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Alto Pharmacy Technician

Alto Pharmacist

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When it comes to critical pharmacy needs, patients with diabetes often feel like they’re navigating the complexities of their care paths with very little control or clarity. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

The Best Pharmacy for Your Diabetes Care

Millions of Americans suffer from endocrine disorders, caused when hormone levels are either too high or too low or when the body doesn’t react to hormones the way it’s supposed to. Some of the most common endocrine disorders include Type 1 and Type 2 Diabetes (which affect over 30 million Americans), thyroid disorders (over 20 million Americans) and osteoporosis (10 million Americans). When it comes to critical pharmacy needs, patients with endocrine disorders often feel like they’re navigating the complexities of their care paths with very little control or clarity. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

Meet Josh. Josh has Type 2 diabetes, an endocrine disorder that affects the way his body processes blood sugar (glucose). He visits his local pharmacy two-to-three times a week to pick up his various medications and medical supplies, which are each filled at different times. When he’s at the pharmacy, he is faced with long drive-thru lines or crowded store aisles and phones ringing off the hook. There have been times when Josh has arrived to pick up one of his medications or his insulin pump only to find out that they are no longer covered by his health insurance. Along with the burden of scheduling various pick-ups and dealing with unexpected costs, Josh worries there will be a time when he needs one of his critical medications, and he won’t be able to reach his pharmacist for help. 

Many of the brand-name medications commonly prescribed to diabetes patients simply aren’t covered by health insurance plans or come with strange restrictions. Patients can arrive at their pharmacy to find that their medication is only covered for their first “x” doses, or in some cases, not covered at all. Left with the stressful decision of whether to pay higher-than-expected prices or return home empty-handed this can often deter treatment from starting on time.

No guaranteed access to medication or their pharmacist

People living with diabetes often suffer from multiple comorbidities, increasing the complexity and number of their medications. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. Retail pharmacists can be difficult to get a hold of, especially with the increasingly long lists of administrative tasks they are asked to complete. Diabetes medications are critical: missing one dose or experiencing one contraindication can be life-threatening. Added time spent waiting for a pharmacist to answer can be stressful and, in some cases, dangerous.

Doctors are often kept in the dark along with their patients when it comes to costs and insurance- based restrictions on medications. The current system is designed such that doctors often have to perform investigative work and complete prior authorizations with insurance in order to get a patient’s medication covered, meaning hours of extra calls and paperwork. When someone like Josh has an issue with the cost of their medication, they can’t simply swap it out for a new one. They have to connect with their doctor who can perform the necessary research to find them a new medication.

At Alto, we believe that everyone deserves exceptional pharmacy care. We are here to reduce the stress and confusion that comes with navigating insurance, and we offer transparent, consistent communication so you always understand your options. Our specialty pharmacy team will help sync your many medications into one delivery, get you set up on automatic refills, and work with your doctor on any prior authorizations needed for your medications.

Our pharmacists and billing specialists work with doctors and health insurers proactively to ensure the medications you are prescribed will be covered. We take on the investigative work and communicate the cost upfront so there are no surprises. We ensure you get the best prices on your medications - including branded oral and injectable medications - and we automatically apply any coupons or copay cards.

We’ve created a team of patient care pharmacists who are solely dedicated to answering questions and walking patients through their medications, so you’ll never spend 40 minutes waiting on hold. We provide real-time support via our mobile app or over the phone seven days a week, including evenings. If you have questions around a refill or need a refresher on injection instructions, you have direct access to help.

We deliver medications directly to your doorstep - for free! - and eliminate those dreaded, numerous trips to the pharmacy with crowded aisles, long wait times and no sense of privacy.

With Alto you’re always in control over when you want to receive your medications. Simply choose the delivery window that’s best for you and track your courier in real time. 

Ready to get started or want to learn more about Alto? 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 other qualified health provider with any questions you may have regarding a medical condition.

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. Here are a few things you should know now to feel empowered about your health.

