Specialist
Former director at (ScriptDash) Alto Pharmacy LLC
Agenda
- Prescription delivery and e-pharmacy market overview, focusing on Alto Pharmacy
- Coronavirus implications and relationship dynamics between providers and delivery entities
- Alto Pharmacy’s technology interface and platform, highlighting superior innovation vs other players
- Competitive overlap vs Amazon's (NASDAQ: AMZN) PillPack, Capsule and others
- 2022 growth trajectory and potential buyers
Questions
1.
What important trends and developments in the e-pharmacy and prescription delivery industry have you been following over the past year?
2.
How has Alto Pharmacy evolved over the past few years in light of the dynamics you mentioned?
3.
To what extent could increasing healthcare digitisation from the pandemic serve as tailwinds for a company such as Alto Pharmacy? How are consumer attitudes towards prescription delivery and e-pharmacy shifting? Is standing in line at a bricks-and-mortar pharmacy becoming an increasingly outdated idea?
4.
To what extent could coronavirus pill and antiviral distribution be a short-term benefit for Alto Pharmacy? Could we see similar exclusive arrangements to the New York City-Alto distribution agreement announced in January 2022? Is this a meaningful near-term revenue driver?
5.
Could you discuss Alto Pharmacy’s management team and company culture? What makes Alto unique compared to other healthcare tech start-ups?
6.
Could you walk us through Alto Pharmacy’s unit economics? How should we evaluate its cost structure, revenue streams and other key factors driving its economic value?
7.
What’s Alto Pharmacy’s approximate reimbursement mix across commercial, Medicare, Medicaid and self-pay?
8.
How might Alto Pharmacy’s prescription drug makeup shift, considering ‘maintenance drugs’, generics and specialty pharmacy? President Biden has discussed shortening the FDA-approval window before generics are introduced. What might a higher proportion of generics mean for Alto’s longer-term margin profile?
9.
Could you expound on Alto Pharmacy’s relationships with payers and PBMs [pharmacy benefit managers]? Could pharmacy ownership of large PBMs be a pain point for Alto, given it’s stealing foot traffic from retail pharmacies?
10.
How material are CAC [customer acquisition costs] in e-pharmacy? Is Alto doing anything unique to build brand equity and optimise membership base growth?
11.
Could you discuss Alto Pharmacy’s tech infrastructure and app interface? How do these capabilities lend themselves to a better user experience? Is the company ahead of the curve in this area?
12.
How material are Alto Pharmacy’s shipping and delivery costs? What can the company do to optimise the delivery process and protect margins? Could strategic partnerships with ride-share companies make sense here?
13.
How do you assess Alto Pharmacy’s competitive positioning vs PillPack, Capsule and other mature e-pharmacy companies? Could you outline some key differences in business model, tech infrastructure and relative scale?
14.
How are legacy pharmacies such as CVS, Walgreens and Rite Aid responding to the disruption from players such as Alto?
15.
Do you have any thoughts on GoodRx? How much change is this player bringing to the industry?
16.
Where might Alto Pharmacy deploy the USD 200m it just raised in Series E funding from VC firms? Which avenues make the most strategic sense to invest in, perhaps considering tech infrastructure, customer acquisition or M&A?
17.
Do you expect Alto Pharmacy to be acquired or merge, and who would be likely strategic buyers/complements? Alternatively, could it remain opposed to M&A from a cultural standpoint?
18.
Would you like to highlight anything else around Alto Pharmacy that we haven’t touched on?
