Hims & Hers Built a $4B Healthcare Brand by Ignoring Healthcare Marketing Rules

Hims & Hers spends roughly 50 cents of every revenue dollar on marketing. That number makes finance teams wince. But in 2024, the company posted $1.5 billion in revenue, grew 69% year-over-year, flipped from a $23.5 million net loss in 2023 to $126 million in net income, and crossed 2.2 million subscribers. The spend isn't reckless. It's structural.

The more interesting question isn't whether the spend is high. It's why it works. The answer runs straight through some of the most important ideas in modern marketing science.

The Light Buyer Problem That Built a $4 Billion Company

Hims & Hers was founded in 2018 to sell prescription treatments for conditions most people avoid talking about: hair loss, erectile dysfunction, acne, anxiety, weight management. The market wasn't small. Proponents of the company's model point to a potential customer base of 100 million or more. The problem was access, not demand.

Most of those potential customers weren't walking into clinics. They were avoiding the category entirely.

This is exactly the dynamic that Byron Sharp and his colleagues at the Ehrenberg-Bass Institute have documented across categories: brands don't grow by extracting more from their most loyal customers. They grow by converting light buyers, the people who purchase rarely, sporadically, or not at all yet.

Patrick Gilbert covers this in Never Always, Never Never, drawing on Sharp's work to make the case that the majority of any brand's revenue growth comes from occasional buyers, not fanatics. Heavy buyers are already purchasing near their ceiling. Light buyers, or in Hims & Hers' case, non-buyers, represent the real opportunity.

Rather than targeting the small population of people already comfortable seeking care for hair loss or ED, the brand went after everyone who had ever noticed the problem and done nothing about it. That's a fundamentally different marketing job, and it required a fundamentally different budget to match.

Spending ~$60 million per month on acquisition isn't a flex. It's the cost of reaching a population that was previously unreachable because stigma kept them out of the category. Every dollar spent on awareness is an attempt to nudge someone's probability of buying from essentially zero to slightly more than zero. As the book explains, that's how advertising actually works: not in dramatic behavioral shifts, but in small cumulative tilts across a massive population.

Destigmatization as a Category Entry Point

The mechanics of the Hims & Hers marketing model are well-documented. The company dominates Meta, TikTok, and Instagram with short-form video. It spends approximately $3 million per week on social and video ads. It backs that up with roughly $500,000 per month on desktop Google Search, primarily defending branded terms. It runs national TV, sports sponsorships, and took a Super Bowl spot in 2023. It uses a three-tier influencer structure: nano and micro-influencers for authenticity, mid-tier creators for scale, and celebrities like Kristen Bell for credibility in categories like mental health.

But the channel mix isn't the strategy. The strategy is destigmatization, and it's inseparable from the idea of category entry points.

Chapter 14 of Never Always, Never Never explains how David Ogilvy built Guinness's American footprint not by competing on product attributes, but by planting the brand in a specific moment of need: when you eat oysters, you drink Guinness. That's a category entry point. It's a memory structure that connects a brand to a situation.

The brand did something similar, but at the category level. The "situation" they claimed isn't "buy hair loss treatment." It's "the moment you notice a problem you've been too embarrassed to address." Every piece of content, every ad, every SEO guide (the site draws over 1 million organic visitors per month) is built around that moment. The brand shows up when someone types "is my hair loss normal" or "how do I talk to a doctor about anxiety" into a search bar, and it makes the next step feel easy.

That's mental availability at work. Not brand awareness in the traditional sense, not recall of a logo, but the brand being retrievable in the exact moment a need arises.

Pastel Colors and Pill Packaging Are Not Accidents

Most healthcare brands look like healthcare brands: clinical whites, navy blues, stock photos of smiling doctors. Hims & Hers made a deliberate choice to look nothing like that.

The pastel aesthetic, approachable copy, and consumer-friendly packaging are distinctive brand assets, not design preferences. They exist to signal something specific: this is not a clinic, this is not intimidating, this is for you. Every touchpoint reinforces the same message.

Jenni Romaniuk's work at the Ehrenberg-Bass Institute defines distinctive brand assets as the memory hooks that make a brand easier to recognize and recall in buying situations. The goal isn't to prove you're better. It's to be easier to notice and retrieve. Understanding this early, the brand ensured its packaging looked nothing like standard pharmaceutical products, avoiding the same avoidance behavior it was trying to overcome.

This is the differentiation vs. distinctiveness distinction that runs through Chapter 14 of Never Always, Never Never. Differentiation asks consumers to compare and evaluate. Distinctiveness works on memory. You don't need to convince someone that Hims is better than going to a doctor. You need them to remember Hims exists when they finally decide to do something.

The pastel branding, the direct-to-consumer digital intake, the transparent cash pricing, even the brand name itself (approachable, vaguely tech-company, decidedly not clinical) are all building the same mental shortcut. This isn't Consumer Packaged Goods aesthetics applied to healthcare for fun. It's a systematic effort to make the brand feel retrievable in a moment when most people's instinct is to close the tab.

The Spend That Scares Analysts

Some analysts have raised a legitimate question: is spending approximately 56% of gross profit on marketing sustainable?

