Every story about direct-to-patient is a story about price. LillyDirect, NovoCare, TrumpRx — the discount is real, and it's not the point. A competitor matches price tomorrow. What compounds is a first-party, full-journey view of your own patients: ad to refill, no lag, nowhere for the leak to hide. And as direct-to-employer and direct-to-payer bring covered patients through the same door, that advantage stops being affordability and becomes reach.

Years ago during annual brand planning, while working in pharma and leading a COE, an executive asked a question I’ve never put down: without changing the revenue goals and spend, how would this brand survive the elimination of DTC advertising? Now this hypothetical scenario is becoming a reality for broadcast DTC.