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Alto Pharmacy Technician

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It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

Be Part of a Great Place to Work — Join Our Team

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

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

Blog | Alto Pharmacy

To the greater Alto community: today we’re reaching out with something a bit different.

Our area health systems are experiencing a shortage of the critical personal protective equipment (PPE) that healthcare workers need to stay safe while providing care for the increasing numbers of COVID-19 (coronavirus) patients.

Alto Pharmacy is launching a PPE donation pick-up program to support our healthcare colleagues across the Bay Area (see our courier zone for pickups here). Donations will be retrieved by our Alto courier team and will go directly to the healthcare providers at hospitals throughout our communities. 

Unused disposable N95 respirators and surgical masks.*

Unopened containers of disinfectants and disinfectant wipes

*The packages can be opened, as long as the masks have not been used.

First, confirm that you are in our SF Bay Area courier zone here, and then complete this short form to request a donation pickup. 

Print off this form and follow the instructions for placing the donation items in an enclosed bag. Label the bag "Alto Donation," include the form, and leave the donation bag in the designated safe place before the start of the scheduled pick-up window. An Alto courier will come to pick up the donations - no contact needed!

Requests must be made before 8pm on the evening before the window.

Q: Are you only accepting donations from people who already use Alto's services?

A: No, donations can be collected from anyone in our SF Bay Area courier service zone.

Q: Are you offering this donation pick-up service in your other communities?

A: We're starting with our SF Bay Area neighbors first to make sure we can ensure the donated supplies make it to healthcare professionals in need. If the program is successful, we hope to expand the program to our other communities. 

Q: Which organizations will receive the donations?

A: We're working with a number of healthcare organizations providing front line care in San Francisco, the East Bay and the South Bay.

Q: I have supplies that are already opened and/or used - can I donate them?

A: All supplies must be unopened, unused and in original packaging with the exception of disposable N95 respirators and surgical masks (those can be opened, but unused).

Q: How will you be ensuring the safety of your couriers and those who are donating?

A: Alto's courier team is using a no-contact pick-up process. Our couriers will also be wearing gloves and masks when they pick up the supplies. They will place the supplies into separate bags and dispose of the gloves used after each pick-up. 

Other questions? Please contact community@alto.com.

Help Bay Area Healthcare Workers Fight COVID-19

Alto’s local same-day courier delivery: now with later cutoffs and Saturday service.

Starting Monday, March 23, Alto is offering expanded service for our fertility patients residing in the greater San Diego area. Alto’s weekday cutoff for prescriptions is now 5 pm, Monday through Friday, and we’ve added a weekend afternoon delivery window from 2 - 5 pm.

To ensure the safety and health of both our customers and our courier staff, we’ve implemented a no-contact delivery model during COVID-19. Our delivery model is both safer than a traditional retail pick-up experience and more convenient.

You can send prescriptions to Alto via eRx (search for Alto Pharmacy), over the phone at 1 (800) 874-5881 ext 1, or via fax at 1 (415) 484-7058.

Monday - Friday
Prescribing Cutoff: Rxs received by 5 pm PT and delivery scheduled with patient by 5 pm PT for same-day evening delivery
Delivery Window: 6 - 9 pm PT (6:30 - 9:30 pm PT for outlying areas)

Saturday and Sunday
Prescribing Cutoff: Rxs received by 12:30 pm PT and delivery scheduled with patient by 1 pm PT for same-day afternoon delivery
Delivery Window: 2 - 5 pm PT (2:30 pm - 5:30 pm PT for outlying area)

Customer support hours are 6 am – 9 pm PT Monday – Friday, and 7 am – 6 pm PT on weekends. Download the mobile app for secure messaging or call 1-800-874-5881. 

Quite simply, courier delivery means more control. 

Our evening delivery windows allow patients to more easily plan to be at home to receive their packages. Patients schedule deliveries to the location of their choice - home, work, or hotel - and on the day of their choice. They can even track our couriers in real time on our mobile app!

