Well, Zach and Wendy, great to have you here. Both of your companies are in the center of the biggest shift in drug distribution in a generation, I would say. Zach, you just launched the Wegovy pill on Ro and added Eli Lilly's oral GLP-1 to your formulary. You've said that GLP-1s are serving as a foil for all the flaws in our health care system. Can you walk us through what you mean by that?
Yeah, absolutely. We did just launch both of those and they've been tremendous for patients. When you think about GLP-1s, I think the incredibly rare part about them is that they satisfy like five criteria we've never before seen for any drug before, right? And that has a very powerful cascading effect. The majority of the US population is eligible for these drugs. The majority of the population either has overweight or obesity. Patients want them, providers want them, they're incredibly effective, and they're scalable. And so that's never happened before. And what is the impact that that has to your point in terms of it being a foil and shedding a light on all of the flaws? Well, two years ago, these drugs were $1,300. There's one or two of them moderately covered by insurance, even the minority, and they're pretty inaccessible for people. Fast forward two years later, because of those five things, because the majority of the population wanted them, providers wanted them for people to have them, they were upstream of the leading causes of death that we face. That put a tremendous amount of pressure. And the result was well, pharma went direct, right? And what happened after that? Well, you saw a lot of price competition. There was no law that forced price transparency, it just naturally happened. That list-to-net gap that people have been fighting to remove for decades magically disappeared and we're asking the questions of why does my employer get to dictate what health insurance or health coverage or drugs are covered. And so when you think about it from a society's perspective, when we have this really centralized massive problem and there's enough pressure, which I think we saw with COVID, with telemedicine, it really did take an international virus for us to be able to sit here and say maybe you should be able to text your doctor. It's the same thing that I think is happening now with GLP-1s where because the majority of the people benefit, they're all knocking at the same door in different ways and it's really highlighting all of the fundamental flaws in our healthcare system, I think.
Actually, I want to talk about a problem that both of you have acknowledged, which is almost a billion prescriptions are left at the pharmacy counter each year still because of affordability. That's a lot. You're both trying to solve that problem. Wendy, why aren't we solving that problem faster? What needs to happen?
Yeah. Well, I think look, systemically part of the reason we're not solving that is just price. It's unaffordability and so they get left at the counter. So you've got a prescriber who goes through the mass machinations to see you to write a prescription for you and then ultimately you're standing at the counter and you're surprised when you get there. So the experience isn't necessarily a digitally integrated one outside of what some of our companies that are here, both GoodRx, Ro and others, are integrating such that on your phone you automatically know your combination of insurance and/or cash, which one is going to be more favorable and then seamlessly can go pay for it at the pharmacy counter and then also not have a switcheroo at the pharmacy counter. But I think more so is just the combination that have been the forces pushing back on manufacturers such that their interest in providing a competitive cash price to the consumer has been a bit thwarted by payers. They feel as though they will be punished if they're not going to push through a rebate model to be on formulary with a payer. The alternative, and I will give this administration credit as well as the bipartisan forces behind it to push on direct-to-consumer pricing, has not been better modeled than what has just happened with GLP-1s. His comment on those original prices. That is what ultimately led to Lilly standing up a direct program because they said we want to be able to get it in consumers' hands faster and platforms such as ours that said launch your oral formulations with a cash price, don't go through the funded mechanism. These channels can work for consumers in much the same way that you and I get consumer goods for everything else. And there's absolutely no reason that for our drug acquisition and the way we consume and get them, it shouldn't function as seamlessly as any CPG item that we buy online. And that continues to be the aim and that's how we start to influence what's continuing to be unfilled.
So TrumpRx, your company is powering the infrastructure behind it. But of course critics have pointed out that this routes patients to discounts that existed that you guys offered. Is TrumpRx a genuine policy innovation or is it a government-branded marketing campaign for GoodRx?
Well, look, I will say that TrumpRx was not our idea. That was the administration's idea. And what I will say very clearly is anything that gets lower prices into Americans' hands, I support. I will applaud that. As to whether or not they mirrored prices we already have, I would suggest you direct that question perhaps to someone inside HHS. But what I will say is if it's a duplicative platform by which these competitive prices are accessible for you and me, I'm fine with that. I'm very comfortable with that.
Both your models depend heavily on partnerships with pharmaceutical manufacturers, which creates a question about independence. When a manufacturer is your partner and your revenue source, Zach, how do you make sure the patient's interest still comes first?
Yeah, I think that it's I want to add on the TrumpRx part, but in this part, I think it's no different than right now when someone goes to the doctor's office and they go to the pharmacy. We've just reduced such a tremendous amount of friction and then seamlessly integrated that. So, I think there's this myth when someone goes to Ro that they're not interacting with the doctor. The doctor's making that decision and they're determining with them and the patient what's best and then it's just much more affordable and seamless. We're using the power of the internet and as Wendy mentioned, when we announced that the Wegovy pill launched on Ro, there were two companies in that announcement. When we announced Lilly's Zepbound launched on Ro, there were two companies. There wasn't an insurance company, wasn't a PBM. There were far fewer and so we removed middlemen, the classic thing that people have been trying to do for decades in healthcare, remove middlemen, pass those savings on to patients. And I think the reason we've been able to successfully integrate with multiple pharma companies unlike many of our peers, the reason is it's very clear that we do not put our thumb on the scale in any way, but we actually just empower patients to find what option is best for them. That's why we're the leading provider of branded GLP-1s in the entire country. It's why we have both pharma products on our platform. Patients come, they can see what's best for them and then they and their provider figure out what's best and then we facilitate the seamless delivery and ongoing care of that.
But I want to push you on that just a little bit because I know Ro declined to add ADHD medications to your platform. So you said it would compromise patient safety. But you're now offering GLP-1s which you know is a powerful drug with side effects. How do you decide where that line is? I know that the clinical guidelines aren't always clear. It goes state by state but how do you think about that?
I do think controlled substances well, all drugs have side effects. They have risks and benefits. I think controlled substances and GLP-1s are two like personally I think those are wildly different categories. And then I think how we make that decision, we don't. So there's an independent medical practice. They determine what they think is safe and appropriate to be treated via telemedicine and then we build the technology and tools to empower them. I think the best part about direct-to-consumer that you talked about is there were companies that tried to take advantage of patients in those scenarios and I think people often talk about they'll point to and there have been recent cases of this, they'll point to consumer companies and say look at direct-to-consumer failing and what I would say is I actually think the best disinfectant is more and more sunlight in consumer. I don't think you see any bad actors rooted out faster in healthcare than when it's consumer. How long did it take Purdue Pharma to be held responsible versus any single time a digital healthcare company steps out of line for more than a couple months, it's on the cover of the New York Times and it gets acted on very very quickly. So, I'd say the two things there to me are one, we aren't making that decision. Doctors are, we're building the technology to it. And then two, I do think GLP-1s, I mean I'm quite biased, but I think people have a broad misunderstanding of these drugs. They're not just approved for diabetes and obesity, but diabetes, obesity, heart disease, sleep apnea, kidney disease, chronic liver disease. And they're being studied for substance use disorder, neurogenerative disease, pain management. That's pretty much the leading causes of death. And that's very different in my mind than ADHD medication, which is a very serious condition that many, many people have, but I think wildly different when thinking about offering it via digital health.
