Expires 04/01/2021

Specialty Pharmacy

We're here to support you through COVID-19 with free home delivery.

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

Alto Pharmacy Technician

Alto Pharmacist

Our mission at Alto is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

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. 

Alto / Blog

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. 

Place donation items in an enclosed bag, label it “Alto Donation,” 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 3:30 pm, Monday through Friday, and we’ve added a Saturday afternoon delivery window from 3 - 6 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 3:30 pm PT and delivery scheduled with patient by 4 pm PT for same-day evening delivery
Delivery Window: 6 - 9 pm PT for North County, 7 - 10 pm for San Diego

Saturday
Prescribing Cutoff: Rxs received by 1 pm PT and delivery scheduled with patient by 1:30 pm PT for same-day afternoon delivery
Delivery Window: 3 - 6 pm PT

Customer support hours are Monday - Friday 9 am - 9 pm PT and Saturday - Sunday 10 am - 6 pm PT. Patients can reach out to Alto via phone, text, email or app.

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 17,000 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

Small changes, big difference: designate a safe place to minimize contact with our couriers

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. 

Alto’s utmost goal is the safety and health of our customers and our staff. During this period of uncertainty and the continued risk of exposure to COVID-19 (also known as coronavirus), Alto is implementing a few minor changes to our free doorstep courier delivery service:

Designated safe places: Rather than physically handing deliveries to our customers, our couriers will knock on the customer’s door and ask to leave the package on the doorstep or in the designated safe place. You can update a safe place with our patient care staff over the phone, via text or in our mobile app under Account > Delivery Addresses > Edit > Delivery Instructions.

Delivery confirmation: For packages requiring a signature on receipt, the Alto courier will sign on your behalf after visually confirming you have received the package via your designated safe place.

These small changes help to minimize physical contact between our customers and couriers while still ensuring deliveries are made on time and on schedule. Thank you in advance for your patience as we implement these extra precautions to make continued use of Alto’s services safe and easy.

Questions? 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.

To Your Health: Updates to Alto’s Free Same-Day Doorstep Delivery

People and healthcare providers deserve more from today's healthcare system. See how Alto is building a new kind of pharmacy aimed at improving the pharmacy experience for everyone. Learn more!

Building a Better Pharmacy | Alto Pharmacy

After three months of listening, learning, and living, I am excited to share a bit about what I learned on my journey to join Alto as Chief People Officer. The accomplishments of this team are already extraordinary -- and we’re about to embark on scaling to even greater heights. 

My journey to becoming an Altoid* started in November 2019 when I came onboard with the short-term scope of helping the team get traction on their 90-day goals, hire several leadership key positions, and develop the 2020 People Operating Plan and budget. The experience and the energy of how much we accomplished in a short period were surreal, and  I observed a People team truly committed to delivering an amazing experience to our 400+ Alto employees and contractors. It gave me a clear perspective of the direction I wanted to take my career.

I knew I would select my next opportunity based upon three criteria: the team, the product, and the impact the organization has on society. I appreciate that I have been blessed with opportunities to be a part of some of the world’s top workplaces and brands, including Accenture, Google and Dropbox, and finding my next role would take some awesome soul searching. 

People and healthcare providers deserve more from today’s healthcare system. At Alto, we're building a new kind of pharmacy to cure one of our healthcare system's most startling ills: over 50% of prescriptions are never picked up. Because staying on track with doctor's orders requires more than just delivering pills, we're managing everything from insurance logistics to pricing, late-night questions to supply chain, and anything else that could stand in the way of effective treatment.

Given the importance of this mission, it shouldn’t surprise you that the team at Alto is special. It is a group of pharmacists, fulfillment operators, patient care specialists and partnership managers that are experienced, committed to our mission, and go above and beyond every day for our patients and provider partners. The product suite includes an intuitive platform built in partnership with our patient care and frontline teams using empathy and rigor. 

The impact we’ve had and will continue to have is substantial: our patients fill their prescriptions 30 - 50% more often than with the national chains (“adherence” to those in health care). We’ve helped patients save more than $23M on their medications through automatics savings searches and other programs. And these numbers reflect the impact of just the six markets we’ve launched in (two of which launched just this past month). Imagine what we’ll see as we expand across the US. 