Every package comes complete with clearly labeled ancillary supplies, a temperature tracker, and cold storage when needed. Our pharmacists and dedicated patient care team is available to answer questions, walk a patient through their first injection, and advise on proper medication handling.

Fertility is Complicated. Your Medications Don’t Have to Be.

Alto knows fertility pharmacy. With more than 50,000 patients served, we understand the treatment complexities and concerns of fertility patients. Alto will automatically connect you with all manufacturer-sponsored financial assistance programs for qualifying prescriptions. Alto also works with many fertility benefits programs, including ProgynyRx, and many leading financing and loan providers. If we cannot bill your insurance, we’ll find you a pharmacy that can.

At this time, Alto is only offering fertility medication services in the San Diego market. Any updates to service areas and offerings will be available at alto.com/locations.

Alto Pharmacy Expands Local Daily Delivery in San Diego

Stephanie Curry is famous at Alto. No, she’s not related to Steph Curry, she’ll say right upfront, but Stephanie is known at work for her joyful, carefree singing that echoes through our Alto Pharmacy headquarters in San Francisco. She brightens our day. And among Alto’s patients, Stephanie is beloved for her reliable, friendly service, delivering medications to their doorsteps — along with big, warm hugs.

Q: What do you do at Alto and how did you learn about Alto?

A: I drive for Alto and deliver medications to patients’ homes, six days a week. I’ve worked all my life from delivering newspapers when I was 11 to being a nursing assistant in home care centers and to driving for Uber. When I heard about Alto, that I could deliver medications to patients, I applied and got the job! I’ve been driving for Alto for almost two years and I love that it gives me space to do my thing and I get to see patients.

Q: Tell us about some of the patients that are most memorable to you?

A: There’s a patient I’ve been delivering medications to for months, and usually it’s a family member or caregiver who answers the door. I see the medical equipment so I figure the patient is ill or bed ridden. But then one day, I drive up to the house and I see this elderly woman, sitting on the porch. It’s the patient and she’s waiting for me! She told me that she hears my friendly voice every time I come and that she wanted to come out to meet me in person and tell me how much she appreciated me. She gave me a big hug and that’s how I started to get to know her.

Editor’s note: At Alto, we’ve heard from countless patients who have also been touched by Stephanie. Not only the patients, but often the patient’s caregivers, children, and dogs look forward to Stephanie’s Alto deliveries.

Q: Do you know all your patients by name?

A: I work the East Bay regularly so I get to know the roads, the houses and the patients pretty well. Whenever I see a patient, I always greet them by name, like “Hello, Miss Maria”. No one taught me that — I just think it’s natural really, the only way to communicate with one another. People already have so much going on, having to take medications — they don’t want to feel like another number. So I want them to know that I know them. I love that this company is about dealing with people — it’s personal, you know who you can talk is a live person, you can see their face.

Q: And what makes you memorable to patients?

A: My hugs. A lot of patients ask me for hugs, and I don’t hesitate. Oh, and my car. Patients tell me that when they get a notification from Alto that their delivery is a few minutes away, they look out the window. They always know it’s me when I step out of my shiny, black Lincoln car. I know it’s not a typical car for a courier, but I love it. My husband bought it for me and he’s the love of my life. We were married 31 years and we have three beautiful children together. So I drive that car wherever I go.

Q: What do you do for fun, outside of Alto?

A: I love to play Bingo  —  I’m the Bingo Queen, I just came back from Vegas. I also love to cook. I used to run a restaurant in Sacramento and my family raves about my Gumbo. I just live, enjoy life, because as I tell my friends and family, you can’t take nothing with you when you leave!

Delivering Care to Patients: An Altoid Profile

Breaking Open the Black Box of Medication Pricing

Anna left her doctor’s office with a glimmer of hope. For months, Anna had been struggling with digestive issues and now her doctor had suggested they try a promising new medication. Finally, she thought, maybe this new medication could provide some relief and her life could return to normal. But when Anna arrived at her pharmacy, she was shocked to discover the medication would cost $400 per month! The pharmacist at the counter explained that if she couldn’t afford the copay, she would need to call her insurance or her doctor to “figure it out.” Frustrated and overwhelmed, Anna left the pharmacy empty-handed and with the distinct feeling that healthcare had been designed to work against her.