Managing Your New Diabetes Diagnosis

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. While it’s completely understandable to feel overwhelmed, we assure you, your confidence will grow as you get a good grasp on the basics. Here are a few things you should know now to feel empowered about your health.

There are many genetic and environmental factors that played a role in your diagnosis. Having diabetes means your body isn’t functioning as it should, and that is not your fault. What matters is what you can do to improve your outcome going forward. 

Diabetes isn’t curable, but it is absolutely manageable. With care and consistency, you can live a long and healthy life. Though there can be very serious consequences if the disease progresses without treatment, know that these outcomes are largely avoidable. Commit now to following your treatment plan and learning everything you can about your diagnosis. You won’t be alone—our pharmacists and care specialists will be there to help. Your lifestyle will play a large role in managing this disease and that’s great news. It means you have power over your future health.

At first, keeping track of your health stats may make your head spin. Know that it gets easier, and soon you’ll be a well-versed pro. To start, the National Institutes of Health (NIH) recommends getting to know three important numbers:

A1C - This blood test will provide insight into your blood sugar levels over the past few months so you’ll know if your treatment has been working. 

Blood pressure - Diabetes puts you at a higher risk of heart disease, so it’s important to keep this number in a healthy range.

Cholesterol  - Diabetes and high cholesterol often go together, which can further increase your risk of heart disease. 

Your doctor can help you understand what your target numbers should be and how you can stay within a safe range. Your goal numbers will be unique to you, so be sure to fully discuss them with your healthcare provider and set up a plan for regular testing and checkups. 

You’ll likely need to test your blood sugar on your own, either throughout the day or from time to time. This will help you determine how your medications, specific foods, and certain types of exercise impact your blood sugar levels, as well as other factors like stress. Your doctor will let you know how often you should test and what your target range should be. 

Logging your results will help you notice patterns and see your progress. The Diabetes Teaching Center at the University of California, San Francisco offers a free, printable logbook that can help you get started. You can also use an app like Glucose, or mySugr which will take care of much of the work for you, allowing you to set reminders and view trends over time. 

In most cases, you’ll need to take medication. With type 1 diabetes, you’ll require some form of insulin therapy—either injections or an insulin pump. Treatment can be quite varied for type 2 diabetes. You may need insulin, oral medications, both, or none at all. Your doctor may also prescribe medications for high blood pressure or cholesterol.

It’s important to know that type 2 diabetes is a progressive disease, and your treatment may change over time. However, changes in your prescription are not an indication that you’re failing somehow. Your goal should be focused on maintaining normal blood sugar levels and keeping those important numbers in a healthy range, not on which medications you’re taking. 

We know this is a lot to take in, so the patient care pharmacists at Alto can provide you with a free consultation to discuss your medications. From answering questions about side effects to helping you set up dosage reminders, we’ll help you feel confident and informed. 

Food and exercise affect your blood sugar levels, so you’ll need to pay close attention to both. It’s not just about what you eat, but the size of your meals and the balance of carbohydrates, protein, and fats. You don’t need to cut out carbs completely, but you’ll likely need to learn to count them to make managing your blood sugar easier. The CDC offers a great breakdown of how this works and enlisting the help of a registered dietician can take some of the pressure off as you learn. 

Like the rest of your care plan, this will become more and more effortless with time. At least for now, we recommend finding resources with recipes that are designed specifically for diabetes. The American Diabetes Association’s Food Hub and Eating Well’s Diabetes Diet Center are excellent places to begin. 

In addition to the testing we already described, you should plan to get a yearly physical and eye exam and see a dentist every six months. Diabetes complications can cause damage to your eyes, nerves, kidneys, and gums, but controlling your blood sugar and getting regular check-ups will help you detect any issues early and prevent these problems.

It’s important to let those closest to you know about your diagnosis. There will be times when you get frustrated or discouraged, so make sure you have someone to confide in when you need support. 

