Nurx
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Nurx has $22.5 million in new money, a path to profitability and new treatments for migraines on the way
As the COVID-19 epidemic spread across the U.S. earlier this year, Nurx, like most other digital providers of healthcare and prescription services, saw a huge spike in demand.
Now, with $22.5 million in new financing and a surging annual run rate that could see the company hit $150 million in revenue, the company is emerging as the largest digital practice for women’s health.
“We saw this tremendous surge in need for our contraception and sensitive health services,” says Nurx chief executive Varsha Rao .
The growth hasn’t come without controversy. Only last year, a New York Times article pointed to corner cutting at the startup, which boasts Chelsea Clinton as an investor and advisor.
Undeterred, Rao said the company has now seen tremendous acceleration in all areas of its business. It’s now providing care to more than 300,000 patients on a monthly basis, boasts that $150 million run rate and has new investors like Comcast Ventures, Trustbridge and Wittington Ventures — the investment arm of one of the largest pharmacy chains in Canada, Shoppers Drug Mart.
The new $22.5 million is an extension on the company’s previous $32 million round and will take the company to profitability by 2021, according to Rao.
And while birth control and contraception are still the largest areas of the company’s business, Nurx is growing its range of services, seeing adoption of its testing for sexually transmitted infections including HPV and herpes and a new treatment area for migraines.
That focus on sexual health and what the company calls sensitive health is different from trying to be a primary care provider, says Rao. “Our real focus right now is on our core demographic who are women between the ages of 20 and 40 and really focusing on their needs,” she says. “That’s why migraines make a lot of sense. It’s not exclusively hormone-related, but it often is… One-in-four women experience migraines and they’re largely from hormonal changes… This is a condition we’re well-positioned to address.”
Another way that Nurx differentiates itself from competitors like Hims and Ro, which provide women’s health and contraceptive prescriptions as well, is through its ability to take insurance. “It’s actually pretty challenging to build the system to actually offer insurance,” says Rao. “And yet, we don’t think you can be a true healthcare company if you don’t accept insurance.”
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Healthcare startups Nurx and Carbon Health ship at-home COVID-19 test sample kits
Efforts to get at-home test kits for the COVID-19 coronavirus are ramping up quickly, and two more health industry startups are bringing their own products to market, with both Carbon Health and Nurx starting to ship their own in-home sample collection kits.
Both of these new offerings are the same in terms of approach to testing: They deliver swab-based sample collection hardware that people can use at home to collect a mucus sample, which they then ship back using included, safety approved, projective packaging to be tested by one of the existing FDA-approved commercial labs across the country.
These tests follow the PCR-based method, which tests for the genetic presence of the COVID-19 virus in a patient. These have a high degree of accuracy, at least when performed in a controlled setting and administered by a medical professional, and are the same tests that are available via drive-through testing stations being set up by state agencies.
At-home use is relatively new to market, and could introduce some potential for error in the collection part of the process, but both Carbon Health and Nurx are offering consultation with medical professionals to help ensure that samples are collected properly, and that results, when available, are correctly interpreted and provided with guidance on next steps for those taking the tests.
None of these tests are free — the Carbon Health test costs $167.50, and the Nurx test costs $181, including shipping and assessment. These are in line with other offerings, including the one from Everlywell we covered earlier this week, which retails for $135. These are described as essentially at-cost prices, and all parties say they are subject to coverage by FSA or HSA money, or potentially by insurers depending on a person’s plan.
One big question around these types of tests is how much supply will be available. Nasopharyngeal swabs used for the in-person type of testing are already reportedly in short supply in some regions, and testing needs are only growing. Carbon is using different swabs to collect a simple saliva sample, which it notes are not in as short supply as the nasopharyngeal version. Other types of tests, including a “serological” one being developed by startup Scanwell, instead work by analyzing a patient’s blood, and could provide some relief for the swab-based tests, especially now that the FDA has expanded its emergency guidance to include their use.
