One of the things I learned earliest in my career is if you can't hire people that are smarter than you, you will fail.
What you gain confidence in with brand marketing over time is that consistency is required.
Now, I am so excited for the show today.
We have Andrew Dudham, founder and CEO of HIMS.
HIMS are reinventing healthcare.
Wow!
It's been a tough six months.
They are down 66%.
They've got a market cap of 4.35 billion as of today, but they do over 2.3 billion in revenue.
It's nuts.
I'm so excited to sit down with Andrew today where we discuss this and so much more.
When you're disrupting an industry, you have to have a team that is used to being uncomfortable and used to getting through it and used to staying calm and having that resilience.
I might be the only person that believes this, but I think running the company in the public markets is more fun than being private.
Ready to go?
Andrew, it's been like six, seven years.
I was young and fresh when we lost.
I was a lot younger.
We looked a lot better back then, but I'd say we're pretty good right now.
I think life's been pretty kind to both of us.
Can I start with a super weird one?
And you might be like, dude, I thought we were buddies.
But I speak to so many public company CEOs today and I can't find a happy one.
I think I might be the only person that believes this, but I think running the company in the public markets is more fun than being private.
Why you get shit on every day.
Did I see it?
And I'm like, oh, poor Andrew.
And I said, I brought in a lovely wife and I'm like, oh, I like you so nice.
And I see the shit.
I love it.
I love it for a few reasons.
One.
Um, if you're a highly competitive person, You get to put out high benchmarks every 90 days and see if you can actually deliver on it.
And you can build a high performance team to say, hey, we put this out and it's a big stretch.
Let's go kick ass and figure it out.
When you're private it's so easy to get, to get cozy.
You know the worst case scenario if you got some vcs that call you and they're stressed out about something.
But in the public markets it's like it's boot camp.
It's it's like you got to be.
You have to deliver.
So i love that from a competitive standpoint.
I also love the the the ability to hire talent, like in the public markets, because they can see the vision and you're forced to not only talk about where you're gonna go 10 years from now, but if you're gonna actually like make steps quarter to quarter to prove it.
So as a competitive person, I think it's a lot of fun.
Also, when you step back, we went public really early.
We went public after, I think, 36 months of launching, which was a little bit crazy.
When you look at the biggest companies in the world, they went public within the first few years of launching.
Google, Facebook, Apple, Amazon, all of them.
They didn't stay private for 10, 20 years.
The founder was forced to figure it out in the public markets how we're going to grow, how we're going to get efficient and how we're going to tell a big vision.
I think that's a lot of fun.
I love that.
Google, Apple, Facebook, Amazon, hymns.
Right.
Nice.
It's actually one of the oldest marketing tricks ever, which is like marketing by association.
You know this?
It's called Six Flags.
Do you remember Six Flags?
The really shit theme parks?
Yeah.
So I don't know them because I'm British, but they wanted to be better than everyone else.
And so they just did massive billboards that said, not as good as Disney.
Smart.
Very smart.
I know.
I like a good marketing.
Fascinated.
You said there about going public so early.
If you were sitting down with the Collisons today, would you tell them to go public?
I think if your business is ready from a predictability standpoint and you have a long-term orientation, then I would encourage you to go public.
I think those two things have to be true.
I think you have to actually be able to predict your business with consistency, because you can't enter the markets without that confidence.
And you also have to be ready to sign up for a decade or two in the markets, right?
This is not something, it's not a quick exit.
It's not a liquidity event.
It's the beginning.
I would encourage any founder that has those two dynamics to consider it.
Do you think you can do what you want to do from a long-term strategic objective standpoint and have the as you said, I love it the 90-day ticker of like hey, we've got to go hard for the 90 days?
I think you do.
It takes discipline.
I think it takes hiring the right people.
I focus on hiring a certain type of people.
They're not particularly fancy in background.
They're not credentialed with all of the really great tech companies.
That's not what I look for.
I look for mostly people who have been builders and have gone through some shit is the honest reality.
So if you look at our team, Yemi, our CFO, he was the divisional CFO of Uber during COVID.
The whole business disappeared overnight and he had to figure it out.
Or Deirdre, our chief product officer.
She was at Robinhood during GameStop.
Right had to figure out that chaos.
Do you seek out crisis in their lives?
I know it sounds stupid, but you've mentioned two very iconic Yeah, I seek out grit.
I seek out a lot of grit because I think when you're disrupting an industry, which we are and even in the last year our category has exploded and changed and been fraught with all types of chaos
You have to have a team that is used to being uncomfortable and used to getting through it and used to staying calm and having that resilience.
And so I absolutely search for people that have seen those types of ups and downs and thrived in them, because I think when you're disrupting, it's just inevitable that that's going to happen.
I spoke to so many people around you.
Really, I stalked the shit out of you, which was nice because I know you, but to hear stories from owning donut shops didn't tell me that, did you?
My Augustus Gloop was coming out there.
But the talent element was one.
And they said, in particular, Jules Maltz, I think it was, from IVP, said that you're incredible when it comes to acquisition and retention.
What do people get most wrong, do you think, about acquiring great talent today?
I think often people as they scale maybe founders as they scale fall into the trap of trying to hire people that have seen bigger scale than them and are more strategic and they feel like they've gotten to the point of success where now it's time where they up level the talent to non startup folks right to like real professional people.
And I think that is a huge, huge mistake.
Huge mistake.
You know, when I look at, you know, Chris Payne is on our board.
He's one of my mentors.
Yeah, great guy.
I think one of the best operators I've ever met.
And when I look at the team over it that Tony's built at DoorDash, you know that team is an operating machine and they're huge.
Right, it's a 80 100 billion dollar company.
Um, yet they're still operating with speed and focus like a startup, and i think so much of that is because the team that tony's assembled around them is a team of operators that love to build, And so I think as you scale, there's a pressure to go hire that big strategy person who has more credentials than you.
And it's kind of, it feels almost confidence inducing as a founder to like get to that level.
And I think you have to fight that at all costs.
I've made mistakes.
I've hired people like that because I thought it was the right move.
