The Story of a ‘Simple and Elegant’ Health Care Startup

by Diana Drake

Like most high school students, sister and brother Shreya and Rahul K., spent part of the pandemic hunkered down at home — in their case, Rumson, N.J. But rather than succumbing to the isolation and frustration, their quarantine became a time of innovation. They have added the title of co-CEOs to their résumés.

With the help of Sourish J., a rising sophomore at the Wharton School, University of Pennsylvania (Penn), who lives in neighboring Holmdel, N.J., in April 2020 the three friends co-founded Altrui Foundation. The nonprofit diverts short-dated medicines that will be expiring within a year to community organizations, rather than the typical practice where manufacturers destroy those medications. They have built a 20-person project team of students, ranging in age from high school to medical school.

7 Manufacturers, 7 Organizations

The result is a growing entrepreneurial venture that Wharton management professor Tyler Wry calls simple, elegant and effective.

“Nothing is really pattern-breaking about what they’re doing, but it’s a clever solution to a problem they saw with these orphan medicines not being able to find good homes and being destroyed instead of being put to good use,” says Wry, an expert in entrepreneurship who was approached by the group to serve on Altrui’s five-person advisory board. “What I really like about this is that they weren’t trying to do something insanely overwrought or innovative for the sake of being innovative. That’s where the best social ventures come from.”

Shreya, Rahul and Sourish have collaborated before on social-impact projects, including distributing water filters to students in India. But this one seemed especially important during a global pandemic.

“I feel like I’ve had a lot of conversations about health-care related issues, and this one made so much sense to work on,” says Shreya, who just graduated high school and is headed to Yale University in the fall. “We’re helping the patients and getting the medications somewhere more useful, instead of destroying them. We came across numbers that said $5 billion worth of excess and unused medications go to waste each year. That’s a crazy statistic.”

Charities that distribute medicine to patients in need will accept short-dated medications anywhere from three to nine months before they expire. Altrui is committed to the mission that end users will never receive expired medications, which can contain harmful bacteria and lose strength and effectiveness.

Altrui’s business model pairs manufacturing companies with community organizations to distribute medicines to people in need, supported by technology. Chief Technology Officer Justin Z., a rising sophomore at Penn (and also a Holmdel native), has spent a lot of time in the past few months automating Altrui’s process on its medication-distribution platform 2L, complete with messages detailing legal terms and conditions for handling orders between manufacturers and organizations.

It works like this: pharmaceutical manufacturers upload an Excel spreadsheet to the Altrui platform listing what short-dated medications they have to offer. Short-dated medications are typically three to nine months from expiring. Depending on legal specifications, they can designate a specific organization to receive those medications, or they can make them available to any charities on the platform.

Charitable organizations that distribute medicines to the community then review and download the inventory that the manufacturers have to offer and specify their medicine order on the spreadsheet. They re-upload the spreadsheet to Altrui’s platform, and the pharma company is notified of the organization’s request. The manufacturer ships the order to the organization and uploads the packing slip. The organization also uploads a receipt once the order has been received to verify the specifics. Altrui finally provides a slide to both sides detailing transaction information, including the size of the donation, an estimated tax, and the number of bottles shipped.

“The constant goal is to bring on as many partners as we can, both manufacturers and organizations.” — Shreya K., Altrui Co-founder

To date, Altrui has partnered with seven pharmaceutical manufacturers, including Rising Pharmaceuticals, Aurobindo Pharma, Ingenus Pharmaceuticals and Camber Pharmaceuticals, and seven community organizations, such as MAP International, CitiHope International, Americares, SIRUM and Faith Community Pharmacy.

In the past nine months, Altrui has supported the shipment of seven rounds of medications and handled 45 total orders. This has involved getting more than $40 million of medications to the nonprofits and to the patients in need, totaling some 100 million bottles. The most common diverted medications on the platform are Omeprazole, Cetirizine and Amoxicillin, for which Altrui has facilitated the shipment of 50 million units.

“From the manufacturer side, it’s really beneficial,” notes Rahul, who will start his senior year at St. Paul’s School in New Hampshire this fall. “A lot of times the reason why manufacturers don’t donate to an NGO [non-governmental organization] or charitable organization is because of lack of convenience, lack of standardization, and a lot of the legal work hasn’t been developed yet. We have standardized that system and made it more transparent for both sides, and that’s helped get the transactions flowing.”

