How Telemedicine is Transforming Healthcare Distribution with Peter Ax, CEO of UpScript Health

[00:00:02] [SPEAKER_00]: Hey everybody, welcome back to the Outcomes Rocket Founder Stories.

[00:00:07] [SPEAKER_00]: Saul Marquez here and I'm so excited for our guest today.

[00:00:11] [SPEAKER_00]: His name is Peter Axe and he's the founder and CEO of UpScript Health, a direct consumer

[00:00:18] [SPEAKER_00]: telehealth company providing new distribution channels for pharmaceutical and medical

[00:00:24] [SPEAKER_00]: device brands.

[00:00:25] [SPEAKER_00]: As one of the earliest pioneers of the telemedicine industry, UpScript Health was the first

[00:00:31] [SPEAKER_00]: US company to receive regulatory approval to write online prescriptions in 2002 and

[00:00:38] [SPEAKER_00]: they've helped develop much of the industry's regulatory framework over the last two

[00:00:42] [SPEAKER_00]: decades.

[00:00:43] [SPEAKER_00]: As we've seen, healthcare is taking a turn more on the consumer side of things.

[00:00:48] [SPEAKER_00]: As we see companies like Best Buy in the game, the game is changing and Peter has been

[00:00:54] [SPEAKER_00]: changing it since the early 2000s.

[00:00:56] [SPEAKER_00]: So Peter is so great to have you here excited for our interview today.

[00:01:00] [SPEAKER_01]: Thanks, Saul.

[00:01:01] [SPEAKER_01]: The lighting to be here always the light in the talk about UpScript and our story.

[00:01:05] [SPEAKER_01]: So thanks for the opportunity.

[00:01:06] [SPEAKER_00]: The pleasures are as Peter look, we're going to have plenty of time to unpack up script

[00:01:11] [SPEAKER_00]: but before we go there I love to get to know you better for our listeners and viewers

[00:01:15] [SPEAKER_00]: to get to know you better.

[00:01:17] [SPEAKER_00]: What got you into entrepreneurship and why healthcare?

[00:01:21] [SPEAKER_01]: Saul is a great story.

[00:01:23] [SPEAKER_01]: First off, I had a significant education.

[00:01:26] [SPEAKER_01]: I was sort of an education focused kid.

[00:01:28] [SPEAKER_01]: So I went to undergrad, or I finished on graduate with the law school and I finished

[00:01:32] [SPEAKER_01]: law school, I wanted more education.

[00:01:34] [SPEAKER_01]: I went and got an MBA and after that I ended up working on Wall Street and I was a Wall

[00:01:39] [SPEAKER_01]: Street investment banker for almost a decade, a two focused banker, private equity focused

[00:01:45] [SPEAKER_01]: banker.

[00:01:46] [SPEAKER_01]: But what I always felt was missing was understanding how businesses ran and what a business

[00:01:51] [SPEAKER_01]: really was.

[00:01:51] [SPEAKER_01]: I was excellent at funding businesses, found financing a really interesting area to work

[00:01:56] [SPEAKER_01]: in but I wanted to really operate a business someday.

[00:01:59] [SPEAKER_01]: So after about a decade on the street I left and became an entrepreneur and the first

[00:02:04] [SPEAKER_01]: deal I worked on was I consolidated a laundromats around the country brought up a 200

[00:02:09] [SPEAKER_01]: plus stores or built 200 plus stores in 24 cities sold that asset to credit Swiss and what

[00:02:21] [SPEAKER_01]: was it when I bought everything from a coal mine to a refate printed part business.

[00:02:28] [SPEAKER_01]: And somehow I ended up winning an internet pharmacy in 2000 and I acquired internet

[00:02:34] [SPEAKER_01]: pharmacy.

[00:02:35] [SPEAKER_01]: So to really answer your question, I didn't pick healthcare as an industry.

[00:02:40] [SPEAKER_01]: I wanted to initially work in.

[00:02:41] [SPEAKER_01]: I just saw it as an opportunity to make the reader return on investment.

[00:02:46] [SPEAKER_01]: So that's how I made it.

[00:02:47] [SPEAKER_00]: Man, super cool.

[00:02:48] [SPEAKER_00]: I love the history, Peter and you're the finance guy, MD, JD, investment banking,

[00:02:57] [SPEAKER_00]: PE and then you're like man, I gotta get in the trenches.

[00:02:59] [SPEAKER_00]: I gotta do this.

[00:03:02] [SPEAKER_01]: I'm always looking to reinvent myself in certain ways.

[00:03:05] [SPEAKER_01]: It's just built my history because and it's fun.

