The news: Pharma commercialization company Eversana bought digital health tech Waltz Health and is creating direct-to-consumer (D2C) and direct-to-payer models that cut out rebate negotiators, or pharmacy benefit managers (PBMs).
Digging into the details: Eversana wants to facilitate the direct purchase of prescription drugs at a lower-than-list price between manufacturers and buyers, such as employers and insurers. Typically, purchasers buy drugs at full price, but get rebates back later through PBMs.
- Eversana already works with Eli Lilly’s LillyDirect D2C telehealth and pharmacy platform for Lilly’s obesity, diabetes, and migraine medicines.
- Waltz Health founder Mark Thierer, who is now CEO of Eversana, is a former PBM executive. He was CEO of Catamaran, which was bought by UnitedHealth Group in 2015. He then served as CEO of UnitedHealth’s PBM OptumRx for two years.
Why it matters: President Trump is demanding pharma companies adopt D2C distribution models, and bypass PBMs, as one part of his plan to lower US drug prices.
- Lilly, Novo Nordisk and Pfizer already have D2C channels, but others including Roche and AstraZeneca are considering direct sales channels, per recent Q2 earnings calls.