From the community-organization side, Altrui appears to be serving a market need. Paul S. Moore II, CEO of CitiHope Relief and Development in Margaretville, N.Y., began working with Altrui in the fall of 2020. Moore began his mission work 30 years ago, and has organization has since delivered more than $1.4 billion in medicine and food aid around the world.

“We have worked across the globe, from former Soviet republics to eastern Europe, across Africa, and Latin American and the Caribbean. Most of the communities we serve are experiencing poverty in addition to limited access to adequate nutrition and health care,” says Moore. “Even in situations where medicines might be available, the costs can make them prohibitive to patients. Our donated medicines are (and must be) freely distributed.”

‘Exuberance and Humility’

Altrui, Moore adds, is opening up more donations to be used by charities and is doing the work of making sure the pharmaceutical companies’ need for good reporting is satisfied. “I started my humanitarian work at 17, and seeing such highly engaged and passionate young people who want to make a difference in this world has been inspiring,” says Moore. “The humanitarian world can be just as dog-eat-dog as any industry, and most NGOs and PVOs [Private Voluntary Organizations] hold their donors pretty close to the chest. Yet the team from Altrui have been clear in their desire to help and so disarming in their approach. Their combination of exuberance and humility in listening and learning from our experience in humanitarian relief and development is quite rare.”

According to Moore, both pharmaceutical manufacturers and community organizations want and need centralized donations, but other platforms often require compensation in exchange for them. Altrui is committed to remaining entirely free for its network.

Several members of Altrui’s 20-person team of students from high school to med school.

Professor Wry clearly sees the business benefits. “When you look at the model and the idea they have, it’s zero risk for these pharmaceutical companies,” he observes. “Altrui can go to a pharmaceutical company and say, ‘Hey, let us take your trash and you will get a reputation bump for it and you don’t have to do anything really.’”

Still, Wry, who is building an entrepreneurship boot camp for the Wharton Global Youth Program, also wonders about the sustainability of this so-far purely social model — and so many others that are flooding entrepreneurship channels these days.

“The worry that I have with some of these ventures, Altrui included, is that these students who want to do well in the world think that is enough to build a sustainable organization, and it’s not,” Wry cautions. “It’s going to do some helpful things for you, but if you’re not systematic about how you go about it, and then more importantly how you go about thinking about the cold, hard dollars and cents part of it, you can end up building something that will never scale or sustain itself. Your commitment to altruism is getting in the way of actually putting a more sustainable profit-maximizing model on the back of it.”

At least in the short-term, Altrui is focused on making smart decisions with the money it does have. “We’ve won a lot of funding from different sources: the Startup Challenge at Penn and also seed funding from Venture Lab’s VIP-Xcelerate, an accelerator program. We are also seed funded by Weiss Fund of the Weiss Tech House,” says Rahul, referring to a student-run innovation center at Penn. “We are working on how to best use that funding to scale Altrui, for better optimizing the platform and for marketing costs.”

What likely began as an experiment to embrace during COVID has gained some serious traction — with a vision for growth. “The constant goal is to bring on as many partners as we can, both manufacturers and organizations,” says Shreya. “We’ve only cut a small piece of the pie of manufacturers, and there are hundreds across the world. We want to scale as quickly as possible.”

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Conversation Starters

What is Altrui Foundation’s business model?

What does Professor Tyler Wry mean when he says, “If you’re not systematic about how you go about it, and then more importantly how you go about thinking about the cold, hard dollars and cents part of it, you can end up building something that will never scale or sustain itself.”

If you could ask Shreya, Rahul and Sourish questions about Altrui Foundation, what would they be? What else would you like to learn about their entrepreneurial process?

9 comments on “The Story of a ‘Simple and Elegant’ Health Care Startup

  1. For a long time I followed the business beat in New Jersey and wrote articles about one of the state’s most robust industries, pharmaceutical manufacturing. The state is home to something like 15 of the world’s largest pharmaceutical companies, including J&J, Bristol-Myers Squibb and Merck. I’m wondering if the Altrui team has knocked on the doors of some of these giant pharmas, as well as how they have been able to persuade other pharmas to engage with their platform. What does it take to convince a multi-million-dollar company or even a smaller drug firm to give back in this way?

    As the article suggests, this team of students, led by two high schoolers, has made some serious progress toward their mission in the past year. It’s hard not to feel this is exceptional! I think it is also a testament to how far a group of earnest and ambitious students can take an idea if they devote the necessary time to the effort. If you bring the goods and are serious about what you’re proposing, people will listen. Your age and lack of experience need not be deterrents.

