Shop Alto Essentials to add pharmacy products to any delivery!

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

Alto Pharmacy Technician

Alto Pharmacist

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

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

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

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

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

Blog | Alto Pharmacy

The Alto product and engineering team has long been focused on initiatives that improve our unit profitability. Now that we’ve laid a strong foundation, we've started to think about our next big bets: How do we expand our services beyond delivering prescriptions? How do we test new value-add offerings quickly and iteratively? That’s where the incubation team comes in.

Meet the Innovation Team Building Alto's Next Big Bets

The Alto product and engineering team has long been focused on initiatives that improve our unit profitability. Now that we’ve laid a strong foundation, we've started to think about our next big bets: How do we expand our services beyond delivering prescriptions? How do we test new value-add offerings quickly and iteratively? That’s where the innovation team comes in.

Newly launched in 2022, the team is small and scrappy by design. We’re a product manager, two engineers, a part-time designer, and a part-time manager with a single mission: to launch at least two significant new business experiments per year. If an experiment is successful, we’ll scale it into a full workstream before handing it off to a stand-alone product team.

We started with over-the-counter (OTC) medications. OTCs, or medications you can buy without a prescription, like Advil, are high-margin products that users are accustomed to purchasing at traditional, brick-and-mortar pharmacies. The goal of this experiment was to assess how much interest users have in adding OTCs to their order while checking out in the Alto app. We set a target conversion rate and offered OTCs only from our San Jose pharmacy, which is less busy than our San Francisco pharmacy but close enough to engineers in San Francisco for in-person troubleshooting.

Our initial hypothesis: if we present users with a small selection of OTCs targeted to their needs (based on the prescriptions in their cart), they’ll be more likely to convert. With support from our pharmacy partners, we carefully curated a recommendation algorithm that would suggest nine OTCs based on the medications already in the user’s cart.

In the interest of lean experimentation, we wanted a scrappy technical solution that could be implemented quickly while meeting our high user experience standards and minimizing operational risk. We settled on the following architecture:

We prioritized creating a clean API for Alto’s customer-facing app and using as much of our current infrastructure as possible. Although OTCs are distinct from prescriptions, we decided to reuse our existing prescription model rather than build a new one from scratch. This allowed us to leverage existing systems and operational workflows, reducing engineering time and risk of regression.

Behind the API, we opted to store our OTC formulary and associated metadata in in-memory data structures:

ADVIL = SkuId.new(sku: '...', sku_type: '...').freeze
CLARITIN = SkuId.new(sku: '...', sku_type: '...').freeze
FISH_OIL = SkuId.new(sku: '...', sku_type: '...').freeze
...
METADATA_BY_SKU_ID = {
  ADVIL.hash_code => {
    image_url: '...',
    name: 'Advil Ibuprofen 200mg Coated Tablets',
    quantity_description: '100 tablets',
    product_description: 'Easy to swallow powerful pain reliever for headaches, joint and muscle pain.',
  },
  CLARITIN.hash_code => {
    image_url: '...',
    name: 'Claritin 24 Hour Allergy Tablets',
    quantity_description: '30 tablets',
    product_description: 'Non-drowsy, 24 hour relief of symptoms due to allergies: sneezing, runny nose, itchy and watery eyes.',
  },
  FISH_OIL.hash_code => {
    image_url: '...',
    name: 'Fish Oil 500mg Softgels',
    quantity_description: '130 softgels',
    product_description: 'Dietary supplement with EPA and DHA omega-3 fatty acids to support heart health and maintain normal triglyceride levels.',
  },
  ...
}.freeze

This gave us a nice balance of speed and flexibility. We knew that we could optimize once we had established our OTC offering and gained an understanding of how it would evolve within Alto.

The results of phase 1 were a bit disappointing, but very interesting: the conversion rate of users who checked out with an OTC was just under our target. However, nearly half of all users who saw the experience would scroll down to peruse all nine OTCs that were offered.

Based on this positive sign of engagement, we hypothesized that perhaps we just weren’t showing the right OTC products to the user. For phase 2, we decided to scrap the limited recommendations and allow users to explore an entire catalog of OTCs.

