No matter what you need in the next minute or ten—sheets, coffee, razor blades—there’s a sleek-looking start-up promising to have the best product, the easiest ordering process, and the smoothest delivery. But should you really be clicking on all those ads in your social feeds for free medical consults and cheap, easy meds? “It’s good and bad…it’s complicated,” says Ateev Mehrotra, M.D., an associate professor of health-care policy and medicine at Harvard Medical School. Here’s what to consider before you click to order meds from a new online purveyor.
The perks of specialty wellness websites
First, the big one: If you don’t have a doctor or don’t have time to wait around to see the one you have, a click on these sites promises to take care of that. You’ll have an easier time finding potential treatment for health problems—especially those that carry a stigma, such as anxiety and hair loss.
And the sites could save you money, too. Even with health insurance, a specialist visit can cost you $50 or more in copays. “Your local doctor has to rent an office with a waiting room, pay for a receptionist at the front desk, and can only see around 20 patients a day,” says Dr. Mehrotra. “But doctors at these sites can sometimes review the information for hundreds of patients in a day, so they can charge a lot less.” Sometimes the site won’t even charge for the consult, just for the treatment. While many such companies don’t accept insurance, their prices for meds are often less than what you’d typically pay at a brick-and-mortar pharmacy.
The drawbacks
For all the ease, you’re likely missing expertise. “You’re supposed to go see a doctor, tell them what’s going on, share some medical history, and then the doctor tells you what you have and what you should do to treat it,” Dr. Mehrotra says. But with prescription sites, you’ve already decided what your problem is—depression or allergies, for instance—and you’re looking for a med to treat it. “Are you being diagnosed correctly? That’s what I wonder,” he says.
What’s worse, experts worry these sites will dole out drugs to anyone who asks. “They are using their screening questionnaires to weed out people who can’t use the drug, but they aren’t asking if someone should use it,” says Suzanne Bollmeier, Pharm.D., of the University of Health Sciences & Pharmacy in St. Louis. Not to mention the fact that behind the curtain, venture capitalists have become very interested in health care and new business models, says Dr. Mehrotra. “They want to grow rapidly, get lots of VC funding, get a good valuation, and get acquired.” That’s a very different approach from, say, that of a Hippocratic-oath-taking M.D.
All this means that the onus is on you to monitor what’s going on. “A lot of sites say you can access them whenever you want, but there’s no follow-up being done to make sure your body is handling the medications correctly,” says Bollmeier. In fact, many sites encourage you to set up subscriptions for your meds, so you’re likelier to just keep them coming. Automatic reordering is great for dog food but maybe not for controlled substances.
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What to ask before you click
If you have a single issue with a clear medical solution, clicking may be fine. “But if you have multiple medical problems, my concern about this goes way up,” Dr. Mehrotra says. “When you have one company for mental illness, another for hair loss, and another for allergies, you have a lot more people who aren’t talking to each other.”
If you fall on the “I’m relatively healthy and want to give it a try” end of the spectrum, make sure you’re asking these questions:
Who’s doing the prescribing?
“A lot of these sites have big, famous doctors linked to them, but they are often advisors, not the ones doing patient care,” says Chad Ellimoottil, M.D., the director of the Telehealth Research Incubator at the University of Michigan. Check that there’s more than an algorithm that determines whether you pass the screening. You should always be able to access a real person.
Will you be monitored?
“It’s really important to have some longitudinal care—like if you’re taking testosterone, you need your PSA levels and your hemoglobin checked,” says Dr. Ellimoottil. Be sure there’s someone who determines when you need certain tests and when you need to change or come off the meds.
Can you keep track of your own medical chart?
Some of the drugs available through these sites can have major interactions with other ones. For instance, alpha blockers taken with Viagra can create a dangerous dip in blood pressure. Your primary-care provider should know everything you’re taking.
What to know about some of the hot new websites
The Company: Curex
How it works: Not sure if that stuffy nose is due to ragweed or your pup? Curex will mail you an allergy-test kit to find out. Just prick your finger, take a blood sample, and mail it in for analysis. Then chat with one of Curex’s clinicians to go over the results and get any meds. Note: This type of test detects only indoor and outdoor allergens (so you won’t discover a shellfish allergy, for example).
The cost: $129 for the kit; meds start at $65 per month with a three-year plan.
Know before you try: The results can be misinterpreted. “A positive test may not mean you have that allergy,” says Jay Portnoy, M.D., at the University of Missouri-Kansas City School of Medicine. That might be okay if you just need sneeze-control meds. But see an allergist before you give away your dog.
The Company: Keeps
How it works: Pick your baldness pattern, send some pics, fill out a health-history questionnaire, and every three months, Keeps sends you meds to give your hair new life. Some states require an Rx from your own doctor before you get meds; others let you use the on-site docs. Products include finasteride and minoxidil, which are both relatively safe to use long-term, according to dermatologist Annie Gonzalez, M.D., at Riverchase Dermatology in Miami.
The cost: The first doctor consult is free and follow-ups are $5; meds start at $10 per month.
Know before you try: Make sure you talk about follow-ups. “You want your PSA-level baseline before you start finasteride, and it should continue to be monitored,” says Dr. Gonzalez.
How it works: This dermatological service has you send photos of your problem areas and answer questions about treatments you’ve tried. Within two days, it’ll send over a plan. Medications include creams like tretinoin (an acne and wrinkle fighter) and metronidazole (for rosacea) as well as oral meds.
The cost: $20 for the initial consult, which is credited toward your prescription; meds start at $10 per month.
Know before you try: AI is generally considered to be pretty good at diagnosing common skin issues—but you’ll still need a live derm if your spot needs a biopsy.
The Company: Minded
How it works: This company wants you to stop putting off getting refills of your antianxiety meds or antidepressants. Fill out an assessment, then chat with a psychiatrist or nurse practitioner to see what you might need.
The cost: The assessment is free; membership is $40 per month, not including meds; currently only available in CA,FL, IL, NJ, NY, PA, and TX.
Know before you try: Our experts don’t love your getting these meds online. They can have side effects and serious complications, says MH psychiatry advisor Gregory Scott Brown, M.D. Don’t be tempted to replace your doc with a service like this. Also, some of these drugs can be hard to discontinue, so be sure to talk about an exit strategy before you begin.
This story originally appeared in the March 2022 issue of Men’s Health.
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