Among the demands that President Trump has made to the pharmaceutical industry to lower drug prices, there’s been one that companies have enthusiastically supported: selling drugs directly to consumers.
Even before Trump began discussing the idea, Eli Lilly and Novo Nordisk had adopted this model for their blockbuster weight loss treatments — offering discounted cash prices to patients not using insurance.
More recently, Bristol Myers Squibb said it would start selling its popular blood thinner Eliquis this way, and Novo said it would do the same with Ozempic, its diabetes drug. Major companies including Pfizer, AstraZeneca, and Roche have also voiced their backing in recent earnings calls. The idea has been discussed so often that some in the industry have adopted a snappy turn of phrase to describe it: “pharm-to-table.”
The reality, though, is far more complicated. Selling drugs directly to consumers is unlikely to make most of them more affordable, even if doing so boxes out insurers and the “middlemen” known as pharmacy benefit managers, several health policy and drug pricing experts told STAT. The cash prices that pharma companies are willing to offer for their drugs (which currently stand at several hundred dollars per month) will never be as low as the prices patients can get through insurance. And if patients buy their drugs directly from pharma companies, none of their spending contributes to their deductibles or out-of-pocket maximums meant to limit costs over time.
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