This Week in Startups: E980: The Next Unicorns: Alto Pharmacy CEO & Co-founder Mattieu Gamache-Asselin is working to fix the broken US pharmacy system by removing friction & aligning incentives among patients, doctors & insurers, shares insights on trading short-term profits for long-term success, combating the opioid cri

0:51 Jason intros Mattieu Gamache-Asselin

2:52 Changing from ScriptDash to Alto Pharmacy

4:19 Meeting and working with Twitch founder Justin Kan in the early days of Alto

6:51 Message to HBO’s Silicon Valley writing room

7:26 Working out of Justin Kan’s house

8:15 Why are pharmacies broken? How is Alto fixing them?

14:25 How did Alto’s team architect a 1.0 version of their pharmacy?

21:44 US Healthcare is broken due to bad incentive structures

28:23 Does Alto compare to Hims and Roman?

32:24 What are Alto’s profit margins?

35:00 This Week in Cinema: It’s a Wonderful Life

39:07 Maintaining balance between being scrappy/aggressive while also abiding by all medical regulations

39:54 How has Alto scaled so far?

45:55 Who is responsible for the opioid crisis?

51:24 What is Alto building to combat the crisis?

53:27 Trading short-term gain for long-term gain

56:56 How Alto was initially received among investors

1:01:03 This Week in Cinema: The Mission

1:04:30 What skill does Matt think many founders lack?

1:07:02 Operational excellence in former Amazon executives

1:13:49 #1 Lesson that Matt has learned since becoming a founder