Healthcare is Broken—This Company Wants to Fix It

Ed Elson sits down with Andrew Dudum, co-founder and CEO of Hims & Hers, to discuss why the company went public so early, how it made GLP-1s more affordable, and whether healthcare regulation has gone too far. They also explore why Hims & Hers chose to disrupt the system instead of working within it. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

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• 0:36Ed Elson?

  Welcome to the Prof G Markets Founder Series. I'm Ed Elson. Healthcare in America isn't just expensive, it's often out of reach. Nearly half of Americans can't access or afford quality care, and even for those who can, the system is broken. Long wait times push nearly 40% to delay or skip appointments altogether. In 2017, my next guest set out to make healthcare 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.

• 1:18Ed Elson?

  With more than 2.5 million subscribers, it is reshaping how people engage with care and redefining what the future of healthcare could look like. This is my conversation with Andrew Dudum, 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. Back in 2017, you start this company, and back then, I started to see a lot of ads around New York City that were these kind of iconic ads that I remember of these like cacti on these billboards, and we're trying to figure out what this company did.

• 1:57Ed Elson?

  And ultimately, it seems like the main product back then was erectile dysfunction medication. So tell us a bit, a little bit about the beginnings of this company. Is that right? Is that how you started?

• 2:12Speaker 03

  When I started the company in 2017, at the heart of it was this opportunity to build something that really changed what people thought about healthcare. You know, all of us, when I looked at my peers, my family, you'd go to the doctor, you know, essentially if your leg was bleeding or if you broke something, and otherwise, you just really hated that experience. But then, when you look at other aspects of our lives, you pick up your phone, you click a button, and you can get access to amazing financial services. You can get on-demand food, and you can buy a car from your iPhone, right? I mean, like, everything had been completely consumerized in a beautiful, price-transparent

• 2:53Speaker 03

  way. Yet, healthcare was still this environment that was paternalistic, that was, lacked any empowerment, that lacked all price transparency, and really was built for a system, not a consumer. Right? And so, what I set out to do was, can we take the best of consumer love, the best of consumer healthcare, the best of consumer technology, the things that we've grown to appreciate in Amazon and every other service, and reimagine what's possible for everyday people when it comes to their health? And part of that is, to your point, Ed, like, the stigmatization of healthcare.

• 3:35Speaker 03

  Things like sexual dysfunction, things like hair loss that affect maybe 50% of the population, things like weight loss that affect 70% of the population, actually normalizing the fact that these things happen and they're common, and everyday people suffer from them. That's a big first step of it. Then, the next step of it is actually making it incredibly easy to get care on demand. You click a button, you can connect with a Hims and Hers doctor in minutes, often, or within an hour, from any state in the country, and now across nearly a dozen countries globally. And then, you can receive amazing personalized care. You can get that treatment delivered to your door within a couple of days, and it makes you feel great, right? That type of opportunity to rethink what's possible in healthcare, move it from a very

• 4:19Speaker 03

  reactive system to a proactive one, but also build something that people love, that was really the ambition. And I think in the early days, some of the stigmatized conditions were a really great way for us to start the conversation with people about what healthcare could look like in the future.

• 4:35Ed Elson?

  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? Because I'd say, I think, in the beginnings of the company, that's how Hims, I mean, it originally was Hims, and it's transitioned to Hims and Hers. I think a lot of people think of this company originally as, this is specifically for male issues, things like hair loss, things like ED. Why did you focus on those issues to begin with?

• 5:14Speaker 03

  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 have one more question." And that one more question was actually the reason they came to the doctor's appointment, right? And that one more question was something like hair loss, or something like mental health, or something like weight loss, or something like erectile dysfunction, or

• 5:55Speaker 03

  concerns around menopause. It was all of the things that everyday people go through, but are kind of uncomfortable to talk about. Like, that's actually the reason you are motivated and activated to go and interact with the system. And it makes sense, because it's a thing that affects you every day, right? You wake up in the morning, they're deeply personal, they affect your relationships, how you feel with your partner, how you feel in the world, your confidence. And so, to me, as a consumer technology nerd, that was an incredible opportunity to expand on, right? If we could build a system that actually started conversations and activated you to come talk to the healthcare system, we could then go wide, now that we have you, and have

• 6:39Speaker 03

  delivered on this issue you might be concerned with, and treat other things. So, a good example, erectile dysfunction. It's actually the only physical symptom of cardiovascular disease, period. There's no other symptom. And cardiovascular disease is the number-one thing that kills men in the world. So, if you can build something that activates men to come talk to you, get care for something like erectile dysfunction, you actually are bringing one of the most at-risk populations in the door. And then, you can say, "Hey, while you're here, what if we send you that home blood test and just test some basics?" Right?

