Direct-to-Consumer and Direct-to-Patient Healthcare Models

Accessing healthcare can be complex, and this complexity is driven by a number of different factors. Patients and carers are finding it increasingly difficult to get face-to-face appointments with healthcare professionals, and if they then get a prescription, they may have to make an additional trip to a pharmacy at another location. The time this takes can be hard to manage for people who struggle to get time off work or who have multiple caring responsibilities. Travelling to hospitals, clinics and pharmacies adds another challenge, particularly for people with limited mobility, or who live in rural or impoverished areas where public transport and health infrastructure are poor.

During the Covid-19 pandemic, consumers got used to accessing services online, from streamed entertainment to grocery shopping. Telemedicine, online platforms and remote monitoring have already made healthcare more accessible. In a 2022 survey carried out in the USA, 34% of respondents said that they preferred virtual care to accessing traditional venues. Globally, the healthcare e-commerce market was worth around $261 billion in 2021 and $310 billion in 2022, and is expected to grow by a compound annual growth rate (CAGR) of 18.7% to $614 billion by 2026. [1-3]

While uptake of digitised healthcare clearly has grown, patients are demanding a smoother and more efficient experience, greater affordability and a better range of choices. Direct-to-consumer (DTC) and direct-to-patient (DTP) healthcare models provide services directly to patients without going through a third-party payer, for example an insurance company. As the next step in digitised healthcare, these models have the potential to change how patients receive healthcare and how it is delivered by pharmaceutical manufacturers. [2, 4]

The benefits and challenges for patients and providers

By streamlining the supply chain and dealing directly with consumers and patients, DTC and DTP models may cut the costs of healthcare for individuals, improve the quality and of the service and allow for a quicker and more agile response and better communication. DTP and DTC models can provide care more efficiently, increase the personalisation of care by providing integrated, real-time support, ensure the services are tailored to include only what the patient needs, and improve patients’ access to information, helping them to take ownership of their own care. [3-5]

The benefits are not just for the patients. These models allow providers to control the patient’s experience from beginning to end. The efficiency of DTC and DTP models can help healthcare providers to see more patients in a given period of time, potentially saving on staffing costs or increasing the turnover of patients. Being able to interact more closely with patients can improve relationships and communication, as well as increasing job satisfaction, which in turn may make recruitment easier and improve retention. [3-5]

The challenge of DTP and DTC models for providers is that it can be hard to reach patients as they have to proactively seek out services rather than being referred by a healthcare professional, and this can also mean that generating repeat customers may be difficult. [4]

Ensuring compliance with regulators

Whether it’s provided via a traditional route or through a DTP/DTC model, patients who are accessing healthcare need to know that their care will be safe and effective and that their data will be secure. Companies providing the healthcare must ensure that they meet the regulatory requirements, which can be challenging if the service provided is new or innovative. [3, 4]

DTC and DTP modes: Case studies

In January 2024, Eli Lilly announced the launch of LillyDirect, digital disease management resources for patients in the US living with obesity, migraine and diabetes. LillyDirect includes access to independent telehealth providers, tailored disease state and healthcare educational information, and direct home delivery of select Lilly medicines through LillyDirect Pharmacy Solutions, a digital pharmacy provided by third-party pharmacy fulfilment services. [6]

OnyxMP, based in Austin, Texas, provides access to compounded formulations using an e-commerce platform (Rugiet Health) and an end-to-end telehealth platform (CompoundLive) that connects patients, physicians and compounding pharmacies. The company offers medications for erectile dysfunction and hair loss, as well as a combination oral formulation for weight loss. [7]

Hims and Hers Health is a US-based telehealth company that provides prescription medications, over-the-counter medications, and personal care products. Its offerings include out-of-pocket physician services, group therapy services, telepsychiatry (through ReGroup Telehealth), and prescription medications for erectile dysfunction, genital herpes, weight loss, hair loss, depression and anxiety. As well as branded injectable formulations of GLP-1 weight loss drugs (Wegovy and Zepbound), the company also provides access to off-label injectables approved for weight loss (Ozempic, Mounjaro and generic liraglutide). It also supplied compounded GLP-1 drugs at 85% less than the branded versions. Novo Nordisk terminated its partnership with the telehealth company after less than two months, saying that this was over marketing tactics and sales of Wegovy copies, and alleging that Hims & Hers was violating federal law by selling compounded versions of the drug (compounded sales were allowed during Wegovy shortages). Hims & Hers Health responded, saying that Novo Nordisk was “anti-competitive”. The disagreement resulted in a 32% drop in Hims & Hers’ share price. [8-11]

Direct-to-consumer advertising: Benefits and pitfalls

Direct-to-consumer healthcare will need to learn from direct-to-consumer advertising (DTCA), which began in its current form in the 1980s. DTCA is only fully legal in the USA and New Zealand. In the US, the first piece of DTCA was a print advert in 1981 for Merck’s Pneumovax vaccine. The initial The Food and Drug Administration (FDA) requirements were that the adverts were not false or misleading, presented a fair balance of risks and benefits, included facts material to the advertised uses of the drug, and noted every risk in a brief summary. The FDA later eased the regulations to only include the major risks and provide resources that included full information on risks, and this led to a large increase in DTCA in the 1990s, growing further recently with adverts on social medial and the internet. [12, 13]

Direct-to-consumer advertising has potential to build engagement and foster trust with patients, encourage patients to contact their healthcare professionals thereby reducing underdiagnosis and undertreatment, and empower patients to become more involved in their own healthcare. It also allows patients to provide direct feedback to drug and device companies, potentially speeding up product development and improvement. [12-14]