The leadership team is committed to expanding the culture in a meaningful way, and I’ve found the culture to be one built on curiosity and collaboration. Before I arrived, the leadership team aligned on a leadership framework based upon Conscious Leadership. Its’ 15 commitments are by no means new or innovative, but I can honestly say this team’s whole-hearted embrace of open and honest dialogue about where we are and are not fulfilling the commitments is refreshing. This commitment will help us become better both as individual leaders and as a company and serve to further differentiate us as a workplace committed to open and constructive conversation.

For those embarking on a similar journey to find your next opportunity, I share the following:

Take time to reflect -- identify what you love.

Recognize that no opportunity is likely to check all your boxes, even in this HOT HOT market.

Take every meeting. This meant I didn’t have much time off between gigs but I learned a lot.

Seek opportunities to really work with your future team. Not everyone or every company will be open to this kind of interim opportunity but ask for more than just interviews

Ask to attend a regular leadership meeting.

Ask to take a real problem the leadership team is facing and work through it in real life with a member of the leadership team.

We’ve aligned on the five key tenants for the People Team at Alto. They are our north star and will help guide us on this journey.

Our first priority on the People team will be our People: We will have lots of goals and metrics but will always ask: “Is this doing the right thing by our people? Are we improving the quality of the experience they’re having at Alto?” Our team will be available when you need us, and you’ll have an advocate and sounding board any time you need one.

Look across our people’s end-to-end journey to deliver amazing experiences: HR too often stays stuck in our silos of recruiting, employee relations, compensation, benefits or performance management. We will differentiate our workplace and teams by threading the needle through each of those traditional processes to identify the impactful parts of the journey. Our goal is to amplify the joyful moments and support Altoids through difficult ones.

Connect disparate, siloed systems (recruiting, core HR, payroll): To help create a cohesive overall experience for employees and foster collaboration, we will connect disparate siloed systems. We will improve adoption and engagement of these tools and help Altoids learn and grow using world-class technologies to deliver people services and optimize their experience. Finally, connected systems will mean comprehensive data to support visualizations and better decision making by leaders.

Grow smart with efficient processes and automation: We can do a lot of what we want to deliver awesome experiences by adding lots of people, but that wouldn’t be using Alto dollars efficiently. We want to grow smart and scale using lessons learned by the many, many companies who’ve come before us. We’ll measure the efficiency of our processes, operations, and engagement with Altoids and candidates using a myriad of solutions from technology, vendor-partnerships and lean practices across our journeys.

Evolve our culture to one filled with curiosity, collaboration, inclusivity, creativity and workplace with intentional design, actions, and reinforcing behaviors: Delivering a workplace that is more diverse, inclusive and equitable requires thoughtful frameworks starting with attracting talent, defining behaviors creating an inclusive environment where all communities and people feel they belong, and rewarding and growing people equitably based upon their results and how they achieve them.

My hope in sharing these reflections is that some will learn from my experience and therefore do one or two better in the search for their next opportunity.

The future of work is about us all learning and growing faster than we did before. If any of this interests you, reach out, connect or apply online to one of our positions now (or in the future). To learn more take a look at our brand video and then apply today!

Alto Rebrand Sizzle Video

*We affectionately refer to Alto employees as “Altoids.”

People and healthcare providers deserve more from today's healthcare system. See how Alto is building a new kind of pharmacy aimed at improving the pharmacy experience for everyone.

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

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.

Breaking Open the Black Box of Medication Pricing

How My Experience as an IVF Coordinator Showed Me the Importance of Alto’s Care Model

I knew from a very young age that I wanted to work with moms and babies. My mother ran a daycare from our home throughout my childhood, and for my sixth grade report on “what I want to be when I grow up,” I interviewed a well baby RN at a local hospital. After completing my Bachelor’s degree, I started working as front desk staff at a fertility clinic and I knew immediately that I had found my spot. I could work with soon-to-be moms and new moms every day.

I quickly shifted from the front desk to being a Medical Assistant for a physician where I was able to participate in ultrasounds, retrievals and transfers. The first time I was in a pregnancy ultrasound and heard a baby’s heartbeat, I was in tears and overcome with emotion. Eventually I transitioned into the role of IVF Coordinator where I was a key part of a patient’s — and their partner’s — journey to building a family.

I really got to know my patients — in fertility, you become a trusted confidant. Their loss is your loss, and their win is your win. While you might not bring your work home physically, emotionally the job never really leaves you — IVF coordinator was the most emotionally taxing job I’ll ever have. But each time we received a positive pregnancy test, it made up for all the ups and downs.

Alto’s model shouldn’t be so revolutionary, but it is. Clinics and patients don’t have to be okay with today’s standard pharmacy experience — Alto offers a fundamentally better model.

