According to The Wall Street Journal, telehealth company Ro, co-founded by CEO Zach Reitano, facilitated a dramatic price drop for weight-loss drugs like Ozempic and Wegovy, cutting a monthly supply from $1,300 to $149 by working directly with drugmaker Novo Nordisk and bypassing insurers and pharmacy benefit managers. Reitano, who started the company (originally Roman) at age 25 after his own health struggles, has vertically integrated a national digital doctor’s office, lab tests, and its own pharmacy. The company now uses AI to automate calls and slash side-effect response times by 70%, while amassing vast amounts of patient-controlled health data from sources like Apple Watches and even food delivery receipts. Despite helping millions, Ro faces pushback on privacy and its marketing, like using Serena Williams to promote GLP-1 drugs without mentioning side effects.
Cutting Out The Crazy
Here’s the thing about the traditional healthcare pricing model: it’s built on opacity. List prices are fiction. Rebates are secret. And the patient is the last to know what anything actually costs. What Ro did with Novo Nordisk on those weight-loss drugs is basically a giant middle finger to that whole system. They connected the drugmaker directly to the patient, eliminated three or four layers of middlemen, and boom—the price falls off a cliff. It’s a powerful proof of concept. But let’s be real, it only works for certain types of drugs. These are chronic, elective-ish treatments that people want badly and are willing to pay for out-of-pocket. Try that with a lifesaving cancer drug and the math, and the moral dilemma, gets way messier.
From Gatekeeper To Sherpa
Reitano’s “Sherpa” analogy is catchy, but is it accurate? In the current system, your doctor is often a gatekeeper you have to convince to give you a referral or a prescription. A Sherpa, in his vision, is a guide who uses all available tools and data to help you navigate the climb to better health. That’s the shift. And it’s fueled by data most doctors never see. Your sleep score from an Oura ring? Your resting heart rate trend from your watch? Your DoorDash history? No doctor has time for that in a 15-minute visit. But an AI-powered platform like Ro’s can theoretically ingest it all and look for patterns. The potential is huge—moving from “I’m sick, fix me” to “Hey, your data suggests you’re heading for a burnout, let’s adjust.” But it also raises a ton of questions. Who’s liable if the AI misses something? And do we really want our telehealth provider knowing we ate a 4×4 burger from In-N-Out at 2 a.m.?
The Data Play And The Risks
This is where Ro’s sneaky long-term value is. It’s not just a drug dispensary. It’s a data-absorbing shop. They own the customer relationship and are building a unified health record that you control. That’s a powerful position that pharmacies like CVS, insurers, and hospitals all covet. Whoever owns that comprehensive data picture owns the future of health management. But with great data comes great responsibility, and Ro is already feeling the growing pains. Privacy concerns are obvious. Their influencer campaign with Serena Williams felt tone-deaf because it glossed over serious side effects. Building trust is paramount when you’re asking for this level of intimate information. You might tell an AI chatbot things you’d never tell a human doctor, but only if you’re confident it won’t be used against you.
Who Wins The Patient?
So we’re heading for a turf war. Pharma companies are going “direct-to-table.” Retail pharmacies are adding clinics. Everyone wants to be your health home. Ro’s advantage is starting from a clean slate with software at its core, unburdened by legacy physical infrastructure or insurance contracts. They can move fast. But healthcare is a regulated brick-and-wall industry, not just bits and bytes. Their model works beautifully for discrete, software-friendly problems like ED, hair loss, or weight management. Scaling that “Sherpa” model to complex, multi-system chronic diseases is a completely different beast. Still, I think Reitano is onto something fundamental. Even if Ro doesn’t win, it’s proving that when you introduce transparency and cut out unnecessary complexity, prices can fall and patients can feel more in control. And in a system famous for its crazy cycles, that’s real progress.