Unfortunately, Anna is not alone in encountering obstacles that prevent her from getting the medication she needs. From the moment we leave the doctor’s office, we are thrust into a maddening, depersonalized system that feels like a big black box. We are left to navigate it all on our own, especially when it comes to medication pricing. 1 in 3 Americans admit that they aren’t taking the medication they need because of cost. This is not only harmful to our long term health as patients, but also a devastating cost to our country. It is estimated that there are 125,000 avoidable deaths per year and nearly $300 billion in downstream medical costs due medication non-adherence. You may have heard stories of diabetic patients who, faced with climbing insulin costs, died from skipping doses or resorting to cheaper alternatives. For these patients and their families, getting the right medication is an issue of life or death. And for many like Anna, it’s, at the very least, very high stakes.

Today, medication pricing is set by multiple stakeholders in a process that is entirely hidden from patients and doctors:

Your employer contracts with a pharmacy benefits manager (or “PBM”, like Caremark, Express Scripts, etc.) whose job is to determine which medications should be covered or not under your insurance plan (even down to the exact dosage and brand that your doctor prescribes).

The PBM negotiates with the drug manufacturers to agree upon a specific price to charge the employer for a medication, the remaining copay for patients, and the PBM’s hefty cut for administering the service. It’s not hard to imagine how commercial incentives might color decisions on which medications are covered and how they are priced.

Drug manufacturers also offer copay assistance programs for select medications, with varying eligibility criteria, but these are marketed primarily through doctors, meaning patients often don’t know these assistance programs exist or if they qualify.

Today, none of this data is transparent or shared. These parties (doctors, drug manufacturers, PBMs) do not have the incentives nor the technology in place to coordinate with one another to act in the patient’s best interest. Drug manufacturers and pharmacies get paid by the medications dispensed, doctors get paid by the appointment/procedure, and PBMs get paid through taking a hefty cut of the negotiated medication price. These parties are naturally incentivized to pursue a path that delivers the highest financial return with the least amount of effort. Sitting in the center of this web, pharmacies are uniquely positioned to coordinate the best outcome for the patient. Traditional retail pharmacies, however, don’t have access to technology solutions that would easily bridge the gap between insurer, manufacturer and physician. It’s no wonder medication prices continue to climb and the process of getting medication remains so inefficient.

At Alto, we asked ourselves, “What if every patient could have a pharmacy expert on standby to help him/her navigate the complex world of medication pricing?”

We believe that pharmacy’s role is to make the process work around patients, rather than asking patients to learn how to work the system. So we built a modern pharmacy software platform that enables our Alto pharmacists, billing specialists and patient advocates to coordinate between doctors and insurance companies to ensure patients have clear choices and transparency on medication pricing.

Alto is the first pharmacy to proactively:

Show patients the price of a medication both with and without insurance, within minutes of receiving their prescription. These prices matter because sometimes the price without insurance is actually cheaper.

Match patients with savings and copay assistance programs offered through drug manufacturers. Often, patients and doctors don’t have time to manually keep track of these programs, so our service automatically searches for eligible programs.

Help patients and doctors navigate the complexities of insurance, whether by identifying an alternative medication that is more affordable under the patient’s plan or helping to petition insurance to cover the medication (a process called Prior Authorization). Compiling all the paperwork and medical history data required by these insurance processes takes up valuable time from doctors (estimated at 20 hours of work per week per doctor). Our technology automates this process so patients can quickly get access to the medications they need.