Phase 2 required categorizing our list of OTCs into buckets such as “Top Sellers,” “Covid Care,” and “Allergy & Asthma.” We built a new fetch_categorized endpoint to return our OTC catalog structured by category, adding search functionality into the client so that users could quickly filter for a specific product. This search field was also heavily tracked with analytics events to help us learn which products to add to our catalog in the future.

This new experience immediately outperformed phase 1. After a few performance improvements (speeding up our catalog and product image load times), we eventually hit our target conversion rate — even managing to surpass it on some weeks!

Our eventing did show that a significant number of users with multiple prescriptions or smaller screens were not even seeing the OTCs in Cart, as they were pushed below the fold. We tried experimenting with alternate spots to show our catalog:

1. An interstitial that shows after Cart and before Checkout - this didn’t perform any better than the control and was quickly scrapped.

2. A single carousel at the top of Cart - this out-performed the control but at the cost of our guardrail metric. With a decrease in the overall checkout rate, we decided to stick with the control for now.

This phase of UI experimentation validated that our users wanted an offering of categorized OTCs. However, our initial technical solution wouldn’t scale as we rolled out to more of our pharmacies. The following questions led us to this conclusion.

How might we support changes to our OTC catalog on a per-pharmacy basis?

Given factors such as inventory, geography-related price sensitivities, and experimentation, we wanted to make sure that we could tweak the OTC experience for users getting deliveries from a specific pharmacy.

In the status quo implementation, that would have likely meant adding an additional layer to our data structures like so:

SKUS_BY_PHARMACY_AND_CATEGORY = {
  SF_PHARMACY_ID => [
    AddOnOtcCategoryType::TopSellers => [
      IHEALTH,
      FLONASE,
      ASPIRIN,
      ...
    ],
    ...
  ],
  ...
}

We weren’t worried about memory space limits given our relatively small number of pharmacies and OTC catalog. We were concerned, however, that each modification would require an engineer to go in and make code changes, get PR approval, and wait for a full deploy for the update to go live. This would be a bad use of engineering time, and our CI/CD process would become a bottleneck to otherwise quick modifications.

How might we add and remove OTCs from our catalog?

Similarly, we knew that adding and removing OTCs from our catalog would also be a somewhat regular workflow. There are some other considerations when adding a new OTC (Is it in our product database? Do we need any new procurement/inventory workflows to make sure it gets stocked in our pharmacies? Do we have a nice image to render in the app?), but we wanted to automate the technical side as much as possible — or at least be able to automate it.

The natural next step was to move our OTC catalog into the database.

Alto’s OTC Database Schema. Some columns excluded for brevity.

Now, rather than grabbing from in-memory data structures, we are efficiently querying the database for the OTC catalog of a user’s specific pharmacy, preloading all of the associated models needed for our API response.

OtcCategory
  .includes(otc_category_products: { otc_product: :otc_product_metadata })
  .where(otc_category_products: { pharmacy_id: pharmacy_id })
  .where(otc_product_metadata: { pharmacy_id: pharmacy_id })


At the time of writing, an engineer is still required to go in and make the changes at the database level. However, we plan to build an admin dashboard so that designated pharmacy partners can tweak our OTC catalog without the help of an engineer.

We’re excited about our next iteration, which will allow users to add OTCs to their upcoming deliveries at any point, not only when checking out. It will likely be live by the time you read this.

Once that’s released, we will continue to learn, iterate, and pay down technical debt — more specifically, maturing the OTC data model in our backend and eliminating the need for them masquerade as prescriptions.

Looking even further ahead, the innovation team has more exciting and impactful projects on our roadmap. We can’t wait to share what’s in store!

We’re excited to share that Alicia Boler Davis will be Alto’s next CEO. She will start on September 1, 2022. This is a big moment for Alto, so we wanted to share how we got here.

Introducing Alto’s New CEO - Alicia Boler Davis

We’re excited to share that Alicia Boler Davis will be Alto’s next CEO. She will start on September 1, 2022.

This is a big moment for Alto, so we wanted to share how we got here.

Alto has come a long way since we started out in 2015 by acquiring AG Pharmacy in San Francisco. Those first few months revealed just how much opportunity there was to build a better pharmacy experience for patients by rebuilding the entire end-to-end technology stack, combining it with a more efficient operational process, and backing it all with a talented and caring team. And with that insight we started forging ahead with bright eyes and relentless optimism toward our ultimate mission: fulfill medicine’s true purpose - to improve quality of life - for everyone who needs it.

