Expires 04/01/2021

Specialty Pharmacy

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

Alto Pharmacy Technician

Alto Pharmacist

At Alto, we’re obsessed withour missionto improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

Hear first-hand from members of the Alto technology teams.

Alto / Blog

In recognition of Women’s History Month, we highlight four women at Alto shaping the future of pharmacy. These leaders share their advice for women in the workplace, their unique super powers, and what they appreciate most about Alto's culture.

Celebrating Women at Alto Pharmacy

Liz Kelly, National Sales Manager Fertility 

I'm responsible for hiring, coaching and supporting the needs of the national fertility sales team. I also work closely with fertility business and operations teams to deliver on our clinic and customer promises.

Before joining Alto, I was finishing up a sabbatical where I spent my time volunteering on the board of a non-profit called ServeHAITI. Prior to that, I was the West Coast Area Business Director at EMD Serono and worked with Matt and Jaime [Alto’s co-founders] to secure a contract to distribute fertility meds when they were still working out of AG Pharmacy!

What do you appreciate the most about Alto's culture? 

Hands down my favorite part of being on the Alto team is that the patient is truly at the center of every decision we make. I value that we make business decisions with our mission in mind.

What do you like doing outside of work?  

Of late, my favorite pastime is heading to the dog beach with my rescue, Bodhi, who has been the best medicine to ease some of the COVID-19 isolation I experienced over the past year. Before the pandemic, I made sure to travel to at least one new international spot a year. I love the experience of getting exposed to all things about another culture: cuisine, culture, belief systems, language.

I like to think that my super power is seeing the greatness in others, sometimes before they see it in themselves.

I aspire to live by the motto "be the change you wish to see in the world." I encourage women to speak up for what they believe is right, even if nobody else agrees. That includes planning for your own career path and making it a priority to develop your skill sets so that you are prepared to climb the ladder that serves your own greatness.

I graduated from pharmacy school in May of 1979 and started working at AG Pharmacy after passing my boards later that year. I bought AG in 1998 when the previous owner wanted to retire - he had been with AG since it first opened in the early 60's.

My family moved to San Francisco from Hong Kong when I was five years old. Our story is one similar to those of many immigrant families who came to America looking for a better life in search of the American dream: own a home, have a car, raise children safely and give them the opportunity of a good education and a chance to have a better life. My parents raised their children here, emphasizing family, hard work and education. They lived their American dream, and I have them to thank for all that I am today.

What’s your favorite thing to do outside of work? 

I love to travel. There are so many unique places to visit in this world. With the different cultures, the food, and the amazing sceneries/landscapes, there are endless things to see and experience! 

The thing I appreciate most about Alto's culture is that everyone works so hard together to bring about the best pharmacy experience for all our customers. You can feel the energy and the motivation of all the Altoids. I cannot emphasize how amazing it is to be a part of this team and to watch Alto grow and evolve into the pharmacy of the future and the pharmacy of our dreams!

What’s your favorite memory thus far at Alto? 

In the very early days, when Alto was still Scriptdash Pharmacy, a customer needed to get her trigger shot [as part of a fertility protocol] within the next few hours. It was close to rush hour, and we had no couriers available to deliver to the South Bay. Our CEO Matt came to the rescue on his motorcycle, and off he went to make the delivery. It was such a wonderful and warm feeling to watch and cheer him on together. That is truly what Alto love is all about!

I manage our amazing IT Support team, helping all Altoids get the technology support they need, when they need it. 

For the better part of the last decade I have been managing IT Support teams. From Facebook and Twitter to Lyft and Uber, I’ve seen it all (or at least most of it!).

Our incredible dedication to our mission. In my short time here, I truly see us putting patients first, and it’s moving to see. 

What do you like doing outside of work? 

I’m a big traveler, but since COVID-19 has put a damper on that, I enjoy flying around Colorado with my partner in our vintage Beechcraft Bonanza. I also love hopping on my motorcycle and just exploring! 

I’m in love with Central and Eastern Europe. Some of my favorite places are Prague, Vienna and Budapest. 

Elnaz Moshfeghian, Senior Engineering Manager

I’m originally from Iran but moved a lot growing up, including Oklahoma, Australia, Qatar, Kuwait, and Chicago. I have been in San Francisco for the last six years. I stumbled across software engineering in college and found a passion for building products and teams. I joined Alto as the third engineer and this is now the largest company I’ve ever worked at. 