[00:03:07] [SPEAKER_01]: I even think now about how to reinvent an upspifte about six years ago into a different

[00:03:13] [SPEAKER_01]: type of business.

[00:03:15] [SPEAKER_00]: So you know, this is great.

[00:03:16] [SPEAKER_00]: This is a great thank you by the way.

[00:03:18] [SPEAKER_00]: I respect your hustle and your thirst for knowledge.

[00:03:22] [SPEAKER_00]: And so I want to just like index this, this idea of redoing up script.

[00:03:28] [SPEAKER_00]: But before we go there, so I want to open up that parenthesis for later, I want to ask you

[00:03:33] [SPEAKER_00]: more about up scripts.

[00:03:34] [SPEAKER_00]: You know, for the benefit of all of us, we want to learn about what you do.

[00:03:37] [SPEAKER_00]: So help educate us on what it is.

[00:03:40] [SPEAKER_01]: So what we do is we help form a company's brain medications direct to consumer.

[00:03:45] [SPEAKER_01]: And we do that with our software platform and our telemedicine network that we

[00:03:51] [SPEAKER_01]: that we own and operate.

[00:03:53] [SPEAKER_01]: So what that means is if you go shopping for specific medication, let's say you

[00:03:58] [SPEAKER_01]: suffer from diabetes and you're looking for a particular drug, you'll go to the website

[00:04:02] [SPEAKER_01]: of that branded drug.

[00:04:04] [SPEAKER_01]: And on that website, you will likely find a button that says would you like to speak

[00:04:09] [SPEAKER_01]: to a telehealth provider?

[00:04:10] [SPEAKER_01]: Would you like to see if this medication is right for you?

[00:04:14] [SPEAKER_01]: You click on that button and you're on the up script health platform.

[00:04:18] [SPEAKER_01]: What we do then is we'll have you visit with a telehealth provider.

[00:04:23] [SPEAKER_01]: We'll have you then assuming the provider decides to prescribe the medication, we may

[00:04:28] [SPEAKER_01]: send the medication directly to you.

[00:04:30] [SPEAKER_01]: But we can use another channel of distribution.

[00:04:32] [SPEAKER_01]: But we make it really, we take an entire ecosystem of healthcare and make it into a closed

[00:04:38] [SPEAKER_01]: loop where you can see a provider immediately, decide if something's right for you and

[00:04:44] [SPEAKER_01]: then have it shipped to you right away.

[00:04:46] [SPEAKER_01]: And what we've really done if you want to pack it, we really create a new channel of distribution

[00:04:52] [SPEAKER_01]: for healthcare and making it extremely patient centric.

[00:04:56] [SPEAKER_00]: I love that, Peter.

[00:04:57] [SPEAKER_00]: And I'll tell you, it isn't right now.

[00:04:59] [SPEAKER_00]: And it could be better.

[00:05:01] [SPEAKER_00]: And you know, it sounds like you guys are doing a really great job of making this possible.

[00:05:06] [SPEAKER_00]: So we moved to Puerto Rico and I was trying to get, you know, I did some blood work.

[00:05:12] [SPEAKER_00]: And I was trying to get some medications and it was just the hassle to get it.

[00:05:17] [SPEAKER_00]: And then, you know, being over here is another layer on top of it, you know?

[00:05:20] [SPEAKER_00]: But what you're doing is big.

[00:05:22] [SPEAKER_00]: So back in 2001 when you acquired the online pharmacy, what was it?

[00:05:27] [SPEAKER_00]: And what did you see it as and how is it different than what it is today?

[00:05:31] [SPEAKER_01]: It's really interesting.

[00:05:32] [SPEAKER_01]: So in 2001, and you may not remember back to that, but there were biaggress spam websites

[00:05:39] [SPEAKER_01]: all over the world.

[00:05:41] [SPEAKER_01]: You were constantly being bombarded with biaggress spam website.

[00:05:44] [SPEAKER_01]: And the company that we acquired was selling biaggress on the unit.

[00:05:47] [SPEAKER_01]: It was also selling a couple of other medications.

[00:05:49] [SPEAKER_01]: It really wasn't in the spamming business, but it had built up a pretty substantial

[00:05:53] [SPEAKER_01]: client base.

[00:05:54] [SPEAKER_01]: I acquired the company with a vision that someday you would be speaking with your doctor

[00:06:01] [SPEAKER_01]: on a desktop computer.

[00:06:03] [SPEAKER_01]: In those days, there were no iPhones, by the way.

[00:06:05] [SPEAKER_01]: So I only thought in terms of desktop computers.

[00:06:08] [SPEAKER_01]: So within 24 hours of acquiring his business, I met with regulators and said, look, we

[00:06:13] [SPEAKER_01]: think there's a lot of broader application that just biaggress on the internet.