And I've always come back to find people who love the mission, who love to build, who are tactically excellent at what the function actually requires and again, who are gritty as hell.
What are you not excellent at in the role of CEO, but persist relentlessly, despite your lack of skill.
So many things.
So many things.
I mean, I'm constantly trying to find the balance of being in the weeds and building a team that can scale independently of me.
Right?
Like you're.
You're that line of how hands on you should be, how strategically involved you should be, how tactically involved you should be.
Versus.
Why do you come down on that then?
Because we have the founder mode and the.
I love Ryan at Flexport, but like that I'm so in the weeds and I love him for it.
Yeah, I think you have to be intentional about where you get into the weeds.
I don't believe in this concept of.
Every design review comes through me, everything that ships comes through me, every decision comes through me.
One of the things I learned earliest in my career is if you can't hire people that are smarter than you, you will fail.
And young managers struggle with this all the time.
They're scared to hire people that are better than them, because they feel like if I hire somebody better than me well, what the fuck am I even doing here?
Why am I here if I just hired somebody who's better than me?
And in fact, it's completely the opposite.
If you wanna continue to scale in our organization, or any organization that's growing, you have to realize that your job is changing every 12 months, right?
To level yourself up to the next highest leverage focus area.
In order to do that, you have to replace yourself every 12 months with talent equal or better always.
To me, that's a really important realization as a CEO and founder, which is I want to hire people better than me.
And so I trust them.
Yet, at the same time, if there are specific areas of the business that are critical, either strategic decisions or tactical implementations being worked on, You have to know when you go deep and you need to acknowledge the team.
Hey, this is something that's really important.
I'm going to go deep on it.
I'm not going to go deep on everything, but this is important.
I'm going to be in the weeds here.
Do I sit in these boards nowadays?
And honestly, they're mostly useless is so exhausting.
Um, and AI is at the top of every big company board discussion topic.
Okay.
No shit.
How does your business change with AI?
How many people do you have today?
About 2,000 employees.
Okay, you have 2,000 employees.
How many do you think you'll have in 2030?
That's a great question.
Probably not many more than 2,000 to 3,000.
That's a big range.
Yeah, we operate about a million square feet of pharmacy fulfillment throughout the US.
And so we have a large chunk of labor force which is actually just variable labor, responsible for actually pharmacy oversight, pharmacy review and actually shipment of medication.
AI can do a lot in regard to efficiency for core product engineering accounting finance marketing, et cetera.
But when you're actually running facilities, physical facilities and a lot of this is actually required doctor and pharmacy oversight those you can't get as much leverage on.
Are you pushing AI down into every function of the org?
Yes.
Yes.
Are you seeing how dramatic implications We have eng and we have customer support.
I think we over exaggerate elsewhere where it has impact.
I think those two areas are critical.
We're also seeing it have massive leverage in design.
Right.
So we deploy about a billion dollars in marketing spend every year across the HIMS and HERS brands.
And the cost to do a live photo shoot, the speed of a food photo shoot.
For every single product launch, we probably have thousands of variations of TV commercials Facebook ads, Google ads, et cetera.
The speed of iteration with AI in that function, I think is actually one of the most tangible that I've seen across our organization.
In terms of cost reduction and in terms of supply expansion?
It's mostly in regard to output.
I would say you have the same team, but you're probably delivering three to four times the amount.
The other area that we see a big degree improvement is actually on the clinical side.
So we treat 10,000 plus patients a day.
We're probably the largest healthcare system in the US if you actually look at volume of patients treated.
And now with recent markets, definitely the largest globally from a digital health standpoint.
If you can apply AI to the medical side, the EMR, where doctors are actually making clinical decisions, and it can help give guidance with regard to certain protocols and speed up that process, That is a huge amount of leverage for the clinical end from an efficiency standpoint, but it's also a meaningful improvement in quality because you have essentially an intelligent brain helping standardize care across thousands of doctors that are making decisions every single minute.
When you speak about the explosion of the business, That explosion is driven largely by GLP-1s and weight loss.
How much of that is the core business today?
Is it like 80% weight loss, 20% everything else?
What does that look like?
No, no.
I think that's one of the funny things about our business is we are constantly in the headlines as a single category business.
When we first launched, when you and I first met, we were the erectile dysfunction business, right?
And it was, you know, front page of the New York Times and it was fun and silly and provocative.
And all we did from everyone's perspective was ED.
And then we launched hair and then all of a sudden it was like we're a hair loss business.
And then we launched the HERS business and everyone said, oh, HERS is never gonna work.
You're just an ED and hair loss business.
And then eventually, we launched GLP-1s and everyone said oh, now you're just a weight loss business.
And a year from now, people will say oh, you're just like a peptides business, probably if I were to take a guess right, and and so i think the the reality is under the hood is that you have a dozen completely different clinical categories, completely different businesses, each scaling with very solid, robust growth.
Which is why this business is interesting like that's why i run this business is the durability of it is quite strong because you have 10 different businesses with completely different customer segments.
So weight loss is actually, you know, nowhere near the majority of this business.
And I don't think ever will be, just because you're continuing to expand core categories and a lot of new categories.
So Do you run those as separate businesses?
When I had Nick from Revolut on the show, he said something fascinating.
He said, we run 26 different product experiments at the same time.
I treat it much like a venture incubator and I give them more or less money depending on how well they perform.
Do you run them as like a venture incubation unit?
Absolutely.
I mean, you know, when we first met, I was over with Jack Abraham running Atomic Ventures for a long time.
And that training of zero to one exploration, that is what HIMS and HERS is, right?
Like.
I think of it as a public shell for innovation and bringing great healthcare to consumers, which means every year we're testing completely new go-to-market strategies, completely new categories.
And the way we think about it internally is just different bets.
And some bets you starve and some bets you fund and some bets you ring fence to allow exploration for a year or two, but they're run increasingly independently.
And I think the DNA of management is to look at it as a portfolio that continues to scale.
Because ultimately, In our business, health and wellness what makes up great health and wellness is constantly changing.
