What does it actually cost to acquire a telehealth patient?
Short answer: Hims and Hers' reported 2025 acquisition spending divided by net subscriber growth gives roughly $2,832 per net addition. That is not customer acquisition cost (CAC), and it cannot establish patient payback. Your acquisition ceiling depends on your own contribution margin, retention, capacity, and cash runway.
Working on your own budget? Start with what your margins and capacity can support, then test your first-party inputs in the LTV/CAC simulator. If acquisition cost is already climbing, check the four possible causes before changing campaigns.
If you need help deciding what to do with those numbers, bring your acquisition-cost question to a free 15-minute call with Pranay.
Hims and Hers reported $798.5 million in customer acquisition expenses in 2025 and finished the year with 282,000 more subscribers than it started with. Dividing those figures gives roughly $2,832 per net subscriber added. That is a spending-to-net-growth ratio, not the cost of acquiring a new patient. In 2023 the same calculation gave $764.
The ratio rose about 3.7 times in two years. That does not establish that CAC rose by the same amount. The distinction matters before using these numbers to set a budget.
Why is there no telehealth CAC benchmark?
There is no single benchmark that applies to every telehealth business.
Benchmarks need matching definitions. A booked consultation, a first purchase, and a retained subscriber are different outcomes. Before comparing costs, check the conversion event, included expenses, channel, measurement period, and customer population. A published range can provide context without being a suitable target for your business.
Off-Label does not have a benchmark dataset, and this page is not going to pretend otherwise.
Public-company filings provide another kind of evidence: reported spending and subscriber counts. Those disclosures let us calculate a ratio. They do not, by themselves, reveal the company's cost per new customer or your acquisition ceiling.
What do Hims's filings show about spending and subscriber growth?
This analysis follows the spending-divided-by-net-growth approach used by Preston Alexander in The Healthcare Breakdown in April 2024. His 2023 calculation gave about $785 using advertising costs that included content production. Here, the narrower customer acquisition expense series is used consistently, and the result is labeled spending per net subscriber added, not CAC.
The correction, because two numbers are circulating and they are not the same number
Hims discloses acquisition spending in two different places, and they do not match.
In the management discussion, the company reports customer acquisition costs: $379.7 million in 2023, $594.5 million in 2024, and $798.5 million in 2025.
In the advertising footnote, it reports advertising costs for customer acquisition and content production, a wider figure that bundles in the cost of making the ads: $390.3 million in 2023, $604.6 million in 2024, $814.9 million in 2025.
The widely repeated $785 figure divides the footnote number for 2023 by that year's net adds. Most people quoting a recent Hims figure use the management discussion number. Crossing the two inflates the base year and understates everything that happened since. This page uses the management discussion series, the narrower one, throughout.
The three-year series
Cost per net subscriber added, from the Hims and Hers 10-K filings for 2023, 2024, and 2025:
| Year | Customer acquisition costs | Subscribers at year end | Net adds | Cost per net add | Change |
|---|---|---|---|---|---|
| 2022 | $230.4M | 1,040,000 | |||
| 2023 | $379.7M | 1,537,000 | 497,000 | $764 | |
| 2024 | $594.5M | 2,229,000 | 692,000 | $859 | +12% |
| 2025 | $798.5M | 2,511,000 | 282,000 | $2,832 | +230% |
The ratio increased much faster in 2025 than in 2024.
In 2024, acquisition spending rose 57 percent, annual net additions rose about 39 percent, and spending per net addition rose about 12 percent. These movements do not establish the profitability or efficiency of individual acquisition campaigns.
In 2025, acquisition spending rose 34 percent and annual net additions fell 59 percent. Spending divided by net additions reached roughly $2,832.
Before anyone draws a conclusion from that, here is what the number is not
It is not Hims's customer acquisition cost, and it should not be called one.