    • Thank you for your kind words, Ms. Drake! As there are tons of generic pharma manufacturers in the United States, and specifically in New Jersey, our team at Altrui has been relentless in pursuing these opportunities. In order to be able to partner with these companies, I found that it is crucially important to be persistent by following up with your contact points at least almost every other day. I had to understand that in most cases, employees have higher priority tasks and our messages might ‘fall’ to the bottom of their inboxes, and so, a good skill to pick up is understanding how to conscientiously follow up. More so, it is necessary, that in a startup, you offer the value proposition for the clients or partners. In our case, we inform that by working with Altrui, manufacturers would increase their CSR, reduce their storage and destruction of medication costs, receive tax exemptions from the government, and donate their pharmaceuticals through a more streamlined and automated process.

      To answer your second point, you should never let your age deter you from achieving your goals and making an impact. A true entrepreneur and social visionary would find a challenge, invent a solution, and face all obstacles in order to make real change. Earlier this year, I spoke with Professor Tyler Wry at Wharton, whose quote, “An entrepreneurial mindset is about embracing a pain point as an opportunity to create novel and productive solutions,” has had a tremendous impact on me. I thank our student-led for how much they worked through this opportunity, and I commend their eagerness in wanting to scale this non-profit.

  2. Thank you Diana for sharing your thoughts! The work of these kids is incredible, particularly in being grounded with social impact. I agree with you on their work being a testament to spending time and effort for something you believe in. I would note that there is a difference between noticing an issue and taking action or implementing a solution for it. The initiative that Rahul and Shreya have taken up has considerable impacts on the communities they are serving, making it true to the mission. They have been able to grow the team to more people passionate to the cause, which is a fundamental pillar to any nonprofit organization. Furthermore, just like you mention that people will listen to you if you are serious about it, that is just what these students have been able to achieve. Having a mission and a vision is important for the sustainability of any organization, and the Altrui Foundation has drilled it down. I agree with you at the whole about the students. Channeling ideas into innovation is needed for any startup, and that ability to turn an idea into a reality for helping society is really what makes this commendable.

  3. Just about 2 months ago I sat down to write my Interdisciplinary Unit (IDU) exam for my IB MYP E-Assessments. The way these IDUs generally work is that they are focused on a topic which can be reasonably linked to 2 subjects and in this case, the topic in focus was healthcare and the subjects responsible for our understanding of the same were English and Science. Over the months prior to this examination we had discussed the successes and failures of healthcare systems, the quality of healthcare worldwide, and the development and usage of drugs around the world. One topic, however, which we had found ourselves continually returning to and debating was that of ‘the insulin crisis’ (which refers to the rising cost of insulin world-wide and the resulting decrease in accessibility of the drug). We spoke about how the cost of a vial of insulin in the United States has risen from $35 to $275 in just the last two decades, about how the 422 million diabetes patients worldwide would be impacted by this rise in insulin price, and about how the 1.6 million deaths attributed to diabetes each year would most likely continue to rise if we do not find a solution to this crisis.

    In the practice tests given to us in preparation for this exam we were often asked to come up with a solution to this crisis and when discussing our solutions afterwards, we were generally told that they were too ‘general’ or ‘vague’. Honestly, this frustrated me and many of my classmates because it seemed like we could not find a solution to the grave problem we had been discussing for weeks and months on end. However, after reading about Altrui and their work I am personally much more hopeful that the insulin crisis and other problems much like it which have their roots in the inaccessibility and unaffordability of drugs will soon be addressed.

    For this reason, I would like to commend Rahul, Shreya, Sourish and the rest of the team at Altrui for developing something that is undoubtedly impactful during the COVID-19 pandemic but which will also undeniably solve problems that existed well before the pandemic and which will spring up long after it.

  4. After reading this astounding article about Rahul K., Shreya K., and Sourish J creating a business called Altrui, which they have a desire to make a social impact out of it, my view has widened on the whole situation of the whole Altrui team of being successful. This is because any contributes to improving the covid-19 situation is needed. Also, the time and effort being put into this project show the dedication of what they want to accomplish which could result in the outcome being even more fortunate.

    Moreover, the Altrui foundations business model pairs manufacturing companies with community organizations to distribute medicines to people in need, supported by technology. In my opinion, this sounds interesting and very high-tech which is good in today’s day and age as everything is more or less revolved around technology. It also shows how much thought the co-workers put into the idea to make it advanced.

