Second Chances | Phil Baker, PharmD, Founder at Good Shepherd Health

Transcript Disclaimer: This transcript is generated using speech-to-text technology and may contain errors or inaccuracies.

Mike Koelzer, Host: [00:00:00] Phil for those who haven't come across you online, tell our listeners who you are and give us a snapshot of kind of what we're talking about in general 

Phil Baker, PharmD: today. My name's Philip Baker, um, pharm D I'm a pharmacist, uh, graduated from the university of Tennessee in 2005. I'm seeing the retail world in the hospital world.

My story is. In 2013, I was really pleased with how my life had turned out, felt a burden to know if this is the plan that the Lord had for me after feeling like I was called, and started a nonprofit dedicated to medication management. I formed the nonprofit, um, Decided to open an onsite pharmacy and said, we're not gonna accept insurance.

We're gonna be 100% transparent. If the drugs are free, we're gonna give 'em away for free. If we can't get something for free, we're gonna sell it at our cost with no markup and we're gonna live and die on our membership fees. When we got to a thousand patients, uh, it was September of 2017. When we actually pulled this off, we synchronized all 1000 patients, all of their prescriptions.

So they're all due on the same day, four times a year. So the whole pharmacy operates on a set schedule. You said a 12 week schedule that resets with each quarter. What we call the batch 

Mike Koelzer, Host: fill? Every patient is on that one date. It's not like your floating date. It's all on that one. Date four times a year.

Phil Baker, PharmD: Exactly. It changes the pharmacy's operational model to align with these forcep chip dates. And so we just did a batch. We do a batch in January. All of our patients, all of their refills were due in their hands by February 1st. 

Mike Koelzer, Host: You've got the time then each quarter to make sure you're getting the right amount of medicine for that.

Phil Baker, PharmD: Right. It fundamentally shifts the pharmacy in a way that actually aligns the incentives of the pharmacy with the incentives of the patient. So that sounds like highfalutin, but what that means is we don't feel anything unless it has to be filled. We're, we're trying to do as few fills as possible. We make the same me.

Fee if they do six fills in a month, or if they do one, so we wanna be as efficient as we possibly can. Um, and so we have the batch fill and then if there's any new medications or changes that get started between she set ship dates, then we only send enough medicine to last until the next ship date. We 

never do a 30 day fill.

We always do 

an odd number. It may be 62 pills, cuz that's gonna last you until February 1st and then everything is gonna go out together again and be kept on the same schedule all the time. You're not getting 

Mike Koelzer, Host: paid for the fill. You're getting paid the membership fee. That's more efficient. You can be the better.

Phil Baker, PharmD: Which benefits the patient as well. You want them ideally. I mean, ideally to, if you're doing your job, well, they're gonna take fewer prescriptions. They're gonna get healthier. They're gonna take fewer prescriptions. The incentives are aligned. We don't wanna overfill anything. We want to give you exactly what you need when you need it and nothing more.

And because we're not profiting off every single one. We can focus on making sure we do a profile review every 30 days on every one of our patients, not like a 

computer generated one like human eyes, looking at 

the profile review. If we get a new prescription between ship dates that stands out, why are we getting this what's going on here?

And so it's enabled us to be hyper efficient, that processes, um, we call, I call it group synchron. Really creative in that, but it's group synchronization of prescriptions. And, um, we've applied for a patent, a method patent on that. We've made it work with several different pharmacy systems. So it's not specific to QS one or pioneer any specific system.

We can teach people how to do it. And I do believe 

that fundamentally by synchronizing 

the entire group, you get several. Blue ocean changes that create real opportunities. For one, you shift the business model from an inventory business model where you gotta have all these drugs on the shelves, cuz you never know who's gonna walk in with what to a J I T model.

So we carry about a $10,000 inventory, uh, in a pharmacy that normally has like a $2 million inventory. 

We're able, you know, cuz we can, we 

I know it needs to be filled on this date. We know what we're filling. We can order everything in one huge order and get bigger discounts than you might get without the bulk ordering.

But we can also go step further and order precision. Oh, I gotta call precision ordering. So. If I know. And, I do know that I gave my patient 90 pills on February 1st, February, March, April. They should run out of that medicine by March 31st. So 

if it, if it expires in 

June, I don't care. I know I'm safe.

I'm within that expiration date. So if there's synced and you can purchase short, dated stuff up in bulk as well, all of this serves to drive the price. Below average market, even average market pharmacy, wholesale cost. You're 

Mike Koelzer, Host: getting drugs either from. The manufacturer, or even some people that have unopened bottles and so [00:05:00] on.

And so that expiration date very 

Phil Baker, PharmD: important. We accept donated meds directly from manufacturers, but we, we generally get we're tied into every disaster relief organization in the country that provides prescription meds to charity pharmacies and safety net clinics and all those sorts of. So there's a handful of programs that did exist that allowed reclamation from hospitals and nursing homes, but there weren't any that allowed individual patients or family members to make a donation.

And so Tennessee didn't really have any laws on the books. And when we went with the legislators to get the law changed, we made sure that we had it written so that we could accept it from any individual person anywhere in the country. So we can literally accept donations from any individual, anywhere in the country.

They have to. Unopened unexpired. They have to be in absolutely pristine condition, essentially. They're in, you know, the manufacturer's original packaging with the foil seal. We are not taking back the Amber vile. It has gotta be in blister packaging. Luckily these, um, these specialty meds are so valuable that they're usually in kind of fancy packaging, but so, so, um, that happened.

We couldn't legally accept the meds, seeing really, you know, 30, $45,000 meds coming in. I worked with a leg, a couple of legislators in Tennessee for two years to get a bill passed so that we could create a program. We made sure that a program allowed us to accept donated meds from anywhere, any individual, anywhere in the country.

Those meds have to go first to uninsured, low income uninsured patients in Tennessee. If there's not a low income uninsured 

patient in Tennessee, that's available. When we 

have the med, then it can go 

to other states, other healthcare facilities in other 

states. And so what we did was we started, 

we really started officially in March of 

this year.

Like right before COVID hit, we created a campaign that allows anybody to donate their unused unopened oral chemotherapies. And we did specifically narrow it down to we're only accepting oral chemotherapies. Um, I didn't. Just simply can't afford to open up and say, I'll take anything. Anybody wants to send it to me.