I lead a group of 20 engineers across three teams. Two teams are focused on getting prescriptions ready to schedule quickly and accurately, and one is focused on enabling faster, higher quality, and more enjoyable product development across the broader product and technology organization. My work involves a lot of collaboration, creativity, transparency, and flexibility. 

I was an early software engineer at a small startup; before that I was a hybrid software engineer and product manager at a design and development studio. 

I like how passionate everyone is about what they do. 

I’m at my best managing a crisis or finding a path through conflicting strong opinions. 

I want to start with some advice for our allies: get more curious about the experience of the women you work with and learn about ways you can support and amplify the work of the women around you. Diversity, equality and inclusion is a team sport and, even if we win a game or two, it’s about the continuous pursuit of excellence. 

For my fellow women at Alto, I wish I knew earlier to focus more on improving my craft and impact so I can get a seat at the table, rather than trying to juggle advocacy and my own work. Once you’re at the table, you can really advocate for hiring, growing, and retaining women. 

To learn more about the work of our six employee resource groups (ERG’s) focused on building community - including Umoja (Black), Auténtico (LatinX/Hispanic), Women (WOAA), Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents - read our 2020 Diversity, Equality and Inclusion Report. 

Are you passionate about shaping the future of pharmacy? Join us as we deliver our industry-leading pharmacy care to millions of Americans. 

Alto Pharmacy is recognized by Forbes as one of America’s Best Startup Employers in 2021, ranking 13th among 60 healthcare startups.

Alto Pharmacy Announced as One of Forbes Best Startup Employers

After discovering that half of all prescriptions aren’t even picked up—resulting in 125,000 avoidable deaths every year—we set out to build a new kind of pharmacy that focuses on the person behind every prescription.

Here at Alto, we’re transforming a $500 billion industry by reinventing what a pharmacy can do—from hand-delivering medications for free to offering on-call help by text or chat. Our customers are at the center of everything we do, and it shows. After delivering more than one million prescriptions, we have an NPS score of 86 and over a thousand five-star reviews on Yelp.

In addition to delivering a better pharmacy experience for everyone who needs medicine, we’re committed to cultivating a better workplace for for our team, every day. That’s why we’re honored to be recognized by Forbes as one of America’s Best Startup Employers in 2021, ranking 13th among 60 healthcare startups. Inclusion on the list was based on professional reputation, employee satisfaction, and growth, among other criteria. 

This accolade follows several others in recent months including LinkedIn’s Top Startups in 2020 and San Francisco Business Times Largest Bay Area Digital Health Companies in 2020. In addition, Alto’s CEO, Matt Gamache-Asselin, recently received recognition as one of The Top 25 Consumer Health Tech Executives of 2020 by The Healthcare Technology Report. 

“We have a lot to be proud of in the past year, especially in light of the challenges presented by the COVID-19 pandemic,” shared Gamache-Asselin. “I’m so proud of the hard work and commitment exhibited by every member of our team in providing exceptional pharmacy care in our communities. As we continue to expand our services to more and more people, we’ll also be growing our team of incredibly knowledgeable and caring professionals.”

Are you passionate about shaping the future of pharmacy? Join us as we  deliver our industry-leading pharmacy care to millions of Americans. 

For the full employers list and an overview of the selection methodology, head to the Forbes site. .

Alto Pharmacy Announced as One of Forbes Best Startup Employers 

Forbes 2021 America's best startup employers

Starting Friday, March 12, residents of the greater Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Dallas-Fort Worth!

Alto’s launch in the Dallas-Fort Worth market extends our industry-leading patient care model to even more Texans. 

Starting Friday, March 12, residents of the Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

At Alto, we believe it’s our job to ensure you have your medications at the best price, on time and with the support you need. We bring pharmacy to you - no more waiting in line, making an extra trip, or finding out your prescription isn’t ready to be picked up after you’ve already arrived. Our free doorstep delivery means your medications come directly to you on the day and time you select, and most medications are available the same-day. Stay up to date on your courier’s progress with text alerts or in our mobile app. 

Starting a new medication or doing an injection for the first time? Message a pharmacist with your questions, even in the evenings and on weekends. And we’re a full service pharmacy - we stock all major brand, generic, over-the-counter and specialty medications, meaning your entire family’s pharmacy needs can be managed in the Alto app and coordinated into one delivery.

