Soon, the very same guy who delivers your dinner could be bringing a side of birth control or PrEP, an anti-HIV medication, to your doorstep. Nurx, a web app that launched in December, streamlines access to birth control and delivers within hours, either by priority mail or Postmates. Nurx plans to add PrEP delivery to its services within weeks.
Nurx makes the process of obtaining medication pretty straightforward—users log on, request their medication, review drug pricing, and receive the medication via courier or mail. Nurx is known for delivering birth control; in fact, the company began birth control deliveries in New York last week.
But obtaining PrEP is much more difficult than birth control. In most states, birth control simply requires a prescription (Oregon will soon be joined by California in allowing patients to purchase birth control over the counter). But PrEP requires an HIV test before a prescription is written, and subsequent blood tests every three months. Nurx partners with LabCorps and other blood testing services to receive the test results.
Adding a drug that requires frequent in-person medical visits to its remote-access model may seem like a strange choice for Nurx. But the challenge of making PrEP accessible was attractive to Nurx co-founder Hans Gangeskar. "That's part of why we wanted to tackle it, to show a complicated problem could be fixed with telehealth," he told Motherboard by phone.
Telehealth is the medical industry's buzzword for services like Nurx that make healthcare accessible without visiting a doctor's office or a pharmacy in person. It's a booming sector of the tech industry that raked in $9.6 billion in 2013 and and is expected to grow to $38.5 billion by 2018, according to a Ken Research study.
But Gangeskar and his co-founder Edvard Engesæth were not only interested in making PrEP available because it offered an interesting engineering puzzle. "We think this is an area where traditional healthcare has left people unserved," Gangeskar explained. "Truvada for PrEP has been out there since 2012 but it's failing to reach the people who need it. This is somewhere we can actually make a difference and show that telehealth can be a better approach."
PrEP is a relatively new drug, and Gangeskar says that some of the access barriers are the result of doctors not understanding or feeling comfortable with it. "It's crazy; people get passed from doctor to doctor," he said. "Some doctors feel that HIV is outside their core competency and they want to send patients to an infectious disease doctor. That delay causes unnecessary HIV infections."
Access to HIV medications can be particularly difficult for those who are at high risk for infection, such as intravenous drug users. But Gangeskar thinks Nurx can reach patients, even if they don't own smartphones. "We wanted to start with a web app that works on Android phones you can get at Walmart," he explained.
Nurx will make PrEP available on its app in California in the coming weeks, and hopes to expand to other states soon.
But beneath Nurx's do-gooder motivations is a smart business opportunity—because PrEP and birth control users stay on the drugs over many years, working with these patients is more lucrative than providing one-time deliveries of antibiotics. "We don't want to stay in the sexual health niche longterm," Gangeskar said. "Both of these drugs are prescription drugs. You take them month after month, day after day, so it's a way for us to build a relationship with our users."