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Doctor sounds alarm about pills bought online & delivered to your door

JACKSONVILLE, Fla. – They are ads that seem to be popping up everywhere, and that's how News4Jax first learned about Hims and Hers -- one company with two separate websites: one for men and the other for women.

The company Hims/Hers claims to offer convenient, affordable access to prescription products and medical advice. We felt the promises for some of these prescriptions seemed too good to be true and found out quickly that we were not alone. 

"My ears always popped because they said baldness could be optional," said Dylan Smith, a News4Jax employee who received "Hims" ads on multiple occasions promoting hair loss prevention medication.

Dylan checked the Hims website out at www.forhims.com. He said it appeared to be everything he could have wanted. 

"The price point, the convenience, and taking the awkwardness out of it as a young millennial guy are three huge important things for me," he said. 

"Seems pretty harmless?" we asked.

"Yes, exactly," he answered.

Here's how Hims/Hers works: First, find the problem you want to fix. If the solution is over-the-counter, you checkout and then you're done. If the medication requires a prescription, the company has you create a medical profile and you speak with a physician. Finally, your order is shipped to your door. 

"To me it sounds like a vending machine kind of approach," said Dr. Amit Vijapura, a licensed psychiatrist for almost 30 years

Within seconds of us showing him the website, he raised some major concerns. 

"It's all kind of marketing and there's no quality control," he said.

The prescriptions sold through Hims/Hers are marketed for people who suffer from things like stage fright or low sex drive. But Vijapura said the pills behind them -- Propranolol and Addyi -- come with very real side effects. 

"Once it's prescribed, we have to monitor that patient. We have to make sure they are taking it properly. This particular medicine, if you drink alcohol and use this medicine, there's a black box warning," he warned. "That means you can have a really bad reaction." 

While looking on the Hers website, we couldn't immediately find a black box warning. But when we kept looking closer, we did find on the Addyi page: "...do not drink alcohol."

"Look at the small print," said Vijapura after we found the warning together. "That's covering the important message."

But that's not Vijapura's only concern. 

"When they're ordering the medication, we don't know where those pills are coming from," he warned. "We don't even know what's mixed into these pills. They're not even FDA cleared or approved."

We specifically followed up with Hims/Hers and asked if the pharmacies that package the pills they sell are FDA certified. A spokesperson responded by saying the pharmacies are VIPPS certified and have to be licensed by each states' Board of Pharmacy. But they did not mention anything about the FDA in that response. 

However, in an earlier emailed response about packaging, we were told:

 "The pharmacies include all FDA-required package inserts and safety information with the products. Comprehensive safety information, including risks of side effects, is provided to customers and patients through a number of channels, including through the website, the consultation process and the prescription fulfillment process."  

We want to tell you, we asked Hims/Hers to do an interview about the entire concept for our story, and we were scheduled to speak over the phone with the company's head of medical. However, a spokeswoman canceled at the last minute via email.

We emailed back and forth asking for the opportunity to reschedule that phone interview, but instead, we were told due to their own scheduling, they could only send email responses to our questions. Many of the answers they provided in writing referred us to articles already on their website.  

Below are all the emailed questions from News4Jax and the responses from Dr. Adrian Rawlinson, Vice President of Medical Affairs at Hims/Hers. 

News4Jax: Take me through the process of meeting with the doctor. What kind of medical history is being taken?
Hims/Hers: Please read this article which will take you through every step of the process. Additionally, this article provides some important information on the flow and what information is provided.
 
One aspect of the commitment we make to patient safety is to ensure both doctors and patients have the information they need about each other to build a strong doctor-patient relationship, and that physicians and pharmacies have the information they need to keep patients safe. Hims & Hers collects specific identifying information from you and, together with the physicians, verifies the accuracy of the information you submit at multiple touch points during your consultation, similar to the process you’d experience at an in-person doctor visit. We do this to protect your quality of care and make sure both you and your doctor can be confident the information and care you are receiving. 
 
When you log into the Hims & Hers platforms to connect with a doctor, you’re asked for both your ID and to provide a selfie that’s been taken in the last 24 hours to verify your identity. This is to ensure that the physician feels confident in the (identity) of the person they are treating and helps verify they are receiving accurate information to make informed treatment decisions.
 
This information is then sent through our secure platform to a doctor for review, along with your detailed medical questionnaire. The doctor then manually reviews the patient’s ID and selfie to personally double check that the patient is who they say they are, and confirm that they are treating the right person. Once your information is verified, the doctor can review medical charts, your corresponding health questionnaire, as well as diagnostic photos patients upload.
 
The dynamic online questionnaires each patient fills out has also been specifically designed with redundancies to ask the same question in a number of different ways to ensure nothing is missing when it comes to important health information for your doctor. This helps eliminate human error factor and ensure providers are addressing all possible issues while evaluating the correct aspects of a patient’s medical history for any red flags. These redundancies and other aspects of the questionnaires are also used to weed out anyone who may be trying to abuse the system or are providing untruthful information. Creating access to safe, high-quality care is our priority, and we take significant steps to ensure that people can’t “game” the platform to inappropriately obtain prescriptions.
 
