HealthDyne executives make the case for direct-to-patient drug sales | Asembia AXS26 Summit

It’s not a silver bullet; there is never a silver bullet. But direct-to-patient drug sales can help make precription drugs, even specialty drugs, far more affordable, argue HealthDyne’s David Skomo and Sarah Thomas

“It’s not the end solution, by far, but they [direct-to-patient models] are laying a really good foundation that delivers on the promise of affordability and transparency in ways that the traditional system has not yet achieved and maybe will not achieve,” Skomo said in an interview with Managed Healthcare Executive (MHE).

“Foundationally, does it solve affordability? No one thing is going to solve affordability, right?” added Thomas. “I do think this is an important component of giving patients choice, allowing them to have access to price points that they would not have had access to without this channel existing and haven't historically been able to achieve.”

Skomo, chief operating officer for HealthDyne, and Thomas, head of growth and commercialization, led a session today about affordability and direct-to-patient drug sales at the Asembia AXS26 Summit, a specialty pharmacy meeting in Las Vegas.

HealthDyne, a pharmacy technology and distribution company that distributes specialty drugs from pharmacies in Lakeland, Florida, and Centennial, Colorado, announced in January that it will be a dispensing pharmacy for certain Eli Lilly medicines. In March, Lilly announced the launch of Lilly Employer Direct, a version of direct-to-patient sales that is configured as a benefit that employers can offer alongside other drug coverage managed by traditional pharmacy benefit manager. The Lilly announcement about the employer program said that HealthDyne and CenterWell will be its dispensing pharmacies.

In an interview with MHE, Skomo and Thomas discussed the relevance of direct-to-patient drug distribution to specialty medications and how employers might be involved in direct-to-patient drug sales.

So far, the glucagon-like peptide 1 (GLP-1) drugs are the success stories of direct-to-consumer drug sales. Thomas acknowledged that the higher prices of specialty drugs make direct-to-patient distribution and sales more “nuanced.”

“I don't think it's necessarily ever going to be a high volume channel, but if you have patient populations that are really trying to get access to a therapy — maybe their PBM doesn't cover the drug that works really well for them — being able to have a price point that is more palatable than the list price and is more transparent and outside of the benefit structure is absolutely a value-add to patients who are trying to get access to therapy,” Thomas said.

Thomas continued, “I don't know that it replaces, as a specialty manufacturer, your go-to market strategy around payer coverage and other channels. And as you get into the million-dollar therapies, even PBMs, they're struggling with those, right? So I think it's an ‘and.’”

Skomo said that direct-to-patients can work with employer-based health benefit by pairing direct-to-patient distribution and prices with health reimbursement arrangements (HRA). HRAs, which are sometimes called health reimbursement accounts, are tax-advantaged accounts that employers fund and that employees use for healthcare expenses. Skomo said that HRAs give employers more control than the health savings accounts that are commonly part of high-deductible health coverage.

Thomas and Skomo spoke about the advantages of direct-to-patient sales and distribution for drugmakers.

“It can help convert those employer dollars into guaranteed therapy starts, reduce that abandonment that manufacturers so often see even more acutely with the specialty therapies,” Skomo said.