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In the last year, Thirty Madison, a startup that prescribes medicine and does online doctors’ visits, nabbed a partnership with Eli Lilly, and grew its subscriber base by threefold.
In August, the startup raised $47 million from venture firms Johnson & Johnson Innovation, Polaris Partners, Maveron, and Northzone, bringing the startup’s total funding to $70 million. 
Thirty Madison treats 250,000 active patients with migraines, acid reflux, and hair loss with companies called Cove, Evans, and Keeps, respectively. It’s rolling the new funds into a fourth treatment area, CEO and cofounder Steven Gutentag told Business Insider, declining to say which.
Similar to healthcare startups Ro, Hims, Livongo, and Omada, Thirty Madison’s business has been helped by the recent move to telemedicine during the coronavirus pandemic. It’ll pass 100 employees in November after doubling the team since March, according to the company. But it’s also riding another wave, which is a deeper issue in healthcare, Gutentag said: Not enough people have consistent relationships with primary care physicians. 
A run-in with hair loss kicked off the idea for a startup that prescribes and ships medications to your door
Gutentag and cofounder Demetri Karagas started the company in 2017 after working for Google’s ads group for the search page. Neither of them had healthcare experience other than as patients and sons of doctors, but Gutentag’s run in with hair loss gave the pair an idea, he said.
“I’ve had Crohn’s my whole life, or almost my whole life. Funny enough, that was not the issue that did it,” Gutentag said. “It was more the vain health issue of hair loss that got me to wake up.” 
For the first time, he said, he found himself having to navigate the healthcare system alone. 
Thirty Madison’s goal is basically to spare patients the issue of “navigation” altogether by giving them treatment plans and long-term relationships with specialists. The startup is based in New York’s Midtown neighborhood and is named after Madison Avenue.
It offers memberships around $30 per month and messaging with doctors for up to $5 per month or $5 per visit, depending on the condition. Treatment costs, like a $25-per-month hair loss pill called finasteride, aren’t included in the membership, and it’s all generally self-pay. 
The hope is to connect patients with an otherwise strained supply of specialists for conditions like migraines, Gutentag said. There’s about 40 million people in the US who suffer from migraines, but fewer than 500 specialists, per the Migraine Research Foundation. 
More than 60% of Thirty Madison’s migraine patients have nine or more migraines per month, Gutentag said. As of August, 70% of them were seeing reductions in their severity, and 79% were visiting the ER less, the company said in the funding announcement.
How Thirty Madison convinced a pharma giant to invest in its model
Gutentag sees the model heading more towards Teladoc and Livongo’s soon-to-be massive primary care network than Ro and Hims. In the recent funding round, he said investors, particularly Polaris and J&J, wanted on board when they realized the company is building models of actually delivering care, not just consumer brands for drugs.
The startup’s physicians are employed or contracted by Keeps Medical Group, and it sends drugs through the mail with pharmacies licensed in all 50 states, including Amazon’s PillPack. It makes up a closed system for each condition that allows patients to get advice, treatment, and facetime with physicians all from the same platform, the cofounder said.
“That’s why you’re seeing the rise of solutions that help patients beyond just one part of the health issue,” Gutentag said. “It’s not just about me being a better doctor’s office or a better pharmacy. It’s about actually helping someone drive to a better outcome over a longer period of time.” 
Here’s the pitch deck that won Thirty Madison $47 million and backing from J&J, which omits one slide about the platform description that’s no longer accurate, according to the company.Thirty Madison starts off the presentation by introducing its mission, which is to run a healthcare company that’s designed around patients, not doctors and bills.

The company points out the giant chronic care market, and hints at what might be its next treatment area: cholesterol, hypertension, or COPD.

The startup makes connects patients with doctors who can then create treatment plans.

A lot of chronic care patients can’t find or afford the treatment they need in the traditional healthcare system. There’s too few migraine specialists given the roughly 40 million patients in the US, according to the Migraine Research Foundation, and wait times for dermatology can range from 10 days to 78 days, depending on the city, per a Merritt Hawkins survey in 2017.

Thirty Madison shares a patient testimonial from Alanna. The photo used in the slide is a stock image, not the patient.

Thirty Madison lays out its “care model” across hair loss, migraines, and gastrointestinal conditions like acid reflux.

Thirty Madison’s guidelines for treatment and diagnoses are developed with the help of medical advisors from institutions like Massachusetts General Hospital and Johns Hopkins.

Thirty Madison makes clear its ambitions to expand to new treatment areas. Gutentag told Business Insider that they’re looking to tackle chronic issues that impact millions of patients each year.

Thirty Madison dedicates a few slides to “Keeps,” its platform for treating hair loss.

Daniel, a hair loss patient, says Thirty Madison lives up to its promise.

The startup offers doctor-recommended plans, treatments, and support along the way in what the cofounders describe as a “close-looped system,” or one where patients get their various health needs met without seeking outside care and prescriptions.

Thirty Madison works with drug companies to get the cost of treatments down. For migraine treatments, it works with specialists to design protocols, and five leading pharmas to offer new treatments — including Eli Lilly’s injectable Emgality, a prescription drug that’s meant to prevent migraines before they start, for as little as a $0 copay with insurance. This slide shows the cost of hair loss medicines.

Thirty Madison then dedicates a couple of slides to “Cove,” its platform for treating migraines.

Most of Cove’s patients are severe, in that they have more than 9 migraines every month.

Keeps and Cove are tackling $7 billion and $16 billion markets, respectively, Thirty Madison says.

Thirty Madison told investors it’s looking at a $1.5 billion revenue opportunity. Over the past year, its revenue has tripled, the company told Business Insider.

The startup shares its third platform company, Evens, which treats acid reflux.

Thirty Madison is building treatment regimes one chronic condition at a time. It starts with partnering with advisors like Johns Hopkins and hiring leadership, and doesn’t launch until the platform’s been tested.

The leadership squad is from Google, Amazon, McKinsey, Uber, and other high-profile shops.

The presentation closes with Thirty Madison’s logo and the promise of a “once-in-a generation opportunity” to transform healthcare.

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