Um, but we narrowed it down to oral chemotherapies and we created a website called flip your script.com and it shows how you can text a picture of it. And if it's, if it's something we can legally accept, then we text that person, uh, a donation form and a FedEx 

link so that we cover the shipping. It doesn't 

cost them anything.

They fill out the form, they throw it in a box and have FedEx pick it up. And, and it's on our. And so that kicked off in March of this year. And, from March to the end of the year, we brought in upwards of 3 million worth of oral chemotherapies, uh, 300 different 30, you know, they're usually in a 30 day packaging.

So 330 let's call 'em 30 day supplies. We didn't start connecting those with uninsured patients immediately because I didn't know what I was gonna get. So it was pretty late in the year when we started matching meds with patients. 

Mike Koelzer, Host: When you said that was the parameters of having to use it. My first thought was, well, of course you'll find somebody because you have people in need.

But I imagine with certain cancer medicines, you might not have somebody that needs that medicine, right. 

Phil Baker, PharmD: Especially for us, like, we're just starting out. So where we're at now, like nine, 10 months in, we have a handful of cancer centers and oncologists that, that is, they love us and they're finding all their patients, but starting out, man, it was like, Hey, we've got this stuff.

Just put the word up. This was it's a, it's gotten it's the, the, the program's called remedy chain. And we do plan to expand it this year to, uh, beyond, uh, specialty meds to do any brand name drug. But it's gotten so much attention that people don't realize it's it's it was our side gig. It was this other thing that we were gonna do, so that we didn't have to, you know, tell people to throw these meds away.

But all that to say that we have, we did match meds with 16 patients last year. We've got, um, we've got three or four active patients. We've got one patient who's been, we've been providing chemo too for five months now. Um, And we got a really active program at, uh, we've we're really the world's kind of getting out.

We're the medications in November, we got $345,000 worth. Uh, medication donations in a single month, that was our best month ever. And our donations are just hockey sticking. So from individuals, 50% from, from individuals and family members, but 50%. And I really want to emphasize this has come from pharmacists who care, who are in a cancer center somewhere, and they're seeing meds get thrown away, or they have people bring them back.

Stuff like happened at my pharmacy. And even though they're not legally supposed to accept it, they throw it in. I've been meeting those people and they've been sending me millions of dollars worth of meds. literally 

Mike Koelzer, Host: someone might bring it back. And the typical pharmacist, it might have been a wife of a husband who died and they say, he's got all this cancer medicine and the pharmacists know they can't do anything with it, but they might not wanna throw it away in front of the, in front of the spouse or something.[00:10:00] 

But these pharmacists then are able to flip the script to look in your program and, and do it. With 

Phil Baker, PharmD: our program that, yeah, it actually serves a pain point, cuz people do take a lot back to the clinic. Um, and they prove, and, and not in all states, some states do allow the physicians to do a little bit if they Repens it right back out of there.

But for most part, yeah, we're the solution. They don't even. The clinic we don't, we made sure it's no work for the nurse in the clinic. All we have to do is say, go to flip your script.com or they can text us. We try to do everything over text message. We designed the whole platform to really run over text messages.

They text us, we send them a form that they open. They take a picture of the med. It's all, you know, highly automated. And the cancer center doesn't have to register that. They touched it, or they didn't have to do anything at all. Um, So, yeah, like most of us like 50%, I can't say most 50% have come from individual family members like we expected, but I've been pleasantly surprised that I'm hitting on these, what I call super donors, which are pharmacists in cancer centers in Louisville, Kentucky.

And, 

um, we've got one in Wyoming. 

We've got some folks in California that, um, don't get anybody in trouble, but just that people brought stuff back and they threw it in a box cuz they didn't have the heart to flush. 

Mike Koelzer, Host: Do those pharmacists have to get their fingerprints at all on it? And I'm, I'm not saying it's, I'm just kind of thinking, like, let's say a pharmacist was skeptical, but Mrs.

Smith brought something back. Can they send it without sending a bunch of pharmacy information? They 

Phil Baker, PharmD: have the option. So when they fill out the donation form, if they have Mrs. Smith info, we want that info. Um, but if they don't, they can, we can accept a donation from any individual or any healthcare provider.

If it's a healthcare provider like a pharmacist, then they have to write on what date they receive the med and how we got it. And so either way they can make the donation. If a pharmacist makes a donation in that way, there is no record. The only record is a picture of their signature. So what we have to report to the state is that they signed the form.

We don't have to report the pharmacist's name and address and all this other stuff. There's nothing to worry about there. Additionally, the program is 100% voluntary and all liability for all participants in the program has been waived. So there shouldn't be anything to be concerned about. When 

Mike Koelzer, Host: I was at Purdue years ago, we had a, we had this, uh, mission called Matthew 25, you know, in the Bible where it talks about feeding the poor and visiting the prison and stuff like that.

But they would just take back like they would just take open, vile bottles and stuff from people. Hey, Phil, I gotta ask this question before we go on. You are an air traffic control. When 

Phil Baker, PharmD: straight outta high school, uh, I left outta high school. Yeah. I left for the Marine Corps the day after I graduated high school.

Why 

Mike Koelzer, Host: was that a ROTC kind of thing or do 

Phil Baker, PharmD: you just decided to go? Uh, it was a reservist thing, but because I wanted to do air traffic control, I ended up being on active duty for quite some time. And so I signed up, I was in the delayed entry program the summer before my senior year, I did like a month long thing.

And then once a month, during my senior year, I drilled with the Marines in Millington, near where I live. And then the day after I graduated high school, I was on a bus headed to Paris island. How long 

Mike Koelzer, Host: After that, did you do air traffic? When did that 

Phil Baker, PharmD: start then, man, I never got to do it. So I, um, I went to you to go to basic training and then you go to combat training and then you go to your school air traffic control school.

I wanna say it's been 20 years. I wanna say it was, um, It's about a year long, probably nine to 12 months long, and then certifications follow the school and they take some time too. Um, I was supposed to be a reservist and drill once a month here in Memphis where I live. And while I was in the course of going to those schools and everything, they moved my Marine Corps unit to Dallas, so that when I got out of the reserves and was ready to finally be a reservist, they moved my unit and I.

Be a reservist. I ended up going on the inactive reserves. So I did all the school and the certification, but I never really 

Mike Koelzer, Host: got, oh, so you trained for it all, but you didn't get to go live. All right. So here's a question I have: all these pharmacists are, we all have horror stories of working in the.

