Swiss pharmaceutical giant Roche is exploring a direct-to-consumer sales model for its prescription medicines in the United States, aiming to reduce patient costs amid mounting government pressure on drugmakers to lower prices. CEO Thomas Schinecker announced the consideration during a call with reporters on Thursday, stating that the model could work for all of the company's medicines.
The move comes in response to President Donald Trump's executive order issued in May, which directed drugmakers to align their medicine prices with what other countries pay. Schinecker indicated that Roche is engaged in discussions with the US government as part of this broader industry-wide initiative to address drug pricing concerns.
Industry Trend Toward Direct Sales
Roche's consideration follows recent actions by other major pharmaceutical companies. Last week, Bristol Myers and Pfizer announced they would begin selling their blockbuster blood thinner Eliquis directly to cash-paying US patients at discounted rates. Additionally, Eli Lilly and Novo Nordisk already offer their popular weight-loss drugs Zepbound and Wegovy directly to US patients at rates below the drugs' list prices.
Lucas Montarce, Eli Lilly's chief financial officer, revealed at an industry conference last month that the company had shared implementation details of its direct-to-consumer model with the Trump administration, suggesting coordinated efforts between industry and government.
Bypassing Pharmacy Benefit Managers
The direct-to-consumer approach would circumvent pharmacy benefit managers (PBMs), which currently act as middlemen between drugmakers and consumers. These entities negotiate volume discounts and fees with drugmakers on behalf of employers and health plans, create insurance coverage lists for drugs, and reimburse pharmacies for prescriptions. The current system has faced criticism for inflating costs rather than reducing them.
Schinecker emphasized that implementing a direct-to-consumer model would help lower costs in the US quickly by eliminating pharmacy benefit managers from the equation. This streamlined approach could provide more transparent pricing for patients while reducing administrative complexity.
Viable Drug Categories and Market Appeal
Industry sources indicate that small-molecule drugs dispensed at retail pharmacies represent the most viable candidates for direct-to-consumer sales. These include treatments for diabetes, cardiovascular conditions, and respiratory diseases like asthma, as they are simpler to distribute and price directly compared to complex medicines such as certain cancer drugs that require special handling and injection.
The model's appeal extends beyond uninsured or under-insured patients to include those with insurance coverage. Industry sources explain that insured patients would compare the cost of accessing drugs through their insurers with direct cash prices. For instance, if a patient pays $20 to an insurer for a drug with a $100 list price, a direct-to-consumer offer would need to beat that $20 cost to be attractive.
Strategic Preparations and Investment
Beyond pricing strategies, Roche has taken steps to prepare for potential market disruptions. Schinecker revealed that the company has increased inventories to avoid potential disruptions from tariffs, demonstrating proactive supply chain management.
The pharmaceutical giant announced in April its commitment to invest $50 billion in the United States over the next five years, signaling long-term confidence in the US market despite ongoing pricing pressures and regulatory challenges.