The annual report does not provide the gross new-customer count needed to calculate CAC. Net subscriber growth is not that count: it reflects additions and departures, and is not a measure of customers attributed to paid campaigns. The spending category also includes brand promotion and awareness, while excluding content production and other marketing overhead. This is not a fully loaded CAC calculation or a first-purchase advertising benchmark.
Here is the denominator problem in plain English. One company could add 1,000,000 subscribers and lose 718,000, while another could add 282,000 and lose none. Both finish with 282,000 in net growth. Their gross additions, churn, and true acquisition costs could be very different. The public filings give the net change, not those separate flows.
This matters enough to say twice: if you see this number quoted anywhere as Hims's CAC, including on a page that took it from here, it is being quoted wrong.
So why publish it at all?
Because it raises a useful question. More reported acquisition spending accompanied less net subscriber growth in 2025. Explaining that combination requires information about gross additions, retention, reactivations, spending mix, and measurement scope that this ratio does not supply.
The limit is part of the finding. The ratio can rise even if acquisition cost per new customer stays flat, for example when more subscribers leave. It cannot tell us which factor dominated at Hims, how much went to winning back former customers, or whether a different company's paid campaigns will be profitable.
Why this is not a payback calculation
Revenue per subscriber answers a different question from acquisition cost.
Monthly online revenue per average subscriber went from $54 in 2023 to $81 in 2025, a 50 percent increase. Dividing $2,832 by $81 gives about 35, but calling that 35 months of customer payback would be wrong. The numerator is spending per net addition, not acquisition cost for a customer cohort. The denominator is average revenue, not that cohort's contribution profit.
To estimate payback, use acquisition spending attributable to a defined customer cohort and the contribution profit that cohort generates over time. These disclosures do not establish either patient lifetime value or a customer payback period.
The 2025 filing also says Hims anticipates no longer reporting monthly online revenue per average subscriber beginning with the quarter ending March 31, 2026. Do not assume that series will remain available for future comparisons.
What actually makes a patient cheap?
The Hims ratio does not prove that paid acquisition is failing. For a founder, the practical question is which routes bring suitable patients at a cost the business can support.
Paid media competes for attention, but budget alone does not determine acquisition performance. The offer, creative, audience, conversion experience, and retention all matter.
Differentiation and distribution are two other areas to evaluate. Neither guarantees cheap acquisition.
Differentiation
A patient who wants specifically what you do, and cannot get it from the next result down, does not have to be outbid for. The auction only prices attention that is up for grabs, and a patient who came looking for you was never up for grabs.
This is why undifferentiated telehealth is so expensive to buy patients for, and it has nothing to do with how many competitors exist. It is that when your promise is the same as everyone else's promise, the only remaining variable is price, and the only way to move price is to bid. How you build a position a competitor cannot copy in a quarter is its own problem, and it is where most of the return in this business hides.
Distribution
Distribution is any route to a patient that does not run through an auction. An audience that already exists. A referral base. An employer contract. A health system relationship. A partner who is already in the room when the need comes up.
These routes have costs too: content production, relationship-building, partner fees, and ongoing maintenance. They offer alternatives to buying each visit through an ad auction, not a promise of permanently lower prices. There are three kinds of distribution, and only one of them is actually yours.
And why both together is a moat
Differentiation gives patients a reason to choose you. Distribution gives them a way to find you. Building both can reduce dependence on a single channel, but the economics still need to be measured.
So what do you do if all you have is paid?
Here is the part that is uncomfortable to write on an agency's website.
If paid is your only lever, the highest-return use of your next marketing dollar is usually not another dollar of media. It is buying a lever you do not have.
From Pranay Parikh, MD, founder of Off-Label:
"I tell them they need to start organic as soon as possible. I actually attack go-to-market from three different angles, like a trident. Organic, paid, and B2B. B2B is collaborations with organizations, the way Ro did with Planet Fitness. It could also be affiliate."
Three angles, with different costs and dependencies. Organic work requires ongoing investment, and partners can change their terms.
