With high drug prices remaining an ongoing concern for U.S. politicians, Roche is considering following in the footsteps of some of its peers with a direct-to-consumer (DTC) model to cut out the middlemen.
Pharmacy benefit managers (PBMs) and innovative drugmakers have long blamed each other for high U.S. drug prices, with pharma companies calling out the so-called “middlemen” for prioritizing drugs with higher costs in order to collect higher rebates.
About 50% of the money spent on drugs in the U.S. healthcare system goes straight to PBMs instead of the companies that create the medicines, Roche CEO Thomas Schinecker called out in a press conference on Thursday.
The CEO suggested that the U.S. chop drug prices in half, “take out these people in the middle” who don’t contribute “at all” to innovation and reap the benefits without having to take risks.
One example he pointed to is that of Roche’s multiple sclerosis med Ocrevus, which was priced at a 25% discount to the existing standard of care at launch but ended up being more expensive for patients because of PBM dynamics.
Bringing the drugs directly to the consumer could be a solution to positively impact pricing for patients “without destroying innovation,” Schinecker added on a separate Thursday call with investors, noting that the company has discussed the matter with the U.S. government and its Department of Health and Human Services.
Pfizer and Bristol Myers Squibb recently went a similar route to sell their megablockbuster blood thinner Eliquis, one of the drugs targeted by the U.S. in the first round of its Inflation Reduction Act-mandated price cuts. The companies unveiled a DTC program that allows uninsured or underinsured patients to buy the medicine online at a sharp discount to its current list price. Eli Lilly and Novo Nordisk previously adapted DTC models for their respective obesity and diabetes treatments.
The Eliquis DTC program is “absolutely something that we would consider” for “the right product” in our portfolio, Roche’s pharma head Teresa Graham said on the investor call, suggesting it could be “a really good type of program” for obesity assets. While the company can’t describe details due to ongoing talks with the U.S. government, there are also other areas in which the DTC model could apply, Schinecker pointed out.
The pricing talks come after President Donald Trump inked a “Most Favored Nation” executive order in May, aiming to tie U.S. drug prices to lower prices in other developed nations. The plan was quickly called out by industry voices such as the PhRMA trade group, which labeled it a “bad deal” for U.S. patients.
Roche, too, wasn’t in favor of the Favored Nation move, signaling concern over previously announced U.S. investments at the time. In April, the company announced a $50 billion U.S. investment spree over five years, including a new plant in Indiana and a gene therapy manufacturing facility in Pennsylvania.
Despite the pricing concerns and PBM complaints, Roche’s pharma unit is still seeing growth to the tune of 10% in the U.S., compared with 5% in Europe, over the first half of 2025. Top sales drivers Ocrevus, hemophilia med Hemlibra and eye drug Vabysmo helped Roche’s total pharma sales reach 24 billion Swiss Franc ($30.1 billion) over the period.