Courier delivery windows
Monday - Friday: 6 - 9 pm CT
Saturday - Sunday: 2 - 5 pm CT

Walk-in hours
Monday - Friday: 9 am – 7 pm CT
Saturday - Sunday: 10 am - 5:30 pm CT

Dallas-Fort Worth residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

Need to pick up? Our pharmacy is located at 475 State Highway 121, Suite 150, in Lewisville.

General customer support hours are Monday - Friday 9 am - 11 pm CT and Saturday - Sunday 10 am - 7 pm CT. Patients can reach out to Alto via phone/text at 1 (800) 874-5881, email or app.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and currently delivers across the greater Bay Area, Los Angeles, Orange County, Seattle, Denver, Las Vegas, New York City, Houston and Dallas.

Starting Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

Hello, New York City!

Alto extends beyond fertility medication support to offer full-service pharmacy operations in New York City.

Starting today, Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

Courier delivery windows
Monday - Friday: 

3 - 5 pm ET for Manhattan to 125th St, 4 - 6 pm ET full service area 

6 - 8 pm ET for Manhattan to 125th St, 7 - 9 pm ET full service area

4 - 6 pm ET for Manhattan to 125th St, 5 - 7 pm ET full service area

Walk-in hours
Need to pick up? Our pharmacy is located at 100 Park Avenue - that's 40th between Park and Madison.
Monday - Friday: 9 am – 7 pm ET
Saturday - Sunday: 10 am - 6 pm ET

New York residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

General customer support hours are Monday - Friday 9 am - 12 midnight ET and Saturday - Sunday 10 am - 9 pm ET. Patients can reach out to Alto via phone/text at 1 (800) 874-5881, email or app.

At Alto, we’re obsessed with our mission to improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Our mission and diversity work are tied together with one word from our mission -- everyone. Too often, only those with significant resources access the best and benefit from innovation in healthcare. We see it everyday in the data. Too many among us continue to struggle with solvable challenges, in our own wellbeing and in the larger healthcare system. These statements and environments have existed in the workplace as well, influencing the products, services, and policies that steer how the organization works for all of us.  Our work is to make Alto different.  Our work is to build and sustain an inclusive culture.  Our work is to attract, develop, reward and retain talent from all the communities we serve as patients and build a product that supports everyone. 

Today marks another step in our diversity, equity, and inclusion journey as we release our first annual diversity report. We share it because this work is central to our mission and in doing so, we use transparency to hold ourselves accountable, as well as hopefully play a part in raising expectations and norms throughout the healthcare and technology industries.

In 2020, across the company we saw a 13ppt increase in women and 7ppt increase in underrepresented groups (Black, Hispanic/LatinX and Native professionals).

As for women in leadership, we saw increases of 3ppts in Women Managers and 1ppt in Product, Engineering and Design driven by both hiring and promotion. At the leadership level, 32% of leaders identify as women.

In 2020, we saw 10ppt increase across our underrepresented managers to 13% Black, 16% Hispanic/LatinX, 2% Native/Indigenious.  In the leadership group, we saw an 8ppt increase to 15% Black and 2% Hispanic/LatinX. 

In 2020, we also established our Alto Advisory Board and our first two anchor members, who will help guide Alto towards our mission, advise on key decisions, and support strategic initiatives. We’ve formed the Advisory Board to support our leadership as we navigate the regulatory landscape, launch new features to modernize the pharmacy experience, and adhere to the highest standards of operational excellence and patient care.  

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College, one of the nation’s oldest and largest private historically Black academic health sciences centers. He received his Bachelor’s degree from Harvard University, his Ph.D. in immunology from Oxford University as a Rhodes Scholar, and his medical degree from Johns Hopkins School of Medicine. He was the first Black American in the 125-year history of Johns Hopkins School of Medicine to earn full professorship with tenure and is internationally known for his influential HIV research.

Jennifer Kent served as the Director for the California Department of Health Care Services, where she led the second largest public healthcare system in the nation, with an annual budget of over $100B and serving over 13 million Californians. She oversaw the administration of 24 managed care plans as well as 56 county behavioral health plans. She has also held leadership roles in the Health & Human Services Agency, Governor's Office and has experience in the private sector as a lobbyist, consultant, and association executive. She has more than 15 years of health administration and policy experience in California.

Alto created our DEI strategy with our team aligned to four pillars – Hire, Include, Develop, and Invest.  Each pillar's actions tie to our people and our business. This means the return on investment is clear and goals are aligned to business outcomes.

