Founder Stories: TJ Parker, Co-Founder and CEO of PillPack

Today, Challengers and Icons comes to you from Boston, where I am talking to TJ Parker, who's the CEO and co-founder of PillPack. Launched in 2014, PillPack is the first pharmacy designed to help people take the right medication at the right time by simplifying medication management and by delivering a better, simpler experience through convenient packaging, modern technology, and personalized service. TJ, a second-generation pharmacist, met business partner Elliot Cohen through MIT's Hacking Medicine. They wanted to redesign the traditional pharmacy experience and proved that managing meds could actually be simple. As finalists of the Techstars Accelerator program in Boston, TJ and Elliot have raised $13 million to date from investors, and PillPack is now available in 47 states in America. Well, TJ claims to be a designer at heart, a pharmacist by training, and a vocal advocate for making things that don't suck. He has been listed as one of Forbes' 30 Under 30, and PillPack has already been nominated for several high-profile design awards. Welcome, TJ, to Challenges and Icons.

Thank you.

Okay, so TJ, it seems like from the very beginning PillPack was on to something big. Can you just tell us a little bit about the journey? Where did the moment of inspiration come from for the idea behind PillPack?

Sure, so as you mentioned earlier, I'm a pharmacist, but it actually— I'd grown up in a family that owned your traditional mom-and-pop pharmacy on the street corner. And so as a 16, 17-year-old kid, I was both working behind the counter in the pharmacy as well as out delivering medications to people in their homes. And in that process, you know, everyone had this cornucopia of pill bottles on their kitchen counter and this Excel spreadsheet that they'd crossed out and highlighted with all their medications on it. There was one lady that I would actually color each one of her pill caps for, for a different time of the day so she could figure out when to take each one. And I had to imagine there was a better way to do that, right? Everything from going to the pharmacy to arranging the meds, to figuring out how they work and communicating with your pharmacist. And so during pharmacy school, I got separately interested in design specifically. So I was taking classes at MassArt, learning as much as I could about design, and then sort of started getting involved over at MIT with the entrepreneurship things that were happening over there. So I helped run the $100K at MIT, which was their business plan competition at the time, and through that met Elliot Cohen, who would go on to become my co-founder. And we'd started this thing called Hacking Medicine where we had weekend hackathons for healthcare ideas. And you'd get designers and engineers and physicians all in the same room for a weekend to sort of present a problem and spend the weekend coming up with a solution and then pitching that at the end of the weekend. And so I'd just been learning about design and technology and also in pharmacy school. And throughout that entire time, my dad started a new pharmacy in 2004 that was pre-sorting and packaging meds but for assisted living facilities and nursing homes in New Hampshire. And so that business was growing, we were learning how to do the operations on the backend, and after I graduated school in 2012, it became very apparent that there was an opportunity to take what we had learned there, combine that with everything I'd learned about design and starting a company and raising money, and turned that into PillPack. And so we knew that people loved the product, we had done a very sort of lightweight version of it at my dad's pharmacy, and we wanted to make that sort of reimagine the end-to-end experience for consumers as opposed to people that lived in facilities. And we ended up pitching it at one of these Hacking Medicine events at MGH. And this was the fall of 2012. And from there, it sort of just immediately started to get legs and traction. We pitched it in the fall of 2012. We did Techstars 3 months later. I quit my job then. And that was only 2 and a half years ago. So it's been a whirlwind couple of years.

Yeah, so it's very much a rolling journey. And the inspiration came out of your life experiences as much as anything else. And so now PillPack's been out there for a year and a half, something like that?

Yeah, we've been in market for, yeah, about a year and a half.

Okay.

A little over a year.

And phenomenal success so far, really high profile. Has there been any obstacles along the way that's presented you with challenges you weren't expecting, or that have kind of been a challenge to the way you want to build the business?