[00:06:17] [SPEAKER_01]: We think you can deliver a healthcare really can be at the patients here this mechanism.

[00:06:22] [SPEAKER_01]: And so we met with regulators literally right after signing documents to acquire the

[00:06:26] [SPEAKER_01]: company with 20-prowels and other regulators and said, we want to build a model for online

[00:06:31] [SPEAKER_01]: care.

[00:06:32] [SPEAKER_01]: And in a lot of ways, the regulators, they really didn't know what was happening to the

[00:06:37] [SPEAKER_01]: world.

[00:06:37] [SPEAKER_01]: They knew that people were selling drugs on the internet.

[00:06:40] [SPEAKER_01]: They didn't like it.

[00:06:40] [SPEAKER_01]: They wanted to do everything they could to shut it down.

[00:06:43] [SPEAKER_01]: And here we were coming to them and saying, look, we're going to do this for right way.

[00:06:46] [SPEAKER_01]: We want to work with you.

[00:06:48] [SPEAKER_01]: We don't want to work against you.

[00:06:50] [SPEAKER_01]: We want you to help diagnosis to how we build a model.

[00:06:52] [SPEAKER_01]: And that's what we did.

[00:06:53] [SPEAKER_01]: We started with CEDU Utah, which is where the company was based on my body.

[00:06:58] [SPEAKER_01]: And we met with regulators and we opened up the dialogue that took about 14 months for

[00:07:04] [SPEAKER_01]: us to formulate a joint consent order that said, here's the prouders under which you

[00:07:10] [SPEAKER_01]: operate.

[00:07:11] [SPEAKER_01]: This is the software we need to develop.

[00:07:13] [SPEAKER_01]: It needs to be sort of intelligent software that when a patient answers a question,

[00:07:18] [SPEAKER_01]: they need to be ordered to the next question that's relevant based on the previous

[00:07:22] [SPEAKER_01]: questions they've answered.

[00:07:23] [SPEAKER_01]: And so we kind of had to develop some intelligence software.

[00:07:27] [SPEAKER_01]: We had to make the protocol with our doctorate's very specific.

[00:07:30] [SPEAKER_01]: They had to be able to show resumes over our doctorate's patients with no

[00:07:33] [SPEAKER_01]: with their talking to.

[00:07:35] [SPEAKER_01]: There were a lot of parameters that were created in those initial,

[00:07:37] [SPEAKER_01]: in that initial year.

[00:07:39] [SPEAKER_01]: And that became the form of stone of what is up to today with the ability to write

[00:07:44] [SPEAKER_01]: a prescription on the air.

[00:07:45] [SPEAKER_00]: And that's really cool Peter.

[00:07:47] [SPEAKER_00]: So back then, you didn't have the virtual care component of a platform.

[00:07:51] [SPEAKER_00]: It was just distribution.

[00:07:53] [SPEAKER_01]: It was about distribution.

[00:07:54] [SPEAKER_01]: It was about writing a prescription on the internet.

[00:07:56] [SPEAKER_01]: So it was about the internet interaction you have with a healthcare provider that needed

[00:08:02] [SPEAKER_01]: to rise to the standard of care that was typical in the marketplace.

[00:08:06] [SPEAKER_01]: So if a standard of care in the state of Utah was to meet and face to face,

[00:08:11] [SPEAKER_01]: visit with a position, then we needed to be able to do a video transmission in the

[00:08:16] [SPEAKER_01]: state of Utah to meet face to face with the position.

[00:08:19] [SPEAKER_01]: And so forth.

[00:08:19] [SPEAKER_01]: And then after Utah, we went state by state, different states had different requirements

[00:08:24] [SPEAKER_01]: for us.

[00:08:25] [SPEAKER_01]: Someone say, well, you can have a phone call.

[00:08:27] [SPEAKER_01]: Our doctors in our region described simply with phone calls.

[00:08:31] [SPEAKER_01]: So you can have a phone call.

[00:08:32] [SPEAKER_01]: That became another modality, little of a rare care and so on.

[00:08:36] [SPEAKER_01]: And so what ended up happening over about a decade is states sort of subcategory

[00:08:41] [SPEAKER_01]: horizon to three different general categories.

[00:08:44] [SPEAKER_01]: The standard of care was item meant with a video transmission or an audio transmission

[00:08:50] [SPEAKER_01]: or in some cases neither it could be meant with simply a question set being prepared

[00:08:54] [SPEAKER_01]: on the internet and the question set, patient responding to and having the physician review

[00:08:59] [SPEAKER_01]: that not in real time.

