Healthcare is Broken—This Company Wants to Fix It

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I'm Ed Ellson. Health care in America isn't just expensive. It's often out of reach. Only half of Americans can't access or afford quality care and even for those who can. System is broken.

Long wait times personally 40% to delay or skip appointments altogether. In 2017, my next guest set out to make health care more accessible. Launching a platform that connects patients with doctors and treatments directly through their mobile devices. Today, it's grown into one of the leading telehealth companies offering care across sexual health, hair loss and weight management with no waiting room required.

With more than 2.5 million subscribers, it is reshaping how people engage with care and redefining what the future of health care could look like.

This is my conversation with Andrew Dudham, co-founder and CEO of HIMS and hers. Andrew, thank you for joining me on the podcast. I guess I want to start with the founding story of HIMS and hers. In 2017, you start with this company. Back then, I started to see a lot of ads around New York City that with these kind of iconic ads that I remember of this CAC dye on these billboards.

And we're trying to figure out what this company did. Ultimately, it seems like the main product back then was erectile dysfunction medication.

“So tell us a little bit about the beginnings of this company. Is that right? Is that how you started?”

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 length 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 and 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, everything had been completely consumerized in a beautiful, price-transparent way. Yet healthcare was still this environment that was paternalistic that was lacked any empowerment that lacked old-truck price transparency. And it really was built for a system, not a consumer, right? And so what I said out to do was, "Can we take the best of consumer love, the best of consumer health care, 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 at like the stigmatization of healthcare. Things like sexual dysfunction, things like hair loss, that affects maybe 50% of the population, things like weight loss, that affects 70% of the population. Actually, normalizing the fact that these things happen and their 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 hymns-in-hurst 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 builds something that people love.

“That was really ambition and I think in the early days some of the stigmatized conditions were really great way for us to start the conversation with people about what healthcare could look like in the future.”

So it sounds like those stigmatized issues such as hair loss, such as erectile dysfunction, these sort of male-focused issues. Maybe that was your entry point into becoming a larger, telehealth company that focuses on a range of different issues. I guess the question is, why did you focus on those issues to begin with?

And it's transition to hymns and hers. I think a lot of people think of this company originally as this is specifically for male issues, things like E.T.

Why did you focus on those issues to begin with?

“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 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 now one more question was actually the reason they came to the doctor's appointment, right?

And now 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. 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 in 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, "Why?" Now that we have you and have delivered on this issue, you might be concerned with and treat other things. So a good example or reptile 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 that on blood test and just test some basic?" Right? And it turns out now we treat tens of thousands of people every year who came for erectile dysfunction actually are 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 in the things that maybe they need. Yeah, that tracks with how I've seen this company because, you know, there are a lot of telehealth companies out there and a lot of companies that have had the idea of how do we figure out how to streamline the healthcare industry. There are all these issues in how it works and can we digitize it and make it, you know, work for a digital Asian for a digital consumer. But it seems as though with him's and hers,

the thing that really got you guys out ahead, at least from an observer's perspective, is that you are willing to tackle the issue that no one really wanted to touch. And this is something we've talked about on our show a lot, which is the mental health crisis, among young men, also the sexual health crisis, among young men, the fact that young men aren't going out and socializing, they're not finding girlfriends, they're not finding establishing romantic relationships,

they're not having sex and erectile dysfunction is the amount of people in the rates, or the share of the population who are experiencing that is on the rise. So it seems as though that seems to be like the entry point that puts him's on the map. And I guess I'd be interested to hear more about your views on young male health at large and how you spotted this very early in the game.

We started talking about this issue a couple of years ago, you started this company in 2017. So you were very early to look at this issue and to really go out and try to address it.

“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 shit, 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.

I'll look at our calendar and I've meetings on my calendar called Paramet Aboss, right?

And then there's meetings on my calendar called Directile Disfunction. 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 in lowliness 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 health 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 him's in hers, and I think we try to do this to be aspirational and to be energizing.”

So 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 fucking easy to feel great. Because if we can help you feel great, you're then going to get out in 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 can 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 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. So you ended up taking the company public via spec in 2021, which was three years after you launched.”

Take us through what happened between launching this company and then suddenly you're publicly traded on on public stock exchanges. I mean, how did that go down? 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 was there. The demand was there immediately. The need was 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 of the opportunity.