Yes, I think for us, I mean, there's obviously a lot of work from when you have the initial idea to being able to to deliver a product to folks in their homes, right? And so, it took us a year just to build out the distribution and get licensed. You have to get licensed in each and every state individually to ship there. And so, by the time February of 2014 rolled around, which is a year in, we were able to ship all across the country. We launched in 32 states at that point. And we, as a business, were in a really weird situation where we could deliver meds to people in their homes, but we couldn't use online channels like AdWords and Facebook to advertise the service because of a accreditation that you needed to do that. And so we were actually in a place as an online business, you know, a startup where we could deliver people meds but couldn't advertise to them. And so for us, we did a lot of PR and other things to help, you know, build the brand recognition and get the word out that we existed. But then by the time we got that accreditation and turned the marketing channels on, it was really just a game changer for the business. So I would say, you know, that wasn't— for the business was an interesting place to be, but We've gotten through that, and we're now growing super quickly, and people love the service, and we're all over the country. We've learned a lot in the process, I think. From the tools that we've built and things that we've done have evolved a lot since we first launched, and the way that we think about product development and everything else has evolved as well.

So I suspect the rapid growth that we've seen in the first year and a half is going to continue, and probably the challenges you're going to face in the near future about scaling the business, I would imagine. How do you see that going forward, the idea of scale and the challenges that that presents?

Yeah, I think we, you know, when we first launched, we were obviously a very small company with the intention of taking what is currently a really arduous and complicated experience and making that really, really simple. And a lot of that is building a team around that idea that that is the philosophy and the service that we are trying to deliver. But as you scale, a lot of it that becomes then process and tools that you build so that as you scale and add more people, it's very clear why we do what we do and why we're trying to solve this problem. And so a lot of it is being very thoughtful about building really high-quality tools for our pharmacists and the folks that are interacting with our customers every day. I think it's not that pharmacists in your traditional pharmacy down the street corner aren't trying to do a great job and aren't trying to help. But they really are not equipped with appropriate tools to be able to sort of help you manage your meds. You think about something that seems as simple as making sure you don't run out of refills, right? The only process that's in place in a traditional pharmacy is two auto-faxes, and then if you don't happen to hear from the doctor, it falls off the face of the earth. As the customer, you walk into the pharmacy to pick up the med, and it just happens to have run out of refills, and you have to come back in two days to pick it up. And all of these things are the types of experiences that end up creating a really, really bad end-to-end customer experience. And so we built a discrete tool that is very much like a consumer-grade tool but just for chasing refills for our customers. And when we first started the business, that was a pharmacist and a tech on the phone, on fax machines doing it manually. And as we've scaled, you have to then productize those things and build tools around them so that we can offer that level of service but at scale. And I really think what's been missing in pharmacy is that no one is really coordinating this for the customer. It's really just a very transactional business. You get a prescription, you fill the prescription, they leave. You don't have any context of whether it's a dose change or a new med or whether they even should be taking that med with this other med. And we feel like the future of pharmacy is being the coordination for the customer so they don't have to deal with that. They don't have to be trying to figure these things out themselves. And you can't do that at scale without building really, really great internal tools for your people. And that's what we've been focused on for both the last 6 months and for probably a very long time.

Great. Essentially, what you've been talking about so far is simplification. You've simplified something incredibly, potentially complex. If you're taking multiple medicines a day, I think 10% of the American population takes over 5 different types of medicines a day. And so the potential for confusion and the stress of sort of getting close to running out of Supplies and reordering, the things that you've been talking about. You simplified that whole process and you used design throughout the whole business system, the tools that you're using, and the consumer experience ultimately is very simple. You, if you receive a pill pack, you now know that you have a daily medicine in here and you just, the time is on here and your medicines have all been sorted for you and it's in it and It is all done so that the peace of mind is there in the actual consumer, the end user, who is taking care of themselves. So you've thought the whole thing through from a design point of view. So clearly, when you're thinking about design, your definition of design is much bigger than maybe somebody else's. So design is incredibly important to you. Looking at the way that you view design, you clearly see it's important. How do you see that going forward? What other innovations might we see coming from pill pack that could be part of the designed experience?