• 7:18Speaker 03

  And it turns out, now, we treat tens of thousands of people every year who came for erectile dysfunction and actually are at severe risk of heart attacks, and now, they're getting personalized treatments with combinations of therapies to address both. So, I think there's this idea of, how do you activate consumers? How do you energize them and understand the things that people want and care about? And then, from there, build trust and expand into the things that maybe they need.

• 7:44Ed Elson?

  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 agent, for a digital consumer? But I, it seems as though, with Hims and Hers, the thing that really got you guys out ahead, at least from an observer's perspective, is that you were 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

• 8:25Ed Elson?

  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 those, the amount of people and the rates or the share of the population who are experiencing that is on the rise. So, it seems as though that, that seems to be like the entry point that puts Hims 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

• 9:09Ed Elson?

  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.

• 9:18Speaker 03

  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.

• 9:48Speaker 03

  Has created, I think, a real isolation for young men. And I think in a lot of ways, that's very, very concerning. So internally, I push our team, because it's funny, I'll look at our calendar and, you know, I have meetings on my calendar called perimenopause, right? And then there's meetings in my calendar called erectile dysfunction. And I think we've normalized the uncomfortable conversations internally in an attempt to try to normalize them externally, right? If we can't talk about it directly and honestly as an issue, as a clinical issue that actually results, as you said, Ed, in loneliness and depression rates and social media addiction and not getting out.

• 10:32Speaker 03

  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 Hims and Hers, and I think we try to do this, to be aspirational and to be energizing. Say, hey, this is not going to be a whole bunch of models that you're going to see. You're going to see real people that actually feel great. And we're going to try really hard to make it really 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.

• 11:17Speaker 03

  You're going to be a better dad, you're going to be a better partner, you're going to help find a partner. All of those things are confidence, but they have huge impacts downstream in your life. And so I think the brand really tries to capture that. And I think there's a willingness from us to venture into uncomfortable conversations and be a brand that actually, you know, sits in that uncomfortable conversation because that is how you activate that consumer. Like that is how you actually have a conversation with people that they really need to have. And it catches their attention and that's ultimately what matters most.

• 11:53Ed Elson?

  So you ended up taking the company public via SPAC 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 public stock exchanges. I mean, how did that go down?

• 12:13Speaker 03

  It was a crazy time scale. I mean, I think it was probably the fastest or one of the top few fastest companies from founding to IPO. And, you know, what became obvious to me was the opportunity was there. The demand was there immediately. The need was kind of coming through the door. And we needed very quickly to establish the capital resource, the brand resource to go and actually go after this scale of the opportunity. I mean, this is, when you step back and look at Hims today, we treat 10,000 or 15,000 patients a day globally. That is the largest healthcare system, I think, in the world, right?

• 12:57Speaker 03

  The actual number of patients that are getting treated every single day, more on Hims and Hers than our associated global brands than any other place in the world. And so the opportunity for impact is huge. And I think we're in the earliest of innings. You know, I think right now, you've got a few million subs on the platform. I think the offerings that we're expanding into and the size of the opportunity is such that my vision is nearly everybody you know would be silly not to have a Hims 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 unbelievably accessible from a price standpoint and beautiful and easy

• 13:41Speaker 03

  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, right? And you see it from our stock, it's gone to whatever, 70 to 2, to 50, to 10. I mean, it's like up and down. Like, you have to have a stomach of steel, but more importantly, the team has to get really good very quickly at both setting quarterly targets and meeting long-term vision, right? You have to be able to deliver growth and efficiency at the same time. You have to be able to tell the street with confidence, we're going to hit these numbers a year out. And then you have to hit them, or else you lose all trust.

