The $262m headline that points the wrong way

The total went up. The intensity came down#

The fox does not count rabbits. It counts rabbits per mile walked, because the first number flatters and the second one feeds you. Every healthcare marketing strategy argument that has ever gone badly in a boardroom went badly because somebody brought the first number.

In its Q2 2026 results, published on its own investor site, Hims and Hers reported revenue of $753.2m and an expense line labelled simply "Marketing" of $262.2m. That is 34.8% of revenue spent on marketing in a single quarter, which is the figure that has been travelling around trade coverage this week.

Now read the comparative column. In Q2 2025 the same company reported revenue of $544.8m and marketing of $217.9m. That is 40.0%. Marketing intensity did not rise. It fell by 5.2 percentage points, because revenue grew about 38% while marketing spend grew about 20%.

Why the direction matters more than the level#

A falling ratio with rising revenue is the shape every healthcare marketing strategy is supposed to produce. It means each additional pound of revenue is costing less to win than the last one did, which is the only durable definition of marketing working. A rising ratio with rising revenue means you are buying growth, which is a legitimate choice but a different one, and it should be made deliberately rather than discovered at year end.

The half-year confirms the direction rather than contradicting it: 39.7% in the first half of 2025 against 35.6% in the first half of 2026. Two independent windows, same movement. That is what a real trend looks like, as opposed to a quarter that happened to land well. The full statements sit on the company's investor relations site for anyone who wants to check the arithmetic rather than take it on trust.

A healthcare marketing strategy that reports only the total is laying a trail nobody can follow back. The ratio is the paw print: small, repeatable, and it tells you which way the animal was going.

What a defensible benchmark looks like#

The next question every board asks is the obvious one, and it is the one this trade answers worst. How much should a marketing budget be? The usual reply is a confident percentage borrowed from a vendor blog with no sample behind it, which is worse than no answer because it sounds like one.

There is a defensible number available. The CMO Survey, run by Duke University's Fuqua School of Business with Deloitte and the American Marketing Association, reports that marketing budgets "stand at 9.0% of company revenues", and that budgets as a share of overall company budgets have fallen to 9.6%, their lowest level since 2021, with overall marketing spending up just 1.7% over the prior twelve months.

State the method with the number, because a benchmark without a method is a rumour. That survey was fielded between 7 and 29 January 2026, invited 2,111 marketing leaders at for-profit US companies, and received 308 responses, a 14.6% response rate, with 97% of respondents at vice-president level or above. Healthcare is 9.5% of that sample, which the survey publishes openly rather than burying.

Most numbers quoted in a healthcare marketing strategy deck cannot survive that paragraph being written about them. That is the test worth applying: if stating the method kills the number, the number was never evidence, and a fox that trusts a trail it has not sniffed ends up in somebody's bin.

So this business spends roughly 3.9 times the cross-sector average share of revenue on marketing. That is the genuinely striking figure, and it comes with a caveat that must travel with it: the survey covers US firms across all sectors, not direct-to-consumer health or subscription businesses specifically. It bounds the comparison rather than matching it.

Two other benchmark sources arrived this month and both deserve caution rather than adoption. Google announced benchmarking against anonymised similar businesses inside its advertising and analytics tools, and Microsoft added topic-grouped citation reporting to its own free tooling. Both are useful. Neither tells you what a peer's payback period is, which is the number that would actually justify a ratio.

A platform-defined peer set is a comparison you did not design, drawn from a cohort you cannot inspect, in a category where a regulated brand and an unregulated one can look identical to a classifier. Use it to spot a direction, never to set a healthcare marketing budget.

Use a healthcare marketing strategy ratio as a question, never as a target#

The wrong lesson is that a healthcare marketing budget should be 35% of revenue because a listed telehealth business runs at that level. The right lesson is that a subscription business with high lifetime value and a short payback can rationally run at several times the cross-sector average, and that whether yours can is an arithmetic question about payback and retention rather than a matter of nerve.

A healthcare marketing strategy built by copying somebody else's ratio inherits their retention curve, their gross margin and their category, none of which you have. Copy the method instead: measure the ratio, watch its direction, and require a reason whenever it moves.

What a falling ratio does not prove#

This is where an honest piece has to slow down. A falling marketing ratio is good news about marketing. It is not automatically good news about the business, and treating the two as the same thing is how a healthcare marketing strategy gets blamed for something it did not cause, or credited with something it did not do.

