Direct-to-Prescription Telehealth Arrangements: Recent Expansion, Concerns, and Policy Optionstechnical_reportsThe growth of direct-to-consumer pharmaceutical marketing, telehealth expansion, and vertically integrated pharmacy distribution has enabled new direct-to-prescription (DTP) telehealth models that allow patients to obtain medications quickly through online platforms. While these models may improve access and convenience for some patients, emerging evidence raises concerns about inappropriate prescribing, fragmented care, conflicts of interest, and rising health care spending. Policymakers, regulators, journalists, and researchers have raised concerns that these arrangements may steer patients toward specific drugs, weaken the physician-patient relationship, and create financial incentives tied to prescribing. Existing regulatory tools, including fraud and abuse laws, may not fully address these structural risks. Policymakers are increasingly examining how to balance the potential benefits of telehealth access with safeguards that ensure appropriate prescribing, patient safety, and sustainable health system spending. Against this backdrop of rapid market evolution and emerging federal oversight, this brief provides background on the growth, regulatory landscape, and policy concerns of DTP telehealth models. To date, the policy discussion has centered on regulating direct-to-consumer advertising for prescription drugs by pharmaceutical and telehealth companies. This policy brief offers policy options to address the financial conflicts of interest created by DTP telehealth arrangements that may threaten patient safety, fragment care, and drive unsustainable spending, while eroding the relational foundations of the physician-patient relationship.Erin C. Fuse BrownAuthorJacob ElbergAuthorIsabelle BounAuthorCorrie MookAuthorJared PerkinsAuthor2026-02-02TelehealthDirect-to-PrescriptionPolicy BriefAll rights reservedIn CopyrightAll Rights Reserved10.26300/6ehk-4g06