There's new diagnostics, there's new devices, there's new drugs, there's new learnings about the sauna and cold plunges, or whatever it might be, whatever's trendy, right.
Like all of this is changing and it's gonna continue to accelerate.
And our job is to curate the best and bring it to people at scale at an affordable cost.
And so we have to think about this, frankly, as a portfolio that's constantly evolving.
I can't get my head around the sauna, Andrew.
You have to do this on a four times.
No, I don't.
Grease for 20 minutes.
It cuts all.
Have you seen what it does to the motility of your sperm?
You've got three kids, buddy.
Some of us have got none.
Just got to bring an ice pack in there.
I'm not going to bring an ice pack for my balls.
I'm sorry.
Genuinely, this was like the most unattractive thing ever.
And it's like, you know, Huberman's like, oh, it extends life by like, you know, three decades.
He's not doing ice packs.
We'll sauna together next time I'm in London.
I'd do it with you.
There you go.
You said they're about kind of the best.
What did you do that with the benefit of hindsight you wish you hadn't done?
For us as a business.
I think it's important to constantly be in a customer's mind, the mind share of the new evolving health and wellness categories.
And so I think in many categories, we've been quick to market.
And in many categories, we've been kind of like patient to market.
And in retrospect I constantly am kind of evolving my perspective on like, how fast we should be there.
My net net takeaway is I don't think we actually need to be first ever in market.
I want to be best in market, and so when i think of new categories peptides, for example right, you know a lot of conversation about 10, 15 peptides going from class to category 2 to category 1, compounding so that people can actually get access to things like BBC 157 TB, 500.
This is an incredibly interesting category.
You won't see us be first to market in this category.
You'll see us when we launch it feel extremely confident in the clinical protocols, extremely confident in the guardrails.
Make sure that the supply chain and the quality is done to a level we feel is bulletproof from a pharmaceutical standpoint.
So there's a lot of introspection in my brain around speed and prioritization of which categories to enter.
But what I always come back to is not being first but being best, so that, from a brand standpoint, people know hims and hers to be high quality and trusted, like when we actually bring something to market.
You know it's safe, you know it's done right.
And you know, it could be something that's that's powerful and important for your for your health.
I always remember Hugo Bauer, who was the product guy from Xiaomi, and he said on the show when you're doing anything in physical product, you need to choose one.
You need to be feature king or you need to be price king.
Yeah.
What are you?
I think you have to be both for us.
I think you have to have the best at the most affordable price eventually.
How come it was eighteen hundred dollars to two thousand dollars for wagovi and his mp then, which wasn't wholesale.
Well, what is it now?
Well, the self-pay price at the time was 300 to 400.
Yeah, it's down to about $149 in 18 months, on hymns.
We just announced the will go be pill 149.
So I think, I think post Novo deal.
Oh, yeah, yeah, it's the partnership.
No, absolutely.
Go totally.
So we want to be price king and feature king.
I think for us, we want to curate the absolute best at prices the masses can afford.
And I think the way you do that is you work with ecosystem partners, you leverage the scale of the platform right.
We're the largest global distributor at this point probably of medicines.
And so by able to then working with the best diagnostic companies, the Cancer Grail Detection Company.
I don't know if you've ever taken this test.
This is a test that I've been taking for five years.
I've had everyone in my family take because there's cancer in my family.
It's called the Gallery Test by Grail.
It's a blood test and it can detect 50 to 100 cancers and it focuses specifically its best stat from a clinical standpoint.
Some of the harder to find cancers prostate pancreatic, ovarian cancer.
And it's a simple blood test.
This blood test was thousands of dollars for the last few years.
We were able to work directly with Grail.
Bring that test, I think it's in market now in hims and hers at like 600 bucks.
And my hope is, over the coming years I'll continue to come down to a few hundred bucks where everybody could do this on an annual basis like going to the dentist, right?
It's just check to see if there's any early signs, any early protein indicators of stage one cancer tumors.
So there's an arc, right?
When the GLP-1s first came out, it was $2,000 list price.
We applied incredible pressure to the drug companies.
I think the current administration in the US did an amazing job.
And thanks to the drug companies, they actually agreed to bring them down from the thousands of dollars to 150 to 200 cash pay prices.
I mean, that is like completely transformative.
It's not something that's really happened in pharmaceutical history that the blockbuster drug of the century gets cut by 80 in 18 months.
Right.
And the reason for that?
I think the reason it happened in part is because companies like us and consumers applied massive pressure to change the distribution model.
In 18 months, the distribution model has completely changed in pharmaceuticals in the US.
Instead of going through PBMs and insurance, they're going straight to customers through platforms like ours, at prices everyday people can afford.
There's an arc to that price reduction, but I think for us we want to have the absolute best and also want to be able to apply pressure to bring that cost down as much as we can.
Do you think like a PillPack sold too soon when you think about the erosion of PBM's power that you mentioned there and how challenging it was for a business like PillPack?
You know, I don't know too much about PillPack to be totally honest.
What I don't believe is that the pharmacy fulfillment part of our business independently is a particularly valuable business.
How should I think about the preventative healthcare companies that I'm pitched every day?
Whether it's your pre-novos or your necos in the UK, which is expanding to you.
Is that the future, where some are much deeper, some are much shallower, some are much more expensive?
How do you understand and analyze that space?
Is that something that HIMSS would do?
We spend a ton of time looking at that space.
And actually, we did a partnership with ProNovo that was announced just a couple of weeks ago.
I think where there's a lot of interesting companies right now is in highly specialized levels of testing for clinical areas that are meaningfully unmet right.
So you look at things like uh, cardiovascular disease, um right, still one of the number one killers.
Most dads die of a heart attack.
Um, yet a statin is you know two cents for me to manufacture.
And if you take a statin every day, um then you won't die of a heart attack, or you're meaningfully less likely to die of a heart attack.
Yet nobody does it.
And so there's biotech companies right now working on therapies where a single injection quarterly or a single injection annually can absolutely obliterate your cardiovascular risk.
And if you can do something like that, you meaningfully curve that rate of death and you get ahead on prevention for cardiovascular disease.
