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Last month, Alto celebrated the well-deserved promotions of many Altoids across the company. Among those promoted is Elnaz Moshfeghian, who is now Alto’s VP of Strategic Planning & Business Operations. Elnaz shares more about her new role, what she’s most excited about at Alto, and advice she has for those looking to make a career pivot.  

Catching up with Elnaz Moshfeghian, Alto’s new VP of Strategic Planning & Business Operations | Alto

Last month, Alto celebrated the well-deserved promotions of many Altoids across the company. Among those promoted is Elnaz Moshfeghian, who is now Alto’s VP of Strategic Planning & Business Operations.

Elnaz joined Alto in 2016 as a software engineer and when we last connected with her in 2020, she shared her thoughts on building a career in engineering. Since then, Elnaz has pivoted to a truly cross functional, strategy-focused role, where she applies learnings from her engineering experience with her ability to identify opportunities for growth. 

Below, Elnaz shares more about her new role, what she’s most excited about at Alto, and advice she has for those looking to make a career pivot.  

To start, congratulations on your new role! You joined Alto 6.5 years ago, and so much has changed both within the company and the industry at large. Can you tell me a little bit about your journey at Alto? 

I’ve always been attracted to problems that are cross functional and can be solved by bringing together different teams - pharmacists, technicians, logistics, dispatch, sales. I really enjoyed it as an engineer, given that when I joined there were no product managers. We all had to figure out what we were going to build and build it ourselves. I loved working with teams, which is why I pursued the manager track. I noticed pretty quickly that the most interesting and challenging problems rarely came down to technical decisions, but more-so to people and priorities. 

As I grew in my engineering career, and got to lead teams solving problems, I was always searching for how to expand my understanding and impact across the business. I had the opportunity to shift into a strategy and operations role, which allowed me to shadow the CEO and learn a great deal while also identifying the company’s key priorities, understanding how they're doing, and ensuring that they stay on track. The new role allows me to use everything I’ve learned over the last 6.5 years at the company while at the same time, learning a lot from a seasoned leader like Alicia on how to run a business. 

Your previous experience was in engineering, and you didn’t work in healthcare or pharma before joining Alto. What has been the biggest surprise to you since joining the company? 

There are a lot of different hands in healthcare; it's a really complex space and there’s a lot at stake. I’m always mystified by how hard it is to align different parties’ incentives to result in the right outcome for patients. It underscores the importance of Alto’s mission: to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

Tell me a little bit about your current role. What are you most excited by? 

I’ve loved seeing how the different pieces of the company connect, and being able to connect the dots when we’re missing something. It’s been really fun to see how a little bit of communication and collaboration can go a long way. I also love thinking about how what we’re doing today could set us up for bigger things in the future, and how we build today in a way that opens a lot of doors for us down the line. 

In your opinion, what are the biggest opportunities for the company? 

There’s always an opportunity to be excellent at the basics. Are we consistently providing the best patient experience? Are we getting patients the best price? Are we saving time for prescribers and their offices? Those are problems that we’ve been solving for a long time, but it just gets more interesting and challenging as we’ve gone into new markets and therapeutic areas, and worked with different kinds of patients and prescribers than we used to. 

Something that I’ve always been intrigued by is - how do you bring more transparency around pricing to prescribers and patients at the earliest possible time, so that they can make the best decisions? It’s something that’s really missing in the industry. It’s not easy to do, and that’s definitely something I think a lot about - ‘How can we be the one who makes it easy for prescribers to know what they’re about to send to the patient, and for the patient to know what their other options are?’ Because a lot of times, what your insurance may cover and what your doctor may prescribe may not always be the best option. There might be other options, and I think a lot of people don’t know to ask about that. 

What are the biggest challenges in the pharmaceutical industry today? 

I think there’s been a lot of great activity from different patient advocacy groups and state governments to regulate the worst of what’s happened in healthcare. It’s been cool to see that take shape over the last five years. The challenge is that it’s very hard to write legislation and force some of these things, and so I’ve honestly gotten more interested in how do you write the right laws and approach regulation in a way that allows innovation to still happen and thrive, and still protects the patient at the end of the day. 

Back to your engineering roots – what advice do you have for young engineers?

Given the state of venture capital and the industry, a lot of engineers are going to earlier-stage companies, because there’s a little bit more investment and activity happening. I had to figure that out along the way - how do you operate as the third engineer on the team? Being anyone in an early-stage, small company - and an engineer especially - comes with its own unique challenges and skills. It’s not something there’s a ton of resources around. There’s a lot of resources about how to start a company, but not a lot for how engineers can grow their career at a company at that stage. So, my advice would be to seek out mentorship and cross functional peers from whom you can learn and grow. 