I mean, this is when you step back and look at him's today. We treat 10 or 15,000 patients a day globally. That is the largest health care system I think in the world, right? The actual number of patients that are getting treated every single day more on hemids and hers in our associated global brands than any other place in the world. And so the opportunity for impact is huge. 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 that my vision is nearly everybody.

Nearly everybody you know would be silly not to have a hymns and hers membership because it just helps make it helps make feeling great and being healthy easy. And my goal is to make that so unbelievably obvious to the average person. And so I'm going to be 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 bootcamp. Like public markets is brutal. 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 to 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, this like pressure cooker, when you step back and look at some of the biggest companies in the world that have been built, you know, Google and Microsoft meta Amazon, these companies were public within a few years of being founder.

And not saying you can't do this in the private markets, but the public markets make it required. And so I've really, 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.”

So did you intentionally decide that you did not want to continue raising in the private markets because you wanted the opportunity to kind of playable in the public markets? I mean, most people today are like, would prefer to play in the private markets, not deal with the headache, going public reporting or the financials, etc.

That's why you didn't raise privately.

That's right. I mean, we raised privately for a few rounds. The company was doing north of 100 or 200 million in revenue and it was profitable. And we had very good line of sight into this business going from 100 million in revenue to a billion. And companies now got into this here something like three. So I think you believed 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, which is 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. Just a side question, do you look at the stock price? Because it's true. The stock price has been very volatile up and down. Do you look at it? Do you care much about it when you're running the company did it?

The team at this point, mostly the team has been building this company for north of six years. And so, you know, this is a team that's woken up in it was $2.97 and woken up in 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 and goes up 15%. So I think we've gotten to the movements long term. I think is where everybody is focused.

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.

I think our combination of consumer understanding, design, clinical excellence and kind of goal to like 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. You're 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.

And I think the combination both is absolutely critical.

Just for a management perspective, say Amazon puts out some press release and the stock falls 10%. Just like immediately. What do you say to the team? Like, you know, I think a lot about this organization. How do we keep up morale? How do we keep everyone motivated and invested in the mission? And I feel like I would find it very difficult to do that. If random news events were causing the stock price to fall on any given day. So what do you say to your employees and to your team when things like that happen?

“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 at the stock rockets for no reason. I'm still in slack still in amplitude AB 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 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.

Everybody in the world is incentivized for you to lose, right? PBMs, the insurers, the drug companies, the regulators, the unionized, you know, provides everybody has 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 we're not, 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. Support for the show comes from engine. The company's winning right now aren't cutting travel. They're booking smarter. Here's the reality.

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See full rewards terms for details. Go to engine.com/ax/rewards-terms. We're back with Andrew Dudham. So GLP-1 drugs and diabetes, weight loss drugs. This is a new category for you guys. It's generated a lot of press.

We've talked about it a lot on our podcast. We found it super interesting when you guys entered the GLP-1 market, which was back in 2024.

And there was a lot of controversy because of course these GLP ones were, I mean, they were being supplied by Nova Nordisk and then eventually Eli Lilly, but there was this shortage of supply. And the rules around the FDA meant that if there is a shortage of those drugs, then you can sell these compounded drugs, these sort of alternative versions of these chemical type drugs, which is what you were selling. And then there was a resolution in the shortage. There was a kind of an interesting legal battle with Nova Nordisk that you guys had.

To the extent that you can describe what happened there, to walk us through him's entry into the GLP-1 market, how things played out with some of the more legacy players are now where you are today.

“It was one of those sagas that I think was exciting to read about, and so it was everywhere from a new standpoint.”

But the actual strategy and rationale was actually really quite simple, and the regulatory framework was also really quite simple. You had a lot of new FDA medications that had come and the demand was through the roof. So there was, as you said, there were immediate shortages of these medications. And so we have about a million square feet of infrastructure across the US and globally, where we can compound these medications personalized for patients.

You have to do exactly what you would do through CGMC kind of requirements, as you would it out any other drug manufacturing, right? Like we hold the same bar of quality.

“And just for our audience to understand, what is compounded actually mean when you say you compound these drugs?”

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 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 need their vitamins, kids cancel all the 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 regularly 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, this side effect rates are astronomical, massive gastrointestinal side effects, diarrhea, nausea, vomiting, people go to the ER for this stuff. And so you have 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. 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 good believer when you step back and look at the healthcare system today. The future of healthcare is in patients getting one of three dosing regiments. It's also understanding you add your body mass, your metabolism, your desires, your goals, and actually taking safe medicines approved by the FDA, and personalizing them for you. It's, it's an obvious iteration of where a medicine should go. When you think about precision medicine, every body is different. And so with these medicines, particularly the side effects 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. There's blew up. Yes, the company doubled overnight. And it was amazing for 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 it to them for something like $150.

