CEOs of Pfizer and Eli Lilly have received letters from four US senators expressing concerns about their new direct-to-consumer (DTC) telehealth platforms.
The letters outlined worries that the new platforms might influence patients’ decisions in favour of the pharmaceutical giants, or open the door to inappropriate prescribing from which Pfizer and Eli Lilly might gain financially.
As the letters explain, this would violate the federal Anti-Kickback Statute (AKS), which is intended to protect patients from financial factors that might influence medical decision-making.
They read: “DTC advertising of prescription drugs has been shown to increase both patient demand for specific medications and the likelihood of a patient receiving a prescription for that drug.”
Dick Durbin (D-IL) and cosignatories Bernie Sanders (I-VT), Peter Welch (D-VT) and Elizabeth Warren (D-MA) requested further information about Pfizer and Eli Lilly’s relationship with their telehealth prescribers. The 13 listed questions include queries about advertising expenditure, insurance eligibility, compensation for telehealth partners, terms of agreement and the percentage of users who receive Pfizer or Eli Lilly prescriptions. Answers are expected by 25 November.
The letters also outline the ease with which the telehealth platforms enable patients to speak to a doctor. To both companies, the senators wrote: “This creates the impression that any patient interested in a particular medication can indeed receive it with just a few clicks, and the appearance of Pfizer’s/Eli Lilly’s approval that these chosen providers can ensure a patient receives the given medication.”
The issue is akin to previous concerns about the fraudulent financial potential of telehealth. In 2022, the US Department of Health and Human Services’ Office of the Inspector General (HHS OIG) issued a Special Fraud Alert after a series of fraud investigations involving telehealth, telemedicine and telemarketing companies.
According to the alert, the HHS OIG found examples of telemedicine companies that “intentionally paid physicians and nonphysician practitioners (collectively, practitioners) kickbacks to generate orders or prescriptions for medically unnecessary durable medical equipment, genetic testing, wound care items, or prescription medications, resulting in submissions of fraudulent claims to Medicare, Medicaid, and other federal healthcare programs.”
Telehealth has found itself in the spotlight in the US, particularly since the Covid-19 outbreak prompted a rapid uptake of remote solutions. In a 2023 report, GlobalData noted an exceptional demand for telehealth devices in the US, stating “that perhaps this market is more permissive in terms of reimbursement and acceptance by the healthcare industry”.
It also mentioned: “Additionally, in recent years, rural access to healthcare has become a strategic priority in the US, leading to telemedicine solutions being championed.”
GlobalData is Medical Device Network’s parent company.
Despite the risks of misuse, however, GlobalData expects the telehealth market to continue to grow in the US in response to the healthcare sector’s broader needs. In particular, its 2023 report identifies rising healthcare costs and unexpected billing as a driving factor behind the development of DTC healthcare offerings.
“Digital technology, with retail sensibilities, has begun to introduce healthcare services directly to consumers, bypassing the typical health system and hospital infrastructure,” it said. “These players tend to offer telemedicine and virtual care, as well as in-home diagnostics, drug delivery, and mental health services. These types of services offer convenient ways for patients to access healthcare and only pay for the services they know they will use.”
