The Broken US Pharmacy System and the Opioid Crisis

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The hosts discuss various topics related to the broken US pharmacy system and the opioid crisis, including the company Alto Pharmacy's efforts to remove friction and align incentives among patients, doctors, and insurers. They highlight the responsibility of pharmacists in identifying and addressing prescription drug abuse, as well as the existence of a central database to track opioid prescriptions. The chapter also explores the importance of prioritizing long-term success and societal impact over short-term profits in the tech industry.

0:51 Jason intros Mattieu Gamache-Asselin
2:52 Changing from ScriptDash to Alto Pharmacy
4:19 Meeting and working with Twitch founder Justin Kan in the early days of Alto
6:51 Message to HBO’s Silicon Valley writing room
7:26 Working out of Justin Kan’s house
8:15 Why are pharmacies broken? How is Alto fixing them?
14:25 How did Alto’s team architect a 1.0 version of their pharmacy?
21:44 US Healthcare is broken due to bad incentive structures
28:23 Does Alto compare to Hims and Roman?
32:24 What are Alto’s profit margins?
35:00 This Week in Cinema: It’s a Wonderful Life
39:07 Maintaining balance between being scrappy/aggressive while also abiding by all medical regulations
39:54 How has Alto scaled so far?
45:55 Who is responsible for the opioid crisis?
51:24 What is Alto building to combat the crisis?
53:27 Trading short-term gain for long-term gain
56:56 How Alto was initially received among investors
1:01:03 This Week in Cinema: The Mission
1:04:30 What skill does Matt think many founders lack?
1:07:02 Operational excellence in former Amazon executives
1:13:49 #1 Lesson that Matt has learned since becoming a founder