• 14:24Speaker 03

  And that environment, I think, is one of the most powerful assets that we've had in the last decade of our company. Like, it is just forced rigor, it's forced discipline. And when I step back, and this was a really critical part of why I decided to put us in this, 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, Microsoft, Meta, Amazon, these companies were public within a few years of being founded, right? The founders put themselves in the public markets and then had to be forced with both having a long-term vision and building a great business.

• 15:07Speaker 03

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

• 15:23Ed Elson?

  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 play ball in the public markets? I mean, most people today are like, would prefer to play in the private markets, not deal with the headache of going public, reporting all the financials, et cetera. That's why you didn't raise privately?

• 15:45Speaker 03

  That's right. Yeah, I mean, we raised privately for a few rounds. The company was doing north of 100 or 200 million in revenue and was profitable. And we had very good line of sight into this business going from 100 million in revenue to a billion. And, you know, companies now, guidance this year is something like three. So I think you believe that we had the capabilities to deliver in the public markets. But then also, the public markets have unlocked incredible assets for us, right? So we've been able to acquire very strategically critical infrastructure. We acquired one of the only US manufacturing peptide facilities last year in California. We acquired IP for one of the only at-home blood testing devices. We acquired international leaders.

• 16:30Speaker 03

  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.

• 16:43Ed Elson?

  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 day to day?

• 16:56Speaker 03

  The team at this point, most of the team has been building this company for, you know, north of six years. And so, you know, this is a team that's woken up and it was $2.97 and woken up and it was $70. And many of the, 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%. Somebody else puts out a press release, it goes up 15%. So I think we've gotten numb to the movements. Long-term, I think, is where everybody's focused. 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.

• 17:39Speaker 03

  Like, I think our combination of consumer understanding, design, clinical excellence, and kind of gall 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, 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.

• 18:24Speaker 03

  And they know everything about you and they're helping you make it easy to be your best. Both your best in the most clinical ways, cardiovascular disease, diabetes, obesity, and also in the ways that give you confidence, hormonal support, skincare dermatology, sexual health, right? And I think the combination of both is absolutely critical.

• 18:49Ed Elson?

  Just from a management perspective, if, 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 organizationally. How do we keep up morale? How do we keep everyone motivated and invested in the mission? 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?

• 19:24Speaker 03

  Yeah, I think you have to set the expectation early with the team that it's going to be a ride. And I do that, I think, very intentionally and very often to anybody, new employees, old employees, so that on those days, it's not unexpected, right? On the days that the stock rockets for no reason, I'm still in Slack, still in amplitude, A B tests, like asking the same questions as to why the numbers aren't getting better. And on days when the stock tanks for some reason, I'm still doing the exact same thing. And I think that, that culture of the stock is not the company, right? The company is how we impact patients over the long haul

• 20:07Speaker 03

  and how we actually build a profitable cash flow business. Like, that is the company. The ruthless focus on that, I think, people can get. But you have to be very consistent in that communication. The first time you bring it up can't be the day that the stock goes down 10% from Amazon. You actually have to tell people, you know, every quarter, hey, expect that the stock is going to go down. Somebody's going to put out a press release, somebody's going to do something. It's going to go up and down. Because when you're disrupting something so big as the healthcare system.

• 20:39Speaker 03

  Everybody in the world is incentivized free to lose. Right? PBMs, the insurers, the drug companies, the regulators, the unionized providers. Everybody has figured out a way to make money from this system as it exists today. Yet, none of the financial outcomes of the system have any relation to how consumers actually feel and whether or not they are getting better. There's no relation at all to those economic dynamics. And so I think establishing in the company's mind, everything we're going to do is for the consumer. We're only going to make money when the consumer is happy. If they're not happy, they're going to leave. If they're happy, they're going to stay. We make more money.

• 21:23Speaker 03

  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 we're not, I mean, you can see this just from the business. We're not a team that is shy when it comes to having hard conversations or pushing into new categories. We will fight on behalf of the consumer, and that often does cause friction and disruption. But that is a part of the DNA, because we think that is right for what's best for people. And so I think with that expectation, people are good with the ups and downs as you push forward.

• 22:07Speaker 03

  We'll be right back.

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• 22:55Ed Elson?

  We're back with Andrew Dudum. 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-1s were, I mean, they were being supplied by Novo 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 semaglutide

• 23:40Ed Elson?

