Nurx (YC W16) Will Deliver Prescription Medication to Your Door for Free | Hacker News Reader

Nurx (YC W16) Will Deliver Prescription Medication to Your Door for Free

7x7.com

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> If you're a woman living in the United States, you already know that getting your hands on birth control can be a complex and expensive process.

I'm not a woman nor in the US, so this was news to me. It's really easy and cheap here in NZ, so it surprised me that this is still a problem in any developed nations.

Can anyone add more background on what the difficulties are in the US?

Up until recently, it wasn't guaranteed to be covered under your health insurance. The ACA — "Obamacare" — required plans to cover many options, but it's not guaranteed that your preferred option(s) will available. Generally, coverage is supposed to be free, but again, only certain options may be free (generics only, for example) and some may require a significant copay (IUDs, I believe).

For the birth control pill, you still A. need a prescription (which usually means you need to occasionally make an appointment, take off work, and see a doctor, probably not for free), and B. need that prescription to be filled. Oftentimes, that means picking up a new package of pills in a five-day window during semi-limited business hours because many pharmacies avoid giving out an extra supply. Planning for a vacation can be a pain (1-month notice) but an emergency trip is almost undoable.

Not every pharmacy even needs to carry the birth control pill or other options, so it's a very real scenario that people may not have access to their preferred method. Recent court challenges (Hobby Lobby in particular) have made it more complicated and allowed some companies to NOT provide such coverage.

Also, pharmacies have not been above charging women for products that should be free.

Lots more detailed info here: http://obamacarefacts.com/obamacare-birth-control/

IANAW but I am married to one.

On the other hand, you can walk into a Walgreens and get "Plan B" over the counter (without a prescription). Some parts of the US don't do as good a job at stocking it, but in a place like the Bay Area, it's a piece of cake.

Plan B is to be taken as an emergency contraceptive; it is should not be used as a normal, routine method of birth control.

Given how unpleasant the experience is I doubt any woman would choose plan B as a routine contraceptive.

or the birth control pill, you still A. need a prescription (which usually means you need to occasionally make an appointment, take off work, and see a doctor, probably not for free), and B. need that prescription to be filled.

So it sounds as complicated as getting any other prescription drug? I don't see huge barriers here.

In most states, pharmacists can legally refuse to dispense contraception on religious grounds. No federal law prohibits pharmacists from doing so. Only eight states explicitly prohibit refusals and six states explicitly permit refusals. According to the National Women's Law Center, reports of refusals are increasing.

http://nwlc.org/resources/pharmacy-refusals-101/

Unfortunately not all forms of birth control are fully subsidised by PHARMAC in NZ, so not always cheap.

It's not true in the slightest; it's political propaganda. You can walk into almost any drug store in the United States and buy armfuls of contraception without any difficulty.

It is true that in certain limited cases if a company has a religious objection against contraception, they are not required to pay for it as part of their employees' health plan, but a) that's very, very few employers, b) that doesn't prevent the employees from buying it themselves, and c) the over-the-counter expense of contraception is trivial anyway.

Interesting. Looks like a combination of PillPack/ScriptDash plus a doctor on staff to handle the prescriptions. The most annoying part of getting birth control is jumping through the hoop of getting a doctor to prescribe it, so this is definitely valuable. I hope it catches on and manages to expand.

Given what http://blog.ycombinator.com/nurx-yc-w16-prescribes-and-deliv... says, and the madness this thread is going to descend into otherwise, I think we can justify a s/Birth Control/Medication/ on the title.

This app is going to run up against the thorny issue of telemedicine legislation if they ever want to expand from California. California is a pretty easy state to start out in, but a lot of states have some pretty... interesting... views on telemedicine.

We (Nurx) have already expanded to New York and will be expanding to many more states in the coming weeks.

Thanks for the comment. It seems like a great product but I'd imagine you will have to re-tool it for states that have stricter telemedicine laws, correct? For example, the ones that require a video conference or things along those lines. Those were the states I was referring to.

Applied there last year - didn't know they were going through YC. Good luck to them!

