Speaker 1 00:00:05 Hey there, thoughtful listener. Are you looking for introductions to partners, investors, influencers and clients? Well, I've had private conversations with over 2000 leaders asking them where their best business comes from. I've got a free video you can watch with no opt in required, where I'll share the exact steps necessary to be 100% inbound in your industry over the next 6 to 8 months, with no spam, no ads, and no sales. What I teach has worked for me for over 15 years and has helped me create eight figures in revenue for my own companies. Just head to up my influence comm and watch my free class on how to create endless high ticket sales appointments. Also, don't forget the thoughtful entrepreneur is always looking for great guests. Go to up my influence. Com and click on podcast. I'd love to have you. With us right now it's Aria Nasri. Aria, you are the co-founder and CEO at Carey Health. You're found on the web at Carey Health. Carey is Carey Health. It's great to have you, Aria.

Speaker 2 00:01:22 Thanks for having me, Josh.

Speaker 1 00:01:23 Yeah, well, give us an overview of the work you do, who you serve, and your impact in the world.

Speaker 2 00:01:28 Yeah. So, Carey Health serves health plans and manufacturers, and we are a digital pharmacy ecosystem. That is B to B to C, so we work with health plans manufacturers and their patients. and we really, you know, do a lot around data analytics but with a specific focus around digital pharmacy and pharmacy fulfillment.

Speaker 1 00:01:49 Yeah. Well, obviously this is a world that you've been in for quite some time. for those of us who are a little bit on the outside, do you mind maybe just giving us a little state of the union or kind of what's going on in your world? Because obviously anything related to drug and pharmacy right now is there's just, oh, there's so much disruption, I think, and so much movement going on. so I appreciate your insight.

Speaker 2 00:02:16 Yeah. I'll give a quick high level. So, you know, in the pharmacy space, you have about anywhere from 5 to 600 billion, in revenue going through the system.

Speaker 2 00:02:29 And roughly I would say about 70% of that is what's called specialty pharmacy. And specialty pharmacies specifically is typically high cost drugs. So think about drugs that cost anywhere from $1,000 per bottle or unit and more, and believe it or not, can go up to $1 million right when you start getting the gene therapy. and so, you know, we we've really started operating in that specialty pharmacy space. and so we are working with manufacturers that have drugs that are called limited distribution drugs, rare and orphan drugs. So these are medications that you probably would not be able to get at your local CVS or Walgreens. They're typically stocked by specialty pharmacies like ourselves. and so limited distribution refers to the fact that only a few pharmacies can actually service those patients and medications. So, that's the space we operate in as far as on the manufacturing side. and on the health plan side, you know, health plans, we typically work with our regional health plans, for the most part. Not to say that we can't work with larger, but, sort of our sweet spot in the personas we go after operate in the regional health plan space.

Speaker 2 00:03:45 so, you know, one of our big clients is Carefirst Blue Cross Blue Shield and the DC Maryland, Virginia market. And, you know, they operate different plants, so they serve as commercial plans. federal employee plans at one of their larger plans. Medicaid. So they do manage care. Medicaid. So, you know, working with patients of, state Medicaid plans, and they also have Medicare plans. right now we're primarily working with Medicaid and Medicare patients. And the reason for that is because a lot of focus goes into what's called quality measures. And quality measures in both Medicaid and Medicare really are benchmarks clinically and how well a health plan is performing as far as patient health. Now, there are also customer service metrics as well that go into these, but we focus primarily on clinical quality measures.

Speaker 1 00:04:42 So and are you I'm seeing information. So I'm on your website right now and you're talking about leveraging you know, AI technology and AI models. You claim to have a proprietary AI model. help me connect the dots there.

Speaker 1 00:04:57 I'm just want to make sure I understand, exactly where you fit in.

