Alto Pharmacy

Alto Pharmacy is a digital pharmacy that fills prescriptions, handles insurance and coupon processing, and delivers medications free and often on the same day, with pharmacists available by text or chat. It was founded in 2015 in San Francisco by Jamie Karraker and Matt Gamache-Asselin, both former Facebook engineers, and was headquartered at 645 Harrison Street. In 2017 it acquired a startup that had built a smart pill bottle. Alicia Boler Davis, formerly head of fulfillment at Amazon, became CEO in August 2022.

Alto's largest rounds came from SoftBank. In January 2020 it raised $250 million from investors including SoftBank's Vision Fund 2, Greenoaks Capital, Jackson Square Ventures, Olive Tree Capital and Zola Global, in a deal that sources told CNBC valued the company at more than $700 million. It filed SEC Form D notices in January 2021 and October 2021 ($36.4 million sold in the latter). On January 27, 2022 it announced an oversubscribed Series E of about $200 million led by returning investor SoftBank Vision Fund; the related Form D reports $132.2 million sold against a $162.3 million offering. Syndicates from Gaingels and What If Ventures filed their own Form D notices to buy Alto shares between 2022 and 2024.

At the Series E, Alto reported a revenue run rate above $700 million, more than double the prior year, across 12 U.S. markets; Fortune reported in 2022 that the company was on track for $1 billion in revenue and that it reached about 20 percent of the U.S. population through 13 distribution centers. It partnered with New York City to deliver COVID-19 antivirals and with Mark Cuban Cost Plus Drug Company, and in October 2024 launched Alto Technologies to sell its pharmacy software to manufacturers and hubs. On May 21, 2025, Fuze Health, formed from the 2024 merger of Truepill and LetsGetChecked, launched and announced that Alto had joined the company that week; terms were not disclosed, and alto.com now redirects to Fuze Health.

For investors, Alto shows how the 2020 to 2022 growth-equity cycle played out in pharmacy. Venture funding culminated in SoftBank-led growth rounds, one at a valuation above $700 million, a billion-dollar revenue business, and then a combination with other venture-backed health companies about ten years after founding rather than an IPO. Returns to Greenoaks, Jackson Square Ventures and SoftBank were not disclosed.