Sure, so we think, to your point, we think about design in a much broader way than just the aesthetics of the way something looks, right? It's really about each touchpoint that you have with your customer and how thoughtful you are about how that feels to be that customer. And so we've worked very, very hard to make things like switching to pill pack and the onboarding experience really, really simple. And obviously the pill pack speaks for itself. It does just show up every 2 weeks. But even something that seems as simple as every 2 weeks was really thoughtful. Most prescriptions are filled in 30-day increments and as a human you can't think about— you don't think about the world in 30-day increments. So this month it's Friday, next month it's Tuesday, the following month it's Thursday. And so each one of those individual things that we've done, we tried to think about it in the lens of the customer as opposed to what the health system might do today or pharmacies might do today. Going forward, we are trying to keep adding value in that process of managing meds and so Today you get the pill pack, it shows up automatically. We manage your refills for you so you don't have to worry about that. But going forward, we're thinking about things like medication reminders. I think there are existing tools on the market that help, that are very, just alarm-based medication reminders. And we have spent the last 6 to 9 months rethinking what a reminder should be, how it should fit in your life more normally than just being an alarm. And so we are launching a med reminder app that for our customers feels feeds in the exact times of day that you take your meds, what meds you take. It's one of the pieces of data that we are one of the only pharmacies to have because we have to package the meds, right? And then setting triggers based on not just the time of day, but what might be happening in the rest of your life. So using the sensors on your phone, be more intelligent about that. So set an alarm, remind me to take my meds when I'm leaving the house, or remind me to grab my meds when I'm leaving the house. Or when I get to work in the morning, remind me to take my meds. And so we are trying to be much more intelligent about how we fit into your life. And not make you fit into the life of the reminder app that you happen to download. And I think for us, it's really about learning from our customers and learning about the needs that they have, and this was one of the things that we felt like we could really do a better job of. And that tool will not just be for our customers, so it's for anyone that takes medications. They can utilize that tool. So we're really excited about that.

So the app is coming out very shortly. It's, again, it's a designed experience to simplify and to make it personal to the individual. So in a way, you're kind of shaking things up in the pharma landscape. And when you were building PillPack, were you thinking about that, the redefinition of the pharma landscape? Is that something that you feel is a mission that you would like to see happen from the small beginnings that you've started?

Yeah, I think we think that the vast majority of health experiences are not well designed. Of course. I think they're frustrating, they're complicated, and they were designed to meet the needs of typically entities other than the customer or the patient that is receiving care. And our ambition is to make not just pharmacy better, but healthcare at large better. And I think we would be remiss if that was only just PillPack, if we didn't have an impact on the rest of the industry. And folks hopefully will follow us and think about the things that we're doing and maybe implement the same things. I think Healthcare needs folks that are showing them what the experience looks like in other industries. I think we lag behind 10 or 15 years, and I think we have an opportunity to show that you can fit in within the existing system, but actually create a great customer experience and think about what a great sort of holistic design experience looks like. And so it's absolutely our goal to shake up not just pharmacy, but healthcare and make it less of an obnoxious sort of experience.

Well, you're clearly tuning into the, you know, the ability for personalization through online subscription. The model is now proving itself to be very effective in other areas of industries—fashion, food, and so on. And we see you benefiting from those kind of channels. We're now seeing potentially the app affecting people's lifestyles. May we see you somewhere else, appearing in the high street, maybe? I don't know. Is that the kind of thing that we could imagine in the future?

Yeah, I think we always think about how we can build great experiences, and some of those are digital, as you've mentioned. Some of them are now physical in packet form. But I think, what does a retail experience look like as a PillPack customer? And we think about those things a lot. So I think we think there's an opportunity there to do that version of pharmacy better as well, and those things will hopefully be, you know, you'll see them at some point in the future.

And ultimately, I imagine this is all about driving personal engagement. Yep. And creating a holistic lifestyle that is all being considered from the business model to the consumer perspective for their individual benefits at the end of the day.

