13 ms·

The Hollow Men of Hims

214 points by quadrin 1y ago

htrp 1y ago
so Hims found a way to VC back, blitzscale, and legitimize those shady online internet pharmacies from the dark corners of your inbox
leoh 1y ago
>What happened in those eight weeks reveals something essential about the kind of company Hims has become. Even as they shook hands with Novo executives in April 2025—presumably in a conference room with aggressively modern furniture—Hims continued selling what their new partner called "illegitimate, knockoff versions" of Wegovy. These were compounded semaglutide injections sourced, according to Novo's investigation, from Chinese suppliers whose quality control standards remained opaque at best and terrifying at worst. Yes, problematic >We threw in Elizabeth Holmes for a lot less—though one suspects her fatal error was not the fraud itself but the transparency of it, the sheer crudeness of promising blood tests that did not work rather than the more sophisticated approach of selling actual drugs through loopholes so baroque that even their exploitation carries a patina of legitimacy. What? >The pharmaceutical equivalent of putting both ketchup and mustard on a hot dog and calling it gourmet—though one suspects the hot dog vendor would display more honest shame about his craft. Huh?
- randallsquared 1y ago
  Yeah, the sound of the axe grinding obscured the message.
- nijave 1y ago
  >What? Yeah, that's quite a stretch of comparison... Questionable quality control vs brazen fraud
scifi 1y ago
The writing is hard to engage with—possibly trying to be funny, but it comes off as overly antagonistic. Phrases like “—presumably in a conference room with aggressively modern furniture—” feel distracting and undermine the point.
- mingus88 1y ago
  I had the opposite take, actually. I had to think about it for a sec and suddenly, “oh, right. Novo nordisk == Danish == Scandinavian design” cute. This style of writing is a welcome change from all the AI slop or self promoting blogs out there. It’s a personal touch without making it all about the author. Long form articles with some humor used to be all I wanted to read on the web.
  - striking 1y ago
    I think it is potentially still AI prose, perhaps just well-edited or working from a good prompt. Aside from using quite a few em dashes and being relentless in shoving cleverness in, there's a link to Wikipedia with a `?utm_source=chatgpt.com` in there. To be clear, whether or not it is AI prose is beside the point in my opinion. I think this piece is informative and funny but could be edited down significantly, regardless of how it was produced.
    - deleted 1y ago
      [deleted]
  - gwern 1y ago
    > This style of writing is a welcome change from all the AI slop or self promoting blogs out there. Dude. This is AI slop. And quite obviously so! You think all those EM DASHes are there naturally? Or the constant use of reversal? No one writes like that. (Even the people who love em-dashes and make a point of using the Unicode point will change it up more than that, rather than using it like a metronome.) Even if there wasn't that adrafinil referral URL giving it away (which incidentally tells you that OP wasn't doing all his own research but relying on the search plugin to compile a report he could spin), at this point you should recognize the 4o style. This just doesn't sound like the normal ChatGPT because the author prompted ChatGPT to make it as invective and rhetoric and axgrinding as possible (or possibly, just went through and heavily edited a more neutral ChatGPT draft but I doubt that is responsible for the bizarre analogies or rhetoric like the hot dog thing). So, a good example of the "don't worry about seeing AI slop on HN; worry about when you stop seeing AI slop on HN" evolution. Stripping referrers or avoiding EM DASHes is, after all, easy to do... Also, top keks: >> It is worth noting that the culture that produced Hims—Silicon Valley's peculiar blend of messianic self-regard and algorithmic thinking—has convinced itself that traditional gatekeepers are inherently suspect, that disruption is inherently virtuous, and that the phrase "move fast and break things" applies as beneficently to human bodies as it does to software systems.
giantg2 1y ago
"The law, as Hims understood it, was not about intent but about technicalities," Well, according to the principle of lenity, or strict construction, that's exactly how the law is supposed to work.
- parpfish 1y ago
  Im all-in for using technicalities to get what I want out of the healthcare system instead of having them all weaponized against me.
jackdeansmith 1y ago
>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. Strongly disagree with almost everything in this article, but specifically this. The reason people make these choices is not because of slick marketing working against them, it's because the existing process to get medical treatment is paternalistic, hard to navigate and often expensive. If you want safe and really high quality medical care you should absolutely have a personal physician you have a personal relationship with, who understands your lifestyle, your risk factors for side effects, and your medical needs deeply. How many Americans have that? Maybe a few dozen? The market has responded to just how terrible the existing system is.
- binarymax 1y ago
  It’s possible for both you and the article to be right. The system sucks, but Hims are also terrible, and medical care should not be like Amazon prime.
  - WalterSear 1y ago
    One's a storefront. The other is a foundation of society. These are not the same magnitude of sin, particularly since one's shortcomings are large reason for the existence of the other.
  - alphazard 1y ago
    > and medical care should not be like Amazon prime. Speak for yourself; that is exactly what I want. And anyone else who wants a similar experience should be able to purchase it.
    - bigyabai 1y ago
qgin 1y ago
I might be crazy, but I am more sympathetic to Hims after reading this than I was before.
- mingus88 1y ago
  Up until the part where people couldn’t cancel their subscriptions or got charged out of the blue
  - nocoiner 1y ago
    I hate subscriptions and dark patterns and the like as much as anyone, but I am not sure putting a six-month pause on your subscription and getting billed in month 7 is “out of the blue.”
    - teaearlgraycold 1y ago
      And it’s not the best customer service if you can’t cancel something that’s already shipping to you. But it’s also not outrageous. You could always chargeback if you don’t mind them backlisting you.
    - jjcob 1y ago
      WTF? Why offer a "pause" on your subscription at all? The only reason to do that is to trick customers. If the company was honest, they'd get confirmation before resuming the subscription. I hate that companies use sleazy practices like this all the time, and then people are like "well it's your fault for not reading the fine print".
      - ProfessorLayton 1y ago
        Pausing unlocks bulk pricing for customers taking meds as-needed (ED pills etc.). I'm not sure about Hims pricing since they require a questionare/login, but similar sites offer a sizable discount for larger quantities, and then it's just pause/unpause as needed.
LordDragonfang 1y ago
This buried lede is really the core of the article: > They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. This is what disruption looks like when applied to the oldest human needs: not improvement, but the illusion of improvement And contrary to what the article claims with hundreds of words of flowery indictment, it is improvement. As everyone on this site should be able to tell you, UX matters, and the medical establishment has some of the most frustrating, unpleasant, and confusing UX of any necessary service. Of course shady companies are going to get lots of business when all the competition following the law most faithfully provide a broken UX, and the only way to do otherwise is to bend the rules.
- jitl 1y ago
  OneMedical (now owned by Amazon) provides a version of this that also connects you with a general practitioner doctor who you're able to see in your area. They additionally have telehealth-style prescription requests in the app, but you end up with the FDA approved version coming from Amazon pharmacy for $5/month (on top of the $200/year for OneMedical), or for $cheap at your regular pharmacy. A++ would recommend. However, when I get referrals from OneMedical to specialists like eg sleep apnea, those 3rd party specialists usually have like 8 month waiting lists. So, back to Hims-style online-only providers for that sort of thing.
  - n8cpdx 1y ago
