Several pharmaceutical companies have announced plans to sell drugs directly to patients, bypassing traditional intermediaries (wholesalers, pharmaceutical benefit managers, and pharmacies) and their associated markups. This so-called “Pharm-to-Table” movement includes widely prescribed medicines, including apixaban for nonvalvular atrial fibrillation, dapagliflozin for type 2 diabetes, and tirzepatide for obesity.
While the phrase ‘pharm-to-table’ is a lighthearted play on words, the ambition of cash-pay, direct-to-patient portals is similar to those of restaurants that seek to source their meats and vegetables directly from farmers: In both cases, eliminating the middleman creates different economics -- and forges a different kind of relationship -- between producer and end user. A template is emerging among companies that have launched such efforts. Interested patients can visit a website set up by the manufacturer. From there, patients with valid prescriptions are sent to a specific online pharmacy that processes the transaction, charging the patient directly.