Chains and being bombarded and not getting away for lunch and all this stuff. And I've always said to myself, how does that compare to an air traffic controller? Because you hear about like air traffic controllers being like, well, you know, you got people's lives in your line and these planes might crash and all that kind of stuff.

If you could line these two up between a, a, you know, a busy pharmacy with the upper management, just coming down and just, you know, All the stuff that goes along with that versus an air traffic controller. Is it close? Is any one of them in the lead of being a terrible pressure job or what 

Phil Baker, PharmD: [00:15:00] if you can?

Okay, so I've never been asked that before. It's a great question. So I would have to relate it to being at a community chain pharmacy, um, on a Friday evening. When you've got a two hour wait and your, and your counter is lined with prescriptions that haven't been entered yet yet. And you've got 30 people in line at the register, angry and looking at you, um, which I've been there.

obviously 

you come 

outta school and get slammed on a weekend. Um, the pressure is the same. The pressure is the same. The stress is, um, different. The situation is different, but keeping a cool head. Under pressure is that's the name of the game, not letting it get to you. So having a bunch of plates in the air, um, at the same time is, if I tell you there's the, the, the three things that come to mind are like that pharmacy description I gave you.

Um, when I was in high school, I worked at a long John Silver's and I worked the drive-through and that was one of the most stressful things I ever did as well. 

Mike Koelzer, Host: Now we 

got long John Silver's in the mix too So out of the three, then which one out of those three. Jobs. And I know you didn't get a chance to go live, live with the air traffic, but I'm sure you saw a lot of it out of those three, which one is going to just frazzle 

someone.

Phil Baker, PharmD: Oh, definitely. Man. You screw up their fish at long John Silver's They're going to be out for blood at least in Memphis where I'm from north Memphis. 

Mike Koelzer, Host: Seriously? Which one? 

Phil Baker, PharmD: Well, I tell you, I, I don't think man, that's kind of the, I'm not very 

elegant, but the, I guess the point I'm trying to make is it's, it's the same. 

Mike Koelzer, Host: It's the same 

Phil Baker, PharmD: in that.

Yeah. The intensity level. 

Mike Koelzer, Host: Gotcha. 

Phil Baker, PharmD: You're focused. You don't want to make a mistake. 

Mike Koelzer, Host: Gotcha. 

Phil Baker, PharmD: But you also can't be too focused cuz you've got, to see the bigger picture of what's going on and 

Mike Koelzer, Host: there's no, um, 

Phil Baker, PharmD: it's kind of like I tell my kids, 

Mike Koelzer, Host: I've got, 

Phil Baker, PharmD: my oldest is 14 and. We got it all the way down to a baby, but she's, um, starting on calculus and asked me, is it hard?

And it's like, I tell them anytime you're learning it, there's no different. There's no different degrees of difficulty. If something's just hard, then it's hard, you know, then, and, and that's what I relate it to. I've told 

Mike Koelzer, Host: people that it's like, let's say you had to get up and give a commencement speech or something like that.

And then let's say some other time someone has to return something to Walmart, but they're not sure. There's gonna be confrontation, you know, it's the same adrenaline inside the people. Mm-hmm , if you're a person that's gonna get kind of nervous from that, you can't always look at the difference of the thing as just like pressure sometimes is just pressure.

This can hit you from all sides. Yep. My wife grew up on the other side of town and she always tells me how poor they were. And her example of poverty. She said we were so poor that my friends and I, after school, we would go to long John silvers and they would give us the, um, the chromes, the chromes

they'd get the crumbs, you know, those little droplets of the, of the batter. And they would eat those. And that was her big, poor story. And I'm thinking, well, that's not so bad. If that's your definition of poor, then you know, that's okay. Yeah. 

Phil Baker, PharmD: So Phil, 

Mike Koelzer, Host: When you talked about finding God's path in your life, you weren't just throwing out the idea of going, you actually did a few mission trips.

What, when was that in your, in your field, Belize and NIAG? 

Phil Baker, PharmD: Um, well, I didn't come to faith until I was pretty late in life. I think I was 35. Um, and so 

that 

is, uh, I really had hit rock bottom and, um, that was the biggest turning point in my life was coming to know Jesus Christ. When, when that happened for me, um, my life started looking really different.

I'd been. I still, still am a very selfish self-centered person, but I say that to say, I'd never volunteered anywhere. I was 35 years old. I didn't do volunteer work. I didn't care about anybody but myself. So, um, one of the first things I did was start volunteering at LA Bon or to just go hold the babies at a hospital there.

Yeah. A children's hospital here in Memphis. Yeah. Gotcha. And simply you just go and you just hold the sick babies, cuz they need to be held as much as they can. Um, and then that led to different volunteer opportunities and, and through the church I had joined, um, I, I learned about, uh, I saw a mission trip for Belize and I had never even heard of the country of Belize pharm D truth.

I'd never heard of it. I didn't know where it was. And I was like, wow, that's crazy. I want to. And so that intrigued me. You were married at the time? No, I wasn't. I actually, you weren't married yet? No, I actually. I met my wife on the airplane on the way to Belize on that mission trip. No kidding. Yeah. and we met, we, uh, we were on that mission trip together for a week and I fell in love and we were engaged six weeks later and married just a few months after that.

Wow. Yep. And then I did do a trip, um, with a, a, it wasn't a mission trip so much because it was, uh, [00:20:00] a bunch of Jewish doctors and healthcare workers to Nicaragua. That was, I'm dying to go back. It was just so phenomenal. We were up in the mountains in Nicaragua. And, uh, helping PA you know, patients that don't get out of the coffee fields, super young mothers, um, carried meds with us into the country, um, and just super, super fulfilling work.

I've since gone on to have, uh, I say I have, my wife has had, um, Five babies and we have baby number six on the way. Oh congratulations. And so the mission trips aren't just happening right now, as much as we would like, but we're both committed to a life of mission trips and ministry is what we hope to do and teach our kids.

Mike Koelzer, Host: When was it, after the mission trip that you. Thought about the change in pharmacy when you were, you know, praying for direction and that kind of stuff was that cuz you'd already been in pharmacy then for 10 years or so, right? Yeah, 

Phil Baker, PharmD: I think so. No five at that 0.5. Yeah. Oh, because of the Marines and all that stuff.

