Healthcare is Broken—This Company Wants to Fix It

When I started the company in 2017, at the heart of it was this opportunity to build something that really changed what people thought about healthcare. You know, all of us — when I looked at my peers, my family — you'd go to the doctor, you know, essentially if your leg was bleeding or if you broke something, and otherwise you just really hated that experience. But then when you look at other aspects of our lives, you pick up your phone, you click a button, and you can get access to amazing financial services. You can get on-demand food, you can buy a car from your iPhone, right? I mean, like everything had been completely consumerized in a beautiful, price-transparent way. Yet healthcare was still this environment that was paternalistic, that lacked any empowerment, that lacked all price transparency, and really was built for a system, not a consumer. Right? And so what I set out to do was: could we take the best of consumer love, the best of consumer healthcare, the best of consumer technology — the things that we've grown to appreciate in Amazon and every other service — and reimagine what's possible for everyday people when it comes to their health. And part of that is, to your point, Ed, like the stigmatization of healthcare: things like sexual dysfunction, things like hair loss that affect maybe 50% of the population, things like weight loss that affects 70% of the population. Actually normalizing the fact that these things happen and they're common and everyday people suffer from them — that's a big first step of it. Then the next step of it is actually making it incredibly easy to get care on demand. You click a button, you can connect with a Hims & Hers doctor in minutes, often, or within an hour from any state in the country, and now across nearly a dozen countries globally. And then you can receive amazing personalized care. You can get that treatment delivered to your door within a couple of days, and it makes you feel great, right? That type of opportunity to rethink what's possible in healthcare, move it from a very reactive system to a proactive one, but also build something that people love — that was really the ambition. And I think in the early days, some of the stigmatized conditions were a really great way for us to start the conversation with people about what healthcare could look like in the future.

They were conversation starters, which I think was really important in healthcare. You know, we spent a lot of time talking to doctors, and what they told us over and over again was men would come into the hospital. They'd have an annual appointment. The appointment would be going well. They'd answer all their questions, and then on the way out, as the doctor is literally leaving the room, the patient goes, "Hey, there was one more thing. I had one more question." And that one more question was actually the reason they came to the doctor's appointment, right? And that one more question was something like hair loss, or something like mental health, or something like weight loss, or something like erectile dysfunction, or concerns around menopause. It was all of the things that everyday people go through but are kind of uncomfortable to talk about. Like that's actually the reason you are motivated and activated to go and interact with the system. And it makes sense because it's the thing that affects you every day, right? You wake up in the morning, they're deeply personal. They affect your relationships, how you feel with your partner, how you feel in the world, your confidence. And so to me, as a consumer technology nerd, that was an incredible opportunity to expand on, right? If we could build a system that actually started conversations and activated you to come talk to the healthcare system, we could then go wide now that we have you and have delivered on this issue you might be concerned with and treat other things. So a good example: erectile dysfunction. It's actually the only physical symptom of cardiovascular disease. Period. There's no other symptom. And cardiovascular disease is the number one thing that kills men in the world. So if you can build something that activates men to come talk to you, get care for something like erectile dysfunction, you actually are bringing one of the most at-risk populations in the door. And then you can say, "Hey, while you're here, what if we send you an at-home blood test and just test some basics, right?" And it turns out now we treat tens of thousands of people every year who came for erectile dysfunction and actually are at severe risk of heart attacks, and now they're getting personalized treatments with combinations of therapies to address both. So I think there's this idea of how do you activate consumers? How do you energize them and understand the things that people want and care about, and then from there build trust and expand into the things that maybe they need?