While DTCA can support patient engagement, there are concerns that it can have a negative impact when not used properly. DTC adverts may overemphasise treatment benefits and underestimate risks and could even promote drugs as an alternative to healthy lifestyle choices. There have also been cases where they lead to non-optimal prescribing. As an example, in a study of antidepressants that have appeared in DTC adverts, individuals with a standardised profile were told to ask their doctor for a brand name drug or an antidepressant in general, or not to ask for a drug at all. Those who requested drugs were more likely to get a prescription than those who didn’t, raising concerns about the impact of patient requests on prescribing. There have also been concerns raised that DTCA pushes up prescription costs by driving branded prescribing over generics. [12]

A 2013 study assessed television adverts for prescription and nonprescription drugs and showed that only one third were objectively true. Over half (57%) were potentially misleading and 10% were false. In a 2023 study, those drugs with the lowest levels of added benefit tended to spend more on advertising to patients. A decade on from a call from the American Medical Association to ban DTC adverts for prescription drugs and medical devices, US Senators Bernie Sanders and Angus King have introduced the End Prescription Drugs Now Act, which seeks to ban DTCA, including on social media. [15-18]

References

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2.Tie, C. The New Era of Pharma is Direct-to-Consumer Healthcare. Last accessed: 18 January 2024. Available from: https://www.nasdaq.com/articles/the-new-era-of-pharma-is-direct-to-consumer-healthcare.

3.Tomlin, W., A. Smith, and A. Blumberg. Why it’s time for a digital, direct-to-consumer health care revolution. Ernst & Young Last accessed: 20 June 2023. Available from: https://www.ey.com/en_gl/alliances/why-its-time-for-a-digital-direct-to-consumer-health-care-revolution.

4.Direct To Consumer Model. Healthie. Last accessed: 23 July 2025. Available from: https://www.gethealthie.com/glossary/direct-to-consumer-model.

5.Erwin, J. Using Digital Tools To Drive Convenience And Personalized Care. Forbes. Last accessed: 8 September 2023. Available from: https://www.forbes.com/councils/forbesbusinesscouncil/2023/09/08/using-digital-tools-to-drive-convenience-and-personalized-care/.

6.McCully, M. and J. Fletcher, Lilly Launches End-to-End Digital Healthcare Experience through LillyDirect™. Lilly. 4 January 2024. Available from: https://investor.lilly.com/news-releases/news-release-details/lilly-launches-end-end-digital-healthcare-experience-through.

7.OnyxMP. Last accessed: 23 July 2025. Available from: https://www.onyxmpgrowth.com/.

8.Shieber, J., Hims launches group therapy services as first foray into broader mental health initiative. TechCrunch, 7 April 2020. Available from: https://techcrunch.com/2020/04/07/hims-launches-group-therapy-services-as-first-foray-into-broader-mental-health-initiative/.

9.Hims. Last accessed: 23 July 2025. Available from: https://www.hims.com/.

10.Cerullo, M., Hims & Hers says it's selling a GLP-1 weight loss drug for 85% less than Wegovy. Here's the price. CBS News, 21 May 2024. Available from: https://www.cbsnews.com/news/hims-hers-glp-1-weight-loss-drug-199-wegovy-price/.

11.Jacobsen, S. and A. Niasse. Novo, Hims & Hers engage in war of words after Wegovy deal falls apart. Reuters. Last accessed: 23 June 2025. Available from: https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-ends-collaboration-with-hims-hers-over-weight-loss-drug-sale-2025-06-23/.

12.Parekh, N. and W.H. Shrank, Dangers and Opportunities of Direct-to-Consumer Advertising. J Gen Intern Med, 2018. 33(5): p. 586-587.

13.Roberts, L. The pros and cons of Direct-to-Consumer Advertising in the Pharma industry, from marketing to ethics to public health. Last accessed: 23 March 2025. Available from: https://www.orientation.agency/insights/pros-cons-of-direct-to-consumer-advertising-in-pharma.

14.Trend Brief: 2025 Pharma and Medical Device Trends for Manufacturing Leaders. 2025. Available from: https://www.mastercontrol.com/resource-center/life-science-manufacturing-trends/.

15.Taylor, P., US lawmakers seek ban on DTC advertising. PharmaPhorum, 13 June 2025. Available from: https://pharmaphorum.com/news/us-lawmakers-seek-ban-dtc-advertising.

16.Faerber, A.E. and D.H. Kreling, Content analysis of false and misleading claims in television advertising for prescription and nonprescription drugs. J Gen Intern Med, 2014. 29(1): p. 110-8.

17.AMA calls for ban on DTC ads of prescription drugs and medical devices. American Medical Association. 17 November 2015. Available from: https://www.ama-assn.org/press-center/ama-press-releases/ama-calls-ban-dtc-ads-prescription-drugs-and-medical-devices.

18.DiStefano, M.J., et al., Association Between Drug Characteristics and Manufacturer Spending on Direct-to-Consumer Advertising. JAMA, 2023. 329(5): p. 386-392.

About the Author

Based in the north of England, Suzanne Elvidge is a freelance medical writer with a 30-year experience in journalism, feature writing, publishing, communications and PR. She has written features and news for a range of publications, including BioPharma Dive, Pharmaceutical Journal, Nature Biotechnology, Nature BioPharma Dealmakers, Nature InsideView and other Nature publications, to name just a few. She has also written in-depth reports and ebooks on a range of industry and disease topics for FirstWord, PharmaSources, and FierceMarkets. Suzanne became a freelancer in 2006, and she writes about pharmaceuticals, consumer healthcare and medicine, and the healthcare, pharmaceutical and biotechnology industries, for industry, science, healthcare professional and patient audiences.