You pivoted from engineering to operations and strategy. What advice do you have for someone looking to make a career change? 

As an engineer, I’ve really focused on making an impact, whether that’s through building a product or shaping the business with what I know, with tech being the backbone. And I think that’s something we don’t talk about as much in engineering - how do you take your skills and really channel them for maximum impact and better understanding of a business? And for people who want to start their own companies someday, taking the path I did could be really valuable. It allows you to be a better entrepreneur and a better contributor if you can see the connection between engineering choices and the systems you’re building, and how they impact your customer and other parties. 

The other piece is being comfortable with wearing a lot of different hats. It’s what really helped my growth, and it’s counter to a lot of advice you get. People will tell you to go deep, get specialized and go down one path. You need to, to some extent; I absolutely had to figure out how to be a better engineer and a better leader. But the most growth for me wasn’t necessarily to stay in engineering – it was to take a turn. Hopefully, I can give colleagues a little more confidence who want to take a turn and increase their impact, growth and learning. 

Catching up with Elnaz Moshfeghian, Alto’s new VP of Strategic Planning & Business Operations 

Staying on track with treatment and fully benefiting from a medication entails more than simply filling a prescription. It requires patients to take an active role in their health journeys, with education, clinical monitoring, and side effect management all necessary for proper drug utilization.

How Alto’s High-Touch Model Supports Patient Engagement

Pharmacists are an invaluable healthcare resource for those with complex treatment plans. Unfortunately, the traditional retail and mail-order models fail to maximize the possibilities of pharmacy care, without opportunities for ongoing engagement with patients. Not only are retail pharmacists often inundated with many tasks, it’s difficult for patients to discuss their health in a crowded store with a line of other customers behind them. And patients receiving their medication by mail often have limited visibility into delivery details or difficulty connecting with the pharmacy team. 

Alto Pharmacy offers a supported and convenient prescription journey at every step. We ensure that our patients have the information they need to get started with specialty medications and feel confident about their care. In addition to providing a simple onboarding experience, we have a team with robust clinical expertise and a high-touch model that allows patients to easily benefit from it.

We are also expanding our reach to fertility patients through our new nationwide* mail-order offering. Patients who receive fertility medications through mail-order experience the same convenience and support as those we serve via local courier delivery, with seamless onboarding, easy and supported medication management, and access to experts. 

And with an integrated and customizable tech stack — including both our proprietary pharmacy management software and our patient app — there are many ways for partners to provide additional engagement and supplement other support programs.

Here’s how Alto’s model enhances medication education and gives you, as a partner, the opportunity to more deeply engage our shared patients.

Alto offers a supportive and simple patient onboarding experience with proactive multichannel communication. We give patients a welcome text or call within 60 minutes of receiving their prescription, guiding them through their first order. Those who need to transfer an existing prescription to Alto can do so within minutes in our app.

If more information is necessary to fill a prescription, we make sure that patients and providers are both fully in the loop. We keep the patient informed at every step of the billing process, offering support with prior authorizations as needed. Through Alto Connect, our free communications portal for providers, clinical teams can view active medication details and quickly understand when additional steps are required to fill a prescription.

Partner Opportunities to Supplement Patient Support

The majority of Alto patients use our app for intake, medication ordering, and delivery scheduling. Not only does this give patients control and convenience in managing their prescriptions, it provides opportunities for additional engagement from partners.

Our flexible technology capabilities allow for many possibilities, including in-app introductions to your medications. In this video, a specialist from our fertility team walks patients through injecting the Gonal-f® RFF Redi-ject® Pen.

Follow-Up and Improving the Patient Experience

Easy onboarding is just the beginning. Alto supports patients at every stage of the prescription journey so that they can get the most benefit from their medication. Our dedicated medication therapy management pharmacists, who focus entirely on disease state education and support for chronic conditions, proactively contact patients who take specialty medications to review their regimens.

We ask if they are experiencing any side effects and track all patient-reported outcomes. As a partner, you can have access to data and insights into your patients’ experience of your medications.

We’re also able to tailor a patient’s treatment to any titration schedule prescribed by their provider. In these cases, we inform the patient of this schedule and change in medication dosage at every step of the treatment.

We see our NPS of 88 as an attestation of our patients’ love and commitment to both Alto and their health. 

Choose Alto Pharmacy for your limited distribution network

Alto’s end-to-end dispensing model is specifically built for specialty and specialty lite products. To learn more about partnering with us, reach out to partnerships@alto.com.

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.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Tech-Based, High-Touch Patient Engagement at Alto

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list celebrates the most innovative and game-changing private companies across various industries. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Alto Named to 2023 CNBC’s Disruptor 50 List

At Alto, our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. By putting patients first, we’re increasing accessibility to medicine, improving prescription adherence and making a meaningful difference in the lives of patients. 

