Hims launched testosterone treatment on October 21 with an at-home blood draw and follow-up labs built into the program.
Every lab is a step a patient can skip without clicking cancel. Below, how to turn those steps into lifecycle events, plus Teladoc's Q3 numbers and Hims' first defense against the FTC.
The Pulse
BetterHelp lost 12% of its paying users in a year.
Teladoc reported on October 28 that BetterHelp averaged about 336,000 paying users in the third quarter, down 12% from 382,000. BetterHelp revenue fell 13% to $206.6 million.
Total Teladoc revenue was $605.1 million, down 3%. The release reports no retention metric, so the user count is the only signal on how well the base held.
Revenue (down 13%) and paying users (down 12%) moved almost in step, which reads as a volume story rather than a price story.
If your paying base shrank at that pace, new patient spend would go to refilling it before it grew anything. Track paying patients by month and by plan, not only revenue.
Hims launched injectable and oral testosterone with follow-up labs built in.
On October 21, Hims added a compounded twice-weekly injection, once-weekly generic testosterone cypionate and Kyzatrex, an FDA-approved oral option. Hims' own release notes that compounded products are not FDA-evaluated.
Patients collect a blood sample at home, the lab tests 22 biomarkers, and a provider reviews the results in a live visit. The release lists ongoing assessments and follow-up lab testing as part of treatment.
Hims reports third-quarter results after the close on November 9.
Repeat labs add steps where a patient can go quiet without cancelling. Those steps are the Deep Dive.
Hims asked a federal judge to dismiss the FTC's subscription and privacy suit.
On October 22, Hims moved to dismiss all nine counts. Judge Vince Chhabria has set a hearing for January 7, 2027.
On subscriptions, Hims argues its fixed-term installment plans are not negative-option billing, that checkout disclosed recurring charges (it cites $147 every 90 days), and that patients could cancel by phone, email or chat, with more online options added in 2023. These are Hims' arguments, and the FTC's claims remain allegations.
Whatever the court decides, your checkout screen and your cancel channels are the evidence. Save dated screenshots of both.
The Deep Dive
Testosterone is a sticky category, so the exit is rarely a cancel click. It is a lab step that never gets finished.
TRT patients tend to stay, because stopping is itself a clinical decision. That moves the job from persuading them to continue toward protecting the routine around the prescription.
Hims built follow-up labs into its program, and that adds a kind of event a lifecycle setup can easily miss.
In consult-required categories, much of the loss already happens between booking, bloodwork and approval, before a first dose is paid for. Repeat labs can bring a smaller version of that stretch back into each cycle.
1. Your ESP may only see the order, not the lab.
Behind every refill in a repeat-lab program sits a chain:
Kit shipped
Kit delivered
Sample returned
Results ready
Visit booked
Visit completed
Prescription renewed
Each link can stall while the subscription stays active. Ask your platform which of these it can already receive as events.
If your ESP only receives the order and the billing event, every dashboard reads healthy while patients drift.
2. Key reminders to the clinical calendar, not the billing calendar.
A reminder sent a fixed number of days after purchase fits few patients.
If a refill needs a recent panel, work backward from the refill date. Subtract your lab turnaround, then shipping time, then a buffer, and that is when the kit should ship.
Take the lead times from your own lab, not from a benchmark.
Then trigger each later nudge off the kit's state, not days elapsed. Delivered but not returned gets a different message than returned but not yet reviewed.
3. Treat a stalled step as a care problem first.
A patient who has not returned a kit has often hit a snag, not made a decision. Write as the care team, in plain text, with one clear way to reply.
Offer what removes the snag, such as a replacement kit or a rebooked visit. A discount does not return a sample.
4. Give lab messages their own consent state.
Most email and SMS stacks keep one subscription state per phone number. A STOP reply to a promotional text can then silence "your results are ready" as well.
Keep operational and promotional SMS on separate consent states, so a patient who declines offers still hears when the clinical step is waiting.
The takeaway: In a category where patients stay, the loss lives between the steps. Make every step an event, and the quiet exits show up where you can see them.
Quick Takes
Sell the program, then convert it to recurring.
Hims is defending fixed-term installment plans in court, and the packaging idea behind them is worth knowing. A $1,200 program billed as six payments of $200, for example, reads as installments toward an outcome rather than an open-ended subscription.
Retention through the program period tends to run higher than month to month, and the move to recurring afterwards meets less resistance because the payment habit already exists.
State the conversion to recurring at checkout, in plain words, not in a later email. Have counsel review the wording.
One Thing to Try
List every clinical step between purchase and refill for your highest-volume treatment, such as kit, sample, results, visit and renewal.
Next to each, mark whether your ESP receives it as an event or only learns about it from the order.
For the first step with no event, send the request to your platform or portal vendor this week. In the meantime, build a stopgap reminder keyed to the refill date minus your lab turnaround, and expect the whole exercise to take under an hour.
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