To get a better idea of what a happy and healthy life with diabetes can look like, join some of the many online communities that are available on almost every social media platform. Try searching “diabetes” within Facebook’s groups or exploring the American Diabetes Association’s online Support Community to start connecting with others who can truly understand what you’re experiencing. 

Lastly, if you think you might be experiencing depression, or your mental health is suffering in any way, please seek out help from a mental health professional. Ask your doctor if they can refer you to someone who specializes in chronic health conditions. Please don’t try to go it alone, there is so much support available to you. 

We know there’s a lot to unravel with a new health diagnosis, but this information is meant to empower you to thrive. While you undertake the task of learning and adjusting, we’d be happy to take care of your prescriptions—walking you through your first insulin injection to delivering medications right to your door. 

Interested in switching to Alto? We’ll handle the transfer. 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.

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

More Americans than ever are receiving their prescriptions through the mail. But with recent United States Postal Service (USPS) policy changes to delivery times, prescription mail-order delivery is no longer a reliable or affordable option.

Concerned about Mail Delays tying up your Prescriptions? There’s a Better Way.

How to avoid postal delays and pharmacy lines with Alto

More Americans than ever are receiving their prescriptions through the mail due to increased interest in delivery, greater convenience and the safety of avoiding crowded pharmacies. But with recent United States Postal Service (USPS) policy changes to delivery times, and temporary price increases due to the upcoming holidays, prescription mail-order delivery is no longer a reliable or affordable option for many people

In 2019, over 170 million prescriptions were filled by mail in the United States. According to a recent report, that number increased by 20% since the onset of COVID-19. But the USPS continues to be overburdened and unable to keep up with demand, admitting that standards for first-class mail delivery services have decreased in the last year and will only continue to slow down by 30%. 

That means millions of people with chronic conditions like diabetes, heart disease, and asthma are facing a dangerous dilemma. They can either risk unnecessary exposure to COVID-19 knowing they are especially vulnerable to the virus or possibly go without life-saving medications for days due to delays in the mail. 

Alarmed by the striking slow down, Jacqueline W. Fincher, MD, President of the American College of Physicians, released a statement cautioning that “a delay in receiving a necessary prescription could be life-threatening. My patients who rely on their insulin, or their inhalers, or any other type of medication can’t wait weeks to see whether or not their prescription will be delivered.”

A pharmacy partner that’s always on your side

The solution to mail order stress and delays? Alto Pharmacy’s free courier delivery service. Here’s why our doorstep hand-delivery is the best method for ensuring your prescriptions arrive safely and on time.

Same-day, contactless delivery: We skip the mail, preferring to hand-deliver your medications that very day. We also provide contactless drop-offs to ensure everyone stays safe.

Zero risk of in-transit delays: Your prescriptions will never change hands during the delivery process, increasing not only speed, but safety as well.

Convenient scheduling: Select from multiple daily 3-hour delivery windows that work with your schedule.

Real-time tracking: Stay updated throughout the delivery process via text 

Always free - There are never any hidden fees—your delivery is completely free. 

Say goodbye to lost and late prescriptions

We’re committed to helping you lead a healthier life by providing swift and safe access to the medicine you need. And we’ll work with your health insurance to ensure you’re receiving your medications on time and at the lowest price possible. 

Making the switch to Alto is easy - we’ll handle the transfer. Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

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.

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

Concerned about Mail Delays Tying up Your Prescriptions? There’s a Better Way.

When trying to understand the (rather large) differences between type 1 and type 2 diabetes, we find that it’s helpful to start with what they have in common—namely, a problem related to the hormone insulin. 

What’s the Difference between Type 1 and Type 2 Diabetes?

Put very simply, diabetes is a health issue that affects how the body converts food into energy. This simple understanding is complicated, however, by the fact that it’s actually a term for several conditions. When trying to understand the (rather large) differences between type 1 and type 2 diabetes, we find that it’s helpful to start with what they have in common—namely, a problem related to the hormone insulin. 