    I also have one medical, (cheaper if you have Prime), but they don’t do ozempic/wegovy, so you’re still at the mercy of insurance, or paying out of pocket if you want GLP-1s. They’re still a great option if you have other needs, like Prep or stimulants.
- sarchertech 1y ago
  Take the case of a antibiotics. A large percentage of people want their doctor to prescribe them antibiotics when they have a virus. It’s been shown that doctors who over-prescribe antibiotics get better patient reviews for example. Now you have a “better UX” that pops up that gives people exactly what they want. They answer a few questions on a website and they get an antibiotic prescription. There is no way for the medical establishment to compete with a site that will give people what they want even when it’s harmful to them without even requiring any kind of examination. In the case of antibiotics, this kind of behavior breeds resistant bacteria that regularly kill people. In the case of other drugs or combinations of drugs, the risks are usually only to the patient themselves. But the risks are real and patients assume this stuff is regulated.
yold__ 1y ago
Semaglutide / GLP-1 compounding is not limited to just Hims. Lot's of pharmacies do it. The manufacturer (Novo Nordisk) charges 5x-10x for the exact same thing. The author calls the GLP-1s used in compounding "Chinese Knockoffs", but offers no evidence of quality control problems, and is instead relying on the reader's prejudices. GLP-1 drugs may be a game-changer for obesity and diabetes, the same way that cholesterol (statin) drugs have greatly improved heart health. Hopefully reversing a long trend of increasing waistbands in developed / developing countries. Unfortunately, America will pay the highest price (including Medicare). I'm all for anything that makes them cheaper, including the many compounding pharmacies currently exploiting the loophole the author takes issue with.
- adxl 1y ago
  [flagged]
- Spooky23 1y ago
  The problem with your position is simple: where does it come from? The legit path for compounded semaglutide is buying up Rybelsus, impacting the supply for diabetics. Compounding pharmacies are notoriously shady, and are likely using grey market materials from questionable sources.
  - jrflowers 1y ago
    Can you give some specific examples of compounding pharmacies buying up Rybelsus or using grey market GLP-1
    - Spooky23 1y ago
      There’s a bunch of material out there including acknowledgment from the association of compounding pharmacies. They are in general shady, and the Florida pharmacies are notoriously under-regulated. Guess where most of the online dick pill outlets do their compounding?
    - Brian_K_White 1y ago
      Why would this product be different from any other product?
mlsu 1y ago
The explosive growth of Hims and other side-channel healthcare businesses (using this model -- telehealth combined with compounded meds) is entirely due to the "legitimate" healthcare system's complete and total failure to serve patients' needs. You can maybe talk about the hollow men of Novo and Lilly, who colluded with PBMs and insurers for most of a decade to push the cost of insulin analogues into the stratosphere, taking billions in profit while people died in agony rationing insulin. (in horrible agony -- blood turning into acid until brain death)
- turnsout 1y ago
  [flagged]
  - ggm-at-algebras 1y ago
    I am unsure why you have been down voted because fundamentally your point is correct. Health is a fully regulated space, and no entity should be supplying medical products without adherence to requirements appropriate to their role. Compounding GLP-1 seems to me to be in the higher bar space.
    - WalterSear 1y ago
      I'd hazard the downvotes are due to the existing toxic relationship between legislation and the medical cartel.
    - turnsout 1y ago
      [dead]
      - ch4s3 1y ago
        Factually healthcare is more regulated than most industries in the US and the web of regulations has no design and where it does, patient safety is rarely the primary goal.
      - tomhow 1y ago
n8cpdx 1y ago
> Regulatory arbitrage disguised as innovation, dressed in the fashionable vocabulary of patient empowerment while serving no master but the quarterly earnings call. No masters except the patients that are literally being empowered to make choices about their medical care and are paying a substantial premium (in many cases) to do so. I would happily be empowered by my doctor and UnitedHealthcare instead, but sadly that’s not on the table. Try getting tretinoin from a real doctor; I’ve been written prescriptions multiple times, never once succeeded in actually getting it, because insurance is a fucking nightmare. And I’m not on a cheap plan. Also note that the compounded semaglutide is superior because it comes in adjustable dose vials, unlike the pens. But I’m sure the author would claim that taking a smaller dose to reduce side effects is “a dangerous and unproven approach to medicine that puts patient lives on the line purely for profit”.
- gunsle 1y ago
  Tretinoin is easily prescribed by seeing a dermatologist. What do you mean it’s a nightmare to get even with a prescription? I think a tube of cream cost like $10 at Costco. You don’t even need to use your own insurance to buy things from the pharmacy as long as you have a prescription. I never once had a problem filling it before I switched to Accutane.
  - kridsdale1 1y ago
    I was able to buy it two times from an Indian website. I have no concerns about its safety profile. Fuck the AMA gatekeepers. Bodily Autonomy means I should get to buy and use any medicine I decide it worth my personal risk assessment.
  - n8cpdx 1y ago
    My doctor keeps prescribing it and the pharmacy keeps not filling it. I’m not really sure what’s going wrong, I haven’t taken the time to debug the situation. I shouldn’t need to, and I’ve never needed to with hims.
    - gunsle 1y ago
wonderwonder 1y ago
Hims is actually very expensive. I get the same Semaglutide for far cheaper either via my hormone dr. (provides a small, reliable dose of testosterone (trt) every month and legit access to hard to get compounds via a compounding pharmacy. No hoop jumping, they have a menu, I order from it. In real life I take 2 - 3x the testosterone dose when I am on but when I am coasting its easy no stress way to get what I want delivered monthly. When I am not using what they provide I just set it aside for the apocalypse :) ) GLP-1s are a miracle drug, people want it so will do what they must to get it. Unfortunately for many of them they cannot afford the $1,000 a month price tag that comes with legitimacy. On top of that, regular doctors make you jump through hoops to get it, having to see the exercise and diet department of whatever hospital group they belong too. this adds hundreds / thousands to the cost. Let people have what they want. Hims parasitized the process but I don't blame them for it. They gave the people what they wanted and made a profit at the same time. Adults should be empowered to make their own health care decisions but unfortunately so many of those decisions are made either by insurance companies or the attractive sales reps that frequent the doctor offices. GLP-1's, testosterone, peptides, whatever, remove the gate keepers and allow the free market to compete. The fact that you can go to jail for ordering a 10ml bottle of test cyp over the internet is madness. I rarely go to the doctor now, except for things that are clearly beyond my limits, xrays, colonoscopy etc. For everything else there is the internet and chatGPT. GLP-1s, peptides, steroids, even anti biotics, almost everything you want can be found if you look. The way it should be. I even order my own labs and have chatGPT interpret them for me. I'm in the best shape of my life at 46 and haven't been to a non hormone doctor except for specialists in several years. Last time I went to the doctor I told them I wanted GLP-1s and they said no, I would have to go and see their diet department. I told them if they did not prescribe them I would just get them online but I would prefer to use them under the supervision of a dr. They just shrugged. I'm on cycle currently but when I am done and coasting again I am going to hop on metformin to take a crack at stabilizing my liver levels caused by fatty liver before I took control of my own health. Because... why not? Think a doctor would prescribe this? Let people be the decision makers of their own health. I'm not knocking doctors, they are often highly intelligent people doing good work but their power as gatekeepers does not come with neutrality and they are often beholden to their own bottom line as opposed to the patients well being.
- 1y ago
alphazard 1y ago