Speaker 2 00:05:02 Yeah. So, you know, our core offering is sort of our digital pharmacy platform, but we do have another product called Claire Clear, and that's at Ask Claire. I, Claire is a clinical reference, leveraging, our AI model or proprietary model. And the idea is, you know, you could use ChatGPT to ask clinical questions. Right. And the issue there is there are not guardrails in place to ensure you're getting an answer from consistent sources, right. Like, GPT, for instance, uses the entire web like it'll scrape Google for answers. The idea with Claire is we have a curated database of clinical documents. 2 million plus clinical, I'm sorry, 200 million plus clinical studies, 2 million drug interactions. Every FDA label, we have clinical guidelines as an example. So I think there's hundreds of clinical guidelines. And so the idea is, you know, every time you're getting an answer from one of those references and we're providing that reference each time you ask a question.

Speaker 2 00:06:01 So you can validate the answer that we give you. so that that's really the core of our, the work we're doing in generative AI. And we've taken care and have really incorporated it throughout our infrastructure as a copilot. So whether we're working with a manufacturing client or a health plan client, Claire lives within our other products as a copilot and can not only answer clinical questions, but we have a lot of other nice clinical features to help streamline efficiency. And we also help with just generally helping make tasks like writing responses, clinical responses more efficient. So as an example, we can help streamline responding to questions from healthcare providers, giving that clinical answer, providing a reference. we also have an eye. MTM product is what it's called, and that's basically suggesting medications to add, remove or modified to a patient's regimen to ensure that they're always taking optimal medications. So we're putting a lot of stock generally in AI. And we believe gosh.

Speaker 1 00:07:01 Yeah.

Speaker 2 00:07:02 Right. So you know, I think really the majority of companies out there, if not every company has to at least understand AI and be involved AI at some point and really put stock into it as far as making sure you're leveraging it for efficiency and automation.

Speaker 2 00:07:16 And so, you know, we're no different. And I think that's what really differentiates us is just, you know, ensuring that we're automating processes and helping our partners as well improve efficiency and lower costs.

Speaker 1 00:07:29 Yeah. Well, and I think that this is, you know, as consumers, I mean, this is just something that we are going to be seeing more and more. I know recently I went into the doctor and, you know, had a question or concern about something and they were able to enter in all the data. But I thought it was really interesting that the doctor came back with with her opinion. But then she said, and we also entered everything through, and the eye and everything took every bit of data that we have access to. And also agreed with my, you know, my, my prognosis of this as well, like, that is exciting, right? Because you think about the limitations of the human mind and the ability to, you know, understand and encapsulate 200 million, you know, documents or pieces of information or journal articles or that sort of thing.

Speaker 1 00:08:21 that's impossible to do. And so now it's really going to be fun, I think, to watch the evolution here, because I think that ultimately, if we can provide better outcomes for patients faster, everybody wins. Reduce cause, you know, we're not making mistakes there. We're not going down rabbit holes. you know, another thing I think a lot of people have concerns about is, you know, just am I getting just this doctor's opinion because they're a big fan of XYZ, or is this actual good science? I have relatives that are doctors and they, you know, they said today, I don't think the medical field has ever gotten so much pushback because everybody with a search engine and, you know, follow their favorite influencers and bloggers, all of a sudden there's a bunch of great medical advice to come into their doctor with.

Speaker 2 00:09:12 I think evidence based answers are more important than ever because of that reason. Right? So, and look, every health care provider, right, from physicians to dentist to pharmacist, you go to school to learn how to learn, right? you're not there to memorize and learn how to memorize information.

Speaker 2 00:09:27 You're there to learn how to learn so you can continuously learn, absorb new information, new studies, and continuously adjust your position on whatever you're, you're evaluating. and so with something like Claire, the idea is not to replace it is to aid and to your point, right. There's so much information out there, you can't possibly memorize everything, and your brain does not have an API connection to every clinical guideline out there or every study. Right? So you you're not necessarily syncing with the latest and information. certainly you're doing continuing education, but not at the rate at what something like Claire can update. So Claire will update instantly when there's a new study available. I say instantly is probably next day, but let's just say instantly. but yeah, I mean, in general, I think it's important to have a tool available that can give you all those latest studies, all the latest FDA information, and to present to your patient and to some degree, this is great, right? Patients are making informed decisions and and really trying to challenge in some ways, right, to make sure that they're getting the best care possible.

Speaker 2 00:10:23 And so I think it's a good thing. Right. And so as a physician, if you can come in and say, look, this is the best way to treat your disease, and here's the evidence that suggest that. And then you can actually forward them that evidence I think it's a win win for everyone.