Prunovo I think is another interesting one, right?
It's how do we get ahead of detection for things like cancer and early tumor detection?
My dad had stage four colon cancer when he was 39.
It then costs the health care system, you know, hundreds and hundreds of thousands of dollars, if not millions of dollars, to have surgery and then treat him for many years with chemotherapy.
Right.
And then afterwards, the care involved to kind of get him back to a steady state.
The idea of an annual exam that can scan your body for early signs, early proteins through blood testing or early, actually imaging signs that can detect a millimeter-sized tumor, is incredibly fascinating.
Now i think a lot of clinical people, um and they're smart, you know believe something like that is not yet ready for mainstream and it might not be right.
I kind of choose to be opportunistic in giving people um uh, the ability to make those trade-offs for themselves.
I take prunovo annually, so you know i recommend it to my family.
Is it perfect?
Absolutely not.
How much is prenova?
I think now it's maybe about 1000 or 1500 bucks a month a year.
Okay, that's better than I thought.
Again, these are machines that cost 500000 one-time purchase to buy, but then you're charging 1000 or 2000 a month or a year.
The idea that this cost could come down dramatically is very real.
A 500K machine capitalized over a decade, the cost could come down to something like 300 a year to do this test eventually.
And that's where my brain goes when I'm thinking about the future is what are the Swiss cheese layers we can give people that together make up really great prevention working backwards from what we know causes shortening of life and health span.
Is the biggest threat to your business not actually open AI?
And if ChatGPT is the kind of consumer interface with a lot of healthcare questions that people have today which it is in most cases actually, and that's why obviously, health is a big focus for them is it not the most natural extension ever that they extend that into delivery supply, being your on-demand doctor, something that people have been talking about a lot?
Actually, Daria was mentioning this recently.
I think some of the most defensible businesses in the age of you know Anthropic and OpenAI are businesses that actually do something physical.
Like they require actual specialization and they require infrastructure.
And a huge part of what we do every single day is treat tens of thousands of patients with thousands of doctors that are specialized and licensed in every state or country in the world and then actually help make people medicine.
And this is a million square feet of pharmacy fulfillment.
This is hundreds of pharmacists and robotic machines that are actually compounding treatments or fulfilling branded pharmaceuticals.
So when I actually think about the most defensive businesses, the businesses that can thrive in the age of AI and actually be enabled by them, are ones where the conversation of something like ChatGPT massively expands the funnel of people engaging in health and wellness but then can be driven to a platform that actually connects them with the specialist and connects them with the products and actually can get that delivered to their door.
Ultimately, I think we're a combination of all of those businesses together.
I think there's a lot of opportunity with that funnel that opens up with things like ChachiBT.
I agree with you in terms of physical infrastructure.
And real world requirements, meaning that's just inherently more value there because it's harder to do.
So does that look like a partnership then?
Say I come in and I say, hey, I've got a, I don't know, a rash here and I'm worried about it.
And then they siphon it off to him.
So what does that relationship look like?
Yeah, I mean, I think it's similar to what you see on Google.
I don't think it's going to be all that much different, right?
That you'll be able to partner directly with Anthropic and ChatGPT and find patients that are looking for certain services and then have handoffs to specialized implementations right.
It's going to be.
I think there's great opportunities to partner with all of these players.
We mentioned kind of transition of how people consume healthcare.
In terms of how people find you.
I actually had Eran from Monday on the show, which is a fascinating show.
And he said that, with AI overview on Google, that they've lost 18 or I might be butchering 15 to 18 of their AdWords in terms of acquisition.
How are you seeing the way that people find hymns change?
It hasn't had particularly dramatic changes since some of these new AI companies have grown.
I think for us, a huge number of people that come to us are first time patients interested in some of these care categories.
And so they're hearing about it through watching Fox News.
They're hearing about it through watching NFL on Thursday nights.
They're hearing about it from their friend who all of a sudden is feeling great.
And the friend is talking about the treatments that they're on or the fact that they're getting care from him and hers.
So I think more and more for us, the brand and the spend is moving towards channels where you're talking about the opportunity to feel You're not reliant on, maybe the AdWords Google funnel that you mentioned.
I do think those businesses inevitably will have struggle in transitioning to some of the chat-based interfaces, but there'll be ad networks that are built through those chat-based interfaces that eventually just replace them.
Ultimately, I'm not sure it will matter.
But for us, I think an increasing amount of spend is actually going towards just telling people about all of the new things Hims and Hers is doing, the fact that you can feel great, the fact that it's affordable and you can come check it out.
And it's a lot of market creation both in the US and globally, versus latent demand that you're capturing through some of these more streamlined channels.
If I gave you an unlimited checkbook, what would you spend on today that you're not currently spending on?
I would definitely sponsor Ferrari F1 because I've told my wife that if I were to have one job that wasn't my current job, it would be a Ferrari driver.
But she did not really like that answer.
No, but I think we were probably- Do you think that would be a net positive for HIMSS as a business?
Don't laugh.
The Ferrari sponsorship?
Yeah.
At this point probably not, because I'm not sure we're live in every market with the penetration we would want where that global footprint matters.
I think eventually it would.
I think eventually in the coming years, you know, World Cup and global sponsorship opportunities actually do matter, because we are
This year was a huge level of commitment to win internationally.
I mean, we did not dip our toe.
I mean we acquired three or four companies very large- Did you acquire Eucalyptus for like one and a half billion in cash?
Somewhere around there.
That's great.
How does that come to be, dude?
You know what, it comes to me because you get to know the people really well.
I've known Tim probably four or five years.
I think he was the best operator overseas, no question.
I mean his understanding of the customer, his ability to build a team that just moves fast experiments, is willing to take risks and fail.
I mean, when I first met Tim, he was live in like six or seven markets and it was all failing.
And he was telling me how chaotic it was.
And I was like, I don't know, man, this sounds crazy.
You're in like Indonesia, you're in Japan, you're in all these different places.
Like, is it gonna work?
He's like, I'm not sure, but we're gonna try it.
And then a year later, he's like, okay, it didn't work.