Given the healthcare bureaucracy in America, it's hard to find anything for the consumer to be mad about here other than the quality of the medications. The intended audience of this article must be pharma and healthcare investors, not consumers. As with most products, companies need a way to make promises to consumers about what's in the products. The only way the consumers will believe those promises is if the consequences for lying are severe. Clearly room for improvement here, maybe some of these 3rd party certification labs can start putting their seals on medications too. The article mentions that medication from China isn't part of an FDA approved supply chain, but as a consumer I don't really care about that. I'd rather have mass spectrometry data on the side of the tin than the FDA's blessing.
- CSMastermind 1y ago
  I see a lot of complaints about "the healthcare bureaucracy in America". And I don't doubt that it exists. But I will say the limited number of times I've needed to interact with the system it was surprisingly cheap and downright pleasant. The only negative experiences I've had is interacting with government run health systems (the VA).
  - ryandrake 1y ago
    Even if it isn’t cheap or pleasant, does that mean we should all turn to supplements and quackery? I’m really surprised at the replies dunking on this article. The fact that anyone can just go out there and make claims about and market their snake oil “medicine” should be worrying to more people.
  - wakawaka28 1y ago
    Doctor visits usually aren't so bad. But if you ever go to the ER or have to do something major like stay in the hospital, you will be surprised how expensive that gets.
  - potato3732842 1y ago
    Yeah, they're real good at doing needless work with a smile on their face. Next time you go to a GP's office for no reason other than to gatekeep a specialist you know you need ask yourself what all those people are being paid for any why the situation deserves anything more than someone on the order of an RN saying "yeah looks like an infection to me" via a screen, to pick but one example. Like all bureaucracy, every single part of the system has some skin deep reason to justify its existence or scope but when you take a step back and look at it all you'll find that huge swaths are either redundant or completely unnecessary, and that the industry is rife with this BS from top to bottom and we're all made effectively poorer for it.
parpfish 1y ago
> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being. Does the telemedicine appeal to people because they want to avoid embarrassment, or because they know that traditional doctors will schedule you for an appointment three months out just to say “have you tried getting better sleep, losing 30 pounds, and reducing stress?”
- nijave 1y ago
  Diet and exercise! Don't forget that 3 month out appointment is probably 15 minutes long with a 30 min office wait which you'll then inevitably fight insurance over (Hims doesn't bill insurance either)
- genocidicbunny 1y ago
  It's a little of column A, little of column B, but in a mixed way. A lot of doctor visits for basic health issues are ones that can be dealt with over a phone or video call. Routine stuff like updating your medicines, changing dosages, showing a bruise or dealing with a mild fever don't require you to be physically present at the doctor's office. Having to deal with insurance, scheduling, waiting times, driving to the doctor's office in the middle of the workday are unnecessary for a large proportion of the sorts of day-to-day issues people deal with. Telemedicine isn't a panacea, but in a system with major constraints on doctor bandwidth and where in-person visits are very expensive, it's extremely helpful. And yeah, a lot of that is because so often the solution is as you said -- get more sleep, eat better, maybe work out a little, reduce your stress. I'd much rather have a quick 15 minute call to be told that, instead of having to take several hours off work to go visit the doctor in person.
  - parpfish 1y ago
    I always lol at “reduce stress” as medical advice. May as well tell depressed people to “work on your attitude, turn that frown upside down!” If people could just “reduce stress” on a whim, they would. Having a doctor tell you reduce stress will actually increase stress.
theturtle 1y ago
Those commercials are inane and stupid (along with BlueChew and FridayPlans). "The shameful doctor visits." The what? Seriously, doctors in urology and related fields have seen guys whose dicks haven't just malfunctioned, they were BLOWN OFF, so shame really isn't a factor here!
- yCombLinks 1y ago
  You don't get to speak for how other people feel.
- malfist 1y ago
  The perspective of the doctors is not what a patient is embarrassed about
rKarpinski 1y ago
They make a case for not trusting Hims but not sure why that means I should trust Novo Nordisk
helf 1y ago
[dead]
cpf_au 1y ago
In Australia there is a company named Pilot which appears to follow an identical playbook.
teaearlgraycold 1y ago
I actually really like the compound hair loss solution they sell. I was already using ketoconazole after talking to my doctor and buying minoxidil over the counter. Getting something with finasteride as well consolidated and simplified things. And I know full well I’m paying more than I should. One of these days I’ll look for a cheaper alternative.
khernandezrt 1y ago
Except finding a doctor that genuinely cares about their patients personal needs is exceedingly rare. This is what Hims takes advantage of.
sandspar 1y ago
Interesting how a few rare commenters strongly agree with this article and yet most comments here don't. Perhaps HN is full of people with high digital literacy, relatively high reasoning ability etc. People like this can benefit from the service. The article's core point is that Hims uses unethical marketing. Maybe the HN crowd is privileged: people here may be able to resist marketing. The article's unstated point is that many people who use Hims would be better off not using it. HN people tend to be wealthy tech workers. I'm not sure how many people here know about the brutal conditions outside their cozy tech bubble. There are tens of millions of Americans with low cognitive ability, low digital literacy, high susceptibility to advertising, high stress, poor health, and demeaning jobs - all at the same time. Many of these unfortunate people spend pretty much their whole lives bouncing around from scam to scam. At age 15 they get exploited by an older boyfriend. At age 26 they get exploited by a for-profit college. Then at age 45 they get exploited by unethical pharma companies. Like Hims. The healthcare industry spends a lot of time dealing with this population. Many of these people tend to be "frequent flyers" of government-run programs. People who work in hospitals understand these unfortunate people intimately. When those hospital workers make laws, they spend a lot of time thinking about how to protect these people. Then Hims come along and targets them specifically. The article's point is that Hims exploits vulnerable people. And I agree.
- floxy 1y ago
  >these unfortunate people spend pretty much their whole lives bouncing around from scam to scam. Should these people be eligible to vote?
  - sandspar 1y ago
    Thanks for asking a challenging question. I don't know. Historically most systems of popular representation have excluded them. I assume for reasons that made sense at the time. I guess I'd rather live in a country that had universal franchise + the means to escape these people's gravitational well. Rather than a country that disenfranchises them albeit for solid reasons. Basically you try to build a stronger engine rather than to reduce drag. These people are here and they're not going anywhere. We have to somehow make our shared world work. It's a large and difficult problem and most people really dislike talking about it.
anon291 1y ago
I know it's funny because it's boner pills, but realistically, the article does not paint as bad a picture of hims as it is attempting to. The various rules they make to skirt the law seem silly, but are really the result of over-regulation. The simple truth about hims algorithmic care is that the vast majority of medical care could be given this way. This was a major revelation to me when I had a medical question that I asked through Amazon's online doctor platform (off-insurance) for just $30. The system asked me several quiz style questions. It determined exactly what was the problem (because again... most primary care is really not that hard). It gave a suggestion of what I'd probably get from the doctor. It sent all the details, including its suggestions to a board-certified medical doctor, who reviewed it within an hour, and then chatted directly with me via a secure messaging site. She agreed the plan suggested by the computer made sense. She asked a few more questions. Within 10 minutes, amazon pharmacy had my order and I received the medication the next day. I even received follow up care. Honestly, this was way better than using insurance for a physician visit. Half the time you go to the doctor, you already know what they're going to tell you. I could be wrong, but I believe this system was first made legal during COVID. Despite all the pearl clutching, it works exceptionally well, and should have been legal earlier.