The price of the FDA approved medication at the time was $1500. And so the pure exposure, the transparency of a model like him's in hers where it says, hey, we're consumer rated. We can make this stuff. We have these facilities. It costs us about 80 bucks all in with all of our stuff. So we're going to put a mark up on it. We're going to sell it to you for 150. And it was very transparent about how this all worked resulted in immense pressure on the drug companies to take the blockbuster medicine of this century and bring its price down to what consumers could actually afford.

And through all types of regulatory pressure through corporate pressure from us to consumer pressure, those medications are now available to consumers for $150. The brand name medications. That is 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 that people could afford.

So that was an amazing transition. So that happened. The second thing happened on the personalization site. The drug companies and we were talking 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 in your belly, you click a button and you get five milligrams. Well, 70% of those people are throwing up and stop using it because five milligrams is too much.

“And so now fast forward to years later and the drug companies have done a phenomenal job. Novo and Lily have adopted it very quickly. They now have vials on Lily direct 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 will go V 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. Well, the course of 18 months or 20 24 months are 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 Nordist directly, which is fantastic. We've 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. Such an interesting story because it all happened because of this strange regulatory dynamic where if there's a shortage of the drug, which is what was happening because it was so new to the scene and demand was going just so crazy. Then you can do these things specifically compounding, which is basically a fancy word for let's take different ingredients, put them together at an interesting way and then give it to the public and you were allowed to do that because of this, I guess sort of like a regulatory glitch.

And it's it's it was created for exactly as purpose feature not a bug maybe yeah it's a feature it's not a bug it's saying hey if the drug companies can't make enough medicine.

All of you pharmacies around the country you can make it which to me brings up questions of how a regulatory system and healthcare actually works because if it won't for the fact that there was a shortage of the supply of GLP one drugs. You wouldn't have had the regulatory or the legal ability to go out there and create a different version of the drug at a much cheaper price and we probably wouldn't be here today where you have essentially forced the hand of the large healthcare companies to offer that drug at a lower price.

We think all regulatory restrictions perhaps to stringent is it is it may be a problem that we the only reason that you were even allowed to pursue this model is because there was some issue in the supply chain of the GLP one industry itself.

“I think a lot of people are thinking that I mean I think the new peptide's conversation that's taking place is another version of this conversation right there's a there's a push to deregulate.”

But the administration qualifies as supplements right BPC 157 TB 500 at the talent all of these all of these peptides.

During the Biden administration removed to a category to list no longer letting pharmacies manufacture them or compound though. Now there's a meeting in July pushed by by RFK to see if those can be then reintroduced into a category one list to allow access to consumers.

Now the the traditional industry doesn't want this to happen at all right because by doing so.

You are frankly educating consumers that peptides which are just chains with amino acids that that are found in the body can be sourced produced. And safely manufactured and delivered to consumers for let's say 50 to a hundred dollars. Well the drug industry will love for for that knowledge not to be known because if you can pat in those if you can take was amino acids and throw something on the side of.

So again, this the system you know is set up to to to make a ton of money and so I do think there's a real conversation that should should happen around. Consumer empowerment and health care and that doesn't undermine I think the importance of the FDA's oversight in making sure things are safe and things are manufactured right from the right facilities with the right regulatory frameworks and that the risks of those are are mitigated. But there also has to be an opportunity for consumers to have empowerment and get access and ultimately have more choice.

So there's no question that the FDA and the regulatory oversight to make sure medicines are safe is required and needs to be respected. Yet the same time consumers have to be able to have empowerment to work with their provider and work with their doctor and explore what's right for that and that could be adjustments to dosing that could be combination therapies or that could be exploring things like peptides.

“And so I think we as a business sit at a really interesting intersection because I think we can lead by both empowering customers to have access to this level of innovation.”

But establishing what doing it the right way means and to me you know peptides as an example what doing it right means is always doing it hand in hand with the provider.

So making sure the clinical oversight is there the understanding of you is there and that a doctor is involved and active in that decision making so that you have informed understanding of your choice. And then second making sure that the actual supply and manufacturing and sourcing is entirely gold standard. So when you look at you know the compounding of weight loss medications in the last couple of years just like when you look at the compounding of peptides right now almost all of it is coming from unregulated imported sources overseas.

