Telehealth will be worth about $25 billion in 2021

SUMMARY: Deloitte predicts that the percentage of virtual video visits to doctors will rise to 5% globally in 2021, up from an estimated 1% in 2019. While 5% may not sound like much, consider that 8.5 billion doctor’s visits, worth a total of approximately US$500 billion.

The most time-consuming task is to make an appointment with your doctor just to ask for a new Rx or an Rx renewal.  In April 2020, 43.5% of all US Medicare primary care visits were via telehealth primarily driven by the pandemic. The question is what percentage of healthcare visits can be replaced with telehealth?

According to Deloitte the newly skilled at videocalling includes tens of millions of people over age 65, who visit doctors more frequently than younger individuals. Although only 17% of the population, the 65-plus demographic accounts for more than 30% of all doctor’s visits in the United States; in 2016, people age 65 and up made 80% more office visits than the average number of visits among the general US population.

Historically, research has shown that elderly users, even when they have the right tools and connections, are still less likely to use digital applications, in part due to unfamiliarity.11 COVID-19 provided the impetus for them to change that. To stay in touch with children, grandchildren, and friends, the 65+ population underwent rapid and forced training on video hardware and software. For them to be able to use it for virtual video visits with physicians is a fringe benefit that can drive substantial growth in the video visit market.

According to JAMA among the 35,131 DTC telemedicine visits in their sample, 25,162 (73.9%; 95% CI, 73.4%-74.4%) were from female users, and the mean (SD) user age was 36 (12) years. Compared with the overall population in these 20 states, DTC telemedicine patients were more likely to live in urban areas (85.0% vs 75.4%; P < .001) and areas with a higher income (32.8% vs 25.0% of the top quartile of zip code median household income; P < .001). Of all DTC telemedicine visits, 14.4% (95% CI, 14.0%-14.8%) were for patients living in a primary care health professional shortage area. Primary care health professional shortage areas are designations that indicate shortages in primary care professionals based on a needs assessment conducted by state primary care offices reviewed by the Health Resources & Services Administration.

There is no doubt that telehealth will grow, but we should understand that telehealth is part of healthcare and not a replacement for in-person visits.


When it comes to telehealth, there are endless opportunities to partner with HCPs, but pharma has to be part of the solution and can’t gink in terms of “marketing” to patients.

If, for example, a patient wants to use telehealth to ask for an Rx for flu-related symptoms, an HCP should recommend certain websites to a patient that talks about managing flu symptoms beyond just an Rx. Pharma’s content needs to focus on helping patients rather than selling them.

When it comes to asking for a new Rx or a request to switch brands, pharma will have to provide HCPs with the criteria to switch patients from one product to another or start them on a new therapy. More importantly, they also need to help physicians decide when an in-person visit is required versus a telehealth session.

While the telehealth business will increase rapidly, medical studies will need to measure patient outcomes using telehealth versus in-person office visits. The media also could play a huge part. All people need to see is that a telehealth patient was misdiagnosed to scare people into going back to their doctor.

Will physicians jump on the telehealth bandwagon? As one doctor told me, “I would rather a telehealth visit than no visit at all, but I still rely on seeing patients in-person to help me diagnose patients and recommend treatments.”

In a way, beyond the pandemic, physicians have pushed the drive towards telehealth. Too many briefly meet with patients and are quick to write an Rx. Patients believe they could save a lot of time using telehealth, but I can see many warnings and recommendations before using telehealth.