rsync 1y ago
This is what I was saying here, speaking of pinpointed, personalized advertisements: https://news.ycombinator.com/item?id=44318773 https://news.ycombinator.com/item?id=44318773 "What to do with this massive infrastructure and billions of dollars of investment and workers employed by this global machine?" ... and that is where gambling and vaping (and ED pills and hair thinning medication) come in. I'm skeptical that the (personalized, aggregated data, pinpointed advertising machine) works for things of value and substance that require thought and nuance to purchase. As a consumer of online advertising for over 25 years, I have found much of it to be a grift. But if I were selling nicotine pouches ... or weightloss aids ... or access to gambling ... I'll bet it finally delivers as promised.
55555 1y ago
Sorry but the new breed of companies like Hims is making our system massively more convenient and cheaper and I won’t pretend they aren’t.
nmca 1y ago
This article is quite bad: haughty in tone and confused in content. If you are interested in learning something about a key part subject matter (compounding loopholes and their impact on drug prices), this article is much better: https://www.astralcodexten.com/p/the-compounding-loophole https://www.astralcodexten.com/p/the-compounding-loophole
VeninVidiaVicii 1y ago
The attitude in this article is suffocating. I’m 40, healthy, and picked up cheap generic Cialis for the hell of it with no shame, no crisis. It flipped my sex life on its head, instantly. The real scandal is how cheap, safe, and transformative this stuff is, and yet the medical world acts like you’re doing something dangerous by just wanting better sex. It’s not a problem. It’s the most fun I’ve had in years.
- wakawaka28 1y ago
  They have to make it sound overly serious, because if it wasn't then you might question why you must go to a doctor or why the prices are (or were) high. When a new version comes on the market, they will conveniently find lots of negative side effects to make you take the newer and more expensive one. I had to laugh at the gas station sex pill thing. In other countries not only do they have the gas station pills with Viagra in them, but they have a lot of basic "prescription" meds for sale over the counter at the pharmacy.
- sizzle 1y ago
  It can cause increased eye pressure and other scary eye stuff if you take it too often. Definitely look into it
deathanatos 1y ago
> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being. Maybe. > Finasteride for hair loss runs about $10-15 per month as a generic, I wish. Generic finasteride costs ~$70+t¹/3mo but only from a PBM, and $80/mo from a pharmacy, and is utterly uncovered by insurance. Or maybe, it is that this is what American Rx healthcare looks like: https://imgur.com/a/awRSOsA https://imgur.com/a/awRSOsA ² > and can cost as little as $2 per month with a GoodRx coupon. And how does GoodRx somehow magically make drugs cheaper? > On February 25, 2020, Consumer Reports published an article stating that GoodRx shared user data—specifically, pseudonymized advertising ID numbers that companies use to track the behavior of web users across websites, the names of the drugs that users browsed, and the pharmacies where user sought to fill prescriptions—with Google, Facebook, and around twenty other internet-based companies. > On February 1, 2023, the Federal Trade Commission fined GoodRx US$1.5 million for violations of the Breach Notification Rule and the Federal Trade Commission Act for allegedly failing to obtain specific, informed, and unambiguous consent from users before disclosing health-related information to Facebook and Google. (https://en.wikipedia.org/wiki/GoodRx#Controversy https://en.wikipedia.org/wiki/GoodRx#Controversy) Last time I was offered a GoodRx coupon (well past those dates) it came with no informed consent of any kind, being merely presented as "magic coupon make drug cheaper" which triggered my "that's too good to be true" alarm. AFAICT, selling your information is the company's business plan. ¹Cigna is utterly incompetent, and while the discount of playing their game is sizable, it costs a great deal of time. It took, I think, 4? 5? calls to customer support to set up a prescription? ²No, proceeding to checkout does not get you the price. You don't get to know the price until after you've placed the order. I have to go on past experience, and prayers.
- skunkworker 1y ago
  You can get generic finasteride 1mg/180 (6 month) for as low as ~$17 if you go to a Kroger pharmacy and use their preferred savings program (I forget the name off hand) and no insurance coverage. Kroger discontinued their Kroger savings and now have a preferred card, which ended up being half the cost of the best deal on GoodRX. Source: I picked up a 6 month supply last week.
- 1y ago
DoingSomeThings 1y ago
This is a frustrating article. To pick one example: "The most damning aspect is not their exploitation of loopholes or their willingness to combine dangerous drug cocktails or even their reliance on unvetted Chinese suppliers..." "unvetted" is doing a lot of work here. There's no evidence provided for this claim of working with shady sources and doing no diligence on the products they are selling. I know that to be false from first-hand connections in the telehealth space. Hims works with 503B pharmacies. They are FDA inspected. They run batch testing on their source material and require strict compliance. All safe, legal, vetted pathways. It's bizarre to me that the author is linking Novo Nordisk newswire press releases as sources of truth but is unwilling to to do basic research on how Hims operates. NN is hardly a faultless player here. They're selling this medicine for $1k+ per month! Separately -- Algorithmic care is fine because most decisions are algorithmic. It's no different than what you receive from the 5-minute dr visit in person. In a perfect world we'd have primary care doctors to coordinate care, direct you to the perfect pharmacy for each medicine you need, etc. In our real world, convenience and access are a good things. The shift from "patient" to DTC "client" is a net win for the public.
- matthewdgreen 1y ago
  This is the one aspect of this article I’d have liked to understand better. It can simultaneously be the case that these compounding pharmacies are regulated, and also that they’re buying peptides from Chinese suppliers that aren’t regulated and hence there’s some room for serious problems. I’d be much happier if I felt that these suppliers were being carefully regulated and monitored but I’m not convinced that this is the case.
raspasov 1y ago
"sildenafil and tadalafil — an illegal combination" It is not an "illegal combination".
Traubenfuchs 1y ago
PDE5 inhibitors and semaglutide should be OTC. Leave fat people that want to lose weight and men with weak dicks that want to be able to have sex again alone, for fucks sake.
raspasov 1y ago
In a wild turn of events, this is actually a genius marketing piece paid for by Hims & Hers.
rendall 1y ago
What is Hims?
crmd 1y ago
Is there a literary/journalistic term for the style of writing in this piece?
- nmca 1y ago
  “bad” seems fine?
- ternaryoperator 1y ago
  It's a tongue-in-cheek style.
weeznerps 1y ago
This is one of the absolute dumbest things I have ever read. People want their problems solved without waiting months for an appointment and spending an insane amount of money, case closed. The fact that this market exists is an indictment of the current system. The paternalism of medicine is infuriating. Doctors have been, for the most part, annoying gatekeepers of medication I already know I want or need. Way more medications should be over the counter.
DontchaKnowit 1y ago
Article is unreadable. The auther is trying to be funny and clever but it just ends up being a slog. Im like 4 paragraphs in and still have no idea what Hims did wrong at all. Just present the information...
richard___ 1y ago
Stupid article. Bottom line is I’ll pay a premium not because of shame but because I don’t want to schedule and drive to a physical location for a Drs appointment
reverendjames 1y ago
The author has yet to reach puberty or move out of his parents' house, so he doesn't yet appreciate the company's products.