Like any transformational startup, the journey has not been without its challenges. We’ve been consistently humbled by the complexity of the pharmacy industry and the challenges inherent in transforming how it works. Yet we’ve also been consistently amazed by how much opportunity there really is to make a meaningful difference in the lives of patients, and how receptive people are to a better solution. And through persistence and grit, combined with an increasingly talented and diverse team, we have overcome all the challenges that we have faced so far. We have served over 300,000 patients, with a 90 Net Promoter Score, are unit profitable, and are expected to pass $1 billion in annualized revenue in the next few months. We’re making faster progress than at any point in the company’s history. 

So if things are going so well, why are we hiring a new CEO? The opportunity ahead of us is huge, and along with that the challenges are getting more complex. Despite how far we’ve come, we are still only 0.2% of the total pharmacy industry market share. Capturing this massive opportunity will require leveling up our already world-class team with an even greater level of bold, rigorous, caring, experienced leadership.

As we got to know Alicia over the past few months, we realized that we had found the perfect partner to lead us through the next phase of Alto’s growth. Alicia was most recently the SVP of Global Customer Fulfillment at Amazon, and before that the EVP of Global Manufacturing at General Motors. Alicia grew up in Detroit, and got her first job as an engineering intern at GM. Over the next 25 years she worked her way up to running a plant, then running multiple plants, then running all of quality and customer experience, and finally running all of global manufacturing. She was the first Black woman to accomplish each of these things at GM. In 2019 she joined Amazon, and was quickly promoted to the prestigious S-team, which is the exclusive inner circle of the most senior leaders at Amazon. When she was barely a year into the job, the Covid-19 pandemic hit, and over the next two years she oversaw Amazon nearly doubling its fulfillment network capacity to keep up with surging demand, while managing a team of over 800,000 people. Alicia built a reputation for successfully navigating the toughest challenges while driving unparalleled growth by bringing out the best in her teams.

From the day we started, we have always tried to build a team that is balanced between the rigor and operational excellence needed to execute in this complex industry, along with the heart and care that we saw was missing from the industry. These are not mutually exclusive attributes, but they are extremely rare to find in the same person. In Alicia, more than any other leader we’ve ever met at her level, we’ve found someone who can bring that balance that we seek. She is one of the world’s top executives in operations, and is a rigorous, disciplined operator. And at the same time, she leads with real heart and care for the people that she serves and that she works with.

With Alicia coming on board as CEO, Matt and I will continue to be involved full-time, both in supporting Alicia and with our own portfolios of projects to lead. We’re more committed than ever to Alto, and more excited than ever about the real opportunity we have in front of us. And we are so early in this journey that it is clear there is no shortage of work to do and problems to solve. Matt and I have never been attached to any particular role or title, and have each worn many different hats over the years. We are humble about what we are good at and what we are not, and just want to do what is best for our team in order to achieve our mission. In the short term we will focus on ramping Alicia up, and after that we will work more on what we do best: building our long term strategy, leveraging our entrepreneurial spirit to spin up new business lines, defining and evolving our culture, and sharing the Alto vision.

We are just getting started, and there is still so much opportunity to fix this broken industry, and truly help people live happier and healthier lives. We can’t wait to see what we will do together in this next phase of the Alto journey.

Alto’s launch in the Long Island market extends our industry-leading patient care model to even more of the New York metro area.

Hello, Long Island!

Alto’s launch in Long Island, New York, extends our industry-leading patient care model to even more New York-area residents.

With the addition of our latest pharmacy location in Plainview, Long Island, even more residents of the greater New York City metro area can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. Alto Long Island opens its doors today, Tuesday, April 5, 2022.

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

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

Courier delivery windows
Monday - Friday: 

12:30 – 3:30 pm ET (1:30 – 4:30 pm ET for outlying areas)*

6:00 – 9:00 pm ET (7:00 – 10:00 pm ET for outlying areas)

2:00 –5:00 pm ET (3:00 – 6:00 pm ET for outlying areas)

Need to pick up? Our new Long Island pharmacy is located at 100 Manetto Hill Road, Suite 104, in Plainview.

