Telemedicine startups Roman, Hims, and Keeps show enormous growth

NOTE: Bloomberg Second Measure launched a new and exclusive transaction dataset in July 2022. Our data continues to be broadly representative of U.S. consumers. As a result of this panel change, however, we recommend using only the latest posts in assessing metrics, and do not support referring to historical blog posts to infer period-over-period comparisons.


Thanks to advances in telemedicine, prescription grade medications are making their way into the subscription box fad. For three startups, prescribing and delivering monthly medications for men has spurred rapid growth, expanded product ranges, and—at one company—prompted the rollout of a women’s line last month, too. Just how fast are these boxes growing? Leading competitors Hims, Roman, and Keeps have all seen spending grow by 10 times or more since their first full month of sales, but are each fueling their success differently.

Second Measure on telemedicine startups: Sales up 10x or more at Roman, Hims, and Keeps

All three companies are capitalizing on the freedom of telemedicine, which removes the hurdle of a visit to the doctor’s office and offers a new avenue for patients to address tough-to-talk-about concerns, like sexual health, hair loss, smoking cessation, and more. Hims and Roman were both founded in the last few months of 2017, right before expiring patents opened up the market for erectile dysfunction drug Viagra to be sold as a discounted generic.

Hims attracts customers best, but they spend most at Roman

Of the three telemedicine startups, Hims is the largest, bringing in 20 percent more year-to-date sales than its closest competitor, Roman. But that gap has been closing. In October, spending at Roman was just 8 percent lower than spending at Hims. Though sales may be comparable, key customer metrics reveal different strategic focuses across competitors.

Hims has attracted new customers the fastest. More than twice as many men have tried Hims as its nearest competitor, Roman. Both Roman and Hims will sometimes offer the first box on the house, hoping to entice new patients to sign up rather than take their telemedicine prescription elsewhere. The promotions leave new subscribers on the hook for only the medical consultation fee—at Hims, $5 and $15 at Roman.

Second Measure on telemedicine startups: Hims attracts customers best, but they spend most at Roman

Though Roman has acquired fewer subscribers, its customers spent an average of $246 in their first six months—the highest of the three telemedicine startups. Keeps customers spent $181 during the same period, while that number at Hims was $101. All three companies offer a mix of prescription and OTC treatments. None of them currently accept insurance.

How likely customers are to stick to their new routine also varies by company. Keeps, which treats only hair loss, retains subscribers best. Its quarterly boxes and concentration on a narrow audience have resulted in 72 percent of signups returning two quarters after their first purchase. (The company is too new for a full-year analysis.)

For all three brands, there’s plenty of room for more growth, as combined market penetration is less than half a percent of all U.S. consumers.

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