Rise of Direct-to-Patient GLP-1 Sales Shakes Up Care Models, HCPs Split on Pharma’s Expanding Role

Sermo Barometer reveals shifting access pathways, evolving prescribing behavior, and long-term impacts on patient care.

NEW YORK--(BUSINESS WIRE)--The 43rd Barometer from Sermo, a fast, frictionless HCP social engagement platform and leader in healthcare insights, shows that pharma-led direct-to-patient (DTP) GLP-1 prescribing programs are transforming treatment access pathways. Yet findings from 953 surveyed GLP-1 prescribers reveal sharp divisions over how involved pharma should be in clinical evaluation and prescribing.

DTP Models are Gaining Ground and Disrupting Traditional Care

Awareness of pharma-led DTP programs is widespread with 71% of HCPs saying they are very to somewhat aware of DTP platforms from companies like Lilly and Novo Nordisk. Endocrinologists and Advanced Practice Providers, including Nurse Practitioners and Physician Assistants, are the most aware of these models.

The strongest divide in the study centers on pharma’s expanding involvement in patient evaluation and prescribing.

• 31% of HCPs believe pharma can appropriately provide full clinical evaluation and prescribing
• 35% prefer a limited role, with prescribing only under the oversight of the patient’s primary provider
• 29% want pharma to support access only, leaving the prescribing exclusively to the patient’s primary provider.

Still, over half of HCPs consider pharma DTP the most clinically acceptable option when insurance denies GLP-1 coverage, out-performing telehealth platforms (36%), retail membership programs (29%), compounding pharmacies (26%) and local weight loss clinics (28%).

Dr. Estylan Dan Arellano, DO, Sermo Medical Advisory Board Member and board-certified Emergency Medicine physician who transitioned into telemedicine captures the tension well:

"The rise of pharma-run DTP programs is changing the front door of obesity care. In telehealth, we’ve learned how powerful virtual models can be when integrated with a patient’s broader care team. The challenge now is making sure patients don’t get siloed into pathways where prescribing happens without full visibility into their long-term health needs."

To better improve the continuity of care, HCPs would like pharma-led DTP programs to provide structured follow-up reports (69%), access to dieticians and nutrition specialists (64%) and shared EHR/Clinical notes (52%).

Microdosing Goes Mainstream as HCPs Take the Lead

The study shows a clear shift in how HCPs view microdosing and dose-adjustment practices. In Sermo’s 2024 Weight Loss Barometer (Study 35; n=1159), 91% of HCPs expressed concern about patients adjusting their own GLP-1 doses. This year, however, 67% of HCPs say they regularly or occasionally lower doses themselves to improve tolerability. The practice is even more common in non-traditional care models with 87% of telehealth HCPs and 83% in medical spas or weight-loss clinics report adjusting doses downward. This trend signals that microdosing is increasingly adopted in practice, as HCPs adapt GLP-1 dosing to manage side effects and keep patients on therapy longer.

Long-Term GLP-1 Use is Becoming the Norm

GLP-1s are not only transforming access pathways, but they’re also changing the expectations around long-term treatment. As Dr. Arellano explains, “GLP-1s work and that’s why patients are staying on them longer. Our job now is to help them maintain those results responsibly and affordably.” That perspective is reflected in the data: 40% of HCPs say patients remain on GLP-1s for 6–12 months, and another 39% report patients staying on therapy for more than a year. After reaching their weight-loss goals, most HCPs either continue patients on a maintenance dose (58%) or transition to diet and exercise only (54%). HCPs are also observing broader metabolic improvements, with reduced need for diabetes (75%), blood pressure (70%), and cholesterol-lowering medications (62%).

This survey was fielded from December 1-5 as the 43^rd edition of Sermo’s ongoing Barometer study and 3^rd annual Weight Loss Barometer. The survey included 953 global healthcare professionals whose specialties ranged from PCPs, physician assistants, nurse practitioners, cardiologists, endocrinologists, OBGYNs, and pediatric medicine. To explore more findings, visit: https://app.sermo.com/barometer

About Sermo: Sermo is a fast, frictionless physician engagement platform, providing the healthcare industry with real-time business insights and authentic physician touch points through our global community of 1M+ healthcare professionals and state-of-the-art technology. For over 20 years, Sermo has been turning physician experience, expertise, and observations into actionable insights that benefit pharmaceutical companies, healthcare partners, and the medical community at large. To learn more, visit www.sermo.com.

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