What Is Direct-to-Consumer Pharmacy?
Direct-to-consumer (DTC) pharmacy is one of the newest trends in healthcare delivery. This model, which allows medications to be shipped directly from manufacturers or fulfillment partners to patients, is reshaping how people access treatment — especially in the weight loss space.
DTC pharmacy bypasses traditional retail and mail-order pharmacies. Prescriptions are sent directly from a provider to a manufacturer or third-party fulfillment partner. Telehealth platforms like Hims & Hers, Noom, Ro and Hone are leading the charge, offering integrated virtual consultations, prescribing services and providing medication fulfillment.
While this model improves convenience and adherence ‒ thanks to home delivery and auto-ship options ‒ it also raises safety concerns. Because DTC often bypasses the pharmacy benefit, medications may not be checked for interactions or duplications. For example, a patient could unknowingly take both Wegovy and Rybelsus, not realizing they share the same active ingredient, semaglutide. Additionally, DTC programs often lack utilization management strategies, allowing patients to access medications like Zepbound without prior authorization or clinical review.
Why the Growth?
The DTC surge is a response to the explosion of GLP-1 compounding. With branded medications like Wegovy and Zepbound in high demand, manufacturers are fighting back against unregulated compounded alternatives. Novo Nordisk, for instance, launched public awareness campaigns ‒ “Choose the Real Thing” and “Check Before You Inject” ‒ to educate patients on the risks of counterfeit semaglutide.
As of May 22, 2025, compounding of semaglutide and tirzepatide is no longer permitted unless specific patient needs justify it. However, some compounders are skirting regulations by:
- Adding ingredients like vitamin B12 or glycine to claim the formulation is “customized.”
- Offering micro-dosing strategies, where patients receive smaller, nonstandard doses for maintenance or to reduce side effects.
- Claiming medical necessity, such as allergies to commercial excipients or the need for intermediate strengths not commercially available.
These tactics aim to exploit regulatory exceptions that allow compounding when a significant clinical difference exists between the compounded and commercial product.
Market Shifts and Telehealth Turbulence
Telehealth platforms have played a pivotal role in expanding access. Some platforms still offer branded GLP-1s through partnerships with manufacturers. However, a major shake-up occurred in June: Novo Nordisk terminated its partnership with Hims & Hers after accusing the company of promoting and selling knockoff versions of Wegovy under the guise of personalization. The fallout was swift ‒ Hims & Hers’ stock dropped over 30% as the news broke.
This development underscores the heightened scrutiny around DTC and compounding practices. Novo Nordisk cited patient safety and legal noncompliance as key reasons for the split, reinforcing its stance against mass sales of compounded drugs.
Spotlight on LillyDirect and NovoCare
Two major DTC programs are leading the charge.
LillyDirect offers Zepbound at discounted self-pay prices ($349–$499 depending on dose). Patients receive vials ‒ not pens ‒ requiring self-measurement and injection. Manufacturer coupons are available for those with pharmacy benefit coverage. LillyDirect also partners with lifestyle coaching programs to support long-term success.
NovoCare provides Wegovy in pre-filled pens for easier administration. Pricing is a flat $499/month. The program emphasizes authenticity and safety, steering patients away from compounded alternatives.
Formulary and Coverage Shifts
A major formulary change went into effect July 1: CVS Caremark now excludes Zepbound from its preferred list, favoring Wegovy instead. This could significantly disrupt treatment for members currently using Zepbound. Clients should explore alternatives to avoid gaps in care. For those wishing to continue offering Zepbound, solutions are in development.
CVS pharmacies, in partnership with Novo Nordisk, will offer Wegovy at the same $499/month cash price through the NovoCare program. Meanwhile, Cigna is capping copays at $200/month for covered GLP-1s, helping members manage costs while maintaining benefit integration.
Implications for Employers and Patients
The direct-to-consumer pharmacy model is rapidly transforming how patients access GLP-1 medications, offering convenience and affordability — but not without trade-offs. As compounding restrictions tighten, strategies like micro-dosing and formulation tweaks are emerging to maintain access. Meanwhile, shifting partnerships and formulary exclusions ‒ such as CVS Caremark’s move to drop Zepbound ‒ are creating ripple effects across the market. Staying informed and proactive remains essential for clients navigating this evolving landscape.
References:
- Andrea Park. “‘We Cannot Stay Silent’: Novo Nordisk Flags Dangers of Compounded GLP-1s Following Hims & Hers Super Bowl Ad,” FiercePharma, 2025.
- Staff. “GLP-1 Shortage Ended: Can You Still Legally Prescribe or Compound Semaglutide and Tirzepatide,” Hendershot Cowart P.C., 2025.
- Anne M. Komé. “One Size Does Not Fit All: Understanding Microdosing Semaglutide for Diabetes in Multidose Pens,” American Diabetes Association, 2025.
- Nathaniel Weixel. “Novo Nordisk Ends Partnership With Hims & Hers Over Wegovy Copycats,” MSN, 2025.
- Grace Snelling. “Hims & Hers Stock Plummets After Novo Nordisk Ends Partnership Over ‘Knockoff’ Wegovy,” MSN, 2025.
- Diana Ernst. “Knockoff Wegovy Concerns End Partnership Between Novo Nordisk and Hims & Hers,” MPR, 2025.
- Annika Kim Constantino. “Novo Nordisk Ends Deal with Hims & Hers Over Sales of Wegovy Copycats; HIMS Drops 34%,” CNBC, 2025.
- Mary Cunningham. “Novo Nordisk Halts Wegovy Sales on Hims & Hers, Claiming ‘Deceptive Marketing’ Practices,” CBS News, 2025.
- “LillyDirect Pharmacy,” Eli Lilly and Company, 2025.
- “NovoCare Pharmacy,” Novo Nordisk, 2025.
- “GLP-1 Formulary Information,” CVS Caremark, 2025.
- Chris Morris. “CVS Strikes a Deal to Offer Wegovy at a Discount,” Fortune, 2025.
- Amina Niasse. “Cigna to Offer $200 Wegovy, Zepbound Weight-Loss Benefit,” Reuters, 2025.
