Zach Reitano - Building Ro and Why Healthcare Should Be 50% of GDP - [Invest Like the Best, EP.500]
Zach Reitano - Building Ro and Why Healthcare Should Be 50% of GDP - [Invest Like the Best, EP.500]
Podcast1 hr 16 min
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Note: AI-generated summary based on third-party content. Not financial advice. Read more.
Quick Insights

Eli Lilly (LLY) is a way to track expanding GLP-1 demand; monitor whether rising sales volumes continue to offset price cuts, as the discussion offers no price target. Novo Nordisk (NVO) is another leading GLP-1 maker to watch, particularly for how competition affects pricing and market share. Treat GLP-1s and digital healthcare as longer-term themes, not specific buy recommendations; Ro is private and has no public ticker.

Detailed Analysis

Ro (Private company)

  • Ro is a telehealth and healthcare platform, not a publicly traded stock. The CEO said its run rate grew from about $250 million to more than $3 billion over four years, while the company had about 30% fewer employees after a reset.
  • Ro says it is the leading U.S. provider of GLP-1s and has built an integrated platform spanning software, providers, labs, pharmacies, and fulfillment. The CEO attributed its growth to that infrastructure, patient-focused service, and a major GLP-1 tailwind.
  • Ro offers access to GLP-1s made by Novo Nordisk and Eli Lilly, including help checking insurance, cash-pay options, and multi-month subscriptions. The guest said some subscriptions can save patients $600 to $1,800 a year.
  • The CEO emphasized that differentiation requires continued innovation and that healthcare companies need to focus on what patients want as well as what they need.

Takeaways

  • Ro’s story illustrates the potential of combining consumer distribution with vertically integrated healthcare services. The transcript does not provide a way to invest in Ro through a public ticker.
  • For investors evaluating similar businesses, the discussion points to growth, patient retention, affordability, and the ability to keep innovating as useful areas to examine. The guest also described strong competition and the need to continually earn patients’ business.

Eli Lilly (LLY)

  • Lilly was discussed as one of the two leading GLP-1 drugmakers and a Ro pharma partner.
  • The guest said that in Lilly’s earnings, lower prices were more than offset by higher sales volume, suggesting that expanded access can benefit drugmakers even as prices fall.
  • The discussion framed GLP-1s as treatments with potential applications beyond weight loss, including diabetes, obesity, heart disease, kidney and liver disease, and sleep apnea. Other uses were described as areas of study.

Takeaways

  • The discussion highlights the potential for strong demand and volume growth in GLP-1s, alongside pressure for more transparent and lower prices.
  • An investor considering Lilly could track demand, pricing, and how broad access to GLP-1 treatments develops. The transcript gives no stock-price target or recommendation.

Novo Nordisk (NVO)

  • Novo Nordisk was named alongside Lilly as one of the leading GLP-1 drugmakers and a Ro partner.
  • Ro says it offers access to products from both companies, positioning itself as a channel that helps patients compare treatment options based on cost, quality, and convenience.

Takeaways

  • The discussion points to a growing market for GLP-1 treatments and to distribution platforms as a way drugmakers may reach more patients.
  • The guest stressed competition among drugmakers and access providers. Investors could monitor how competition affects pricing, patient access, and market share; no specific price target or recommendation was given.

Amgen (AMGN)

  • The guest cited Repatha, Amgen’s PCSK9 cholesterol-lowering drug, as part of his personal treatment regimen.
  • He said Repatha had become less expensive when offered directly to consumers, describing a price decline from about $600 to $200 per month.
  • The guest discussed PCSK9 treatments as an example of how research into genetic factors associated with lower LDL cholesterol can lead to new therapies.

Takeaways

  • The example highlights potential demand for treatments addressing cardiovascular risk, as well as the effect direct-to-consumer access may have on pricing.
  • The guest also noted that medication decisions involve trade-offs such as cost and side effects. His personal experience is not a general recommendation to use Repatha or any other treatment.

Merck (MRK)

  • The guest described an oral PCSK9 treatment from Merck as an emerging development that could offer an alternative to injectable PCSK9 drugs.
  • He used the treatment as an example of how research into genetics and cholesterol may lead to new options. The transcript does not discuss Merck’s overall business or provide investment analysis of the stock.

Takeaways

  • The discussion suggests that new formulations and easier-to-use treatments could expand access to cardiovascular therapies.
  • Investors could follow the treatment’s development and availability, while keeping in mind that the transcript provides no sales estimates, price target, or specific recommendation.

