Telehealth has quickly become a regular part of our lives. Now, a new generation of pharma brands are using this channel to upend the sales and marketing status quo within this highly regulated industry.
Pharmaceutical advertising featuring cheery images of people frolicking, picnicking and (according to the voiceover talent) living their best lives has become tired to the point of memeification.
What’s emerging in its place is a new school of brands ditching the traditional approach in favor of a radically new business model that combines telehealth, direct-to-consumer (DTC) sales and deft marketing.
Foundational to this change has been the rise of telehealth. Only 21% of the US population opted for virtual visits pre-Covid. Since the pandemic, however, this number has rocketed to 43%, according to a study conducted by HealthInsurance.com.
This radical shift has helped propel a new cohort of brands that offer telehealth services combined with direct-to-consumer sales of certain pharmaceuticals. This includes Ro, Hims, Nurx, Capsule, Keeps and others.
These brands are circumventing the tried-and-true practice of running ads that encourage consumers to ’ask your doctor’ about the product. Instead, these companies are functioning as both the physician and the pharmacist.
“Historically, we’ve used the term ‘direct-to-consumer marketing’ to include running an ad for Nexium on the nightly news or putting an ad for an erectile dysfunction drug in Men’s Health magazine,” says Dr Christopher Robertson, a leading expert in health law and a Boston University professor of law. “It has traditionally been done by the major pharmaceutical companies, such as Pfizer and AstraZeneca, but those have always culminated in the phrase, ‘Ask your doctor about this product’. So although the patient would be the target of marketing, they couldn’t just go buy the product without a prescription. What seems to be changing at this moment is that brands are bundling the drug with the healthcare.”
Robertson says we are experiencing a defining moment for DTC pharma and telehealth. “What we’re seeing is some degree of change that speaks to patients’ desires to be consumers and to make choices for themselves.”
The origins of the new model
It’s important to understand how and why it’s possible for these brands to lump both care and pharmaceutical sales together.
When it was announced in 2017 that Viagra’s patent would expire in April 2020, the market saw an influx of brands rushing to meet demand for erectile dysfunction (ED) drugs. What began as a few companies offering DTC ED sales evolved into a crop of new brands offering products to address ’sensitive healthcare areas’ – ie, treatments for hair loss, sexually transmitted infections, acne and more.
Today, many brands that began by offering treatment for these conditions have evolved with the aim of creating a one-stop-shop for healthcare services, select pharmaceuticals, as well as a range of non-prescription care products.
Take Ro, the parent company of men’s and women’s lines Roman and Rory, as an example. Ro began by offering telehealth for weight loss, smoking cessation, skincare, genital herpes and other health needs. Its physicians prescribe pharmaceuticals as well as recommend over-the-counter solutions sold by Ro. But its scope has expanded significantly, with co-founder and chief growth officer Rob Schutz saying: “We’re building a vertically integrated primary care platform that is patient-centric.”
Today, Ro offers a suite of healthcare services, pharmaceutical sales and in-home care options, plus a nationwide network of providers and physical pharmacy locations, “so that every American can kind of get their basic health needs met from diagnosis to delivery of treatment to ongoing care” through one centralized platform, says Schutz.
The model appears to be working: Ro has helped facilitate over 6m digital healthcare visits, across every county in the US, including 98% of primary care deserts – areas with particularly low access to primary healthcare.
What’s next for this model remains to be seen, says Robertson. Healthcare providers – whether practicing in a traditional setting or online – have historically been required to establish a face-to-face relationship with every patient before writing them a prescription.
“States were starting to loosen up those rules for the last seven or eight years, though some states have gone a lot faster than others,” he says. ”But the pandemic has caused many states to [loosen them further]. A lot of them are adopting a rule that the physician can use their judgment as to how they establish a relationship. As long as it is reasonable under the circumstances, a physician can establish a relationship fully online.”
In the law and policy community, he and others are waiting to see how these regulations might change post-pandemic.
Convincing consumers this isn’t a scam
The telehealth space has been subject to a lot of skepticism and distrust. That’s why education has been a marketing pillar for a number of brands within the space.
Nurx, for example, is a telehealth company that got its start selling birth control. It has since expanded its product and service lines significantly, but its marketing efforts have always focused primarily on education.
