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