The Telehealth Gold Rush

I get a lot of ads for cheap GLP-1s, which probably tells you a lot about my Google search history. One recent one, from RxPros online, reads ‘To The Woman Starting GLP-1,” which just sounds kind of odd to me, and then goes on to promise tirzepatide, the active ingredient in Zepbound, for just $119.97 a month. (Zepbound goes for $399 and up, depending on the dose.) Once I clicked on one of these sites out of curiosity, I started getting ads for dozens more, including for sites that prescribe and sell meds for performance anxiety and toenail fungus. I dove into the weird world of telehealth for my latest feature:

The Rise of Telehealth ‘Pill Mills’

I’d heard of telehealth sites like Ro and Hims & Hers before starting to report this story, but was astounded at just how many sites there are out there. Many of them are extremely niche, writing scripts for meds like eyelash growers. I was also surprised how many of these sites work through asynchronous communication, which basically means that you don’t have a call or Zoom with a doctor, you just fill out a form and then they skim it and send you a prescription for a drug.

An interesting part of this story that I didn’t go into for this piece is how many entrepreneurs see this as their big ticket to a passive income (I love passive income stories as they just seem like an opportunity for one person to scam another, see my Amazon passive income story here.) I talked to one guy who was told by another entrepreneur selling a course on this that he could make a million dollars in revenue in his first month by setting up a site selling GLP-1s; he found out the market was saturated only after he’d invested $85,000.

^{Above, an Instagram ad for a telehealth site}

But big money is getting into this too, such as private equity and venture capital. The software to ramp up a telehealth site is easy to access and anyone can start a site, and you can make a lot of money if you find the right niche. (This NYT story about a guy who started a telehealth site with the help of AI was good, even if it didn’t go into the huge ethical problems with the site.)

Telehealth has, of course, improved access to care for people who don’t have the time or ability to go to their medical provider; it’s also helped people get treatment for conditions they might not want to talk to their doctor about. But these sites are extremely unregulated. They sell drugs that are not supposed to be on the market (see this Eli Lilly lawsuit from this week) and have essentially become pill mills that dispense to just about anyone who wants a prescription.

My story, again, is here: The Rise of Telehealth Pill Mills

I also looked into the Trump administration’s push to have food companies disclose what new ingredients they add to food and why maternity care deserts in the U.S. might get worse in the coming years.

Books to Fall Asleep To:

I usually skip books about many, many, many centuries ago because they are too broad; authors can’t get too many details because the events happened so long ago that a lot of records have been destroyed or they didn’t have good paper to write on. I made an exception for Alexander at the End of the World: The Forgotten Final Years of Alexander the Great by Rachel Kousser. It details the final seven years of Alexander’s life, from 330 B.C. to 323 B.C., when his conquests just keep going and going to what is now India and Pakistan. His soldiers were not very happy by this point, and the details of how he makes them battle all these different civilizations and then lets the leaders of the civilizations continue to lead after they win is interesting. My favorite part is when his armies face a new army from India, and they have war elephants, which his soldiers had not seen at the time. The soldiers absolutely panicked, which is probably the right instinct upon seeing a giant elephant.