NURX: the app that's like Uber for birth control and PrEP

Medical treatment should be a healing experience. Unfortunately, that’s not the case for most. The anxiety of sitting in waiting rooms for hours, only to be met with cold doctors and expensive medical bills is the exact reason NURX was created. This March, Redefine Enough spoke with Allison Berry from NURX and had a candid conversation about why people should be looking to NURX for more of their needs.

What is the story behind NURX?

“So the story around NURX was this ‘radical’ idea that we should give women agency over their reproductive decision… giving people access and control over when they have children, how they have children, if they have children. The idea was founded by two people from Norway who moved to the United States, and felt like the barriers that people have when it comes to accessing birth control is unbelievable.

So the idea was brought up as sort of like… What happens when you actually give people control and agency over their health? You actually partner with them to help them make healthier decisions, instead of it being sort of top down see what it looks like to actually deliver contraceptive access in this modality, right.”

How did you get involved?

“So I got involved, probably about a year later. I'm a nurse practitioner by training and have worked in public health, and particularly sort of HIV treatment and prevention for the past decade or so. I was at the International AIDS Conference, weirdly enough and having a conversation with people about how backwards healthcare is in the United States and how hard it is for people to get basic healthcare access. One thing led to another and I connected with the co-founders. At the time, they were just doing this model for birth control and I was like… I think we can do this for PrEP, and what would it look like to actually do HIV prevention in this way? And that's where it started… It's been a wild ride.”

I can only imagine. A lot of the pieces that you bring up revolve around accessible healthcare. Outside of it just being accessible, what are the top three reasons people should consider NURX as a realistic option for them?

“It’s about affirming and aligned healthcare, right. But more than that, it's about having a space where you feel heard and that you are seen for who you are, and that we're going to meet you where you are. We're going to take care of you regardless of anything. This isn't about imposing judgment about what you do or what you don't do, or who you are, or who you're not, but really about sort of like aligning with people around being on this health care journey together."

So the hope is, is that people can come and they can say the things that maybe they haven't been able to say to anyone else about what they're looking for, as it relates to contraceptive access, or PrEP access, or new service lines as they come... And it's going to be met in a non-judgmental way. So that would be the first thing. 

Cost is going to be another thing.  Access is also about affordability and making sure that we don't create access only for people of means and privilege. So understanding that NURX is an option that's affordable, and price transparent.

Then the final piece is that our current service lines are sort of just the beginning. What else can we show this model works for? Down the line, we would love to be able to be full spectrum and offer other areas of people's health care. Because we understand that people come with a lot and there's more than just birth control, PrEP, and HPV screening.”

As you mentioned, people come with a lot. Personally, I am so used to being in the doctor's office and it feeling like an assembly line. Considering that we all have different factors that affect our well being, what's the process of getting individualized support?

“Yeah. Um, so I think that we all have that experience, right? Part of the reason [NURX clinicians] work for NURX … is because you get more connection to patients via an app than you would in a clinic.

The model is set up so that people who have nothing to say, they’re just like, ‘I just want my birth control without hoops to jump through.’ By all means, we have a streamlined system and we can just get you this birth control without questions asked. But for the people that have maybe tried 10 different things and they feel like no one's ever listened to them before… There's a lot of space for people to go through the survey and then they have an opportunity to chat back and forth with a variety of people in the medical teams that are with their providers. With the app, there are over 20 nurses where all they do for us is provide counseling. So it's this way in which we're not just going to send you out the door with a prescription and never hear from you again.

If you start to see you have some side effects... write us, talk to us, let us help you work through it or let us change it. And that's a big difference between even like the best of the best of in person care. This idea that like, not only is this not an assembly line when you're going through the process, but then when you have a question afterwards, you don't have to pay for that. That's actually part of it. We answer your questions on the back end and make sure that you feel cared for through the entire process.”

That's awesome. Since Redefine Enough and the AFFIRM audience are very diverse women of color from all different backgrounds, what is the process for someone really wanting to connect with a doctor who shares a similar ethnic background?

“So we try really, really hard to have a diverse representation amongst our provider group. And some of it happens naturally, because people are drawn to this type of work for the same reasons why patients are often drawn to this type of service, right.? So we naturally have a really diverse provider group.

In terms of people being able to choose the actual provider that they see, we do the best as we can. So I think some of it is, is based on state coverage. Some states, we have lots and lots of different providers, some are more limited. So we do the best that we can but we're really intentional about who we hire.”

How does someone actually go through the process of using NURX?

“Oh, they can either download the app if they have an iPhone and the Android app is coming soon. I promise! They can access the website:

It's a very... what I would say is a very simple sort of survey process. So you're going to sign up, either create an account or people can even do a guest account, upload an ID, answer some medical history questions. Ideally, about 24 hours later, not less, someone on our medical team takes it from there and engages in care with them, and prescribes for them.

 So we offer at home testing for PrEP labs. Oftentimes, HIV prevention is just totally left out of the conversation, that we know women of color, in particular, experience disproportionately high rates for new HIV infections. We really try to break down those barriers … and talk about HIV prevention, not just about contraceptives. And we take it from there. We try to make it as sort of seamless and easy as possible for people to access care.”

That sounds really easy. I do have one more question. In doing my own research of PrEP, I’ve learned it’s a very expensive medication. How do you set up different payment plans and financial options? 

“Truvada is an expensive medication, but it does not cost people a lot of money. It’s a weird sort of distinction, but it's a really important one. So it is an expensive medication, but no one should be one, regardless if they use NURX or not, should be paying for Truvada out of pocket.

There are tons of programs and we navigate people through all of those. So there is something called a Patient Assistance Program, which is for people that don't have any type of health insurance or health insurance that do not does not cover PrEP. It's actually a program we enroll people to get the drug completely free for them from the drug company. If people have insurance, but they have a high co-pay, we will sign people up for a copay assistance that actually covers up to $7200/ year of the their out of pocket costs for the drug.

 So nearly all of our patients, they've actually paid nothing for the drug, they paid zero dollars for the drug. We just navigate them through these program that can feel a little bit like jumping through hoops. But we help you that entire way to get people coverage for the drug.”

That is amazing! I was completely unaware of that. I’m glad to know that resource is available because people do become fearful about medical expenses. It’s great to know that money doesn’t have to a major barrier for PrEP.

“We’re just very focused on meeting people where they are. There’s a lot of intentionality about making sure that this is a very approachable experience for people and understand that people come from like a lot of different backgrounds and history of trauma with the healthcare system. So we're really intentional about making sure that this is a good experience and that we can re-shift that paradigm for people and maybe get people better faith.”