The Best Direct-to-Consumer (D2C) Telemedicine Startups

Have you noticed the boom in startups offering medical diagnosis and treatment over the internet? You may have heard of companies like Roman and Hims who’ve raised a bunch of VC investment to bring medical services into patients’ homes via the web. But those aren’t the only two players making waves. Hundreds of direct to consumer brands have entered the business of connecting  patients with doctors virtually to prescribe treatments online that previously required an in-person visit to the doctor.

 

The trend isn’t likely to slow down any time soon. Read on to learn why, discover a few of the best known telemedicine brands, and discuss the growth strategies that so many are adopting.



So what exactly is driving the proliferation of telehealth startups these days?

 

 

Underserved Patients

 
The traditional medical establishment in the United States is great at providing care to insured people in major urban areas. But, it fails to do so at a reasonable cost. According to the Peterson-Kaiser Healthcare System Tracker, the annual US per capita spending is over $10,000. That’s almost double the cost per person in other developed countries who average just a tad over $5,000. According to the National Association of Community Health Centers (NACHC), 62 million individuals in the United States currently have no or inadequate access to primary care as a result of physician shortages. These systemic problems have lead many doctors and entrepreneurs to develop telemedicine solutions with the potential to materially drive down the cost of care.
 

 

Recent Regulation

 

Regulatory changes have also been a catalyst for telemedicine as laws start to adapt to improvements in technology that allow for doctors to interact with and help patients from afar. The first example of this started over ten years ago when the medical community realized it could be safe to offer radiological services remotely, since the doctors who traditionally viewed these images often never needed to meet the patient in person. Digital images were displayed to radiologists, who then provided the diagnosis to the patient’s doctor. Since the digital images could be sent anywhere electronically, some hospitals began to rely on remote radiologists to view their images. This was particularly helpful in rural areas, where hospitals could not easily staff qualified radiologists 24/7.

 

Today, major telemedicine providers like TeleDoc or Lemonaid Health offer doctor visits via the computer or smartphone. While certain medications still can’t be prescribed online, many states have removed the requirement for a physical examination for a wide range of prescription drugs. As a result, telemedicine is growing rapidly every year (22% annually according to one estimate) with nearly 7 million Americans accessing care through online or over-the-phone doctors in 2017 alone.

 

 

Expired Patents

 

In addition to regulatory changes and growing demand among underserved patients, expiring drug patents have also catalyzed the rise of new telemedicine brands. Recognizing their opportunity to rebrand generics, it’s no coincidence companies like Roman, Hims, and Keeps all launched men’s hair loss subscriptions soon after the expiration of Merck’s patent on Finasteride in 2014. The same is true for popular drugs like propranolol (for performance anxiety) and sildenafil (for ED). One drug company’s loss is a new DTC telemedicine brand’s gain.



Top Direct-to-Consumer Telemedicine Startups

These telemedicine brands have attracted a substantial amount of venture capital funding to prescribe drugs online. Don’t see your favorite on our list? Drop us a note and let us know why you think ought to be included.

 