Yeah. Mm-hmm yeah. I started a little later than everybody else. Was it around 

Mike Koelzer, Host: That time that you're saying, all right now I gotta find out what I'm supposed to be doing with all this. Yeah, 

Phil Baker, PharmD: I was, uh, I, I was, like I said, the director of pharmacy at a, I was a really comfortable job. It wasn't. Under rehab hospital, the patients are there for two weeks.

They're not turning beds every 48 hours. You get to know them. Well, we did a lot of hip and knee replacements, and so, um, it just wasn't like a high, stressful, busy job. It was really comfortable and I'd met my wife and we'd been married. It probably was. Two months after we got married. So a couple years after the mission trip that I actually started the nonprofit.

Did you feel like 

Mike Koelzer, Host: Were you bored or did you think that you weren't hitting your full potential when you were kind of looking for more direction? What was the thought pattern of thinking that God might have different directions for. 

Phil Baker, PharmD: It wasn't, it wasn't so much boredom, but I'd come from a low, low to a super duper high where I was literally just didn't really want to go on anymore to, I just married the most beautiful woman I've ever met.

And we've got a brand new baby son and we live in a really nice neighborhood and I work a job where I'd actually have to go to work six hours a day. It's not super stressful. And I'm 35 years old or 37, whatever I was then. And. That's pretty much all I had ever wanted for myself is this, it wasn't boredom so much as like, was this just it then?

Is this, you know, really the Lord's has blessed me with everything that I could've thought for, for, for myself that I would've wanted. And so I thought, well, what does, what does he want and how come I've never asked him? Well, Lord, what, what, what would you have for me? What would you like me to do? I really, I believe strongly that, um, I, I met my wife because I prayed to, to meet my wife, to meet the woman that the Lord had set aside for me.

And he answered that prayer better than I ever could have imagined. She's the most wonderful woman I've ever met. And so it was kind of the same thing. Well, wow. You did that for my marriage. Lord, what would you do for my job? What would you have me do? Um, and so it wasn't boring. It was just, I guess, seeking more fulfillment and just truly wanting to know.

Um, that I was in his will and, and saying, and then that's the other thing too, because this good Shepherd's five years old now. And as I mentioned earlier, like we've gone on, we've got basically five different companies. 

It's grown to this incredible 

project, but it didn't the Lord. Didn't say here's a vision to go build this huge organization five years ago.

He said, trust me. " One step at a time, go start a pharmacy. We started the pharmacy. When we won a grant for $25,000, it was all the money we had. I quit 

my job. We 

We had free rent for the first year, but when 25 grand did the bank, I quit my job and had no revenue. And we just started cuz the Lord said to get started.

And so. Every year, every month, it's just, all right, Lord, what are we doing now? Where are the opportunities? Where can we have the biggest impact when people bring you $30,000 drugs and you tell 'em, they gotta flush 'em down the toilet. That doesn't take a lot of thinking. Like that's not right. That doesn't make sense.

Let's fix that. We, um, We never really had any, we've never had a ton of money as a nonprofit. So we've had to be innovative. One of the first things that we did was we started a free pharmacy technician school. So I was getting tech students from Remington and Concord and you know, all the usual places. And I was surprised to find out how much those students paid in tuition.

It's just an incredible amount. And. So I decided I'm gonna do it for free . They'll come in, they'll get 400 hours in the pharmacy. They'll get one on one with me and I'll get them certified. I've done that. I've hired sharp high school students and taught them what they need to know. I've been doing it for years.

Um, and so we did, we kicked that off and since then we've graduated five students who are [00:25:00] now certified technicians and make 15 bucks an hour more to work for us full time. Um, the reclamation program, it's kind of. If you look at your list of expenses as a pharmacy, your biggest one's gonna be drugs. We have a remedy chain to kind of help offset that.

Then you've got labor. We have the technician school and the pharmacy schools. We get a lot of students from them. We offset those. And then shipping is another project, a whole nother company. Now that we've started that's, um, doing prescription delivery, using share ride drivers, but just going down that expense list and thinking, how do we make it?

This is better. Um, specifically the question I asked myself is how do I get, okay, so drugs, how do I get somebody to pay me to take their drugs? That was the thought that led to kind of, to doing this whole thing. How do I actually get drugs and make money? Just bring them in before I dispense them. Yeah, 

Mike Koelzer, Host: I've always said I wanted to get into the, um, excavating business, you know, because people pay you to , they pay you to take the dirt and then someone.

Pays you to drop it off. You're bringing up the term, the remedy chain. And I know that's the flow of the medicine where it's been and so on. 

Phil Baker, PharmD: So when we did the reclamation program at the same time, that was really firing up. I was reading because I'm a super nerd. I'm not really a technology guy, but I was interested in blockchain technology 

with all that was happening with Bitcoin and all this stuff and not cryptocurrency.

But blockchain technology is what specifically interested me, which they 

Mike Koelzer, Host: use it for electricity sharing, all kinds of stuff. Yeah. People think of Bitcoin. Yeah. But it goes all over the place. Uh, blockchain, you 

Phil Baker, PharmD: digitize any asset at all that intrigued me because now this was a couple years ago, but now it's well known that blockchain is really good for pharma.

It's good for the supply chain because our data is standardized into the NDC lot number expiration date and with a serial number on the package. You can track anything. Um, but early on, I realized we've got these high value meds. What if we, you know, track them on a blockchain, we could tokenize them. We could create a digital asset or digital twin, if you will.

We could do a lot of different, interesting 

things. And that really was, I didn't realize how early on that was in the blockchain technology cycle. 

I got connected to a community 

of people in. 

Domain. That has been just the biggest blessing in my life. Some of the smartest people I've ever met are really at the cutting edge of healthcare and technology and, um, that network, I recruited all the people, the best people to work with me on the remedy chain.

So the chemo meds get all the attention as they should. They're very high, you know, high dollar expensive. We match em with patients we're saving lives. They're time critical. They're wonderful. Well, what's not spoken about that is even more valuable are the medications that aren't able to be recycled. So the data on prescription waste doesn't get captured anywhere in the ecosystem.

There's no private entity or government agency that is responsible for tracking prescription waste. The thought behind the remedy chain has been that, yes, we're gonna get the stuff that can be recycled. The pristine unopened. Great. But the stuff that has to be thrown away, we're gonna get the data on it so that we can identify what that looks like.