Doesn't it seem like these specialized delivery services will kind of get trampled when self driving cars become commonplace? I feel like there will be 1-2 big delivery companies (Google + whoever else figures out self driving cars) and then companies like Postmates, Doordash, etc will go out of business. Or maybe Google will provide them with the infrastructure to actually have profitable business.

The doctor on staff providing prescriptions definitely increases the barrier to entry, but I don't think it is something that will hold up in the long run.

Disclaimer: I'm not a woman, so my perspective could be (read: probably is) complete bullshit

You're describing the process of actually delivering - that's currently UPS/FedEx, etc. They will certainly struggle with Amazon in the near future (and maybe Google). Shipping will always be owned by the big guys because it's a tough, expensive problem.

But ecommerce? That will always be open to smaller players because the start-up cost is low (you develop a way to sell it and give it to a shipping service).

Looks like delivery free and $15 for the meds

So, exactly the same as existing services like https://lemonaidhealth.com/?

Hey @WestOfRome we prescribe AND deliver. One stop shop for birth control and Truvada for PrEP. Our friends at lemonaid get you a 3month prescription for a cash. We get you a 13month prescription for free.

Hey @Edvard, Truvada needs a prescription. Are you licensed to receive a prescription from the doctor?

Doctors prescribe both Truvada and Birth control on our platform :) There is no automated system dispensing drugs. A licensed physician reviews each request.

Thanks for the response. So, you guys are creating a 3-way market with Customer, Doctor and Pharmacy (Invisible to the user)? Sounds like a huge play.

Why do you do @handle when replying here? Don't we have threads for that?

It's too bad that this doesn't seem to be viable in the 3rd world (yet). It's needed there far more than here. (Not that this service isn't useful here.)

please stop referring to it as the 3rd World.This classification is outdated(colonialism ended centuries ago), insulting and condescending(trust me no one wants to be reminded every day how poor and miserable they are, even if it was true).

Here are a few alternatives for you: * Developing World ( still patronizing, but a better alternative) * Majority World ( yea, actually the US and Western Europe are just a small fraction of the global population) * Middle-Income Economies * Southern Hemisphere(I see you, Australia!) * etc.

Please, anything but the 3rd World...

This classification seems to date to the Cold War rather than to early European colonialism.

https://en.wikipedia.org/wiki/First_World

https://en.wikipedia.org/wiki/Second_World

https://en.wikipedia.org/wiki/Third_World

(You could still view it as obsolete following the end of the Cold War... just more recently obsolete.)

The classification is not outdated, and did not originate with colonialism.

Being in the "third world" simply means your country elected to not join NATO or the Warsaw Pact, and as a result did not receive the economic stimulus of the Cold War buildup.

What's the value proposition for investors here? The data they gather from associating the medication to patients?

Presumably the company will want to make a profit by billing the health insurance company (or customer, if they don't have one), and the investors will want a slice of those profits.

Their FAQ says they're HIPAA-compliant, and data collected about a patient's health is extremely confidential.

I am an investor in the company. Yes this correct, there will be a cut from the health insurance company. Gradually the company will add more RXs with higher margins.

My guess is telemedicine insurance coverage arbitrage.

Insurance companies reimburse doctors for consulting and prescribing the medication to the patients. For low risk/low effort consultation, like birth control, the doctor can go through more patients via telemedicine than having them come into the office with similar reimbursement rate as traditional visit.

Rightly or wrongly, I always felt like getting a Pap smear was part of the "deal" when it came to getting a birth control prescription. So it is surprising to me that Nurx can/will (I assume) give you a prescription without having a recent exam.

Yep. States are moving toward an easier process of receiving birth control.

It's not like getting a cervical exam isn't totally sensible for women having unprotected sex, which is often an of those taking birth control pills.

So will my pharmacist, and my insurance company

The proliferation of female contraceptives is something we can all get behind (no pun intended).

Joking aside, I think this paves the way for legitimate, regulated drug delivery; which itself may create a more favorable environment for the legalization of recreational drugs.

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