214 points by quadrin 1y ago

htrp 1y ago

so Hims found a way to VC back, blitzscale, and legitimize those shady online internet pharmacies from the dark corners of your inbox

leoh 1y ago

>What happened in those eight weeks reveals something essential about the kind of company Hims has become. Even as they shook hands with Novo executives in April 2025—presumably in a conference room with aggressively modern furniture—Hims continued selling what their new partner called "illegitimate, knockoff versions" of Wegovy. These were compounded semaglutide injections sourced, according to Novo's investigation, from Chinese suppliers whose quality control standards remained opaque at best and terrifying at worst. Yes, problematic >We threw in Elizabeth Holmes for a lot less—though one suspects her fatal error was not the fraud itself but the transparency of it, the sheer crudeness of promising blood tests that did not work rather than the more sophisticated approach of selling actual drugs through loopholes so baroque that even their exploitation carries a patina of legitimacy. What? >The pharmaceutical equivalent of putting both ketchup and mustard on a hot dog and calling it gourmet—though one suspects the hot dog vendor would display more honest shame about his craft. Huh?

randallsquared 1y ago
Yeah, the sound of the axe grinding obscured the message.
nijave 1y ago
>What? Yeah, that's quite a stretch of comparison... Questionable quality control vs brazen fraud

scifi 1y ago

The writing is hard to engage with—possibly trying to be funny, but it comes off as overly antagonistic. Phrases like “—presumably in a conference room with aggressively modern furniture—” feel distracting and undermine the point.

mingus88 1y ago
I had the opposite take, actually. I had to think about it for a sec and suddenly, “oh, right. Novo nordisk == Danish == Scandinavian design” cute. This style of writing is a welcome change from all the AI slop or self promoting blogs out there. It’s a personal touch without making it all about the author. Long form articles with some humor used to be all I wanted to read on the web.
- striking 1y ago
  I think it is potentially still AI prose, perhaps just well-edited or working from a good prompt. Aside from using quite a few em dashes and being relentless in shoving cleverness in, there's a link to Wikipedia with a `?utm_source=chatgpt.com` in there. To be clear, whether or not it is AI prose is beside the point in my opinion. I think this piece is informative and funny but could be edited down significantly, regardless of how it was produced.
  - deleted 1y ago
    [deleted]
- gwern 1y ago
  > This style of writing is a welcome change from all the AI slop or self promoting blogs out there. Dude. This is AI slop. And quite obviously so! You think all those EM DASHes are there naturally? Or the constant use of reversal? No one writes like that. (Even the people who love em-dashes and make a point of using the Unicode point will change it up more than that, rather than using it like a metronome.) Even if there wasn't that adrafinil referral URL giving it away (which incidentally tells you that OP wasn't doing all his own research but relying on the search plugin to compile a report he could spin), at this point you should recognize the 4o style. This just doesn't sound like the normal ChatGPT because the author prompted ChatGPT to make it as invective and rhetoric and axgrinding as possible (or possibly, just went through and heavily edited a more neutral ChatGPT draft but I doubt that is responsible for the bizarre analogies or rhetoric like the hot dog thing). So, a good example of the "don't worry about seeing AI slop on HN; worry about when you stop seeing AI slop on HN" evolution. Stripping referrers or avoiding EM DASHes is, after all, easy to do... Also, top keks: >> It is worth noting that the culture that produced Hims—Silicon Valley's peculiar blend of messianic self-regard and algorithmic thinking—has convinced itself that traditional gatekeepers are inherently suspect, that disruption is inherently virtuous, and that the phrase "move fast and break things" applies as beneficently to human bodies as it does to software systems.

giantg2 1y ago

"The law, as Hims understood it, was not about intent but about technicalities," Well, according to the principle of lenity, or strict construction, that's exactly how the law is supposed to work.

parpfish 1y ago
Im all-in for using technicalities to get what I want out of the healthcare system instead of having them all weaponized against me.

jackdeansmith 1y ago

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. Strongly disagree with almost everything in this article, but specifically this. The reason people make these choices is not because of slick marketing working against them, it's because the existing process to get medical treatment is paternalistic, hard to navigate and often expensive. If you want safe and really high quality medical care you should absolutely have a personal physician you have a personal relationship with, who understands your lifestyle, your risk factors for side effects, and your medical needs deeply. How many Americans have that? Maybe a few dozen? The market has responded to just how terrible the existing system is.

binarymax 1y ago
It’s possible for both you and the article to be right. The system sucks, but Hims are also terrible, and medical care should not be like Amazon prime.
- WalterSear 1y ago
  One's a storefront. The other is a foundation of society. These are not the same magnitude of sin, particularly since one's shortcomings are large reason for the existence of the other.
- alphazard 1y ago
  > and medical care should not be like Amazon prime. Speak for yourself; that is exactly what I want. And anyone else who wants a similar experience should be able to purchase it.
  - bigyabai 1y ago

qgin 1y ago

I might be crazy, but I am more sympathetic to Hims after reading this than I was before.

mingus88 1y ago
Up until the part where people couldn’t cancel their subscriptions or got charged out of the blue
- nocoiner 1y ago
  I hate subscriptions and dark patterns and the like as much as anyone, but I am not sure putting a six-month pause on your subscription and getting billed in month 7 is “out of the blue.”
  - teaearlgraycold 1y ago
    And it’s not the best customer service if you can’t cancel something that’s already shipping to you. But it’s also not outrageous. You could always chargeback if you don’t mind them backlisting you.
  - jjcob 1y ago
    WTF? Why offer a "pause" on your subscription at all? The only reason to do that is to trick customers. If the company was honest, they'd get confirmation before resuming the subscription. I hate that companies use sleazy practices like this all the time, and then people are like "well it's your fault for not reading the fine print".
    - ProfessorLayton 1y ago
      Pausing unlocks bulk pricing for customers taking meds as-needed (ED pills etc.). I'm not sure about Hims pricing since they require a questionare/login, but similar sites offer a sizable discount for larger quantities, and then it's just pause/unpause as needed.

LordDragonfang 1y ago

This buried lede is really the core of the article: > They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. This is what disruption looks like when applied to the oldest human needs: not improvement, but the illusion of improvement And contrary to what the article claims with hundreds of words of flowery indictment, it is improvement. As everyone on this site should be able to tell you, UX matters, and the medical establishment has some of the most frustrating, unpleasant, and confusing UX of any necessary service. Of course shady companies are going to get lots of business when all the competition following the law most faithfully provide a broken UX, and the only way to do otherwise is to bend the rules.

