As Direct-to-Consumer Companies Grow in Popularity, Their Efficacy is Questioned


Direct-to-consumer companies attract attention on social media, but are they as effective as traditional healthcare services?

Direct-to-consumer health care services are becoming more popular in both pharmacy and the overall healthcare space—but there are limits to these products’ potential.

As the needs of patients change over time, pharmacy services need to be able to evolve with their patients. With the rise of the digital age and the COVID-19 pandemic, direct-to-consumer pharmacy services have grown.

In a poster1 presented at the American Society of Health-System Pharmacists 2022 Midyear Clinical Meeting, held December 4 to 8 in Las Vegas, Nevada, researchers aimed to understand the nuances of direct-to-consumer companies in comparison to traditional mail-order pharmacy services, their accessibility, and potential areas of growth.

Researchers conducted a search to identify direct-to-consumer pharmacy companies and mail-order pharmacies. Inclusion criteria included being founded before 2020, based in the United States, did not require health insurance, and provided services on an easily accessible platform. The companies that were selected also provided telehealth services and consultations and could be easily accessed via mobile applications or the internet.

Six companies were chosen from the initial list based on the disease state targeted to minimize overlap and get the most comprehensive look at direct-to-consumer pharmacies. A literature review was conducted to learn more information about the companies.Companies selected included Cove, Curology, Hims/Hers, Lemonaid, Nurx, and Ro. Data were also collected from mail-order pharmacies including CVS, Caremark, Amazon Pharmacy, and Capsule.

Data were collected from each company’s website, including disease state treated, medication classes included, and special services provided (e.g., testing for COVID-19, sexually transmitted infections, and pregnancy/fertility tests).

Each of the 6 companies had different areas of focus; some focused on specific disease states while others provided a wider variety of medication services. Services offered fell into categories of sexual health, contraception, hair and skin care, mental health, migraines, primary care, smoking cessation, sexually transmitted infectioncare, and at-home lab testing.

“Each company had a disclaimer on their website saying that not every patient who tries to use their service will need medication and that their providers will use their clinical judgment to best help the patients that seek care through their company,” researchers wrote.

All of the direct-to-consumer companies charged either a flat monthly charge or per consultation for consulting services and charged for medication dispensed. Explanation and transparency about services ranged by company, but mail-order pharmacies had the most limited and ambiguous language observed in the study.

“More investigation should be done about the safety of these services and into understanding the future and position of mail-order pharmacies as more companies join the market and new models of care evolve,” the researchers concluded. “Many of these companies have a prominent presence on social media, attracting the attention, particularly of those from younger generations, but time will tell if these companies are effectively reaching the wider range of populations who have limited access to healthcare,” researchers concluded.


1. Patel R, DeRose A, Tsai H, Madden J. Overview of direct-to-consumer pharmacies and their role in pharmacy practice. Presented at: American Society of Health-System Pharmacists 2022 Midyear Clinical Meeting and Exhibition; December 4-8, 2022, Las Vegas, NV. Poster 3-306.

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