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list recognizes private companies that are chasing some of the market’s biggest opportunities, and growing despite a tough capital markets environment and slowing economy. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Despite the challenging economic headwinds that all industries are facing, we’ve remained competitive, agile, and committed to delivering outstanding patient care. Just last year, we launched Essentials from Alto, allowing customers to purchase pharmacy items along with their prescription medication in the Alto pharmacy app. This provides even more access to individuals who are disabled, lack physical mobility, or otherwise can’t reach a pharmacy. 

As we celebrate this achievement, we are also mindful of the challenges that lie ahead. The healthcare industry is complex, and there is still much work to be done to ensure that every patient receives the care they deserve. But with our innovative offerings and unwavering commitment to our customers, we are confident that we can make an even bigger difference. 

Alto Named to 2023 CNBC Disruptor 50 List

At Alto Pharmacy, a patient’s financial wellness is of the utmost importance. We understand that cost is one of the most common barriers to medication access, and we go above and beyond to connect patients with any savings opportunities that they may qualify for. 

Alto Pharmacy’s Product Controls for Coupons

At the same time, as a specialty pharmacy, we have a responsibility to protect the integrity of assistance programs and ensure that only eligible patients benefit from these resources. Our integrated technology stack provides the controls needed to restrict savings access to qualifying patients. Take a look.

The two components of Alto’s technology stack are both integral to our coupon controls.

Our proprietary pharmacy management software, Wunderbar — through which more than 80% of our prescriptions are automatically billed by algorithms — gives us both control and flexibility, with the ability to set custom workflows and requirements.

Our patient app — which the majority of Alto patients use for intake, medication ordering, and delivery scheduling — integrates with Wunderbar. With many areas for patient input, including coupon sign-ups, the app allows us to easily provide data to partners and further supports our controls.

Multiple guardrails for controlling coupon use

Our robust technology platform gives us multiple ways to ensure that coupons are applied to those who are eligible.

Providers often include ICD-10 diagnosis codes on prescriptions to aid in prior authorizations and coupon use. The provided information is entered into Wunderbar during our automated intake process. Our billing controls can limit coupon use to a specific diagnosis code if necessary, allowing for proper distribution of a medication. 

If a provider did not include the necessary diagnosis code for coupon verification, the patient can verify their diagnosis through the app. Our tech capabilities allow us to create pop-ups or notifications as needed for patient input. This patient attestation can be customized for different medication coupon scenarios and reported outcomes.

With a flexible tech stack, we can easily create additional workflows or automations to further regulate savings applications. These are some of the filters we can use:

Since we use proprietary software, we’re not only able to ensure appropriate application of savings opportunities — we have so much available data about coupon use to share with partners like you.

We can provide NDC and patient-level insights, including coupon application, the exact amount of money saved, and how many fills were delivered. These data insights could help develop market access strategies by monitoring gross to net gaps and identifying the opportunities for copay accumulators and maximizers.

At Alto Pharmacy, a patient’s financial wellness is of the utmost importance. We understand that cost is one of the most common barriers to medication access, and we go above and beyond to connect patients with any savings opportunities that they may qualify for. 

At the same time, as a specialty pharmacy, we have a responsibility to protect the integrity of assistance programs and ensure that only eligible patients benefit from these resources. Our integrated technology stack provides the controls needed to restrict savings access to qualifying patients. Take a look.

A great pharmacy is so much more than a place where patients fill their prescriptions — it’s a partner in their care. The quality of a pharmacy is especially important for specialty medications, which typically include additional considerations like cost, storage requirements, administration, side effects, and more.

There’s no better judge of pharmacy care than the patients themselves. Alto is an industry leader with an NPS score of 85, positioning patients and caregivers to regard your medication in the highest possible light.

What to Consider When Choosing Your Limited Distribution Drug Partner

A great pharmacy is so much more than a place where patients fill their prescriptions — it’s a partner in their care. The quality of a pharmacy is especially important for specialty medications, which typically include additional considerations like cost, storage requirements, administration, side effects, and more.

There’s no better judge of pharmacy care than the patients themselves. Alto is an industry leader with an NPS score of 85, positioning patients and caregivers to regard your medication in the highest possible light.

Here’s what makes a great patient experience at a specialty pharmacy, and how Alto offers support for specialty medications at every step.

It can be time-consuming and stressful for a patient to get started with any type of medication, from getting that medication covered by insurance to searching for savings opportunities. With limited distribution drugs in particular, there are usually many steps between getting a prescription from a provider and actually beginning treatment, as these medications often require a prior authorization for insurance coverage. And since they are typically more expensive, thorough research into medication cost savings is essential from the standpoint of both a patient’s physical and financial wellness.

