Telehealth unicorn Thirty Madison merges with birth control platform N

Online speciality health care company Thirty Madison is merging with Nurx, a telehealth platform most known for providing affordable birth control. The merger is an all stock deal that is light on specifics.

“We saw women’s health as a really ripe area for our model, we saw it as a place where we can improve access and drive an outcome,” says Thirty Madison president Michelle Carnahan, who has previously held executive roles at both Sanofi and Eli Lilly. Carnahan will remain in her role as will Thirty Madison CEO Steve Gutentag. Nurx CEO Varsha Rao will become head of Nurx.

Thirty Madison delivers care for migraines, hair loss, allergies, and gastrointestinal problems, both direct to consumers and by working with fee-for-service insurance plans. In 2021, it raised $140 million on a valuation of $1 billion, making it one of several telehealth companies to reach unicorn status last year.

Meanwhile, Nurx—which works with insurers such as Aetna and Anthem—has slowly been expanding beyond the pill. In addition to birth control, the company has rolled out sexually transmitted infection testing and access to the preventative HIV treatment PReP. In 2020, it raised a $22.5 million extension of its 2019 series C, which it used to grow beyond sexual health into migraine care (later that year, it took out a $10 million loan, according to Pitchbook data). Since then, Nurx has launched dermatology treatments for rosacea, acne, and aging. Prior to this merger, Nurx was valued at $332 million.

Together, Nurx and Thirty Madison will serve 750,000 patients. The combined company expects to reach $300 million in revenue in its first year. The goal of this merger is to bring together their separate competencies into one broad-based health care company. Together the two companies will span many aspects of everyday health, from managing acid reflux to getting a prescription for Plan B or even a COVID-19 test. “We are trying to provide specialty level telemedicine with personalized treatment and ongoing condition management,” says Carnahan.

Of course, Thirty Madison is not the only telehealth company hoping to dominate at-home care. CVS, Amazon, Ro, Hims, Teladoc, Amwell, and a bevy of other smaller companies all trying to vie for whatever care patients hope to receive from the comfort of their couch. In many cases, that’s turning out to be low-acuity health issues like erectile dysfunction and hair loss, urgent care for easy-to-treat problems such as urinary tract infections, and chronic care in areas such as diabetes, hypertension, and mental health.

The competition is intense, which is why consolidation is the name of the game—not just for Thirty Madison and Nurx, but for everyone. While Ro and Hims started as digital pharmacies focused on erectile dysfunction, both now identify as primary care providers and are adding new services all the time (Thirty Madison too launched an urgent care during the pandemic, which it has since shuttered). In the last 18 months, Ro acquired Workpath, which allowed it to pilot an at-home vaccination program for seniors in New York, and Modern Fertility, which pushed it into more aspects of sexual health. Meanwhile Hims launched mental health services and acquired Apostrophe, a dermatology startup that creates personalized treatment regimens for acne. As more telehealth companies added mental health programs to their roster of services, tele-therapy company Ginger and mindfulness startup Headspace merged in order to offer people a range of services that aren’t necessarily clinical.

Carnahan says that mental health services are on her company’s road map as well. But she doesn’t think that her company competes with Hims and Ro.”In fact, the only place we directly can compete with them is in hair loss,” she says. Thirty Madison focuses on continuity of care, meaning each patient has a doctor they see repeatedly, whereas other platforms connect patients with whatever doctor is on call. At one point that was a big differentiator, though other platforms are increasingly offering the ability to stick with one doctor. Eventually as each of these telehealth players extends into all the possible care you can get at home, they will all start to look somewhat the same. In the mean time, expect to see more companies that tackle single health issues get subsumed into larger telehealth companies.

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