I think one of our high-level goals as a brand and as a business is that today the action of taking medications is very shunned. It's something people are embarrassed about. They hide their pill bottles in their purse and they don't, you know, they're embarrassed about this pill box that they have to put in their suitcase when they travel. Yet they're proud of going to Whole Foods, they're proud of going to the gym, they're proud of exercising, other things in their life that keep them healthy. And we think if you make this experience simple and delightful, it might be something that people actually are proud of because they are keeping themselves healthy. And as a business, we would love the ability to start to move that conversation away from something I'm embarrassed about to something I'm proud of. And I really think that we have an opportunity to do that. And I think it's about building a great experience and a great service. And I think we can start to reshape that conversation.

Well, it's a very simple, clear proposition. It deals with consumer needs in the way that you've described. And makes, you know, potentially troublesome or kind of personal kind of decisions around taking medication pleasant. And it actually makes you get on with your life and makes you feel like optimizing your life. Do you feel that the impact that you've made to individuals is also having an impact on the big, you know, pharmacy giants? Are you aware that people are— your big competitors are sitting up and taking notice of what you're doing?

I mean, I hope so. I think our goal really is to make this experience better for as many people as possible. And if that means that folks see what we're doing and they try to rejig the way that they're doing business to make a customer's life easier, that's great. I think, from my perspective, I think if a larger chain was to copy the packaging itself, I think it's unlikely that they're gonna get all the touchpoints right. I think it's really hard given the system and everything baked around these very transactional experiences. But I hope that something like managing refills for customers becomes an industry standard, because that would be some version of success where folks— this is a less obnoxious experience for as many people as possible. So I hope that we can start to move the needle there much more broadly than just for PillPack.

So how would you feel if one of the big pharma giants approached you with a view to absorbing your business. Is that something that you would consider, or is it a target for you in the future, or is it—

I think our goal is very much to build what we think is the best version of pharmacy, and to get that version of pharmacy into the hands of as many people as possible. And I think we have a real opportunity to build a really large business, and a really sort of redefining business, not in just pharmacy, but in healthcare at large. And so it's not our intention to sort of get absorbed into a large pharmacy chain. It's really, our intention to reshape the end-to-end customer experience in pharmacy. And I think it's very hard to do that without being an independent company that that is all you're solely focused on. I think one of the reasons that something like PillPack that seems as simple as it is hasn't taken shape and hasn't actually made its way into the market is that there was no incentive within these large companies to change the way that they do business. It was a relatively stable profit, you know, profit-driven business. To get absorbed in that business and then to be conflicted with other priorities would, I think, stunt our ability to keep building and making this experience better.

I mean, ultimately you are the challenger to those businesses. And you're right, they haven't had the incentives, or they haven't maybe looked at the shifts that are taking place in terms of people's lives and how we're living in the connected world that we're living. I think you're in a very good position to keep that challenge going and to let the small ripples that you've started to make spread out very quickly and continue to make a lot of change, which is great. If you hadn't started PillPack, is there something that you would have done, do you think?

I don't know. I really love design, and I think when I say design, that sort of rethinking what it, you know, what an experience should look like. And I've also really come to love healthcare, and I think mostly because I think there's so many opportunities to provide better healthcare services. And so I think that the culmination of those two things is what I'm the most interested in. And so if it wasn't PillPack, maybe it's some other version of a service in healthcare that really is not servicing the customer well. I think there are other companies, with similar models but in other facets of healthcare. But I think the intersection of those two things is both fascinating today, and I think will become even more and more interesting as more compelling sensors come down the line, and we can learn more about your health through technology. And the intersection of that with fashion, with healthcare design and fashion is a really interesting combination. And so it would be somewhere in that sphere.

So all of the factors that led up to PillPack, we've kind of discussed earlier. But I wonder if you'd ever had any thoughts about what you would have done if you hadn't done PillPack.