Monday - Friday: 9:00 am – 7:00 pm ET
Saturday - Sunday: 8:00 am – 4:30 pm ET

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

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

*Weekday afternoon delivery is only available to residents of New York City's five boroughs at this time.

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

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today

Five Black Healthcare Leaders to Celebrate

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today. (For additional inspiration, revisit the first post in this series.)

Dr. M. Jocelyn Elders: the first Black U.S. surgeon general

As a Black woman born to farmers in a rural, poverty-stricken area of Arkansas, M. Jocelyn Elders encountered numerous obstacles on her path to becoming the first Black U.S. Surgeon General in 1993. At 16, she met a doctor for the first time, but she didn't consider a profession in healthcare until she connected with Edith Irby Jones, the first Black person to attend the University of Arkansas Medical School, during college.

Throughout her career, Dr. Elders balanced clinical practice and research, increasing the public’s awareness of adolescent health issues. In 1987, Bill Clinton, then the governor of Arkansas, appointed Dr. Elders as head of the state’s Department of Health. The Arkansas state legislature mandated sexual education and substance misuse prevention programs in the K-12 curriculum in 1989 in large part because of Dr. Elders’ advocacy. During her tenure as Surgeon General, Dr. Elders continued to champion progressive policies, advocating for better sexual education programs, distribution of condoms in schools, and abortion rights. She remains active in the field of public health as a professor emeritus at the University of Arkansas School of Medicine.

Bernard J. Tyson: former CEO of Kaiser Permanente

As chairman and CEO of Kaiser Permanente, Bernard Tyson transformed the company’s services to account for social determinants of health like food access and affordable housing as well as the importance of mental health and wellness. He was also instrumental in the development of the Kaiser Permanente School of Medicine, which trains physicians to be not only clinicians, but patient advocates and innovators, too. By shining a spotlight on how social determinants of health contribute to disparities in health outcomes, Tyson leaves behind a legacy that reaches far beyond Kaiser’s services.

Nadine Burke Harris: first surgeon general of California

A physician, researcher, advocate, and California’s first surgeon general, Dr. Nadine Burke Harris has transformed how our society responds to childhood trauma. While running a health clinic in an underserved San Francisco neighborhood, she observed that preventative health practices and quality treatment didn’t resolve her patients’ risk for poor health outcomes. Drawing upon research from the CDC and Kaiser Permanente on adverse childhood experiences (ACEs), which linked early adversity to higher rates of chronic illness later in life, Dr. Burke Harris studied her own patients and found that more than 67% had experienced at least one ACE. She has helped increase public awareness of ACEs and toxic stress, advocating for universal screening of children and adolescents for signs of trauma. Her 2014 TED Talk, “How Childhood Trauma Affects Health Across the Lifetime,” has been viewed more than 7.5 million times, and she published The Deepest Well: Healing the Long-Term Effects of Childhood Adversity in 2018.

Dr. Patrice Harris: first Black female president of the American Medical Association

Despite not knowing any doctors while growing up in West Virginia, Dr. Patrice Harris’ passion for medicine started early. The board-certified psychiatrist initially planned to pursue pediatrics but shifted her focus after discovering an interest in psychiatry during medical school. Her focus on child psychiatry allows her to merge her passion for children with her expertise in mental health. Throughout her career, Dr. Harris has focused on the role of implicit bias within the medical profession and how unconscious biases among healthcare workers influence health disparities.

Dr. Harris’ involvement in the professional healthcare community spans many leadership positions at state and national organizations. She became the first Black woman elected as president of the American Medical Association in 2020. During her tenure, she focused on a variety of health issues, from opioid addiction to COVID-19. She previously chaired the AMA’s Opioid Task Force, providing evidence-based recommendations to clinicians with the goal of ending the opioid epidemic.