[00:09:01] [SPEAKER_01]: So those became the three modalities of care.

[00:09:04] [SPEAKER_00]: That's awesome.

[00:09:05] [SPEAKER_00]: Super interesting approach.

[00:09:07] [SPEAKER_00]: You know, a lot of founders and a lot of business owners, they think about expansion

[00:09:13] [SPEAKER_00]: and sort of where the puck is going.

[00:09:17] [SPEAKER_00]: Some people would even say, they try to direct the puck.

[00:09:21] [SPEAKER_00]: You're directing the puck with what you do.

[00:09:23] [SPEAKER_00]: You've been doing it for years.

[00:09:24] [SPEAKER_00]: How do you balance cash flow, profitability and the money that you invest in the future?

[00:09:31] [SPEAKER_01]: Yeah, great question.

[00:09:32] [SPEAKER_01]: And it looked, the real challenge here is you're working in the healthcare industry

[00:09:35] [SPEAKER_01]: and given in the healthcare industry is the safety of the patient.

[00:09:40] [SPEAKER_01]: So money ever becomes a determining factor ahead of that, your loss.

[00:09:45] [SPEAKER_01]: You lost your soul, you cannot operate a business in healthcare.

[00:09:48] [SPEAKER_01]: You won't have the longevity, you won't get funding ultimately, et cetera.

[00:09:52] [SPEAKER_01]: You have to make patient centric.

[00:09:54] [SPEAKER_01]: And you have to be sure that safety is a winner of everything you do.

[00:09:58] [SPEAKER_01]: And then it's been on mantra and we've never focused on bottom line profits over patient safety,

[00:10:04] [SPEAKER_01]: over patient efficiency, over the patient having a good experience.

[00:10:07] [SPEAKER_01]: And that's when we've operated our business.

[00:10:09] [SPEAKER_01]: Unfortunately, it's worked.

[00:10:10] [SPEAKER_01]: It's we've been over pretty nicely profitable enterprise based on doing the right thing.

[00:10:16] [SPEAKER_01]: Now, we haven't been able to chase the brass ring.

[00:10:19] [SPEAKER_01]: We haven't been able to build a giant market cap by putting drugs out there everywhere

[00:10:24] [SPEAKER_01]: to be seen and generating a profit.

[00:10:28] [SPEAKER_01]: We've seen a lot of companies do that generate a fair amount of value.

[00:10:32] [SPEAKER_01]: That's never been the way we've operated.

[00:10:34] [SPEAKER_01]: We've operated it thoughtfully cautiously.

[00:10:36] [SPEAKER_01]: We've grown slower than a lot of companies would normally like to grow.

[00:10:40] [SPEAKER_01]: But a part of the reason why we're going to do that is we're not funded by institutional capital.

[00:10:45] [SPEAKER_01]: I funded the company originally, I funded it since.

[00:10:48] [SPEAKER_01]: And then we've not really had many institutional investors so there's not been any pressure for an exit.

[00:10:53] [SPEAKER_01]: Not been any pressure for months, this growth.

[00:10:56] [SPEAKER_01]: Over year we grow a little bit, we get better and better of what we do.

[00:10:59] [SPEAKER_01]: And right now we're finding we really owned the market space where it right now because of that.

[00:11:05] [SPEAKER_00]: That's fantastic.

[00:11:06] [SPEAKER_00]: Now I love that.

[00:11:07] [SPEAKER_00]: Thanks for the insightful answer there Peter at the end of the day patient centric.

[00:11:12] [SPEAKER_00]: If we're doing that, the business will be solid and you'll get the type of capital that you're looking for.

[00:11:19] [SPEAKER_00]: Long as you're solving those problems.

[00:11:22] [SPEAKER_00]: And so at the beginning of our interview Peter, you talked about reinventing this next question that I want to ask you.

[00:11:28] [SPEAKER_00]: I want to take it toward the reinventing path you were taking us to.

[00:11:32] [SPEAKER_00]: And that's about your biggest setback.

[00:11:35] [SPEAKER_00]: So talk to us about what that has been with up script and a learning that came out of it.

[00:11:40] [SPEAKER_00]: And maybe that's where the reinvention came from.

[00:11:42] [SPEAKER_00]: Maybe not.

[00:11:44] [SPEAKER_01]: Look there's been a lot of setbacks.

[00:11:46] [SPEAKER_01]: This is not going easy.

[00:11:48] [SPEAKER_01]: Right?

[00:11:48] [SPEAKER_01]: And anyone who any time you see a deal that's like, oh, they became a star overnight.

[00:11:54] [SPEAKER_01]: I don't believe it overnight success.

[00:11:56] [SPEAKER_01]: I really do believe it.