We're like toning it back.
We're gonna focus here.
His humility and his willingness to experiment and test and learn is incredible.
And because of that, they've just moved so much faster than everybody else.
I mean they're the dominant player in Australia, dominant player in the UK, dominant player in Germany, quickly growing in Japan.
I mean, it's just a phenomenal business.
And I think the power of what we built in the US from a cash flow standpoint has enabled us in the last four or five years to buy that business with pretty moderate dilution right.
Because you can actually just fund the purchase of it off the balance sheet over the next couple of years, which is incredible.
And so we have committed a huge amount of dollars and focus internationally because I just think the opportunity for the brand is pretty consistent.
Whether there's a national system in the UK or not.
Does it give you cold sweats at night, being as aggressive as you have been, as quickly as you have been?
I remember interviewing Dax from Lightspeed, Dax De Silva, and he mentioned the challenge.
Lightspeed, the POS system in a lot of restaurants, and he mentioned the challenge in acquiring so much so quickly.
I think they made 18 acquisitions in a two-year period.
Are you worried of like oh fuck, I now have to integrate Eucalyptus in these three other businesses.
Definitely.
There is a very fine line of driving so fast that you're losing control.
There's no question about that.
What I've found, at least in running this business, is if you don't feel like you are getting close to that line, you're probably not pushing hard enough.
And so I do think that uncomfortable gut feeling, where you're constantly questioning, constantly evaluating, constantly tweaking the strategy or the tactics, like that feeling is what success feels like.
And so I've kind of taught my team that we're gonna get really comfortable with that feeling.
We're gonna get really comfortable sitting in that feeling and questioning and reevaluating and pushing, because I think that's how you win right.
Like I was a rower in high school And I remember you know my coach saying you know the group of guys out there that is willing to be the most uncomfortable and in the most pain are gonna win this race.
And that's actually true in that sport.
And that's true in, you know, in most sports.
And I think that's true in business is like if you can put yourself in environments where you're being aggressive but smart, taking the right bets, but have a team that is, you know, bought into the mission and comfortable with that level of aggressive risk.
And I think I think it's the right formula.
So to me, that's what makes this fun.
When with the benefit of hindsight, did you push too hard, and you had to pull back?
In the early years and I think I still try to moderate this with our business we could launch so many things within a month.
You could launch a skincare routine.
You could launch like a makeup brand.
You could launch sleep vitamins.
You could launch like a wearable device.
You i mean there's just like anything people are doing in health and wellness could live in the hims and hers brand, which is pretty powerful and also extremely um risky right, because if you, if you do too much and you you move into the wrong areas, you waste a ton of resource.
So in the early years I thought just having everything on the platform was how you win.
And so we invested in skincare regimens and we invested in vitamin supplements and we invested in so many things that in retrospect, were fairly commodity products.
And for pretty much the same price or even less, you could walk across the street to Walgreens and get something that was pretty much the same thing.
And I think that was a massive mistake.
I think it was a belief that just assortment won.
And I think there's a more nuanced perspective that the right assortment wins.
And so we're really careful about categories we enter, products we launch, to make sure that the products and offerings that are actually differentiated for people, that are hard for other people to receive and get access to.
And maybe that means it's pharmaceutical grade.
It's manufactured in a way that is very, very challenging to get quality.
Or there's a level of personalization that is required in this care of treatment that makes it unique to you.
But when I think about some of the early DTC brands that launched, you know they were selling commodity products.
And those products capped out at a billion in revenue or a couple hundred million in Facebook spend, and the curves were like this
And that's my nightmare.
And so in the early years, made a lot of those mistakes and try to make sure we don't do that again.
I do want to go back to the brand marketing element, just because I suppose you mentioned obviously, brand being a core component of the defensibility.
When I interviewed Nick at Revolut, he said brand marketing was the single biggest thing he's changed his mind on in the journey of Revolut, which I thought was an interesting statement.
What do you know now about brand marketing and spend on things that seem facile?
What do you know now that you wish you'd known?
You know, I think what you, what you gain confidence in with brand marketing over time, is that consistency, consistency is required.
So I think in the early years, with brand marketing, as companies are growing, they throw some dollars.
You know, let's do an out of home campaign in New York.
Cause it's like really cool.
It's like takeover subways, right?
Which we did a ton of.
I mean, they do it once and everyone this team is so fucking excited because it's so cool and you can see it and you take pictures of it.
But you do it once um, and then like months go by and and it gets taken off and then, and then that's it right, because you did it and it was fun and cool.
And you look at the numbers and like ah, maybe there's like a little spike in new york city, maybe on this day, like you can't really tell, probably not, but you hopeful um, and then the next year like okay, what are we gonna do this year?
Right, like that's just like it's a guaranteed way to just lose money.
It's a great way to feel good and it's super fun.
It's like so much fun and we've done a ton of it and it's really fun, but like that's not a business strategy.
I think in order to have brand marketing work, I think it has to be consistent.
It has to be consistently random. if that makes sense.
Like you, have to be appearing in different places for people in a randomized way, but with consistency, because it's the multiple hits.
Like you have to be hit 10 different times in 10 different ways for, all of a sudden, that to say.
Hey, there's like a cultural zeitgeist association with hymns right now that I need to pay attention to.
Like what are they doing?
That is showing up in so many ways in my life, where your brand trust elevates, your cultural relevancy elevates.
So it isn't a one-off thing.
And I think in the early years you hope it is and you try to track it, but it does require a level of dollars.
It requires a level of consistency.
And actually Cathy, our chief comms officer, told me this when we were interviewing, which I completely believe.
She's like.
The thing early companies struggle with when it comes to communications and their brand is they get bored of saying the same thing and then they move on to the next thing.
Like early companies were excited, were young, were changing.
So like, here's our vision and here's what we stand for.
Then three months later, like, it's changed up a little bit.
I wanna say something different.
Cause I already said that thing in that last podcast.
Let me say something new in this new one.
And, in fact, what makes great brands great is the fact that everybody knows why they exist, why they fight, who their customer is, what the value is they deliver.