Fertility pharmacy plays a key role in a patient’s fertility journey. Medications need to arrive on time, in the correct assortment, with all necessary ancillary supplies. Often, the decision to change a dose or initiate a trigger shot means that medications are needed that same day or on the weekend. As an IVF coordinator, helping my patients make a decision about pharmacy was tricky — each pharmacy option offered some of the service qualities I was looking for, but no pharmacy offered all of the things I wanted for my patients. Remembering which pharmacy checked which boxes was really challenging.

It was so important to me that my patients were taken care of and receiving the highest quality of care. When they had questions, I was always available and responsive, even in the evenings and on weekends. What was most frustrating about working with fertility pharmacies was that when I’d send a prescription out, I’d have no control over the quality of the patient’s experience with the pharmacy.

For my patients, I wanted a pharmacy option that was accessible, responsive, cost conscious, and accountable for making sure nothing was getting lost or off track. For my clinic team, I wanted a pharmacy partner that didn’t require me to micromanage everything about a patient’s medications. I hated being the middle person between the patient and the pharmacy. The first time a pharmacy [Alto] came in and told me I could send any patient with any insurance to them and they would triage it, I thought, “We’ll send everything to them.”

Alto Pharmacy’s patient care model checked all those boxes. When I first heard about their same day delivery, evening and weekend hours and benefits coordination, it sounded too good to be true. Having access to a local fertility pharmacy with same day delivery was simply unheard of.

But if this was all true, it was clearly something that I wanted to be a part of. I knew from my experience as an IVF coordinator that this model served a crucial need for both patients and their care teams. I wanted to bring my knowledge and experience to help make the Alto care model even better than it already was.

What I quickly learned after joining Alto Pharmacy to help build partnerships with fertility clinics was that while same day delivery is extremely practical and necessary in fertility, it’s our patient care team that is the most standout quality. Our patient care staff have the same drive and commitment to helping build families that initially drew me to work in fertility. They genuinely care about the success of the treatment and making sure that the patients are being taken care of. This focus on the patient is unmatched in the pharmacy space — fertility pharmacy is not a truly personalized experience anywhere else but Alto.

The patient care team consistently goes above and beyond to make sure that patients have what they need, when they need it, so that cycles aren’t interrupted. Those same-day medication changes and trigger shot decisions mean that our team is processing late notice prescriptions and frequently staying late to get deliveries out the door. Many members of our patient care team have even driven medications direct to patient’s homes so that cycles stay on track. They know how much going the extra mile is going to relieve the patient’s stress.

What I like to tell people is that we haven’t found some magical secret sauce at Alto — we didn’t create texting, or mobile apps — but pharmacy has been behind the times for so long compared to many other industries and especially within healthcare. Alto’s model shouldn’t be so revolutionary, but it is. Clinics and patients don’t have to be okay with today’s standard pharmacy experience — Alto offers a fundamentally better model.

Alto is the West Coast’s leading fertility pharmacy with more than 15,000 patients served. We’re open evenings and weekends, offer free delivery seven days a week, and will always work to help you find the best price. Interested in using Alto’s services for your fertility medications? Ask your care team to send your prescriptions to Alto or give us a call at 1 (800) 874–5881.

Tina Simon is a Fertility Partnerships Manager for Alto Pharmacy in the San Francisco Bay area.

The View from Both Sides of the Fertility Pharmacy Experience

How Alto Pharmacy provided support and peace of mind during my embryo freezing process

I’m 33 years old and have been married for three years. I don’t have any children yet, but have always known I wanted a family. I have spent much of my career working in healthcare and have most recently worked at an education startup. I’m passionate about doing work that empowers women.

Many of my friends have gone through the egg freezing process, and my husband and I visited a clinic last year to learn more about our own fertility health and to explore the option of egg freezing as a future backup plan. The clinic we chose uses Alto for their fertility pharmacy services and referred me once we decided to go through a round of embryo freezing.

I had a great experience with Alto. The entire journey of learning about fertility preservation, deciding whether or not to go through with a procedure, and then starting the process is really stressful and often left me feeling like I needed a lot more information and guidance than was readily available. With Alto, everything about getting my prescriptions filled and finding answers to my questions was straightforward and dependable.

At my very first appointment, the clinical team decided to start me on medications that same night. I signed up with Alto, and they delivered my medications same-day within the span of a few hours. The customer service reps at Alto were really helpful and worked with an urgency that I appreciated given how out of control I felt in that initial phase of the treatment plan.