[00:11:57] [SPEAKER_01]: I don't even a lot of years and taking us 20 plus years to get where we are.

[00:12:01] [SPEAKER_01]: So a setbacks have been in the form generally speaking of regulatory and the early days in

[00:12:06] [SPEAKER_01]: generally speaking in the form of regulatory issues.

[00:12:09] [SPEAKER_01]: So we thought we were making great traction and for example the state of Texas 15 years ago.

[00:12:14] [SPEAKER_01]: And we'll behold the attorney general wants to give us a hard time about cleaning

[00:12:18] [SPEAKER_01]: prescriptions on the internet and we're trailed from writing prescriptions in Texas until

[00:12:24] [SPEAKER_01]: we litigate there and ultimately prevail and ultimately we were able to write prescriptions

[00:12:30] [SPEAKER_01]: using our modalities.

[00:12:31] [SPEAKER_01]: Those are setbacks we had throughout the way.

[00:12:34] [SPEAKER_01]: We very states, various regulators who were often not healing from a sense of doing the right

[00:12:40] [SPEAKER_01]: thing for the patient as much as they were very frightened as to what might happen with patients

[00:12:44] [SPEAKER_01]: and they were very frightened of our motivations and other companies' motivations so they immediately

[00:12:48] [SPEAKER_01]: shut the door.

[00:12:49] [SPEAKER_01]: I think we had a number of those checkbacks and that happened over kind of like say the first

[00:12:54] [SPEAKER_01]: 10 or 15 years of our development.

[00:12:56] [SPEAKER_01]: Then what happened is the telemedicine stats used to cold and regulators started to realize

[00:13:01] [SPEAKER_01]: no there's a role for telemedicine and what we had been calling internet pharmacies for years

[00:13:05] [SPEAKER_01]: now became telemedicine pharmacies where telemedicine websites.

[00:13:09] [SPEAKER_01]: And so telemedicine story to have brought adoption so that was solved.

[00:13:13] [SPEAKER_01]: But then what we found ourselves, we were in the business of selling generic medications at a

[00:13:19] [SPEAKER_01]: profit writing prescriptions on the internet and we generated profits from signed these generic

[00:13:23] [SPEAKER_01]: medications.

[00:13:25] [SPEAKER_01]: Well I view that as there was suddenly going to be a lot of competitive forces,

[00:13:31] [SPEAKER_01]: margins would erode it'd be very difficult to operate a business of all you're doing

[00:13:35] [SPEAKER_01]: selling generic goods at a profit.

[00:13:37] [SPEAKER_01]: It's eventually you get to zero large in business and I think companies like Roman and

[00:13:41] [SPEAKER_01]: him, you'll probably speak first and I'm sure they've seen more margin erosion over time

[00:13:47] [SPEAKER_01]: because it's just more work competitive than doing what they're doing.

[00:13:50] [SPEAKER_01]: So what we had to do was then say okay how do we create a business that is defensible

[00:13:55] [SPEAKER_01]: that's proprietary that has moats around it and what does that look like?

[00:14:00] [SPEAKER_01]: And so when you talk about disappointments I'd say the disappointment was the core

[00:14:03] [SPEAKER_01]: business that we were involved in for a decade plus earning really attractive profits and

[00:14:08] [SPEAKER_01]: we really had to pivot.

[00:14:10] [SPEAKER_01]: And that was really a defining moment for us.

[00:14:13] [SPEAKER_01]: And our pivot became let's provide direct consumer platforms for pharmacy brands because the

[00:14:21] [SPEAKER_01]: pharmaceutical manufacturers are going to need to be in this business.

[00:14:24] [SPEAKER_01]: They're going to need to have this channel of distribution of direct to consumer.

[00:14:27] [SPEAKER_01]: They don't know how to do it and from a regulatory standpoint they can't only,

[00:14:30] [SPEAKER_01]: they need a third part of the do it for them.

[00:14:34] [SPEAKER_01]: So let's start making headway and build a platform that pharmaceutical companies will use

[00:14:41] [SPEAKER_01]: for us to go direct to consumer.

[00:14:43] [SPEAKER_01]: And that really, so when you talk about the biggest disappointment I'd say the biggest

[00:14:46] [SPEAKER_01]: of why it is the core we had to shift the core business and pivot into a new business.

[00:14:50] [SPEAKER_01]: And that was about six years ago.

[00:14:52] [SPEAKER_01]: And Peter what was the reason for that?

[00:14:54] [SPEAKER_01]: Why did you have to do it?

[00:14:55] [SPEAKER_01]: What we were feeling was that generic medications being sold online was ultimately going to be

[00:15:01] [SPEAKER_01]: a job-wide in business.