Your cells use a simple sugar called glucose for energy. Your body obtains it by breaking down the carbohydrates that you eat. Once the glucose enters your bloodstream, your pancreas releases insulin in response, which promptly helps move the sugar out of your blood and into your cells. In a person with diabetes, however, one of the following things happens: 

The pancreas does not produce any insulin at all

The body doesn’t respond to insulin in the right way, which is known as “insulin resistance.”

Without treatment, a person with diabetes will develop a condition called high blood sugar, which is just as it sounds—too much glucose in the blood. This can lead to serious and even life-threatening complications such as heart disease, vision loss, kidney disease, or nerve damage. There is currently no cure for diabetes, but it can be managed through lifestyle interventions and, depending on the type, oral medication and/or insulin injections. 

According to the Centers for Disease Control and Prevention (CDC), over 34 million Americans, or about 1 in 11, have diabetes. In addition, it’s estimated that 1 in 3 adults are currently at serious risk of developing type 2 diabetes, meaning more than 40% of American adults are in some way affected by this disease. In case you glossed over that last statistic, we’ll let it sink in again. Experts believe that nearly half of all American adults have either diabetes or prediabetes. 

To understand this disease’s startling prevalence, let’s take a look at how and why each type occurs. 

Type 1 diabetes: The immune system on the attack

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, meaning people with type 1 diabetes don't produce any insulin at all and must rely on insulin injections to control their blood sugar. 

Because type 1 diabetes commonly begins in childhood, it used to be known as juvenile-onset diabetes. However, it can happen at any age to people of all races and body sizes. The CDC estimates that it affects nearly 1.6 million Americans, making it much rarer than type 2 diabetes.

Symptoms of type 1 diabetes usually come on very quickly and can include excessive thirst or hunger, frequent urination, sweating, nausea or vomiting, and weight loss. The cause is unknown, but genetics plays a role and those with a family history of type 1 diabetes are at increased risk. If you experience these symptoms, it’s important to contact your doctor right away.

Type 2 diabetes: A silently growing epidemic

In the case of type 2 diabetes, the pancreas is usually able to produce some insulin. The problem is either that it’s not enough insulin or the body isn’t able to use it properly. This means glucose doesn’t easily reach the body’s cells to provide essential fuel. 

Type 2 accounts for over 90% of all people with diabetes. It develops over the course of many years due to a mix of genetic, lifestyle, and environmental factors. Unlike in the case of type 1 diabetes, those at risk for type 2 can often prevent its onset through lifestyle interventions such as losing weight, eating healthy, and staying active. 

This high-risk phase is known as prediabetes, and occurs when a person’s blood sugar levels are significantly elevated, but not high enough for a type 2 diagnosis. It’s estimated that more than 88 million adults have prediabetes and 85% of them have no idea. 

So how do you determine if you’re within this group? Well, you could be at higher risk of prediabetes if you are:

Black, Hispanic/Latino, American Indian, Asian American, or Pacific Islander (The reasons are not yet understood, but researchers have found varying rates of diabetes among different racial and ethnic groups)

High blood pressure or take medication for it

Low HDL cholesterol and/or high triglycerides

Been diagnosed with Polycystic Ovary Syndrome (PCOS)

Falling into just one of these categories puts you at higher risk, however they do not mean that a diagnosis is in your future. Staying active and eating well is the best way to lower your risk.

Indicators of type 2 diabetes include tingling in the hands and feet, excessive hunger or thirst, fatigue, frequent urination, slow-healing cuts and bruises, and blurry vision. Quite often, however, there are no symptoms at all or they develop very gradually. If you’re feeling uncertain, talk to your doctor. They may recommend an A1C blood test to check your average blood sugar levels over the past few months. The American Diabetes Association offers a free one-minute test that can help you or a loved one learn more about your risk. They also provide a variety of tools focused on preventing or managing a diagnosis, from recipes to fitness plans.