It's a fair challenge. That number is high by almost any industry standard. But the counterargument has real force.

Hims & Hers is operating in a category with roughly 100 million potential customers who are not yet buyers. The brand's entire model depends on being top-of-mind across a population that rarely acts on its interest. If you reduce spend, you stop reaching the non-buyers. The non-buyers don't convert. The subscriber base stagnates. A subscription-based recurring revenue model without subscriber growth isn't a business.

The 2024 numbers suggest the bet is working. Subscribers grew 45% year-over-year to 2.2 million. Adjusted EBITDA reached $177 million, up from $49.5 million in 2023. The company turned profitable on a net income basis. That's not the profile of a brand burning cash without return. That's a brand investing in category expansion at a rate the market is rewarding.

The email metrics reinforce the efficiency argument. A 53% average open rate is well above industry norms. Abandoned cart recovery emails drove a 61% increase in conversion. Retention across categories sits at 44%. These aren't numbers that suggest wasteful acquisition. They suggest that once someone enters the funnel, the brand is good at keeping them.

The 60/40 rule in marketing, developed through Les Binet and Peter Field's analysis of the IPA DataBank, holds that brands should allocate roughly 60% of spend to long-term brand building and 40% to short-term performance. Hims & Hers doesn't follow that split precisely, but their channel mix reflects the same underlying logic. The Super Bowl ad, the influencer tiers, the SEO content, the national TV are all building brand salience. The Meta and Google performance campaigns are converting the demand those channels create. Both are running simultaneously.

What DTC Marketers Get Wrong About the Playbook

The dangerous misread of Hims & Hers is to see a performance marketing success story and conclude that aggressive digital spend is the formula.

It isn't. Performance marketing is the visible part. The less visible part is what makes it work: a distinctive brand identity that makes every impression add up, content that owns category entry points before the purchase decision forms, and a product model (telehealth subscriptions with recurring prescriptions) that actually retains customers once you acquire them.

Most DTC brands that have tried to replicate this model failed because they copied the spend pattern without the supporting architecture. You can't run $60 million a month in Meta ads if your brand has no distinctive assets, no organic presence, and no product that generates recurring revenue. The acquisition math only works when lifetime value is high enough to justify it.

This is a pattern we've seen across many DTC brands at AdVenture Media: brands that scale acquisition before building the brand foundation tend to see diminishing returns faster. The channel doesn't fail. The brand fails to stick.

At Hims & Hers, the brand was built first, then the spend scaled. The pastel aesthetic, the destigmatization positioning, the content strategy, the influencer architecture were all in place before the Super Bowl. By the time a nationally televised ad ran in 2023, there was already a brand for that ad to reinforce. That's how brand advertising is supposed to work. Not as awareness from scratch, but as amplification of something already building in memory.

For a closer look at how this pattern plays out across DTC brands, our analysis of Glossier's rise and reset covers similar dynamics from a brand that got the community-building right but stumbled on the commercial architecture.

The AI Layer Is Just Getting Started

In 2025, Hims & Hers ramped AI-driven personalization across email and retargeting, segmenting users by health profile and behavior to deliver more relevant follow-up communications. The reported outcome is materially lower churn and higher lifetime value.

This is worth watching for a specific reason. The brand has spent years building a content and data infrastructure around conditions that people research slowly and privately. The organic search traffic, the email subscriber base, the behavioral data from telehealth intake forms: all of that feeds a personalization engine with unusually rich signal.

Most brands that talk about AI personalization are applying it to generic e-commerce data: what did you browse, what did you buy, what do similar customers buy next. Hims & Hers is applying it to health data tied to specific ongoing conditions. That's a different quality of signal, and it creates a compounding advantage that's genuinely hard to replicate.

The AI double helix framework described in Never Always, Never Never argues that AI creates the most durable advantage not as a standalone tool but when it's woven into both the product and the marketing simultaneously. Hims & Hers is doing exactly that: AI in the clinical intake, AI in the marketing follow-up, both feeding off the same underlying data. The brand that built its moat on destigmatization is now building a second moat on personalized health journeys at scale.

The Actual Lesson

This is not a story about spending a lot on marketing. It's a story about identifying a category filled with light buyers who were avoiding purchase due to stigma, building a brand distinctive enough to change the emotional valence of seeking care, and deploying enough spend to ensure that brand shows up in the moment the decision forms.

Byron Sharp's research tells us brands grow by reaching more people more often. Jenni Romaniuk's work tells us distinctive assets are what make those impressions stick. The IPA data from Les Binet and Peter Field tells us brand and performance need to work together, not in competition. Hims & Hers is running all three playbooks simultaneously.

The 45–50% revenue spend on marketing looks aggressive until you understand what they're buying. They're not buying transactions. They're buying mental availability across a population that has been conditioned to avoid the category. That's a long-term asset, and the 2024 financials suggest it's starting to compound.

The principle from Never Always, Never Never applies here as cleanly as anywhere: there's no universal rule that says your marketing spend should be 10% or 20% or 50% of revenue. The right number depends on your category, your growth stage, and the size of the unreached population. For Hims & Hers in 2024, the data says the number was right.