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INFLECTION POINT/ The Pharm-to-Table Evolution Continues, Showcasing Demand for a Consumer-First Approach to Care
It’s officially spring, which makes me want to lead the newsletter today with an extended pharm-to-table metaphor about how the industry is sowing the seeds of a more customer-centric approach to health care, etc.
But I should probably just get to the news: Novo Nordisk is linking up with three telehealth firms — Ro, Hims & Hers, and LifeMD — to sell cash-pay Wegovy. That’s not particularly surprising — Lilly already struck a similars deal with LifeMD and Ro — but it does suggest there is a roadmap for both pharma companies and telehealth firms.
There’s a ton of coverage, but not a lot to it beyond the news that everyone’s stock is up on the announcements.
Two elements of the deal caught my eye.
First, this presumably eliminates one of the bigger limits of Novo’s pharm-to-table approach. Because Novo’s cash pay approach had previously been implemented through a patient savings card, those with government-sponsored insurance couldn’t take advantage.
It sounds like if you go through the telehealth partners to access that price, that won’t be an issue. (I’m not certain on that point, but I can’t find any fine print in any of the press releases or on the telehealth sites to suggest limits.)
The second is the nature of this particular price war. The Novo/Hims deal makes all doses of its pens available for $599 a month, which is inclusive of the Hims telehealth services. Lilly’s cash-pay meds come in vials and start at a lower price point ($349), with Ro’s service ($145) extra. I assume that’s the same deal for Ro+Wegovy. LifeMD’s service looks like it runs $75 a month on top of the med price.
What’s striking here is that the Hims/Ro/LifeMD wrapper is not strictly needed. Both medicines have cash-pay prices that can be accessed without the third-party rigamarole. And yet there’s demand for having the telehealth layer on top of the medicine itself.
That’s notable, and it gets back to one of the foundational concepts behind pharm-to-table: the assumption that patients are willing to pay extra for a health care experience that just works.
Indeed, if there is any lesson from the Hims/Ro corporate arcs, it’s that patients will pay non-commodity prices for generic medicines if they can get what they need in an easy-to-use environment.
The revolutionary nature of that insight has generally been overlooked, but the continued evolution of the branded pharm-to-table phenomenon is making that reality harder and harder to ignore.
QUICK TURNS/ Mostly Tariff Stuff, Sorry (Though I Have Hidden a 340B Item Below, Too)
There is a lot of tariff stuff you could read this morning, though I don’t know how insightful any of it is. This Endpoints piece gets at Novartis and AstraZeneca’s approach to tariffs. The topic will come up on Pfizer’s earnings call today, no doubt. Here’s the Wall Street Journal editorial board inveighing against pharma levies. There are probably others. I have my limits.
The best link to click on the topic is David Wainer’s deep look at the intersection between tax-management strategies — especially the practice of putting IP in the hands of overseas subsidiaries — and tariffs. Turns out if that companies with aggressive tax approaches are most at risk from tariffs, and vice versa. (Ed Silverman touched on this a couple of weeks ago.)
Gilead and Vertex are cited as examples of companies that seem to be escaping the worst of the tariff headwinds as a result, though you could make the argument that the two companies also have the two most interesting drug launches of 2025, so there is some confounding there.
ELSEWHERE:
Sandoz CEO Richard Saynor threw some shade at the Financial Times letter from Novartis and AstraZeneca last week. That letter suggested that Europe needed to get its act together on prices, lest access continue to suffer, which Saynor said was the wrong approach. (He also said he thought that the United States would find a way to lower prices.)
This feels like three-dimensional chess, but Endpoints said that a pill penalty fix could end up being linked to a new bill that would remove the tax deduction for drug ads. I feel like it’s trial-balloon season in Washington, so I’m going to try not to get too invested in any particular legislative machinations.
Smart stuff from Shawn Gremminger, the CEO of the National Alliance, on the Cassidy 340B report.
PatientView puts out a survey of thousands of patient advocacy groups each year to assess the reputation of the pharmaceutical industry as a whole and companies specifically. It’s kind of a hard effort to parse because a lot of the groups have financial relationships with industry that are hard to see in aggregate. Still, coverage from STAT of this year’s edition emphasizes a small drop in reputation and flagged data that fingered prices as the culprit.
Speaking of that PatientView report … the survey didn’t only ask about impressions of the biopharma industry. It also polled on opinions on the rest of the health care system. And by that measure, biopharma looks great. Peep the way that insurance companies and PBMs are seen by advocacy groups:
Cost Curve is produced by Reid Strategic, a consultancy that helps companies and organizations in life sciences communicate more clearly and more loudly about issues of value, access, and pricing. We offer a range of services, from strategic planning to tactical execution, designed to shatter the complexity that hampers constructive conversations.
To learn more about how Reid Strategic can help you, email Brian Reid at brian@reidstrategic.com.
