The JMIR analysis highlights how 2026 federal Most-Favored-Nation deals, manufacturer DTC platforms, and telehealth integration slashed GLP-1 list prices below $350 monthly, yet this model severs continuity protections because spending never accrues toward deductibles. Beyond the reported price drop, large-scale evidence reveals the stakes: the STEP 1 RCT (n=1961, semaglutide 2.4 mg) showed 14.9% mean weight loss at 68 weeks versus 2.4% placebo with high adherence under trial conditions, while SURMOUNT-1 (tirzepatide, n=2539) reported up to 20.9% loss; both were industry-funded with strict monitoring absent in cash-pay telehealth. Observational claims data (n>100k) indicate real-world discontinuation exceeds 50% by month 12, a gap the JMIR piece underplays. Equity risks are also overlooked: $350/month remains prohibitive for lower-income patients, potentially widening obesity outcome disparities documented in NHANES-linked studies. Extending this infrastructure to insulin or COPD therapies could succeed only if digital platforms incorporate RCT-validated adherence tools rather than relying solely on convenience.