Best D2C Nutrition BrandsOverviewPrescribes forFunding (VCs)Related Reviews
Himshims is an online dermatologist with telemedicine treatments for acne, hair loss, wrinkles, Rosacea, & more. Use code FIN10 at checkout for $10 off.Hair Loss &Erectile Dysfunction &Performance Anxiety &Premature Ejaculation &Acne$197m Series C (Redpoint, Founders Fund, SV Angel)Hims vs Rogain review: https://finvsfin.com/hims-vs-rogaine/
KeepsKeeps prescribes premium men's hair loss meds online.Hair Loss$22.8m Series A (First Round, Greycroft)Hims vs Roman vs Keeps: https://finvsfin.com/hims-vs-roman-vs-keeps/
hersHers sells prescription birth control, anxiety meds, and acne treatments for women online.Hair Loss &Birth Control &Performance Anxiety &Acne &Yeast Infection$197m Series C (Redpoint, Founders Fund, SV Angel)proactive vs curology vs hers: https://finvsfin.com/proactiv-vs-curology-vs-hers/
RomanRoman is an online pharmacy offering prescriptions for men's hair loss, ED, Premature ejaculation, & more.Hair Loss &Erectile Dysfunction$176.1m Series B (FirstMark)Roman PE review: https://finvsfin.com/roman-premature-ejaculation-reviews/
WaldoWaldo manufactures affordable daily contact lenses and sells them direct to consumers online.Contact Lenses$6.8m Series A (PROfounders Capital, YYX Capital)Hubble vs Waldo: https://finvsfin.com/hubble-vs-waldo/
Blink HealthBlink Health is an online pharmacy for a wide range of prescription medications.All$165m Series B (8VC)Blink health review: https://finvsfin.com/blink-health-reviews/
The pill clubThe pill club is an birth control delivery and subscription brand.Birth Control$61.7m Series B (Y Combinator, Union Square Ventures, Kleiner Perkins)Hers vs nurx vs Pill Club: https://finvsfin.com/hers-vs-nurx-vs-pill-club/
RoryRory helps women in Menopause with treatments for vaginal dryness, latisse, and more.Menopause$176.1m Series B (FirstMark)Rory vs latisse: https://finvsfin.com/rory-latisse-review/
ZeroZero is anti-smoking gum designed to help you kick your nicotine habit.Smoking$176.1m Series B (FirstMark)Zero smoking cessation review: https://finvsfin.com/zero-smoking-cessation-reviews/
coveCove is the only DTC brand focuses on migraine relief treatments.Migraine$22.8m Series A (First Round, Greycroft)Cove Migrain Relief Review: https://finvsfin.com/cove-migraine-reviews/
HubbleHubble offers an affordable daily contact lens subscription.Contact lenses$73.7m Series A (Founders Fund, FirstMark, Greycroft)Hubble vs waldo: https://finvsfin.com/hubble-vs-waldo/
LemonaidLemonaid is an online pharmacy offering wide range of prescription medications.All$20.7m Series A (Hikma Ventures, Novartis Venture Fund)Roman vs Lemonaid: https://finvsfin.com/roman-vs-lemonaid/
nurxNurx is a leader in online birth control and STI testing for women.Birth Control &STI Testing$41.1m Series B (500 Startups, Shasta Ventures)Nurx birth control review: https://finvsfin.com/nurx-reviews/
ApostropheApostrophe is an online pharmacy offering prescriptions for men's hair loss, ED, Premature ejaculation, & more.Dermatology$6.1m Seed (Signal Fire, 500 Startups, Nelostone Ventures)Apostrophe skincare review: https://finvsfin.com/apostrophe-reviews/

If you want to learn more about these D2C startups, we’d love to hear from you! We cover the telemedicine startups closely with many in-depth reviews comparing one brand’s offering to another. For instance, I recommend our comparison of Hers vs Nurx vs The Pill Club to get a feel for online birth control providers, or check out our review of Hims, Roman and Keeps for mens hair loss. Subscribe to our newsletter to stay ahead of the telemedicine trend and learn more about popular direct-to-consumer brands.

How are direct-to-consumer telemedicine startups growing so fast?

Besides the high demand for convenience and lower drug prices, there are several key factors driving the rapid growth of direct to consumer telemedicine startups. Here are three:

 

 

COVID-19 shelter in place

 

Although telemedicine offerings had been growing steadily prior to 2020, nothing accelerated its adoption like the global pandemic. It was not longer a question of preference —  in person vs video chatting with a doctor — we all were forced to experiment with virtual care, or forgo medical attention altogether. The number of telemedicine startups emerging during quarantine is astounding, and all indications are that most will continue to thrive in this “new normal” long after it’s safe to mingle in public.

 

 

Tasteful rebranding of popular generics

 

While some telemedicine companies like Blink Health or Teledoc are essentially online pharmacies offer every drug under the sun, other D2C telemedicine startups are focused on branding narrow sets of generic drugs needed within niche groups. Examples include Ro’s family of distinct brands that now includes Roman (for men’s hair loss and ED), Zero (for smokers), and Rory (for women with menopause). An impressive side effect of this is a rapid decrease in the price of particular medicines.

 

Similarly Hims caters to males with hair loss and ED pills, but has also created a separate brand called Hers for prescriptions specific to women.