Healthcare, GLP-1s, and digital health

  • The guest argued that healthcare spending could rise if the cost of individual treatments falls and access improves. He described patient control, transparent pricing, and removing unnecessary intermediaries as important forces behind that change.
  • He predicted that more than 50% of people could be on some form of GLP-1 medication in 10 years, citing the prevalence of overweight and obesity and the possibility of broader preventive use. This is the guest’s forecast, not a consensus estimate.
  • He described three tailwinds for digital healthcare: more health data becoming available, AI helping with tasks that once required specialists, and treatments that can materially affect health outcomes.
  • He also noted challenges: drug affordability, side effects and tolerability, uneven access to treatments, and the long feedback loops and unstructured data involved in medical research.

Takeaways

  • The conversation presents healthcare technology, GLP-1 medicines, and patient-focused distribution as long-term investment themes rather than specific stock recommendations.
  • A practical way to assess companies in these areas is to examine whether they improve access or outcomes, can manage costs and patient safety, and can sustain growth amid competition and changing healthcare rules.
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Episode Description
My guest today is Zach Reitano, the co-founder and CEO of Ro, the country’s leading provider of GLP-1s. In four years, Ro has grown from a $250 million run rate to over $3 billion, with fewer people than it had in 2021. The heart of our conversation is what he sees as the central flaw in American healthcare, which is that the patient is not the customer. He points to GLP-1s and LASIK as examples of what’s possible when patients pay directly, and he thinks AI could bring healthcare down to the price of a Netflix subscription. But to capture that opportunity, Zach first had to rebuild Ro's culture around high performance and a big heart. It shows in the stories Ro shares from people like Serena Williams, which help patients get past the stigma of seeking treatment. The inspiration behind it all is his father, a doctor whose care Zach wants to recreate in software. Please enjoy my conversation with Zach Reitano. For the full show notes, transcript, and links to mentioned content, check out the episode page ⁠here⁠. ----- Become a Colossus member to get our quarterly print magazine and private audio experience, including exclusive profiles and early access to select episodes. Subscribe at ⁠⁠colossus.com/subscribe⁠⁠. ----- ⁠⁠Ramp’s⁠⁠ mission is to help companies manage their spend in a way that reduces expenses and frees up time for teams to work on more valuable projects. Go to ⁠⁠⁠ramp.com/invest⁠⁠⁠ to sign up for free and get a $250 welcome bonus. ----- Trusted by thousands of businesses, ⁠⁠Vanta⁠⁠ continuously monitors your security posture and streamlines audits so you can win enterprise deals and build customer trust without the traditional overhead. Invest Like the Best listeners get a special offer of $1,000 off Vanta when you go to ⁠⁠vanta.com/invest⁠⁠. ----- ⁠WorkOS⁠⁠ is the infrastructure B2B and AI-native companies use to sell to enterprise. It covers everything enterprise security requires: SSO, SCIM, RBAC, Audit Logs, AI governance, and more. Trusted by 2,000+ fast-growing companies, including OpenAI, Anthropic, Cursor, and Vercel. ----- ⁠Rogo⁠ is the AI platform for finance. They're building agents for Wall Street that are trained to understand how bankers and investors actually do work: from diligence and modeling, to turning analysis into deliverables. To learn more, visit ⁠rogo.ai/invest⁠. ----- ⁠⁠Ridgeline⁠⁠ has built a complete, real-time, modern operating system for investment managers. It handles trading, portfolio management, compliance, customer reporting, and much more through an all-in-one real-time cloud platform. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ridgeline.ai⁠⁠. ----- Editing and post-production work for this episode was provided by ⁠The Podcast Consultant⁠. Timestamps: (00:01:35) Why Healthcare Spending Should Rise (00:05:39) Putting Patients in Control (00:10:37) Inside Ro's GLP-1 Business (00:16:29) How GLP-1s Could Reshape Society (00:23:15) The Hidden Cost of Protecting Jobs (00:28:35) Rebuilding a Zombie Company (00:36:33) What Drove Ro's 10x Growth (00:43:49) Where Healthcare Goes Next (00:46:27) Zach's Personal Health Stack (00:54:07) Finding the Work You Were Born For (01:00:15) Ro's Consumer Playbook (01:04:39) Breaking Medical Taboos (01:12:54) The Kindest Thing
About Invest Like the Best with Patrick O'Shaughnessy
Invest Like the Best with Patrick O'Shaughnessy

Invest Like the Best with Patrick O'Shaughnessy

By Colossus | Investing & Business Podcasts

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