[00:15:02] [SPEAKER_00]: Understood.

[00:15:03] [SPEAKER_00]: Yes, yep.

[00:15:03] [SPEAKER_00]: You made a clear point of that.

[00:15:04] [SPEAKER_00]: Yeah, I got it.

[00:15:05] [SPEAKER_00]: Thanks for clarifying.

[00:15:07] [SPEAKER_00]: So we pivoted and said let's partner with farm and manufacturers.

[00:15:11] [SPEAKER_01]: And that's what we did.

[00:15:13] [SPEAKER_00]: So when we talked about this idea come about like I'm just curious, how did that idea come?

[00:15:17] [SPEAKER_00]: Because that's a very nuanced hypothesis, right?

[00:15:21] [SPEAKER_01]: I wish I could say we were geniuses of K-Welph with it.

[00:15:23] [SPEAKER_01]: Oh, here's what happened.

[00:15:25] [SPEAKER_01]: So it's a huge story.

[00:15:27] [SPEAKER_01]: It was a great idea.

[00:15:29] [SPEAKER_01]: Yeah, watch in pharmaceuticals came to us and a guy named Fred Wilkinson who was very senior

[00:15:34] [SPEAKER_01]: well-known in healthcare industry.

[00:15:36] [SPEAKER_01]: He came to us and he said Peter I've been watching you in regulatory battles, state

[00:15:41] [SPEAKER_01]: house to state house across the country trying to do the right thing.

[00:15:45] [SPEAKER_01]: We have a drug that we want to watch to you exclusively upon the internet.

[00:15:49] [SPEAKER_01]: It's called Ella.

[00:15:50] [SPEAKER_01]: It's an emergency contraceptive product.

[00:15:53] [SPEAKER_01]: It needs to compete with the morning after pill and the only way it can compete

[00:15:57] [SPEAKER_01]: with morning act bills if we make the prescribing pattern really simple.

[00:16:01] [SPEAKER_01]: So we want you to prescribe on the internet.

[00:16:04] [SPEAKER_01]: So in 2010, what did years ago now, Watson Pharmaceutical was as a largest

[00:16:09] [SPEAKER_01]: general, it's manufactured in the world of the time.

[00:16:12] [SPEAKER_01]: Watson came to us and said we want to launch a drug through you.

[00:16:15] [SPEAKER_01]: And that was the aha of all of it.

[00:16:16] [SPEAKER_01]: Right?

[00:16:17] [SPEAKER_01]: We said wow.

[00:16:19] [SPEAKER_01]: This is a business model we like.

[00:16:22] [SPEAKER_00]: I love it.

[00:16:23] [SPEAKER_00]: And by Peter, so what an awesome story, right?

[00:16:25] [SPEAKER_00]: And I've heard this the best way to succeed in business is to be in business and

[00:16:30] [SPEAKER_00]: stay in business.

[00:16:32] [SPEAKER_00]: You did just that.

[00:16:33] [SPEAKER_00]: So did you run into this guy at a conference that he call you or how did that happen?

[00:16:38] [SPEAKER_01]: Call me out of the blue.

[00:16:39] [SPEAKER_01]: And you have to do it.

[00:16:40] [SPEAKER_01]: In those days people called me on the blue was usually a tell me they were going to

[00:16:44] [SPEAKER_01]: sue me because we shouldn't sue you.

[00:16:46] [SPEAKER_01]: You do their stay.

[00:16:47] [SPEAKER_01]: I see.

[00:16:49] [SPEAKER_00]: Oh man, that is insane.

[00:16:52] [SPEAKER_01]: Well, that was a great call.

[00:16:53] [SPEAKER_00]: Oh yeah, you were going to say something.

[00:16:54] [SPEAKER_00]: Go for it.

[00:16:55] [SPEAKER_01]: The extension of that was within days Fred Wilkinson had about 20 people flown out to our

[00:17:01] [SPEAKER_01]: offices in the hospital Arizona.

[00:17:03] [SPEAKER_01]: Our offices were beating up for a company 20 people.

[00:17:06] [SPEAKER_01]: We had to rent office space temporarily to accommodate these 20 plus people flying in

[00:17:11] [SPEAKER_01]: and we sat around for three days and came up with exactly what we were going to build

[00:17:14] [SPEAKER_01]: software wise to be able to sell along line.

[00:17:17] [SPEAKER_01]: Love it man.

[00:17:18] [SPEAKER_00]: Love it.

[00:17:19] [SPEAKER_00]: And then you put it together and you're like, we've got something here.

[00:17:24] [SPEAKER_00]: We've got something here.

[00:17:25] [SPEAKER_01]: We thought this is lightning at a block.

