Health Affairs December 5, 2025
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.
The Trump Administration has also embraced the idea. In May, an Executive Order directed the Secretary of Health and Human Services to “facilitate direct-to-consumer purchasing programs for pharmaceutical manufacturers that sell their products to American patients at the most-favored-nation price.” In September, the President announced a “TrumpRx.gov” website, launching in 2026, that is designed to aggregate cash-pay options. In November, the administration announced that the widely prescribed GLP-1 drugs from Eli Lilly...
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