If you go to the remedy chain website, it doesn't say anything about chemo meds. The messaging is basically for good health. Everybody should empty out their medicine cabinet. Once a year, everybody has board meds. There's tons of stuff my kids have gotten into my medicine cabinet. You know? So when you do that once a year, let's say you got 10 drugs in.

Nine 

of them will 

probably need to be disposed to be Amber vials. But let's say there's one in there. That's good. That can be donated. Well, we would have you take a picture of each med and send it to us on the one good med. We'll send you a donation form and a link. So you can send that in on the other nine.

We say, Hey, there are drug disposal boxes in your neighborhood where you can properly dispose of that medicine instead of flushing it down the toilet and then further. If they do that, if they text us a picture from the disposal unit, from anyone that we sent them, I E check in from the disposal unit, then we enter them for a $500 raffle.

What we're doing is incentivizing people to empty the medicine cabinet, to properly dispose of the stuff that needs to be disposed of to reclaim the stuff that can be recycled. And we're capturing the data. Everything without having to get into the disposal business, because they take the meds to a recognized disposal.

Like we're not having, we're just capturing the data. 

Mike Koelzer, Host: Do you ever find out if it was half they used or if it was like, let's say they put in a quantity of 90, do you know that they used, or do you care that they used half of the prescription? 

Phil Baker, PharmD: Not 

Mike Koelzer, Host: yet. You don't care about the goals necessarily of compliance so much.

You're gonna get a count of what was wasted. Yes. 

Phil Baker, PharmD: So what we do is we get a picture of every pill. Um, as you know, from a picture of the pill, you can go to Google pill box, and you can say it's a white round pill with an X on it. And what is it? So we can identify the NDC level. [00:30:00] From a picture, what the medicine was.

And then we just take the patient's reported quantity, cuz it is, you know, if somebody wanted, if, if somebody wanted to argue that that's not accurate, then then fine. What we're really proving is that because it's never. Say it's never, it's rarely just one med again, it's the medicine cabinet. It's eight or nine different NDCs.

The goal being with that information, in a perfect Phil Baker's mind in a perfect world. The way this would work would be a circular economy. So from a picture I can say, okay, that's a Pfizer pill. I can collect. All this data for a month and I can say, okay, Pfizer in the city of Memphis this month, we recorded 15,000 pounds worth of your meds being disposed of.

Here's your bill for that? Um, counties have mandated it and it's kind of spreading, especially primarily in California right now, but, um, counties can enforce that wholesalers and manufacturers have to fund the disposal of meds within their own. So we're hopeful with the remedy chain that if manufacturers would essentially buy back their waste data, then that would fund the platform that allows everybody to get donated meds for free.

That would financially support the whole thing by buying back their waste data. They can compare that with their production data, like every other industry does and, and determine if maybe they're producing too much or not enough. And like, by starting to track this waste data, there's gonna. I believe just tons and tons of value that comes out of it.

Manufacturing ecosystem, you know, just all different kinds of things. So the remedy chain is a database. It's a blockchain data lake of this waste data that people are sending us from all over the country. We standardize the data and we put it on a blockchain so that whenever we get to scale, whenever there's enough, we'll actually.

Ultimately be able to use machine learning to predict waste. Let's make a prediction about where we think we might see waste. Now tell me what you 

Mike Koelzer, Host: mean by token. Is that the same? That's not like in Bitcoin where someone searches for these and gets like money because of their computer power and stuff.

Is that the same thing with 

Phil Baker, PharmD: this? They don't, they don't have to be minded. Are you familiar with crypto kiddies? 

Mike Koelzer, Host: I just know about mining. I don't know about 

Phil Baker, PharmD: crypto kiddies, so there's two kinds of tokens. There are fungible tokens, which means they can be spent like money. And then there's non fungible tokens, which are, uh, absolutely unique.

They're one of a kind creations, digital assets. And so, um, there's two different holes. Categories of what you can do with those crypto Kittys is ridiculous. I've never had to describe this to anybody. It's gonna sound really stupid, but a crypto kitty is 

a 

little, 

Phil Baker, PharmD: uh, a cartoon version of a kitty cat and, um, which is back to a blockchain record, but each one is unique.

So it may a, a green eye and a black eye in polka dots or whatever. What makes them valuable is that people value them. So there's like, like baseball cards, there's a market where these things go for $50,000, $150,000. 

Mike Koelzer, Host: It's like searching for Pikachu 

Phil Baker, PharmD: or something like that. Kind of like that. Yeah. But you know, with it, because it's on a blockchain that you've got the only one you've got, it's completely unique.

Mike Koelzer, Host: How specific do you think they're gonna get with blockchain? Is it gonna be down to a lot or down to a bottle 

Phil Baker, PharmD: we're already down to a bottle? Yeah. My system is down to a bottle with the serialization of the meds. It's already the number's already on the. 

Mike Koelzer, Host: You think they'll ever get down to a pill with like a little bit of a computer chip in every 

Phil Baker, PharmD: one of.

We've made our system so that you can get down to a pill, so you can do the blockchain record and you can open a bottle and you can unit dose them. And if you wanted to, you could tag each individual pill. We built the system that does that. And that's too. So that's part of the remedy chain. Now it's we bring the meds in, but what we want to build is basically one part, at least one partner site per state, because, uh, recycled medicine laws.

are determined by the state board of pharmacy for that state. And they vary tremendously. Instead of like, what I can't do is build a mail order pharmacy that distributes these things over the country. It would, it would just be too difficult, but we can do like one per state and we can shift between centers in each state.

Like that sort of structural work. So the remedy chain is access to the meds, but it's also a blockchain inventory system that we would be giving these sites to maintain as well. So that we're all on the same database, 

Mike Koelzer, Host: because you're already cut down this to once a quarter and you're saving money. That way you're already saving on, let's say two trips a quarter.

Now, when that trip actually happens, you were mentioning Uber. Kind of thing. Were you tell 

Phil Baker, PharmD: me more about that? Our patients pay a monthly 

membership fee. Um, they get all their meds at cost. And they're mostly low income and uninsured. It occurred to me 

a couple years ago. Why don't we set 

up a program where our patients, [00:35:00] you know, say you're paying 50 

bucks a month, you could do five deliveries a month.