Since a type 1 diabetes diagnosis means you cannot produce your own insulin, you will require regular insulin injections and frequent testing of your blood sugar levels. Even with an insulin prescription, meal planning and daily exercise will help to further regulate your blood sugar. The important thing to remember is that this disease is manageable and it doesn’t have to mean being held back in life. The American Diabetes Association puts out a magazine called Diabetes Forecast that’s full of information, recipes, and fitness tips and there are many online communities you can join for advice and support.

Managing your insulin prescription might feel overwhelming at first, but the team of pharmacists at Alto will have your back, answering your questions and ensuring the seamless delivery of your insulin and other medications. 

Treatment for type 2 diabetes works a little differently for everyone. You may need to take oral medications or insulin injections, or you might be able to manage it with lifestyle changes alone. 

Oftentimes, treatment includes a mix of several oral medications and/or insulin. To minimize confusion over multiple prescriptions, the Alto app can help you easily manage everything in one place and set up automatic refills. Not to mention, our team of pharmacists will always be standing by to offer guidance. 

But whether you need a prescription or not, eating right and exercising will be extremely important parts of your life with type 2 diabetes. A healthy lifestyle will help keep your blood sugar stable, maintain healthy cholesterol levels, and control your blood pressure. The American Diabetes Association offers free resources that can help you get started, and you certainly won’t be alone. There are many millions of people currently living and thriving with type 2 diabetes around the world. An online community is a great place to start connecting.

A diabetes diagnosis can be daunting, but it never has to mean missing out on life. Remember, we’ll be here to help you understand your medications and set up a delivery plan that fits into your schedule. 

Looking for a partner to help you manage your prescriptions? Our team is available to answer your questions from 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

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

In this post we'll explain what causes medication side effects, how to manage them, and provide 5 suggestions to remedy. 

How to Manage Medication Side Effects

From the occasional skin rash to more chronic illnesses such as diabetes, prescription drugs are often critical in treating or even preventing symptoms and improving overall quality of life. All medications carry the potential for complications or other symptoms known as side effects. From periodic nausea or upset stomach to more adverse effects such as liver or heart problems, each medication carries its own potential for introducing ailments unrelated to the original diagnosis. In this post we'll explain what causes side effects, how to manage them, and provide 5 suggestions to remedy. 

What is a medication side effect and why does it matter?

Put simply, medication side effects are unexpected reactions that can occur as a result of using a prescription, over the counter medication or herbal supplement. There are two types of side effects: common and adverse. Common side effects are generally described as “normal” after-effects of treatment such as constipation, dizziness, dry mouth, headaches and skin rash. Adverse side effects are much more serious and can include internal bleeding, kidney damage and heart dysfunction among other symptoms. 

The main difference is that common side effects are unwanted, but known, while adverse side effects are unintended, and often not accounted for in treatment plans. Side effects can vary with all medications, so it’s important to understand what is common and what is adverse with the particular medication you are taking. Side effects are also not always dose dependent, meaning that they can occur at any dose or strength; some side effects, however, are worse or more pronounced the higher the dose. It's always important to take the medication as prescribed by your provider and to not increase your dose without first consulting your physician.

1) Communicate with your healthcare professional: Informing your healthcare provider of any allergies or known reactions to medications before starting a new medication can reduce the possibility of side effects. Be sure to also include all disease states past and present as this will help your doctor make the best choice for your medical care. New patient intake forms or patient portals usually provide an opportunity to list any known reactions to medications. Otherwise, be sure to update your doctor if anything has changed since your last visit. 

2) Discuss current medications: Transparency is key for all members of your healthcare team. If you have multiple doctors or pharmacies for different treatment plans, be sure to keep them each informed of all your current medications, including over the counter medications such as pain relievers and wellness supplements such as multi-vitamins or herbal supplements. Full-service pharmacies like Alto make it easier to track all of your medication needs in one place.

