A battle between two healthcare companies over money has turned into a viral debate about women's rights under the hashtag #CVSDeniesCare

Courtesy The Pill Club

One of The Pill Club's "care packages."

• Birth control delivery startup Pill Club is battling with health giant CVS Caremark over how much it gets paid for prescriptions.
• Pill Club has taken the feud to the public, posting a plea on its website titled "CVS, don't take away access to birth control."
• The hashtag #CVSDeniesCare also went viral on Twitter on Thursday morning. 
• Pill Club patients who get prescriptions covered through CVS Caremark are an important part of the startup's business. If reimbursement rates are cut there's a "chance that Pill Club can't work with CVS Caremark," a spokeswoman for Pill Club said. 
• No other birth control delivery startups contacted by Business Insider early Thursday could confirm that they were also affected, and CVS had no immediate comment.
• The episode shows how public outrage could become a new tool in health startups' contract negotiations with established healthcare companies.
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Birth-control-delivery startup Pill Club is taking a clash with health giant CVS Caremark to the public arena.

Pill Club and CVS Caremark are feuding over how much CVS pays Pill Club to send prescriptions to its customers. The startup posted a plea on its website to CVS, titled "Don't take away access to birth control," and the issue began trending on Twitter on Thursday morning, under the hashtag #CVSDeniesCare.

And with that, a feud between corporations over reimbursement rates turned into a battle over hot button issues like access to contraception and women's rights. The American Civil Liberties Union weighed in, as did the president of pro-choice advocacy group NARAL. 

A spokeswoman for Pill Club said that the company sent an email Thursday morning to its users and "alerted its partner organizations and friends close to the company about the situation." The spokeswoman said that the company didn't launch the viral Twitter campaign. 

Pill Club patients who get prescriptions covered through CVS Caremark are an important part of the startup's business, the spokeswoman said, though she did not comment on the specific amount.

"If we cannot convince CVS to change course in the next few weeks, we will have no choice but to stop serving people with CVS Caremark pharmacy benefits," Pill Club said on its website.

Pill Club is one of a crop of new startups like Nurx and Hers that prescribe birth control online and ship it to the customer's door, and viral social media posts have suggested that the CVS Caremark change could affect other birth control delivery startups as well. No other birth control delivery startups contacted by Business Insider on Thursday could confirm that they were also affected

A CVS spokesman had no immediate comment.

Pill Club has also sought to portray CVS as hostile to women's health issues. In an email to Business Insider, a Pill Club spokeswoman wrote that "CVS clearly doesn't see women's health as a priority," citing the health giant's connections to the Trump administration and its majority-male board of directors. The language used by Pill Club also closely mirrors that used by some people on social media.

Read: A feud between Amazon's pharmacy and the healthcare industry exemplifies just how disruptive the tech giant could be

A new online model for prescriptions

Pill Club works like this: Customers who go online can say what their birth control preference is, and list out any health concerns that might be relevant.

One of the company's physicians then reviews that information, and decides whether to write a prescription. Pill Club's pharmacies send those pills, or other birth control, to a customer's front door, where it comes in a "care package" that also includes goodies like sweets and stickers. 

Companies like Pill Club are part of a new trend towards more convenient, online models for prescription medications. These new startups typically combine a virtual doctor's visit with medication shipped directly to the customer.

Pill Club is one of a handful of these companies that fills prescriptions through a patient's health insurance. That's where companies like CVS Caremark, termed "pharmacy-benefit managers," come in. They agree to pay a certain amount of money per prescription to pharmacies. 

This isn't the first time online startups have taken disputes with PBMs public. In 2016, now-Amazon-owned online pharmacy PillPack got into a public argument with Express Scripts that almost resulted in PillPack getting cut from the PBM's massive network.