platform, LillyDirect, to participate in a telehealth visit, received a medication prescription. This includes all patients who had a virtual visit with Cove.

Not only that, but the report reveals that 9amHealth patients were six times more likely to receive a prescription for an Eli Lilly medication than another brand-name drug, and 66% of 3,759 Form Health patients received Eli Lilly prescriptions.

The LillyDirect platform offers virtual diabetes care through 9amHealth, migraine care through Cove, and obesity care through Form Health and 9amHealth. Eli Lilly offers several diabetes, migraine and weight loss medications.

Eli Lilly's influence on prescribing is also apparent in its payments made to telehealth prescribers, according to the report. For example, the company made 41 payments to two Form Health providers. An Eli Lilly drug was one of the providers' highest-prescribed medications for Medicare patients, resulting in more than $230,000 in Medicare spending in a single year on that drug.

Similarly, 85% of patients routed to UpScriptHealth for telehealth services by Pfizer's PfizerForAll platform received a prescription. The report also found that UpScriptHealth notifies Pfizer about which physicians wrote prescriptions.

Additionally, the report found that pharmaceutical companies gather large amounts of patient data through their telehealth contracts. For instance, Eli Lilly receives patient data from all three telehealth partners, including the number of patients receiving prescriptions, their demographic characteristics and their medication adherence information.

Per data-sharing arrangements, Pfizer may also be able to access the patient's contact information or the prescribing clinician's name.

Pharmaceutical companies pay a high price for the benefits of telehealth partnerships. Eli Lilly's three contract payments to its telehealth partners total $942,500; meanwhile, one telehealth company charges clients, including Pfizer, between $510,000 and $2.45 million over the life of a three-year contract.

"Our findings shine a light on potential conflicts of interest and inappropriate prescribing that can balloon health care spending and lead to inferior care for patients," Durbin said in a press release. "With these revelations, we must crack down on Big Pharma's latest ploy to promote and sell expensive medications at the expense of patients and taxpayers."

The Senate offices conducted the investigation over nine months, using information gleaned from written responses from pharmaceutical and telehealth companies, telephone and video calls with stakeholder representatives, reviews of open-source sites like Healthgrades and examinations of the federal Open Payments Database and the Medicare Part D Prescriber Look-Up Tool.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.