Telehealth Firms That Partner With Big Pharma Prescribe More Drugs, U.S. Senate Report Shows

Telehealth firms that partner with pharmaceutical companies prescribe more medications and their physicians are more likely to receive inappropriate financial incentives from pharma companies, according to a U.S. Senate investigation.

The investigation focused on websites launched by drug companies that refer patients to hand-selected telehealth companies that can prescribe their medications.

These relationships have “drawn criticism from consumer advocates and lawmakers who fear patients are being pushed to buy expensive and unnecessary medication,” according to The Washington Post.

The Senate’s report, published last week, followed a nine-month investigation led by Sens. Dick Durbin (D-Ill.), Bernie Sanders (I-Vt.), Elizabeth Warren (D-Mass.) and Peter Welch (D-Vt.).

Most patients who used new telehealth platforms launched by pharmaceutical manufacturers were given a prescription, frequently for drugs offered by the same pharmaceutical company, according to the report.

“At best, these relationships raise questions about conflicts of interest. At worst, they create the potential for inappropriate prescribing that can unnecessarily increase spending for federal health care programs,” the report stated.

The report focused on two direct-to-consumer platforms, PfizerForAll and LillyDirect, which partner with telehealth firms.

According to the report, “drug companies are now advertising a drug and linking a patient to a doctor — ostensibly chosen by the drug company — who can write a prescription for it,” while “glossing over the comprehensive evaluation necessary for high-quality patient care.”

In statements published by the Post, Eli Lilly and Pfizer denied their platforms incentivized telehealth firms or physicians to prescribe their drugs.

Eli Lilly said LillyDirect offers “patients educational materials, the option to connect with independent telehealth platforms or in-person care, and convenient home delivery of certain FDA-approved Lilly medications.”

Pfizer said its agreements with telehealth services are “structured to ensure clinicians can make their own independent decisions regarding patient care, including any therapies they may prescribe.”

“If telemedicine platforms are driven by pharmaceutical incentives, the risk of overprescribing drugs skyrockets, turning healthcare into a quick prescription mill,” Dr. Michelle Perro, a pediatrician, told The Defender.

In a statement cited by Fierce Pharma, Warren said:

“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.”

Report criticizes ‘cursory’ telehealth visits

The Senate report found that a high percentage of patients routed to telehealth providers through PfizerForAll or LillyDirect were given a prescription — 85% and 74%, respectively.

The report cited the example of telehealth provider 9amHealth, which collaborates with LillyDirect. Nearly 83% of LillyDirect patients referred to 9amHealth were issued prescriptions, compared to 39% of 9amHealth’s patients overall.

LillyDirect users who saw a 9amHealth doctor were six times more likely to be prescribed an Eli Lilly drug, while 66% of all prescriptions issued by Eli Lilly partner Form Health were for Eli Lilly drugs.

Eighty-five percent of patients who conducted a telehealth visit through Pfizer-linked UpScriptHealth received a prescription.

The report suggests patients accessing PfizerForAll or LillyDirect may believe they could receive a prescription for an Eli Lilly or Pfizer drug “with just a few clicks.” The report noted that telehealth firms Populus Health Technologies and LillyDirect-linked Cove let patients preselect the drug they want to receive even before meeting with a physician.

The report also suggested many of the appointments booked with telehealth firms linked to PfizerForAll or LillyDirect were “cursory.” Many of the appointments did not require video, “meaning providers may be prescribing Pfizer and Eli Lilly drugs without laying eyes on a patient.” Also, patients were usually asked to complete a questionnaire instead of providing full medical records.

Physicians at risk of being entangled in kickback schemes, report says

The investigation also found pharmaceutical companies incentivized physicians to prescribe their own drugs. According to the report, the companies “want individual telehealth prescribers working under these contracts to write prescriptions for Eli Lilly and Pfizer medications.”

Although the report did not provide concrete examples, it suggested some incentives were financial.

In a statement cited by Fierce Pharma, Durbin said:

“Big Pharma’s newest sales scheme funnels patients to telehealth companies chosen and paid by the drug companies, seeking to influence prescription pads … 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.”

According to the report, there may be a link between physicians who received payments from Big Pharma companies and doctors who appear in the search results on platforms like LillyDirect.

The report also suggested that pharma companies collected patient data through their telehealth partners, that telehealth companies share physicians’ names with their pharma partners, and that some telehealth companies also informed physicians when a patient was routed to them through LillyDirect or PfizerForAll.

The report states the physicians in question are at risk of becoming entangled in kickback schemes to issue prescriptions for medically unnecessary medications.

However, the report noted that the collaboration between pharma companies and telehealth firms has not resulted in a large number of new customers for the latter.

According to the Post, Danish pharmaceutical company Novo Nordisk recently ended its partnership with telehealth company Hims & Hers Health. Hims & Hers sold its own weight-loss drug, which Novo Nordisk felt competed with its drug, Wegovy.

Some experts say allowing patients to obtain drugs directly from the drugmaker makes it easier for drug companies to target patients without regard for whether their drug is the right one for that patient.

