There was once a time when you couldn’t talk about the future of healthcare without mentioning Honeybee Health Inc.
In 2019, CNBC listed it as one of the 100 most promising startups. In 2021, Fast Company named it one of the 10 most innovative companies. In 2023, it was one of Time Magazine’s 100 most influential companies (next to Space Exploration Technologies Corp., TikTok Inc. and OpenAI).
The company’s rise to national fame came at the right time. The Culver City-based startup, which was founded in 2017, was one of several online pharmacies to see mass adoption during the coronavirus pandemic. The idea that patients could get medication – sensitive, highly regulated and expensive medication – delivered to their door was novel, and venture capital poured a record $3.05 billion into the sector, per PitchBook.
But Honeybee Health went further, becoming the first online pharmacy to deliver abortion pills – like Mifepristone – at a time when the Supreme Court reversed its Roe v. Wade decision in 2022, leading to states restricting access to abortion. Dr. Jessica Nouhavandi, a co-founder and the face of the company, was catapulted into national fame.
Nouhavandi spoke with the Business Journal about what it’s like to run a company while navigating the changing regulatory and social environments.
The thing you are most known for – advocating for access to abortion, via medication or otherwise – is not necessarily the thing that makes you money. I want to talk about both parts, but I first want to get behind the impetus of selling abortion pills.
My relationships with lots of clinics, Planned Parenthood, providers – they were like, “Can you do this? We can’t. Patients can’t come into the clinic.” I’m also crazy and a big risk taker, so I was like, “Yeah, let’s figure it out. Let’s figure out how we’re going to do this.”
I always tell people that it was the right place at the right time, and I had the power to do it when it was very much a grey area. It was a no-brainer decision for me to do it because the end goal (of Honeybee Health) was always to care about taking care of people and to separate healthcare from politics.
So you had to explicitly seek out a way to buy and distribute Mifepristone? Digital pharmacies have been around in some form for years before Honeybee Health started, so I wonder why other companies didn’t pursue stocking this medication before.
I mean, look, we were the only female-led national pharmacy (at the time) that I know of. I think that played a big part in the decisions that I made during 2020 on what we were going to do and the path that we were going to take. I didn’t see any of my male counterparts make any big decisions on care for reproductive health.
Going back to you specifically buying Mifepristone – how does this process work? You basically create a list of drugs you want to be able to distribute, and then what?
There are levels of purchasing. There are wholesalers, there are distributors, there are manufacturers. It really depends on how much you’re purchasing, and where it makes the most sense to get in and get the best pricing. So as we’ve grown, we’ve been able to use our patient basis leverage to negotiate better pricing. And yes, that is on a drug-by-drug basis.
For example, for a medication for blood pressure, we’ll say, “We just spent 60,000 units of these a month. So what’s the best price you can give us?” And it’s really like shopping. We have a whole procurement team and all they do all day is try to find the best pricing.
Your company, Santa Monica-based GoodRx Holdings Inc. and the Mark Cuban Cost Plus Drug Co. questioned the long-held paradigm that patients needed insurance in order to make generic medication cheaper. But a lot has changed for the online pharmacy sector in recent years with funding dwindling. Where do you – and the digital pharmacy industry as a whole – stand today?
A lot has happened. We have grown nationally, big time. We’ve expanded our pharmacy capabilities by really investing in our technology. We really are a technology company at our core, and we’ve built a lot of automation to help not only our workflow, our pharmacist technicians, but also the partners that work with us. We fulfill for some of the largest telehealth organizations in the country.
The industry has changed so much. We’re primarily a business-to-business company now. But we still do our direct-to-consumer work, and you can still go on our website.
I think there was a period of time where everyone was like, ‘What’s going to happen to consumer health post-COVID?’ And people were kind of very skeptical about digital health.
People are accessing care virtually more than ever before, and it’s not going anywhere. It’s here to stay. GLP-1 (online pharmacies) have proven that, and almost everything in the last few years has proven that people prefer to access care online when it’s possible and when it is safe.
When I talk to startup founders about company strategy, I usually have two types of questions: ones that deal with internal strategies they have control over – like how to use their funding. Then there are questions about how they’re dealing with external factors that affect the company – like tariffs, war, climate change regulations and government funding. In your case, it’s the politics behind abortion access. How do you see your advocacy work in relation to your company’s success or failure?
If you want to protect access and patient access, it’s not just about filling the prescription. We do that really well. But you have to be willing to shape the policies that determine whether those prescriptions can be filled in the first place.
The ability for us to even order Mifepristone from a manufacturer and getting access to the drug and being able to distribute that to people, that’s a whole other world, right?
We can do the pharmacy part well. We can give you a good price. We’ll give you the best service. You can speak to pharmacists six days a week and all that stuff. But if you go one level higher, what’s the politics behind that? How come (online) pharmacies weren’t able to do this before COVID? There is no good healthcare reason for it. It was just political barriers put in place to prevent access.
We’ve gone from simply taking that chance on dispensing the medication to being much more involved in shaping the future of access, by working with legislators. We’ve written several amicus briefs to the Supreme Court. I’m now writing a document to the FDA in support of continued access to the main medication in medication abortion.
What’s it been like to kind of be the face of this?
It’s been challenging, you know what I mean? But it’s also very meaningful. And you’re actually the first interview I’ve done in a long time. I stopped doing press a little over a year ago because there were just so many threats to me. We’ve been doing the work, but we’ve kind of stayed quiet for a little bit outside of all of the legislative work we’ve done. I haven’t done press in a while.
Administrations change; the laws change. But at the core, our mission hasn’t changed. We don’t believe that healthcare should be dependent on where a patient lives or the political climate. Everyone deserves access, and our mission from the beginning is giving people access to the medications that they need. We’ve just found different paths to do that.
