WASHINGTON -- Online startups including Hims and Roman are banking on a mix of convenience, viral marketing and glossy packaging to turn generic prescription drugs and other pharmacy staples into a profitable new business model. But some in the medical establishment are raising concerns about their marketing and the quality of care they provide.
Like other on-demand services, Hims and Roman promise consumers quick, convenient access to what they want. That means customers essentially self-diagnose, selecting the medication of their choice and -- pending approval by a doctor -- receive the prescription by mail or through a local pharmacy. In place of a traditional exam, patients answer a battery of questions about their symptoms, medical history, allergies and other details.
Similar companies specialize in contraceptives, sleep medications and pills for anxiety. Backing the trend are millions in venture dollars from investors searching for the next Warby Parker or Dollar Shave Club -- blockbuster online brands that have upended the markets for eyeglasses and razors by cutting out traditional retailers.
"There are both opportunities to improve access to care, but also risks to patients, and I think regulators are having to address that," said Lisa Robin, an executive with the Federation of State Medical Boards, which represents the organizations that license and discipline physicians.
The group has been advising U.S. physicians to carefully consider "their professional and ethical duties" before signing up to work for the companies.
Hims and Roman each said in separate statements that their doctors are required to deliver the same standard of care on their platforms as they do in person.
Dr. Adriane Fugh-Berman, who studies pharmaceutical marketing, worries the companies are minimizing the role of health professionals in carefully diagnosing and treating patients.
"These are lifestyle drugs, and they have potentially serious adverse effects, and this seems like too casual a way to be obtaining them," said Fugh-Berman, a professor at Georgetown University.
Potential side effects of Viagra include dizziness, blurred vision, muscle pain and sudden hearing loss. The female libido drug Addyi, which is also available through the websites, can cause fainting when combined with alcohol.
In some cases, the websites promote prescription drugs for unapproved uses, such as blood pressure drugs to reduce anxiety.
Hims' website touts blood pressure-reducing beta blockers as a way to ease "performance anxiety during your big event -- like a big presentation at work or interview."
While that kind of "off-label" prescribing is common for many physicians, drug-makers are barred from advertising such uses because they have not been federally approved. The online startups, echoing Uber and other Silicon Valley startups, say they are technology companies and are therefore not subject to those rules.
The FDA didn't comment on the websites but said in a statement that off-label drug use "should be a conversation between the consumer and the health care provider."
Prescription drugs sold by Hims and Roman -- both founded in 2017 -- are available at most pharmacies nationwide. And retail giants such as Walmart and CVS Health also offer medical consultations through apps and websites.
Hims' 30-year-old founder, Andrew Dudum, says his company is revamping the process "so people can have an amazing experience" and get "extremely beautiful products."
Hims -- which also sells shampoo, vitamins and other consumer items -- puts its products in discrete, minimalist packaging stamped with the company name. Its female-focused site, Hers, similarly offers custom-wrapped medications for low sex drive alongside hair and skin products.
Customers are invited to "Shop Sex" or "Shop Hair," alongside Instagram-ready photos of young models and messages like: "we're here to help reduce the stress and guesswork out of your sexy time."
Roman Chief Executive Officer Zachariah Reitano, 28, says his company offers customers a chance "to talk about these things that can be highly stigmatized."
Business on 06/06/2019