Medical Health Care Premiums and Part Time Health Care Benefits in SF: 

In order to increase access and affordability to critical health-care services, we asked our broker to offer a special mid-year open enrollment 2020, reducing premiums for most plans by 5%. We reduced out-of-pocket maximums and speciality office visits by an average of 37%. We reduced co-insurance as well as costs for labs, x-Rays, and emergency room visits for our Cigna plan by 50%. Finally, prescriptions copays were reduced by 25% for Brand medications and 75% for Generic prescriptions. This benefits the employee with direct access to care and a better employee experience as compared to direct contribution to the city fund.

We increased our paid parental leave across all US locations to 8 weeks (up from 6 in 2020) for all parents requesting leave as of January 1st.  Throughout 2020 parents and other caregivers were impacted significantly as schools, daycare, and caregivers were closed, isolated, or unable to rely on pre-covid support. We offered laptops to parents who couldn’t afford them for each child to participate in remote learning.  We offered expanded benefits above and beyond FFCRA. Finally, we offered paid sessions for remote learning, tutoring, and experiences for parents and caregivers.

Finally, in December we launched Modern Health with 6 paid coach/therapy sessions and access to a digital wellbeing library and resources to all Altoids.

We launched six ERGs in 2020. Formalizing the work of our original Diversity Committee into six groups: Umoja (Black), Auténtico (LatinX/Hispanic), Women, Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents. These groups are focused on building community with both those who identify and allies. They support our education, development and investment in our communities. Each has been given a budget, an executive sponsor, and access to other company resources.

We recognized as a leadership team that we needed to educate ourselves. We were not going to rely on those from underrepresented communities to educate us. We embarked on four three-hour sessions focused on learning about diversity and inclusive language, naming our privilege, and starting the work each of us wanted to do. It was only after these sessions, with clear self-awareness and awakening; that began the work of empowering other leaders -- managers and other Altoids on this journey. There is more work to be done, as Neil Frye, Chief People Officer, mentioned in his blog post in late 2020 -- this is not a sprint, nor is it a marathon; it is life-long work.

Focus on Latinx Senior Manager to VP talent; with targeted outreach, activation and networking for opportunistic and open hiring

Expand employee resource group events throughout the year supporting inclusive environment, educating and investing in our communities

Get to full participation in DEI Workshops and launch additional sessions like What’s My Privilege and Moving to Action across the company

Explore new partnerships with Community & Higher Ed Institutions (i.e. Historically Black Colleges and Universities, Hispanic Serving Institutions, etc.)

2020 Diversity, Equity & Inclusion Report

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Houston!

Alto’s launch in the Houston market extends our industry-leading patient care model to Texas.

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

Houston area residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Need to pick up? Our pharmacy is located at 4950 Terminal Street, Suite 200, in Bellaire.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and currently delivers across the greater Bay Area, Los Angeles, Orange County, Seattle, Denver, Las Vegas, New York City and Houston.

Here’s what you need to know about potential changes to your coverage when your plan updates on January 1st. 

What You Need to Know About Your Insurance in the New Year

With a new year comes new insurance benefits, copay costs, and deductible resets. Here’s what you need to know about potential changes to your coverage when your plan updates on January 1st. 

It is common for insurance companies to adjust their rates and offerings each year and then allow people to select new plans or renew their current coverage. The process enables insurers to update their plans based on inflation, the introduction of new medications, and other market changes. It also provides each of us an opportunity to assess and adapt our health insurance needs every year. 

If you had health insurance this past year, you likely went through an “open enrollment” period in the fall. During that time, you learned how your plan was changing and which key benefits would continue. You then had the opportunity to renew your current plan for another year or switch to a new option altogether. 

Why are insurance renewals important right now?

Most health insurance plans operate on a calendar year, meaning any changes take effect on January 1st. We recommend reviewing any recent changes to your plan to avoid unwelcome surprises later in the year. 

Which insurance updates might impact me the most?

As you review your yearly changes, you’ll want to make special note of the following, as these updates could affect your budget: 

Your premium is the cost of your health insurance plan each month. It’s common for your premium to change slightly from year to year, so be sure to double-check if yours is going up.

Your deductible is the amount you have to pay for healthcare services before your insurance starts to help cover the costs. For example, if your deductible is $2,500, you will need to pay that amount for covered services on your own before your copay kicks in. Your deductible resets at the beginning of the year, which could mean a significant uptick in your healthcare expenses until you spend enough to cover your deductible. Make sure to budget accordingly. 