Nurx, which also offers at-home HPV screening, says that it will have 10,000 kits available to patients “over the coming weeks,” and hopes to expand to cover “over 100,000 patients” in the “near future.” Carbon Health CEO and co-founder Eren Bali tells me that it should ramp to around “10,000 per day capacity in about two weeks,” through its medical device partner Curative Inc., and that it can do 50 per day today, with an estimated increase to 150 per day by Monday and 1,000 per day by end of week.
All of these tests are gated by a screening and assessment questionnaire, and the round-trip time is likely to take a few days even with round-trip shipping due to testing times. It may seem like a lot of these are popping up, but these startups at least have proven track records in healthcare services, and there will be a need for very widespread testing in order for any broad attempt to flatten the curve of the virus to prove successful, so expect more of these providers to come on line.
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The Pill Club is donating 5,000 units of emergency contraception
Eleven million women in the U.S. live more than an hour from an abortion clinic, a number expected to increase as facilities close up shop following new restrictions on women’s healthcare in several states.
Planned Parenthood and other leading nonprofits continue to put up a good fight while private “mission-driven” companies in the burgeoning women’s health tech sector are all talk and little action. But a new effort from The Pill Club, an Alphabet-backed birth control and prescription delivery startup, may lead to change in the nascent sector.
The Pill Club has partnered with Power To Decide, a nonprofit campaign to prevent unplanned pregnancies, to dole out free emergency contraception to women in need. Together they’ll distribute 5,000 units of a generic form of Plan B, a pill taken after sex to stop a pregnancy before it starts. For the next three months The Pill Club will also match all donations up to $10,000 made to Power To Decide’s Contraceptive Access Fund, which helps low-income women access contraception. Anyone can sign up now to receive free units.
The Pill Club’s decision to share resources with a nonprofit comes as several states this year have imposed new laws restricting or outlawing abortion procedures. Alabama, for example, earlier this year passed a Senate bill banning abortion in the state. Arkansas, Indiana, Kentucky and others have also OK’d new restrictions on abortion.
This is The Pill Club’s first effort to donate emergency contraception to populations in need, as well as its first partnership with a not-for-profit entity. Co-founder and chief executive officer Nick Chang says the startup thought long and hard about how it could be most helpful to women in this political climate.
“We thought, what can we do to support women in these states in ways that other companies may not be able to?,” Chang tells TechCrunch. “This is the moment where private companies can really go out and benefit women in ways that may not be supported in other avenues. Since we have the means and ability to do it in ways that are more convenient and private, it’s our opportunity to drive access and support.”
Founded in 2014 and backed with more than $60 million in venture capital funding, one might argue The Pill Club should have forged partnerships like this from the get-go. Curious what efforts other well-funded birth control startups were making to support women in 2019, especially women in contraceptive deserts who are likely unfamiliar with the new line of consumer birth control brands, I reached out to The Pill Club’s competitors Nurx, a fellow birth control delivery company, and Hers, a line of women’s healthcare products owned by the billion-dollar startup Hims.
Both companies emphasized the fact that many of their customers live in Southern states, or the region most impacted by new limitations to abortion care, but didn’t mention any new efforts to increase access, like partnerships with nonprofits or donations. Hers provided this quote from the company’s co-founder Hilary Coles, which didn’t answer my question but did make clear the company is thinking about serving contraceptive deserts:
“At Hers, our mission is to provide women with more convenient and affordable access to the healthcare system,” Hers co-founders Hilary Coles said in a statement. “Approximately 3.5 million patients go without care because they cannot access transportation to their providers and 19.5 million women have reported not having access to a clinic that provides birth control specifically. That’s simply unacceptable. Closing the gaps caused by geographic barriers between patients and their doctors was one of the primary challenges we set out to address when founding Hers. We’re proud to be a resource for women nationwide, including those who live in contraceptive deserts who may not otherwise have access to the care they need. It’s crucial to Hers to be part of the solution in alleviating the pain points women experience within the healthcare system.”