The same results show gross margin at 64%, down from 76% a year earlier, and a net loss of $86.3m against net income of $42.5m in the prior-year quarter. Adjusted earnings before interest, tax, depreciation and amortisation fell to $60.3m from $82.2m. Marketing got more efficient while the economics underneath it got harder.

Both things are true at once and neither cancels the other. If you are the growth lead in that business you have a genuinely strong quarter to report. If you are the chief executive you have a margin problem that no amount of marketing efficiency will fix, because it is not a marketing problem.

The measurement discipline this implies#

Report the ratio and the direction together, every quarter, alongside the two or three lines that could confound it. Gross margin, retention and mix are the usual suspects. A telehealth marketing report that shows acquisition cost falling while saying nothing about margin is technically true and practically misleading, and somebody senior will eventually notice.

The same discipline applies to expansion. Rest-of-world revenue grew 1,641%, from $7.5m to $131.4m, which sounds like a marketing triumph and largely reflects an acquisition. Growth bought through corporate development is real growth and it is not evidence that your channels are working, so keep the two in separate columns.

The next cost increase is already visible#

A ratio that falls for two consecutive periods invites complacency, so it is worth naming where the next upward pressure is likely to come from. For healthcare specifically, a new paid surface has appeared inside the answer itself.

A study published on 10 August by SE Ranking measured advertising inside ChatGPT across 50,006 commercial prompts spanning twenty niches, roughly 2,500 per niche, collected on 23 July 2026, with relevance judged by embedding similarity and manual review of flagged cases. Ads appeared on 25.94% of commercial prompts overall. Healthcare was the highest niche measured, at 28.69%.

Read that as a warning about competition rather than a recommendation to buy. Nearly three in ten commercial health prompts already carry a paid placement, which means the answer a patient reads is becoming an auction surface in exactly the category where trust is the scarce resource. Search Engine Land's coverage of the same study notes the relevance problem alongside it, with 14.35% of placements no more related to the prompt than a random pairing.

Consolidation is the other pressure#

The supply side is consolidating at the same time. Hinge Health announced on 4 August that it will acquire Cylinder Health for $105m in cash, extending from musculoskeletal care into gastrointestinal care, with the acquired business covering nearly 100 clients across two million lives.

Point solutions becoming multi-condition platforms changes what a healthcare marketing strategy is selling. A single-condition pitch competes on depth; a platform pitch competes on breadth and on procurement convenience, and those need different proof, different content and different buying committees. Hinge Health's own positioning shows the shift in progress rather than in prospect.

For anyone selling into the same buyers, that is a scent worth following early. When a competitor moves from one condition to several, the procurement conversation moves from clinical depth to vendor consolidation, and a healthcare marketing strategy still arguing depth is answering a question the committee stopped asking.

None of this is a reason to raise the ratio pre-emptively. It is a reason to know which of your acquisition costs are exposed to a new auction and which are not, so that when the ratio does move you can say why in a sentence rather than in a post-mortem.

A healthcare marketing strategy that can name its exposures in advance is a healthcare marketing strategy that gets believed when it asks for more money later. That credibility is built quietly, in the quarters when nothing is going wrong, and it is spent in the one quarter when something is.

Five rules for the budget conversation#

These are the rules that turn a defensive budget meeting into a short one. None of them require new tooling and all of them require somebody to write a number down before the quarter starts.

The sentence to take into the room#

If a healthcare marketing strategy can be defended in one line, it is this: our marketing intensity is x per cent, it has moved y points in the last four quarters, and here is the reason. Every board that hears that stops asking about the total, because the question they were actually asking has been answered.

One closing caution about borrowed confidence. The figures in this piece describe one listed business in one quarter and a cross-sector survey of 308 firms. Neither is your company, and a healthcare marketing budget set by analogy to either will be wrong in a direction nobody can predict. Use them as a method for asking better questions, which is all any external number is honestly good for.

The fox that eats well in winter is the one that learned to count what the walking cost, not what the field looked like. If you want that ratio built and defended against your own numbers rather than described in the abstract, that is what folkfox healthcare marketing does, alongside paid search, content marketing and SEO and GEO work for regulated categories where the claim has to survive scrutiny.

Frequently asked questions#