Speaker 1 00:10:37 Now Carrie started off, the B2C. But then along the way, you found obviously incredible opportunity by expanding into B2B. Do you mind sharing a little bit about that evolution? Because I think I think there's a lot of us that are like that. You know, we initially like I and I think about like, our touches. Right. So most of us are like, I'm a consumer myself and I have these consumer experiences or this is right here in my face or it's, it's part of my world. So yeah, it can be easier to go to B2C first because we have so much familiarity with it. But then once you get into the world a little bit and you learn who the players are and where the big opportunities are, I'm kind of making some assumptions here.

Speaker 1 00:11:22 You made the right, as I've seen this life cycle quite a few times.

Speaker 2 00:11:25 Yeah, you made the right assumptions. So my partner, came from the B2B space. He started a company called Karnataka. It's a geospatial database. and so, you know, he he had a lot of experiences with go to market product market fit. And, you know, I think that was invaluable as we went through our journey with Carrie initially. and so I'll give you the backstory, but we launched in 2017 as Carrie. I'm a pharmacist myself. and so, you know, I saw the challenges in the space with not just prescription delivery, but generally a lack of digital experiences for patients, but also for pharmacists internally working at pharmacies. You know, that was me, myself working as a pharmacist. I just saw the lack of digital infrastructure. And so we we launched Carrie in 2017 with the idea of streamlining internal operations in order to give the best possible digital experience to patients. And the idea was to have a same day delivery Uber of pharmacy experience, if you will, for patients, so they could get prescriptions delivered to their home within the hour or same day.

Speaker 2 00:12:29 Really up to them. Right. So scheduled deliveries or within the hour and everything was great, honestly. Right. The experience was amazing. And we still operate that business today. And so we still have that same day delivery capability in the DC metro area. and you know, reviews were amazing. Retention was over 90%. patients were raving that we were just becoming an important, integral part of their lives. And, you know, they just love the fact they didn't have to walk into a pharmacy anymore and deal with everything associated with that. however, from a business perspective, and we knew going in unit economics could be a challenge. The margin was pretty tight. And, we were fortunate to be running above the average margin. So industry averages are around 22% or so. And for the first couple of years we were running at about 30%. But there was a lot of scrappy work going into making sure that stayed at 30%, right, both on the cogs side. So keeping our acquisition costs low as well as targeted sales, ensuring we're getting high value therapeutics from specific doctors.

Speaker 2 00:13:29 And so we knew that wasn't scalable. And so I think this is like kind of one lesson for every entrepreneur is, you know, be brutally honest with your business and if it's scalable, right. you know, is this something that you can if raise capital on or, you know, using your cash flow scale, right. Either one is this VC investable number 1 or 2, can you use a cash flow to keep expanding? And I don't think with that first business model we could do either. I don't think it was investable. although a few in the space have invested very large funds. And, you know, you don't you're just deferring the same problems. but from a cash flow perspective, there wasn't enough cash flow to continue scaling, the space on free cash. So, you know, we took a step back. We were honest as a team and saying, hey, like, this was a great idea and patients love it, but this might not be the right way to approach it.

Speaker 2 00:14:18 And so we took a step back. And just like you said, we looked at the space, follow the money. Right? Like we looked at the space. And like I said earlier in the call here, you know, 70% of the space is specialty pharmacy. And, if you can't beat them, join them. Right. So we started working with the people that dictate margin. Let's go work with manufacturers. and let's go work with health plans who are, you know, heading up reimbursement. but then we saw a bigger opportunity not just to do pharmacy fulfillment and patient experience, but also to offer other SaaS products. And so I, you know, I touched on some of our products, but we do have other offerings that we give to those enterprise customers. And, around 2019 when we started this pivot, it's gone. Well, you know, a lot of our thesis, I guess you could say has been proven right and that, you know, it's just a big space. There's a lot of opportunity.

