Telehealth is the newest pharma marketing channel

We were promised innovation, we got more creative ads

Last week, Senators Durbin (D-IL), Sanders (I-VT), Warren (D-MA), and Welch (D-VT) released a report investigating the effects of the business relationship between pharmaceutical companies Pfizer and Eli Lilly and telehealth companies Populus Health, UpScriptHealth, 9amHealth, Form Health, and Cove.¹

Their findings were striking, if not particularly surprising. They found that 75-100% of patients who communicated with one of the investigated telehealth providers received a prescription. They also found that many of the visits didn’t require video, meaning that the provider was prescribing without ever seeing the patient. For their end of the deal, Lilly and Pfizer received detailed patient and prescriber information, and many of the patients were prescribed Lilly and Pfizer-branded drugs.

Marketing to the online population

It was perhaps inevitable that pharma companies would see the opportunity to partner with telehealth providers to ensure that their products reach as many patients as possible. I haven’t been in the rooms where they make their advertising decisions, but I imagine that pharma companies noticed many patients were seeking pharmaceutical help for common, low acuity conditions like obesity and migraine, and that many of these patients searched for DTC telehealth providers through which to access these medications. TV ads work for older audiences, but there is perhaps more room to get creative with younger, more online audiences.

Eli Lilly and Pfizer joined the game in 2024 by launching their direct-to-patient platforms, respectively named LillyDirect and PfizerForAll. Pfizer’s product is a white-labeled engine that directs patients to independent telehealth providers furnished through companies like Populus Health and UpScriptHealth, while Lilly links out to telehealth providers like 9amHealth and Cove, depending on the patient’s chief complaint.

I expect this will become a more common pathway in the future — Populus Health literally brands itself as a media company advertising to patients on behalf of their life sciences clients.

Pick and choose medication

When I used to write about telehealth startups, I assumed that there would be a split between generic commodity telehealth, which would be accessible for run-of-the-mill cold and flu (say, through your insurance provider) and specialty telehealth, which I referred to as “virtual care.” I also assumed that “virtual care” would evolve into specialty care hubs similar to a hospital Center of Excellence.

But instead of being a collection of specialty docs with world-class expertise, many telehealth companies are prescription hubs, enabling patients to self-diagnose, choose the medication they think is best suited for their condition, and then receive a prescription. This was probably always true, but the telehealth-pharma partnerships are making it even more blatant.

When I looked at Novo Nordisk’s website, NovoCare, recently, they were running a sale that I would normally associate with...anything other than drugs. NovoCare is different than PfizerForAll and LillyDirect in that it doesn’t link out to telehealth providers; instead, it sells branded drugs directly to cash-pay patients who already have a prescription. Still, I think it’s striking that prescriptions are becoming ever more accessible, rather than high-quality care becoming more accessible.

I should’ve realized — Centers of Excellence are mostly a marketing play, and telehealth’s latest iteration is too. At least they’re not prescribing stimulants at a rapid clip anymore, I guess.

Reaching doctors

Doctors have long received creative payments from pharmaceutical companies, whether it’s free meals or speaking fees. These payments are associated with more prescriptions by those doctors. At its most extreme, one study published in 2019 found that pharmaceutical company payments were linked to significantly higher deaths from opioid overdose.

The creative payments are happening with the telehealth marketing channel as well. The senators’ investigation noted that some telehealth companies report back to their pharma partners which doctors wrote prescriptions for patients, and some doctors also received separate speaking fees and other payments from the pharma partners. Some job listings for these telehealth companies indicated that doctors would be paid per completed appointment, defining a completed appointment as the approval or denial of a prescription.

This might be incentivizing doctors to steer patients toward more expensive branded medications, even when there’s a generic or non-pharmaceutical alternative.

Innovation vs. survival

This isn’t the future of healthcare innovation I expected, this is a new form of pharma advertising. It might help some people on an individual level (and I hope it does!) but it’s not going to do anything for population health or value-based care or any of the other phrases I associate with big swings in healthcare innovation. This form of care is delivered impersonally through video and asynchronous messaging, with doctors who may never lay eyes on the patient.

It may have been inevitable, but it’s disappointing to watch.

1. I worked for Thirty Madison, the parent company of Cove, from 2021-2022.