Pharma D2C strategy is no longer a fringe consideration. As reimbursement constraints limit patient access to high-demand therapies, and as pricing pressures from policies such as the IRA and MFN executive orders tighten manufacturer margins, the direct-to-consumer channel is becoming a serious commercial and strategic question for pricing and market access teams. GLP-1s have made this tangible: a product category with enormous patient demand, constrained public access, and a rapidly developing ecosystem of manufacturer-owned and third-party D2C platforms.
Market access has traditionally followed a familiar playbook: HTA submission, commercial negotiations, reimbursement recommendation, formulary placement. Although this playbook isn’t going away, a parallel Direct-to-Consumer (D2C) lane is emerging alongside it, and pharma pricing & market access (P&MA) teams need to be paying attention.
Why are GLP-1s the defining case study for pharma D2C strategy?
GLP-1s are a live case study for D2C strategy. In the UK alone, an estimated 2.4 million people are accessing GLP-1s, primarily via the private sector, given the eligibility, commissioning and capacity constraints that limit NHS access. Demand is there, but traditional channels cannot meet it at scale. This is where D2C models, with online platforms and digital pharmacies, have stepped in to serve patients willing to self-pay.
The pricing dimension of this shift is significant and often underestimated. When patients purchase directly, manufacturers are setting prices outside the reimbursed channel, which creates both commercial opportunity and strategic risk. Self-pay prices that diverge materially from reimbursed net prices can attract scrutiny from payers, generate international reference pricing exposure, and complicate future negotiations. Getting the D2C price point right requires a clear view of where it sits relative to existing access agreements, what signals it sends to health technology assessment bodies, and how it is likely to be interpreted across different markets.
Understanding how D2C prices sit relative to your reimbursed channel across markets.
GPI Pulse gives pricing and market access teams real-time visibility across global pricing data and IRP exposure signals, so you can see how a D2C price corridor is likely to land before you set it.
What does manufacturer-led D2C look like in practice?
Manufacturer interest in D2C channels is already visible. LillyDirect® and NovoCare® are established examples, bypassing the traditional intermediaries, combining direct patient access to anti-obesity medications with telehealth services. In an ever-evolving policy landscape of increasing pricing pressures on manufacturers (from IRA to MFN policies), manufacturer interest in D2C is only expected to grow, especially in chronic therapy areas with high patient demand and engagement, like obesity and metabolic health.
The strategic challenge is not whether D2C makes commercial sense for a given asset. In categories with strong patient demand and constrained reimbursed access, it increasingly does. The harder question is how D2C fits within the broader pricing and market access architecture. Volume assumptions, patient segmentation, and channel sequencing all affect the commercial case. And the knock-on effects on payer relationships, formulary positioning, and long-term negotiation leverage need to be worked through before a D2C pathway is committed to, not after.
What does a D2C channel mean for pricing and market access strategy?
Ultimately, the implication for P&MA teams is clear: treating D2C as an afterthought or a standalone decision is no longer a viable option. This raises complex questions for the team:
- Under which circumstances does D2C make most commercial and strategic sense? How does it fit within the broader asset strategy?
- How can D2C be a financially viable and durable commercialization pathway? How should price levels be set without increasing risk elsewhere?
- How can D2C coexist with traditional access channels, and what are the potential knock-on effects on price, volume and stakeholder relationships?
- How should D2C offerings be designed to align with the patient journey?
These questions do not have universal answers. The right approach to D2C depends on the therapy area, the competitive landscape, the regulatory environment in each market, and the existing access agreements already in place. What they share is a need for the same analytical rigour applied to conventional market access decisions: scenario modelling, price corridor analysis, and a clear view of where a D2C channel creates value without eroding it elsewhere.
How GPI supports pharma D2C strategy
At GPI, we help clients work through these questions, navigating D2C as an integrated part of their P&MA strategy.
Get in touch if this is on your radar.
FAQs
A: A pharma D2C model allows manufacturers to sell or distribute medicines directly to patients, bypassing traditional intermediaries such as pharmacy benefit managers, wholesalers, or health system formularies. Examples include LillyDirect and NovoCare, which combine direct medication access with telehealth services. D2C models are most prevalent in therapy areas where patient demand is high but reimbursed access is constrained, such as GLP-1 anti-obesity medications.
A: D2C pricing operates outside the reimbursed channel, which creates both opportunity and risk. Self-pay price points need to be set with reference to existing net prices, reimbursement agreements, and international reference pricing exposure. If D2C prices diverge significantly from reimbursed net prices, they can attract payer scrutiny, affect future negotiations, and create unintended signals for HTA bodies in other markets. Integrating D2C into the broader pricing and market access strategy is essential to manage these risks.
A: D2C models are most commercially viable in therapy areas with high patient demand, strong patient engagement, and situations where reimbursed access is constrained by eligibility criteria, capacity, or commissioning limitations. Obesity and metabolic health, driven largely by GLP-1 adoption, represent the clearest current example. As pricing pressures from policies such as the IRA and MFN executive orders intensify, manufacturer interest in D2C is expected to grow in other chronic therapy areas with similar demand characteristics.
D2C is on the agenda for more P&MA teams than are talking about it publicly
Whether you are in early-stage scenario planning or actively evaluating a D2C channel for a specific asset, GPI can help you work through the pricing, IRP, and access implications with the same rigour applied to conventional reimbursement strategy.
