Telehealth Shakeout: Hims, Ro, Lemonaid in 2026

Hims & Hers raised 2026 full-year revenue guidance to $2.8–3.0 billion — implying 19–28% YoY growth from $2.35 billion in 2025. The company's GLP-1 weight-loss business drove the acceleration; the GLP-1 business is also the source of the platform's biggest regulatory exposure. Ro and Lemonaid have stayed private, smaller, and more focused — but the same GLP-1 wave reshaped their economics too. The U.S. direct-to-consumer telehealth market is consolidating, and 2026 is the year the shape of the consolidated winner becomes legible.

The market is no longer a startup-stage feeding frenzy. Hims & Hers is a $5+ billion public company; Ro is the largest private DTC telehealth platform with a 2023 valuation of ~$7 billion; Lemonaid was acquired by 23andMe in 2021 and has since been folded into 23andMe's broader health platform. The "telehealth platform" as a category has bifurcated into the publicly-scrutinized DTC pharmacy aggregator (Hims, Ro) versus the data-and-genomics-adjacent diagnostics aggregator (23andMe/Lemonaid).

How the three platforms compare in 2026

Platform	2025 revenue (approx)	Core categories	GLP-1 exposure	Notable status
Hims & Hers	$2.35 B	Sexual health, mental health, dermatology, weight loss	~25–30% of 2025 revenue mix	Public (NYSE: HIMS); FDA + SEC investigations of compounded GLP-1 practices ongoing
Ro	~$700–800 M (estimated, private)	Weight loss, sexual health, fertility, hair loss	Significant; less compounded-product exposure	Private; last reported valuation ~$7 B (2023)
Lemonaid (via 23andMe)	Folded into 23andMe (combined ~$300 M)	Primary care, mental health, ED treatment	Limited	Acquired 2021; 23andMe restructured 2024–25

The GLP-1 wave — and the regulatory mess that followed

The GLP-1 weight-loss class (semaglutide marketed by Novo Nordisk as Ozempic and Wegovy, tirzepatide by Eli Lilly as Mounjaro and Zepbound) reshaped DTC telehealth in 2023–25. Hims & Hers led the most aggressive rollout, offering compounded versions of semaglutide at substantially lower price points than the branded versions. The market caught fire — Hims & Hers added an estimated 350,000 GLP-1 customers in 2024 alone.

The regulatory backlash arrived in late 2024 and intensified through 2025. The FDA's official position is that compounded versions of FDA-approved drugs are only permitted during periods of drug shortage; once Novo Nordisk's manufacturing capacity caught up, the FDA tightened compounding rules. Hims & Hers flagged a $65 million revenue headwind in Q1 2026 from the shipping restrictions on compounded semaglutide. The company is now in active SEC investigation over its disclosures, in an FDA investigation over compounding practices, and in patent litigation from Novo Nordisk.

The strategic implication: the compounded-GLP-1 era is closing. Hims & Hers is pivoting toward branded GLP-1 medications under direct manufacturer agreements, which preserves the customer relationship but dramatically compresses margin. Ro followed a more cautious path with less compounded exposure and is structurally better positioned for the post-compounding era. Lemonaid via 23andMe largely avoided the category and is therefore less exposed.

What each platform is actually good at

Hims & Hers is the broadest. Sexual health (the original ED-treatment business), dermatology (Hers + Hims hair loss), mental health (anxiety and depression telehealth via partner clinicians), and weight loss (the GLP-1 wave). The platform is the most consumer-marketing-driven of the three; the customer-acquisition motion is essentially performance marketing plus celebrity endorsements. Margin profile is volume-dependent and currently under GLP-1 pressure.

Ro is the most clinical of the three — its model puts a board-certified physician in front of every prescription, with longer consultations and a deeper patient-record system. Pricing tends to be modestly higher than Hims for the same indication. The strategic positioning is closer to a "real" primary-care experience delivered via telehealth, vs Hims's more obviously retail-pharmacy model. Ro's fertility business (egg freezing, IVF coordination) is differentiated and not directly addressed by competitors.