Here’s what all this means for a patient like Anna:

When Anna told her doctor about the expensive copay, her doctor sent the prescription to Alto. Anna’s doctor knew that Alto would help with the paperwork needed to petition insurance to cover a patient’s medication. Within a few hours, Anna received a notification from Alto that they’d worked with her doctor to start the process with her insurance. In the meantime, Alto had matched her with a program from the drug manufacturer that would reduce her copay so she could get started on her therapy right away. When her first Alto package was delivered that evening, Anna regained that early glimmer of hope, relieved to have the Alto team in her corner. Within days, Anna’s insurance approved the coverage, and Anna has been able to stay on the medication, better managing her symptoms (and her medication costs) for over a year now. Anna has been able to focus on her health and feel some semblance of her new “normal.”

Since Alto Pharmacy opened four years ago, we’ve had the privilege to help hundreds of thousands of patients and physicians. By harnessing the power of our pharmacy team and our technology, patients get access to the best medications, at the best possible prices, delivered to their home the same day. 

We are proud to be cracking open the black box surrounding medication pricing and giving Alto patients a new level of transparency and control in their health journey. And we are hopeful that with increased awareness and patient advocacy, systemic changes are on the way that will help make medications more accessible and affordable for everyone.

Monica Tran has led the Product and Design team at Alto for two years, helping build a suite of products for pharmacists, physicians and patients that allows Alto to break down barriers to medication access and transform the pharmacy experience. She recently transitioned into a leadership development and coaching role, helping to scale Alto’s organization, values and patient experience.

Editor's Note: The post was updated on November 8, 2021 to reflect the rebrand of AltoMD to Alto Connect.

Choose when and how you are notified about prescriptions with our Prescriber Notifications feature.

Starting tomorrow, February 14th, Alto Connect users have access to improved prescriber-based notification options in Alto Connect. These new settings help users manage which patient prescriptions generate email notifications for pharmacy actions.

Control which patient prescriptions generate email alerts when there are pharmacy questions or actions;

Subscribe to updates by the patient or by the prescriber; and

Keep your email inbox clean and focused only on the patients you work with on a daily basis.

Occasionally, Alto will need additional information from a clinic to fill a patient’s prescriptions. For clinics using Alto Connect, the Alto team can send brief messages via the portal rather than having to reach out via phone, voicemail or fax. These messages can be quickly responded to in between rooming patients or while handling other administration duties — no more waiting on hold or playing phone tag with the pharmacy!

Notifications allow Alto Connect users to receive email alerts when there is a new message requiring the clinic’s attention. To help you limit which patient alerts you receive, Alto Connect has offered the ability to subscribe to an individual patient (get alerted for all messages for that specific patient). Our new prescriber-based notifications allow an Alto Connect user to subscribe to updates for all patients for a given prescriber (get alerted for all messages for all patients with scripts written by that prescriber).

Alto Connect is designed to keep you off the phone, away from the fax machine, and focused on your patients. Our existing patient-based subscription functionality allowed users to get targeted notifications about patients, but required active management in the patient directory to keep up to date on all needed subscriptions. Opting into a prescriber’s notifications means it’s easier to get all updates on the patients you care about, with fewer steps.

Prescriber Notifications: Select which prescribers at your practice you would like to follow; by following or subscribing to a prescriber, the user will receive email alerts when there are pending pharmacy actions requiring attention.

Revamped Settings page: Your user profile and notifications settings are now at the top of the page; click into the “Notifications Settings” module to add (or remove) prescribers that you want to receive updates on.

Revamped Patient Directory filters: Filter the patient directory listing by notification status: all, following, not following; this filter will show all individual patients you have subscribed to, both individually and by prescriber.

Alto Connect is a complimentary service that allows prescribers and clinic staff to track prescriptions, view medication histories and message directly with the Alto Pharmacy care team. By streamlining prior authorization workflows and coordinating with insurance companies, Alto Connect helps clinical teams stay focused on patient care.

If you have any questions, feedback or ideas, please email providersuccess@alto.com or reach out to your Partnerships Manager.

More Choices and Control With New Alto Connect Notifications

Today, we are excited to announce a $250 million Series D funding round, bringing our total funding to over $350M.