“And people say oh it's made in America compounded America it's not right we know the same five facilities and manufacture all of this stuff.”

And so there is a real gray market and there's a black market for these therapies that is dangerous. There's there is lack of understanding of the purity and the exposure and when you're talking about sterile pharmacies like people aren't injecting these things like the oversight of these facilities from an FDA standpoint is needs to be very high. And so I do think as we enter this world where there's more consumer empowerment there's more interest in things like BPC 157.

It will be critical for hymns and hers to establish that gold standard of of quality say hey this is actually made in America the APIs are manufactured here.

“This is how you do third party testing this is how you do certificates about authentication so people know exactly what they're getting and this is how you do doctor and clinical oversight to make sure you're thinking about this the right way.”

And and we're putting a ton of effort into making sure that the the approach for all of our categories looks like that and that doesn't mean it's going to be the cheapest but I think it's going to be done right and I think I think companies are going to need to find that middle ground. We'll be right back. Support for the show comes from engine the companies winning right now aren't cutting travel they're booking smarter here's the reality. The average business traveler spends 45 minutes booking a single trip on a legacy platform with engine that booking time drops to his little as two and a half minutes.

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Over regulation the stringent regulation around these drugs has resulted in an ecosystem where a lot of these companies there are huge barriers to entry and these companies have essentially established these maybe monopolies maybe you'd say oligopolis they have unbelievable pricing power there is no price transparency they're ratcheting up these prices to extraordinary degrees and it's having real adverse effects on the actual health of.

Of the American people and it's probably worse in the United States than in any other nation when you just look at the amount of money that was spending per capita on health care costs.

“And there is a really good argument as you say and I think that your story really brings it out in how over regulation that is actually been lobbied for by a lot of these large corporations has led to that outcome at the same time though.”

In a world of health care in a world where in an industry where we're talking about the actual biological health of human beings.

The idea of being loose with regulation and sort of letting everyone kind of do whatever they want to do is also a very scary.

It's a game to play because there is a world in which you know maybe let's just assume that there was a GLP one shortage and then you were compounding these drugs and maybe you guys got it wrong you didn't and you delivered great medication for a lot of Americans. But if you had messed up in some way then suddenly that's a moment where you'd say well why did we let this guy who's kind of new to the health care game get involved in these drugs and sell these things to people. So I guess at a sort of very high level how do you think about regulation like what is the right balance and what should we be pursuing from a policy level.

Even from a company level to deliver low cost health care to Americans without making them potentially more sick. You know I think the administration right now is doing a great job pushing the right balance to be honest.

The government applying pressure to the drug companies to come to the table with regard to government negotiated drug pricing was an incredible step.

We're the only country in the world that doesn't do that and he's stat was country in the world that doesn't do that which is why you know people could buy will go via Canada and UK and Australia and Japan for a hundred dollars hundred fifty dollars for the last few years and here in the US where there's a massive massive obesity epidemic.

“The medications were ten times that and so I think it was a great first start for the administration to say hey these these are important people and we're going to force change.”

No we wanted to do that no drug company wanted to do that and it could only it was only possible because frankly the president made that happen I think that's a great. A great start and I think that should continue. I think that should continue as president for the mass market therapies that are needed by the American people. I don't think there's any reason that the margins of these companies need to be so exorbitant. I believe that formulas get paid back for their innovation no question huge believer in that and I think the US has benefited from that innovation. But there is a middle ground there right there's a way to also make it accessible to people as well.

You guys are one of the leaders I would say in GLP one drugs at this point I mean of course there's no of an artist can eat I literally who are manufacturing stuff but you're getting it out to a lot of people. How how large is the GLP one opportunity like is it that some people are going to be skinnier and that's kind of how you see it or does it I mean. I can just tell you that my coach got out of way he thinks that GLP ones are more important than AI.

“I think the other people wants to have more impact in global society over the next five years in AI no question.”

And it's not just because you know somebody's losing 10 pounds right the science at this point the price points of them coming down overseas they just want generic and Canada. This year the you know some like we've time will go generic in the US in about four years right it's already it's already expanding into new form factors with novo in the pill which unlocks a completely different customer audience.

That's going to then up downstream on diabetes deaths all metabolic resistance you're seeing cancer data come out in the last few weeks which is just tremendous.

“You're seeing fatty liver and and kidney I mean it's just like I think you essentially have a population that is metabolically.”