Speaker 2 00:15:07 And that same kind of initial problem we we recognized with digital experiences for patients and pharmacists. it held true. Also on the other side, for those enterprise customers, just a lack of digital pharmacy infrastructure at scale was really the big problem we were going after and able to solve. So, you know, we're very fortunate that we have a great team. we came together. We could have wrapped up shop and just said, all right, we gave it a good try, but this is not a great business scale up. We could have also just try to stick it out to the end and just eventually gone out of business just because cash flow wouldn't have been there. But we had the foresight to kind of take a step back and pivot, and it's turned out well.

Speaker 1 00:15:46 so a lot of folks who listen to this podcast, they're researching you, they're researching Carrie, they found you, they found this conversation. So obviously there's several ways that you engage, but particularly kind of in the B to B world, you know, should that person be listening, who should be reaching out? And what do those initial conversations generally look like?

Speaker 2 00:16:08 Yeah.

Speaker 2 00:16:08 I mean, as far as who we look to work with, it's, manufacturers. So pharmaceutical manufacturers, we work with small, medium and large manufacturers for fulfillment. You know, really we're focusing on rare and orphan and limited distribution drugs. So small and medium size really fit. Well, some of our generative AI products include Claire and another product called On Label, which could be a fit for small to large manufacturers. This is a product that works with metaphors. Teams, met info teams, sales teams of field teams. And on the health plan side, we work with, like I said, regional health plans oftentimes manage care entities. we're usually working with personas like, you know, a director or VP of pharmacy, a chief clinical officer, CFOs as well. Right. So, you know, our our platform's excellent at really helping lower expenditure, but also get a nice consolidated view of all your data in one place and understanding how you're allocating, expenditure. so yeah, and as well we're now working with health systems.

Speaker 2 00:17:14 We're working on bringing our first health system client. And this is for our product, Claire, and using it as a clinical reference for your team. One of the leading products today in the space is up to date. And the idea is to use Claire as something that can give you an answer more on the fly, so it's a quicker answer. It gives you references quickly. You don't have to dig and dig for that, right clinical question and answer. So it's a more efficient tool. And we also are able to integrate Claire into workflow. Kind of like the example you gave about your doctor saying they incorporate all that took place. and so we can do the same thing. We can incorporate Claire into workflow, whether it's for AI, TMS, which could play a great role in ICUs. Right. So as you're doing rounds and you want to make sure you have the right pharmacotherapy on a per patient basis, this can help Claire can help streamline it with AI, MTM and say, hey, like these medications should be modified for dosing or removed or this medication should be added.

Speaker 2 00:18:09 And in the ICU, removing medications is the way you get patients out of the ICU. So it could play a huge role there. We also have a product that can help streamline how we do any diagrams. so getting resistance data and implementing the latest, but yeah, there's a lot of different use cases. I don't go into it all, but, you know, we're really looking to talk to health systems as well.

Speaker 1 00:18:29 We've got all the, URLs for the websites because carries the main website is, Kerry Dot health. and from there and again that's c a r y dot health. And from there you'll see the various products. obviously we talked about Clare. Kerry. those are all linked there. and so again, great, great conversation. Aria Nazari, congratulations on your success. Congratulations, by the way, on your significant ranking on the Inc 5000. So, it's great to see the growth and and thank you for continuing to make the world a better place, both kind of behind the scenes and ultimately for consumers.

Speaker 2 00:19:11 Thanks so much. Yeah, we we were surprised and very, very excited to reach 82 on the Inc 5000 and also be the fastest growing company in Washington DC. So and number two, which is amazing. So we're we're really excited about that and, hope to keep it going.

Speaker 1 00:19:27 Awesome. Aria Nasri, co-founder and CEO at Carey Health. Ariel, thank you for joining us.

Speaker 2 00:19:33 Thanks, Josh. Appreciate it.

Speaker 1 00:19:40 Thanks for listening to The Thoughtful Entrepreneur Show. If you are a thoughtful business owner or professional who would like to be on this daily program, please visit up my influence. Com and click on podcast. We believe that every person has a message that can positively impact the world. We love our community who listens and shares our program every day. Together, we are empowering one another as thoughtful leaders. And as I mentioned at the beginning of this program, if you're looking for introductions to partners, investors, influencers, and clients, I have had private conversations with over 2000 leaders asking them where their best business comes from.

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