Bringing Alto to a Neighborhood Near You

Mattieu Gamache-Asselin, CEO & Co-founder

Today, we are excited to announce a $250 million Series D funding round, bringing our total funding to over $350M. We are honored to welcome Softbank to our team of investors and thrilled that our existing investors — including Greenoaks, Jackson Square Ventures, OliveTree Capital, and Zola Global — have reinvested to accelerate our mission to bring the Alto experience to 100 million people by 2025.

Over the past four years, we’ve delivered over 1 million prescriptions directly to our patients’ doors, and created a service that makes our patients happier — our patient NPS is over 80 for the fourth year in a row — and healthier — our medication adherence rate is 77% compared to an industry average of 50%.

This has been possible because we’ve learned from experienced community pharmacists, we’ve reimagined and rebuilt the underlying infrastructure of pharmacy, and, most important of all, we’ve built an amazing and diverse team that truly lives out our values every day. Never in my wildest dreams did I imagine I’d get to work on such a meaningful mission with such a genuinely passionate and talented team. Whenever I have a tough day and need a boost of energy, I walk through our pharmacies and look around in awe at all the hard work, care and perseverance that goes into making this type of service possible for our patients — from our pharmacists and patient care champions to our couriers and product managers, all working together.

This new round of funding will enable us to take everything we’ve built and learned over the past four years and bring it to more people and more patient demographics. I’ve seen many companies scale too quickly, hire too fast, and in that process lose sight of the heart of the company’s values and mission. What is most important to me as Alto enters this next chapter is that we maintain the same empathy and human connection we’ve had since we were a small community pharmacy.

I want to thank our team for joining us on this mission, to thank our investors for believing in us, and most importantly, I want to thank our patients for reminding me every day of why we’re on this journey.

Alto’s launch in the Seattle market extends our industry-leading patient care model to Washington state.

Alto Pharmacy Launches Local Daily Delivery in Seattle Metro Area

Starting Tuesday, January 21, fertility patients in the Seattle metro area can now choose Alto’s same-day doorstep delivery and have their medications delivered by our Alto team.

Our evening delivery windows allow patients to more easily plan to be available to receive their packages. Patients schedule deliveries to the location of their choice — home, work or hotel — and on the day of their choosing. They can even track our couriers in real time on our mobile app. Next-day mail order service is also available for patients outside of the courier zone.

Courier delivery windows
Monday — Friday: 

12:30 pm - 3:30 PM (1:30 -4:30 pm PT for outlying area) 

6:00 pm – 9:00 pm PT (6:30 pm to 9:30 pm PT for outlying areas)

2:00 pm – 5:00 pm PT (2:30 pm - 5:30 pm for outlying areas)

Walk-in hours
Monday — Friday: 9 – 7 pm PT
Saturday: 8 am – 4:30 pm PT 

Fertility patients interested in using Alto’s services for their medication needs can ask their care team to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax).

Alto knows fertility pharmacy. With more than 50,000 patients served, we understand the treatment complexities and concerns of fertility patients. Our dedicated patient care team is available in the evenings and on weekends to walk you through your first injection or answer questions about medication storage, dosing or interactions. Our fertility deliveries include all necessary ancillary supplies, such as syringes, sharps container and alcohol swabs, and are carefully packaged for temperature control. Delivery is always free.

Alto will automatically connect you with all manufacturer-sponsored financial assistance programs for qualifying prescriptions. Alto also works with many fertility benefits programs, including ProgynyRx, and many leading financing and loan providers. If we cannot bill your insurance, we’ll find you a pharmacy that can.

At this time, Alto is only offering fertility medication services in the Seattle market. Any updates to service areas and offerings will be available at alto.com/locations.

Editor’s Note: This post was originally published in January 2020 and has been updated for accuracy and completeness.

Alto Pharmacy Expands Local Courier Delivery to Sacramento and San Diego

Expansion of daily courier delivery to Sacramento and San Diego means greater control and reliability for fertility patients across California.

Fertility patients in the greater Sacramento and San Diego metro areas can now choose Alto’s same-day doorstep delivery and have their medications delivered by our Alto team.