Your copays and coinsurance—the amount you’ll owe for healthcare services after you’ve exceeded your deductible—may also change. Different types of health services can have different copays, so look closely at the ones you think you’ll use most often. 

A formulary is a list of generic and brand-name medications that are covered by your insurance company. The list includes tiers that indicate which medication versions are preferred by your insurer and therefore offered at a lower out-of-pocket cost for you. 

If you have current prescriptions, you’ll want to make sure that your plan still covers your specific medications. You may also want to find out if there is a cheaper version of your medication available that you can discuss with your healthcare provider. If you fill your prescription with Alto, we’d be happy to investigate the options for you and let you know if there are alternatives that could lower your costs. 

For more on decoding common insurance terms, we recommend this helpful glossary from JDRF. 

What can I do if I find out my medications are more expensive?

Combing through insurance updates can be confusing, especially if you discover that you have to pay more for your medications this year. If copay changes and deductible resets affect your out-of-pocket expenses, we’ll search for any available savings, so you’ll know you’re getting the lowest price. 

If your insurance company requires a written request from your doctor to keep you on the same medication because of formulary tier changes, we’ll work with your doctor to proactively file the paperwork. Plus, we’ll keep you informed the whole way. 

Read more about prior authorizations and how we can help here. 

Yes! Your updated health insurance plan may come with new benefits that can save you money and enhance your health. Look for bonus perks like free annual exams and preventative care; discounts on fitness and nutrition programs, gym memberships, chiropractic care, and massage; savings on health products; and reduced vision care rates. Often, people forget to use these benefits, which can mean money left on the table.

As you make your health plan for the coming year, don’t forget the benefits of choosing a better pharmacy. With a simple switch to Alto, you’ll get insurance support, price investigations, and your medications hand-delivered for free. Plus, you can call or text our pharmacists any time for quick advice. If 2020 saw you waiting in line or on hold to access pharmacy support, let this be the year that the care you need comes directly to you.

Ready to switch to a better pharmacy? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. In this article, we’ll explore some of the financial options available and how we at Alto can help. 

Managing the Costs of Fertility Treatment

For hopeful parents who are struggling to conceive, the costs of pursuing fertility treatment can often seem insurmountable. Though assisted reproductive technology (ART) makes it possible for many people experiencing infertility to become parents, the emotional and financial stakes are high. 

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. However, there are ways to manage or lower the costs so you can move forward on your path to becoming a parent. In this article, we’ll explore some of the financial options available to intended parents pursuing ART and how we at Alto can help. 

If You Have Health Insurance, Start There

Unfortunately, not all insurance plans cover fertility treatments. As you dig into your plan’s details, you may find that some options are covered with contingencies, while others are not covered at all. It’s best to contact your insurance provider for an in-depth explanation of your fertility coverage. 

Be prepared to ask questions about whether your plan covers diagnostic testing, medications, treatments, and consultations. Ask if there is a cap on coverage or a waiting period required to try certain treatments. You want to walk away with a comprehensive understanding of what your out-of-pocket costs might be.

Several states have enacted legislation that requires insurance providers to cover infertility treatments. The American Society of Reproductive Medicine maintains this online database with information by state.

Many fertility clinics now offer no- or low-interest financing. As you seek out the clinic that’s right for you, inquire about what cost-assistance services are available. It’s perfectly reasonable to seek out a clinic that makes you feel confident and fits your budget.

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club and CapExMD to help our customers get the fertility medications they need. Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

There are grants available through government programs, nonprofits, and private companies that can help cover fertility treatment costs. Many are designed to benefit intended parents who demonstrate financial need while others were created to support specific groups, such as veterans or the LGBTQ+ community. There are even some that will award money to those willing to share their infertility story. 

These grants won’t usually cover all of your costs, but they can provide a significant boost. CoFertility keeps a database of fertility grants and other funding opportunities, as does RESOLVE: The National Infertility Association. 

Fertility medications can represent a significant portion of your total treatment costs. At Alto, we’ll always advocate for you to ensure you get the lowest possible prices on your medications. We’ll run a thorough insurance benefits investigation and if your insurer requests a prior authorization, we can work with your doctor’s office to submit it on your behalf. Plus, we’ll remind you to collect any available manufacturer rebates with a monthly email.

