Media bought against lifetime value, inside the rules of every platform.
Paid social, search, YouTube, TikTok, native and retargeting are the channels that carry telehealth growth. We run them as one portfolio, allocate budget by payback, and structure accounts so a policy review never takes the growth down with it.
- CACCost per acquired patient
Blended and by channel, tracked to the prescription rather than the form.
- PAYBACKCAC payback period
How fast each channel's patients return the spend, which decides its budget.
- CVRClick-to-patient conversion
Shows whether a channel sends people who qualify and go on to convert.
- SCALESpend at target CAC
How much budget a channel can absorb before efficiency breaks.
How Performance Media works.
Four working rules that shape every decision the capability makes, from the first audit to the weekly cadence.
- 01
One portfolio, one objective
Channels compete for budget against the same measure: cost per acquired patient and how fast that patient pays back. Spend moves to whichever channel is producing profitable patients this month.
- 02
Measured to the prescription
Platform-reported conversions stop at the form. We track to the approved prescription and the first refill, and model the gaps where privacy limits the data, so bidding, audiences and creative are judged on patients.
- 03
Built to survive review
Healthcare categories are policy-sensitive on every platform. Account structure, claim language, landing pages and targeting are set up so a rejected ad or a flagged domain never takes the engine offline.
- 04
Creative is the biggest lever
In a mature account the creative drives more of the cost than the bidding does, so media runs on a weekly cadence with the Creative Lab, rotating winners in and fatigued concepts out before performance decays.
What is included.
The full scope of the capability. Every engagement starts with the audit, then the scope is set to the parts of your funnel where the economics are decided.
- 01
Channels
- Paid social
- Paid search and shopping
- YouTube and connected TV
- TikTok
- Native and advertorial placements
- Retargeting and remarketing
- 02
Operations
- Account structure and policy-safe setup
- Bidding, budgets and pacing
- Audience and geography strategy
- Weekly creative rotation with the lab
- Landing page assignment by channel and intent
- 03
Measurement
- Conversion tracking to the prescription
- Server-side and privacy-safe event setup
- Incrementality tests and holdouts
- Channel-level CAC and payback reporting
- Policy monitoring on accounts and domains
How the work runs.
A build phase with a fixed end, then a standing cadence. The rhythm is what makes the learning compound.
- 01Weeks 1–3
Build
Tracking to the prescription, account restructure, policy review and the first campaigns live.
- 02Daily
Check
Pacing, delivery and account health reviewed every day, with same-day action on rejected ads or flagged domains.
- 03Weekly
Rotate
Budget reallocated by payback, new creative rotated in, fatigued concepts retired, results scored with the lab.
- 04Monthly
Reset
Channel-level economics reviewed against the plan, incrementality tests read, mix reset with Growth Strategy.
One connected operating system.
Performance Media does not run on its own. This is what it hands to the other three capabilities, and what it takes back from them.
- 01
Growth Strategy
Takes its budget ceiling, channel mix and payback targets from the plan and reports back what actually happened.
- 03
Creative Lab
Supplies the weekly test slots and performance data the lab needs, and runs the winners it produces.
- 04
Conversion Lab
Sends each channel's traffic to pages built for its intent, and shares the click-to-patient data that shows where the funnel leaks.
Questions about Performance Media.
Something specific to your program? scale@scalewithsand.com
Which channels do you start with?
Wherever the payback is shortest for your category. That is usually paid search and paid social together, with YouTube, TikTok and native added as creative volume and budget allow. The audit sets the order.
How do you handle policy rejections?
By designing for them before launch: claim language agreed with your clinical team, landing pages that satisfy platform healthcare rules, separate account structures so one review cannot pause everything, and a daily check so anything flagged is fixed the same day.
Do you take over our ad accounts?
We work inside accounts you own. You keep the data, the history and the relationships with the platforms. We hold the access we need to run them and hand it back cleanly if the engagement ends.
Applied across eight categories.
The capability is the same on every engagement. What it is pointed at changes with the category, its claim rules and its retention curve.
- GLP
GLP-1 & medical weight loss
High-intent demand, compounding subscription economics, heavy creative regulation.
- TRT
TRT & men's health
Recurring labs and refills where retention decides the CAC you can afford.
- HRT
HRT & women's health
Long consideration cycles that reward education-led creative and patient trust.
- HAIR
Hair loss
Commoditized offers where landing page and pricing presentation win the margin.
- SEX
Sexual health
Platform-sensitive claims that demand compliance-literate creative testing.
- DERM
Dermatology
Visual-first categories where before/after storytelling has to stay compliant.
- LONG
Longevity & wellness
Premium cash-pay programs that sell on outcomes and hold their price.
- CASH
Cash-pay care
Any recurring, direct-to-patient program with real unit economics.
Build a stronger, more profitable patient acquisition engine.
Tell us about your program and current numbers. We will come back with a point of view on where the growth is.