Our evening delivery windows allow patients to more easily plan to be available to receive their packages. Patients schedule deliveries to the location of their choice — home, work or hotel — and on the day of their choosing. They can even track our couriers in real time on our mobile app. Next-day mail order service is also available for patients outside of the courier zone and for Saturday deliveries.

San Diego courier delivery windows:
Monday — Friday: 6–9 pm PT
Saturday — Sunday: Not available at launch

Sacramento courier delivery windows:
Monday — Friday: 7–10 pm PT
Saturday- Sunday: Not available at launch

At this time, Alto is only offering fertility medication services in the Sacramento and San Diego markets. Any updates to service offerings will be available at alto.com/locations.

Alto Pharmacy Expands Local Courier Delivery to Sacramento 
and San Diego

Alto Pharmacy Launches Local Daily Delivery in Denver-Boulder Metro Area

Alto’s launch in the Denver-Boulder market marks Alto’s first courier-based expansion outside of the West Coast.

Starting today, October 14, fertility patients in the Denver-Boulder metro area can now choose Alto’s same-day doorstep delivery and have their medications delivered by our Alto team.

Courier delivery windows:
Monday - Friday: 

2:00 – 5:00 pm MT for Denver metro area

Fertility patients interested in using Alto’s services for their medication needs can ask their care team to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Editor’s Note: This post was originally published in October 2019 and has been updated for accuracy and completeness.

Starting today, August 13th, prescribers and clinics using Alto’s AltoMD platform have access to a new feature set designed to help clinical partners understand the current status of any medication sent to Alto and exactly what will happen next.

Track Every Prescription Through Every Step

Editor's Note: The post was updated on November 8, 2021 to reflect the rebrand of AltoMD to Alto Connect.

True visibility with Alto Connect’s improved patient profile pages

Starting today, August 13th, prescribers and clinics using Alto’s Alto Connect platform have access to a new feature set designed to help clinical partners understand the current status of any medication sent to Alto and exactly what will happen next. Track a medication as it moves through the full Alto workflow (now with more detail!), view patient contact logs, and drill down into medication histories.

Alto Connect is designed to keep you off the phone, away from the fax machine and focused on your patients. Our previous patient profile pages answered some questions about medications but didn’t go far enough in helping clinic teams understand exactly where each prescription falls in the fulfillment process or how to help move things along. These improvements allow Alto Connect users to:

See how and when Alto is contacting our shared patients;

Determine exactly where a prescription is in the Alto fulfillment workflow;

Quickly understand any blockers to getting the prescription filled; and

New Patient Contact Log: See when and how Alto is communicating with our shared patients, including phone calls and in-app messages.

Revamped Patient Medication List: Filter and sort by medication name, fills remaining and delivery status.

New Medication Detail View: View the current active prescription details, progress through the Alto fulfillment process, related inactive prescriptions and detailed medication history.

You can also message the Alto pharmacy team with patient specific questions and subscribe to updates from the patient profile page.

Alto Connect is a complimentary service that allows prescribers and clinic staff to track prescriptions, view medication histories and message directly with the Alto Pharmacy care team. By streamlining prior authorization workflows and coordinating with insurance companies, Alto Connect helps clinical teams stay off the phone, away from the fax machine and focused instead on patient care.

The Founding Story of Alto

On August 1st, 2015, I was so excited to move into my shiny, new office: a storage closet. I looked across to my co-founder, Jamie, and wondered how two engineers from Facebook ended up in the back of a small, family-run pharmacy in the Mission.

Earlier that summer, Jamie and I had left our jobs to start a company that could create lasting change in the world and have massive impact on people’s lives. We were drawn to healthcare and shocked to learn that in the U.S., 50% of people don’t get or take their medications as prescribed. This problem, referred to as medication non-adherence, is one of the country’s leading causes of hospitalization and deaths, and is often due to the high costs and friction in the pharmacy experience. We’d both been at big, retail pharmacies and saw how broken the system was — deeply inefficient and in many ways, inhumane. So, we decided to start by tackling pharmacy.