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program, which could help you save up to 75% off your fertility medications if you qualify. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

We accept ACH (direct) payments and offer a one percent discount for anyone who prefers this option over using their credit card. And don’t forget—with Alto, delivery of your medications is always completely free.

With mail-order pharmacies, you usually have to order your fertility medications all at once to ensure your precisely timed doses don’t get hung up in the mail. Because it’s difficult to predict exactly how much medication you will need, you often end up ordering excess. Not only will these leftovers add to your out-of-pockets costs, but you’ll also end up with wasted medication that you'll have to dispose of when you're done with treatment.

When you fill your prescriptions with Alto, we’ll hand-deliver your medications from our local fulfillment centers. That means we can deliver your medications every few days, avoiding overorders and minimizing how much you spend. 

Finally, we know that your time is the most valuable resource you have, so we’re focused on giving as much back to you as we can. Send us a simple text when you have a question, and keep all your medication information—plus expert advice—at your fingertips using our mobile app. You can also schedule refills and track your shipments from our pharmacy to your doorstep in real time. If you suddenly need to add a day of injections, there’s no need to stress or go running to the pharmacy. We’ll handle the details and coordinate delivery to your doorstep. 

If you’re interested in learning more, you can request a price quote online. Our care team and fertility specialists would be happy to answer your questions about navigating fertility medications. We know that the start of your ART journey can feel full of uncertainty, but we’re here to do whatever we can to make the process easier and more affordable. 

For more on choosing the right fertility pharmacy for your journey, read, “What to Consider When Selecting a Fertility Pharmacy.”

While it’s not always possible to predict the course of your fertility treatment, it can be helpful to set goals and parameters. Is there a maximum number of in vitro fertilization (IVF) cycles you’re willing or able to try? Are there other options you’d like to pursue first, such as intrauterine insemination (IUI)? What are the scenarios where you might try using donors or a gestational carrier, or consider fostering or adoption?

Once you have an idea of your budget, coverage options, and potential out-of-pocket costs, create a roadmap that outlines your treatment goals in relation to your financial, physical, and emotional well-being. 

Remember—dealing with infertility issues can take an emotional toll, especially if some options feel out of reach financially. Know that you are not alone, and there is a community of other hopeful parents you can lean on. Support groups like RESOLVE and The Fertility Tribe offer virtual meetups and online community groups. It’s also essential to lean on loved ones for emotional support during this time. The journey you’re taking isn’t easy, but you certainly won’t be walking it alone. 

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

We were honored to sit down with Dr. Hildreth to discuss the challenges and opportunities we are facing at this pivotal moment in history. In addition to recounting his inspiring personal story, he shared many profound insights about the COVID-19 pandemic and the state of American healthcare. 

The COVID-19 Vaccine & Racial Disparities in Healthcare: A Q&A with Dr. James Hildreth

In August, we announced that Dr. James Hildreth had joined our newly formed Advisory Board as one of its first two anchor members. Dr. Hildreth’s extensive healthcare expertise has been invaluable as we’ve sought to guide Alto into the future and continue reimagining the pharmacy experience. 

A Fascinating Chat with Dr. James Hildreth

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College—one of the nation’s oldest and largest historically Black academic health sciences centers. He is internationally renowned for his decades of influential HIV research and is deeply entrenched in our current global health challenge as a member of the FDA’s COVID-19 Vaccine Review Committee.

Can you tell us about your background and professional journey?

I grew up in a small town in Arkansas. It was one of those towns where if the two traffic signals were synchronized, you could drive right through and not even notice it. My father passed away when I was eleven years old. Quite honestly, because we were poor and Black, my father received very little medical attention. That was what prompted me to become interested in medicine.

I had no role models to look to, so I went to the library and read books about medicine. At age thirteen, I read a series of books that ranked your chances of getting into various medical schools. One of the universities was head and shoulders above all the rest, so my life’s work became getting into Harvard University.

To make a long story short, I got scholarships to Harvard, Princeton, Brown, Yale, Stanford, and many other places. But because my research had shown that Harvard was the place to go, that’s where I went. I got a job at the medical school, and the professor who ran the lab was also from Arkansas. He took me under his wing, and suddenly I wanted to be an immunologist. 

It was too late to change my major, but I was hooked. I applied for and was awarded a Rhodes scholarship in 1978, becoming the first Rhodes scholar from Arkansas who was Black. I got my Ph.D. in Immunology then went to Johns Hopkins School of Medicine. 

