Launching a telehealth brand in 2026: notes from my podcast with Mark Lombardi
I sat down with my partner Mark Lombardi for a fireside chat on one question: what does it actually take to launch a telehealth brand in 2026? I spend most of my time on the payments and finance side. Mark has built and sold companies in health data, owns a large portfolio of exact-match peptide and drug domains, and has consulted for more than a dozen telehealth brands. Here's what I took away from it.
1. Distribution is the advantage
Mark said paid acquisition for a new brand on Meta now runs $400 to $700 per customer, against $200 to $250 a few years ago. If you're new and trying to out-advertise eight- and nine-figure brands on GLP-1s, you're late. The people with the biggest upside are the ones who already have trust: creators, people with an audience in an adjacent industry, research-brand owners, and med spas with a local client base. Organic content and real relationships lower acquisition cost in a way ad budgets can't.
2. Lead with one mechanism, then serve the whole journey
Pick one thing you're known for, based on who your audience is. Then plan for the follow-on needs your customers raise once their first program is going well. Mark put gross margins around 55% on the telehealth side, which means a handful of retained customers can cover operating costs. That's why he says the most important hire after launch is a lifecycle or care-team lead, not more front-end marketing.
Map the money model before you pick a single product.
3. AI makes the care team possible, inside HIPAA
A lifecycle manager with a thousand customers at different stages used to need a data team. Now one person with the right tools can see who needs a check-in and what comes next. The catch: you're operating in a HIPAA-regulated environment, so every tool has to be compliant. No shortcuts.
4. Launching got a lot simpler in the last two years
Clinician networks, pharmacy networks and compliant platforms used to be separate, hard-to-access pieces. They've converged, so a new brand can plug into them. Some prescriptions can go through an async visit; others need a synchronous consult and labs, and HRT is the obvious example. Simpler doesn't mean easy. Intake, privacy and prescribing rules still have to be done right.
5. Buy versus build
Mark's first principle for 2026: if someone already solves a problem well, license it unless building it yourself is your competitive advantage. Put your energy into the one thing that makes you different, and partner for the rest. Done that way, a brand can go live in under a month, and a founder with an existing audience can sign up their first customers the week they launch. I wrote more on this in Buy vs. build.
6. Med spas should move fastest
Med spas already have the trust, the client base and the in-person relationship. Adding a telehealth division lets them serve clients who can't come in and stop stocking compounds on-site. Mark couldn't think of a good reason for a med spa to wait.
7. The exit picture
We closed on M&A. Mark pointed to recent deals in the space, including 30 Madison's acquisition of Remedy Meds and Hims & Hers buying Eucalyptus, as signs that large buyers want distribution. Brands under about $5M in revenue get lower multiples, so growth and scale matter. Likely buyers are drug companies, distribution companies, or private equity entering the market.
The bottom line
It's still early. If you already have an audience, a research brand, or a clinic, you have the hardest part of a telehealth business. That's what Mark and I built Telehealth Launch Team to help with. Watch the full episode for the details.
This post is a business discussion, not medical or legal advice.