We'll give you 10 bucks for each delivery and you could pay 

down your membership fee by making deliveries. Um, also a neat use case potentially for a cryptocurrency or a token. Um, so we built a platform to do it. And, uh, we built an app that integrated with pioneer RX does integrate with pioneer RX that allows us 

to take a pool of volunteer drivers and bring them in.

So when we do our deliveries, because it's a batch fill, we do 250 deliveries in S one time. It does 

work like. B besides just for the batch, like for regular pharmacy 

as well. So, um, that was a 

side project that I was like, we're, we're spending $2,000 on postage for these deliveries. If we can use volunteers, that's 

200 that's $2,000 per quarter.

Back in the bank. And so we built that it's called script ride and it was meant to be a volunteer platform where you could volunteer to your 

favorite pharmacy to make deliveries, or you could 

any sort of ride share delivery services. You could volunteer at St. Jude to pick up families at the airport and take them to the Ronald McDonald house.

It was gonna interact with nonprofits in 

this way. Then COVID happened. And all my pharmacy friends started calling me and they were saying, Phil. I need you to teach me how to be a mail order pharmacy on my own. And, um, started looking at that and realized you don't need to be a mail order pharmacy.

You need to be a delivery pharmacy, because if you're an independent and everybody lives in your neighborhood, you don't wanna send it to the post 

office so that they can deliver 

it across the street three days later. And so, um, this platform that we built, we scrapped using volunteers and we. Shared ride drivers to make the deliveries.

And that has 

become a whole 

a new company now called script ride. Where it's a customized delivery service designed for pharmacies, pharmacy deliveries are not like other deliveries. There's very rarely an emergency where you need to get atorvastatin to a patient within two hours. You know what I mean?

So, and if you get a, if you can get it there by eight, 

o'clock the same. You're generally gonna be 100% good to go. And if you can get it there the next day, 80% of the time. So we've structured it so that there's a daily pickup and then you can do stat deliveries as needed. Um, but by getting enough pharmacies involved, we can support a 

driver locally.

Um, Just to do those and that's building out now our, my, my share ride partner has drivers in 34 markets. And so we're about to expand it and try to grow it to 

other independence as well. We, 

What we do is kind of different too, is there's the application. We 

make it as simple as possible. And then our drivers, when we come in, we bring all the.

Boxes you're gonna need, because if you've never done delivery before you don't know what kind of boxes to get, what's most efficient, you don't know what kind of coolers to get. And we brand everything with the, we don't put our branding on it. We put the pharmacies on it. And so when the box shows up at your patient's door, it says Smith pharmacy.

It doesn't say script ride. You can maintain 

your own brand throughout. 

Mike Koelzer, Host: Instead of you saying, Hey, I'm an Uber customer standing at the airport. I need a lift is basically you're signing up your prescription and saying, this needs to go somewhere and the drivers can choose it or pick it, or are they doing more group, bigger batch 

Phil Baker, PharmD: stuff?

We, we have made it 

both ways. So our platform, if one of our own drivers, cuz we want our drivers to be HIPAA certified. I don't think they're required to be, but we don't want some stranger off of 

Lyft. We have our own drivers 

that we depend on. However, 

we built the platform so that if our 

driver isn't available, it does go, there's an API with Lyft and it does put a call out for a Lyft driver to pick.

When you 

Mike Koelzer, Host: talk about programs. So let's say now in the last few years you've had to make, oh, let's say half dozen programs or something. Do you have software people you like, are you skilled at it yourself? I mean, how are you throwing these apps together? Who's doing this for you? 

Phil Baker, PharmD: There haven't been very many apps.

And I do. I have a software partner. I have a good friend who owns a software development company and has 30 full-time developers in Bucharest, Romania, which are some of the best in the world, but we haven't built very many apps. So the blockchain technology, that's just different. You don't build apps.

There are gaps that you can build, but that's been largely, so it's so much in its infancy, but just determining the, the, the information standards and how we're gonna do it. So we built, I built, let's say I. Our remedy chain team built out the MVP of the remedy chain and what that looks like. Um, but 

it didn't take, uh, a software development firm when I 

Mike Koelzer, Host: went online and looked at it and I saw that it had the pictures of what to do.

And you take a picture and do this. I'd forget if I was looking at an app or, or were they just taking a picture and texting it somewhere? 

Phil Baker, PharmD: I don't consider it an app, but it is on our website. There's an app that shows our inventory in real life. That we just [00:40:00] created using a little SAS software platform.

It's a very, very simple little app. It's nothing you would, you wouldn't go to the app store and download the remedy chain app. 

Mike Koelzer, Host: As the numbers got up there, you could do something more, but right now you haven't spent a lot of time in apps yet. That's 

Phil Baker, PharmD: exactly right. What I've learned in business in the last five years is I was always quick to try to build an app or build a system.

And man, in this day and age, I don't know that you ever, I'm not convinced anymore that you ever need to do that. We're able, and that's kind of the value we bring to the table too, with this membership model that I want other people to employ. If you wanna start a membership pharmacy, how are you gonna set up recurring billing?

What CRM are you gonna use? How are you gonna be HIPAA compliant? So we. Figured all those things out. You used Stripe for your building. You used, uh, G suite to be hooked to your email, all the different systems. There's a HIPAA compliant tech service that we use. Uh, the CRM is really key to how you work, which pharmacists are not familiar with.

You know, it's not, it's not an operating system. It's not a pioneer. It is different. Can I ask 

Mike Koelzer, Host: what CRM program 

Phil Baker, PharmD: it is? It's uh, copper is the one that we use, which sits on top of the G suite. It used to be called prosper work, and now it's called copper. And that one's good, cuz it works really well with everything we do . We're Google based for the most part.

So we got really far on Google sheets and little apps that read off Google. We've gotten way further than anybody I've actually, I built a remedy chain app legitimate to show the live inventory, scrapped it and went back to just something that was easier that we could piece together using a couple different things.

Well, part 

Mike Koelzer, Host: of the problems with apps, even if you're not paying a lot for 'em, you can spend weeks waiting for a, a color change or, you know, a different font or something like that. In the meantime, you could have been cranking this stuff out with all of the, uh, you know, the things you mentioned, all the different programs that are already out there and, and you can always shine it up later, but you know, a lot of times it's best to get some, get some numbers, get some, get some beef funder at first, and then you'll probably know more of what you want anyways, at that.

agreed. So let's say you have these quarters. All right. And if I talk to like a, uh, accountant, you know, they're gonna say, oh geez, April, you know, April 15th, that's a pain in the ass or, you know, the first of the year or something like that, I'm sure in theory, it'd be great to level this stuff out. So you feel about the same amount of joy and stress throughout the year.

