Digital health · Telehealth and contraception
Nurx
One of the first American companies to put a birth control prescription behind an online questionnaire instead of an office visit. A decade later it is a brand inside somebody else’s company, and still carries a 2019 newspaper investigation into how it grew.
A prescription without an appointment
You open the site, pick a pill or say you do not know which one, and answer questions about blood pressure and clotting history. A clinician licensed in your state reads the answers and writes the prescription, or does not. A pharmacy mails it. In 2017 that cost $15 a month without insurance and nothing with it.
The company was Nurx, said out loud as NUR-ex. When it opened in Texas in June 2017 it had its biggest signup week yet. “Texas is our largest market every week,” co-founder Hans Gangeskar told NBC News that October. Texas also had more counties short of contraceptive clinics than any other state.
The deserts
Close to 20 million women and girls aged 13 to 44 lived in what the National Campaign to Prevent Teen and Unplanned Pregnancy called contraceptive deserts: counties with fewer than one provider per 1,000 women who need one. The prescription requirement is the bottleneck, and the American College of Obstetricians and Gynecologists had already recommended selling the pill over the counter.
“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,” Jessica Knox, then the company’s medical director, told MIT Technology Review in January 2017.
Not everyone agreed a questionnaire was enough. John Seago of the Texas Right to Life political action committee told NBC News he was broadly in favor of telemedicine, then drew a line at prescribing by checkbox. That tension, between access gained and examination skipped, has followed the category since.
Two Norwegians and a very fast start
Gangeskar and Dr. Edvard Engesaeth, both Norwegian, launched in December 2015 and went through Y Combinator’s Winter 2016 batch, though some early coverage dated the launch to 2014. Union Square Ventures led a $5.3 million Series A in late 2016, and partner Andy Weissman set out the thesis plainly: “We believe this is a radical new way of providing care”, built on moving work from doctors to software.
Expansion tracked the politics of contraception: 13 states by mid 2017, 26 and DC by mid 2019, 33 by January 2022. Kleiner Perkins led a $36 million Series B in November 2018. Chelsea Clinton joined the board, as did former US Surgeon General Regina Benjamin.
April 2019
Varsha Rao, a former Airbnb operations head and Clover Health chief operating officer who had already invested in Nurx, succeeded Gangeskar as chief executive on April 17, 2019. Ten days later the New York Times published an investigation headlined Chasing Growth, a Women’s Health Start-Up Cut Corners.
Tess Riski, Natasha Singer and Katie Thomas based it on interviews with a former customer service employee, Matt Cronin, and eight other former employees. Cronin said returned birth control pills were kept in a shoe organizer in an office closet and mailed out again to other customers, a practice the Times reported is generally barred outside a licensed pharmacy. Former medical director Jessica Knox said executives asked her to revise a policy advising against prescribing estrogen-containing pills to women 35 and older who smoke, a group for which CDC guidance says the risks “usually outweigh the advantages.” A customer, Stefanie Kovaleski, described a life-threatening blood clot after taking a pill ordered through the app.
Nurx did not dispute the closet. It said the practice had ended nearly a year earlier, that it affected a tiny fraction of the million orders processed since 2015, and that it was investigating. Gangeskar said by email that he “did not authorize or endorse this practice.” On the prescribing policy, chief operating officer Jonathan Czaja said executives wanted the decision left to women once they had been told the risks; Knox objected, the company backed off, and the Times reported the policy was not changed. On the blood clot, Nurx said clots are a known side effect and that the patient had been told the general risks. “There are no excuses for mistakes made by our former leadership team,” the company said. Four months later it raised $52 million.
From company to brand
On February 9, 2022, Nurx agreed to merge into Thirty Madison, a New York telehealth company built on hair loss, migraine and allergy brands. Terms were not disclosed, and Rao became head of Nurx rather than chief executive. Layoffs followed: 24 people in May, 10 percent of corporate staff in July. In June 2023 Thirty Madison bought assets from bankrupt rival The Pill Club for $32.3 million and moved more than 100,000 of its patients onto Nurx. By January 2025 it had cut back to two brands. On September 3, 2025 Remedy Meds, a weight loss telehealth company founded in 2024, agreed to buy it outright for just north of $500 million in stock. Nurx becomes one product line in a business built on GLP-1 prescriptions.