I planned to become a transplant surgeon until I met my very first patient. She was an African American woman with HIV who had just given birth to a baby who also tested positive. At the time, all we could do was watch them die, and that impacted me deeply enough to change my trajectory. I became an HIV researcher, and I have been studying HIV for the last thirty-eight years. 

I have been President of Meharry Medical College for five years. I feel that my life has come full circle because Meharry’s mission is to give opportunities to individuals who otherwise wouldn’t have them. 

Can you tell us more about Meharry’s mission?

Meharry was founded in 1876, but the story is that in 1826, a young, white teenage boy named Samuel Meharry was driving his salt wagon in the backwoods of Tennessee. His wagon got stuck in the mud, so he knocked on the door of a nearby cabin. An African American family greeted him, gave him a place to stay for the night, and helped him on his way. He promised them that if he ever had any resources, he would do something for Black people. 

Sure enough, fifty years later, he and his four brothers made a gift to a central Tennessee college to start a medical department for African Americans. That department evolved into Meharry Medical College.

To be leading an organization whose purpose is to give opportunities to people who look like me makes me feel that my life has come full circle. Meharry is one of four Black medical schools in the country, and without us, the face of medicine in this country would look very different. We are very proud of our mission and I’m so happy to be leading the organization at this time. 

Given that you’re on the FDA’s Vaccine Review Committee for COVID-19, what is your perspective on how we’ve handled the pandemic to date?

It’s hard to avoid acknowledging how politics have devastated our response to this pandemic. Viruses don’t respect borders, especially when you’re dealing with a pandemic virus. We should have had a nationwide response from the very beginning. Ideally, the whole country should have shut down for several weeks. That would have saved tens of thousands of lives.

What are your thoughts on how the pandemic might unfold going forward?

In my opinion, we’re entering a frightening period because we’re at the base of an exponential rise in cases. It’s essential to understand that for every case we diagnose, there are probably four, if not eight, cases that go undiagnosed. Many people don’t know they have the virus and are spreading it. 

Our country represents four percent of the global population but twenty percent of the people who are dying. That’s unimaginable to me. When you’re dealing with an airborne pathogen that can be transmitted so easily, it is unacceptable and unethical not to have stronger leadership and mandates in place. 

Can you share any insights on potential vaccines and vaccine distribution?

I’m on the FDA committee that will review the data from the drug companies and make recommendations about approval. In a couple of weeks, we will review the Pfizer vaccine. I can tell you that the data from both Moderna and Pfizer are very compelling. Both vaccines appear to be highly effective.

Neither of these vaccines is what we’d call a “sterilizing vaccine,” They will not prevent a person from getting infected, but they will limit the amount of disease that occurs after infection. The other exciting aspect of these vaccines is that they represent a new type: messenger RNA vaccines. Rather than using a protein for the vaccine, we’re using a message that encodes for the protein. There was some doubt if this new type of vaccine would work in humans, but it does. This development will facilitate future vaccines quite nicely. 

By the spring of next year, there will likely be two vaccines approved for use. The question is: who will get those first forty million doses that become available? Healthcare workers will probably get them first, then people in nursing homes and assisted living facilities. Many experts, myself included, are trying to make the case that those most vulnerable to disease and death should be next in line. The CDC has already worked with the states to develop distribution plans, but they are not in line with that thinking. There are going to be a lot of intense discussions in the coming weeks. 

What are the healthcare topics that get you most excited—or keep you up at night—right now?

The pandemic has revealed something that minority healthcare professionals have known for a long time: there is a wide gap in the health status of Americans. If you are African American or Latinx and live in certain communities, you are much more likely to have certain chronic conditions. This increased risk is related to your zip code, educational attainment, where you work, and what your job might be, but running through all of this is an underlying current of racism. 

We can’t solve the problem until this country has a necessary conversation about the role of racism in every domain of American life. I like the way that Martin Luther King put it. He said that when you have centuries of neglect, suppression, oppression, or denial, there is an interest that accumulates. The answers to these problems are going to be much more expensive and time-consuming than if we had been dealing with them all along. 

No matter what industry we’re in, all of us need to have tough conversations about what race really means. Take, for example, the sequencing of human genomes. African genomes are the ancestral genomes—all of us can link our humanism back to Africa. But of all the hundreds and thousands of genomes that have been sequenced, very few of them come from folks who look like me. 

It’s the same as my experience in medical school in the 1980s. We learned to treat the average, middle-aged white male because that’s who the studies were centered on. The exclusion of certain groups from clinical trials, programs, and conversations has created a wide gap that we now have to close. We need to have every healthcare institution at the table trying to work on it.