That that results in all of these perverse outcomes whether it's heart attacks cancer and the body just going astray even neurodegenerative diseases. From a what we can tell from the science is that when you metabolically fix somebody. All of these other things meaningfully reduce and so I think it's going to have massive implications for people's health it's already having massive implications for for things like smoking and drug addiction.

And drug addiction and alcoholism I mean it's.

I would be surprised if. Fast forwarding four or five years from now. GLP ones were not a part of North of 50 to 60% of every Americans daily have it whether it's through a vitamin that they're taking a compounded vitamin orally or through a weekly combination injection that also helps to manage their hormones or or.

“Cardiovascular risks but I think it's going to be a staple in in the global healthcare society no question.”

Do you think that big farmer and large healthcare companies are concerned about this I mean if that we have a drug that sort of systematically.

The results many of the root root causes of all of these symptoms you know obesity leads to all sorts of things and if we see cancer rates going down smoking cessation alcoholism going down all of these things that I mean in a dark way. I'm sure it's companies big fall in the company's benefit from because that making money solving those problems do you think those companies are worried about what this could do. I think there's no question and you see it this year with the GLP one pressure on pricing that the age of.

Restrained farm emergence is gone it's gone. It might still be there according to court but like the the culture has caught on.

“Government has caught on every day people have caught on and whether or not hymns and hers is here any longer players like us expose the reality right and I think him is will continue to do that now what I hope will happen.”

Is they will adapt the adapt to what consumers want and I think there's a tremendous opportunity consumer biotech. That I think him's in hers is at the forefront of and we're able to go you know earlier on in the process of actually starting to work with these drug companies and making these therapies because now there's actually a way to get them to hundreds of thousands millions of people quickly. But I think what's going to happen is consumer biotech is going to start making medicines that people actually want not necessarily the thing is that just keep them treated and sick but stable so good example.

Elon Lilly has a new medication early phase trials where single injection a year removes cardiovascular risk this came out just about a few weeks ago so you don't have to take a stat in every single day. So it's going to take repas though which is $500 a month twice a week you can take one injection that probably costs about $30 30 to 50 dollars to make that one injection and it removes your cardiovascular risk it just drops your LDL to like obliterate it. There's going to be 10 other versions of it also and hymns is going to be and hers is going to want to get that as many people as possible right and people are going to want that because they don't have to be sick any longer they can actually be proactive they can like it's like a vaccine for heart disease right if you could take a vaccine for cancer or vaccine for heart disease a lot of people will do that immediately and so I think there's going to be a new wave of demand for therapies but I do think without question.

It's going to have to adapt very quickly because I think the age of unrestrained margins and just treating illness ongoing is gone I think a big part of this is also just like the gene therapy dynamic the gene editing capabilities actually allows you probably five years from now to fix issues instead of just treat the symptoms of the issue and that is another reason in which I think the whole economic framework is going to have to be changed.

I mean why why would why should people trust that you will not do that at some point?

“Yeah, I think it's just you know we'll walk the walk period right like we the I fundamentally believe.”

That you can build with this company and this is really rare I think something that helps the entire world and is a great business. And that's because when you look at the reasons people are sick and you look at reasons people are dying and the reasons they're depressed or like he's it's it's an a lot of it is an access problem. The in many ways this is not a scientific problem right you have to leave your house and take off work and get a babysitter to drive to then way in line at the doctors to then talk to a doctor who's super tired and barely paying attention to you who's spending four hours a day writing notes to to get like bottom of the barrel service where you're not even getting proactive you're just treating the thing that's most urgent.

Like that's not a system that is loved and that's a system that's extremely costly and so what you've seen him to know is doing the last ten years and you'll see us keep doing it. Is verticalize each part of the infrastructure that's costly and then give that right back to consumers. So instead of having brick and mortar facilities we could tell a massive platform instead of having doctors in the office we've got a digital provider group instead of having to pay you know epic a ton of money for their EMR we built our own.

Instead of having to partner with a compounding facility and and drug manufacturing that's going to have huge margins. We're just going to invest hundreds of millions of dollars and build our own facilities so that these treatments can be 50 bucks so I think you're going to see us just continue to invest.

In a better experience a more efficient experience and ultimately that's because I think.

The only reason we're building this thing is because we actually think that's possible right we think it is possible that people could have a world class state of health and be empowered to feel awesome.