Lemonaid (23andMe) retains a primary-care telehealth offering but its strategic value has shifted toward the genetics-plus-care bundle. The 23andMe-Lemonaid combo lets a customer go from a genetic predisposition report (BRCA, APOE, etc.) directly to a clinician consultation. The financial pressure on 23andMe itself (the company restructured significantly in 2024–25) has constrained Lemonaid's growth investment.

What happens next — the shakeout finishing

Three forces are reshaping the market in 2026:

• Direct-from-manufacturer GLP-1 distribution. Eli Lilly and Novo Nordisk have both launched their own direct-to-consumer channels (LillyDirect, NovoCare) that compete with the telehealth platforms for GLP-1 customers. The Hims & Hers and Ro response is to position themselves as comprehensive-care providers (consultation + ongoing monitoring) rather than as price-arbitrage retailers.
• Federal regulatory consolidation. The 2025 RFK Jr.-era HHS has signaled stricter rules on telehealth prescribing across the board, especially for controlled substances and for compounded medications. Platforms that built their growth on regulatory gray areas have less room to operate.
• Payer integration. The next-decade growth path for Hims & Hers and Ro depends on getting in-network with major insurance carriers and employer health benefits programs. Hims is reportedly close to multiple in-network deals; success there would transform the business from cash-pay DTC to subsidized recurring revenue.

The broader healthcare-AI context, as covered in our analyses of ambient clinical AI and medication management systems, is that the back-end clinical-operations stack of telehealth is consolidating onto the same AI-augmented infrastructure as in-person primary care. The differentiation is shifting from "we have telehealth" to "we have data, AI scribing, and continuity with brick-and-mortar care."

The bottom line

The 2026 telehealth platform market is finishing its first major shakeout. Hims & Hers has the scale and the public-company resources to absorb the regulatory hit and pivot to branded medications; the SEC and FDA investigations are real risks but not company-ending in any base case. Ro is structurally healthier per dollar of revenue but smaller and private. 23andMe-Lemonaid is the wildcard — if the parent stabilizes, the genetics-plus-care bundle could differentiate; if it doesn't, Lemonaid likely gets spun out or sold. For consumers, expect higher prices, more clinical rigor, and fewer compounded-medication options through 2027.

Frequently Asked Questions

How much revenue did Hims & Hers generate in 2025?

Hims & Hers reported $2.35 billion in 2025 revenue, up from $1.5 billion in 2024. The company's 2026 full-year guidance range is $2.8 billion to $3.0 billion, implying 19–28% YoY growth. The growth is driven heavily by GLP-1 weight-loss sales, plus continued expansion in sexual health, dermatology, and mental health categories.

Why is the FDA investigating Hims & Hers?

The FDA is investigating Hims & Hers' practices around compounded GLP-1 medications (compounded semaglutide). The FDA only permits compounded versions of FDA-approved drugs during periods of drug shortage; once Novo Nordisk's manufacturing capacity caught up with demand, the regulatory permission window for compounding closed. Hims is also under SEC investigation related to disclosures of these products and faces patent infringement litigation from Novo Nordisk.

What is the difference between Hims & Hers and Ro?

Hims & Hers is the larger, public, broader-category DTC telehealth platform — sexual health, dermatology, mental health, weight loss. Ro is the smaller, private, more clinically-positioned platform with longer consultations and a stronger fertility business. Pricing tends to be modestly higher at Ro; the customer profile skews toward consumers who prefer a more medical-feeling experience than Hims's retail-style approach.

Is Lemonaid still operating as a telehealth platform?

Yes — Lemonaid Health continues to operate as a telehealth provider for primary care, mental health, and ED treatment under 23andMe ownership. Its growth has slowed substantially as 23andMe's parent business restructured in 2024–25. The strategic value of the combination lies in the genetics-plus-care bundle, where 23andMe genetic results can flow directly into a Lemonaid clinician consultation.

Will DTC telehealth platforms be reimbursed by insurance?

Most DTC telehealth visits and prescriptions are currently cash-pay and not in-network with major U.S. insurers. The 2026 trajectory is toward broader payer integration — Hims & Hers is reportedly close to multiple in-network agreements, and Ro has signaled similar intent. Once these platforms become in-network with major insurers and employer benefits programs, the business model transforms from cash-pay retail to subsidized recurring revenue, which substantially expands the total addressable market.