It’s not the responsibility of these companies to improve the political landscape of the U.S., but with $340 million in private capital shared between them, the trio does have a unique opportunity to innovate, share, collaborate and influence. After all, that’s what’s so great about healthtech; it brings new, innovative solutions to an industry characterized by antiquated systems and slow movers. For once, Silicon Valley’s “move fast and break things” mantra may be appropriately applied to a facet of healthcare. Women need sustained access to contraception and abortion care. Fast.
“This is the time when private companies can step in,” Chang concluded. “We can come in and help out and it’s our responsibility to do that.”
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Birth control delivery startup Nurx taps Clover Health’s Varsha Rao as CEO
Varsha Rao, Airbnb’s former head of global operations and, most recently, the chief operating officer at Clover Health, has joined Nurx as its chief executive officer.
Rao replaces Hans Gangeskar, Nurx’s co-founder and CEO since 2014, who will stay on as a board member.
Nurx, which sells birth control, PrEP, the once-daily pill that reduces the risk of getting HIV, and an HPV testing kit direct to consumer, has grown 250 percent in the last year, doubled its employee headcount and attracted 200,000 customers. Rao tells TechCrunch the startup realized they needed talent in the C-suite that had experienced this kind of growth.
“The company has made some really great progress in bringing on strong leaders and that’s one of the things that got me excited about joining,” Rao told TechCrunch. Nurx recently hired Jonathan Czaja, Stitch Fix’s former vice president of operations, as COO, and Dave Fong, who previously oversaw corporate pharmacy services at Safeway, as vice president of pharmacy.
Rao, for her part, joined Clover Health, a Medicare Advantage startup backed by Alphabet, in late 2017 after three years at Airbnb.
“After being at Airbnb, a really mission-driven company, I couldn’t go back to something that wasn’t equally or more so and healthcare really inspired me,” Rao said. “In terms of accessibility, I feel like [Nurx] is super important. We are really fortunate to live in a place where can access birth control and it can be more easily found but there are lots of parts of the country where physical access is challenging and costs can be a factor. To be able to break down barriers of access both physically and from an economic standpoint is hugely meaningful to me.”
Nurx, a graduate of Y Combinator, has raised about $42 million in venture capital funding from Kleiner Perkins, Union Square Ventures, Lowercase Capital and others. It launched in 2015 to facilitate women’s access to birth control across the U.S. with a HIPAA-compliant web platform and mobile application that delivers contraceptives directly to customers’ doorsteps.
Today, the telehealth startup is available to customers in 24 states and counts Chelsea Clinton as a board member.
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It’s a new era for fertility tech
Women’s health has long been devoid of technological innovation, but when it comes to fertility options, that’s starting to change. Startups in the space are securing hundreds of millions in venture capital investment, a significant increase to the dearth of funding collected in previous years.
Fertility entrepreneurs are focused on a growing market: couples are choosing to reproduce later in life, an increasing number of female breadwinners are able to make their own decisions about when and how to reproduce, and overall, around 10% of women in the US today have trouble conceiving, according to the Centers for Disease Control and Prevention.
Startups, as a result, are working to improve various pain points in a women’s fertility journey, whether that be with new-age brick-and-mortar clinics, information platforms, mobile applications, wearables, direct-to-consumer medical tests or otherwise.
Although the investment numbers are still relatively small (compared to, say, scooters), the trend is up — here’s the latest from founders and investors in the space.
VCs want to help you get pregnant
Clue, a period and ovulation-tracking app, co-founder and CEO Ida Tin talks at TechCrunch Disrupt Berlin 2017 (Photo by Noam Galai/Getty Images for TechCrunch)
This fall, TechCrunch received a tip that SoftBank, a prolific venture capital firm known for its nearly $100 billion Vision Fund, was investing in Glow, a period-tracking app meant to help women get pregnant. Max Levchin, Glow’s co-founder and a well-known member of the PayPal mafia, succinctly responded to a TechCrunch inquiry regarding the deal via e-mail: “Fairly sure you got this particular story wrong,” he wrote. Glow co-founder and chief executive officer Mike Huang did not respond to multiple requests for comment at the time.
Needless to say, some semblance of a SoftBank fertility deal got this reporter interested in a space that seldom populates tech blogs.