We ran some Facebook ads, offering a pretty simple service that would pick up your prescriptions and deliver them to your doorstep. That first week, we succeeded in delivering medications to our first happy, paying customers. We thought speed was the key benefit, so we named the company “ScriptDash.” Little did we know, we would need to build so much more (including a new company name, Alto — a nod to a higher, elevated experience).

We heard about a small, beloved community pharmacy, called AG. Located at Army & Guerrero in the Mission district, AG had been owned by pharmacist Vivian Cheung for over 30 years. We befriended Vivian, and she let us follow her around and learn. As weeks went by, we became more curious and amazed by all the backend steps required to make things work — not only behind the counter at the pharmacy, but also between the doctor, the insurance companies and the patient. Vivian was very kind and patiently explained every step to her two newest ‘interns.’

One day, we were watching Vivian prepare a prescription for a patient, Walter, when she noticed that the copay increased from last month’s copay by a few dollars. Vivian knew that for Walter, a few dollars would matter to him. We watched Vivian pick up the phone to call Walter and explain the copay change. Walter was thankful for Vivian’s call and ultimately came in to pick up his meds that evening. It was that day when I realized that what patients need is for their pharmacist to really know them — the way Vivian knew Walter’s health conditions, medication history and his preferences — so that pharmacists can help patients navigate the complexities of healthcare and get the medication they need. I was excited to think about how technology, alongside a caring, patient-focused pharmacy team, could help us bring this type of experience to millions of patients who desperately need an expert pharmacist like Vivian in their corner. It quickly became clear to us that what patients needed was way more than just delivery, that in order to do this right, we needed to be a fully-fledged pharmacy.

Looking back, one of the most important moments in Alto’s history was raising enough capital to purchase AG pharmacy, allowing us to continue partnering with Vivian and her team. We were fully aligned on our mission, and couldn’t have imagined doing this with anyone else.

Being fully immersed in the pharmacy and working alongside pharmacists every day allowed us to more deeply understand the issues with the existing pharmacy experience and why so many patients don’t get or take their medications as needed. We quickly built out our team, bringing together even more expertise across both technology and healthcare, grounded by the core values and caring ways we learned from AG. That first year, we also built the core pieces of our technology stack — our pharmacy operating system, our physician collaboration tool and an app for Alto patients.

Fast-forward to today. We’ve far outgrown that storage closet. We now serve tens of thousands of patients across multiple cities and multiple specialties, all made possible by our incredible team of nearly 300 and the technology platform we’ve built. We’re able to better educate patients about their medication and pricing, deliver medication to their doorstep and provide expert pharmacist advice on an ongoing basis. We are thrilled when customers tell us that they are happy (our NPS satisfaction rate is 80+, compared to pharmacy chains with 5 points) and healthier (we’ve seen our patient’s medication adherence rise to 70% from the industry norm of 50%). That first year with AG really shaped our vision for what a great pharmacy could be and the type of multidisciplinary team we’d need to build it. It’s amazing to think about how far we’ve come, but in many ways, it still feels like the early days. There’s so much more we need to do to bring this type of caring, community pharmacy experience to all the patients who need and deserve it. We are still just getting started!

Are You Right for Alto?

Why Mission-Driven Software Engineers Hold the Key to Alto’s Continued Success

Alto is the world’s most people-centric pharmacy. Our goal is not simply to distribute medications but to improve health outcomes and quality of life. What’s more, we want to make those improvements accessible to everybody.

To get to that point, we need to understand what is preventing people from accessing all the benefits medicine has to offer. We believe it’s especially important to address non-adherence, which is when people don’t take medications as prescribed. Non-adherence is a national problem that causes 125,000 avoidable deaths per year (more than three times the number of car accident deaths) and $300 billion in avoidable medical costs (more than half the money spent on pharmacy as a whole).

It also means learning how to scale our technology and processes to bring our products to a bigger swath of the population. To achieve both of these things, we need to first scale our engineering team.