Betty Smith Williams: first Black graduate of the Frances Payne Bolton School of Nursing

Betty Smith Williams was the first Black student to earn a nursing degree from Cleveland’s Frances Payne Bolton School of Nursing, in 1954, and the first Black individual to teach at a higher education institution in the state of California, but her individual accomplishments are only a part of her legacy. Williams has helped ensure that today’s aspiring Black healthcare professionals have the opportunities and support to break down barriers of their own. She was instrumental in developing the National Black Nurses Association and the National Coalition of Ethnic Minority Nurse Associations, Inc. — initiatives that have elevated the voices of Black nurses within the profession. In uniting Black nurses, Williams hoped to create better health outcomes among the Black community. In her own words: "We had no voice, but we understood our culture and our unique needs better than anyone else.”

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

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.

Residents of the Austin metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

Hello Austin

Alto's new Austin-based pharmacy marks our third location in Texas.

Starting today, December 7th, residents of the Austin metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

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

Courier delivery windows
Monday - Friday: 6 - 9 pm CT (7 - 10 pm CT for outlying areas)
Saturday - Sunday: 2 - 5 pm CT (3 - 6 pm CT for outlying areas)

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

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

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

Need to pick up? Our pharmacy is located at 4175 Freidrich Lane, Suite 202.

General customer support hours are Monday - Friday 8 am - 11 pm CT and Saturday - Sunday 9 am - 8 pm CT. Patients can reach out to Alto via phone at 1 (800) 874-5881 or in the Alto app.

Editor’s Note: This post was originally published in December 2021 and has been updated for accuracy and completeness.

Get an inside look at the patients team at Alto Pharmacy to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

Get to Know the Team That Builds Alto's Customer-Facing Apps

Imagine an app that allows you to buy things and have them delivered to you the same day, for free. Now take that app and put it in a highly regulated space like pharmacy. You face the challenge not only of building an e-commerce platform from scratch, but also of navigating medication pricing, federal and state regulations, and patient safety—and that's just the way the Patients Team likes it.

"It's a really exciting and fun problem to solve," says Mike Riess, the team's Engineering Manager. Software Engineer Angelique Nehmzow agrees: "There's a really strong product and design aspect, like more traditional startups, but then everything gets a little bit more interesting because it's healthcare."

Below, we chat with the team to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

What does the Patients Team do at Alto? 

Ask anyone on the team why they joined, and chances are, they'll tell you they wanted to be on the product team closest to Alto's customers: "We really try to own the customer experience," says Peter Zeng, the latest Software Engineer to join the team. "If a customer is coming to the web app, or they're coming to our mobile app, we want to make sure that they're able to onboard with us as easily and conveniently as possible."

The team is also responsible for the customer experience beyond onboarding, from the moment a customer schedules a medication for delivery to the time that it shows up on their doorstep. "We already offer great services like free, same-day delivery and cost savings. The Patients Team empowers customers to make the most of our offering," Nehmzow explains. "You can see what prescriptions you have, check on the status of your order, and schedule automatic refills. In a more traditional pharmacy, you don't get that kind of visibility. You have to call them up or even wait in line in person. At Alto, it's a different experience."

What was it like in the team's early days?

Today, there are eleven engineers on the team working to build that better end-to-end experience—but it wasn't always that way. When the team first formed in 2019, it consisted of just three members: Riess, Brian McRae, and Andy Lau, all of whom are still on the team.

"The first priority for us was just stabilizing the foundations," Riess says of the team's early days. Every other week, the three team members, along with Alto co-founders Matt Gamache-Asselin and Jamie Karraker, would meet to audit the app's core flows. "For the first three months we probably didn't make it through some flow at least 50% of the time," Riess recalls. "There would be a ton of bugs in the onboarding experience, things that weren't working with the flows or navigation or deep linking."

Among the team's first projects was a redesign of the checkout flow. "There was a lot of work to be done to streamline the checkout flow, which is pretty much the main function of the app," says McRae, who initially joined the team as a software engineer and later transitioned into product management. "We had to make it easier to add a payment, add your addresses, everything you need to do to schedule your prescription for delivery."

"The growth of the team, in terms of both size and stability of the platform, has allowed us to swing at more interesting bets for the company," Riess says. In particular, the Patients Team has turned their attention toward experiences personalized for specific medical conditions.

"Different customers have different needs. A customer who wishes to start a family will have a different experience than a customer who needs to order their routine heart medications that they've been taking for the last eight years,” McRae says. “The challenge for us is how we serve all these customers well through the app."

