Startup Foundations: Interview with Sophia Yen

Greg Miaskiewiczby Greg Miaskiewicz • 7 min readpublished February 1, 2023 updated December 4, 2023
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Sophia Yen is the CEO and co-founder of Pandia Health, a women-founded and women-led birth control delivery company. Pandia partners with pharmacies and doctors who specialize in women’s health to bring convenient, dignified and stress-free ways of accessing telehealth services.

In our conversation we talked about the goals of Pandia Health, and how abortion laws could potentially impact Sophia’s business. We also discuss how the idea for Pandia Health was born through Sophia’ practice as a clinical associate professor at Stanford, and why she thought birth control delivery company should be doctor-founded and led by women. Sophia also makes the case for physicians being able to practice medicine nationally as opposed to specific state when they’re granted their license.

Sophia shares how she prepared for starting Pandia Health, and how she ended up distributing equity and roles among 6 founders initially. Sophia also discussed finding the first users and product-fit for her company, and the potential dangers of telemedicine abuse.

(Recorded on May 25, 2022)

Greg Miaskiewicz: Tell us what you're working on at Pandia Health.

Sophia: Pendia Health is the only doctor-led, women-founded birth control delivery company out there. We're also building something called Online Health Brand Women Trust. We're starting with birth control, then we're adding on acne, menopause, wrinkle cream, possibly PCOS, and obesity. I purposely chose the name Pandia, the Greek Goddess of healing light full moon because we're all about women's empowerment. And I also made up the definition "pan" is "every" and "dia" is "day". So we got you covered every day, set it and forget it and never run out of birth control on our watch.

Greg: In light of the Supreme Court decision that was leaked, potentially overturning Roe versus Wade, many states have passed laws restricting access to not just abortions but also birth control. How has this affected your business and will it potentially limit the ability for Pandia Health to operate in certain jurisdictions?

Sophia: As of this exact moment, abortion is still legal, but we are betting that the Supreme Court will reverse Roe v Wade mid-June and then it will go all back to the states. And there have been many states that have passed trigger laws that if Roe v Wade passed, the abortion will be illegal in their state. There's a law on the books in Georgia that was withheld because it was based on Roe v Wade, but if they overturn Roe v Wade, then that law may be able to come into play. And that law states that if you leave the state to get an abortion and you come back, they can arrest you on your way back. So that's not good for anybody who's going to college in Georgia, may step back to California, New York or Florida or some other state to have an abortion and then go back to those states.

Greg: Are there aspects of the laws that would potentially penalize the actual providers? Is this a legal risk for your company? Were you to ship birth control drugs to someone that that is living in one of these states that changes the laws like Louisiana?

Sophia: Yes, this is absolutely a legal danger for our company as well as our physicians. The main thing is we have physicians that are licensed in many different states. And so if you lose your license in Texas, because you broke the law by writing birth control, if Texas were to make that illegal or Louisiana, and then you apply for your renewal license in California or New York, they always ask, did you lose your license in another state? And if you do, it makes it a lot harder to get your license renewed, even if it was for, you know, a reasonable thing that is legal. In California, we've never had these kinds of laws where each state is practicing different kinds of medicine and that you could lose your license in one state for something that you would do in, in California. So my example is as a physician, we took the American Board of Pediatrics, the American Board of Internal Medicine, the American College of Obstetrics and Gynecology board. We did not take the California board, we did not take the New York, Louisiana, Kentucky board. But we are given our licenses state by state and that has just been a huge ridiculous thing with respect to telemedicine that we should practice medicine the same across all the states and that we, what is good enough for California to be a doctor should be good enough for New York, Kansas, Kentucky, and vice versa.

Greg: Do you think that there will ever be regulatory changes that would make it simpler for medical professionals to do their work across state borders?

Sophia: Yes. So there's the beginning of that. There's something called the Intermed License Compact. And what's interesting, the major states are not participating. So that was a difficult thing for Pandia Health when we started is that we had to get a license in California, get a license in Texas, get a license in Florida. These three are not participating in the I m lcc, but a bunch of little states that are lower populated who understand that they may need to use a doctor from a neighboring state or a specialist from a neighboring state, have a compact that if you are licensed in one particular state, then you can check the box and get licensed in 10 other states. However, you still have to pay money and you have to follow whatever interesting regulatory things that there might be. But that is the beginning and it would be great if we just made it national.

Greg: Do you think that is actually something that the individual states have to pass or approve? It's probably not something that can actually be implemented top down or are there some potential constitutional limitations here?

