The backend infrastructure built by compound pharmacies to serve telehealth giants like Hims and Ro is now mature. This creates an opportunity for new brands to quickly launch and ship prescription products, effectively using these pharmacies as a platform for regulated health and wellness DTC.

Despite its first-mover advantage, Novo Nordisk lost its lead in the weight-loss drug market by failing to recognize its consumer-driven nature. While it planned a traditional pharma launch, competitor Eli Lilly adopted a direct-to-consumer model, treating the drug like an e-commerce product and capturing the market.

The GLP-1 drug revolution is moving beyond weekly injections for wealthy markets. Upcoming pill-form versions will eliminate the need for refrigerated supply chains, opening up distribution in developing countries. Combined with expiring patents, this focus on form factor and cost will enable mass global adoption.

The two pharma giants are competing aggressively in the direct-to-consumer channel. They're cutting prices on their GLP-1 drugs, anticipating that lower costs will drive significantly higher volume and sales in the long run, even if it hurts short-term revenue forecasts.

Eli Lilly and Novo Nordisk's DTC programs for weight loss drugs give employers an alternative to point employees towards, providing cover to drop expensive insurance coverage and potentially reducing access for patients who rely on it.

Novo priced the maintenance dose of its oral Wegovy pill far lower than anticipated. This aggressive strategy, costing less than the average U.S. monthly grocery bill (~$400), is a direct attempt to regain momentum from rival Eli Lilly and expand the self-pay market before more oral competitors launch.

To solve the insulin price bubble, Eli Lilly launched its own low-list-price biosimilar. However, insurers and PBMs initially refused to cover it because its low price and small rebate threatened their lucrative business model.

The agreement between the Trump administration and pharma on Mounjaro/Ozempic pricing ratified a new "large market, medium price" benchmark. This fundamentally expands the industry's total addressable market beyond the old "small market, high price" model for rare diseases, suggesting a major long-term growth driver.

The launch of Novo Nordisk's oral GLP-1 pill via platforms like Ro marks a pivotal shift in pharma distribution. It's the first time a drug of this scale has launched nationwide with a direct-to-consumer model, enabling patients to go from seeing an ad to receiving a prescription in under 48 hours.