Then, after all this, there are still two additional internal system checks that occur to ensure patient safety and prevent negative prescription interactions or inadvertent overprescribing.
 
News4Jax: How much is a doctor able to prescribe at a time?
Hims/Hers: Please reference this article. This depends on the medication the patient is inquiring about. Our licensed healthcare providers are in the best position to know the risks and benefits of a certain medication and whether it's the best option available for a particular individual. Every provider-patient interaction facilitated by our platform is guided by highest priority for patient care. Consultations and corresponding health questionnaires are tailored to the patient and the specific condition being treated to ensure providers are addressing all possible causes and evaluating the correct aspects of a patient’s medical history for any red flags.
 
News4Jax: How often can a person get a refill?
Hims/Hers: Prescriptions (and corresponding refills) are approved case-by-case by the licensed healthcare providers operating on the Hims & Hers platforms. The dosage prescribed for an individual is always determined by and at the discretion of the prescribing physician based upon what the physician believes is medically appropriate for the patient. Only a qualified healthcare provider knows best the risks and benefits that come with a treatment plan and if medication (and refill) is the best course of treatment for a patient.
 
News4Jax: If a patient qualifies for medication what happens next?
Hims/Hers: All prescription medications offered through the Hims and Hers platforms are only available if prescribed by a licensed healthcare provider after the in-depth patient evaluation. Following an online consultation, if a provider recommends a prescription treatment plan, a patient can choose to have it filled through pharmacies accessible via the Hims and Hers platforms. Alternatively, the patient can have the prescription filled at a pharmacy of their choice outside of the platforms. We offer 24/7 support to customers and access to the Bailey Health providers to answer any follow up questions. 
 
News4Jax: What is the follow up process specifically to make sure patients are reacting well with medicine?
Hims/Hers: If a treatment plan offered through the platform is decided as the best course of action, the patient has ongoing access to our  physician network to address effectiveness, possible side effects, or any other questions or concerns that the patient may have.  
 
News4Jax: Who fills the prescription?
Hims/Hers: Here’s a useful article on the supply chain side of our business. Hims and Hers is not a pharmacy, and does not provide the dispensing or distribution of prescription products. All prescriptions are filled and distributed by licensed pharmacies directly to patients, and these pharmacies retain control and possession over the prescription products at all times. Hims and Hers negotiate arrangements with these independent, licensed, third-party pharmacies that then offer pre-negotiated cash prices to patients. All patients have the option to fill their prescriptions at the pharmacy of their choice outside of the platform. 
 
News4Jax: Who fills those packets?
Hims/Hers: Hims and Hers-branded packaging and information is given to the pharmacies for inclusion with products. The pharmacies include all FDA-required package inserts and safety information with the products. Comprehensive safety information, including risks of side effects, is provided to customers and patients through a number of channels, including through the website, the consultation process and the prescription fulfillment process.
 
News4Jax: Is this meant to be a long term solution? Or will patients eventually need to see a doctor in person?
Hims/Hers: Telehealth is providing patients across the country with an incredible opportunity to be more engaged in decisions around their health and have direct access to licensed healthcare providers when it’s convenient for them. Telehealth allows healthcare platforms to close care gaps caused by geographic barriers between patients and their doctors. If the provider determines a medication is not appropriate for a patient or that he or she cannot obtain the information necessary to render an appropriate diagnosis and treatment plan, the patient is notified and advised to seek care outside of the platform.
 
News4Jax: Is insurance accepted? Why not?
Hims/Hers: No, we do not accept insurance. We pre-negotiate with third-party pharmacies at cash rates on patients’ behalf to alleviate the hassle of insurance. There's enormous value for the consumer that we build into our pricing model. Aside from the convenience and costs saved by not having to travel to the doctor or the pharmacy, a patient gains access to a personalized consultation with a qualified healthcare provider licensed in his or her state and, if applicable, medications at cash rates that have been pre-negotiated with third-party pharmacies on the patients’ behalf, all without the hassle of insurance. We value transparency and believe it’s paramount to our customers’ trust and safety. We’re up front with customers about our pricing and services; the Hims and Hers model eliminates the uncertainty and hassle patients typically face when trying to figure out how much a particular procedure or service will cost. 

Followup question from News4Jax: I took this line from one of the articles you sent to me. “Pharmacies that work with Hims & Hers must be fully licensed and comply with stringent regulations and standards in filling and dispensing medications.” When you say fully licensed does this mean it’s FDA regulated? Can you confirm that for me. 

Response from Hims/Hers: The pharmacies are VIPPS certified and have to be licensed by each states' board of pharmacy.


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