Durbin, Sanders, Warren, Welch Release Investigative Report On Pharma's New Direct-To-Consumer Telehealth Platforms
The nine-month investigation reveals new findings and raises questions about potential inappropriate prescribing, conflicts of interest, and the quality of care provided to patients
WASHINGTON – Today, U.S. Senate Democratic Whip Dick Durbin (D-IL) along with U.S. Senators Bernie Sanders (I-VT), Elizabeth Warren (D-MA), and Peter Welch (D-VT) released an investigative report titled “Big Pharma’s New Sales Scheme: Expanding Patient Access or a Virtual Pill Mill? A Direct-To-Consumer Telehealth Platform Investigation.”
Over the past nine months, the Senate offices have investigated new telehealth platforms launched by pharmaceutical manufacturers Pfizer and Eli Lilly with telehealth companies they have paid: Populus, UpScriptHealth, Form Health, Cove, and 9amHealth. These novel relationships between drug companies seeking to sell their medications, and the telehealth companies hand-picked by these pharmaceutical giants, appear intended to steer patients toward particular medications. As the pharmaceutical industry floods the airwaves with commercials to increase demand for high-cost medications, these new telehealth platforms appear intended to churn out prescriptions to patients with just a few clicks online.
“Sick of advertisements urging you to ‘ask your doctor’? It gets worse. Big Pharma’s newest sales scheme funnels patients to telehealth companies chosen and paid by the drug companies, seeking to influence prescription pads,” said Durbin. “Our findings shine a light on potential conflicts of interest and inappropriate prescribing that can balloon health care spending and lead to inferior care for patients. With these revelations, we must crack down on Big Pharma’s latest ploy to promote and sell expensive medications at the expense of patients and taxpayers.”
“Big Pharma continues to use shady tactics to squeeze patients and line its own pockets. While we’re working to lower costs for families, these giant companies seem to be propping up new telehealth platforms just to push their own drugs on patients who might not even need them. We need to hold Big Pharma accountable and stop this abuse of power,” said Warren.
“Telehealth is a powerful tool in medicine, but consumers deserve telehealth services that put the care of the patient before drugmakers’ profits. Big Pharma’s marketing executives shouldn’t be influencing medical care—whether provided in the doctor’s office or online,” said Welch.
In October 2024, the Senators sent a letter to the CEOs of Pfizer and Eli Lilly in October demanding answers about the pharmaceutical companies’ recent move to establish new DTC telehealth platforms. Following that letter, in March 2025, the Senators sent letters to five telehealth companies that have held contracts with Pfizer and Eli Lilly, inquiring about their financial relationships and possible influence on prescriptions for medications from those two pharmaceutical manufacturers.
Telehealth can help to address barriers to care for patients, especially with under-treated diseases. But absent comprehensive services that ensure a thorough evaluation and follow-up, and with a direct linkage to a pharmaceutical company’s profit motives, high-quality telehealth and its access for patients can be undermined.
Key findings and takeaways from the Senators’ report include:
- High rate of prescriptions issued. Of patients routed by LillyDirect who visited a tele-provider, 74 percent received a prescription—including 100 percent of the patients who had a virtual visit with Cove. Further, it was revealed by the telehealth companies that a 9amHealth patient was six-times more likely to be prescribed an Eli Lilly medication compared to another brand-name drug, and 66 percent of all Form Health prescriptions issued across all patients were for Eli Lilly medications.
- Of patients routed by PfizerForAll who visited a tele-provider with UpScript, 85 percent received a prescription.
- Cursory Appointments. The telehealth appointments do not always have to be conducted by video, meaning providers may be prescribing Pfizer and Eli Lilly drugs without laying eyes on a patient.
- UpScriptHealth, one of Pfizer’s telehealth platforms, advertised a job opening to prescribers with the statement, “on average, providers can complete 6-10 visits an hour” saying “a completed visit is either an approval or denial of prescription request.”
- Patients can choose the drug they need. Eli Lilly’s telehealth partner Cove allows patients to pre-select which medication they seek to obtain prior to any consultation with a provider.
- Opportunities to persuade these providers in other avenues. Despite no overt incentives or bonus payments from Pfizer and Eli Lilly to induce prescribing, pharmaceutical companies want individual telehealth prescribers working under these contracts to write prescriptions for Eli Lilly and Pfizer medications. With information from these DTC arrangements, the pharmaceutical companies have the ability to unleash their sales representatives. For example:
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- UpScriptHealth notifies Pfizer of which doctors wrote prescriptions.
- At least two health care providers working for Form Health received a combined 41 payments from Eli Lilly—with one whose most-prescribed medication to Medicare beneficiaries was an Eli Lilly product, resulting in more than $230,000 in Medicare spending in a single year on that drug.
- Eli Lilly made 13 payments to a single provider listed on 9amHealth’s website. Curiously, 9am Health has chosen to dedicate four providers specifically to the Eli Lilly contract.
- The pharmaceutical companies gather extensive patient information. As part of the contract, Eli Lilly receives a transfer from all three telehealth platforms of at least 21 unique data fields with details about patients that are routed to telehealth platforms. This includes details about how many patients receive prescriptions, and the characteristics of such patients, including demographic information, and medication adherence information. In some instances, Pfizer may be able to access the patient’s contact information or the name of the prescribing clinician, as part of these data-sharing arrangements.
- Pharma is willing to invest significant funds in these partnerships. Eli Lilly’s three contract payments to its telehealth partners are valued at $942,500. One telehealth company charges its clients, including Pfizer, anywhere between $510,000 and $2.45 million over the life of the contract.
For a PDF copy of the Senators’ report, click here.
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