Online GLP-1 sales fuel hormone replacement therapy

• It's created a surging market, but also raised concerns over patient-doctor relationships and compounded drug risks.

The big picture: The global hormone replacement therapy market was valued at nearly $21 billion in 2022 and is expected to grow to more than $35 billion by 2030, per Grand View Research.

• The rise is generally attributed to increasing awareness and acceptance of menopause treatments that for years were hard to obtain.
• It's also coinciding with increased consumer demand for health and wellness solutions, as well as more options for GLP-1 drugs, said Beth Mosier, a director in West Monroe's healthcare M&A group.

Zoom in: Weight-loss app Noom announced its entry into the market earlier this month, joining companies like Midi, which already offer GLP-1s and HRT. The Hims & Hers platform is working to expand into care for perimenopause and menopause, a spokesperson said.

• Women between the ages of 40 and 60 are a key customer base for Noom, and offering both FDA-approved and compounded versions of HRT was a natural addition to its GLP-1 offerings, CEO Geoff Cook said.
• "As menopause approaches, there are shifts in metabolism, how the body metabolizes sugars and fat, and that leads to a host of symptoms, among them, hot flashes, mood changes, but also weight gain," Cook said.
• A Mayo Clinic study in Menopause last year found HRT in tandem with GLP-1s like Ozempic and Wegovy were associated with about 30% more total body weight loss than GLP-1s alone. Other studies have shown similar synergies.

Between the lines: High-end medical aesthetic and wellness spas have been combining GLP-1 and HRT treatments for years, Mosier said.

• Telehealth, with its ability to offer compounded drugs and care that is affordable and convenient, is starting to catch up, Mosier said.
• "They're saying, 'Hey, we can use that model,'" Mosier said, adding they can address issues like muscle mass, underlying weight concerns, sleep and quality of life in a way they couldn't with GLP-1s alone

Yes, but: Direct-to-consumer care and the use of compounded offerings shifts more risk and responsibility to the patient, Mosier warns.

• The rush of newer entrants to HRT makes doctors in the field wary, said Robert Kauffman, a professor in the Department of Obstetrics and Gynecology at Texas Tech University.
• "Most of us who do menopausal medicine are pleased more women are accepting of hormone therapy," he said. But he worries about whether these services may lead women to skip in-person exams with their provider where crucial information can be gleaned.
• "There's a huge profit motive," Kauffman said of companies entering the space. "How often are these doctors following up?"

Editor's note: This story was corrected to remove Ro from the companies that offer HRT.