Regulated Telehealth · Prescription CBD · Pre-Launch
Hims and Hers at peak efficiency in 2021, from their SEC filing: $544 per acquired patient. The consultant's implied floor for a new platform in a new category without prior brand awareness: $50 to $149. The gap was a factor of three before the first impression served.
A prescription CBD telehealth platform was preparing to launch its first patient acquisition campaign. The product was real: licensed clinician evaluation, pharmacist-compounded formulations, a defined patient ICP, and a clinical infrastructure that genuinely differentiated the model from retail CBD.
A consultant had produced an engagement brief for the launch campaign with a budget of $5,000 to $15,000 per month and a target of 100 patients in the first campaign window. Before the budget was committed, the acquisition assumptions were run against published benchmarks.
The consultant's brief implied a customer acquisition cost of $50 to $149 per patient. The implied range was presented without a source.
One afternoon of SEC filing review produced the relevant benchmark. Hims and Hers in 2021, at the peak of their efficiency, with mass market brand awareness, national television advertising, and an established category: $544 per acquired patient. Their CAC in 2023 was $785. Their current CAC is $929. The implied floor in the consultant brief was off the lowest documented telehealth CAC by a factor of three to six before the campaign launched.
The funnel math confirmed the constraint. At $5,000 per month, benchmarked programmatic rates produce 500,000 impressions, 500 clicks, 150 engaged visitors after standard healthcare bounce rates, and 2 to 8 paying patients per month. To reach 100 patients at those conversion rates required $267,000 to $534,000 in total media spend. At $5,000 per month, that is 53 months. The campaign window was three months.
A third constraint compounded both. The month-one cost was $448 for the first patient, $149 for the clinical evaluation and $299 for the first prescription. Healthcare DTC research documents a significant abandonment cliff at approximately $200 for self-pay spending before a benefit is demonstrated. The acquisition model was targeting the general Colorado population in the 35 to 65 age band. The patient who would actually convert at a $448 month-one cost is a self-pay, cash-comfortable, already-spending-on-wellness health investor. That population is real, but it is a fraction of the general population the campaign was targeting.
The benchmark was available in a public SEC filing. The campaign was built against a number that was off the published floor by a factor of three before the first impression was served.
Three decisions before the campaign budget moves.
First: rebuild the acquisition model against the $544 Hims floor as the minimum defensible assumption. Internal modeling at $625 to $800 is appropriate for a new platform in a new category. Any business case, investor conversation, or budget allocation built against a CAC below $500 is built against a number the category has never produced.
Second: reframe the campaign objective for months one through three from patient volume to funnel data collection and creative optimization. The $5,000 monthly budget is appropriate for learning. It is not appropriate as the primary acquisition channel for a 100-patient volume target.
Third: narrow the programmatic targeting to the qualified patient pool before the campaign launches. The patient who converts at $448 month-one is a self-pay, cash-comfortable, already-spending-on-wellness health investor. Targeting the general population produces clicks that will not convert at that price point.
The CAC benchmark analysis was delivered before the April launch. The programmatic funnel model was presented with full benchmark sourcing against public data.
The campaign objectives were reframed from volume to data collection for months one through three. The qualified patient pool targeting parameters were defined against the cash-pay health investor profile rather than the general population.
The benchmark was available in a public SEC filing. The campaign was built against a number that was off the published floor by a factor of three before the first impression was served.
If this pattern looks familiar, the diagnostic takes three to five days.