Because of our unique business model, Alto is positioned to pursue three exciting growth vectors:

New Therapeutic Specialties: In addition to our general pharmacy capabilities, we have developed specialized expertise and infrastructure for managing complex treatments like fertility, dermatology, HIV, psychiatry, and other therapies that come with sticky coordination issues and unique considerations. We have made it easier than ever for people to navigate these treatment areas, but there is more we can do. Our team has identified 26 additional treatment areas that could benefit from specialized technology and processes. Mastering those areas is high on our to-do list.

New Geographic Markets: By expanding into the top 50 U.S. cities, we could potentially serve 55% of the country’s population. If we expand to the top 100 cities, our coverage would increase to 70%.

New Clinical Partnerships: Alto facilitates coordination between our team, healthcare providers, insurance companies, and the people taking the medications. In the process, we improve workflows and health outcomes. That offers a powerful benefit to clinics, medical groups, and hospital systems. Because of that reputation, we currently have a waiting list of healthcare providers who want to partner with us. That’s more demand than we can keep up with, which isn’t such a terrible problem.

When Opportunity and Demand Exceed Capacity

Alto is in a fortunate position. It is rare among companies to have multiple compounding growth vectors and a reserve of would-be partners angling for our product. We are not demand constrained, we are operationally constrained, and even then, we continue to double our business every six to nine months — just not as quickly as our potential promises.

Scaling up as a means of reaching our potential is an exciting challenge we’re already tackling. In late 2018, we closed our Series C, giving us the fuel we need to build out our engineering team and develop the technology and processes that will make our continued growth possible. That work will entail fleshing out each of our existing product areas, scaling them, and identifying and solving even more deep-rooted industry issues through better technology and better processes.

Currently, Alto boasts a small but talented and agile engineering team staffed by individuals who honed their experience at some of the biggest names in tech like Facebook, Google, Uber, 23andMe, MIT, Stanford, and Berkeley. All of our engineers are relatively senior, so everyone has autonomy and ownership over their projects. It’s a collaborative, supportive, mission-driven environment, which is how we’ve been able to build so much in a relatively short period of time.

Up until now, we have been deliberate about keeping the team small, but we’ve reached an inflection point. In the next 18 months, we’re looking to increase the engineering team four-fold. With our new team in place, we will be in a great position to focus on our objectives: building and perfecting our operational efficiencies and product scalability.

We’re approaching the challenge of scalability from a few angles:

One is automation. We want to take the algorithms that are in our employees’ heads and put them into code, so they can focus more on caring for patients rather than logistics. We’ve done a bunch of automation work already, but there’s a lot left to do.

We’re also intent on designing tools to help our own team be more efficient with their time, which will mean better UX, better UI, more batching, and less context switching.

The third angle is self-service, and it’s the one we’re focused most intently on. Right now, there is significant human interaction between our team and consumers because we want to make sure consumers have the information they need to make optimal healthcare decisions. In our next phase of growth, we want to automate that process without losing any transparency or depriving a consumer of any agency, no matter their technological competence.

Essentially, we want to build the pharmacy version of TurboTax (without the part about lobbying to keep the system broken). With the right prompts and information, TurboTax walks users through the U.S. tax system, which is huge and complicated. In effect, the user becomes totally self-servicing. We want to do the same for the people who use Alto. That said, not everybody is proficient or comfortable with technology. In the spirit of accessibility and inclusivity, it will still be important that everyone who uses Alto also has the option to speak to a real, knowledgeable, and friendly person to get their questions answered and needs met. We have a responsibility as a healthcare provider to take care of all our patients, no matter how tech-savvy they might be, but for these patients we can still use technology to enable our team to get the patient the best possible option, quickly and easily.

Our engineering team is working toward products with even more expertise built in. In the process, we will also make our operations more efficient and more scalable, unblocking barriers to expansion in existing markets, new markets, and new verticals.

When we succeed at that alignment, we stand to change the nature of the industry. To get there, we will continue to grow our engineering team with right-fit, world-class talent that not only has the skillset to take Alto to the next level but also the values to keep us aligned and mission-driven in the process.

Learn more about Alto’s company values and mission-driven work culture.

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