Your specialty pharmacy partner should offer the support patients need to access their medications as quickly and affordably as possible. Alto supports the prior authorization process, keeping both patients and providers informed at every step. And with Alto Connect — our free pharmacy communications portal for providers — it’s fast and easy for clinical teams to collaborate with our team on administrative work as needed.

We also conduct price investigations to help patients save on each prescription through manufacturer coupons, assistance programs, and other resources.

Once a medication has been approved by insurance, there shouldn’t be any additional barriers to receiving it. Not only should it be as simple as possible to fill a prescription and place a delivery, patients should be able to trust that their medication will arrive on time, and in the right condition.

Alto’s easy patient onboarding experience features proactive multichannel communication. We send patients a welcome text within 60 minutes of receiving their prescription to help them schedule their first delivery. (Those with a landline will get a call.) And our team is available to answer any questions via in-app messaging or phone.

Our same-day delivery service allows for quick and easy medication access seven days a week, and in-house couriers guarantee reliability and quality. We also offer a free medication bundling service, so those who take multiple medications have the convenience of one easy delivery. And patients are never left wondering where their medication is — the Alto app offers simple and accurate delivery tracking.

Additionally, we use special packaging to ensure that temperature-controlled medications are always stored appropriately before they reach a patient, with clear instructions about safe storage at home. Those who wish to pick up their medication can always visit our pharmacy in person.

Ongoing support with care and patient education is extremely important with specialty medications and limited distribution drugs, which typically require patients to make an ongoing commitment to their health and wellness. Treatment often includes routine testing, clinical monitoring, and side effect management to ensure proper drug utilization and maximize adherence.

So that patients can follow their treatment plan as directed by their doctor, your specialty pharmacy should have robust clinical expertise in specific conditions. It should also have a high-touch model that makes it as easy as possible for patients to benefit from that expertise.

At Alto, patient education and care isn’t a nice-to-have — it’s a must. To ensure that our pharmacists can actively participate in patient health journeys, we have a team of medication therapy management pharmacists who focus entirely on disease state education and support for chronic conditions.

These pharmacists regularly contact patients who take multiple medications or specialty medications to review their regimen by phone. During these calls, our pharmacists ensure that patients understand the purpose of each medication they’re taking and are staying on track with necessary testing.

Coupled with medication management tools like auto refills and medication bundling, our disease state education keeps patients coming back to Alto month after month, improving adherence for the long term.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions. Read on.

Medication Shortages, Explained | Alto Pharmacy

Few things are more frustrating — or frightening — than being unable to access the medication your doctor has prescribed. But it has become a common experience in recent years, as medication shortages remain a persistent healthcare challenge in the U.S. And if you take medication, you may be familiar with the panic of struggling to find enough of what you need.

Not only are these shortages incredibly frustrating and debilitating, they are also confusing and unpredictable, arising seemingly at random, and with little known about an anticipated resolution.

While Alto will always go above and beyond to bring you your medications without delay, these shortages are beyond our control, and we share your frustrations and concerns. To provide more clarity and context as to why these shortages occur — and why, unfortunately, there are few short-term solutions — we’ve compiled answers to some of the questions we hear most frequently.

Like every pharmacy across the country — as well as many around the world — Alto has been affected by medication shortages in the last few years. Each pharmacy’s stock fluctuates in tandem with demand, so if you call multiple pharmacies, it’s possible that one will have a greater supply of an affected medication than another on any given day. But ultimately, no pharmacy is immune to these challenges, and if a medication is in short supply, each pharmacy may feel the impact at some point.

If Alto currently does not carry your medication and you would like to transfer your prescription to another pharmacy, be sure to call that new pharmacy to confirm availability of your medication — medication shortages often impact most pharmacies within a specific region. 

The causes of medication shortages are complex, with multiple, and often intersecting, factors at play.

Any issues that affect the production of a medication may lead to reduced supply. This includes disruptions to manufacturing, like when Hurricane Maria damaged production sites in Puerto Rico in 2017.

Covid is another example of how a natural disaster or global crisis can disrupt medication production. The United States relies heavily on other countries for the raw ingredients needed to manufacture a medication.* This leaves us incredibly vulnerable to changes in workforce capacity or manufacturing activities overseas.

*As of 2019, only 28% of our country’s supply of active pharmaceutical ingredients (APIs) — the substances directly responsible for a medication’s therapeutic benefits — were manufactured domestically.

Even when manufacturing circumstances are ideal, rising demand for a medication can lead to low supply. This winter’s difficult cold and flu season, with high cases of Covid, the flu, and R.S.V., contributed to a decreased supply of children’s formulations of ibuprofen, acetaminophen, and several commonly prescribed antibiotics.