What is proven, and what is still claimed
| Evidence | What the record shows | Source type |
|---|---|---|
| Peer-reviewed study of Nurx clients | Human Enough, Journal of Medical Internet Research, July 5, 2021. Chart review plus 31 PrEP client interviews. Found the service eased barriers to PrEP access. Run in partnership with Nurx, with co-founder Edvard Engesaeth a listed author; the conflict statement reads “Conflicts of Interest: None declared.” | Public record |
| Independent study naming Nurx | Sex Health, October 2022. Content analysis of user reviews of Nurx and Planned Parenthood Direct. Access and clinician interaction were valued; cost drew mixed reviews. | Independent |
| Category screening quality | Zuniga, Grossman and colleagues, Journal of Telemedicine and Telecare, 2020. Assessed nine US online contraception platforms and found them “adequately screening for contraindications and safely providing birth control methods to patients”, while urging stronger questionnaires. | Public record |
| The 2019 allegations | New York Times, April 26, 2019, from nine former employees, five anonymously. Reshipment of returned drugs from an office closet; an attempt to revise the policy on estrogen pills for smokers over 35; one patient’s blood clot. | Independent |
| Company answer | Nurx stood by its safety record, said the reshipment had ended a year earlier and touched a tiny fraction of a million orders, and said the disputed policy was never changed. It told Business Insider no regulator had inquired. | Company-stated |
| Timing of the leadership change | Nurx clinical services lead Jessica Horwitz told Business Insider the leadership changes “had nothing to do with the New York Times.” Rao started ten days before publication, and the company’s statement to the Times pointed to its new leaders as its answer. | Claim and record differ |
| Regulatory action | No state medical board, pharmacy board, FTC or state attorney general action against Nurx located in public searches as of September 2026. Rival The Pill Club settled California Medi-Cal false billing claims for $18.3 million in 2023 and filed for Chapter 11. | Not found |
| Breach and device records | No HHS Office for Civil Rights breach entry naming Nurx or Thirty Madison found. No FDA 510(k) or PMA record, no NIH or NSF award. The two registered trials under the name belong to unrelated NuRx Pharmaceuticals. | Not found |
| What the merger was worth | Neither party disclosed terms. Thirty Madison’s Form D of March 30, 2022 reports $111,997,233 sold to 83 investors and states the amount “represents the issuance of stock pursuant to the Merger Agreement together with the exercise in full of warrants in the aggregate amount of $1,250,132.” | Public record |
Read plainly: the access case has independent support, including from researchers who assessed the category and found the screening adequate. The safety case rests on an absence, since no regulator has publicly acted, and an absence is weaker evidence than a study. The 2019 reporting was never retracted and the company never disputed its central claim. What changed after it was the leadership, the compliance hiring and, in time, the ownership.
What to watch
- Whether the Remedy Meds deal keeps Nurx a distinct brand or folds it into a weight loss funnel.
- Published outcomes. Ten years of prescribing has produced no large outcomes paper.
- State licensure and telehealth prescribing rules, which set the map for services of this kind.
In their words
“There was a closet full of birth control.”
Matt Cronin, former Nurx customer service employee, New York Times, 2019 · Independent
“Hurry, hurry, hurry, and we’ll deal with the consequences later.”
Kathy Hall-Ramer, former Nurx manager, New York Times, 2019 · Independent
“There are no excuses for mistakes made by our former leadership team,”
Nurx statement, New York Times, 2019 · Company statement
“I believe that an important part of that is to have a culture that permits everyone to evaluate and provide input to established practices.”
Hans Gangeskar, co-founder, New York Times, 2019 · Founder statement
“I think this is a perfect use for telemedicine,”
Dr. Daniel Grossman, UC San Francisco, New York Times, 2019 · Independent
“The app is a very simplistic system, which for any public health issue, at the end of the day, if you’re prescribing something that the FDA regulates through a series of ‘yes’ or ‘no’ questions, that’s obviously a public health concern.”
John Seago, Texas Right to Life, NBC News, 2017 · Independent
“Every company makes a few missteps along the way in terms of handling growth,”
Varsha Rao, CEO, Business Insider, May 2019 · Interview
Related companies
Sources
- Public recordForm D, Thirty Madison, Inc., CIK 0001707035
- Public recordHuman Enough: internet-based access to PrEP
- IndependentUser reviews from Nurx and Planned Parenthood Direct
- IndependentChasing Growth, a Women’s Health Start-Up Cut Corners
- IndependentCan Nurx help women in contraceptive deserts?
- IndependentA Game-Changer for Getting Birth Control without the ACA
- InterviewThe CEO of Nurx on a new path forward
- IndependentThirty Madison is merging with Nurx
- IndependentRemedy Meds to acquire Thirty Madison
- CompanyNurx Secures $52 Million
Profile researched and written by Healthcare Discovery. Last updated September 29, 2026.
