FOR SAMANTHA MILLER, health AND wellness HAVE ALWAYS BEEN ROOTED IN biology.

For Samantha Miller, health and wellness have always been rooted in biology. While studying biology at University of California, San Diego, she became fascinated by the complexity of the human body and the power our everyday choices have on long-term health. Eventually, Miller had a realization that would redefine her work: nearly half of all pregnancies in the United States are unintended, yet many women still face unnecessary barriers to accessing contraception and urgent care.

As co-founder and CEO of Cadence OTC, Miller is bringing essential women’s health products directly to store shelves. The company’s goal is ambitious but straightforward: make contraception and other urgent reproductive health solutions as accessible as condoms. Through its flagship candidate, Zena, Cadence OTC is leading the push to secure FDA approval for the first over-the-counter combination birth control pill in the United States—a breakthrough that could dramatically expand reproductive autonomy for millions of women. Read about Samantha Miller’s journey in her C&C 100 interview below.

What’s your earliest memory of feeling connected to health + wellness?

When I began studying biology at UCSD at 18 I was astonished at the amazing complexity and precision of my cells and physiology. I recognized that honoring my biology with smart lifestyle choices would be a top priority throughout my life.

When did you realize this wasn’t just something you loved, but something you wanted to pursue professionally?

My early days in the health industry were a bit different than they are today. I started working in the pharmaceutical industry where I spent years leading $3B+ in strategic deals. The real “aha” moment I felt connected to women’s health was when I learned that nearly half of all U.S. pregnancies are unintended. I saw that essential reproductive care was trapped behind prescription gatekeepers. Medical and public health experts have long advocated for over-the-counter (OTC) access, yet infrastructure hasn’t changed.

I knew I could use my network and experience in the pharma industry to acquire key formulations and build an organization dedicated to democratized, OTC access. My mission is to ensure essential women’s healthcare, like contraceptives and UTI relief, is as easy to buy as condoms.

What’s a behind-the-scenes wellness habit or ritual that plays a major role in how you show up each day?

My most important daily wellness habits are exercising every day for at least an hour in the morning and eating a plant-based diet full of vegetables, beans, and homegrown sprouts.

How do you navigate spaces that weren’t originally built with women in mind?

I love this question because it’s been part of the unique challenge we face in bringing our Cadence OTC mission to life. We are adamant that women should have access to contraception wherever condoms are available. Condoms are easily accessible at gas stations and convenience stores all over the country. While these aren’t necessarily gendered spaces, it’s no secret that convenience stores are more geared towards men and aren’t exactly welcoming to or comfortable for women. Cadence is correcting the notion that women can’t get their contraceptives and other urgent healthcare products in the same convenient way as a man. And to build on that, we want men and women to feel equally comfortable purchasing emergency contraception. Regardless of whether they are the ones taking it, EC is a viable form of contraception that’s important for both genders to have on hand for any “oh shit” moments.

When the stakes are high and all eyes are on you, what keeps you steady and confident in those moments?

The 40%+ of pregnancies in the U.S. that are unintended, and the millions of women who live in pharmacy deserts with no other options. We’re doing this for them. Women deserve access – wherever and whenever they need it.

What dreams/goals do you have for your career that both excite and scare you?

The big dream is to move the entire class of daily birth control pills over-the-counter. Cadence OTC has been leading this effort, working closely with FDA, for ten years for the approval of Zena. While the progestine-only pill moved OTC in 2023 (OPill), the regular combination birth control pill preferred by 90% of women is still only available by prescription. We are determined to change this with Zena and we’re getting close. The combined pill is still the most popular form of female contraception worldwide, and we see this OTC switch as a once-in-a-generation opportunity to fundamentally redefine reproductive autonomy. Moving a new medicine class from Rx to OTC is a complex, multi-year-long process. Reaching this milestone is a daunting task, decades in the making for U.S. healthcare, but couldn’t be more exciting.

How do you define success for yourself now vs. earlier in your career?

Earlier in my career I defined success more by the size of my deals and the level of my title, but today I only really care about what positive impact I can make on the world, my legacy of meaningful change.