Organic is distribution you own. It is slow, it has no dashboard for the first two quarters, and it is the only asset on this list that is still there next year without being repurchased. This is why it goes first, not last, and why it starts before you think you are ready for it. Every month you delay it is a month you have to buy patients at the going rate instead of owning some.
B2B is distribution you borrow. Planet Fitness describes its PF Perks program in its own 10-K as a channel where brands pay it "fees and commissions" for offers delivered to members through its app and website. Planet Fitness had approximately 20.8 million members and 2,896 clubs at the end of 2025. A collaboration like the one in Pranay's example is a route to a patient that never touches an ad auction, and a commission structure can scale with results rather than with whatever Hims decides to bid this quarter.
One thing to be clear about, because it is the part people get wrong: a slot in someone else's program is not a moat. The audience owner controls access and can add other partners. Borrowed distribution is a channel, not a defensible position. It is still worth having. It is not a substitute for owning something.
Paid is the auction, and everything above is about why the auction is the worst of the three places to be standing alone.
A founder relying on paid acquisition needs a budget grounded in their own conversion, retention, contribution margin, and cash runway. The Hims ratio does not establish that a new entrant needs three years of losses, or that organic and partnership channels will necessarily be cheaper.
Two practical notes, because you still have to run the business while you build a lever.
You need a ceiling, and it is not a percentage of revenue. What you can afford to pay for a patient falls out of your capacity and your margin, and there is a way to compute it that does not involve guessing.
And if your own cost per patient is climbing while nothing else changed, that has a differential, and the market repricing around you is only one of four suspects. Rule the other three out before you touch your campaigns.
Use the Telehealth Growth Score to find which part of the system needs attention before treating CAC as the problem by itself.
What don't the filings tell us?
The spending and subscriber totals do not isolate why the ratio increased. Acquisition performance, retention, product mix, reactivation, and changes in business scope are different questions. This calculation cannot establish their individual effects.
The annual report does not provide a gross new-customer denominator for a reproducible CAC calculation. That is a limitation of these public disclosures, not a claim about what the company knows internally.
The figures also do not show how spending splits between first-time acquisition, reactivation, and brand-building. There is no basis here for assigning those shares.
If you read these filings differently, they are linked above, and the arithmetic is three lines long. Show us where it breaks and this page will change.
Frequently asked questions
What is a good customer acquisition cost for a telehealth company?
There is no single CAC target that fits every telehealth business. Compare benchmarks only when the customer definition, included costs, channels, and measurement period match. Set your acquisition ceiling using your own contribution margin, retention, capacity, and cash runway.
How much does Hims spend to acquire a customer?
Hims and Hers reported $798.5 million in customer acquisition expenses for 2025, while subscribers increased from 2,229,000 to 2,511,000. Dividing gives roughly $2,832 per net subscriber added. That is not CAC: net growth is not the number of new customers acquired, and the annual report does not provide that denominator.
Why did Hims's cost per net subscriber jump in 2025?
Reported acquisition spending rose 34 percent while annual net subscriber additions fell 59 percent. That explains the arithmetic, not the underlying cause. The ratio does not separate changes in acquisition performance, retention, reactivation, or business mix.
Can you compete with Hims on paid alone?
The Hims figures cannot answer that for another business. Paid acquisition viability depends on your own customer economics, conversion performance, retention, and cash runway. Differentiation and alternative distribution channels deserve evaluation, but neither guarantees lower acquisition costs.
What matters more, differentiation or distribution?
They solve different problems: differentiation gives patients a reason to choose you, while distribution helps them find you. Neither guarantees a lower CAC. Evaluate their costs and results alongside paid acquisition.
What is a B2B partnership in telehealth go-to-market?
A route to patients through another organization's existing audience, rather than through an ad auction. Planet Fitness describes its PF Perks program in its 10-K as brands paying it fees and commissions for offers made through its app and website. It ended 2025 with approximately 20.8 million members. Affiliate deals work on the same principle: a partner supplies access to an audience without making you buy every visit in an ad auction.