What I liked most about Alto was how dependable they were. When you’re going through a fertility preservation process, your prescription and medication needs change every few days for the duration of the treatment. There were several times where I got a prescription in the morning from my physician and needed to get the delivery that same day. Each time, Alto did a great job of making sure the medication was processed, scheduled for delivery and delivered on time. I didn’t have to stress that something would go wrong and the whole process would be messed up.

I also found that I could rely on Alto to help fill knowledge gaps about what was happening with my care. Each delivery included documents to explain exactly what the medications were for, something that wasn’t always clear when I got a prescription from the doctor. I appreciated Alto’s focus on customer service. They proactively reached out to give me updates about what to expect next, ensure my questions were answered, and even did small gestures like including a few caramels in each delivery that, while small, were appreciated.

I used to have a chronic disease, chronic idiopathic urticaria (hives), that required a specialty medication, and I had a really difficult time dealing with pharmacies and ensuring I got my medication correctly. I had to see one doctor to prescribe the medication, go in person to pick up the medication at a specialty pharmacy and then drive it in a cooler to a second, different doctor to administer it. With Alto, it was so much easier and straightforward to make sure I received my medications when I needed them, without having to leave home.

Alto was easy to work with and dependable which is so important and helpful. While the outcomes of my procedure were not what I had hoped for, I have no complaints at all with my experience with Alto. I would definitely recommend Alto to a friend considering egg freezing or IVF treatments.

Alto is the West Coast’s leading fertility pharmacy with more than 15,000 patients served. We’re open evenings and weekends, offer free delivery seven days a week, and will always work to help you find the best price. Interested in using Alto’s services for your fertility medications? Ask your doctor to send your prescriptions to Alto or give us a call at 1 (800) 874–5881.

This post was written by Rebecca G., a San Francisco Bay area operations and community builder, and Alto fertility patient.

Mattieu Gamache-Asselin, CEO & Co-founder

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!

Working at Alto isn’t just a job. For every team member, from product designers to pharmacists to patient care gurus, Alto is a means to a fulfilling career focused on making a difference in the lives of people who rely on prescription medicine to lead healthy, happy lives. In the process, we’re also changing an industry that has long gone unchecked.

Our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. That takes a dedicated team of mission-driven, value-minded people. Read on to figure out if Alto is the right career move for you.

At the highest level, Alto is a pharmacy. But we are not a traditional pharmacy. Instead of operating dozens of small-volume distribution sites across a metro area like chain pharmacies, we own and operate high-volume pharmacy fulfillment centers staffed by small, highly efficient teams supported by proprietary technology. We have one fulfillment center per metro area that we serve, including San Francisco, Los Angeles, and Orange County, and a centralized operations facility in Denver. Out of our fulfillment centers, we process and fill prescription orders and deliver directly to patients’ homes or offices by way of our free, same-day courier service.

On top of the convenience and accessibility of same-day delivery, Alto has three product pillars that allow us to deliver an exceptional experience to our users: the Alto Patient app, Alto MD, and Wunderbar. Learn more about our products and our industry-disrupting business model.

Alto is the world’s most patient-centric pharmacy. Our goal is not simply to distribute prescription medications but to improve patients’ health outcomes and their quality of life and to make those improvements accessible to everybody.

To get to that point, we need to understand what’s preventing patients from accessing all the benefits medicine has to offer. We believe it’s especially important to address the high-level problem of non-adherence, which is when patients don’t take the medication they’re prescribed. It also means learning how to scale our technology and processes to bring our products to more people in current and new markets. To achieve both of these things, we need to first scale our team. Learn more about Alto’s potential for growth and plans for the future, and how our team contributes to our success.

Loving what you do starts with doing something you believe in. It’s enriched by working alongside people who share your goals in an environment conducive to your work style and aspirations. At the foundation of Alto’s culture is our mission; our core values like acting empathically, thinking rigorously, making impact, staying humble, and putting patients first; the diverse backgrounds of our team members; and the supportive but highly autonomous way we get work done. Learn more about the Alto’s values and culture through the eyes of our CTO and co-founder, Jamie Karraker.

If Alto sounds like an environment you would thrive in, we would love to hear from you! We’re always on the lookout for great people to fill in our product, design, engineering, analytics, people, recruiting, finance, sales, business operations, logistics, pharmacy, and patient care teams. Check out our open positions to see if there is an opportunity that’s right for you!

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.

To Alto’s CTO, an ethical, altruistic, supportive workplace is everything.

