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This App Will Be a Game-Changer for Getting Birth Control without the ACA

Nurx provides birth-control prescriptions and delivery, helping reach even women in health-care deserts.
January 25, 2017
Some of Nurx’s 20-person staff, including medical director Jessica Knox, back row, middle, and co-founders Hans Gangeskar, back row, second from left, and A. Edvard Engesaeth, front row, left.

If I told you there was a delivery app for birth control, you might disregard it as just another Silicon Valley-based subscription service, designed to excuse you from ever leaving your house again. But Nurx, which prescribes birth control online and mails it to users, isn’t a boutique service for busy urbanites. It just might be a key player in blowing birth-control access wide open, especially as women’s reproductive health becomes increasingly politicized in the U.S.

The way Nurx works is simple: you register for a free account online, fill out a questionnaire of basic medical inquiries, exchange a few instant messages with a licensed doctor, and receive a package in the mail containing your birth-control method of choice. There are no consultation or delivery fees, so in most cases if you have insurance, it’s free. If you don’t have insurance, then you pay only for the cost of the medication itself.

Nurx (pronounced “New Rx”) is championing one aspect of women’s health by improving on a low-risk prescription telemedicine model that companies like 1-800-contacts popularized. It is revolutionary in how almost not revolutionary it is—the idea is so simple, yet it is the only company of its kind so far. It’s especially beneficial for women in health-care “deserts” who don’t live near physicians or pharmacies, disabled women who may find it hard to access the physicians and pharmacies they do live near, and working women who can’t afford to take time off to visit a prescribing doctor.

The Web app asks all users to fill out a medical questionnaire that a licensed physician will later review.
Users can access the messenger feature at any time to ask a doctor or customer-service agent questions.

“It’s just not necessary for young, healthy women to be in the doctor’s office once a year to get their birth-control prescriptions renewed,” says the company’s medical director, Jessica Knox. “This is simple, safe medication.”

As Congress works to dismantle the Affordable Care Act, however, Nurx could flip from just increasing access to birth control to becoming the single most affordable way to get it in the U.S. The ACA currently requires that most insurance companies cover the cost of birth control as well as a patient’s annual prescribing visit to the doctor. Without the ACA, birth control itself will likely go back to having a price tag no matter how you get it, but Nurx will at least help patients get these prescriptions without paying to see a doctor.

“Whatever we can do to increase access to birth control is best,” says Rebekah Viloria, the ob-gyn at Fenway Health in Boston, who is not involved in Nurx. She believes skipping the doctor visit for birth control is fine as long as Nurx’s physicians are asking the right questions of patients before writing an electronic prescription.

Nurx is designed for both first-time birth-control users and seasoned pros who know what works for them. You can either scroll through an extensive list of combination pills, progestin-only pills, vaginal rings, and emergency contraception (which you can only order just to have on hand; in an emergency it wouldn’t get to you in time); ask a doctor for assistance if this list is paralyzing; or create your own adventure by answering successive multiple-choice questions that lead to your ideal birth-control match.

“A lot of women who really need birth control don’t know that much about it,” says cofounder Hans Gangeskar. “We want to provide prescriptions, but also be a source of education.”

The app also makes a messaging feature available so users can easily contact doctors or customer-service agents with any medical or account concerns they have.

The company is currently only authorized to deliver in California, Washington, New York, Washington, D.C., Illinois, Virginia, and Pennsylvania. But it's growing quickly—next up will be Massachusetts, Florida, Michigan, Missouri, Minnesota, and Maryland.

When I recently tried it, I received my delivery via priority mail just two days after submitting my questionnaire. The USPS makes most of Nurx’s deliveries, and the company’s maps of its patients show that it is already reaching women in the most rural corners of participating states.

Nurx is not alone in the virtual reproductive health-care space. Other companies like Maven and Lemonaid offer a range of women’s services and online prescriptions, but neither delivers, and they both charge fees. As a birth-control prescription delivery service, PRJKT Ruby is structured most closely to Nurx, but it charges a $20 per month subscription fee, which is more than some prescriptions themselves.

Nurx makes money by taking a cut from insurance companies and collecting a fee from every independent pharmacy that it uses to fill prescriptions. Launched just over a year ago, Nurx is also riding on a $5.3 million investment from Union Square Ventures in New York. 

If demand for better birth-control access surges in the U.S., which it likely will if the ACA is repealed, then Nurx’s biggest challenge could simply be keeping up with it. The startup has a staff of just 20 people right now, including five doctors.

I started my test run being hugely skeptical of Nurx—skeptical of how this service could benefit me, of whether or not it would actually be able to deliver, and of whether some hidden fees would pop up somewhere. But in the end, I came away feeling more empowered, validated, knowledgeable, and in control of my birth-control choices than ever.

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