You know, when I was in university, I think there was an increasing sentiment around it being not masculine to take care of yourself or even to care, right? To try to give a — to make an effort. And I think that as you've seen with the acceleration of pornography, as the acceleration of internet access and different communities in that world has created, I think a real isolation for young men. And I think in a lot of ways that's very, very concerning. So internally I push our team because it's funny. I'll look at our calendar and, you know, I have meetings on my calendar called Parameabos, right? And then there's meetings in my calendar called erectile dysfunction. And I think we've normalized the uncomfortable conversations internally in an attempt to try to normalize them externally. Right? If we can't talk about it directly and honestly as an issue, as a clinical issue that actually results, as you said, Ed, in loneliness and depression rates and social media addiction and not getting out — like if there's a confidence, if you're struggling from obesity and there's a lack of confidence so you're not going out and meeting people, all of those things have very massive clinical impacts, huge clinical impacts to cognitive, mental, that then cycle on top to depression and loneliness and things that we see. So I actually think it's really important for a brand like Hims & Hers, and I think we try to do this, to be aspirational and to be energizing. Say, "Hey, this is not going to be a whole bunch of models that you're going to see. You're going to see real people that actually feel great." And we're going to try really hard to make it really easy to feel great. Because if we can help you feel great, you're then going to get out the front door and you're going to do something. You're going to be a better dad. You're going to be a better partner. You're going to help find a partner. All of those things are confidence, but they have huge impacts downstream in your life. And so I think the brand really tries to capture that. And I think there's a willingness from us to venture into uncomfortable conversations and be a brand that actually, you know, sits in that uncomfortable conversation because that is how you activate that consumer. Like that is how you actually have a conversation with people that they really need to have, and it catches their attention, and that's ultimately what matters most.

It was a crazy time scale. I mean, I think it was probably the fastest or one of the top few fastest companies from founding to IPO. And, you know, what became obvious to me was the opportunity was there, the demand was there immediately. The need was kind of coming through the door, and we needed very quickly to establish the capital resource, the brand resource to go and actually go after this scale, the opportunity. I mean, this is when you step back and look at Hims today, we treat 10 or 15,000 patients a day globally. That is the largest healthcare system, I think, in the world right — the actual number of patients that are getting treated every single day more on Hims & Hers and our associated global brands than any other place in the world. And so the opportunity for impact is huge, and I think we're in the earliest of innings. You know, I think right now, you've got a few million subs on the platform. I think the offerings that we're expanding into and the size of the opportunity is such that my vision is nearly everybody, you know, would be silly not to have a Hims & Hers membership because it just helps make feeling great and being healthy easy. And my goal is to make that so unbelievably obvious to the average person, and so unbelievably accessible from a price standpoint, and beautiful and easy, that people want to do it. And so for me, going public was an intentional decision to put our team in boot camp. Like public markets is brutal, right? And you see it from our stock. It's gone to whatever, 70 to 2 to 50 to 10. I mean, it's like up and down. Like you have to have a stomach of steel. But more importantly, the team has to get really good very quickly at both setting quarterly targets and meeting long-term vision, right? You have to be able to deliver growth and efficiency at the same time. You have to be able to tell the street with confidence, "We're going to hit these numbers a year out," and then you have to hit them or else you lose all trust. And that environment, I think, is one of the most powerful assets that we've had in the last decade of our company. Like it is just forced rigor. It's forced discipline. And when I step back — and this was a really critical part of why I decided to put us in this pressure cooker — when you step back and look at some of the biggest companies in the world that have been built, you know, Google, Microsoft, Meta, Amazon, these companies were public within a few years of being founded, right? The founders put themselves in the public markets and then had to be forced with both having a long-term vision and building a great business. And I'm not saying you can't do this in the private markets, but the public markets make it required. And so I've really loved — as a competitive person, I've loved that environment. I've loved what it's done to our team. And I think it has prepared us to be able to go after a much bigger opportunity.

That's right. Yeah. I mean, we raised privately for a few rounds. The company was doing north of 100 or 200 million in revenue and was profitable, and we had very good line of sight into this business going from 100 million in revenue to a billion. And, you know, companies now — your guidance this year is something like three. So I think you believe that we had the capabilities to deliver in the public markets, but then also the public markets have unlocked incredible assets for us, right? So we've been able to acquire very strategically critical infrastructure. We acquired one of the only US manufacturing peptide facilities last year in California. We acquired IP for one of the only at-home blood testing devices. We acquired international leaders. We've brought in talent that we can actually attract because we've got a public currency. It's just materially different than private markets. So I think the public markets have given us real assets to go and actually pursue the speed at which we want to on the vision.

