Eli Lilly made waves last week after announcing LillyDirect, a new telehealth service that will make it easier for patients to get the newest GLP-1 on the block, Zepbound, directly to their doorstep.

It’s not a shocking move given all of the hype around GLP-1s recently. There have been tons of companies flooding the market, offering GLP-1s directly to consumers via online portals and telehealth appointments. Lilly saw this and wants to take back its piece of the pie.

Under the hood, they are using a service called FORM as their telehealth platform. Besides obesity, LillyDirect is also targeting diabetes and migraines, and I’m sure other conditions are in the pipeline as it scales.

Lilly sees a gold mine in the market right now and instead of letting other companies profit from it, they want to supply the cake and eat it too (does that even make sense!?). The obvious concern is that this will cause a surge in prescriptions without proper clinical assessment. Some clinicians are concerned about the telehealth nature of this model and the need for in-person visits before prescribing weight loss medications. I don’t think that’s as much of an issue but also recognize that there is a fine line here that can get blurry when the incentives of the company supplying the medication and service is to sell as much as possible. We all know how that ended for Cerebral.

Lilly insists they are actively working to make sure this doesn’t happen and that the providers on the FORM platform can’t tell if a patient is coming from the LillyDirect portal. The providers are also free to prescribe any other medications (even if they aren’t Lilly’s medications). These sound like famous last words to me, but let’s see.

If you’re the CEO of Ro or any of the other companies that rely on selling GLP-1s direct-to-consumer, you’re kind of sweating right now. At the end of the day, the model of being a GLP-1 dispenser isn’t a strong moat, and companies will ultimately have to compete on a combination of marketing and customer experience. We see this in other parts of consumer technology (e.g. Dropbox vs Box vs Google Drive for cloud storage), and the worry for these companies is that while other GLP-1 suppliers exist, Lilly is a major source and well-positioned to build this kind of business. There is of course the core competency argument to be made here, and Lilly may solve that by acquiring one of the players if they can’t succeed with their product.

Apart from other companies, patients are the key consideration here. Last year, we witnessed firsthand the supply chain problems with GLP-1s. These issues were so severe that Nova Nordisk had to make real-time adjustments and reevaluate their strategy for the European market. I personally had many patients with diabetes who couldn’t get access to various GLP-1s because multiple pharmacies didn’t have them in stock. These things are often overlooked when we think about these medications as consumer products. However, not being able to get your GLP-1 if you’re someone with diabetes has a much greater impact on your life than not being able to get your hands on a PS5 due to a semiconductor chip shortage. This is a critical issue that requires careful consideration, especially with the potential increase in direct-to-consumer medications.

I’m both excited and worried to see how this new service from Lilly pans out. I doubt it will upturn how things are done and I think there will still be a place for other weight management companies (though their models may have to become a bit more sophisticated). I just hope that with all of this innovation, we don’t lose sight of the patients we are building it all for.