Full pitch deck teardown is here: https://techcrunch.com/?p=2361688

2. |
Delivering $XM ARR and growing >100% YoY
Leading disruptor of $450B pharmacy space
INTRODUCTION
Investment Highlights
Demonstrated positive contribution margin (+$X per order)
Up from -$X in 2019 and on track for +$X by 2023
Powered by the only next generation pharmacy tech infrastructure
In house systems supporting prescription processing from doctor to delivery
Beloved by patients and providers with NPS of 90
NPS of >85 sustained for more than 4 years (with weekly sample >1000)
Capital efficient geo expansion model
Live in 11 cities, centralized Rx processing, licensed in 48 states, and robust regulatory
tech backbone
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2

3. Business
Overview

4. | BUSINESS OVERVIEW
4
~$100B In medical waste directly
tied to the above criteria
Scripts still picked
up at retail
Scripts never
picked up
In drug spend
per capita
NPS at the largest
U.S. Pharmacy1
The Current Pharmacy Experience
is Highly Inefficient
4
1. 2021 NPS for CVS Health
Source: Customer.guru, Wall Street Journal

5. |
Pharmacy is the Largest
Consumer Industry Still Offline
BUSINESS OVERVIEW
It is also one of the last large consumer sectors that
can provide a wedge into consumers’ homes
Source: Statista and other industry data. Pharmacy TAM from third party consulting work.
$1.1T TAM
Grocery
$450B TAM
Pharmacy
$48B TAM
Taxi / Ride-Hailing
$189B TAM
Food Delivery
$778B TAM
Travel
13%
ONLINE
65%
ONLINE
1%
ONLINE
52%
ONLINE
70%
ONLINE
5

6. | BUSINESS OVERVIEW
The Current Experience is Broken
for Patients and Providers
KEY CHALLENGES
You visit your
doctor and they
send a Rx to a
local pharmacy
You drive
homeand
wait...
You call the
pharmacy to
check if the Rx is
ready
Sometime later, you
drive to the
pharmacy
You wait
in line
You’re finally
quoted a
price
You drive
back
home
Next month,
you do it all
again
If you can afford
it, you buy the Rx
Inconvenient in-store
pharmacy experience
Lack of pricing
transparency / affordability
Lack of clear support
channels
Manual processes cause
administrative burden
Lack of visibility to
patient adherence
Patient dissatisfaction with
lead times and refill requests
Provider identifies
drug to prescribe
Provider updates
medication plan
in EMR
Provider asks patient what
other drugs they are taking
to avoid contraindications
E-prescribing via
existing EMR to
chosen pharmacy
Provider goes back and forth
with patient’s insurance and
pharmacy to find a solution
Provider is notified by
patient if there is an issue
with drug availability or
coverage
Provider calls
in or faxes script to
chosen pharmacy
Next refill, your
provider does it all
again
Silence...
KEY CHALLENGES
Provider
Patient
6

7. |
Provider
ALTO VALUE PROPOSITION
Prescription price visibility /
optimization
Real-time care access by
phone, text or app
Flexible and fast courier
delivery
Eliminates 20+ hours /
week of back-office time
Core infrastructure to track
prescription adherence
Patient satisfaction with
prescription service
ALTO VALUE PROPOSITION
BUSINESS OVERVIEW
The Alto Experience Fixes That
You visit your doctor, and they
recommend Alto Pharmacy
You receive a text in minutes notifying you
that Alto is processing your script
In less than an hour, you are notified of the price,
availability, and you can schedule your delivery
You head home, track your delivery on the app,
and your script arrives soon after
You opt-in for refill enrollment, and next month your
medication automatically arrives at your door
Same initial steps from drug identification to
calling in the script to the pharmacy1
Provider can track real-time status of
prescription through AltoMD
Provider is automatically contacted to resolve any
issues with drug availability or coverage
Provider drives medication adherence
Patient
7
1. See prior page for initial steps

8. |
Flexible, Fast
Courier Delivery
Prescription Price
Optimization
Communication
& Visibility
Efficient Health
Management
eCommerce-Like
Experience
Simple order fill, cart review, and
checkout process
Medication adherence
and refill reminders
Price transparency and
automated coupon search
In-app messaging for all
questions
Real-time courier and
delivery tracking
BUSINESS OVERVIEW
Alto Patient Value Proposition
8

9. |
Increased Patient Fill-Rate
& Adherence
Increased
Transparency
Real-time
Communication
Lower Administrative
Burden
Workflow
Optimization
Clear, prioritized action list
all in one place
Easy to use, web-based platform
that cuts down lead times
Visibility into prior authorization (PA)
status and medication adherence
Instant messaging with
Alto care team
Visibility into when patients fill
scripts with follow up reminders
BUSINESS OVERVIEW
Alto Provider Value Proposition
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10. |
Alto App
Mobile-first application for
patient self-service
With an End-to-End Software Platform
Powering the Next Generation of Pharmacy
Wunderbar
Platform
Modern Pharmacy Software for Care,
Fulfillment and Delivery Operations
BUSINESS OVERVIEW
Provider focused portal for transactions,
communication and reporting
AltoMD
Care Operations
Data Infrastructure
Third Party Integrations
Supply Chain Operations
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11. |
Alto Offers a
Differentiated Approach
BUSINESS OVERVIEW
PHARMACY FOCUS
TECHNOLOGY
Patient-First Mentality
Same-Day Delivery
Focus on Provider Pain Points
Navigates Complex Sub-Specialties
Clinical Operations Excellence
Deep, Sticky Patient Experience
11