The team at this point — most of the team has been building this company for, you know, north of six years. And so, you know, this is a team that's woken up and it was $2.97, and woken up and it was $70. And many of the reasons that it fluctuates has nothing to do with the business, right? Amazon puts out a press release and the stock goes down 10%. You know, somebody else puts out a press release, it goes up 15%. So I think we've gotten numb to the movements. Long-term, I think, is where everybody's focused. So I think the vast majority of my executive team will retire with this business, and so the reason that I and them continue to operate is because we actually just see the impact it can have. Like I think our combination of consumer understanding, design, clinical excellence, and kind of go after a huge vision and disrupting what people can expect from healthcare — I think that combination positions us very well to build something that I think is really important to people. You know, I think what we can achieve in the next decade, my hope is and my expectation is, it becomes the gold standard of what is healthcare. What people actually expect healthcare to be. It's proactive. It's got advanced diagnostics. It's with you everywhere through wearables. It's all connected. You've got the intelligence of the masses through AI. You've got doctors on demand whenever you need, and they know everything about you, and they're helping you make it easy to be your best. Both your best in the most clinical ways — cardiovascular disease, diabetes, obesity — and also in the ways that give you confidence: hormonal support, skin care, dermatology, sexual health, right? And I think the combination of both is absolutely critical.

Yeah, I think you have to set the expectation early with the team that it's going to be a ride, and I do that, I think, very intentionally and very often to anybody — new employees, old employees — so that on those days it's not unexpected, right? On the days that the stock rockets for no reason, I'm still in Slack, still in Amplitude A/B tests, like asking the same questions as to why the numbers aren't getting better. And on days when the stock tanks for some reason, I'm still doing the exact same thing. And I think that culture of the stock is not the company, right? The company is how we impact patients over the long haul and how we actually build a profitable, cash-flow business. Like that is the company. The ruthless focus on that, I think, people can get, but you have to be very consistent in that communication. The first time you bring it up can't be the day that the stock goes down 10% from Amazon. You actually have to tell people, you know, every quarter, hey, expect that the stock is going to go down. Somebody's going to put out a press release. Somebody's going to do something. It's going to go up and down. Because when you're disrupting something so big as the healthcare system, everybody in the world is incentivized for you to lose, right? The PBMs, the insurers, the drug companies, the regulators, the unionized providers — everybody has figured out a way to make money from this system as it exists today. Yet, none of the financial outcomes of the system have any relation to how consumers actually feel and whether or not they are getting better. There's no relation at all to those economic dynamics. And so I think establishing in the company's mind everything we're going to do is for the consumer. We're only going to make money when the consumer is happy. If they're not happy, they're going to leave. If they're happy, they're going to stay. We make more money. So all of our decisions are going to be based on how we make people feel better, feel great for more affordable prices. You keep that north star there, and then you let the chaos of the market of disruption happen because, you know, we're not — I mean, you can see this just from the business. We're not a team that is shy when it comes to having hard conversations or pushing into new categories. We will fight on behalf of the consumer, and that often does cause friction and disruption, but that is a part of the DNA because we think that is right for what's best for people. And so I think with that expectation, people are good with the ups and downs. You know, as you push forward.