  5. The Altrui Foundation diverts short-dated medicines that will be expiring within a year to community organizations rather than having manufacturers destroy them. Shreya stated that $5 billion worth of excess and unused medications go to waste each year. The Altrui Foundation is putting these medicines to better use and decrease the possibility of medication entering the environment. Short-dated medicine is being shipped worldwide, from the former Soviet Republic to Eastern Europe, across Africa, Latin America, and the Caribbean. Improper disposal of medication can cause it to leach into water systems. Pharmaceutical-related chemicals can end up in waterways and our drinking water. The Altrui Foundation is not only providing people with the medication they need, but they are also lowering the amount that will end up in landfills or sewages. Having the Altrui platform 2L definitely will help with the communication between pharmaceutical manufacturers and charitable organizations.
    Having a platform where you can easily communicate with your team greatly increases your efficiency. I use Discord to communicate with my teammates. We are members of a non-profit organization aimed to help students in English Language Arts, Math, and public speaking. Through this platform, we can keep everyone on track and target problems more efficiently. I admire how Shreya, Rahul, and Sourish identified a problem in quarantine and took concrete steps to try their best to resolve it. They distribute the donated medicine to communities experiencing poverty and limited access to health care free of charge. By doing so, they are closing barriers that separate those who have health care and those who don’t, allowing everyone to get the treatment they need regardless of nationality, class, race, and income. The Altrui Foundation is a step to a healthier world where everyone has access to medication.

  6. On Air China’s flights to China, passengers are allowed to bring up to two checked bags, one carry-on item, and one personal item. Because we hadn’t gone back to visit China in a while, my parents took full advantage of these rules, stuffing 11 bags with clothes, luxury items, food, and distinctly “American” goods. Out of the 11 bags we ended up carrying, 4 were suitcases dedicated exclusively to medicine and vitamins for our grandparents. The accumulation of five separate Costco runs was not because the same medication isn’t available in China—it’s just incredibly rare and expensive.

    The pressing issue seen in the widespread lack of affordable medication isn’t unique to just China: it’s prevalent everywhere. Thankfully, Altrui stands as a beacon of hope and change in a market stricken with inequality. Rahul, Shreya, and Sourish’s work in securing and donating short-dated medicine for communities in need is largely empowering and inspirational. 100 million bottles of medicine is a staggering statistic that not only goes to show Altrui’s ambition, but also the depth of their impact.

    While I do completely commend all Altrui’s work, I reject Altrui’s description of being “simple.” Although the business model of receiving donations and redistributing them isn’t extremely nuanced in the entrepreneurial space, Altrui’s success and growing presence shouldn’t be minimized to such brush-off terms. Taking in consideration that Altrui’s early team was made up of a group of highschool students, attracting the attention of seven pharmaceutical companies, established professors, and CEOs is no easy feat. In fact, it just goes to further exemplify the complexity and thoroughness of the team’s thinking and planning. Just because the business model itself isn’t inherently more complex than the next, it doesn’t not merit credit to all the success and support the team has garnered.

    In addition, I want to echo the words of Professor Wry on the sustainability of altruistic entrepreneurship, where “It’s going to do some helpful things for you, but… [without] thinking about the cold, hard dollars and cents part of it, you can end up building something that will never scale or sustain itself.” Even for an entrepreneurship team like Altrui, one that has had so much success and support, whether that be college professors, leading CEOs, or numerous scholarships, without profit, Altrui is not sustainable. Personally, I think that speaks volumes about the privilege that is needed to even consider entrepreneurship. Yet, entrepreneurship is constantly portrayed in society as being open to anyone, allowing just anyone to complete the rags to riches American dream, promising a false reality of support when not everyone is privileged enough to pursue such a path and take such risks. It presents a rather unfortunate truth—entrepreneurship isn’t for everyone; it is a bleak dream inaccessible for most. What might be a major risk for a single mother in a low-income community might not even be considered a blink of an eye for the Ivy League-educated entrepreneur from an economically privileged background. My point is: the fluid portrayal of entrepreneurship as a path that pertains to virtually everyone is a major oversimplification of entrepreneurship. It’s about time that we recognize the parallels between entrepreneurship and privilege to better respond to the injustices that it presents.

    Ultimately, Altrui is an extremely promising approach to confront the needs of the pharmaceutical industry. However, if Altrui hopes to pave the way for a more sustainable market of medicine, it is absolutely necessary for them to respond to Professor Wry’s concerns. Luckily, Altrui’s altruistic approach to entrepreneurship allows them to further gain support and engagement from the public. Even though there will likely still be bottles of medicine and vitamins in my suitcases for China in the near future, I have no doubts that Altrui will continue to flourish and innovate, spearheading a more inclusive industry of medication.