"I think that's where Alto can be such a differentiator," Riess adds. "A world-class pharmacy experience is about so much more than just dispensing medications. We want to build tools for customers that help them get the most out of their medications—everything from simple videos teaching them how to perform injections safely at home to the ability to synchronize deliveries for multiple prescriptions for managing complex health conditions."

With these new projects on the horizon, engineers have ample opportunity to focus on the areas that excite them most. "We're full-stack and mobile and web," Nehmzow says. "Part of the team focuses more on experimentation, iterating quickly, and using data to make decisions. Part of the team focuses more on platform work, tooling, and improving the developer experience. There are a lot of areas to explore and contribute to."

One spring night, the Patients Team gathered in a back yard in San Francisco’s Mission District for short ribs and an impressive spread of side dishes. "Kudos to Robbi, who's the grill master. I just provide the grill!" Nehmzow says, laughing. While the team barbecue was the first time some members had met in person, Zeng notes that the team has been supportive of one another even while working remotely during the pandemic.

"The first real project that I was assigned to was working with the communications system. Before writing my first piece of code, I spent two weeks exploring what already exists and understanding the different parts of the system," Zeng says. "I've been really impressed with how understanding my teammates have been. They make the space for you to learn all the different pieces of code we own."

That culture of support is by design, reflected in the six principles—complete with matching emojis—at the top of the #patients-team Slack channel: "Empower each other," "be an owner," "find the path," "learn by doing," "embrace complexity," and "foster trust." 

While these principles echo Alto's company-wide values, they are unique to the Patients Team. "For a long time, we were the only external-facing product team at Alto," Riess says. "These principles were intended to be this motivation around how we win. It's a combination of how we treat each other, how we reason about decision making, and how we approach solving a problem that's never existed before."

As the team looks toward the future, those principles have never been more relevant: "We have a goal and an area we want to focus on, but in terms of which projects we're going to do, it's not a top-down thing," Nehmzow says. "It's very much, 'We're going to figure out how to solve this problem together, even when it's difficult.' That's my favorite part about the team."

The Patients Team is hiring! Learn more about open positions here.

Starting Monday, August 16, residents of the San Diego metro area can now choose Alto's same-day doorstep delivery for their pharmacy needs.

Hello, San Diego!

Alto's launch in San Diego extends our free, same-day pharmacy delivery model to even more Californians.

Starting today, August 15th, residents of the San Diego metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

Courier delivery windows
Monday - Friday: 6 - 9 pm PT (6:30 - 9:30 pm PT for outlying areas)
Saturday - Sunday: 2 - 5 pm PT (2:30 - 5:30 pm PT for outlying areas)

Walk-in hours
Monday - Friday: 9 am – 7 pm PT
Saturday - Sunday: 8:00 am - 4:30 pm pT

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

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

Need to pick up? Our pharmacy is located at 4240 Kearny Mesa Road, Suite 107.

General customer support hours are Monday - Friday 6 am - 9 pm PT and Saturday - Sunday 7 am - 6 pm PT. Patients can reach out to Alto via phone at 1 (800) 874-5881 or app.

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

Editor’s Note: This post was originally published in August 2021 and has been updated for accuracy and completeness.

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

Celebrating Women at Alto Pharmacy

Liz Kelly, Sr. Director Sales, Fertility 

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

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

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

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

What do you like doing outside of work?  

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

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

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

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

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

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

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

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

What’s your favorite memory thus far at Alto? 

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

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

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

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

What do you like doing outside of work? 

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

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

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

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

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

I like how passionate everyone is about what they do. 

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

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

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

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

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

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

Alto Pharmacy Announced as One of Forbes Best Startup Employers

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

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

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

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

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

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

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

Alto Pharmacy Announced as One of Forbes Best Startup Employers 

Forbes 2021 America's best startup employers

Here’s what we know so far about the risk of COVID-19 for people with HIV, vaccine safety, and how to protect yourself from contracting COVID-19. 

What the COVID-19 Vaccine Means for Those With HIV

As of March, 2021, over 115 million people worldwide have been diagnosed with COVID-19. As the COVID-19 pandemic persists, many are wondering what the COVID-19 vaccine could mean for the 38 million people who are living with HIV: is it safe or does it pose a greater risk for these individuals? Here’s what we know so far about the risk of COVID-19 for people with HIV, vaccine safety, and how to protect yourself from contracting COVID-19. 