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

• 24:05Speaker 03

  It was one of those sagas that I think was exciting to read about. And so it was everywhere from a news 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 was 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. These are regulated 503A, 503B facilities. The FDA regulates these. The state boards of pharmacies regulate these facilities.

• 24:50Speaker 03

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

• 25:00Ed Elson?

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

• 25:07Speaker 03

  Yeah, it's essentially pharmacy capabilities to bring active API ingredients, so medications that are approved by the FDA and on very specific lists that you can then combine and adjust in dosage or formulate in new form factors on behalf of the patient. So you think of, you know, one of the simplest examples, and it's not actually compounding, but back in the day, you think of the Flintstone vitamins, right? Kids needed their vitamins, kids can't swallow pills. And so the combination of supplements in something that tastes good, that's chewable for a four-year-old, that's like a very simple example of a compounded treatment.

• 25:51Speaker 03

  And so with this shortage, this drug shortage, our facilities from a regulatory standpoint could start manufacturing and producing these medicines, which we did. Simultaneously, what we identified was that, and this is all very known with these medications, the side effect rates are astronomical. Massive gastrointestinal side effects, diarrhea, nausea, vomiting, people will go to the ER for this stuff. And so you had this interesting dynamic where the demand was through the roof, but about 70 or 80% of patients were stopping the medication within 90 days because of very adverse reactions, like very serious reactions.

• 26:31Speaker 03

  And so the compounding facilities have the ability to make medicine in two circumstances. One, when there's a drug shortage, and two, when there's a clinical necessity for the patient. When a provider says, for this patient, a dosing adjustment is necessary, a formula adjustment is necessary, a combination of therapies is necessary, a different form factor is necessary, any of those reasons. So the legal framework allows for two ways in which you can compound. For us, for about a year or two, we operated under both. There was a shortage where patients could come get the exact same medication, and then there was also a personalization exemption, which allowed us to personalize medicine for patients.

• 27:15Speaker 03

  And I'm a really big believer, when you step back and look at the healthcare system today, the future of healthcare isn't, you know, patients getting one of three dosing regimens. It's us understanding you, Ed, your body mass, your metabolism, your desires, your goals, and actually taking safe medicines approved by the FDA and personalizing them for you. Like, it's an obvious iteration of where medicine should go. When you think about precision medicine, everybody is different. And so with these medicines particularly, the side effect rates were so high that that personalization dynamic was critical for patients. Now, and because of that, the business grew very quickly, extremely quickly, because

• 27:59Speaker 03

  patients wanted that personalization.

• 28:02Ed Elson?

  Yeah, I remember you guys reporting your financials after this happened, and it just blew up. I mean, it was...

• 28:08Speaker 03

  Yeah, it blew up. The company doubled overnight. And it was amazing for, you know, hundreds and hundreds of thousands of people who couldn't get access to this medicine or who had tried the medicine and had severe side effects. Now, what happened was, I think, phenomenal, not without friction, but phenomenal. The drug companies reacted to two different things. One, they reacted to the pricing pressure. So we were able to manufacture and compound these vials personalized for patients and offer to them for something like $150. The price of the FDA-approved medication at the time was $1,500.

• 28:50Speaker 03

  And so the pure exposure, the transparency of a model like Hims and hers where it says, hey, we're consumer-oriented, we can make this stuff, we have these facilities, it costs us about, you know, 80 bucks all in with all of our stuff, so we're going to put a markup on it, we're going to sell it to you for 150. And it was very transparent about how this all worked, resulted in immense pressure on the drug companies to take...

• 29:18Speaker 03

  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, through consumer pressure, those medications are now available to consumers for $150, the brand name medications. That has never happened in the history of this country. When the medicine that is brand new, recently approved and needed by the masses, was able to apply enough consumer force and pressure to bring that cost down to something that people could afford.

• 30:00Speaker 03

  And I think it was a big part, the administration was a huge part of it through Trump RX. They did a phenomenal job in applying pressure. And I think the exposure of the fact that we could actually make this medicine for this cheap and we could sell for 150 and have a really reasonable business resulted in people applying that same pressure to the drug companies. So that was an amazing transition. So that happened. The second thing happened on the personalization side. The drug companies, and we were talking to all of them, saw that 70% of their patients were stopping, right? After starting their medicine because of these side effects. And these were injections with single dose injections. You put it in your belly, you click a button and you get five milligrams.