With your quarterly stuff. Is there a ramp up of energy or of stress or is that pretty level or, or like as you get closer or further away from something like, things seem to lighten up throughout these 

Phil Baker, PharmD: four 

quarters. We've been doing group synchronization since September of 2017. So we've done three years for 4, 8, 12.

13 or 14 batch refills. Now I, I say that to say that, um, 

when you do group 

synchronization and you live within this 12 week, Recurring cycle, you are able to systematize everything. So we have figured out that in week 10 is when you wanna send refill requests, because if you send them too early, the physician's gonna deny it and say, I just wrote refills last month.

You wanna wait all these different processes on how we request different things. How we do the, we, we review every single profile before we really kick it off before we press enter so that 

when we press. Everything moves from the 

refill queue into the, you know, the, the fill queue with as few exceptions as possible.

Mike Koelzer, Host: My listeners know that I'm like a three or four time failure of, uh, syncing, but the group sync sounds pretty interesting. Do you see retail pharmacies being able to? To do that as far as group syncing every quarter, versus like just having patients that are synced, but not to any real schedule, 

Phil Baker, PharmD: the question is will PBMs pay for it when they are directly incentivized not to.

So if you make a dispensing fee on every 30 day fill, there's not a direct, you know, incentivization. I want to do that. I have crossed paths with PBMs in the marketplace, and they'll say we have 90 day fills and, uh, or, or we have, you know, med, we do med sync and we have 90 day fills. It's the same thing, but it's not the same thing.

Cuz if you get a 90 day fill and then you get a new med tomorrow, the whole sync is off. You know, one, one incident and even group sync. As I said before, you're still looking at 2.9 visits every 90 days. There's still quite a few changes. The thing that makes it work is we are not billing claims. And then also we get our money up front.

So the cash model's completely 

different too. Once they're 

synced up, we can say to the employer, okay, Mr. Employer, you have a hundred employees. Their meds are gonna cost a hundred thousand dollars at our cost. We're gonna charge you $20,000 to do fulfillment. So give us $120,000 front. Now we'll go buy the drugs and now we'll do [00:45:00] fulfillment.

So I don't have to wait six months to get, you know, there's no inventory sitting on the shelf. There's no reimbursement lag. We're cash flow positive on the front end, which allows us to get pre purchase discounts, which your folks will know are the best you can get, you know, the best discounts you're ever get or pre purchase and drive prices down further, further, 

further.

How old are you now? I'm 40. I'm about to turn 45 in two weeks. I'll turn 40. 

Mike Koelzer, Host: 45. So do you see yourself at 55? Will you still be part of a good shepherd or will you be way off doing something else? Because this is running fine. And, and there's other ideas for you to do? 

Phil Baker, PharmD: I don't think 

I've talked a lot about halos scripts, which is a for profit business.

We started 

tell us about that 

group synchronization, being our secret sauce after we'd. Doing it for a couple years here, we started working with a local employer and he said, how can you save me? You know, my company money. And we essentially did the same thing. We said, we can take all your employees. We can synchronize all their prescriptions, give you one bill every 90 days at cost, reducing all the markup.

And it ends up reducing the total spend by like 

40%. It's very significant and we make great, great money at the same time. So. We, I basically, for two years, I've been, we've been servicing that account now for two and a half years, but it was very much the Guinea pig. I got the data, I got two years worth of data and I just started, I cost everything out at my price and started crunching it and just crunched it and crunched it and crunched it and tried to figure out how we make this work?

Well, we figured out how to make it work and. Okay. We last year started a separate pharmacy called halos scripts to, to contract directly. It's a for-profit pharmacy that contracts directly with 

employers, all drugs sold at cost. We 

charge a per member, a fee on the, you know, for the group. We charge a percentage of savings actually 

to determine what the fee is.

So there's only savings involved. Give me an example of that. So I sync up all the generics. 

And I say, okay, 94% of these are on 90 day fill and we switched them down to 90. So we saved you X in transaction fees and dispensing fees. You had WP pricing on these drugs that we're now gonna sell you at cost.

So you spent 10,000 and we're only gonna charge you 250. And so the 

total savings is X. Against what a PBM would against what they've been paying on their PBM. So we have the data from their PBM to know exactly what they've been paying, whether it's been 

Mike Koelzer, Host: mail order or through a pharmacy or something, that's what they've been paying.

Phil Baker, PharmD: Yep. 

That's what the company has been paying. And so that's key to the whole thing is we have the data from the company to state. We do not come in and say, we're your new PBM, your new pharmacy solution. We say, we're gonna make the PBM work more 

efficiently. We're gonna synchronize all the 

chronic meds.

And, and do just that. So how we determine what we're gonna charge is what we add. Dispensing fees, administrative fees, plus all the markup. And then we charge, uh, a percentage of that savings that we're saving the company. And it's different for brands and generics and specialty. It ranges from 50 to 25% savings for different things.

Um, so then when we come aboard, it's not, you have to make a big investment. It's like, we're gonna charge you a percentage of savings. You're gonna start saving 

on day one. Yeah. They 

Mike Koelzer, Host: can't lose if they're paying only off their savings. If you can't save anything, then they're not paying anything. What, you know, in 

Phil Baker, PharmD: theory's a win-win for both 

of us.

So there are patients where we save $2,500 every 90 days. And then there are others where we save two bucks every 90 days. But by doing the 50 per 

you know, the, the savings share, we can service 

the entire group. When we started, we were just doing the top 10% of the group, the biggest utilizers, the biggest savings, and the employers wanted us to do the whole group.

They love our service. They. Where they want us to be the company's pharmacy, so to speak, that's halo scripts. We started that company in March of 20, 20, March of last year. We got a half a million dollar investment, to license it nationally and scale it up. We just completed hasn't even been entirely our full year, 

but we, um, our first big company was an Accenture 

subsidiary out of Baltimore that we've been servicing since last March.

And we're about. Get 10 customers that size this year that we've queued up. So things are going really, really well on that front. And again, it's a hundred percent price, price, transparency. We're not marking anything up. We're being honest about what the drugs cost and its fee for service. 

