Subscription-based healthcare can deliver medications to your door, but its rise worries some experts


Need help Lose weight or manipulation depression? How about a pill that lowers cholesterol and treats erectile dysfunction?

Online care subscription services have grown far beyond their roots and primarily deal with hair loss, acne, or birth control. Companies like Hims & Hers, Ro and Lemonaid Health now provide quick access to specialists and regular prescription deliveries for a growing list of health problems.

Hims recently launched a weight loss program starting at $79 a month without insurance. Lemonaid began treating seasonal affective disorder last winter for $95 a month. Ro still provides birth control, but also connects patients trying to have children with regular deliveries of ovulation tests or prenatal vitamins.

This Netflix-like approach promises to help two common difficulties in the United States: access to medical care and prescription refills. But it also raises concerns about the quality of care.

“This is not medicine. This is selling drugs to consumers,” said Dr. Adriane Fugh-Berman, who studies pharmaceutical marketing at Georgetown.

Online providers say they screen their patients carefully and send customers elsewhere if they can't help them. They also believe they have tapped into an approach to care that patients crave.

“The growth we've seen on our platform is a testament to how people are looking to get the care they need,” said Hims spokesperson Khobi Brooklyn.

Publicly traded Hims has surpassed 1.4 million subscribers this year. It hopes to make at least $1.2 billion in annual sales by 2025.

That pales in comparison to the more than $300 billion in annual revenue generated by healthcare giants like CVS Health. But Hims' 2025 projection is more than eight times what the company raised at the beginning of the decade.

Subscription-based healthcare has been around for years, particularly in primary care, where patients can pay monthly fees to get better access to doctors. E-commerce giant Amazon recently entered that niche with a subscription plan that gives some customers access to virtual and in-person care.

Online versions of subscription-based care began to grow after the COVID-19 pandemic made Americans more comfortable with telemedicine. That has led to an increase in investor money flowing to companies that provide this care, said Dr. Ateev Mehrotra, a Harvard researcher who studies consumer health care.

Many condition-specific plans offer patients regular visits to a healthcare provider and then recurring prescriptions for a monthly fee.

That simplicity can be attractive, Mehrotra said.

“You can get the care you need and move on with your life the same way you pay for Netflix or whatever,” he said.

Hims debuted weight loss earlier this month after starting a heart health program last summer that included combination pill treatments.

Rival Ro added weight loss last year to a line that also includes treatment plans for eczema, excessive sweating and short eyelashes, among other problems.

Lemonaid offers treatment plans for insomnia and high blood pressure. It also promotes cholesterol control for $223 a year without insurance. That includes provider visits, lab tests, and generic drug prescriptions.

These companies still promote sexual health aid, especially on social media. But broader growth remains a priority.

Hims says in a regulatory filing that he sees significant future opportunities in menopause, post-traumatic stress disorder and diabetes.

Ro CEO Zach Reitano noted in an interview earlier this year that his company's obesity treatments are “anticipating” other chronic diseases. He said patients who want help losing weight also care about improving their overall health.

Reitano told The Associated Press that he thought one of the biggest problems with the health care system was that “it's not based on what patients want.”

Subscriptions, whether for medications or meal kits, offer predictable costs and may seem like good deals at first. But customer enthusiasm may fade and companies may feel pressure to find new business, said Jason Goldberg, director of business strategy at Publicis Groupe.

The approach also comes with reputational baggage.

RobRoy Chalmers turned to Hims for help with erectile dysfunction. But the Seattle artist decided to cancel his subscription and cut costs after a few months.

You continued to receive bills after you thought you had canceled the subscription. She said she sent an email and called customer service. She didn't get a response until she criticized Hims on social media.

“The amount of effort I had to put in for them to get it right was too much,” he said. “In my opinion, these are all subscription-based companies.”

Fugh-Berman is primarily concerned with quality of care. She noted that psychotherapy can be as effective as prescriptions for some conditions.

“Mental health care should never focus solely on drugs,” he said.

He also noted that a diagnosis can change over time. Patients who take medications regularly should be monitored in case the medication causes problems such as high blood pressure.

Lemonaid Health does that, according to Dr. Matthew Walvick, the company's chief medical officer. He said Lemonaid routinely follows patients to monitor side effects and update their medical history.

Brooklyn said Hims' mental health care program includes psychiatry and psychotherapy.

Representatives from both companies say they also encourage patients to get help in person when necessary.

Mehrotra worries more broadly. She noted that a patient's overall health can be overlooked when customers come to these companies with a specific condition or medication in mind.

Someone who visits a primary care doctor for birth control can also be screened for depression, he noted.

“These companies are very solution-oriented,” Mehrotra said. “They are not thinking about that comprehensive care.”

Walvick said Lemonaid collects an extensive patient medical history that delves into issues such as smoking or drug use to offer “the best comprehensive care possible.”

Brooklyn said Hims & Hers provides access to safe care for many problems, but should not replace a primary care doctor. She added that every part of the health care system should focus on improving access.

“The traditional health care system in the United States has always been slow to adapt to the changing needs of our society,” he said.

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