3) Review the patient package insert (PPI) included with your prescriptions: All prescriptions include a PPI that contains information on the medication, indications and usage, contraindications, warnings, precautions, and dosage administration. This is a quick way to reference any possible side effects so that you know what to be on the lookout for. Take the time to read it and reach out to your prescribing physician or pharmacist with any questions. 

4) Contact your pharmacist: Pharmacists are responsible for patient safety and often act as the bridge between a patient and physician when there are questions about a patient's medications. Pharmacists review all of a patient's current medications to identify any potential adverse effects, and are available to answer questions about your medications' intended use and effects. Look for pharmacies that make it easy for you to ask questions; Alto's pharmacists are available via phone, text and secure message in our mobile app.

5) Be open to alternatives: Stay in contact with your doctor to discuss potential changes to your treatment plan if side effects present a problem. Your physician can evaluate other medications or treatment options if appropriate; simply forgoing treatment without consultation with your healthcare provider presents additional risks and is not advised.

Keep in mind that not all medications will produce side effects and not all side effects will be significant enough to change the course of your treatment. It’s important to pay attention to how you are feeling both before and after taking prescribed medications and to always stay in touch with a healthcare provider to discuss any unexpected symptoms or changes. For more information on how to manage your medications check out this article from Alto.  

Looking for a partner to help you manage your prescriptions? Our team is available to answer your questions from 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or theapp.

Update from the Alto team, March 17th, 2020: 
As the spread of COVID-19 continues to impact daily routines in the communities we serve, Alto remains open and ready to deliver your medications safely to your door. Our pharmacy locations are fully stocked, our couriers are ready, and our pharmacists can assist with coordinating early refills and longer fills to ensure you have access to your medications throughout this period. Reach out to our care team at 1 (800) 874-5881 (call/text) or via secure message on our mobile app. Delivery is always free; we're here to help.

Worried about coronavirus? 
Here’s what our pharmacists want you to know.

As the news continues to unfold about COVID-19 (also known as coronavirus) and its spread in our communities, you’re likely making preparations for you and your family’s medical needs.

Our pharmacists are here to help. Here are their recommendations for staying healthy, but we also recommend following guidance from the Centers for Disease Control and World Health Organization and checking their sites regularly for updates.

COVID-19 spreads much like the common cold or flu. The virus that causes COVID-19 is passed from person to person through close personal contact (things like touching or shaking hands), coughing, sneezing, or touching a surface with the virus on it and then touching your eyes, nose or mouth without washing your hands.

Though everyone is at risk for becoming infected, elderly patients and patients with diabetes, hypertension, and cardiovascular disease have been shown to be at higher risk for severe symptoms. This may change as we understand the disease more.

Symptoms range greatly and can begin to appear two to fourteen days after exposure. Fever and cough are the most common, although some individuals will have no symptoms and others may experience severe difficulty breathing and other respiratory issues. Given that this outbreak coincides with cold and flu season, it may be difficult to differentiate between the diseases.

Wash your hands! Often, vigorously, and with soap and water for at least 30 seconds. If soap and water aren’t available, use alcohol-based hand sanitizer.

Avoid touching your face with unwashed hands. 

Disinfect surfaces and commonly used objects regularly with bleach or chlorine.

Avoid close personal contact with people who are sick or who may have been exposed to the virus. Stay away from work, school or other high-traffic areas if you begin to exhibit symptoms like fever and cough.

Alto’s free home delivery service and automatic refills mean you don’t have to add worrying about your medication supply or going out in public to your list of precautionary measures. We’ll make sure you have the prescriptions you need on schedule. Stocking up on cold medicine or other over the counter medications? Our pharmacists can add those to your next delivery.

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.

If you think you’ve been exposed to COVID-19, contact your healthcare provider via phone or other digital means. Do not go to your healthcare provider’s office in person if you believe you may be exhibiting symptoms from exposure as public health officials will need to coordinate necessary precautions for staff and other patients.

From Your Pharmacy: What You Need to Know About Coronavirus

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.

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