And it's because they say the same damn thing in 20 different ways every single week.
And so I think that's one of the key parts about brand marketing, or comms in general, is consistency, is making sure that that message and that narrative is not changing, which requires an immense amount of discipline.
And in many ways, it's like a lot less fun.
It's much more of an engine.
But over many, many years, I do think it builds.
I agree with you.
I also think everyone.
When you're bored of saying it, you've got to remember that there's a new team member that's never, ever heard it before.
That's right.
And so you need to deliver it with the same passion and gusto that you did.
I also think not enough are opinionated enough.
If you look at The Hims and Hers brand today, where would you say you are not opinionated enough?
I think Kims and Hers will increasingly have a stronger perspective of what great healthcare looks like.
And I think, as we grow, we are building an understanding of patients at a scale that I don't think most have.
When you think about the fact that we're treating 10 20000 patients a day.
The largest health systems in the world are not treating 10 to 15000 patients per day.
So there's an immense amount of knowledge that's being built around different types of patients, their demographics, their risk factors, their biomarkers, what medicines and treatments work why, what side effects they have, how much they feel better.
Combination therapies that are beneficial.
There's just an immense amount of knowledge base growing where I think we're gonna be able to start having stronger perspectives of what excellence looks like in healthcare.
What do we believe the gold standard in preventative care is?
Like.
If you Harry, wanna be the absolute healthiest 29-year-old right and be ahead of the curve, What are the 10 things you should be doing?
What are the tests you should be doing specifically for you?
What are the treatments, whether they're holistic supplements or maybe sauna that you should be doing?
And what's that exact regimen and get ahead of it?
And there you go.
You're gonna be gold standard, right?
I'm so far off gold standard, dude.
You're doing great.
You're doing great.
And I think that's the point of like.
To me that's such a key part of the hims and hers brand is like everybody feels that way.
Everyone feels so far away from optimal.
And it's really fucking hard to take the first step to have that confidence to like make a change.
And so most people that come to Hims and Hers are first time customers, because I think we as a brand try really hard to empower you and say hey, that first step is going to be easy.
We're going to make it easy.
It's kind of like that old Marine or Navy SEAL story of like you make your bed in the morning.
Right, because when you make your bed in the morning, you've completed something like a very tactical action, you've had success.
There's like positive adrenaline.
And then from there you're going to do other great things throughout the day, like hymns and hers.
I want to make it so easy for everyone to take that first step and feeling great that that empowers a lot of people to do so.
And from your person, from your question, we're gonna have a stronger opinion about what great actually looks like.
So for anyone wondering, that is General McRaven's commencement speech.
One of the greatest speeches I think recorded on the internet.
I've listened to it probably a thousand times.
It used to be the start of every single run, because it's 16 minutes, which is always the most painful of any run the first 16.
So amazing aligned.
I've got an out there idea for you.
You said that you want to make it easier.
Why do you not have HIMSS preventative assessments in every city and say hey, we'll tell you what's wrong with you, like a pre-novo does or like any other preventative?
And you can choose to buy with us or not.
But by doing that, you're building up the world's largest set of healthcare data for free, and you give it for free, and the treatment's what they pay for.
It's like you're a loss leader.
Also, what a goodwill engine.
I would go to the dinner party even if I didn't talk about, Even if I didn't buy products.
I'll go to all my friends and be like you'll never guess.
I found this out about myself when I went to HIMSS.
Oh, what's HIMSS?
I think we are very close to that being a reality.
Do you have the elasticity and budget to do that?
I don't mean that rudely.
It requires two tangible things.
So last year we acquired your BioHealth, which is one of the few at-home blood collection devices.
I have it right here on my desk.
And this device costs just a couple of bucks to manufacture and you can click it on your arm and it's got 30 micro needles inside of it.
Each of the micro needles is smaller than an eyelash.
So if you feel nothing, you click a button, you feel nothing, and then a small tube of blood gets extracted from your arm in about a minute or two.
You can then peel that off and you can mail it to New Jersey, which is where we have a lab processing facility and we'll have a couple others in the next year and two and run a full panel, you know, 50 biomarkers, and it will cost us like almost nothing.
Now today, if you go to Quest or LabCorp and try to get that panel, cash pay maybe costs you 1000 bucks or 2000 bucks.
If you go online and go to different competitors, maybe it costs like 300 or 500 bucks for that panel.
And my goal, my vision is like very quickly, I wanna give that away as a part of the Hims and Hers membership for free.
Because if you can get a sense of those metrics and I'm not talking about just like baseline metrics, like your cholesterol and the things I'm actually talking about things that are even more sophisticated, like genetic predisposition risks, which very few people get access to, or cancer risks, or polygenic risk stores
If you have a really accelerated risk of colon cancer.
There's things you should be doing that are different.
So to me, that is the vision, a preventative front door that is near cost or free.
And that requires us to spend hundreds of millions of dollars, which we're doing right now, to totally verticalize this stuff and actually own the devices, the lab processing and that fulfillment.
But then a platform that says, here's everything we know, here's what we can help you with, right?
And give guidance and again, make that next step really, really easy.
I thought it was really interesting.
Gokul Rajaram, he's amazing.
I don't know if you know this, but he basically said his biggest lesson from Square, where he was for many years, was that when you're running a multi-product company, not every product line has to be profitable.
That's so right.
Yeah.
And I think for us, I think that entry point and that data collection, it serves two purposes.
One, most people just don't even have access to this stuff.
So they don't even know if they're doing well.
I'll give you an example.
One of my best friends, he's mid 30s.
He's trying to live healthy.
He was telling me the other day how he's running a lot.
And he looked at his cholesterol numbers and they were they were like kind of out of whack.
So he's like now starting to eat more salmon and going for a run.
I'm like, Oh, that's great.
Awesome.
And then I told him hey, have you done testing for this specific genetic risk factor for heart disease?
It's called lipoprotein little a. He's like, no, I've never done that test.
So he ran and did that test and he came back and he's like, my number is like 450.
I was like, well, that's a problem because that number should be like under 70.
