How Congress’ DTC Pharma Probe Misses the Mark and Jeopardizes Patient Rights

This is Part 1 of “Pharma’s Infrastructure Era,” a three-part series by Wheel CEO Michelle Davey exploring the evolution of virtual care, the infrastructure gap in DTC, and the future of pharma’s patient engagement model.

In reaction to the Senate DTC telehealth report, recent media coverage (STAT News, Fierce Healthcare) is raising an important question: how can we ensure that new models of care put patients, not profits, first? While the question is valid, the investigative report and ensuing coverage focus on the role of pharmaceutical sponsorship in telehealth and, in doing so, present an incomplete picture of how these programs operate when designed responsibly.

More importantly, they risk undermining both the credibility of clinicians and the potential value of virtual care as part of the modern healthcare system.

The report highlights large contract figures, such as $942,500 over three years and $2.45 million per agreement, but it does not explain what these funds support. In practice, these contracts typically fund the foundational infrastructure required to deliver nationwide care that meets complex regulatory, clinical, and operational standards. This includes broad networks of licensed clinicians, secure data platforms, evidence-based clinical protocols, and ongoing legal and privacy compliance. Telehealth is not simply a website or a software tool. It is a care delivery system. Without evidence of wrongdoing, it is a mistake to treat these operating costs as inherently suspect.

Pharma-sponsored programs can expand access to care when designed with proper guardrails. But it is critical to distinguish between clinical infrastructure that is patient-centered and brand-neutral, and systems that are structured to produce a commercial outcome. That is the line that must be drawn and enforced.

A call for accountability, not assumptions

The recent Congressional probe suggests that clinicians participating in these programs may be more susceptible to external influence. That assumption unfairly discounts the training, independence, and accountability of licensed providers, especially those working within platforms that maintain clear separation between sponsorship and care delivery. These professionals are held to the same ethical and legal standards as in-person providers. The Hippocratic Oath does not disappear in a virtual setting. Implying otherwise undermines trust in a workforce that plays a vital role in expanding access at a time when we are facing declining access points for our most vulnerable populations.

The broader direct-to-patient care model under scrutiny is not new. For decades, patients have seen direct-to-consumer pharmaceutical ads, raised questions with their providers, and received prescriptions when appropriate. If a patient clicks through to a consultation from a brand website, the provider’s job is still to assess whether that treatment is necessary, safe, and the best option for that individual. When clinical judgment is independent, and prescribing is evidence-based, this model can enhance access and reduce friction. The digital context may be different, but the principles of care don’t change.

The issue isn’t that patients are asking for care online, or that companies are helping them access it. The risk arises when the care infrastructure is designed in a way that makes a branded prescription the only likely outcome. That is where safeguards are essential for both telehealth companies and pharma. Responsible virtual care platforms should already have these protections in place.

Additionally, the relationship between telehealth companies and life sciences is governed by strict security, compliance, and operational firewalls. Pharmaceutical brands may fund access programs, but they do not write policies, dictate prescribing, and are prohibited from exerting any influence on clinical protocols.

Some have raised concerns about data access, suggesting that pharmaceutical companies now have novel insight into prescriber behavior. In reality, National Provider Identifier numbers and prescribing data have been publicly available for years. This data is widely used across healthcare, including in traditional care settings. What matters is how that information is handled and governed to protect privacy, maintain clinical independence, and prevent undue influence from any third party.

It’s clear that transparency and oversight are necessary, especially as more complex therapies enter the market. Reviewing prescribing patterns and understanding financial relationships should be standard practice. But the existence of a prescription alone should not trigger concern. The more meaningful question is whether the platform supporting that decision is structured to put the patient first.

Virtual care is the infrastructure for access — and it’s working

Like all care models, telehealth is not without its shortcomings. But we must not ignore the vital role of virtual care in serving patients who face structural barriers to accessing clinical services. These include rural patients, caregivers, shift workers, and individuals without reliable access to in-person care. Conflating virtual care with unethical practice undermines the clinicians who deliver evidence-based treatment to thousands of patients every day.

The conversation about guardrails, transparency, and accountability is essential. But we should use this moment to strengthen what works, not discard it. That means building clear standards that support independent clinical decision-making, ensure data integrity, and expand access responsibly. 

Virtual care, done right, is not a loophole. It is modern healthcare infrastructure. Policy should reflect that reality and support the patients and clinicians who rely on it.

Coming soon: Beyond MFN: Pharma Needs Infrastructure, Not Just Lower Prices