Every morning (ok, most mornings), I wake up motivated — eager, even — to get out of bed and go to work. But it’s not because I am some super-performing success-bot. This is not another blog post about a c-level executive’s otherworldly, highly-meticulous-yet-seemingly-effortless morning routine, and I have no prescriptive regimen for staying happy and mindful while still managing to “get it all done.” I only have one piece of advice, but it is one that has served me (and my mornings) well:

Work with people who share your passion and values.

At Alto, the company I co-founded in 2015, everyone, from me (the CTO) to product engineers to part-time prescription couriers, is dedicated to the same mission and vision. Every day, we strive to improve health outcomes by optimizing technology and processes to become the world’s most people-centric pharmacy. I am never not excited to work alongside the few hundred Alto employees that daily act in concert to support the success of our company and make a difference in the lives of people who use Alto.

Underlying this relentless drive toward mission and vision is a set of shared core values that defines our internal culture:

Patients come first — even before our bottom line and industry partners. We will always prioritize the wellbeing of the people who use Alto to manage their prescription medications.

Leave no person behind. It’s more important to be good for all than to be great for a select few.

Start with empathy. We strive deeply to understand the thoughts and feelings of everyone we interact with.

Focus on impact. We prioritize impact over activity and focus on the work that makes the biggest strides toward our goals.

Think rigorously. We’re open to changing our minds and never hesitate to question assumptions and first principles. There is nothing sacred about the status quo.

Be humble. Our work — however expert, technical, or specialized — is in service of our team, the people who use Alto, and the greater good. Everyone’s contributions count, and no one is too important to take out the trash, so to speak. And we are certainly not above other players in the industry whose mission to help patients aligns with our own.

For me and my teammates, it’s extremely fulfilling to contribute to this smart, caring, talented team working tirelessly to help so many people. Everyone’s role is different but invaluable, and our efforts have real meaning. I can say with confidence that working in this environment makes a huge difference in how I carry myself, because I know from previous professional experiences what the opposite looks and feels like.

When my co-founder Matt and I started Alto in 2015, we were both software engineers at Parse, a Facebook-owned company. Having spent years in Silicon Valley, we were already jaded by the tech ecosystem and were ready for a change. In thinking about what we wanted to pursue next in our lives, we noticed that other companies were not working on society’s most meaningful problems; they were focused on catering to the 1%. In contrast, we wanted to use our time and skills to build something that makes a tangible, positive impact on the daily lives of all people, especially those ignored by the tech industry.

And so, we found ourselves drawn to healthcare — a big, broken industry that affects most people negatively, especially the underprivileged. We did a lot of research to figure out what our wedge into healthcare would be, and pharmacy jumped out to us. Essentially, pharmacy is the healthcare industry’s consumer product, and consumer products just happens to be our area of expertise.

If you think about it, pharmacy is a product not unlike Facebook; almost everybody in the country uses at some point in their life. But evidence suggests it’s generally a bad one. The net promoter score of chain pharmacies is somewhere in the vicinity of -10. That’s shockingly bad. (For reference, American Airlines has a net promoter score of four.) Our research also found that more than 35% of all medications sent to pharmacies are never picked up as a result of some upstream issue.

It became clear to us that none of the pharmacy incumbents thought of themselves like a product, and especially not one that is consumer focused. None of them had the mindset to prioritize and optimize the user experience, which is the mindset Silicon Valley applies to photo-sharing apps and ad optimization tools and all sorts of other products we aren’t so passionate about. Instead, pharmacy incumbents focus on extracting value from the system and pushing the cost off onto patients. In that gap, we saw opportunity — and a moral imperative.

Today, Alto is making pharmacy convenient, accessible, and user-friendly. We make it easy for consumers to get information on their medications so that they can make informed healthcare decisions. To get there, we have built and continually work to improve a robust set of user-facing and internal tools to guide consumers through the complex and often barrier-laced process of prescription procurement, payer authorization, and medication fulfillment.

Because health outcomes are what we care about, we’re not pushing pills for profit. We are just as happy if a patient pursues an alternative therapy so long as it is in his or her best clinical interest. Our unique business and operational models make that possible.

In disrupting an industry that can be predatory to the most vulnerable among us, I am proud to say Alto attracts some of the most ethical, altruistic talent I have ever worked with. They make coming to work a pleasure and a privilege, and that makes all the difference, not just in my mornings but also my professional satisfaction and overall well-being. If any of that resonates with you, you might be just our type.

"Work With People Who Share Your Passion"

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