It's a hard question for me to answer. I think I've always been fascinated by design, both the design of physical products as well as digital experiences and everything in between. And so I imagine that it's something in that vein. But I also have really come to both love healthcare and be very, very aware of all of the different facets of healthcare that are not great right now. And so I think the things I'm most interested in are really that intersection of those two things. And I think there are plenty of services in healthcare that could be done a lot better. And I also think with the advent of technology that is coming down the line where we have much more sort of healthcare-relevant sensors that we'll see in the next 3 to 5 years, things like real-time glucose and blood pressure, the intersection of that with great design I think is probably the most interesting thing happening in the next 3 to 5 years. And so it would be in some version of that, but it is very— it's hard for me to imagine a world that I'm not working on PillPack. It's been both the years I spent in pharmacy school to get here, as well as being a kid in the pharmacy. I really feel like that culminated with the experiences that I've had and the things that I care about. PillPack is really the perfect blend of all of those things. Yeah. And so this is probably the right, the right place.

But, well, it's clearly an extension of the lifestyle that you've, you've had and the, your upbringing and the relationship with your, you know, your your parents' profession. And I'm interested in this last point that you're talking about, the intersection of technology, the individual, fashion as well, wearables. You feel that that's very much part of this kind of the future for where things are going from a healthcare point of view?

Yeah, I've been very skeptical about wearables for a long time. I think just tracking solely activity is really not— it's not that interesting. There's not a lot that you can do with it from a from a true medical perspective. But when you do get real data around glucose levels and blood pressure and heart rate and those things, and you have the data around the medications that person is taking, how can you make that useful and compelling and actually close the feedback loop? Like, one of the complexities and one of the reasons people don't take medications like blood pressure medications is there's no immediate feedback loop. It takes months to see the impact of taking those medications every day. But can we use these sensors in intelligent ways to make that feedback loop a lot shorter? And I think we're almost there. I don't think we were there a couple of years ago and we're not quite there yet, but I do think in a handful of years when these devices are both desirable and have a lot of functionality that are useful, I do think PillPack will be well poised to take advantage of that. I'm really excited to think about what those tools look like at some point in the future. But today, obviously, quite focused on this very narrow version of making medication super easy to manage.

Well, you know, we keep coming back to this idea of the designed experience and the simplification and everything that it stands for. I think you've done an incredible job of really getting behind this idea that great design should make people's lives better. And I think your intersection of brand, product, need, and the whole lifestyle around that is a terrific example of fulfilling that statement of design making people's lives better. Congratulations on everything you've done so far. We tend to get questions and followers very much from the startup community and entrepreneurs and designers who have got ideas to build businesses. If you were to give a bit of advice about starting up in a successful kind of way, is there a single piece of advice you might want to give a would-be startup entrepreneur out there with an idea?

Yeah, I think one of the pieces of advice that I heard a lot before I started the company but didn't actually fully believe or engage with is to actually just start working on it and share your idea. PillPack for me was, was in my head for 3 to 4 years before I ever verbalized it or pitched it at an event. And the second that, that we pitched PillPack at that Hacking Medicine event, it really took, took on its own form and became a real thing really quickly. And I think so often people are reticent to share ideas because they may be judged as stupid or they may not have they may not have legs, but I think the faster you're willing to share your ideas and actually to start thinking about what that business might look like, the more likely you will be to actually start a company and succeed. So I think it's super important to share your idea, and a lot can happen from that really small initial step. I mean, I didn't think— the day that I stood up in front of 50 clinicians at MGH and pitched PillPack, I did not think that in 2 years we would have 60 folks packing pills and shipping them all across the country. And what starts as a really small nugget can quickly sort of take shape and become a real thing and become a, you know, change people's lives and make an experience much easier. So, a lot of it is about that first initial pitch.

Well, for a year and a half being in business, you've made an incredible impact on people's lives. Long may it continue. And it's been a very inspirational interview. So, keep up the great work, and thank you very much for talking to us today. Thank you very much. Pleasure.