• 30:40Speaker 03

  Well, if 70% of those people are throwing up and stop using it because five milligrams is too much, they were coming to him's and hers. And so now, fast forward two years later, and the drug companies have done a phenomenal job. Novo and Lilly have adopted it very quickly. They now have vials on Lilly 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 Wegovy pill. So low dose pills where you can titrate and adjust your treatment based on side effects, microdose as necessary and get to whatever the outcome is that you need.

• 31:20Speaker 03

  And so over the course of 18 months or 20, 24 months, our pressure by saying, hey, we've identified something that really matters to consumers. They need this personalization and this price point is a fair price point because it's what it costs us to make. The whole industry responded. And so as a result, we've now been able to partner with Novo Nordisk directly, which is fantastic. We recently launched the Eli Lilly products on the platform because now those products are $150 and can be personalized to patients. And so again, through our lens, we push on behalf of people. And the industry has changed dramatically as a result of the pressure in a way that we think is phenomenal for people. And now it really aligns us very well with many of these drug companies to be able to

• 32:04Speaker 03

  help them get these medicines to millions of individuals.

• 32:08Ed Elson?

  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 in 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.

• 32:43Speaker 03

  And it's not even a glitch and it's, it was created for exactly this purpose.

• 32:47Ed Elson?

  Feature, not a bug, maybe, yeah.

• 32:49Speaker 03

  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.

• 32:56Ed Elson?

  Which to me brings up questions of how our regulatory system in healthcare actually works. Because if it weren't for the fact that there was a shortage of the supply of GLP-1 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. And it makes me think, are regulatory restrictions perhaps too stringent? Is it, is it maybe a problem that we, the only reason that you were even allowed to

• 33:38Ed Elson?

  pursue this model is because there was some issue in the supply chain of the GLP-1 industry itself?

• 33:45Speaker 03

  I think a lot of people are thinking that. I mean, I think the new peptides conversation that's taking place is another version of this conversation, right? There's a, there's a push to deregulate what the administration qualifies as supplements, right? BPC157, TB500, Epitalin, all of these, all of these peptides during the Biden administration were moved to a category two list, no longer letting pharmacies manufacture them or compound them. Now there's a meeting in July pushed by RFK to see if those can be then reintroduced into a category one list to allow access to consumers. Now, the traditional industry doesn't want this to happen at all, right?

• 34:28Speaker 03

  Because by doing so, you are frankly educating consumers that peptides, which are just chains of amino acids that are found in the body, can be sourced, produced, safely manufactured and delivered to consumers for, let's say, $50 to $100. Well, the drug industry would love for that knowledge not to be known because if you can patent those, if you can take those amino acids and throw something on the side of that chain and patent it, well, now you've got blockbuster pharma medications at 80

• 35:09Speaker 03

  or 90% margins, where the population is either forced to pay that out of pocket or the insurance companies are forced to cover it. So again, the system, you know, is set up to make a ton of money. And so I do think there's a real conversation that should, should happen around consumer empowerment in healthcare. 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 mitigated.

• 35:50Speaker 03

  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 at 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 them. And, 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, we as a business sit at a really interesting intersection because

• 36:30Speaker 03

  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

• 37:15Speaker 03

  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 in America. It's not, right? We know the same five facilities that manufacture all 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's, there is lack of understanding of the purity and the exposure. And when you're talking about sterile pharmacies, like people are injecting these things, like the oversight of these facilities from an FDA standpoint is, needs to be very high.

• 37:59Speaker 03

  And so I do think as we enter this world where there's more consumer empowerment, there's more interest in things like BPC157, it will be critical for him's and hers to establish that gold standard of, of quality, saying, 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 of authentication so people know exactly what they're getting, and this is how you do doctor and clinical oversight to make sure you're, 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.

• 38:56Speaker 04

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• 39:06Speaker 05

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• 39:13Speaker 04

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• 39:31Ed Elson?

