Reading between the lines: Google vs Whoop, and Telemedicine vs Pharmacies
Sector lines in healthcare are getting blurrier. Google moves into Whoop's territory, Whoop into clinical services. And German pharmacies might soon move into telemedicine...
Before we start: I’m at LSX Copenhagen from today until Wed (20th), hit me up for a coffee if you’re in town!
Welcome to another edition of “reading between the lines,” where I take recent news headlines and guess what they actually mean. Plus, how they shape the startup market.
This week’s theme: Healthtech used to have pretty defined categories. You had classic healthcare providers, telemedicine and digital health companies, wearable startups, and SaaS vendors all in separate buckets. Today, that’s not true any more. Everybody’s bulldozing into everybody else’s territory - just over the last two weeks, there were three news items worth discussing.
In a nutshell:
Google started a price war in the wearable market
Whoop, a day later, announced moving deep into clinical services (coincidence?)
Germany is about to establish reimbursement for telemedicine in pharmacies
Each one is interesting on its own.
1) Google questions the wearable pricing model
First, here’s what happened: On May 7th, Google launched the “Fitbit Air”, a tracking wristband without a screen. What does that remind you of? Correct, it’s essentially a Whoop. Only that this one costs $99 upfront! The core tracking is free, although an AI coaching offering sits behind a paywall called Google Health Premium.
For comparison, Whoop charges $199-359 a year and has no free option at all. And Oura, the other famous screenless option, sells a $349-499 ring with a $70/year membership.
Two things I’d read into this move:
On a strategic level, Google confirmed that currently wearables are one of the most attractive healthttech product categories. If you can put a sensor on someone’s wrist, you own a continuous data stream and a prime spot in the user’s attention span. This is much better than just being one of 100 apps on someone’s phone. Especially these days when building software is easier than ever. The fact that Google is willing to build their own hardware tells you this is a strategic control point for them.
The subscription-led model Whoop and Oura built their businesses is now in question - or at least the floor was removed. Whoop’s whole business is the subscription. Oura’s CEO publicly defended his business model earlier this year. They probably saw something like this coming, but it’s still going to be a painful quarter for them.
In the end, it’s another case of a big tech company entering a market with an aggressive underpricing strategy. Because they can afford it. For the original category leaders (=Whoop), it means extra pressure to diversify their offering.
Side note: Before this launch, Google published an interesting paper on the clinical use of wearables. They analysed over 500,000 days of wearable data across nearly 400 conditions - great stuff! And while they conclude wearables are super promising, they also admit the evidence isn’t quite there yet for population-level care. Some specific use cases (like detecting a flu early) are already solid. For everything else, you get interesting correlations rather than a reliable diagnosis. On top, you’d have to ask if the health economics make sense. On a positive note: With their new launch, Google is now in an incredible position to push that evidence base forward.
And Whoop? Their business will be fine in my opinion, their brand is strong. They’re not going to be killed or anything - but need to react, which brings me to the next topic.
2) Whoop becomes a clinic?!
Roughly 24 hours after Google’s announcement, Whoop dropped its own news. Probably not a coincidence from a PR perspective. Starting this summer in the US, Whoop members will be able to:
do live video consultations with licensed doctors directly in the app
sync their full medical history through a HealthEx integration
order clinician-reviewed bloodwork through Quest Diagnostics
talk to an AI coach that remembers prior context and pings them proactively
(most surprisingly) get covered by Medicare via the CMS Innovation Center’s ACCESS program
Reading that list, it comes pretty close to a fully-fledged online clinic. What a move - I’m honestly surprised not more people are talking about this.
Why is Whoop doing this? I believe they saw the writing on the wall - Google and others are coming for their market. So while their device gives them a great anchor, they’re now forced to differentiate their offering, and decided to walk up the value chain. It fits the “clinical” branding tied to recent feature launches - blood pressure estimates being the obvious example.
The entire thing looks like a defensive move to me, not an opportunistic upsell.
And it makes sense: Customer acquisition costs are a huge burden on digital clinics - Whoop’s existing use base solves that. Running a digital clinic on its own is not a differentiated business idea. But sitting on top of a wearable brand with millions of daily users, it becomes an attractive package.
3) A tailwind for German telemedicine
Switching over to the German healthcare system, which produces weekly headlines at the moment: The Schiedsstelle (the arbitration body that sets reimbursement rules) signed off on a scheme for “assisted telemedicine” in pharmacies.
What does that mean? As of July 1st (pending ministry sign-off), German pharmacies will be able to bill statutory insurance €30 per assisted teleconsultation. That decreases to €21.50 over the next years, it’s just higher initially to speed up adoption. To my understanding, the pharmacy keeps the full amount, while the telemedicine doctor bills separately through normal channels. For publicly insured patients, the whole service is free. Everybody wins.
A few conditions apply of course (it’s Germany after all): Pharmacies need a private consultation room, secure tech, and proper integration with Germany’s telematic infrastructure. That’s likely the biggest barrier here - telematic infra integration is tedious.
The intended flow behind this is:
A patient walks into a pharmacy. The pharmacist decides whether the patient requires additional assessment
The pharmacist takes whatever measurements are needed (blood pressure, blood sugar, oxygen saturation) with calibrated equipment
The patient does a videocall with a doctor in a private back room, and might receive an e-prescription. This is the classic telemedicine part
The prescription can be filled at the counter on the way out
Sounds great? Well some critics hate this idea. Their main concern is that this €30 fee will lead to misincentives. That pharmacists will push patients into telemedicine to earn extra income, without the guardrail of a proper physician-patient relationship.
I agree these are risks - but believe the benefits outweigh them. Actually, I love the idea: It takes friction out of the system. It’s patient-friendly and makes the horribly fragmented German healthcare journey a bit smoother. The key here is the reimbursement: Of course pharmacies can already integrate telemedicine today - but they’d be doing it on their own time and cost. History has proven that without being paid, our healthcare system struggles to adopt innovation.
If this comes true, it’s a huge move for the German telemedicine scene! Until now, telemedicine here has been pretty restricted. Public reimbursement was capped and the unit economics were ok-ish. Some larger telemedicine players emerged, but they always felt detached from conventional care. With pharmacies as an access point, you suddenly have a high-trust, physical entry point in every neighbourhood.
For startups, the question is which infrastructure to build for this. Are we going to see branded exam rooms inside pharmacies? Telemedicine boxes? And will this flow simply use existing telemedicine platforms or create new networks?
The market is wide open. Perhaps we’ll see a new player like Tessan.io - they’ve built this model in France at significant scale.
Bottom line
Amazing times to be alive. Three weeks and different geographies, but one trend: Business models in healthcare right now are as fluid as ever.
Everyone who’s serious is heading towards some version of a full-stack offering over time. And in Germany, even regulators and payers seem to buy into that idea.
Speak soon,
Lucas
P.S. lmk if you have answers for the pharmacy telemedicine question, and which infrastructure to build! curious which options are on the table