jitl 1y ago
OneMedical (now owned by Amazon) provides a version of this that also connects you with a general practitioner doctor who you're able to see in your area. They additionally have telehealth-style prescription requests in the app, but you end up with the FDA approved version coming from Amazon pharmacy for $5/month (on top of the $200/year for OneMedical), or for $cheap at your regular pharmacy. A++ would recommend. However, when I get referrals from OneMedical to specialists like eg sleep apnea, those 3rd party specialists usually have like 8 month waiting lists. So, back to Hims-style online-only providers for that sort of thing.
- n8cpdx 1y ago
  I also have one medical, (cheaper if you have Prime), but they don’t do ozempic/wegovy, so you’re still at the mercy of insurance, or paying out of pocket if you want GLP-1s. They’re still a great option if you have other needs, like Prep or stimulants.
sarchertech 1y ago
Take the case of a antibiotics. A large percentage of people want their doctor to prescribe them antibiotics when they have a virus. It’s been shown that doctors who over-prescribe antibiotics get better patient reviews for example. Now you have a “better UX” that pops up that gives people exactly what they want. They answer a few questions on a website and they get an antibiotic prescription. There is no way for the medical establishment to compete with a site that will give people what they want even when it’s harmful to them without even requiring any kind of examination. In the case of antibiotics, this kind of behavior breeds resistant bacteria that regularly kill people. In the case of other drugs or combinations of drugs, the risks are usually only to the patient themselves. But the risks are real and patients assume this stuff is regulated.

yold__ 1y ago

Semaglutide / GLP-1 compounding is not limited to just Hims. Lot's of pharmacies do it. The manufacturer (Novo Nordisk) charges 5x-10x for the exact same thing. The author calls the GLP-1s used in compounding "Chinese Knockoffs", but offers no evidence of quality control problems, and is instead relying on the reader's prejudices. GLP-1 drugs may be a game-changer for obesity and diabetes, the same way that cholesterol (statin) drugs have greatly improved heart health. Hopefully reversing a long trend of increasing waistbands in developed / developing countries. Unfortunately, America will pay the highest price (including Medicare). I'm all for anything that makes them cheaper, including the many compounding pharmacies currently exploiting the loophole the author takes issue with.

adxl 1y ago
[flagged]
Spooky23 1y ago
The problem with your position is simple: where does it come from? The legit path for compounded semaglutide is buying up Rybelsus, impacting the supply for diabetics. Compounding pharmacies are notoriously shady, and are likely using grey market materials from questionable sources.
- jrflowers 1y ago
  Can you give some specific examples of compounding pharmacies buying up Rybelsus or using grey market GLP-1
  - Spooky23 1y ago
    There’s a bunch of material out there including acknowledgment from the association of compounding pharmacies. They are in general shady, and the Florida pharmacies are notoriously under-regulated. Guess where most of the online dick pill outlets do their compounding?
  - Brian_K_White 1y ago
    Why would this product be different from any other product?

mlsu 1y ago

The explosive growth of Hims and other side-channel healthcare businesses (using this model -- telehealth combined with compounded meds) is entirely due to the "legitimate" healthcare system's complete and total failure to serve patients' needs. You can maybe talk about the hollow men of Novo and Lilly, who colluded with PBMs and insurers for most of a decade to push the cost of insulin analogues into the stratosphere, taking billions in profit while people died in agony rationing insulin. (in horrible agony -- blood turning into acid until brain death)

turnsout 1y ago
[flagged]
- ggm-at-algebras 1y ago
  I am unsure why you have been down voted because fundamentally your point is correct. Health is a fully regulated space, and no entity should be supplying medical products without adherence to requirements appropriate to their role. Compounding GLP-1 seems to me to be in the higher bar space.
  - WalterSear 1y ago
    I'd hazard the downvotes are due to the existing toxic relationship between legislation and the medical cartel.
  - turnsout 1y ago
    [dead]
    - ch4s3 1y ago
      Factually healthcare is more regulated than most industries in the US and the web of regulations has no design and where it does, patient safety is rarely the primary goal.
    - tomhow 1y ago

n8cpdx 1y ago

> Regulatory arbitrage disguised as innovation, dressed in the fashionable vocabulary of patient empowerment while serving no master but the quarterly earnings call. No masters except the patients that are literally being empowered to make choices about their medical care and are paying a substantial premium (in many cases) to do so. I would happily be empowered by my doctor and UnitedHealthcare instead, but sadly that’s not on the table. Try getting tretinoin from a real doctor; I’ve been written prescriptions multiple times, never once succeeded in actually getting it, because insurance is a fucking nightmare. And I’m not on a cheap plan. Also note that the compounded semaglutide is superior because it comes in adjustable dose vials, unlike the pens. But I’m sure the author would claim that taking a smaller dose to reduce side effects is “a dangerous and unproven approach to medicine that puts patient lives on the line purely for profit”.

gunsle 1y ago
Tretinoin is easily prescribed by seeing a dermatologist. What do you mean it’s a nightmare to get even with a prescription? I think a tube of cream cost like $10 at Costco. You don’t even need to use your own insurance to buy things from the pharmacy as long as you have a prescription. I never once had a problem filling it before I switched to Accutane.
- kridsdale1 1y ago
  I was able to buy it two times from an Indian website. I have no concerns about its safety profile. Fuck the AMA gatekeepers. Bodily Autonomy means I should get to buy and use any medicine I decide it worth my personal risk assessment.
- n8cpdx 1y ago
  My doctor keeps prescribing it and the pharmacy keeps not filling it. I’m not really sure what’s going wrong, I haven’t taken the time to debug the situation. I shouldn’t need to, and I’ve never needed to with hims.
  - gunsle 1y ago

wonderwonder 1y ago

Hims is actually very expensive. I get the same Semaglutide for far cheaper either via my hormone dr. (provides a small, reliable dose of testosterone (trt) every month and legit access to hard to get compounds via a compounding pharmacy. No hoop jumping, they have a menu, I order from it. In real life I take 2 - 3x the testosterone dose when I am on but when I am coasting its easy no stress way to get what I want delivered monthly. When I am not using what they provide I just set it aside for the apocalypse :) ) GLP-1s are a miracle drug, people want it so will do what they must to get it. Unfortunately for many of them they cannot afford the $1,000 a month price tag that comes with legitimacy. On top of that, regular doctors make you jump through hoops to get it, having to see the exercise and diet department of whatever hospital group they belong too. this adds hundreds / thousands to the cost. Let people have what they want. Hims parasitized the process but I don't blame them for it. They gave the people what they wanted and made a profit at the same time. Adults should be empowered to make their own health care decisions but unfortunately so many of those decisions are made either by insurance companies or the attractive sales reps that frequent the doctor offices. GLP-1's, testosterone, peptides, whatever, remove the gate keepers and allow the free market to compete. The fact that you can go to jail for ordering a 10ml bottle of test cyp over the internet is madness. I rarely go to the doctor now, except for things that are clearly beyond my limits, xrays, colonoscopy etc. For everything else there is the internet and chatGPT. GLP-1s, peptides, steroids, even anti biotics, almost everything you want can be found if you look. The way it should be. I even order my own labs and have chatGPT interpret them for me. I'm in the best shape of my life at 46 and haven't been to a non hormone doctor except for specialists in several years. Last time I went to the doctor I told them I wanted GLP-1s and they said no, I would have to go and see their diet department. I told them if they did not prescribe them I would just get them online but I would prefer to use them under the supervision of a dr. They just shrugged. I'm on cycle currently but when I am done and coasting again I am going to hop on metformin to take a crack at stabilizing my liver levels caused by fatty liver before I took control of my own health. Because... why not? Think a doctor would prescribe this? Let people be the decision makers of their own health. I'm not knocking doctors, they are often highly intelligent people doing good work but their power as gatekeepers does not come with neutrality and they are often beholden to their own bottom line as opposed to the patients well being.