[00:17:27] [SPEAKER_01]: Right?

[00:17:27] [SPEAKER_01]: This is a new channel.

[00:17:28] [SPEAKER_01]: There's going to be a lot of companies that need this.

[00:17:30] [SPEAKER_01]: It was still a couple of years later before we did a second deal.

[00:17:34] [SPEAKER_01]: That way.

[00:17:35] [SPEAKER_01]: And it wasn't a couple of years after them before we did a third one.

[00:17:37] [SPEAKER_01]: But in 22 for example, we did seven partnerships like that in 23.

[00:17:41] [SPEAKER_01]: We did 17 partnerships like that.

[00:17:44] [SPEAKER_00]: And in 24, we'll do over 30 partnerships like Kudos.

[00:17:48] [SPEAKER_00]: I love the exponential growth with that.

[00:17:50] [SPEAKER_00]: And let me ask you something like so you saw that this was viable.

[00:17:54] [SPEAKER_00]: Why did it take?

[00:17:56] [SPEAKER_00]: I mean, I don't know how to say it's so long.

[00:17:59] [SPEAKER_00]: But why wait so long to scale?

[00:18:02] [SPEAKER_01]: Yeah, look, the toughest thing about health care is health care moves at a snail's pace.

[00:18:07] [SPEAKER_01]: Yeah.

[00:18:08] [SPEAKER_01]: I get that.

[00:18:09] [SPEAKER_01]: In a part of it is because it should, because patient safety is a really important

[00:18:13] [SPEAKER_01]: factor here.

[00:18:15] [SPEAKER_01]: A part of it is because it's probably way over-regulated.

[00:18:18] [SPEAKER_01]: I mean, we not only have to deal with regulation of positions on a federal level.

[00:18:22] [SPEAKER_01]: We have to deal with regulations of physicians at a state level, 50 state.

[00:18:27] [SPEAKER_01]: We have to deal with pharmacy rules, 50 state level.

[00:18:31] [SPEAKER_01]: We have to deal with federal pharmacy rules, FDA rules.

[00:18:34] [SPEAKER_01]: We have to deal with corporate practice of medicine rules, anti kickback rules,

[00:18:40] [SPEAKER_01]: on and on.

[00:18:40] [SPEAKER_01]: And regulation and really muddy the water,

[00:18:42] [SPEAKER_01]: for us to make things really slow and tedious.

[00:18:46] [SPEAKER_00]: That's fair.

[00:18:47] [SPEAKER_00]: And sort of like the first few years was probably dedicated to

[00:18:51] [SPEAKER_00]: optimization of processes, really getting things tight.

[00:18:55] [SPEAKER_00]: And then slowly.

[00:18:57] [SPEAKER_00]: Yeah, I love it man.

[00:18:59] [SPEAKER_00]: No, this is so cool.

[00:19:00] [SPEAKER_00]: I love it.

[00:19:00] [SPEAKER_00]: Hey, these things did pair nicely.

[00:19:02] [SPEAKER_00]: I had a feeling they would.

[00:19:06] [SPEAKER_01]: We'd love to be the business today and we're a major channel of distribution

[00:19:10] [SPEAKER_01]: growing every single day with people ordering medications to

[00:19:15] [SPEAKER_01]: wreck from the manufacturer.

[00:19:17] [SPEAKER_00]: Yeah, no, I mean it's brilliant.

[00:19:19] [SPEAKER_00]: And necessary, especially with the shortage of physicians and

[00:19:23] [SPEAKER_00]: you know, inability to get into seesome by it, it gets you what you need.

[00:19:26] [SPEAKER_00]: Like this type of stuff makes a lot of sense.

[00:19:29] [SPEAKER_00]: Peter, this is, go ahead.

[00:19:31] [SPEAKER_01]: Do you think about something else when you go in the doctor's office today

[00:19:35] [SPEAKER_01]: and you want an expensive sort of branded medication,

[00:19:38] [SPEAKER_01]: the doctor generally has to complete a prior authorization

[00:19:41] [SPEAKER_01]: to see if you've got insurance coverage.

[00:19:43] [SPEAKER_01]: Well, as a practical matter, doctors are busy.

[00:19:46] [SPEAKER_01]: Only about 50% of those prior off those actions get completed.

[00:19:49] [SPEAKER_01]: So 50% of the runs that theoretically would get sold don't get sold.

[00:19:54] [SPEAKER_01]: Because in the telemedicine space, we in effect manage the telemedicine

[00:19:58] [SPEAKER_01]: offices.

[00:20:00] [SPEAKER_01]: A hundred percent of all prior off of those nations get processed.

