@Nnyck777 once again, you do pick up things early! The link to the Senator's website isn't working, so I couldn't read the entire article. But I've had a wider online search. It is something to monitor. I have been reading a few articles in the WSJ recently about concerns in Washington over prescribing behaviours of the weight-loss drugs, but I never joined the dots to telehealth and $BOT.

When I think about the $BOT model: 1) it requires a dermatologist to issue a script, 2) and the online pharmacy dispensing is a separate entity, as you say. Presumably, however, that is the same model that Pfizer and Eli Lilly follow, because as I understand it, pharma companies cannot dispense prescription drugs direct to consumer, even with a script.

In the US market, regulations for presciption medications allow advertising and direct marketing to the public, so as you know it is a very different world to what we have in Australia. I guess the issue is whether a website link that transports a patient directly into a telehealth channel is a step too far?

The history in the US is interesting. Prescription drugs have always been advertised in the US, and in the 1980's companies were essentially allowed to do direct to consumer (DTC) advertising by placing ads in newspapers and magazines. And in 1997, the FDA set the rules allowing DTC advertising via electronic channels. With the technology that exists now, and that $BOT is using, this enables quite precise targeting of individual consumers based on their online behaviour. (E.g., if I am browsing in an online store for plus-size clothing, I'm going to see ads in my browser for weight loss drugs, with a clickthrough to the drug's website.)

Sadly, even when things go wrong in the US, the political machinery is slow to act. Look how slow and ineffective reigning in the actors profiting off Oxycontin was. The Big Pharma lobby is one of the most well-funded in the nation, and even if this moves into a full Senate Inquiry, the politics around it is so fractured it is hard to imagine legislative change would be easy to achieve. You don't get much bigger than Eli Lilly and Pfizer, so no doubt they will go into bat on this.

Telehealth has become a big part of the US health system. Ramped up during the pandemic, even though its use has come off it's peak, a report by the CDC estimated 37% of Americans had used telehealth in 2021, falling to 30% in 2022, as the system re-opened fully. So, my sense is that there is no putting this genie back in the bottle. Perhaps there will be regulatory changes that inhibit companies from putting patients into a one-way, vertically integrated channel for their product. However, I expect change will occur slowly, industry will be consulted, and $BOT will have the chance to tweak their model to remain in compliance if and when the changes become clear.

Even if there are changes, SOFDRA is operating in a market with few competitors. QBREXA has been around for a while and hasn't amounted to much. So, I imagine that regulatory changes might require a patient or prescribing physican to have to go through a portal and see alternative treatments? Not a problem for $BOT.

Finally, the "boots on the ground" traditional channel is also part of the $BOT strategy. So, even if the telehealth channel is disrupted (which I think unlikely) there is a second, conventional route to market, with a relatively concentrated channel that can be accessed, i.e., the dispensing dermatologists, which won't need a large salesforce to achieve 90% coverage.

Reading back what I have written, I realise I am coming across as complacent or even dismissive. That is not my intent. This is a risk and if it pans out, it would be unwelcome.

Good pick up. Worth doing some more research on, but I'm not at all worried at this stage.

@Nnyck777 At first glance this seems very pertinent to BOT.

Just shooting from the hip here.....

BOT has Sofdra (FDA approved) and four other products in the pipeline for FDA approval.

To get to the bottom of this do we need to be ascribing a value to Sofdra, the other four products and the Telehealth sales platform individually?

How much of the current valuation of BOT is based around Sofdra and how critical is the Telehealth platform to Sofdra sales?

A bit of reading to do....

Held...I just bought more yesterday