1y ago

alphazard 1y ago

Given the healthcare bureaucracy in America, it's hard to find anything for the consumer to be mad about here other than the quality of the medications. The intended audience of this article must be pharma and healthcare investors, not consumers. As with most products, companies need a way to make promises to consumers about what's in the products. The only way the consumers will believe those promises is if the consequences for lying are severe. Clearly room for improvement here, maybe some of these 3rd party certification labs can start putting their seals on medications too. The article mentions that medication from China isn't part of an FDA approved supply chain, but as a consumer I don't really care about that. I'd rather have mass spectrometry data on the side of the tin than the FDA's blessing.

CSMastermind 1y ago
I see a lot of complaints about "the healthcare bureaucracy in America". And I don't doubt that it exists. But I will say the limited number of times I've needed to interact with the system it was surprisingly cheap and downright pleasant. The only negative experiences I've had is interacting with government run health systems (the VA).
- ryandrake 1y ago
  Even if it isn’t cheap or pleasant, does that mean we should all turn to supplements and quackery? I’m really surprised at the replies dunking on this article. The fact that anyone can just go out there and make claims about and market their snake oil “medicine” should be worrying to more people.
- wakawaka28 1y ago
  Doctor visits usually aren't so bad. But if you ever go to the ER or have to do something major like stay in the hospital, you will be surprised how expensive that gets.
- potato3732842 1y ago
  Yeah, they're real good at doing needless work with a smile on their face. Next time you go to a GP's office for no reason other than to gatekeep a specialist you know you need ask yourself what all those people are being paid for any why the situation deserves anything more than someone on the order of an RN saying "yeah looks like an infection to me" via a screen, to pick but one example. Like all bureaucracy, every single part of the system has some skin deep reason to justify its existence or scope but when you take a step back and look at it all you'll find that huge swaths are either redundant or completely unnecessary, and that the industry is rife with this BS from top to bottom and we're all made effectively poorer for it.

parpfish 1y ago

> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being. Does the telemedicine appeal to people because they want to avoid embarrassment, or because they know that traditional doctors will schedule you for an appointment three months out just to say “have you tried getting better sleep, losing 30 pounds, and reducing stress?”

nijave 1y ago
Diet and exercise! Don't forget that 3 month out appointment is probably 15 minutes long with a 30 min office wait which you'll then inevitably fight insurance over (Hims doesn't bill insurance either)
genocidicbunny 1y ago
It's a little of column A, little of column B, but in a mixed way. A lot of doctor visits for basic health issues are ones that can be dealt with over a phone or video call. Routine stuff like updating your medicines, changing dosages, showing a bruise or dealing with a mild fever don't require you to be physically present at the doctor's office. Having to deal with insurance, scheduling, waiting times, driving to the doctor's office in the middle of the workday are unnecessary for a large proportion of the sorts of day-to-day issues people deal with. Telemedicine isn't a panacea, but in a system with major constraints on doctor bandwidth and where in-person visits are very expensive, it's extremely helpful. And yeah, a lot of that is because so often the solution is as you said -- get more sleep, eat better, maybe work out a little, reduce your stress. I'd much rather have a quick 15 minute call to be told that, instead of having to take several hours off work to go visit the doctor in person.
- parpfish 1y ago
  I always lol at “reduce stress” as medical advice. May as well tell depressed people to “work on your attitude, turn that frown upside down!” If people could just “reduce stress” on a whim, they would. Having a doctor tell you reduce stress will actually increase stress.

theturtle 1y ago

Those commercials are inane and stupid (along with BlueChew and FridayPlans). "The shameful doctor visits." The what? Seriously, doctors in urology and related fields have seen guys whose dicks haven't just malfunctioned, they were BLOWN OFF, so shame really isn't a factor here!

yCombLinks 1y ago
You don't get to speak for how other people feel.
malfist 1y ago
The perspective of the doctors is not what a patient is embarrassed about

rKarpinski 1y ago

They make a case for not trusting Hims but not sure why that means I should trust Novo Nordisk

helf 1y ago

[dead]

cpf_au 1y ago

In Australia there is a company named Pilot which appears to follow an identical playbook.

teaearlgraycold 1y ago

I actually really like the compound hair loss solution they sell. I was already using ketoconazole after talking to my doctor and buying minoxidil over the counter. Getting something with finasteride as well consolidated and simplified things. And I know full well I’m paying more than I should. One of these days I’ll look for a cheaper alternative.

khernandezrt 1y ago

Except finding a doctor that genuinely cares about their patients personal needs is exceedingly rare. This is what Hims takes advantage of.

sandspar 1y ago

Interesting how a few rare commenters strongly agree with this article and yet most comments here don't. Perhaps HN is full of people with high digital literacy, relatively high reasoning ability etc. People like this can benefit from the service. The article's core point is that Hims uses unethical marketing. Maybe the HN crowd is privileged: people here may be able to resist marketing. The article's unstated point is that many people who use Hims would be better off not using it. HN people tend to be wealthy tech workers. I'm not sure how many people here know about the brutal conditions outside their cozy tech bubble. There are tens of millions of Americans with low cognitive ability, low digital literacy, high susceptibility to advertising, high stress, poor health, and demeaning jobs - all at the same time. Many of these unfortunate people spend pretty much their whole lives bouncing around from scam to scam. At age 15 they get exploited by an older boyfriend. At age 26 they get exploited by a for-profit college. Then at age 45 they get exploited by unethical pharma companies. Like Hims. The healthcare industry spends a lot of time dealing with this population. Many of these people tend to be "frequent flyers" of government-run programs. People who work in hospitals understand these unfortunate people intimately. When those hospital workers make laws, they spend a lot of time thinking about how to protect these people. Then Hims come along and targets them specifically. The article's point is that Hims exploits vulnerable people. And I agree.

floxy 1y ago
>these unfortunate people spend pretty much their whole lives bouncing around from scam to scam. Should these people be eligible to vote?
- sandspar 1y ago
  Thanks for asking a challenging question. I don't know. Historically most systems of popular representation have excluded them. I assume for reasons that made sense at the time. I guess I'd rather live in a country that had universal franchise + the means to escape these people's gravitational well. Rather than a country that disenfranchises them albeit for solid reasons. Basically you try to build a stronger engine rather than to reduce drag. These people are here and they're not going anywhere. We have to somehow make our shared world work. It's a large and difficult problem and most people really dislike talking about it.

anon291 1y ago

I know it's funny because it's boner pills, but realistically, the article does not paint as bad a picture of hims as it is attempting to. The various rules they make to skirt the law seem silly, but are really the result of over-regulation. The simple truth about hims algorithmic care is that the vast majority of medical care could be given this way. This was a major revelation to me when I had a medical question that I asked through Amazon's online doctor platform (off-insurance) for just $30. The system asked me several quiz style questions. It determined exactly what was the problem (because again... most primary care is really not that hard). It gave a suggestion of what I'd probably get from the doctor. It sent all the details, including its suggestions to a board-certified medical doctor, who reviewed it within an hour, and then chatted directly with me via a secure messaging site. She agreed the plan suggested by the computer made sense. She asked a few more questions. Within 10 minutes, amazon pharmacy had my order and I received the medication the next day. I even received follow up care. Honestly, this was way better than using insurance for a physician visit. Half the time you go to the doctor, you already know what they're going to tell you. I could be wrong, but I believe this system was first made legal during COVID. Despite all the pearl clutching, it works exceptionally well, and should have been legal earlier.

rsync 1y ago

This is what I was saying here, speaking of pinpointed, personalized advertisements: https://news.ycombinator.com/item?id=44318773 https://news.ycombinator.com/item?id=44318773 "What to do with this massive infrastructure and billions of dollars of investment and workers employed by this global machine?" ... and that is where gambling and vaping (and ED pills and hair thinning medication) come in. I'm skeptical that the (personalized, aggregated data, pinpointed advertising machine) works for things of value and substance that require thought and nuance to purchase. As a consumer of online advertising for over 25 years, I have found much of it to be a grift. But if I were selling nicotine pouches ... or weightloss aids ... or access to gambling ... I'll bet it finally delivers as promised.