Adderall®, a stimulant used to treat attention-deficit/hyperactivity disorder, is another medication whose demand has increased in recent years. Prescriptions for the medication increased by 15.1% in 2020, in comparison to a 7.4% increase in 2019. This comes after a surge in new ADHD diagnoses, which more than doubled between 2007 and 2016 and continue to rise. Worker shortages and production delays experienced by Teva, a leading manufacturer of Adderall, have added additional pressure and compounded the challenges.

High demand has also contributed to recent shortages of the diabetes medications Ozempic® and Wegovy®,  as they have been increasingly prescribed for weight loss.

Addressing increased demand is often easier said than done. Most generic manufacturers decide how much of a medication to produce at the beginning of the year, with virtually no flexibility, so it isn’t an option to simply make more. This is why there is often a seasonal pattern to shortages, with many intensifying at the end of the year.

In the case of Adderall, a Schedule II controlled substance, the Drug Enforcement Administration (DEA) imposes strict production quotas to prevent misuse. With quotas based on estimates, our manufacturing system isn't prepared to respond to unexpected factors like the recent rise in ADHD diagnoses. 

Why are shortages happening more frequently?

Medication shortages are in the headlines more these days, but they are not a new occurrence. They have steadily increased since 2006, becoming a public health crisis in more recent years. The American Society of Health-System Pharmacists (ASHP) reports that, at the end of 2022, ongoing and active shortages were the highest they’ve been since 2014.

The growing intensity of these shortages reflects the strain that Covid put on our entire healthcare system — which we still haven’t fully recovered from — along with other unpredictable healthcare patterns, like growing demand for ADHD medications.

Are certain medications more likely to be affected than others?

Ultimately, any medication can go into shortage, but some types are more prone to recurring supply chain issues.

Medication shortages frequently occur with commonly used (and low-profit) generic medications — like the antibiotic amoxicillin — as pharmaceutical companies have little financial incentive to produce more of them.

Some injectable generics are especially vulnerable to shortages. Fewer manufacturers make these medications, so any production disruption can become a larger issue.

The Adderall shortage illustrates that low stock of a single medication can create a class-wide issue. For many people with ADHD, switching to another medication has proven challenging, as alternatives grow scarce too. This is also the case with Ozempic and other diabetes medications.

Medication shortages are rooted in factors that are far beyond any one person’s control, and unfortunately, there is little we can do to prevent them. Industry experts have proposed solutions, including ramping up domestic production of key pharmaceutical ingredients and building a more resilient medical supply chain. These aren’t quick fixes, and government action is needed for meaningful progress.

What can I do to navigate a medication shortage?

While many medication shortages are unavoidable, there are steps you can take to potentially minimize their stress and impact.

You can track medication shortages on the U.S. Food & Drug Administration or ASHP websites to learn more about a medication’s supply.

To give yourself more time to figure out a short-term solution — such as switching to an alternative medication — refill your medication as far in advance as you can. In some cases, it may be possible to get a 90-day supply of your medication, though this isn’t always an option for controlled substances, and your insurance plan may also limit coverage of refills.

If your medication is in scarce supply, speak with your doctor about alternatives. In addition to taking a different medication, you may be able to switch to a different dose or formulation. Many medications require that you safely taper off of them, which is another reason it’s important to stay on top of refills and ideally learn about supply issues before the last minute.

If an alternative medication costs more or is not covered by your insurance plan, there are resources to help alleviate some of the burden, including coupons, manufacturer-sponsored copay cards, and patient assistance programs. Alto is here to support your savings investigations, and we also suggest reaching out to your insurance provider and verifying your plan’s details — they may be required to cover a branded option if a generic is unavailable.

Our team can answer any questions you have about your medications. We also offer same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with treatment.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions.

No industry is immune to burnout, including pharmacy. At many traditional retail pharmacies, individual pharmacists are often asked to do more than is possible on any given workday. Not only does this deprive talented and extensively trained health professionals of a manageable working environment, it deprives patients of the exceptional care they deserve.

pharmacists-spotlight-roni-hein

The better pharmacy model we’ve created at Alto makes life easier for everyone involved in the prescription process: patients, physicians, and pharmacists. And in restructuring how pharmacists work, we haven’t just separated fulfillment and patient care responsibilities into different roles — we’ve ensured that there’s ample support for each specialization, as there should be in any profession.

To wrap up our series of pharmacist profiles in celebration of American Pharmacist Month, we spoke to Roni Hein, a patient care pharmacist lead who takes care of her team so that they can in turn care for patients.

What motivated you to pursue a career in pharmacy?

It all began with my high school and college job at Target. I interacted a lot with the pharmacy team while working in the health and beauty section and eventually moved into that department.