  We're back with Andrew Dudum. The peptide conversation, the GLP-1 conversation, you're sitting at one of the most interesting fulcrums between how everything should be regulated. I mean, it's such a perfect example of the pros and the cons of regulation on both sides, because on the one hand, 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 oligopolies, they have unbelievable pricing power, there is no price transparency, they're ratcheting up these

• 40:15Ed Elson?

  prices to extraordinary degrees and it's having real adverse effects on the actual health 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 we're spending per capita on healthcare 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 has 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 healthcare, 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

• 40:59Ed Elson?

  whatever they want to do is also a very scary game to play because there is a world in which, you know, maybe, let's just assume that there was a GLP-1 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 healthcare 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

• 41:44Ed Elson?

  policy level, even from a company level to deliver low cost healthcare to Americans without making them potentially more sick?

• 41:56Speaker 03

  You know, I think the administration right now is doing a great job pushing the right balance, to be honest. I think 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, any established country in the world that doesn't do that, which is why, you know, people could buy Wegovy in Canada and UK and Australia and Japan for $100, $150 for the last few years. And here in the US, where there's a massive, massive obesity epidemic, the medications were 10 times that. And so I think it was a great first start

• 42:40Speaker 03

  for the administration to say, hey, these are important to people and we're going to, we're going to force change. Nobody 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 precedent 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 pharma needs to 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

• 43:25Speaker 03

  to people as well.

• 43:28Ed Elson?

  You guys are one of the leaders, I would say, in GLP-1 drugs at this point. I mean, of course, it's no venus can Eli Lilly, who are manufacturing the stuff, but you're getting it out to a lot of people. How, how large is the GLP-1 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 could just tell you that my co-host Scott Galloway, he thinks that GLP-1s are more important than AI.

• 44:01Speaker 03

  I think GLP-1s will 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, the, the science at this point, the price points of them coming down overseas, they just went generic in Canada this year, they'll, you know, semaglutide 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. The impacts of these are monumental. Dropping general obesity, like for the first time you're actually seeing, you know, like early obesity curse turn, that's going to then have downstream on

• 44:46Speaker 03

  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 kidney. I mean, it's just like, I think you essentially have a population that is metabolically ill, that then results in all of these perverse outcomes, whether it's heart attacks, cancer and the body just going astray, even neurodegenerative diseases. From 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.

• 45:30Speaker 03

  It's already having massive implications for, for things like smoking and drug addiction and alcoholism. I mean, it's, I would be surprised if fast forwarding four or five years from now, GLP-1s were not a part of north of 50 to 60% of every American's daily habit, whether that's through a vitamin that they're taking, a compounded vitamin orally or through a weekly combination injection that also helps them manage their hormones or cardiovascular risks. But I think it's going to be a staple in the global healthcare society, no question.

• 46:15Ed Elson?

  Do you think that big pharma and large healthcare companies are concerned about this? I mean, if we have a drug that sort of systemically resolves many of the root, root causes of all of these symptoms, you know, obesity leads to all sorts of things. I mean, if we see cancer rates going down, smoking cessation, alcoholism going down, all of these things that, I mean, in a dark way, large healthcare companies, healthcare insurance companies, big pharma companies benefit from because they're making money solving those problems. Do you think those companies are worried about what this could do?

• 46:52Speaker 03

  I think there is no question, and you see it this year with the, the GLP-1 pressure on pricing, that the age of unrestrained pharma margins is gone. It's gone. It might still be there quarter to quarter, but like, the, the culture has caught on, government has caught on, everyday people have caught on. And whether or not him's and hers is here any longer, players like us expose the reality, right? And I think him's will continue to do that. Now, what I hope will happen is they will adapt. They'll adapt to what consumers want.

• 47:37Speaker 03

  And I think there's a tremendous opportunity, consumer biotech, that, that I think him's and hers is at the forefront of and were 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, you know, 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 things that just keep them treated and sick but stable. So good example, Eli 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 statin every single day.

• 48:22Speaker 03

  You don't have to take Repatha, which is $500 a month, twice a week. You can take one injection that probably costs about $30, $30 to $50 to make that one injection and it removes your cardiovascular risk. It just drops your LDL to like obliterate it. Now, when that drug comes to market, there's going to be 10 other versions of it also. And him's is going to be, and hers is going to want to get that to 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 a vaccine for heart disease, a lot of people would do that immediately. And so I think there's going to be a new wave of demand for therapies, but I do

• 49:06Speaker 03

  think without question, traditional pharma is 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.

