The news: Roche is considering a direct-to-consumer (D2C) sales channel for its prescription drugs, CEO Thomas Schinecker said in its Q2 earnings call.

Roche has discussed the prospect of a D2C model with US government officials, positing it as a way to skirt pharmacy benefits managers (PBMs) that “take more than 50% of the profitability,” Schinecker said per a MarketScreener transcript.

Zooming out: The Roche discussions follow new D2C efforts by Pfizer, Eli Lilly, Novo Nordisk, and Bristol Myers Squibb. It also follows a President Trump executive order directing the HHS to come up with a plan to help Americans buy their drugs directly from manufacturers.

• Lilly launched LillyDirect D2C in January 2024 for obesity, diabetes, and migraine medicines. Its self-pay pharmacy now offers its Zepbound weight loss drug at a steep discount of $499, more than 50% lower than its $1,086 per month list price.
• Pfizer’s D2C platform PfizerForAll debuted in August with an emphasis on simplifying Rx management and support for its migraine and menopause medicines, and COVID-19, flu, pneumococcal pneumonia, and RSV vaccines.
• Novo Nordisk added a D2C option in May with NovoCare Pharmacy for weight loss med Wegovy. Its current $299 first-month offer for cash pay is four times cheaper than the Wegovy list price of $1,349.
• Pfizer and Bristol Myers Squibb will launch an online D2C channel in September for cash-pay patients on its blood thinner Elquis at a lowered $346 per month, 43% below its $606 list price.

Why it matters: President Trump has made repeated moves to force pharma to lower prices. He’s tried tariff threats, stricter pharma advertising regulation warnings, and an executive order to equalize US drug prices with the global market with few gains to date.

Pharma companies may see direct sales as a dual win that skirts PBMs profit take, as Roche’s CEO noted, but also earns brownie points with Trump.

Our take: The complex US healthcare PBM and insurance system can’t easily flip to a pure-play D2C prescription sales market. However, we think it will become a reliable channel, especially for underinsured and uninsured patients. Pharma marketers can court them with special pricing deals, a la Lilly and Novo, but ensure they stay on the right side of regulators.

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