In other words, DTC websites run by pharmaceutical companies use “hand-picked telehealth companies to inappropriately steer patients toward specific, high-cost medications and inflate Big Pharma’s profit margins,” the senators write.

In an investigation last year of DTC platforms from Eli Lilly and Pfizer, the senators found that the pharmaceutical giants “spent up to $3 million combined for partnerships with telehealth companies, who funneled patients to the manufacturers’ products. … In one instance, 100 percent of the patients routed to a virtual visit with one of Eli Lilly’s chosen telehealth companies received a prescription.”

There’s already reason to be suspicious of conflicts of interest with TrumpRx, the senators note. There’s a “potential relationship between TrumpRx and an online dispensing company, BlinkRx, on whose Board the President’s son, Donald Trump, Jr., has sat since February 2025” the senators write.

The lawmakers are concerned that TrumpRx will violate the anti-kickback statute, which bars payments for inducing patients to use services or products that are reimbursable by a federal health care program.

Brian Reid, principal at health consultancy Reid Strategic, speculated to Politico that the delay of TrumpRx’s debut may be related to anti-kickback statute concerns.

“In any other administration, it would 100 percent be the AKS stuff,” Reid said. “It’s clear there’s a lawyer somewhere at HHS who has concerns about anti-kickback.”