Samantha Miller: Transforming Reproductive Healthcare Accessibility with Cadence OTC

Cadence OTC is an early-stage consumer reproductive healthcare company on a mission to increase over-the-counter (OTC) access to safe, effective, affordable contraceptives. We own the rights to three of the most popular oral contraceptive formulations, and we’re in the process of moving the birth control pill over the counter and bringing OTC emergency contraceptives and other reproductive health products to convenience stores, especially in healthcare deserts. We are collaborating closely with the FDA to lead the first Rx-to-OTC switch of The Pill, which is progressing through development. At the same time, we have established a commercial organization and partnered with major C-store chains, including 7-Eleven, to make critical products easily accessible nationwide. Cadence generated its first revenue in January 2024 and ended our Q1 2024 with ~$415K in net sales.

I started my career in small pharma and gained expertise in negotiating collaborations between small pharma and industry giants like Pfizer and Bayer. A turning point came when I met Dr. Malcolm Potts, a revered pioneer in family planning and obstetrics, whose life’s mission was to curtail the suffering that unintended pregnancies bring to many women and couples worldwide and here in the U.S. The number he shared was a staggering 2.8 million unintended pregnancies every year (almost half of all U.S. pregnancies). This statistic was far higher than I had assumed, and I could easily imagine the extensive negative impacts on mothers, societies, and our planet as a whole.

 This mission resonated deeply with me, prompting questions about what could be done about it. Malcolm answered, “Well, we need to make it easier for people to have effective contraception anytime they need it.” He went on to say that one of the most important things we could do would be to make the oral birth control pill available OTC and as easy to buy as condoms. Wow, what a simple but brilliant idea.

I became incredibly motivated to help Malcolm and his partner, Nap Hosang, another amazing obstetrician dedicated to public health. However, we faced a daunting obstacle — to initiate the OTC process, we had to own the innovator product rights to an existing Rx product. Long story short, given my background, I was able to convince Pfizer to sell me the rights to two ideal products that are among the safest and most popular products in the class. Cadence OTC was born, and we have been working closely with the FDA to move The Pill OTC ever since.

Our team blends experienced healthcare entrepreneurs, dealmakers, medical doctors, and marketers with deep expertise and proven success in business and consumer goods commercialization.  We have partnered with the number one Rx-to-OTC organization to co-lead the FDA process with us.  Most importantly, our team has a shared vision and commitment to our mission and building a reproductive health company with a double bottom line for social impact and business success.

We are carving out a portion of our raise as a ‘community round’ through WeFunder for two reasons:

1 – Our mission is all about creating equal access to empowering resources. In that same vein, it was important for us to allow our customers, friends, and everyone passionate about reproductive rights to have the ability to participate in and own a stake in our journey to revolutionize contraceptive access. And as they say, the internet is the great democratizer and equalizer.

2 – We also see this community round as a great way to gain an army of new stakeholders to help us spread the word about our Morning After Pill in convenience stores and Zena as The Pill moving OTC.   Our passionate, well-connected stakeholders have always made Cadence more powerful than our core team.  Now more than ever, we need a large diversity of ‘owners’ to build awareness of our commercial products and help amplify our market success.

OTC birth control for everyone everywhere is our top priority and always will be.  At the same time, Cadence has built a specialized commercial organization with proprietary distribution relationships that we can leverage to increase access to other OTC reproductive health products. In particular, the OTC emergency contraceptive (EC) still has limited distribution. It needs to become more available and affordable for the more than 23 million women residing in 7,000 zip codes across the U.S. who need more ready access because there is no drugstore or healthcare clinic in their neighborhood.

Cadence OTC has addressed this issue by acquiring our own EC, Morning After Pill™️, and making it available in neighborhood convenience stores within these healthcare deserts. C-stores are everywhere—there are more than 150,000 nationwide, in every neighborhood, including rural areas, and they are open long hours. We formed an exclusive partnership with the dominant distributor of healthcare products to the convenience store channel, and together, we have signed with the largest C-store chains, including 7-Eleven.

Next month, we are launching our ultra-sensitive pregnancy test called EarlyPT™️, and by end-2024 we expect to launch our third C-store product, a urinary tract infection (UTI) emergency relief kit. Fast access to UTI treatment is crucial, so it fits well in C-stores. By the time Zena (The Pill) is approved for OTC sale, we’ll have three products on C-store shelves and all major retail channels. Our fifth product will be Zena XT, an extended cycle pill that allows women to safely have only four menstrual cycles per year instead of the usual 12.

Our negotiated licensing and manufacturing costs for all five products are remarkably low, so they can be sold at significantly lower prices and retain a healthy margin to build a successful, high-volume business.  Across the five products in our portfolio, the gross margin is between 60-80%, even with a retail price of around half the price of the leading brand at large chain pharmacy stores.  I also love how scalable our business is – these medical products can easily be produced in millions of units, weigh almost nothing to ship, and have a long shelf life (2-4 years).

I’ve seen first-hand that building a genuinely purpose-driven business can be not only gratifying personally, it can also create a major competitive advantage for financial success.  If your higher purpose is integral to your company, guiding our strategic, cultural, and operational approaches, you can inspire loyalty in employees, partners, and customers.