Yeah, it's essentially pharmacy capabilities to bring active API ingredients — so medications that are approved by the FDA and on very specific lists — that you can then combine and adjust in dosage or formulate in new form factors on behalf of the patient. So you think of, you know, one of the simplest examples — and it's not actually compounding, but back in the day, you think of the Flintstone vitamins, right? Kids needed their vitamins. Kids can't swallow pills. And so the combination of supplements in something that tastes good, that's chewable for a four-year-old — that's like a very simple example of a compounded treatment. And so with this shortage, this drug shortage, our facilities from a regulatory standpoint could start manufacturing and producing these medicines, which we did. Simultaneously, what we identified was that — and this is all very known with these medications — the side effect rates are astronomical. Massive gastrointestinal side effects: diarrhea, nausea, vomiting. People will go to the ER for this stuff. And so you had this interesting dynamic where the demand was through the roof, but about 70 or 80% of patients were stopping the medication within 90 days because of very adverse reactions, like very serious reactions. And so the compounding facilities have the ability to make medicine in two circumstances: one, when there's a drug shortage, and two, when there's a clinical necessity for the patient. When a provider says for this patient a dosing adjustment is necessary, a formula adjustment is necessary, a combination of therapies is necessary, a different form factor is necessary — any of those reasons. So the legal framework allows for two ways in which you can compound. For us, for about a year or two, we operated under both. There was a shortage where patients could come get the exact same medication, and then there was also a personalization exemption which allowed us to personalize medicine for patients. And I'm a really big believer when you step back and look at the healthcare system today: the future of healthcare isn't, you know, patients getting one of three dosing regimens. It's us understanding you, Ed, your body mass, your metabolism, your desires, your goals, and actually taking safe medicines approved by the FDA and personalizing them for you. Like, it's an obvious iteration of where medicine should go when you think about precision medicine. Everybody is different. And so with these medicines particularly, the side effect rates were so high that that personalization dynamic was critical for patients. Now, and because of that, the business grew very quickly, extremely quickly, because patients wanted that personalization.

Yeah, it blew up. The company doubled overnight. And it was amazing for, you know, hundreds and hundreds of thousands of people who couldn't get access to this medicine or who had tried the medicine and had severe side effects. Now, what happened was, I think, phenomenal. Not without friction, but phenomenal. The drug companies reacted to two different things. One, they reacted to the pricing pressure. So we were able to manufacture and compound these vials personalized for —

patients and offer to them for something like $150. The price of the FDA-approved medication at the time was $1,500. And so the pure exposure, the transparency of a model like Hims & Hers where it says, 'Hey, we're consumer-oriented. We can make this stuff. We have these facilities. It costs us about, you know, 80 bucks all in with all of our stuff. So we're going to put a markup on it. We're going to sell it to you for 150.' And it was all very transparent about how this all worked. Resulted in immense pressure on the drug companies to take the blockbuster medicine of the century and bring its price down to what consumers could actually afford. And through all types of regulatory pressure, through corporate pressure from us, through consumer pressure, those medications are now available to consumers for $150. The brand-name medications. That has never happened in the history of this country when the medicine that is brand new, recently approved, and needed by the masses was able to apply enough consumer force and pressure to bring that cost down to something that people could afford. And I think it was a big part of the administration was a huge part of it through TrumpRx. They did a phenomenal job in applying pressure. And I think the exposure of the fact that we could actually make this medicine for this cheap and we could sell it for 150 and have a really reasonable business resulted in people applying that same pressure to the drug company. So that was an amazing transition. So that happened. The second thing happened on the personalization side. The drug companies, and we were talking to all of them, saw that 70% of their patients were stopping right after starting their medicine because of these side effects. And these were injections with single-dose injections. You put it in your belly, you click a button, and you get 5 milligrams. Well, if 70% of those people are throwing up and stop using it because 5 milligrams is too much, they were coming to Hims & Hers. And so now, fast forward two years later, and the drug companies have done a phenomenal job. Novo and Lilly have adopted it very quickly. They now have vials on LillyDirect where you can do custom dosing. They've got quick pens where you can adjust exactly the amount of dose for you. And then Novo just put out the Wegovy pill. So low-dose pills where you can titrate and adjust your treatment based on side effects, micro-dose as necessary, and get to whatever the outcome is that you need. And so over the course of 18 months or 20, 24 months, our pressure by saying, 'Hey, we've identified something that really matters to consumers. They need this personalization and this price point is a fair price point because it's what it costs us to make.' The whole industry responded and so as a result we've now been able to partner with Novo Nordisk directly which is fantastic. We recently launched the Eli Lilly products on the platform because now those products are $150 and can be personalized to patients. And so, again, through our lens, we push on behalf of people and the industry has changed dramatically as a result of the pressure in a way that we think is phenomenal for people. And now it really aligns us very well with many of these drug companies to be able to help them get these medicines to millions of individuals.