The Rise of Telehealth and The Hims Model
Hims has become a major player in the direct-to-consumer healthcare market by offering accessible and discreet treatment for conditions like hair loss, erectile dysfunction (ED), and mental health [1.5.3, 1.8.1]. The platform connects users with licensed healthcare professionals who can prescribe medication after an online assessment [1.8.1]. While this model offers significant convenience, it's important to look beyond the marketing and understand the potential downsides.
Medical and Diagnostic Limitations
The primary criticism of the Hims model is the lack of direct, in-person interaction between patient and provider. Care is often delivered "asynchronously" through questionnaires and messaging, with no live video or phone appointments in many cases [1.2.1, 1.8.3]. This "low-touch" care model can be a significant drawback [1.2.1].
- Risk of Misdiagnosis: Without a physical exam, providers may miss underlying health conditions. For example, erectile dysfunction can be an early symptom of serious issues like heart disease, high blood pressure, or diabetes [1.4.4]. A simple online form may not be sufficient to rule out these complex conditions [1.4.2].
- Lack of Personalized Care: Building a long-term relationship with a primary care physician is beneficial for managing complex health histories [1.4.2]. The Hims model is often transactional, which may not be suitable for individuals needing comprehensive, ongoing care [1.2.1].
- Inadequate Follow-Up: The platform has been criticized for not having formal follow-up appointments, which are crucial for monitoring treatment effectiveness and managing side effects [1.2.1].
Regulatory Scrutiny and Marketing Practices
In September 2025, the U.S. Food and Drug Administration (FDA) issued a warning letter to Hims for "false and misleading" marketing claims [1.3.4, 1.9.5]. The FDA stated that Hims' marketing implied its compounded weight-loss drugs were the same as FDA-approved products like Ozempic and Wegovy, when they are not [1.2.4, 1.3.1].
This follows a public split in June 2025 with drugmaker Novo Nordisk, who accused Hims of putting patient safety at risk with "deceptive" marketing and the "illegal mass compounding" of drugs [1.5.5, 1.9.1]. Compounded drugs are created by pharmacists and are not FDA-approved, meaning their safety and efficacy have not been verified by the agency [1.2.5, 1.6.2]. The FDA has specifically warned the public about the risks of using compounded drugs when not medically necessary [1.2.5].
Financial and Subscription Model Concerns
While Hims markets itself as affordable, the financial aspects can be a downside for many users.
- No Insurance Accepted: Hims does not accept insurance for its consultations or subscriptions [1.2.1, 1.2.2]. While some prescription costs might be covered by a user's insurance plan if filled elsewhere, the primary service fees are all out-of-pocket [1.2.2, 1.10.3]. A primary care consultation starts at $39 per visit [1.10.3].
- Subscription Traps: A recurring theme in negative customer reviews is the difficulty of canceling subscriptions [1.2.1, 1.2.3]. Many users report being enrolled in auto-renewing shipments without fully realizing it and then facing unhelpful customer service when trying to cancel [1.2.3, 1.4.5]. The Federal Trade Commission (FTC) is reportedly investigating Hims over these business practices [1.3.2].
- Cost-Effectiveness: While some generic medications on Hims can be cheaper than brand-name drugs at a traditional pharmacy, the overall cost can add up, especially without insurance coverage [1.4.2, 1.10.2].
Hims vs. Traditional In-Person Care
| Feature | Hims Telehealth | Traditional In-Person Care |
|---|---|---|
| Convenience | High (online, no travel, discreet shipping) [1.2.3] | Lower (requires appointments, travel, wait times) [1.4.4] |
| Diagnostic Thoroughness | Limited (no physical exam, relies on questionnaires) [1.2.1, 1.4.4] | High (physical exams, lab tests, established patient history) [1.4.2] |
| Patient-Provider Relationship | Often transactional and asynchronous (messaging-based) [1.2.1, 1.4.3] | Potential for long-term, continuous relationship [1.4.2] |
| Insurance Acceptance | Does not accept insurance for services [1.2.1] | Generally accepts insurance, lowering out-of-pocket costs |
| Cost Structure | Out-of-pocket subscription or per-visit fees [1.2.2, 1.10.3] | Co-pays and deductibles based on insurance plan |
| Treatment Scope | Limited to specific conditions (hair loss, ED, skin, etc.) [1.5.3] | Comprehensive care for a wide range of health issues |
Medication Side Effects and Risks
Like any medication, the drugs prescribed through Hims carry potential side effects. The concern with a telehealth model is whether these risks are adequately communicated and monitored.
- Finasteride (for hair loss): The FDA has warned about risks associated with topical finasteride, including sexual dysfunction, depression, anxiety, and suicidal ideation [1.6.2, 1.6.5]. The Mayo Clinic lists side effects for oral finasteride including decreased libido and inability to have or keep an erection [1.6.4].
- Sildenafil/Tadalafil (for ED): Common side effects include headache, flushing, upset stomach, and back pain [1.6.1]. More serious but rare side effects can include sudden vision or hearing loss and an erection lasting more than 4 hours (priapism) [1.6.1].
- Compounded Drugs: Because they are not FDA-approved, compounded drugs carry inherent risks regarding safety, ingredient quality, and effectiveness [1.2.5].
Conclusion
Hims offers a convenient and accessible solution for men seeking treatment for specific, often stigmatized, health issues [1.4.4]. However, this convenience comes with significant potential downsides. The limitations of asynchronous telehealth, particularly the risk of missing underlying conditions, are a primary concern. Furthermore, recent regulatory scrutiny from the FDA, customer complaints about subscription and billing practices, and the risks associated with non-FDA-approved compounded medications are all serious factors to consider [1.2.1, 1.2.4, 1.3.3]. Patients with complex medical histories or those who prefer a comprehensive, relationship-based approach to healthcare may be better served by traditional in-person medical care [1.4.2].
For more information on the risks of compounded drugs, you can consult the U.S. Food & Drug Administration. [1.6.2]