I never expected it to be more than a college job, but it turned into the beginning of my professional path. As I worked there, I was able to see the impact pharmacists made in customers’ lives each day. It really struck me that in many communities, including mine, pharmacists were the most accessible healthcare providers. That accessibility is so impactful on a person’s well-being.

What challenges have you encountered as a pharmacist?

Limited time and isolation behind the counter, without question. In retail pharmacy, more and more responsibilities were added to my job description, with fewer resources to accomplish them.

All pharmacists value the personal connections we make with patients. I think many of us would say that making an impact through patient counseling is the best part of our day, but that is often what gets lost when pharmacists are asked to do more. Our primary driver for entering the profession is the first thing to go. I found a very refreshing change at Alto.

Everyone at Alto, no matter their department or role, has the same shared goal of improving patient lives by transforming the pharmacy model. As a patient care pharmacist lead, I do that by supporting my people. I create the space for our pharmacists to do their best work. They are able to have better interactions with patients because they are taken care of.

The pandemic has been a trying time for many companies and teams, including mine. I am constantly looking for new ways to ward off burnout and maintain a sense of camaraderie, not only for the pharmacists I manage, but for the benefit of our customers as well.

The individual locations of many retail pharmacies can feel very separate from each other. Each one often serves a single population.

The centralization of Alto’s patient care team is a contrast to that model. We have a cohesive, unified team serving all patients. That means there’s a depth of resources available to each pharmacist, which is also really important for retaining great talent.

Our pharmacists have a great support system in their colleagues. There’s other smart, driven pharmacists to bounce ideas off of. Unfortunately, you don’t always get that in our profession.

It also means that you don’t have to worry about anything falling through the cracks if something comes up outside of work. It's a game changer to be able to take time to grieve a loved one or to care for your child if they’re sick while knowing that your patients are still in expert hands. I never had that in retail pharmacy.

Finally, what is one thing people would be surprised to know about life as a pharmacist?

At a tech-oriented pharmacy like Alto where there’s so much innovation, you’re constantly thinking of new and creative ways to problem solve. It’s challenging in the best possible way. There isn’t a day when I don’t have to put my critical thinking skills to use.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. Meet the other pharmacists featured in this series: patient care pharmacist Travis Allison, specialty patient care pharmacist Gabrielle Kaplan, and medication therapy management pharmacist Wei-Lin Chang.

National Pharmacists Month Spotlight: Roni Hein

If you’re managing a chronic health condition — or multiple conditions — you’re probably familiar with the hassle of filling multiple medications. Not only is it inconvenient to track different refill dates throughout any given month, it makes it much more difficult to prioritize your health, with the potential for missed doses.

To make it as convenient as possible to stay on track with treatment, Alto offers a free medication bundling service that lets you receive all your medications in a single, recurring delivery.

Medication Bundling: One Delivery for All Your Prescriptions

If you’re managing a chronic health condition — or multiple conditions — you’re probably familiar with the hassle of filling multiple medications. Not only is it inconvenient to track different refill dates throughout any given month, it makes it much more difficult to prioritize your health, with the potential for missed doses.

To make it as convenient as possible to stay on track with treatment, Alto offers a free medication bundling service that lets you receive all your medications in a single, recurring delivery.

Medication bundling builds on other tools in the Alto app like auto refills and medication reminders to take the hassle out of living your healthiest life. And like everything at Alto, it bridges innovation with industry-leading care to deliver an exceptional pharmacy experience that puts you first.

While some traditional retail pharmacies offer a similar service, they often require you to do the legwork of coordinating with your doctor and insurance. (Not to mention that there’s the additional inconvenience of traveling to the pharmacy and waiting in line.)

At Alto, it’s a whole lot simpler. The entire process takes place in the app, and if your medications are eligible*, we can organize your bundle within seconds.

We’ll get you started with synchronized refills and bundled deliveries in four simple steps.

1. If you have multiple prescriptions on file with Alto that qualify for bundling, you will be automatically prompted to bundle your medications when you log into the Alto app and we’ll sync your refills. (Have prescriptions at other pharmacies? Transfer them to Alto so we can add them to your refill schedule!)

2. We’ll ask you to confirm your medication list and current supply. Let us know if any of your medications are taken on an as-needed basis, or if any are urgently needed.

3. We’ll create a custom timeline for your synchronized refills. Depending on your insurance coverage, this may be once a month or up to every three months. If needed, we’ll schedule a partial fill upfront to avoid a delay in your treatment while we align your refills.

4. We’ll schedule all refills into a single delivery on your behalf and reach out on a recurring basis when your order is ready for delivery. As always, you’ll pick the delivery window that works best for your schedule.

Ready for one easy delivery? Transfer your prescriptions to Alto to start the medication bundling process today.

