How a DTC Brand Added a TRT Revenue Channel at Scale

Core Insights

Introduction

A direct-to-consumer men's health brand with an established email audience of 120,000 subscribers had positioned itself around performance, energy, and body composition. The audience skewed 30 to 55 years old, professional, and with disposable income. TRT demand in the audience was visible and growing — open rates on content touching testosterone and hormone optimization consistently outperformed the brand's benchmark.

The brand had no clinical infrastructure and a strong preference for keeping operations lean. They needed a TRT program that could serve that demand without adding headcount or clinical management overhead.

Daniel Meursing

CEO

Daniel is a two-time founder who has scaled service businesses across major U.S. markets. A Y Combinator competition winner, he focuses on removing operational and regulatory barriers so operators can build and scale modern healthcare businesses.

Background

Startup Operations & Service Systems

Experience

2x Founder, Multi-Market U.S. Scaling

Qualifications

Healthtech Infrastructure & Patient Access

Key Achievement

Scaled Premier Staff & Eventstaff across major U.S. markets

The Challenge

TRT involves controlled substances in most states, which adds prescribing complexity beyond standard telehealth program categories. The operator needed to confirm that provider credentialing, lab integration, and controlled substance dispensing were all handled within the platform infrastructure before committing to a program design.

The secondary challenge was lab integration. TRT programs require baseline lab work before prescribing. Programs that handle labs manually create friction that breaks subscription retention at the refill stage — the leading cause of poor LTV in TRT programs.

Step 1 — Lab Workflow Integration

Lab orders were integrated into the intake flow before program design was finalized. Patients were prompted to complete required bloodwork as part of the program enrollment process. Results fed directly into the provider review queue without manual routing by the brand's team or the patient.

Step 2 — Controlled Substance Prescribing

Provider credentialing within the FuseHealth network covered the states where the brand's audience was concentrated. Prescribing protocols for testosterone were documented and followed within the async review workflow. Controlled substance prescribing requires more rigorous protocol documentation than standard telehealth categories.

Step 3 — Refill and Lab Cycle Logic

Refill cycles were tied to lab review cadence. Before each refill authorization, patients were prompted to complete updated lab work. The clinical review at refill used updated results to maintain protocol consistency and clinical integrity over long protocol durations.

Integrated Lab Workflow — Lab orders and result reviews were part of the defined workflow. No manual lab coordination was needed at intake or refill.

Controlled Substance Coverage — Provider credentialing covered the primary states in the brand's audience geography. Prescribing protocols documented before the first enrollment.

Refill Retention Through Lab Logic — Refill cycles connected to lab reviews kept patients enrolled rather than dropping at the first manual renewal point.

High LTV Program Category — TRT programs generate some of the highest per-patient LTV in digital health because protocol duration is measured in months or years.

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Step 4 — Pharmacy Fulfillment

Prescriptions were routed to pharmacy partners configured for controlled substance dispensing. Fulfillment timelines were confirmed before launch so patient expectations were set correctly from the first enrollment. Expectation mismatches on fulfillment timelines are a primary driver of negative reviews in TRT programs.

What Launched

The brand launched a TRT program in eight weeks, which included time to confirm controlled substance credentialing and lab workflow integration. The full workflow from intake through refill ran within FuseHealth infrastructure.

Core Insights

The brand launched a TRT program without hiring a clinical director, negotiating pharmacy agreements, or building lab integration technology. The full workflow from intake through refill ran within FuseHealth infrastructure.

Subscription retention was above benchmarks for DTC health programs because the lab integration reduced the manual friction that typically causes dropout at the refill stage.

References

American Urological Association Guidelines (2024) · HHS Telehealth.gov · McKinsey & Company Consumer Health Survey (2024) · Wheel Virtual Care Report (2024)