Pediatric telehealth services not addressed in report

The Senate report did not specify potential next steps in the investigation or clarify whether the companies in question would face penalties.

The report also did not specifically address pediatric care, though the size of the U.S. pediatric telehealth market was estimated at $9.4 billion in 2024, with strong growth expected through the end of the decade.

In 2023, 14.2% of U.S. children had used telehealth services in the previous 12 months, down from 18.3% in 2021, according to a 2024 Centers for Disease Control and Prevention report.

The use of such services declined across all age groups but was consistently highest among adolescents.

According to a 2024 study published in the journal Healthcare, 15.3% of U.S. children in a nationwide sample had used telehealth services due to COVID-19 in 2020, while 3.7% of children had telehealth visits for “other health reasons.”

A study published in Telemedicine and e-Health found that in the first quarter of 2021, telemedicine visits accounted for 9.5% of all pediatric ambulatory encounters. From these, only 7.5% of visits led to an in-person follow-up within three days.

According to a study published in 2023 in the Journal of Medical Internet Research that surveyed 1,206 U.S. parents of children ages 17 and younger, 27.8% of children had been to a primary care telehealth visit in the prior year.

Children with chronic medical conditions were more likely to use telehealth compared to those without chronic conditions, while 8% of children had a mental health televisit.

Telehealth services are becoming increasingly common among pediatricians, according to the American Academy of Pediatrics (AAP).

A 2023 AAP study found 78% of primary care pediatricians used telehealth in the past month, with 91% using them for sick visits, 85% for mental health visits and 71% for chronic disease visits.

According to the same study, 55% of physicians surveyed rated telehealth as “very” or “moderately” effective. Effectiveness was ranked highest for visits relating to mental health and chronic disease.

A study published in 2021 in the journal Clinical Pediatrics, and based on a sample of 767 pediatric telemedicine visits among underserved populations, found 62% were for “acute concerns,” such as rashes or coughing, and 38% were for “chronic concerns” — primarily mental health.

According to the same study, caregivers indicated that chronic patients were more likely to turn to in-person care if telehealth visits were not available.

Other studies showed that a minority of U.S. pediatricians (25.9%) had provided telehealth services as of 2019, but such offerings surged in the early stages of the COVID-19 pandemic before leveling off or declining in some medical specialties.

This article was funded by critical thinkers like you.

The Defender is 100% reader-supported. No corporate sponsors. No paywalls. Our writers and editors rely on you to fund stories like this that mainstream media won’t write.

Please Donate Today

‘Children deserve thoughtful, hands-on care’

Studies have shown pediatric telehealth services lead to lower medication prescribing rates than in-person visits, with one exception: antibiotics in direct-to-consumer telehealth settings, such as PfizerForAll and LillyDirect.

According to a 2024 study in JAMA Health Forum, 29.5% of video visits and 27.3% of telephone visits resulted in a prescription for medication, compared to 39.8% of in-person visits.

But according to a 2019 study published in Pediatrics, antibiotic prescription rates among direct-to-consumer telehealth services were higher (52%) than for urgent care services (42%) and in-person visits with primary care physicians (31%).

Some medical experts said telehealth providers, particularly when connected to Big Pharma companies, are incentivized to prescribe medications at higher rates.

Notably, the AAP boasts funding from several major pharmaceutical companies, including Eli Lilly, GSK, Merck, Moderna and Sanofi. Earlier this month, the AAP was one of six medical organizations that sued U.S. Health Secretary Robert F. Kennedy Jr. over recent changes to COVID-19 vaccine recommendations for children and pregnant women.

Cardiologist Dr. Peter McCullough suggested telehealth services that collaborate with Big Pharma companies are prone to conflicts of interest. There is a growing number of “cash-based telemedicine services” that are “free of both insurance and Big Pharma conflicts of interest,” he said.

“Many are gravitating to this affordable, efficient and high-quality healthcare,” McCullough said.

Perro said that, despite the growth in telehealth use in recent years, it cannot replace in-person pediatric medical visits. She called upon parents to “resist the temptation to succumb to the ease of telemedicine.” She added:

“Telehealth is valuable, but when pediatric care becomes dominated by virtual visits, we lose the subtle clinical observations that are crucial for accurate assessments and treatment. The physical examination is a key component to the medical visit. These visits will morph into AI-dominated healthcare.

“Children deserve thoughtful, hands-on care, not a profit-driven model where Big Pharma influences how and what we prescribe through a screen. We are modeling healthcare behaviors for children through the internet and normalizing online health visits.”

• Eli Lilly’s New Telehealth Platform Puts Weight-Loss Drug Patients at Risk, Experts Say
• RFK Jr. Hit With Lawsuit Over Changes to COVID Vaccine Policies for Kids, Pregnant Women
• RFK Jr.: MAHA Report a ‘Clarion Call’ to End the Chronic Disease Epidemic
• ‘True Corruption’: Agency Capture Responsible for Chronic Disease Epidemic in U.S.
• Children’s Long-Term Mental Health at Risk From COVID-19-related Stress, Experts Warn