Sophia: Yeah, I think that there could be a push to go from the national side and just say all doctors are licensed nationally. You know, it's really the medical boards that want to control what doctors can practice in their state. And I think particularly with telemedicine, it is kind of protecting doctors because you can imagine if somebody's living in Maine, the cost of living is very different than in Silicon Valley. And so all the doctors and they could be stealing all the patients, you know, from California on a telemedicine basis. But, um, I would love to, it currently is being done on a state by state basis, but I think it'd be great on a national just to declare all doctor's licenses are valid in all states. Because we took the national board, we did not take, you know, a California, Florida, Texas board. I think the states would get angry and, and say, you know, they have the right to to license people in their states.

Greg: Well I see the argument more clearly for passing a state bar exam to practice law in that state because there are specific laws that are different from state to state, not just abortion laws. Other laws, especially business ones.

Sophia: I always say it's not right that if you were born or you're living in a different state, that you would have different level of healthcare. And I do think that telemedicine is the opportunity to bring Stanford or Harvard Level care everywhere. And actually in medicine we really try to standardize everything, not just in the United States but internationally. You know, we have national guidelines of how you should do your vaccines, how you should counsel or check for obesity or how often you should check cholesterol or how often you should do a pap smear or mammogram. We don't have those guidelines by state. It's a national or international guidelines.

Greg: Take us back to the beginning of the company, what you, I'm guessing you were a practicing doctor physician. Exactly. What made you decide to do a startup?

Sophia: Startups are my blood, my family, my parents had their own company. Not a typical startup, but one of the old Silicon Valley started in your garage and then grow it kind of situation. But really the reason I started this was eight years ago, was giving a talk to a bunch of doctors cuz I am a clinical associate professor at Stanford. And so I teach other doctors how to prescribe and how to take care of young people to prevent unplanned pregnancies, sexually transmitted infections and other health issues. And was giving a talk on birth control. Why don't women take birth control? And one of the top reasons was, didn't have it in their hand, didn't have time to run to the pharmacy every single month for 30 years of our lives. From age 12 and a half, your first period until 50, your last period is all of your fertile years.

The difficult thing if you don't know is some insurance companies will limit you. You cannot go and get your medicine until seven days or fewer before the medicine runs out. But a lot of us will run out on Sunday. So we'll go the weekend before on Saturday, Sunday, and we'll go in the pharmacy and we're like, can I get my birth control? And they'll run the insurance. They're like, sorry, insurance will pay for it. You gotta come back Monday. And you're like, but I don't have time Monday. I have a meeting, I have a podcast, I have children to pick up from school, whatever, I'm here now, please give me my med. And they're like, sorry, insurance won't let you. And so my, it was the beginning of pay, um, Etsy and Amazon and eBay. Everything was coming in the mail and I was like, why not birth control?

So we started this company that we could ship women birth control and keep shipping it to them until they tell us to stop. And then we ran ads, free birth control delivery. 60% of the women that responded to such an ad didn't have a prescription. And it's like, don't you know, in the United States you need a prescription for the birth control pill, patch or ring. And as a doctor, an entrepreneur, I didn't wanna miss out on 60% of the customers and I could write the prescription. So thus Pandia Health was born asynchronous telemedicine where a doctor can write you the prescription if you want, but if you already have a prescription then we just deliver it to your door. Um, if you have insurance under the Affordable Care Act, no copay, no deductible for any FDA-approved birth control. So you pay us nothing. We make money just like any other mail order pharmacy, the difference from what we get the drug at and what your insurance reimburses us. However, if you wanna use our doctor 20 bucks a total steal once a year, um, with unlimited follow up questions about birth control.

Greg: Did you have co-founders that you worked, uh, worked with when you were first starting the company?

Sophia: I think we had the most co-founders ever because as a woman, as a doctor, I wanted to make sure we had all the elements there before starting a company. And I don't care about sharing pieces of the pie as long as it's fairly divvied up. And it's clear who is contributing what. So we had five or six original co-founders. We had a physician CEO, we had a COO, my sorority sister to run everything and do everything that I didn't know about or I didn't wanna do. We had a chief marketing officer, we had a CTO, we had a pharmacist, we had Perla, who had vision, connections, VC experience and startup experience. So that was our original co-founders and we've since, dire as we say in medicine, had some people leave because we couldn't pay them how much they needed to be paid in order to maintain their house and Nanny in Palo Alto, and then other people just had conflicts of personality. So we're down to of the original founders, our CTO and myself, and then Perla remains on as an advisor board member.