 

While it’s not hard to beat Cialis or Finasteride from a branding perspective, this new breed of telemedicine startups is investing a ton in their own brand image. Like Hubble contacts did, most work with high-end design agency to craft the perfect look, feel, and voice for their audience.

 

Note that these niched-down brands tend to focus on lower-risk prescription categories with cheap generics. No one has created a DTC telemedicine brand for blood pressure medication, for instance. Well, not yet, anyway… When that day comes, you can expect a sleek modern website.

 

 

Heavy advertising investment

 

Although there’s plenty of red tape around advertising  prescription meds, new direct to consumer telemedicine brands are pushing the limits of paid media. Given the stickiness of their subscription offerings (high recurring revenue without high churn), these startups are willing to pay a lot to acquire new customers, shelling out buckets of venture-raised cash on social media ads, SEM, affiliate programs, and offline channels like radio, TV, and billboards. If you visit a D2C telemedicine brand’s site, don’t be surprised if you start seeing their ads everywhere!

 

 

Eye-catching free trials

 

Again, D2C telemedicine startups understand that Rx customers have a high lifetime value (LTV). Offering an appealing free trial is an effective way of drawing more people in the door. A “first month free” (or heavily discounted trial period) is almost universal among modern telemedicine brands. Check out the examples below:

What kind of treatments are top telemedicine brands disrupting?

 

 

We already mentioned how telemedicine startups have first focused on lower-risk drugs, but another common theme is a. focus on more embarrassing or taboo health conditions, often sexual or mental in nature. For men that means conditions like ED and baldness. For women, menstruation and acne. A major thesis behind this is that:

 

 

  • Patients don’t feel comfortable talking about these problems face to face, even with their doctor
  • Well-tested generic meds are now available to lower patient risk and cost
  • From a consumer’s standpoint, these companies’ solutions have real advantages over traditional primary care.

 

 

Why are telemedicine startups appealing to consumers again?

 

 

Greater Convenience

 

Physician visits can be close to automated, with minimal to absolutely no live conversation between the doctor and patient needed AND the goods can be shipped discretely to the consumer’s home, removing the need to pick up (embarrassing) medications at the pharmacy and talk to anyone in person. As an example, the startup Roman now offers premature ejaculation treatments, which may prove to be convenient to many men who suffer ED, as the two conditions may be related.

 

 

Lower Price

 

Big pharmaceutical companies have paved the way by building brand awareness for their drugs, but now that these have come off their patents, direct to consumer telemedicine startups are making cheap, completely equivalent medications available. Thus telemedicine startups are vying for the opportunity to introduce the masses to substantially lower cost generics. As you can imagine, that’s a massive value-add and market opportunity. For example, since the online direct to consumer players entered the hair loss space, the price of Finasteride has dropped from about $70 per month to $30 or less per month.

What questions still need to be answered about telemedicine startups?

 

Telemedicine is still very much in its infancy, and there are many questions about these startups’ business models and how consumers will react to these offerings. Here are two burning questions on my mind:

 

 

Is bundling telemedicine possible?

 

It’s unclear that an individual will want to get prescription hair loss, erectile disfunction, and anxiety medicine from an online provider. It’s even less clear if it’s a good idea for someone with multiple health issues should get treatment from an online doctor, as there may be an underlying issue that should be diagnosed and treated in person by a primary care physician.

 

 

Will virtual doctors get the medical advice right?

 

The belief is that these online providers will be able to correctly (and safely) provide a diagnosis and treatment. The current crop of D2C telemedicine / pharmacy startups seem to have started with medicines that are well understood and have less adverse side effects. But will these doctors be able to identify the small number of patients who have serious underlying medical issues? What might happen if a patient has a serious problem that an in-person physician might have caught?



It's an exciting time to be a telemedicine startup!

Who knows what’s next, and which companies will take off. Hopefully direct-to-consumer telemedicine startups will be able to fix some of the major problems in our healthcare system, and help patients live happier, healthier lives.

 

If you work in telemedicine or at a direct-to-consumer company, we’d love to hear from you. Don’t hesitate to reach out anytime, or subscribe to our newsletter to learn more about top telemedicine brands and the Direct to Consumer space!

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