• 49:36Ed Elson?

  Obviously, you guys are offering way more affordable pricing, as exemplified in the story you told about your compounded semaglutide drug and you're sacrificing larger margins essentially. What's stopping you from eventually becoming like the rest of big pharma and the rest of healthcare where you adopt these unrestrained margins? I mean, ultimately, you have to return value to your shareholders. I mean, why, why would, why should people trust that you will not do that at some point?

• 50:10Speaker 03

  Yeah, I think it's just, you know, we'll walk the walk, period, right? Like we, I fundamentally believe

• 50:18Speaker 03

  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.

• 50:28Speaker 03

  And that's because when you look at the reasons people are sick, and you look at the reasons people are dying, and the reasons they're depressed, or like you say, it's, it's, a lot of it is an access problem. 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 wait 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 get like bottom of the barrel service, where you're not even getting proactive, you're just treating the thing that's most urgent.

• 51:09Speaker 03

  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's and hers do in the last 10 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 have a telemedicine 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 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.

• 51:53Speaker 03

  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. And it only costs 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 paying 15 bucks a month for some movies. You should be able to pay 100 bucks a month, and you are getting preventative screening, the medicines you need to feel great,

• 52:37Speaker 03

  and a doctor watching over you, making sure you're on the right track. Like, I really believe that's possible.

• 52:43Ed Elson?

  When you look at the healthcare industry, I think a lot of people listening to this podcast, a lot of people in this country are just fed up with how the whole system works. And every time we try to dig into this industry,

• 52:59Ed Elson?

  oftentimes, the answers that I get are, it's super complex, and there are all these different players, and it's hard to know who is the problem, or what the problem is actually stemming from. I mean, there's the pharmacy benefit managers, and there's the insurance companies, and there's the actual pharmaceutical companies themselves. As someone who's in it,

• 53:22Ed Elson?

  who's the problem in your mind? Where is the problem coming from?

• 53:27Speaker 03

  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. You can't point a finger and say it's the PBMs. No, 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 a system that breaks the system. If that makes sense. Like, 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 on the same team and say, hey, we're going to shut that down.

• 54:10Speaker 03

  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.

• 54:24Speaker 03

  And that's why we built our own provider group. We built our own pharmacies. We have our own drug sourcing. We buy directly from raw ingredients. Or we actually, in the peptide side, buy 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. So I think,

• 54:45Speaker 03

  I think the system itself has been established for so long and so entrenched, it will be impossible to iterate its way to a great outcome. 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.

• 55:18Ed Elson?

  My final question. I think him's and hers 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. And 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 entrant 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 their careers,

• 56:03Ed Elson?

  who are trying to break into a system, a system which does not want them to win?

• 56:08Speaker 03

  One of my old co-founders, he used to say this, and I think maybe Peter Thiel used to tell him, I don't remember the exact source, but it was something like, don't underestimate toys that can become big companies.

• 56:26Speaker 03

  And, you know, you think of something like Snapchat, right? It was written off, it's like a disappearing photo. It's a feature, right? It's a toy. Or Facebook, right? It's a way to see other, you know, men or women on your college campus. You're 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, or back then, what we talked about today, right? The ambition to disrupt the healthcare system, it would have been 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?

• 57:12Speaker 03

  Completely naive to it. And for many years, the healthcare system laughed at him's and 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 Viagra. And now I think the conversation has really changed. And so I think, you know, I would 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, and don't have a big ego about like, needing to say how you're going to go disrupt this whole system.

• 57:55Speaker 03

  You know, I think founders often like to do that. That 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. 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 start attacking you, they'll make fun of you, and then you'll go through the phase, you know, they'll go through the phases of grief, and then they'll fight you, and then you're actually on to something. But in the early days, like, just find that consumer insight.

• 58:40Ed Elson?

  Andrew Dudum is the co-founder and CEO of him's and hers. Andrew, really appreciate your time. Thank you.

• 58:46Speaker 03

  Thanks for having me.

• 58:51Ed Elson?

  This episode was produced by Alison Weiss and engineered by Benjamin Spencer. Our research associates are Dan Shalon and Chris Nodanou, and our senior producer is Claire Miller. Thank you for listening to the Profity Markets Founder Series. We'll see you next month with another founder story.

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