Greg: Interesting. Did investors react to that when you started out? Did they give you any kind of negative feedback like you have too many, too many cooks in the kitchen or along those lines?

Sophia: I think the key is just who was here at the beginning and willing to take no pay <laugh>. I think the key is really looking at the vision and where we're going and everybody looks at the quality of your team and I love that everybody had skin in the game. I mean it's so important. I I think a lot of founders have a hard time finding a technical co-founder, but having a CTO who is doing this 24/7 and loves this and is motivated rather than some, you know, contractor who may walk away or I've heard people been held hostage with their code in some foreign country, I think is really important is to have everybody vested in the company in where we're going and working all the time. Thinking all the time, how do we make this better?

Greg: How did you find your first investors?

Sophia: The good news is there's a rise of social entrepreneurship investors. I pitched at , at an event that's now called One World Investments. And they're really about teaching investors that you can, you know, make money and do good in this world. You don't have to sacrifice return for doing good. They had a pitch competition, we won most qualified and from there we got an advisor and that advisor made an introduction. Another way that we got another major investor was through Springboard. It's a nonprofit, it's a great accelerator with a huge group of powerful women. And one of the other companies introduced me to her investor and that's how we got, our major investors. One was through a advisor introduction and the other was through Springboard Enterprise. But I've also done Stanford start and they have a great pitch day and you get to meet a lot of investors that way as well.

Greg: So what's next, for Padia Health? What are you excited about in the next year? I know there's a lot of things going on in the world of public policy and law that you can't control that are maybe not so exciting and dismal. But tell us what you're working on, what you're excited about building.

Sophia: Right now we can deliver to all 50 states and we can prescribe in 14 and we want to expand to 20 by the end of this year. And possibly, even more, just depends how soon we get more funding. The thing that I'm excited about is we've launched acne to our internal patients, but more interesting is menopause. I'm planning on researching the best menopause treatment and then offer it to everyone out there and if you don't want the best, then we can go with watever other options that you want out there. And then with that we're thinking of rather than just telemedicine and medication delivery being more holistic and adding on nutrition, adding on support groups, counseling.

Making it kind of more well-rounded and that'll be obviously far more than our current $20 once a year it'll be, you know, upsells and if you wanna join this group or if you wanna see a nutritionist or or stuff like that. And then what you know, differentiates us is, is the only academic doctor led company in this space is I realize that unfortunately a lot of medicine is based on a Caucasian female. And what I was taught at U C S F in Stanford works great for a Caucasian female that wants to bleed every single month. But for an Asian or a black person or a person who doesn't wanna bleed every month, we've actually after, you know, six years in this business and only doing birth control and nothing else and using my academic mind and applying it to it have found a better drug that we have 85% retention at a year versus normally on a birth control pill, 45% of people quit and our patients don't even know because we start you on a great pill, you have no side effects and you're good to go.

Whereas if you go somewhere else where they don't have expert doctors, taking into consideration your body mass index, taking into consideration your age to make sure your bones are okay, taking into consideration that what you were taught only works for Caucasians and this person may not be a Caucasian female who wants to bleed every month, then you have side effects and you quit and you never see that patient again and they're like, oh, the pill sucks when actually there's 39 other pills that we could put you on. So we have a algorithm that our, uh, doctors adhere to when we're prescribing to optimize such that you have the fewest amount of side effects. And then if you do have side effects, we have a grid on what to turn up, what to turn down so you can find the next best, um, birth control for someone.

Greg: What's something that you wish you knew when you were first starting out that you've learned now a few years into the journey of, of running your own company?

Sophia: Oh, there's so many things that I wish I had done differently. Um, one, get everything in writing. Um, two, don't be pressured into anything. Um, you can always say, I need to consult my doctor or not your doctor, your lawyer. Um, don't agree to anything right away. And, um, three, check who your co- founders are because you're go, I'm in year six of this and you're gonna be with them longer than you've been with anybody in college and potentially elementary school. And I think of my team as family almost. I mean, they're my work people and I spend 12 to, you know, 15 hours a day at working and they too are working on this. So I hope you choose something you enjoy, something you're passionate about, and make sure that you get everything in writing, don't agree to anything or disagree to anything without consulting your lawyer. And um, pick a good team.

Greg: All right. Well thanks for joining us on this show and sharing what you're working on.

Sophia: Thank you for having me.

Greg Miaskiewicz

Written by Greg Miaskiewicz

Security expert, product designer & serial entrepreneur. Sold previous startup to Integral Ad Science in 2016, where he led a fraud R&D team leading up to a $850M+ purchase by Vista in 2018.

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