It's become somewhat common in the last year to see news about prescription delivery apps expanding, either to offer more kinds of services or to offer telehealth more generally.
Part of this activity is in response to customer demand: Companies say users are increasingly accustomed to a one-stop-shop experience, especially online, and they're starting to expect similar seamlessness from health-and-wellness tools.
Another part, of course, stems from the spike in telehealth interest triggered by the pandemic.
"Honestly, there's so much demand and so much we could do for our patients in terms of what we can provide," said Dr. Jennifer Peña, chief medical officer at Nurx.
"Our biggest challenge is to try and prioritize that demand," Peña continued.
Nurx, which started as a birth control app, has recently expanded into treatment of migraine and acne in response to requests from both users and providers.
"Our medical professionals are consummate professionals," said Peña. "They want us to be able to prescribe more than just birth control."
Peña pointed to what she sees as the potential for virtual care to widen access. Contraception, for instance, can sometimes be stigmatized or challenging for users to get – as can treatment for sexually transmitted infections, which Nurx also offers.
And going to the dermatologist for acne medication can be prohibitively expensive.
"A lot of people don't feel comfortable being in an in-person setting or they feel apprehension," she said. Given Nurx's asynchronous messaging platform, she said, "patients aren't rushed."
Peña also emphasized that patients won't be "left hanging."
"If it's an infection that requires in-person care, our team will refer them to an in-person clinic in their area that can take over that care," she said.
"Telehealth is safe. It's effective, and I think it makes it easier," she added.
NowRX, meanwhile, announced this past month that it was expanding from a digital retail pharmacy model into telehealth – starting with HIV prevention services.
"With the COVID-19 pandemic, telehealth has been thrust into the mainstream," said Cary Breese, the company's CEO and cofounder.
"However, most telehealth companies in the market do not have their own pharmacy fulfilment capabilities," he continued. "Rather, they delegate that to third-party pharmacies, which can cause additional friction in the patient experience.
"This 'handoff' introduces opportunities for things to fall through the cracks, opens up opportunities for processing delays to resolve insurance coverage issues, [presents] inventory stock issues [and] drug interactions issues," and other potential problems, said Breese, "all of which can cause delays in the time it takes for a patient to get their medication."
NowRX, too, plans to expand into even more services.
"We believe there are immense opportunities in other therapies/disease states, including neurology, dermatology, endocrinology, cardiac, to name a few," Breese said.
Backend tools also reflect the growing market.
Truepill, a business-to-business platform that has historically powered direct-to-consumer prescription delivery brands, recently expanded their offerings to include telehealth.
"To ultimately go end-to-end through a digital solution, you have to have all the components of digital health care," said Sid Viswanathan, the company's president and cofounder.
"Our business has evolved," Viswanathan continued. In response to the COVID-19 pandemic, "we saw telehealth really come to life and take shape."
Rather than competing with other providers – including Amazon Care, which recently announced its intention to provide telemedicine in all 50 states – Viswanathan says Truepill is betting on telehealth expansion in general.
"We think the whole market is going to shift toward this," he said. "If you believe telehealth is the gold rush, our thesis is every gold rush needs picks and shovels."
Of course, such a rush faces limits. For one thing, providers acknowledge that telehealth will not replace in-person care entirely – some needs just aren't appropriate for video chat or messaging.
Beyond typical market factors like supply and demand, the future of telehealth regulations on both a federal and state level remains an open question. This means that users in some states might be shut out.
"It's unsurprisingly very difficult to stay on top of the complex regulatory landscape," said Viswanathan, noting that Truepill has a compliance team to help. "In a specific state, the pharmacy board will say something and the medical board will say something different."
At this point, Nurx is available in 30 states, says Peña.
The company, she continued, is "being very proactive – we have robust teams that work with our legal team to try and stay ahead of all that and proactively recruit providers depending on how whose regulations are shifting."
NowRx, meanwhile, has pharmacies in Arizona and California.
"Like many regulated industries in the US, the laws often vary by state and we work within the parameters promulgated by the individual state medical boards, pharmacy boards," and the like, said Breese.
Still, say the companies, it's an exciting time for telehealth.
"Stakeholders and companies and payers and providers are starting to embrace asynchronous care," said Peña. "This model can be accelerated and can provide care for patients at scale."
"We are extremely encouraged by the patient response we have seen during this initial phase." agreed Breese. "And we are just getting started!"
"The pandemic has been challenging, but with that, it presents an opportunity," said Viswanathan. "There's never been a better time in our lives to be in healthcare."