55555 1y ago

Sorry but the new breed of companies like Hims is making our system massively more convenient and cheaper and I won’t pretend they aren’t.

nmca 1y ago

This article is quite bad: haughty in tone and confused in content. If you are interested in learning something about a key part subject matter (compounding loopholes and their impact on drug prices), this article is much better: https://www.astralcodexten.com/p/the-compounding-loophole https://www.astralcodexten.com/p/the-compounding-loophole

VeninVidiaVicii 1y ago

The attitude in this article is suffocating. I’m 40, healthy, and picked up cheap generic Cialis for the hell of it with no shame, no crisis. It flipped my sex life on its head, instantly. The real scandal is how cheap, safe, and transformative this stuff is, and yet the medical world acts like you’re doing something dangerous by just wanting better sex. It’s not a problem. It’s the most fun I’ve had in years.

wakawaka28 1y ago
They have to make it sound overly serious, because if it wasn't then you might question why you must go to a doctor or why the prices are (or were) high. When a new version comes on the market, they will conveniently find lots of negative side effects to make you take the newer and more expensive one. I had to laugh at the gas station sex pill thing. In other countries not only do they have the gas station pills with Viagra in them, but they have a lot of basic "prescription" meds for sale over the counter at the pharmacy.
sizzle 1y ago
It can cause increased eye pressure and other scary eye stuff if you take it too often. Definitely look into it

deathanatos 1y ago

> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being. Maybe. > Finasteride for hair loss runs about $10-15 per month as a generic, I wish. Generic finasteride costs ~$70+t¹/3mo but only from a PBM, and $80/mo from a pharmacy, and is utterly uncovered by insurance. Or maybe, it is that this is what American Rx healthcare looks like: https://imgur.com/a/awRSOsA https://imgur.com/a/awRSOsA ² > and can cost as little as $2 per month with a GoodRx coupon. And how does GoodRx somehow magically make drugs cheaper? > On February 25, 2020, Consumer Reports published an article stating that GoodRx shared user data—specifically, pseudonymized advertising ID numbers that companies use to track the behavior of web users across websites, the names of the drugs that users browsed, and the pharmacies where user sought to fill prescriptions—with Google, Facebook, and around twenty other internet-based companies. > On February 1, 2023, the Federal Trade Commission fined GoodRx US$1.5 million for violations of the Breach Notification Rule and the Federal Trade Commission Act for allegedly failing to obtain specific, informed, and unambiguous consent from users before disclosing health-related information to Facebook and Google. (https://en.wikipedia.org/wiki/GoodRx#Controversy https://en.wikipedia.org/wiki/GoodRx#Controversy) Last time I was offered a GoodRx coupon (well past those dates) it came with no informed consent of any kind, being merely presented as "magic coupon make drug cheaper" which triggered my "that's too good to be true" alarm. AFAICT, selling your information is the company's business plan. ¹Cigna is utterly incompetent, and while the discount of playing their game is sizable, it costs a great deal of time. It took, I think, 4? 5? calls to customer support to set up a prescription? ²No, proceeding to checkout does not get you the price. You don't get to know the price until after you've placed the order. I have to go on past experience, and prayers.

skunkworker 1y ago
You can get generic finasteride 1mg/180 (6 month) for as low as ~$17 if you go to a Kroger pharmacy and use their preferred savings program (I forget the name off hand) and no insurance coverage. Kroger discontinued their Kroger savings and now have a preferred card, which ended up being half the cost of the best deal on GoodRX. Source: I picked up a 6 month supply last week.
1y ago

DoingSomeThings 1y ago

This is a frustrating article. To pick one example: "The most damning aspect is not their exploitation of loopholes or their willingness to combine dangerous drug cocktails or even their reliance on unvetted Chinese suppliers..." "unvetted" is doing a lot of work here. There's no evidence provided for this claim of working with shady sources and doing no diligence on the products they are selling. I know that to be false from first-hand connections in the telehealth space. Hims works with 503B pharmacies. They are FDA inspected. They run batch testing on their source material and require strict compliance. All safe, legal, vetted pathways. It's bizarre to me that the author is linking Novo Nordisk newswire press releases as sources of truth but is unwilling to to do basic research on how Hims operates. NN is hardly a faultless player here. They're selling this medicine for $1k+ per month! Separately -- Algorithmic care is fine because most decisions are algorithmic. It's no different than what you receive from the 5-minute dr visit in person. In a perfect world we'd have primary care doctors to coordinate care, direct you to the perfect pharmacy for each medicine you need, etc. In our real world, convenience and access are a good things. The shift from "patient" to DTC "client" is a net win for the public.

matthewdgreen 1y ago
This is the one aspect of this article I’d have liked to understand better. It can simultaneously be the case that these compounding pharmacies are regulated, and also that they’re buying peptides from Chinese suppliers that aren’t regulated and hence there’s some room for serious problems. I’d be much happier if I felt that these suppliers were being carefully regulated and monitored but I’m not convinced that this is the case.

raspasov 1y ago

"sildenafil and tadalafil — an illegal combination" It is not an "illegal combination".

Traubenfuchs 1y ago

PDE5 inhibitors and semaglutide should be OTC. Leave fat people that want to lose weight and men with weak dicks that want to be able to have sex again alone, for fucks sake.

raspasov 1y ago

In a wild turn of events, this is actually a genius marketing piece paid for by Hims & Hers.

rendall 1y ago

What is Hims?

crmd 1y ago

Is there a literary/journalistic term for the style of writing in this piece?

nmca 1y ago
“bad” seems fine?
ternaryoperator 1y ago
It's a tongue-in-cheek style.

weeznerps 1y ago

This is one of the absolute dumbest things I have ever read. People want their problems solved without waiting months for an appointment and spending an insane amount of money, case closed. The fact that this market exists is an indictment of the current system. The paternalism of medicine is infuriating. Doctors have been, for the most part, annoying gatekeepers of medication I already know I want or need. Way more medications should be over the counter.

DontchaKnowit 1y ago

Article is unreadable. The auther is trying to be funny and clever but it just ends up being a slog. Im like 4 paragraphs in and still have no idea what Hims did wrong at all. Just present the information...

richard___ 1y ago

Stupid article. Bottom line is I’ll pay a premium not because of shame but because I don’t want to schedule and drive to a physical location for a Drs appointment

reverendjames 1y ago

The author has yet to reach puberty or move out of his parents' house, so he doesn't yet appreciate the company's products.