Consumers want to know “if these are real doctors and if this is even legit”, says Nurx’s chief marketing officer Katelyn Watson. At the same time, she says, people feel like they are “just pushed around“ in the healthcare system. “They have no choices and are just being told what to do: fill out this form, fill out that form.” To Nurx, this resounding consumer frustration presented an opportunity to offer greater access to accurate healthcare information.
Nurx’s marketing efforts center around this mission. “We share messages such as, ‘Did you know that the Centers for Disease Control and Prevention recommends that if you’re sexually active you should get tested for sexually transmitted infections once a year?’” says Watson. ”Most people don’t know that, so we’re going to focus on being that trusted source for information, whether it’s through our providers or our social media ambassadors.” The brand sees this as a way to build consumer trust. And it has proven effective: about 60% of Nurx patients stay with the brand after a year.
Hims, meanwhile, has focused less on health education, choosing to position itself more decidedly as a wellness and lifestyle brand. For example, its female-focused offshoot Hers recently launched a line of sex toys that can be purchased online alongside hair growth vitamins and prescription acne medication. Hilary Coles, co-founder and vice-president of merchandising for Hims and Hers, says: “Healthcare should feel like self-care – a holistic choice that takes into account all the choices that help us feel good, from what we eat to how we sleep and any other ways we get through the day.”
Having fun with health messaging
There’s something markedly youthful about most of these brands. Their branding is bright and playful, with sleek lines and cool typography. Coles says the Hims and Hers brands are ”fresh, fun and modern”, to make people feel welcome and encourage them to take care of themselves. ”For example, you’ll find our website doesn’t contain the cold and sterile vibes that people commonly associate with hospitals and healthcare.” And New York City residents won’t soon forget the pre-pandemic Hims campaign that plastered posters depicting suggestive cacti throughout subway stations across the city advertising ED drugs.
But brands like Hims and Ro are not only appealing to millennial audiences with their youthful feel. In fact, for Ro, these consumers don’t generally represent its target demographic. “One thing that surprises a lot of people about our business is we are not millennial-focused,” says Schutz. Instead, the average age of a Ro patient is 46 and 40% of its patients are over 50, he says.
Schutz and his team have found unique ways to connect with these specific demographics. Roman, the company’s line of products and services marketed toward men, launched a multi-year partnership with Major League Baseball in 2019. “The average age and demographic of a Major League Baseball viewer is a man in his 50s, and that matches up very nicely with Roman’s target demographic.”
However, Roman and Rory still target younger demographics for many of their other offerings. What matters most, Schutz claims, is meeting target audiences where they are – speaking to them in their own languages on their preferred channels – and creating a seamless experience for them by “removing a lot of the friction that currently exists in the healthcare system”.
Talking social issues on social media
In line with their youthful feel and desire to speak authentically, Ro, Nurx, Hims, Hers and the like have established strong social media presences. Hers alone has amassed over 109,000 Instagram followers. It’s worth noting that one can’t scroll the feeds of these brands without stumbling upon obvious social and political commentary. Users see posts celebrating MLK Day and International Transgender Day of Visibility, images of Ruth Bader Ginsburg and calls to end xenophobia.
Schutz says it’s important to speak out on social and political issues. “We are committed to making sure that healthcare is equitable for everyone and that we’re meeting patients’ needs across the board. And as part of that, we feel like it’s really important to take a stance on issues that impact patients and also our employees.
“Racism, for example, is a core social determinant of health and a driver of health inequalities. And it’s our hope that by shining a little bit of light on it, we can help correct some of this and make sure that healthcare is equitable across the board.”
Coles, of Hims and Hers, says it is about connecting with patients authentically. “Our social media presence is simply an extension of our direct relationship with our consumers. The content we prioritize focuses on the topics our customers truly care about – whether that’s cultural, emotional or educational.”
As the healthcare and pharmaceuticals space continues to evolve, we’re likely to see even greater convergence as care and pharma sales become both more intertwined and more consumer-facing. “I don’t think that patients necessarily care about, or in some cases even understand, the difference between prescription and over-the-counter,” says Nurx’s Watson. “What they care about is getting the solution quickly, easily, in a trusted way and delivered to their door.”