Specialist
Former director at ScriptDash Inc (Alto Pharmacy)
Agenda
- Recent trends and developments affecting prescription delivery and volume tailwind from COVID-19
- Strengths and weaknesses of major prescription delivery players
- Relationship dynamics between providers and delivery entities
- Potential competitive threat from pharmacy behemoths
- Outlook, innovation and strategic assessments
Questions
1.
What are some of the key trends and themes you’ve been following more broadly in the D2C pharmacy sector? How would you compare Alto’s evolution over the last couple of years with those macro themes?
2.
What percentage of the total market is addressable by delivery? How do you foresee that changing over time?
3.
What impact has the coronavirus pandemic had on D2C pharmacy utilisation? Has the pandemic served as a tailwind for volumes over the last few months?
4.
How critical has telehealth adoption been in driving D2C pharmacy utilisation volumes? Would you expect a direct correlation in both telehealth and D2C pharmacies?
5.
How would you evaluate the competitive landscape across some of the larger players in the sector, including Amazon PillPack, Alto, NowRx, and other players you have observed gaining traction in the market? What are some of the key differentiating factors that you would highlight? You alluded to Alto’s focus on fertility and the relevant specialty pharmacy area.
6.
Walmart recently acquired CareZone. What’s your opinion on its potential entrance into the market, giving some historical context around CareZone too?
7.
How are some of the larger distributors such as McKesson, AmerisourceBergen and Cardinal affected if market share moves to a company such as Alto vs a traditional pharmacy? I know you alluded to the exclusive agreement between Alto and McKesson but, longer term, are there any shifts in dynamics from the distributor angle?
8.
How are PillPack and other D2C pharmacies progressing against regular pharmacies? How much ground have they gained from independent pharmacies and the likes of a CVS? Do you have any visibility into what prescription volumes are like?
9.
What are some of the problem areas with D2C that you think are worth highlighting? Are there any more specific problems that you might associate with different business models?
10.
What is the status quo with PBMs [pharmacy benefit managers] and how those might evolve? How can these independent mail-order companies compete with the vertically integrated models from players such as Cigna Express Scripts? Where are those market dynamics and how do you imagine those shifting over the next 2-5 years?
11.
What are some other factors that you think will lead to PBM declines over the next few years? There’s the in-house development from these D2C players, but are there other factors that you think will drive the compression of the PBM market?
12.
Would you anticipate any of the larger D2C players making a specialty pharma play? Alto is already operating in that sector, but what about a player such as PillPack, do you expect it to move into specialty pharma, or do you think it is content with the current business model of these chronic medications?
13.
What is important to understand about the relationships with providers specifically? How critical is provider adoption to growth and utilisation or, at this point, is it almost there’s too much momentum behind the D2C pharmacy sector for that to drive growth?
14.
Is there anything that we haven’t spoken about that you think might be important to highlight?