And if it's 450 it means there's a pretty good chance you're going to have a heart attack at like 50 or 60.
And he looked at me, I'm like, do you have, has anyone ever had a heart attack in your family?
He's like well, my dad died when he was 60 and my dad and my grandfather died at 55, both of heart attacks like to me, that moment was why all of this matters, because he went to his doctor.
He went to a cardiologist because he was trying to do well.
They gave him a set of panel and blood tests and his numbers were a little bit off.
So he started to go for runs great, first step.
What they didn't test was a genetic predisposition marker that we now know is so much more important.
And if you have that high genetic predisposition number, your cholesterol numbers need to be like amazing, not good.
They have to be incredible or you're going to have a heart attack.
Like there are so many therapies he should be starting now because he now has access to that number.
That's the kind of stuff I want to give away for free.
Like that level of information helps people actually like get preventative, not reactive.
And put it on a care spectrum where if somebody wants to be aggressive, they can.
If somebody wants to be conservative, they can.
But I wanna give people information and then I wanna give them choice and assortment and a doctor to help navigate that for a cost that isn't overwhelming.
I'm sorry to be, and this may be a total tangent, but is it not like totally fucked that doctors get incentivized by drug companies?
Yeah, the whole thing is totally fucked.
If you look at the existing system in the US, almost nothing has to do with patient outcomes or patient happiness.
So many people make money.
Everybody makes money, but none of them make money in any way.
That's actually reflective of success of the customer or patient.
And I think that's where our model is most powerful.
Like we only make money at hims and hers.
If you are happier and healthier period, because you pay us.
You pay us to be healthier.
If you don't feel healthier, if you don't feel happier, you stop paying us.
And so our incentive is only aligned with you.
And we then fight behind the scenes the drug companies, we fight the diagnostic companies, we fight everybody and we work with them, but we apply pressure to them to get the best stuff at the best price, to bring it to you.
But ultimately, we only succeed if you succeed.
In a way though, your business is like my business, which is like we don't want you to be too successful where you don't need us.
A world where businesses don't need venture capital is a problem for me.
That's not a good thing.
A world where humans don't need any medication.
Andrew, I hate to say it is not a good business for you.
Well, for us, it's not necessarily about medication.
You will always need somebody to help quarterback your wealth and your health.
Right like, as you grow, as you age, you're always gonna wanna have somebody who's an expert partner that's available to you 24 seven, that you trust that can help you navigate how you feel in life.
And this changes, right?
Like at different milestones.
Like you might not be there yet, but in the 10 years from now those things will be popping up all the time.
And that trusted partner becomes so valuable.
And it could be super cute, it could be something small, but I don't think that changes.
And so that relationship that can last decades with hims and hers is what matters, right?
Like me just getting you a specific treatment today and making the most money I can from you today.
That actually isn't what matters to me long term right.
I'm 37.
I've got like a multi-decade perspective on how big this business can be.
In order for it to reach that maximum value, you have to build a brand that people trust to have with you for a very long time.
And that means often saying, hey, right now, this treatment might not be for you.
You know, but we're here for you when something else pops up, and here's more information, and here's more diagnostics, and here's maybe a wearable device, and here's some other habits and food and nutritional support to help you along the way.
What is your least profitable product that is most important?
Do you remember we said about multi-product companies don't have to be...
Right now, it's the lab testing offering.
We offer it essentially at cost.
We haven't verticalized any of this infrastructure, so it costs us, you know, pretty much just as much money as we we sell it for.
And again, it's because i believe the loss leader value to the patient is incredibly important and that margin will continue to be terrible because what we're going to do is continue to reduce the cost as we verticalize it and then actually reduce the cost to the consumer so that that will always be, i think, a platform benefit from my standpoint, where we try to make nothing on but give patients information and access and that ultimately can be really transformative for them.
What do you think not enough people know about HIMSS that they should know?
I think a lot of people are still trying to understand why we are fighting so hard, right?
People see us in the headlines all the time, right?
Recently seeing us in the headlines for GLP-1s and with drug company conversations.
Why do we see negative connotations with you and not Roe?
It seems like the world likes to dunk on you more than Roe.
I think, when it comes to hymns, as a disruptor we are actually.
I think we are pushing buttons that structurally change how people get access to care in this country.
If you look in the last 18 months like we were talking about, the most important medicines of the century got cut by 80.
Not only did they get cut in cost, but now they're available through consumer channels at prices everyone can afford.
I think we played a part of that. intentionally.
We applied massive pressure, regulatory pressure, consumer pressure.
We leveraged hundreds of thousands of patients to raise their voices to say hey, these medicines could save our lives.
Let's actually get them to us in ways we can afford, and coverage is now expanding dramatically and the prices are tanking.
And so I think our willingness to be at the forefront of disruption and push on behalf of consumers, I think, causes friction.
Right.
And I think we're comfortable with that friction.
I think people understand why we're doing.
It is super important because we like to push where it's important to customers.
And I think ultimately that is going to benefit how the ecosystem works.
And Roe isn't innovating in that way, hence they don't get the criticism?
I don't know if I I won't talk specifically about any other brand because I'm not sure their strategy, but I would say
In order to actually disrupt the system, you have to break part of the system.
And I think our strategy is doing that.
What part of the system would you most like to break that you haven't broken yet?
I think we're in the middle right now of breaking how healthcare is distributed entirely.
So, instead of going through the PBMs and then through insurance, and then through reimbursements, all of that complexity that nobody understands in the US, I don't think any of it makes sense.
I think all of it, or as much of it as possible, will go through consumer channels like hims and hers, where you can pick up your phone, have on-demand access, have total price transparency, have complete choice of which doctor, which specialists, which treatment, complete information access and then control.
The system in the US is entirely paternalistic, right?
You get treated with whatever they want to give you.
And the incentives and reimbursements and costs are so convoluted that it's wildly overwhelming.
And so, when I think of every other industry we love food delivery, financial services banking retail, everything is simple.
It's on demand from your mobile device, price transparency, customer choice.
Yet the one thing that is the most important part of our life doesn't have any of those elements.