Are people living with HIV at a higher risk for COVID-19? 

Data is limited and experts are still learning exactly how COVID-19 affects those with HIV, but the Centers for Disease Control and Prevention (CDC) says that those who have HIV (and who are also on effective HIV treatment) generally have the same risk of contracting the virus as those who don’t have HIV. 

So, who is at greater risk? The CDC has evidence that shows older adults and people with certain underlying medical conditions like chronic obstructive pulmonary disease (COPD), type 2 diabetes, and a weakened immune system are at an increased risk for more severe cases of COVID-19. And since nearly half of those living with HIV in the United States are over 50 years old, those living with HIV are encouraged to follow all CDC guidelines to reduce the risk of COVID-19 exposure.

Experts have not found any significant evidence that those living with HIV will experience more severe COVID-19 outcomes; studies performed in Spain and in the United States on a Veterans aging cohort both found no difference in susceptibility to the virus in those with HIV.

Are COVID-19 vaccines safe for people living with HIV?

Yes. According to the United Nations Program on HIV/AIDS (UNAIDS), the COVID-19 vaccines currently being developed or approved by regulators are believed to be safe for most people, including those living with HIV. The COVID-19 vaccines, like other vaccines, undergo the same safety tests and are required to meet rigorous standards. 

Regulators have not yet found any evidence that people living with HIV are at a greater risk from the COVID-19 vaccine in terms of side effects than anyone else.

How does the vaccine work and what symptoms could I expect?

In a recent virtual town hall on COVID-19 and HIV hosted by Getting to Zero San Francisco, experts confirmed that the COVID-19 vaccine has been proven to help reduce the severity of illness from the virus. The vaccine could also prevent infection, reduce transmission, and lead to healthier communities. 

The COVID-19 vaccines work by helping our bodies develop immunity to the virus that causes COVID-19 without us having to actually contract the illness. The different vaccines work in slightly different ways to protect us, but all generally leave the body with a supply of cells that remember how to fight the virus in the future.

After receiving the COVID-19 vaccine, the process of building immunity can result in some people experiencing mild symptoms like a sore arm and mild fever or chills in the days following vaccination. If you have any pain or discomfort, you can talk to your doctor or pharmacist about over-the-counter medications.

How can people with HIV protect themselves from COVID-19?

As you’ve likely heard, the best way to keep from getting sick is simply to avoid exposure to the virus. Everyone, including people living with HIV, should keep taking everyday actions like wearing a mask, staying six feet away from those who don’t live with you, and avoiding crowds, to help avoid contracting and spreading COVID-19.

If you have HIV and are taking your HIV medicine, it’s important to continue doing so and follow any advice from your healthcare provider. This will help keep your immune system healthy and ready to fight off any infection. The CDC also recommends lifestyle practices like eating healthy foods, getting at least eight hours of sleep per night, and minimizing stress as much as you can.

If you develop any symptoms that indicate you might have COVID-19, the CDC recommends calling your healthcare provider and getting tested. Most people have mild illness and can recover at home. If you do develop severe symptoms, the CDC recommends you get emergency medical care immediately.

At Alto, we’re committed to ensuring you receive you medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are fully stocked and our pharmacists are on hand to answer any questions and provide ongoing access to support and advice. Reach out to our HIV specialty team through secure in-app messaging or phone at 1-800-874-5881. 

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

Hello, Dallas-Fort Worth!

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

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

Blog

Meet the Innovation Team Building Alto's Next Big Bets

Introducing Alto’s New CEO - Alicia Boler Davis

Hello, Long Island!

Five Black Healthcare Leaders to Celebrate

Hello Austin, We're Alto Pharmacy!

Get to Know the Team That Builds Alto's Customer-Facing Apps

Hello, San Diego!

Celebrating Women at Alto Pharmacy

Alto Pharmacy Announced as One of Forbes Best Startup Employers

What the COVID-19 Vaccine Means for Those With HIV

Hello, Dallas!

Hello, New York City!

Switch to a better pharmacy.