12. |
1. Satisfied patients
2. Lower administration burden
3. Increased fill-rate & adherence
4. Increased transparency (with AltoMD)
Provider
1. Medication adherence
2. Priority med alignment
3. Lower SG&A: Alto pull-through
Pharma
1. Lower MLR1
via adherence
2. Improved Med D star rating
3. Increased visibility & transparency
4. Patient / employer differentiator
Payor
Alto Uniquely Aligns the Broader
Healthcare Ecosystem
1. MLR means Medical Loss Ratio
BUSINESS OVERVIEW
1. Rx optimization
2. Communication transparency
3. Same-day convenience
4. “White glove” service
Patient
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13. Commercial
& Growth Strategy

14. | COMMERCIAL & GROWTH STRATEGY
14
Revenue Growth
Currently delivering $XM in ARR, and drastically outpacing competitors

15. |
● Expand into high-value U.S. markets
● Deploy hub and spoke model to ramp up
new markets in a capital efficient manner
● Augment and leverage existing logistics
network
COMMERCIAL & GROWTH STRATEGY
Therapeutic Offering
Our Growth Strategy
Provider-Driven
GTM Approach
● Augment sales force to capture market
share in existing and new markets
● Roll out marketing campaigns to generate
greater brand awareness
● Deepen focus in chronic treatments
● Leverage provider and patient relationships
to become one-stop-shop for prescriptions
over time
● Drive conversion to Alto app and
refill-enrollment
● Enter adjacent care markets to increase
value proposition
● Focus on enterprise customers
● Expand patient coverage (e.g., Medicare
Part D, assisted-living, health plans)
Sales & Marketing Efforts
Other Core Initiatives
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Regional Focus

16. |
Cohort by Launch
Year
Cities Population3
2020 and
Prior
SF Bay Area 7.0M
Los Angeles1
13.2M
Seattle 4.0M
Denver 3.0M
Las Vegas 2.3M
2021
New York 11.8M
Dallas 7.6M
Houston 7.1M
San Diego 3.3M
Austin
(coming soon)
2.2M
Alto is Scaling Rapidly
and Efficiently
1. Los Angeles also includes Orange County
2. Includes Washington, D.C.
3. Population figures based on 2019 CBSA data
4. As of August 2021. financial figures are unaudited and subject to change. Annual Run Rate (ARR) calculated as Revenue/business day in month*business days in year
San Francisco
Bay Area
Los Angeles1
Denver
Seattle
New York
Long Island
Houston
Dallas
San Diego
Austin
Existing markets Near term markets
Las Vegas
COMMERCIAL & GROWTH STRATEGY: REGIONAL FOCUS
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By YE21
Alto is expected to
cover ~20% of US
lives with local
distribution
centers
Phoenix
San Antonio

17. |
Alto’s Provider-Driven GTM Motion Drives Patient
Engagement, Enabling Wallet and Margin Expansion
COMMERCIAL & GROWTH STRATEGY: SALES & MARKETING EFFORTS
Build Relationship
to Patient
Conduct Outreach to
Increase Attach Rate
Create Early Wins
With PA Capabilities
Drive Conversion
to Alto App
Fill Refill Enrolled
Patients and Expand
Relationship
Profile Targets
With Sales Ops
Increase Patient
Referrals
Increase Visibility
to Provider
Drive Offering
Through AltoMD
Provider
Service Broader
Prescription Needs
Patient
Adherence to
Medications
Patient
Refill Enrollment means patient opts in to have monthly supply filled and delivered automatically where allowed by regulatory bodies for non-government and non-controlled substances 17

18. |
Expansion Opportunities for Alto
are Attractive and Significant
Source: Third Party Research
1. Represents the midpoint of two estimates from Third Party Research
COMMERCIAL & GROWTH STRATEGY: OTHER CORE INITIATIVES
Best-in-class, same-day
delivery pharmacy
Subscription
membership to increase
monetization and
stickiness, Alto Plus
Access to prescriptions
and primary care doctors
through Alto’s
Telehealth offering
Full range of
over-the-counter
medications,
supplements and
vitamins increases AOV
and patient stickiness
Highest patient
adherence and
outcomes monetized
through disease
management
and data services
Prescriptions Subscription OTC Telemedicine Population Health
Alto is a 90+ NPS service in a ~$800B TAM
with virtually unlimited growth opportunity
$450 Billion $651
Billion
$131
Billion $250 Billion $24 Billion
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19. Operations
Overview

20. | OPERATIONS OVERVIEW
The Pharmacy Sits in the Middle of a
Complex and Confusing Supply Chain
~140M
Americans fill ~5.8B
30-day Rx each year1
20-30%
Prescriptions written
are not filled2
~$300B
Service Agreement
Cost from
non-adherence3
Payment for Product
Formulary Agreement
Rebates
Service
and
Data
Fees
Product Shipment
Product Shipment
Payment for Product
Vendor Agreement
Reimbursement
Wholesaler
Manufacturer
Payor/
Health Plan
PBM
Pharmacy
Physician Patient
Prescription
Copay Insurance Premiums
Service
Contracts
% Pass Through
of Rebate
Reimbursement
to PBM
(incl. spread)
1. Centers for Disease Control and Prevention and a 2019 IQVIA Institute Report
2. Annals of Internal Medicine
3. American Journal of Health-System Pharmacy
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Network Participation

21. |
5+
Years of development efforts
100+
People in the technology team
200+
Releases per month
2M+
Lines of code
Build once, run everywhere
Cloud-first architecture
Technology Infrastructure
Alto Built a Modern Pharmacy Platform
to Help Address These Challenges
OPERATIONS OVERVIEW
21

22. Believe in a better pharmacy.