And it's the biggest industry in the US.
It's where we spend the most money too.
And so I think that's entirely gonna change.
And so I don't think HIMSS is a D to C company.
I think HIMSS is disrupting how healthcare is delivered a consumer-focused fashion.
And I think we're in the midst of that change.
I think people are just coming around to it and you're starting to see it, with the GLP-1s as a prime example.
But I think in the next five years, it's going to accelerate dramatically.
The lock-in and power of Epic is just mind-boggling.
Does that progress or prevent innovation in the healthcare industry?
I don't think it's relevant, actually.
When you look at the patients coming to Hims and Hers today, the patients starting their healthcare journey, the majority of them do not have legacy data and systems within old EMR platforms.
They moved to a new city.
They moved to New York and they're 22 and they're like I don't have a doctor yet.
I'm feeling a little sad.
What do I do?
And their first time entry into the healthcare system is hims and hers.
And so the wave of healthcare for the future, for the next 20 years, for the 50 years after, that is gonna be a patient population that's starting today.
And that's why I think you have to build a relationship early.
You have to have an assortment of care that starts young for people, so that you can give them an example of what grade looks like and then build with them over many, many years.
Final one and then I promise we'll do a quick fine.
I know I've jumped around the whole thing, but that's why I love what I do these days.
I think your food industry is at the root of all your health care problems.
What you guys do to your food is not fucking natural.
Apples are not meant to be that large.
Salmon is not meant to be that cut.
Do you agree that food is at the root of a lot of your healthcare problems?
100%.
100%.
Genuinely dude.
How do you eat healthily and sustainably in New York today when it's all completely artificial?
Yeah, it's really challenging.
I think the current administration is doing an amazing job on that issue.
I really do, right?
Like the push to eat real food, the push to normalize the fact that all of the ingredients on these labels is garbage, it's chemicals.
The push to educate people to actually see what is good for you and look at those labels and require food companies to disclose it and to force changes on high processed foods or corn syrup use.
It's poison.
My wife is French.
And so when we're visiting her family overseas, I look at the labels, it's crazy.
I mean when you look at a French fried bag in a French grocery store.
It's potatoes and it's olive oil.
And that's it.
You know, you go to Safeway here in the US and you look at it and it's 40 different things.
So I think there's a huge problem with the food industry.
I think the government applying pressure and regulation there is a wonderful idea for people because Undoubtedly that's a massive part of the obesity epidemic in the country and also probably the mental health epidemic and many, many other things.
Yeah, I'm totally with you.
Actually, on this one I feel really sorry, for I don't know how to say this without being classes wealth this, whatever but I feel really sorry if you don't have money, because I think it's really hard, then
Oh yeah.
It's so difficult.
I mean, we've got three little boys and I you know We try to feed them well, and so we'll buy like a carton of organic blueberries, right?
And that carton is expensive, organic blueberries in San Francisco.
It might be like seven bucks and I'll open it and I'll put it in front of the boys for breakfast and they'll grab handfuls and it'll be done in 15 seconds.
The idea that you know healthy food costs this much is consumed that easily is a real challenge right now.
Anything people can be doing to eat locally, to have local farms, to make sustainability in their communities easier and better, I think is all positive.
Dude, I want to do a quick fire round with you.
I'm going to say a short statement.
You give me your immediate thoughts.
Does that sound okay?
Sounds good.
What decision have you made in the last two years that you would reverse today?
I think I was too slow to force the company to invest in completely disrupting their team processes with AI.
Which process was disrupted most?
I think customer care, provider quality, all patient interactions.
I think we were a year too slow on totally changing the model of how patients interact with the platform.
CAC goes up or retention goes down.
Which scares you more? retention going down.
There are always ways to optimize efficiency on acquisition.
There are always new channels, new brand campaigns, new growth avenues.
But if you don't have a sticky customer and for some reason they're becoming less sticky, your product market fit, your patient happiness, your customer happiness is going in the wrong direction.
CAC only ever goes one way.
Agree or disagree?
Disagree.
Why?
At scale, I think.
With scale, with assortment, with brand value, new channels become unlocked, new efficiency grows, leverage accelerates with assortment.
I think It often only goes one way, but I don't think always.
Other than Ferrari, what do you not sponsor that you would most like to?
World Cup.
Like the event itself?
Or like the FIFA World Cup brought to you by HIMSS?
Yeah.
Well, you got the US one coming, dude.
It's not too late to spend some dollars.
Right.
Dude, I love that.
What advice would you give to yourself starting hymns again?
You mentioned Jack and Atomic and starting it as part of Atomic.
What do you tell yourself going back to the very start?
I would tell myself to trust my instincts as we continue to build and get bigger and bigger.
Continue to trust my instincts.
And also remember that it's going to be a long journey and the ups and downs are going to come and go.
Um, but that the persistence is going to be most important.
And I think, you know, we do meaningful jobs and you do a hugely meaningful job.
But I think the most meaningful job that you probably do which you'll agree with is being a father.
What's your final one?
What's your biggest advice on being a great father now having three boys?
You know, there's something I watched once where they asked a whole bunch of little kids what their absolute perfect afternoon was.
And these are like two, three, four, five-year-olds.
And the perfect afternoon was.
All these kids answered the same way just playing with their mom and dad, just like sitting with blocks and playing with their mom and dad, or drawing with their mom and dad, or something with their mom and dad.
And I don't think you know, when you're exhausted and you're a parent and you're trying to do everything and pulled so many different ways, you realize that actually all the kids want to do is just have you present and truly present.
And so my greatest advice I think would be to try really, really hard to just play with them.
Like actually play, like get down on your knees, on your butt in whatever they're doing and just ask what they're doing and ask if you can do it with them, because they light up.
Because in parenting it's hard to actually make time for that, but I've found that that's really the most important and valuable stuff.
Dude, I so appreciate you.
I so appreciate the friendship.
I so appreciate you putting up with my incredibly wayward conversation.
I mean, real breadth to the conversation.
You've got to give me credit.
But you've been fantastic.
Appreciate you having me, Matty.
Good to see you again.