[00:20:03] [SPEAKER_01]: So there's a likely little insurance reimbursement as much higher also.

[00:20:06] [SPEAKER_01]: So everybody wins.

[00:20:07] [SPEAKER_01]: I mean, the patient wins.

[00:20:09] [SPEAKER_01]: The physicians don't have to be bothered with prior off ofizations

[00:20:12] [SPEAKER_01]: in their normal everyday practice. You

[00:20:14] [SPEAKER_01]: can do it if you tell a medicine. It's

[00:20:16] [SPEAKER_01]: just, it's a great winning strategy. Agreed.

[00:20:19] [SPEAKER_00]: And the big

[00:20:19] [SPEAKER_00]: one right now will go away some agglutite, GLP ones

[00:20:23] [SPEAKER_00]: are you guys playing there?

[00:20:25] [SPEAKER_01]: We are to some extent.

[00:20:26] [SPEAKER_01]: We're getting, we're going slowly.

[00:20:29] [SPEAKER_01]: It's a massive marketplace.

[00:20:31] [SPEAKER_00]: Massive.

[00:20:31] [SPEAKER_00]: Massive.

[00:20:32] [SPEAKER_01]: You know, our couple of years ago they were predicting

[00:20:34] [SPEAKER_01]: was a 50 billion dollar market.

[00:20:36] [SPEAKER_01]: Then they predicted it was going to be a hundred billion dollar market.

[00:20:38] [SPEAKER_01]: Today they're predicting it maybe as much as a hundred and fifty billion dollar market.

[00:20:43] [SPEAKER_01]: And the largest run to date before this was about 30 billion.

[00:20:47] [SPEAKER_01]: Was that by Agra?

[00:20:48] [SPEAKER_00]: No, that was Shibira, I believe.

[00:20:51] [SPEAKER_00]: Yeah.

[00:20:51] [SPEAKER_00]: Interesting.

[00:20:53] [SPEAKER_00]: Well, we're living an interesting time folks.

[00:20:55] [SPEAKER_00]: That's for sure.

[00:20:57] [SPEAKER_00]: The times are changing.

[00:20:58] [SPEAKER_00]: If you're not changing with them,

[00:21:00] [SPEAKER_00]: you will get left behind.

[00:21:01] [SPEAKER_00]: And that's why I love talking to entrepreneurs like Peter Axe,

[00:21:07] [SPEAKER_00]: founder and CEO at UPScript.

[00:21:09] [SPEAKER_00]: He's doing incredible work.

[00:21:11] [SPEAKER_00]: And he's blazing the trail.

[00:21:13] [SPEAKER_00]: So Peter, we're here at the end.

[00:21:15] [SPEAKER_00]: I love the keep chatting with you.

[00:21:16] [SPEAKER_00]: Maybe we'll do a part two.

[00:21:18] [SPEAKER_00]: What closing thought would you leave our listeners and viewers with?

[00:21:21] [SPEAKER_00]: And what's the best place they could learn more about you and UPScript?

[00:21:26] [SPEAKER_00]: So first of all, go to LookScrewCalth.com

[00:21:28] [SPEAKER_01]: and you'll learn about how we partner with pharmaceutical companies

[00:21:32] [SPEAKER_01]: of all sorts and even consumer products companies.

[00:21:35] [SPEAKER_01]: If I were going to leave some parting thoughts,

[00:21:37] [SPEAKER_01]: I'd say what I've learned through what is now a pretty long career

[00:21:40] [SPEAKER_01]: and 20 plus years in healthcare industry is you always have to do the right thing.

[00:21:46] [SPEAKER_01]: You do the right thing by your investors, you do the right thing by your partners,

[00:21:51] [SPEAKER_01]: you can consumers and all the rest, all the success just come after that.

[00:21:56] [SPEAKER_01]: If you always stick to doing the right thing,

[00:21:59] [SPEAKER_01]: never focus on short term profits,

[00:22:01] [SPEAKER_01]: never focus on your own benefits,

[00:22:03] [SPEAKER_01]: focus on your reals as benefits and you'll do just great and you have a wonderful life.

[00:22:07] [SPEAKER_00]: That's what I like.

[00:22:08] [SPEAKER_00]: What a great way to close a great reminder for all of us.

[00:22:12] [SPEAKER_00]: Let's do the right thing and everything else will fall in the place.

[00:22:16] [SPEAKER_00]: Peter really have enjoyed our time together.

[00:22:18] [SPEAKER_00]: Thank you so much for being with Outcomes Rocket on our Founder Story series.

[00:22:23] [SPEAKER_01]: Great, thanks so much.

[00:22:24] [SPEAKER_01]: It's been wonderful to be here.