  7. In a generation where high-value tech startups emerge from seemingly nowhere, and when capitalist superstars such as Elon Musk and Jeff Bezos exist, it’s easy to lose sight of who and what a “successful entrepreneur” is.

    Rahul and Shreya’s journey is a fresh reminder of what it means to be a successful entrepreneur. In my eyes, a successful entrepreneur is someone who can sustainably deliver to the masses a solution to a problem that raises the quality of life. In Rahul and Shreya’s case, they aimed to solve two problems. The excess medication dilemma and the healthcare inequity issue.

    The disposing of unwanted medicines costs millions of dollars per year, with medication destruction costing $1-3 per pound. The frustrating part of this is that these short-dated or excess medicines are just as high quality and effective as when they first came out of the lab. Considering the current paradoxical state of the US healthcare system with more and more people unable to have access to life-saving drugs despite the US leading in pharmaceutical innovation, it is depressing to see these excess drugs go to waste when they could be saving lives. This is where Altrui comes in. Altrui provides an easy-to-use one-stop-shop web interface that connects pharmaceutical manufacturers with charitable organizations. Manufacturers would upload to the platform what drugs they have available for donation and can either choose what charities they want to donate to or make their drugs available to all. While this may not seem all that innovative, Rahul and Shreya’s simple yet ingenious idea has solved both the excess medication dilemma and the health inequity issue by standardizing the process of medication donation. Manufacturers no longer have to worry about legal terms and conditions when donating and charities no longer have to worry about getting replies from manufacturers. This simplified method of communication helps avoid long extensive back-and-forth emails where things could easily get lost. Altrui’s platform opens the doors between manufacturers and charities allowing more charities being able to connect to manufacturers and vice versa, thus redirecting the flow of excess drugs from landfills into the hands of those who need them most.

    I applaud Rahul and Shreya’s efforts to create a nonprofit during the pandemic, especially when entrepreneurship has become less accessible to the general public, much less high school students. I commend Rahul and Shreya’s passion and motivation for social impact that allowed them to stay true to their mission to deliver millions of dollars of drugs into the right hands. I can’t imagine how difficult it must be to manage a team of 25 plus people and reach out to dozens of charities and drug manufacturers. I love how Rahul and Shreya didn’t overthink their solution to the excess drug problem and that they didn’t try to be innovative for the sake of being innovative. They saw a simple yet effective solution, with technology acting as the middleman between drug manufacturers and charities, and ran with it. Rahul and Shreya prioritized the social impact of Altrui over anything, which allowed them to expand and reach out to more charities and manufacturers. They weren’t title-chasing for “Most Innovative Startup of 2020”, but instead were more focused on being the more effective startup/nonprofit. After reading this article, Rahul and Shreya definitely shifted my definition of a “successful entrepreneur”. My definition of a “successful entrepreneur” shifted from someone who can “take the high road” and “grind it out”, to someone who can do both of those things while being able to change the world for the better and deliver social impact.

    I am so glad that KWHS decided to do an article on Altrui because startups/nonprofits like these don’t get nearly the praise and publicity they deserve. Rahul and Shreya’s story is something that everyone should read, as their story serves as a template to how having a genuine desire to help and make a difference in the world can make anything possible. Rahul and Shreya are paving the way for a new wave of entrepreneurs. A generation where vision, initiative, and passion are used to create a better present and future.

  8. Reading this article, and seeing the successes of Altrui really inspired me. The founder’s idea of this non-profit organization was truly innovative and helpful to society. Coming from a country where I know that so many people don’t have feasible or adequate access to quality Medicare, I feel that the distribution of medicine is something that was necessary especially with the pandemic. After reading dozens of articles and web pages on the topic of medicines and pharmaceutical science, it took me some time to realize how flawed, the distribution of medicine from manufacturing companies are. The statistic of “$5millon” worth of useable medicine that is disposed off on a daily basis by these companies was very shocking.
    Alturi’s motives to partner with big pharmaceutical manufacturers such as Aurobindo Pharma, Ingenus Pharmaceuticals and Camber led to its successful beginning. I believed it built the foundation for the project itself. Alturi has shown that to build a business, communication and partnership is important; and to me it is one of the reasons that they were able to establish trade of medicine to across 7 different countries. The project is very sustainable too, and will help countries even after the pandemic too. Not only did this article seemingly grow my interest about how to start a business but it made me realize that certain non-profit programs profit off the thought that they are helping people. That is what truly inspired me about Altrui.

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