“Maybe 50 to 100 bucks a month. You guess like that's what I really think is possible like you think about Netflix you're playing 15 bucks a month for some movies you should be able to pay 100 bucks a month.”

The medicines you need to feel great and and a doctor watching over you making sure you're on the right track like I really believe that's possible when you look at the health care industry. This country are just fed up with how the whole system works and every time we try to dig into this industry.

Often times the answers that I get are it's super complex and there are all these different players and is hard to know who is the problem or what the problem is actually stemming from.

It's a pharmacy benefit manages and there's the insurance companies and there's the actual pharmaceutical companies themselves as someone who's in it. Who's the problem in your mind where is the problem coming from all of it the ways in which the money flows is messy and deeply entrenched where everybody is the problem like there is no single issue. It's the point of finger and say it's the PBS it's it's it's everybody and it's and it's obvious because at the end of the day they'll all lobby against the system that breaks the system.

“I think they'll they'll fight each other internally to try to make five bucks here and there 5% more within the system but if somebody attempts to break the system all of them are all the same team and say hey or to shut that down.”

And I think that exposes very clearly what's going on and so you know we chose very early to frankly not really try to integrate into the existing system. And that's why we built our own provider we built our own pharmacies we have our own drug sourcing we buy directly from raw ingredients or we actually in the peptide side by our own manufacturing to make our own raw ingredients in the US because we don't believe we can buy them anywhere else high quality.

I think what will force a great outcome is a new system that delivers for consumers that shows that it can be priced affordably that shows it can deliver great care and on demand care and price transparent care and proactive care and things people actually love. And then as a result the legacy system will be forced to change my final question. I think Hamzen has is a really good case study in entrepreneurship because you guys have entered into a system or broken into an industry which from the outset desperately did not want you to exist.

“We've heard multiple stories in this podcast as to how that has played out and as to how you have overcome that and I think that that is really the story of starting a company in a lot of different industries.”

Usually if you're the new intern on the scene the incumbents do not want you to succeed. So my final question to you what would be your advice based on your experience starting this company to founders entrepreneurs people who are starting up in that career as who are trying to break into a system. Which does not want them to win. One of my old co-founders used to say this and I think maybe Peter Teele used to tell him and I don't remember the exact source, but there's something like don't underestimate toys that can become big companies.

And you think of something like Snapchat. It's written off. It's like the disappearing photo. It's a feature. It's a toy or a Facebook. It's a way to see other men or women on your college campus single. It's a toy. It's a joke. It's silly.

Right. If we had launched 10 years ago and talked about today, you know, back then what we talked about today. Right. The ambition to disrupt the healthcare system. It wouldn't be impossible.

“And the ambition hasn't changed. It's been consistent the whole time. But I think our approach was what's the wedge? Like what's the toy? What's the thing that keeps the existing system unaware of what we're doing?”

Completely naive to it. And for many years, the healthcare system laughed at him's in hers. Right. Like I'd go to JP Morgan, healthcare conference. And people are like, why are you even here, right? Don't you guys just like aren't you guys like the cactus? Like you said, you guys like cactus advertisements in New York. That's not healthcare. That's like that's a Viagra.

And now I think the conversation has really changed. And so I think, you know, I push founders to identify the consumer truth that is deeply misunderstood in the legacy system and start there.

And don't be too greedy about I don't have a big ego about like needing to say how you're going to go disrupt this whole system. You know, I think founders often like to do that.

“And doesn't matter. Like what matters like understand the consumer truth that the system is missing.”

Figure out the purest implementation to prove that and go after that.

And if you can figure that out, if you can unlock the consumer love because you've actually understood them better than anybody else. Just keep growing from there slowly keep growing from there.

And it's to your advantage that the legacy system thinks you're a toy and thinks you're a joke and doesn't pay attention to you. And eventually they'll stall or attack you. They'll make fun of you and then you'll go through the phase it, you know, they'll go through the phases of grief and then they'll fight you. And then you actually onto something. But in the early days, I just find that consumer insight. And to do them is the co-founder and CEO of HINs and hers Andrew really appreciate your time. Thank you.

Thanks for having me. This episode was produced by Alison Weiss and engineered by Benjamin Spencer. Our research associates on Dash Lawn and Chris Noodon of you. And our senior producer is Clay Miller. Thank you for listening to the Prof. Markets Founder series. We'll see you next month with another founder story. Support for the show comes from engine. Here's the reality. The average business traveler spends 45 minutes booking a single trip on a legacy platform.

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