*Medication bundling is not available for some medications. In addition, some insurance plans may limit automatic refills.

When Jake Moffatt says he loves building things, he means it — sometimes literally. A construction project manager turned engineer, Jake has spent the past decade building software at mission-driven organizations. Today, as Engineering Manager of Alto Assistant, he leads the team that’s bringing wizard-like support to Alto’s customer-facing app.

Get to know Jake Moffatt, Engineering Manager on the Alto Assistant Team

When Jake Moffatt says he loves building things, he means it — sometimes literally. A construction project manager turned engineer, Jake has spent the past decade building software at mission-driven organizations. Today, as Engineering Manager of Alto Assistant, he leads the team that’s bringing wizard-like support to Alto’s customer-facing app.
Below, Jake chats with fellow engineering manager Mike Riess and recruiter Braden Hanlon about the work ahead for Alto Assistant.

I’d love to learn more about your background to get us started. How did you end up in software engineering?

When I was twelve, I started learning to code in QBASIC because I wanted to make video games. Once I wrote my first program, I was hooked! I loved computers and the creative power they gave to anyone willing to invest the time and energy to learn. Since then, I’ve built games, personal tools and projects, desktop software, and a number of apps and services — I love building things. My career has gone back and forth between construction and software engineering, but it’s been firmly in the software industry for the last ten years or so.

My favorite place to be in a company is working on something new that has a big impact or addresses an important problem. In a previous role, I built an app that helped people find roommates in a city where housing is prohibitively expensive. At that same company, I led the team responsible for creating a new vertical that eventually split off into its own company.

The goal of Alto Assistant is to help customers help themselves before reaching out to support. Our first project is introducing a wizard-like support “assistant” (hence the team name!) that guides the customer through a series of questions to narrow down the area of support. We’ve already identified a few tasks the assistant can help customers complete on their own, including making changes to upcoming deliveries or scheduling new orders.

In cases where we can’t help them just yet, our new tool generates data to help us to learn exactly what customers need help with. It’s a top priority to bake analytics into every new feature we build; even though we have years of experience supporting our customers — and we know intuitively which problems they frequently experience — we don’t have conclusive data to draw upon just yet.

We plan to start with a couple of frequent use cases and measure how often customers reach out to us for support. Then, we’ll chip away at the problem until we’ve seen a substantial improvement in the user experience. From there, we’ll move on to the next biggest problem and repeat the cycle. There’s a reason “Chip away it” is an Alto value: It’s the playbook that we’ve used to automate other critical parts of the pharmacy value stream like intake, billing, and fulfillment.

What opportunities are you most excited about?

Support drives much of the cost of every shipment today, so this is a high-impact area for our business. A year from now, it would be a stellar outcome if the Assistant team could reduce the number of issues that customers need support on by half.

We’re also thinking about the user experience beyond the app. We plan to improve the tooling that our care specialists use to provide support as well. We’ve already discussed some promising ideas like creating the concept of a conversation in support communications rather than an infinite stream of messages and building out enriched communications. We also intend to develop a custom tool that can expedite a customer’s prescription when they need their medication ASAP.

The possibilities are many, and it will take a team of determined, passionate, empathetic people to solve these challenging problems. I’m super excited to see what the Assistant team will do together.

Any lessons learned from previous experience that you’re applying to your role at Alto?

There’s always the temptation to tackle everything at once with new business initiatives. My experience leading new verticals at Apartment List and Snapdocs taught me the importance of being laser-focused on one or two key metrics instead of trying to build out a fully-realized product from the beginning. That’s exactly what we’re doing on the Alto Assistant Team with our clear focus on reducing communications per shipment — how often customers reach out for help because they could not find what they needed in our app.

It’s also important to recognize that we won’t have all the answers right out of the gate! I like to think of product development as a three-step sequence: learning, growth, and maintenance. Alto Assistant is so young that we’re very much still in the learning phase. We maintain a tight iteration loop with everything we ship: launch, measure the impact, and use the results to iterate and refine our hypotheses about what our users want. Our final product could be anything from a customer support wizard to an AI chatbot to a ticketing system — we have to rely on our key metric of communications per shipment, experimentation, and user feedback to shape the direction.

What got you excited to join Alto? What would you pass on to an engineer thinking about applying to the company?

I was impressed by the Altoids I met during the interview process. I knew I would be working with people from whom I could learn a lot, like Elnaz, who started as an individual contributor and went on to become Director of Engineering and, now, Alto’s first Head of Strategy & Operations. I was also impressed by the quality of the interview process itself — a good sign that the company was well-organized internally. Finally, the pitch for the role was extremely clear, with already-established key metrics that would directly contribute to the company’s bottom line and help Alto become more profitable.

