PRIMARY CARE PROVIDERS, MEET YOUR NEWEST COMPETITORS

Two new telehealth businesses aim to siphon popular services from office-based primary care practices. LetsGetChecked, which bills itself as a "healthcare solutions" company, just received FDA approval for an at-home gonorrhea and chlamydia test that uses a urine sample collected by the patient and mailed to a lab. The test is $99, and for $50 more, patients can add trichomoniasis, along with HIV and syphilis performed on blood collected from a finger prick. After patients mail their specimens in, results are delivered in 2 - 5 days, and appropriate infections can be treated over telehealth for $39. At-home hepatitis B and C, herpes, vaginitis (using a vaginal swab), male and female hormones, and thyroid testing are also available.

The other new competitor is drug manufacturer Eli Lilly, which is now offering LillyDirect, a service where they connect consumers with telehealth doctors who can prescribe Eli Lilly medications for diabetes, migraines, and weight loss, including the popular Zepbound. Eli Lilly then ships the drug directly to the patient. LillyDirect also accepts prescriptions from other providers, essentially serving as a mail-order pharmacy for Eli Lilly products.

Primary care providers know that STD screening requests are common - and often obsessive - so there is little doubt LetsGetChecked will be a popular service. Eli Lilly wading into direct-to-consumer care will be interesting to watch, particularly in the obesity drug category.

• LetsGetChecked home STD testing
• LillyDirect website

NEW ASTHMA GUIDELINES RECOMMEND SYMBICORT MONOTHERAPY FOR MOST PATIENTS

Recent asthma guidelines (NHLBI in 2020 and GINA in 2023) recommend most asthmatics use Symbicort (budesonide + formoterol) for both maintenance and reliever therapy; formoterol is a long-acting beta agonist, but it has a rapid onset of action, making it effective for acute bronchospasm. The recommendations are based on studies published in 2018 and 2019 that found as-needed Symbicort was noninferior to combination therapy with a daily inhaled corticosteroid and an as-needed short-acting beta agonist. The guidelines recommend that patients twelve and older start with as-needed Symbicort, with a step up to daily maintenance therapy if necessary, while maintaining Symbicort as a rescue inhaler. Recommendations in younger patients differ somewhat, and Symbicort is only approved for children six and older. One important thing to note is that total inhalations (maintenance + as-needed) should not exceed 8 per day for 6 - 11 year-olds using the 80/4.5 mcg dose and 12 per day for adolescents (≥ 12 years) and adults using the 160/4.5 mcg dose.

One-inhaler therapy simplifies asthma treatment, making it a good choice for many. Symbicort has a generic called Breyna with cash pricing ranging from $70 to $130 per inhaler, according to GoodRx.

• GINA 2023 asthma treatment recommendations
• NHLBI 2020 asthma treatment recommendations
• Symbicort dosing