On a positive note, as the pandemic reveals these disparities, many organizations are awakening to the fact that there is work to be done. I’m encouraged by what happened after we witnessed the senseless murder of George Floyd. It was a really painful time for me because that could have been me, my son, or my brother. It could have been any one of us. But the response that we witnessed wasn’t just from African Americans and liberals. It seemed to me that people of all different backgrounds and races came together to say that this is unacceptable. It gave me some hope that we can change this and become a better nation.

What opportunities do you see for Alto in the world of healthcare?

I think Alto has a great opportunity to improve people’s quality of life who need to take medications to improve their health status. Before she passed, my mother would complain about how difficult it was to get her prescription medications. The ability to simplify and improve the process for everyone will positively impact a significant population of people. 

I was humbled that you asked me to be in your advisory group. I’m excited about what you’re doing, and I think it’s going to make a big difference for many people. 

As we approach the holidays, I’d like to share something I’ve told my students. The last thing you want to do is create a situation where this is the last holiday you’ll spend with some of your older relatives. Please be mindful that there is a lot of the virus out there, wherever you are in the United States. Please take steps to protect yourselves and your families. Have a wonderful holiday, but if you can, make it virtual.

Note: This interview was conducted in early December 2020. 

This October, a generic version of Truvada became available in the United States for the first time. In this article we'll explain what these means for PrEP users and how Alto can help.

An HIV Prevention Milestone: Truvada Goes Generic

The world of HIV prevention medications is still relatively new. In 2004, Truvada roared onto the scene and drastically changed the future of HIV. While the medication was initially used to treat HIV, in 2012 the FDA approved its use as a form of pre-exposure prophylaxis (PrEP), a daily prescription medication that prevents HIV infection.

When taken as prescribed, Truvada is 99% effective at preventing sexually transmitted HIV infection. It has been shown to potentially cause decreased kidney function and a small amount of bone loss in some individuals. Though studies indicate these side effects are slight, they present a barrier for people with pre-existing renal and bone density issues. Descovy, an updated form of PrEP, was introduced last year with research showing kidney and bone safety improvements over Truvada. 

Truvada and Descovy are both patented and manufactured by Gilead Sciences. Both are considered highly effective, safe, and well-tolerated by most PrEP users. While Descovy is less likely to cause unfavorable changes in kidney and bone blood tests, Truvada has been shown to have a more favorable impact on blood fat levels and lead to less weight gain. The FDA has not yet approved Descovy for cisgender women or transgender men—more studies are still needed. Those who are uncertain which medication is right for them should discuss the options with their healthcare provider. 

For more on PrEP, read “All about PrEP for HIV Prevention.”

This October, a generic version of Truvada became available in the United States for the first time. Why the delay? When a brand-name medication enters the market, it is protected by patents and granted a period of exclusivity. Now that Truvada’s exclusivity period has ended, manufacturers with generic alternatives may seek approval from the FDA. 

Teva Pharmaceuticals was the first manufacturer to receive FDA approval for a generic version of Truvada. More generic versions will likely follow in 2021, increasing competition and driving down the price. 

Curious about how medication versions work? Read “What’s the Difference between Generic and Brand-name Medications?”

By lowering the cost of PrEP, the emergence of generic Truvada will ultimately put less strain on the U.S. healthcare system and help make PrEP more widely accessible to those at risk of HIV infection. Those who switch to generic Truvada will likely see their out-of-pocket costs decrease; however, there may be consequences for people who prefer Descovy—the newer formulation of PrEP.

In the wake of generic Truvada’s arrival, some insurance companies have decided to stop covering Descovy due to higher costs. While the two forms of PrEP may well be interchangeable for many patients, Descovy is not identical to Truvada. A small subset of people may have less desirable outcomes if compelled to switch versions by their insurers. People who need or prefer Descovy, especially because of preexisting renal or bone density issues, will likely need to obtain prior authorization approval and could face higher out-of-pocket costs. 

At Alto, we specialize in handling prior authorizations and performing thorough cost savings investigations. If we notice a change in your out-of-pocket cost, we’ll let you know, and we can work to identify ways to save you money. Here’s a closer look at how your pharmacy, healthcare provider, and insurance company work together to manage your prescriptions. 

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An HIV Prevention Milestone: Truvada Goes Generic

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