The, where I 

I wanna land with group synchronization if I'm, I'm really hopeful that we can create a new quote unquote clinical metric so that we can say to the employer, if we.

80% synchronization. We're gonna charge you X, but if we hit 95% synchronization, we're gonna charge you. Y because we know the more synchronized they are, the more savings there is involved. Um, [00:50:00] I'm working with the university of Tennessee and have been for two years to study this model to kind of tease it out to just that it basically boils down to there's three kinds of meds, generics brands, and specialties.

Biggest markup is on the generics. And so you get savings from markup on generics, brand name, drugs. They're, they're more expensive, but they're not horribly marked up. If you're lucky, there's generally about a 10% savings between costs and retail. Um, when you look at brands, which for my employers 

is not.

Terribly significant. Well, it's not nothing, but 

generics is where the real markup is. So when it comes to brands, you got at cost, like I said, 10%, you got Canada, which is 50% savings. And then you've got assistance programs and we're familiar with every assistance program in the country. When you get to specialty, you've got.

At cost, which is nothing. Cuz if it's a million dollar med, it's a million dollars at cost, you know, there's not a ton of markup, you've got assistance programs and then you've got clinical trials and you can, you can look at international clinical trials, you can look at international pharmacy. Um, but whatever the category of drug it is, you've got a fixed number of options.

That'll work for you. And that's it. And we've worked that out. That's our, that's our that's I say my soapbox. So. 

That's how it plays out. We do through our partnership with diamond pharmacy, with halos scripts and they. One of the biggest independently owned pharmacy networks in the country. Also one of the oldest 

over 103 years old, they do 80% of the, um, correctional facilities in the country.

And so they are nationally licensed outta Pennsylvania. They're doing fulfillment for us and big pharmacies. They purchase over 300 million a year in drugs and they're giving us their pricing, their at cost pricing and passing that on to the employers. So we're getting hospital level pricing and passing the employer.

Mike Koelzer, Host: If one of those companies came and they said, Hey, uh, Bob's on a million dollar drug. You're like, all right, you'll pay us a million dollars and then we'll get it for you. It's not like you're taking a loss or you're the insurance company or 

Phil Baker, PharmD: something 

it's never happened where they said, well, that specialty drug we'll just buy it from you at cost because the savings has never been significant enough and there's not much help to be had on specialty meds.

Let me say so, but your one hope is a trial or. An assistance program. When we get a patient into an assistance program, it's a hundred percent savings and we get a percentage of savings. So those specialty me assistance programs are 

really valuable. 

Mike Koelzer, Host: And if something is expensive, if you don't wanna do it, they'll get it still from their PBM 

Phil Baker, PharmD: or something.

They can always get it from the PBM. And you'd almost rather yeah, we're we don't make anything on the meds. So the value of the med is independent of, of what we make. We don't do any controlled substances. Um, again, we tell we have a really good extensive onboarding 

process where we set expectations. We tell 

people we're mail order.

You need something right away. We're probably not gonna be the best option. You still have your insurance, you still have your insurance card. You can go to Walgreens, nothing has changed if you need a narcotic or an antibiotic, go to Walgreens and get it right away. But if it's a chronic med, let us know.

And the value proposition is for the employees. If you get it through, through us, there's no copays. So zero copays show up on a set schedule that we're telling you. Now all your meds kept on the same 

schedule. 

Mike Koelzer, Host: Going back to that question of where you might be in 10 years. If I were to have asked you this two years ago, do you think that it was always going to be in your blood to get back to a for-profit thing?

Is it fun to play in the arena of nonprofit? Fun to say yes, I can do well. Nonprofit. And it's a good calling and it's rewarding and stuff, but I have something to prove that I wanna get out in the for-profit market and I wanna show some cool things I can do in the for-profit stuff. Besides nonprofit. Is that in you?

Phil Baker, PharmD: That it is a little bit of competitiveness in me in that in, in Phil Baker's brain, the goal has always been financial self sustainability. So even though we're a nonprofit, the goal has always been to live and die, to not be beholden to donations, to not be dependent on grants. And so there's in one sense.

We've been successful in that we've gotten donations in grants from the non-profit, since we've been good at fundraising, we've won grants. We've stayed alive, but we haven't achieved the goal of financial self sustainability. Um, on the nonprofit side. And so there, that's still ongoing. I know we can.

I know how to get there. Um, on the, for profit side, it's really, and, and for both, it's always been about a new model of pharmacy. I've always wanted to create it. Not. Never wanna create a big mail, mega mail order pharmacy, big company. I want to invent a different model of community pharmacy that says, you know what, 

two [00:55:00] pharmacists, four technicians, 

a script pro robot can serve 5,000 patients that are group synchronized.

They can make more than enough money so that everybody has a comfortable living and doesn't work themselves. And this is how you do it. You do low income people for a subscription fee. You do business for a difference, and you piece it together. You're 

operationally. Whether they're business people or low income people, 

their prescriptions are on the same schedule.

So everything is synchronized. We're not. Behold to 

claims. And, and so the goal has always been 

to figure out this new model of pharmacy and what that looks like. The goal on the, the for profit side was 

to be successful and to show explosive growth on 

that and to get enough money to do the nonprofit work for the rest of my life as 

Mike Koelzer, Host: 20 years go by and you're at the end of all this, and you look back and all this stuff has happened.

What will you be? This is good. This is cool. This is proof of my goal. How would you describe all this? If it goes the way you wanna, what's that feeling going to be? 

Phil Baker, PharmD: Oh man. The only thing that comes to mind is to look at what God did. That's what I say to myself now, like I said before, I didn't have this big mastermind plan for this.

I was gonna open a charity pharmacy and give meds for free. And that's all and do MTM. And now we've got a blockchain company. We've got a prescription delivery service. We're serving all these people who wouldn't get their meds any other way. And none of it has anything to do with me. Everything that really moved the needle had absolutely nothing to do with me.

It fell into my lap and. Just had nothing to do with me. If 

you don't wanna 

Mike Koelzer, Host: I think it has nothing to do with you throwing the keys up as high as you can tell God to hold down to him and run things for a few months, you'll come back in the fall. Let's see how it's going. All right. Phil pleasure talking 

Phil Baker, PharmD: to you.

Yeah, man. It was a lot of fun. Thank you very much.