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The Hollow Men of Hims

alexkesin.com

21–30 of 277 posts

Re: The Hollow Men of Hims

#21
post #12

Semaglutide / GLP-1 compounding is not limited to just Hims. Lot's of pharmacies do it. The manufacturer (Novo Nordisk) charges 5x-10x for the exact same thing. The author calls the GLP-1s used in compounding "Chinese Knockoffs", but offers no evidence of quality control problems, and is instead relying on the reader's prejudices. GLP-1 drugs may be a game-changer for obesity and diabetes, the same way that cholester…

The problem with your position is simple: where does it come from?

The legit path for compounded semaglutide is buying up Rybelsus, impacting the supply for diabetics. Compounding pharmacies are notoriously shady, and are likely using grey market materials from questionable sources.

Re: The Hollow Men of Hims

#22
post #20

This buried lede is really the core of the article: > They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. This is what disruption looks like when applied to the oldest human needs: not improvement, but the illusion of improvement And contra…

OneMedical (now owned by Amazon) provides a version of this that also connects you with a general practitioner doctor who you're able to see in your area. They additionally have telehealth-style prescription requests in the app, but you end up with the FDA approved version coming from Amazon pharmacy for $5/month (on top of the $200/year for OneMedical), or for $cheap at your regular pharmacy. A++ would recommend. Ho…

I also have one medical, (cheaper if you have Prime), but they don’t do ozempic/wegovy, so you’re still at the mercy of insurance, or paying out of pocket if you want GLP-1s.

They’re still a great option if you have other needs, like Prep or stimulants.

Re: The Hollow Men of Hims

#23
post #15

> Regulatory arbitrage disguised as innovation, dressed in the fashionable vocabulary of patient empowerment while serving no master but the quarterly earnings call. No masters except the patients that are literally being empowered to make choices about their medical care and are paying a substantial premium (in many cases) to do so. I would happily be empowered by my doctor and UnitedHealthcare instead, but sadly th…

Tretinoin is easily prescribed by seeing a dermatologist. What do you mean it’s a nightmare to get even with a prescription? I think a tube of cream cost like $10 at Costco. You don’t even need to use your own insurance to buy things from the pharmacy as long as you have a prescription. I never once had a problem filling it before I switched to Accutane.

Re: The Hollow Men of Hims

#24
post #6

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

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

Re: The Hollow Men of Hims

#25
Hims is actually very expensive. I get the same Semaglutide for far cheaper either via my hormone dr. (provides a small, reliable dose of testosterone (trt) every month and legit access to hard to get compounds via a compounding pharmacy. No hoop jumping, they have a menu, I order from it. In real life I take 2 - 3x the testosterone dose when I am on but when I am coasting its easy no stress way to get what I want delivered monthly. When I am not using what they provide I just set it aside for the apocalypse :) )

GLP-1s are a miracle drug, people want it so will do what they must to get it. Unfortunately for many of them they cannot afford the $1,000 a month price tag that comes with legitimacy. On top of that, regular doctors make you jump through hoops to get it, having to see the exercise and diet department of whatever hospital group they belong too. this adds hundreds / thousands to the cost.

Let people have what they want. Hims parasitized the process but I don't blame them for it. They gave the people what they wanted and made a profit at the same time.

Adults should be empowered to make their own health care decisions but unfortunately so many of those decisions are made either by insurance companies or the attractive sales reps that frequent the doctor offices. GLP-1's, testosterone, peptides, whatever, remove the gate keepers and allow the free market to compete. The fact that you can go to jail for ordering a 10ml bottle of test cyp over the internet is madness. I rarely go to the doctor now, except for things that are clearly beyond my limits, xrays, colonoscopy etc. For everything else there is the internet and chatGPT. GLP-1s, peptides, steroids, even anti biotics, almost everything you want can be found if you look. The way it should be. I even order my own labs and have chatGPT interpret them for me.

I'm in the best shape of my life at 46 and haven't been to a non hormone doctor except for specialists in several years. Last time I went to the doctor I told them I wanted GLP-1s and they said no, I would have to go and see their diet department. I told them if they did not prescribe them I would just get them online but I would prefer to use them under the supervision of a dr. They just shrugged.

I'm on cycle currently but when I am done and coasting again I am going to hop on metformin to take a crack at stabilizing my liver levels caused by fatty liver before I took control of my own health. Because... why not? Think a doctor would prescribe this?

Let people be the decision makers of their own health. I'm not knocking doctors, they are often highly intelligent people doing good work but their power as gatekeepers does not come with neutrality and they are often beholden to their own bottom line as opposed to the patients well being.

Re: The Hollow Men of Hims

#26
post #14

The explosive growth of Hims and other side-channel healthcare businesses (using this model -- telehealth combined with compounded meds) is entirely due to the "legitimate" healthcare system's complete and total failure to serve patients' needs. You can maybe talk about the hollow men of Novo and Lilly, who colluded with PBMs and insurers for most of a decade to push the cost of insulin analogues into the stratospher…

[flagged]

I am unsure why you have been down voted because fundamentally your point is correct. Health is a fully regulated space, and no entity should be supplying medical products without adherence to requirements appropriate to their role. Compounding GLP-1 seems to me to be in the higher bar space.

Re: The Hollow Men of Hims

#27

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been opti…

It’s possible for both you and the article to be right. The system sucks, but Hims are also terrible, and medical care should not be like Amazon prime.

One's a storefront. The other is a foundation of society.

These are not the same magnitude of sin, particularly since one's shortcomings are large reason for the existence of the other.

Re: The Hollow Men of Hims

#28
Given the healthcare bureaucracy in America, it's hard to find anything for the consumer to be mad about here other than the quality of the medications. The intended audience of this article must be pharma and healthcare investors, not consumers.

As with most products, companies need a way to make promises to consumers about what's in the products. The only way the consumers will believe those promises is if the consequences for lying are severe. Clearly room for improvement here, maybe some of these 3rd party certification labs can start putting their seals on medications too.

The article mentions that medication from China isn't part of an FDA approved supply chain, but as a consumer I don't really care about that. I'd rather have mass spectrometry data on the side of the tin than the FDA's blessing.

Re: The Hollow Men of Hims

#29

This buried lede is really the core of the article: > They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition. This is what disruption looks like when applied to the oldest human needs: not improvement, but the illusion of improvement And contra…

Take the case of a antibiotics.

A large percentage of people want their doctor to prescribe them antibiotics when they have a virus. It’s been shown that doctors who over-prescribe antibiotics get better patient reviews for example.

Now you have a “better UX” that pops up that gives people exactly what they want. They answer a few questions on a website and they get an antibiotic prescription.

There is no way for the medical establishment to compete with a site that will give people what they want even when it’s harmful to them without even requiring any kind of examination.

In the case of antibiotics, this kind of behavior breeds resistant bacteria that regularly kill people.

In the case of other drugs or combinations of drugs, the risks are usually only to the patient themselves. But the risks are real and patients assume this stuff is regulated.

Re: The Hollow Men of Hims

#30
> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being.

Does the telemedicine appeal to people because they want to avoid embarrassment, or because they know that traditional doctors will schedule you for an appointment three months out just to say “have you tried getting better sleep, losing 30 pounds, and reducing stress?”

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