For engineers, I think Alto is a great place for both technical challenges and career growth. We’re still small enough that every individual gets exposure to a broad portfolio of high-impact projects. It’s also a great environment for learning about how a business works — the Product & Technology organization does a great job of sharing information and presenting problems in a way that gets to the root business problem we’re trying to solve. There’s a clear line between any project a team is working on and a foundational business metric. Most importantly, we’re a company that makes a truly positive impact on our users’ lives.

Interested in learning more about engineering at Alto? Follow us on LinkedIn.

Alto’s board of advisors was formed in 2020 to deliver strategic guidance as we work toward a better healthcare system for all. With diverse leadership experience in the industry, our board of advisor members ensure that our efforts are both impactful and efficient, with services grounded in the highest standards of operational excellence.

Meet the Newest Members of our Advisory Board | Alto Pharmacy

Today we’re thrilled to welcome three new members to the board of advisors: Adam J. Fein, Harry Leider, and Brad Fluegel. Their passion and expertise will no doubt be an asset as we focus on reaching even more patients — and delivering even more comprehensive care — in service of our mission.

Read on to learn more about their backgrounds in the industry and join us in giving them a warm welcome!

Adam J. Fein, PhD, is the CEO of Drug Channels Institute, a leading source of industry research about pharmaceutical economics and the drug distribution system. Widely published in academic and industry publications, he also heads the Drug Channels website, praised by readers for its comprehensive and witty coverage of pharmacy benefit managers (PBMs), medication pricing, and other industry topics.

Delivering medications to our patients at the lowest price possible is central to our mission. Dr. Fein’s deep expertise in pharmacy economics supports our ongoing commitment to improve adherence rates by way of more affordable medication options and total price transparency.

“The pharmacy industry has entered a period of structural change. There’s a tremendous need for the cost transparency, efficiency, and commitment to patient well-being that Alto delivers. I’m thrilled to support Alto in building innovative solutions to foundational issues within the industry,” Dr. Fein said.

Dr. Fein holds a doctoral degree in managerial science and applied economics from the University of Pennsylvania’s Wharton School of Business.

Harry L. Leider, MD, MBA brings more than 25 years of experience as a senior healthcare executive to our board of advisors. Since 2018, he’s served as Chief Medical Officer and Executive Vice President of Gelesis, an innovative biopharmaceutical company.

In addition to his current leadership in the biotherapeutic space, Dr. Leider has broad experience in telemedicine, retail healthcare, laboratory medicine, and payor strategies, as former Chief Medical Officer of Walgreens Boots Alliance, Ameritox, and Care Improvement Plus.

Dr. Leider shares Alto’s commitment to driving lasting change within the healthcare system for better patient health. With both clinical expertise and executive experience, he’s spent his career designing programs, services, and intellectual property that improve health outcomes.

“Alto’s pharmacy model brings us closer to a future where everyone can receive the highest standard of care and is equipped to manage their health. I’m personally inspired by Alto’s bold vision for healthcare and look forward to what we can accomplish together,” Dr. Leider said.

Dr. Leider has served on the faculty of Harvard Medical School and the Johns Hopkins Carey School of Business and holds five patents in laboratory medicine.

Drawing on more than three decades of healthcare experience, Brad Fluegel is a strategic advisor to organizations, entrepreneurs, and other industry participants. Most recently he served as Senior Vice President and Chief Healthcare Commercial Market Development Officer for Walgreen Co, where he managed all commercial healthcare activities, from sales and contracting to biopharma relationships and market planning.

Previously, Brad oversaw Walgreens’ corporate strategy and business development as Chief Strategy and Business Development Officer. He also led Elevance (then Wellpoint)’s strategic planning and corporate communications as Executive Vice President and Chief Strategy and External Affairs Officer.

His expertise in strategic planning and operations will allow us to deliver an exceptional patient experience as we continue to grow.

“Since 2015, Alto has proven itself to be a leader in the rapidly evolving digital pharmacy space. It’s a privilege to support their efforts to redefine what’s possible in healthcare, and together we can deliver industry-leading care to more patients,” he said.

Brad earned a master’s degree in public policy from Harvard University’s Kennedy School of Government and a bachelor of arts in business administration from the University of Washington. He also serves as a lecturer at the Wharton School of Business.

Dr. Fein, Dr. Leider, and Brad join three other advisory board members: Dr. James Hildreth, the President and Chief Executive Officer of Meharry Medical College; Jennifer Kent, previously the Director for the California Department of Health Care Services; and Ajay Khatri, previously Alto’s Chief Strategy Officer. 

Dr. Hildreth, Jennifer, and Ajay have offered invaluable guidance as we’ve grown throughout the past two years, and we couldn’t be more grateful for their partnership and support.

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