Femtech, a term coined by Ida Tin, the founder of another period and ovulation-tracking app Clue, is defined as any software, diagnostics, products and services that leverage technology to improve women’s health. Femtech, and more specifically the businesses in the fertility and contraception lanes, hasn’t made headlines as often as AI or blockchain technology has, for example. Probably because companies in the sector haven’t closed as many notable venture deals. That’s changing.
The global fertility services market is expected to exceed $21 billion by 2020, according to Technavio. Meanwhile, private investment in the femtech space surpassed $400 million in 2018 after reaching a high of $354 million the previous year, per data collected from PitchBook and Crunchbase. This year already several companies have inked venture deals, including men’s fertility business Dadi and Extend Fertility, which helps women freeze their eggs.
“In the last three to six months, it feels like investor interest has gone through the roof,” Jake Anderson-Bialis, co-founder of FertilityIQ and a former investor at Sequoia Capital, told TechCrunch. “It’s three to four emails a day; people are coming out of the woodwork. It feels like somebody shook the snow globe here and it just hasn’t stopped for months now.”
Dadi, Extend Fertility and FertilityIQ are among a growing list of startups in the fertility space to crop up in recent years. FertilityIQ, for its part, provides a digital platform for fertility patients to research and review doctors and clinics. The company also collects data and issues reports, like this one, which ranked businesses by fertility benefits. Anderson-Bialis launched the platform with his wife, co-founder Deborah Anderson-Bialis, in 2016 after the pair overcame their own set of infertility issues.
Anderson-Bialis said he has recently fielded requests from seed, Series A and growth-stage investors interested in exploring the growing fertility market. His company, however, has yet to raise any outside capital. Why? He doesn’t see FertilityIQ as a venture-scale business, but rather a passion project, and he’s skeptical of the true market opportunity for other businesses in the space.
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Nurx raises $36 million and adds Chelsea Clinton to its board of directors
Telemedicine startup Nurx recently closed a $36 million funding round led by Kleiner Perkins. As part of the investment, Kleiner Perkins General Partner Noah Knauf is joining the startup’s board of directors, along with Chelsea Clinton .
With this new funding, CEO and co-founder Hans Gangeskar told TechCrunch that the startup plans to scale its clinical teams, pharmacies and geographic reach in the coming year.
“We have a new site in Miami where we have a team of nurses being on-boarded, [we’re] building out our engineering and design teams and really just [working to] increase the pace of everything that we’re doing,” Gangeskar said.
The startup launched in 2014 with the goal to make reliable access to contraceptives as easy as opening your web browser. After plugging your information into its online app, users are connected with physicians, given a prescription and Nurx prepares their product for delivery.
Since its launch, this California-based startup now operates in 17 states, and has expanded its products to include not only contraceptives (such as pills, patches, injectables and products like Nuva Ring) but the anti-HIV medication PrEP as well. Gangeskar says the company is also preparing to launch an at-home lab kit soon for HIV testing.
For Gangeskar, creating affordable access to contraceptives is a first step to changing how patients interact and receive medication from their physicians.
“Birth control is one of the fundamental functions of any health care system [so] for us its a natural place to start,” said Gangeskar.
To help advance its plans to redefine this space, Gangeskar says Nurx is excited to welcome public health veteran Chelsea Clinton to its board.
“Her experience in public health and global health from the Clinton Global Initiative has been really valuable, [particularly learning about] rolling out preventative services in large scales, because really that’s the potential of our platform — [to reach] populations that can’t be reached by the conventional medical system.”
While Washington looks to make cuts to American’s healthcare access, startups like Nurx offer a fresh perspective on this critical space.
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The top 7 startups from Y Combinator Winter ’16 Demo Day 1
We asked investors what their favorite startups were from the 60 that launched at Y Combinator’s Winter 2016 Demo Day 1. After huddling with our writers and adding our input, here are TechCrunch’s picks for the 7 most promising companies from the batch, plus an honorable mention. Additional reporting by Greg Kumparak and Megan Rose Dickey. Read More
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