E980: The Next Unicorns: Alto Pharmacy CEO & Co-founder Mattieu Gamache-Asselin is working to fix the broken US pharmacy system by removing friction & aligning incentives among patients, doctors & insurers, shares insights on trading short-term profits for long-term success, combating the opioid cri
Alto Pharmacy CEO & Co-founder, Mattieu Gamache-Asselin, shares insights on fixing the broken US pharmacy system, aligning incentives among patients, doctors & insurers. They discuss building a 1.0 version of their pharmacy, combating the opioid crisis, and trading short-term profits for long-term success. The podcast covers scaling Alto Pharmacy, challenges in the US healthcare system, and the responsibilities in the opioid crisis. They also touch on the importance of operational excellence, the significance of starting a company, and the dangers of prioritizing short-term gains over long-term success.
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Quick takeaways
The responsibility for the opioid crisis lies with everyone in the supply chain, including manufacturers, doctors, and pharmacies.
Alto Pharmacy has achieved significant revenue growth by focusing on mastering the economics and growth model before expanding nationwide.
Alto Pharmacy aims to tackle challenges in the pharmacy industry by verifying prescriptions, preventing abuse, and prioritizing patient well-being over financial gains.
Deep dives
The Responsibility of Pharmacists in the Opioid Crisis
In the opioid crisis, the responsibility for the overprescribing of opioids and the resulting addiction and harm lies with everyone in the supply chain, including the manufacturers, marketers, doctors, and pharmacies. The manufacturer should not have marketed and produced such a powerful and addictive drug like OxyContin with misleading advertising. Doctors should not have prescribed opioids excessively or irresponsibly. Pharmacies, including pharmacists, should have been more vigilant in identifying suspicious or excessive prescriptions and should have taken steps to prevent their abuse. The responsibility lies with the entire supply chain to ensure that these powerful pharmaceuticals are used responsibly and with caution.
Nailing the Economics and Growth Model before Scaling
Alto Pharmacy has been deliberate in its growth, focusing on nailing the economics and growth model before scaling nationwide. By mastering the economics and growth in their existing markets of San Francisco and Los Angeles, they have achieved nine-figure revenue figures. They plan to turn on their model and expand into more cities, potentially scaling nationally, taking advantage of the massive $500 billion pharmacy market within the US.
Challenges in the Pharmacy Industry
The pharmacy industry faces challenges such as the presence of unethical practices, overprescribing of medications, and inefficient coordination among doctors, insurance companies, and pharmacies. Alto Pharmacy aims to tackle these challenges by verifying every prescription, looking for potential abuse or excessive prescriptions, and taking ownership of coordination and patient care. They prioritize patient well-being and responsible medication use over financial gains, and they are committed to delivering a better pharmacy experience to improve patient outcomes.
Combatting the Opioid Crisis
Alto Pharmacy has implemented measures to combat the opioid crisis, such as alerting patients about the addictive nature of opioids and offering alternative medications or non-opioid pain relief options. They aim to reduce overprescribing by educating patients and providing them with fewer opioids, ultimately working towards preventing the misuse and abuse of opioids. Alto Pharmacy is committed to being part of the solution and prioritizes patients' health and safety above financial gain.
The importance of balancing profit and mission-driven approach
The podcast episode discusses the dilemma faced by companies when it comes to prioritizing profit versus a mission-driven approach. It highlights examples of companies like Apple and Amazon, which have focused on maximizing profit without placing enough emphasis on the best user experience or the overall well-being of humanity. The episode emphasizes the need for companies to create a culture and architecture that hold CEOs accountable for considering the best interests of all stakeholders and not just short-term financial gains. It also explores the rise of startups with a more mission-driven approach to company culture and calls for the investment community to be more conscious of supporting ventures that are beneficial for the world.
The challenges and personal growth of being a founder
The episode delves into the unique challenges and immense pressure faced by founders of fast-growing companies. It highlights the need for founders to cope with stress and emphasizes the importance of personal growth and self-care. The discussion touches on the value of mindfulness, meditation, and conscious leadership in managing the intense demands of startup life. It also encourages founders to build strong teams, delegate responsibilities, and surround themselves with talented individuals who share the same vision and passion for the mission. Furthermore, the episode recognizes the significance of sleep, work-life balance, and the perseverance required to navigate the long and often difficult journey of entrepreneurship.
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
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