Launch HN: RonanRX (YC S26) – Personalized Peptides and GLP-1s
Hi HN,I’m Lloyd, one of two founders of RonanRx (https://ronanrx.com/). We are building a vertically integrated pharmaceutical company with software for prescribing, telehealth, compounding, manufacturing, and delivery. We are starting with GLP-1s and peptides.The path to RonanRx is fairly unconventional. During the pandemic, I built one of the largest mask manufacturing factories in the US. We could make a million masks in a day. We converted raw polypropylene pellets into finished pallets of masks.I had a background in software from my YC W10 company, so we took a software approach to building our factory. We used machine learning and computer vision to optimize production. We also vertically integrated almost everything. It worked. We built an efficient manufacturing operation and grew the business to 50 million dollars in revenue. Then people actually stopped caring about masks. Fair enough.Around the same time, I decided to try and lose the weight I had gained while building the factory. I ate nothing but chicken for six months. While this diet got some results, I plateaued. My doctor suggested tirzepatide, a GLP-1 medication.For me, losing weight was only the beginning. "Food noise" was gone. I showed less interest in other compulsive behavior. I stopped scrolling Instagram and quit biting my nails. But that was just the beginning. I was born with a congenital heart defect called aortic stenosis. My whole life doctors told me I'd need open heart surgery in my 40s (I am 45 now). After just 18 months using tirzepatide, my cardiologist’s began to think (and still thinks) my surgery could be pushed back until I am 70 or 80.This was all happening when I was deciding what to work on next. I wanted to keep working on manufacturing. I didn't want to build another product that could be replicated by a frontier model. Pharmaceutical manufacturing was the best combination of digital, physical, biological, and regulatory infrastructure I could find. The thing that bothered me was how disconnected all of the pieces were: telehealth, EHR, prescriptions, dispensing software, production, shipping. No one company has it all.GLP-1s come in a handful of predefined doses, but patients obviously aren't standardized: they respond differently, lose weight at different rates, experience different side effects, and may need very different doses. Compounding pharmacies can fill customized prescriptions, but they are not built like software companies. Workflows are manual, fragmented, and disconnected from the patient’s data. It's our goal to connect those pieces with RonanRx.Patients either come to us directly or are referred by a physician. Once a patient is in our system, we collect medical records, current meds, labs, and data from wearables. Our software follows the prescription through drug formulation, compounding, quality testing, and drug dispensing and distribution.The most interesting feature is the feedback loop. As the patient is undergoing treatment, their response becomes data that can be used by their doctor to modify the treatment. We keep the doctor in the feedback loop.We make money by selling drugs we manufacture. Because people can buy directly from us, their price is usually 3x-10x more affordable. We can do this because we start at the molecule and own the entire stack from manufacturing through prescribing, dispensing, and delivery, instead of paying a chain of middlemen at every step.We are beginning with GLP-1s and peptides since this was where I personally experienced the issue; however, we are more interested in the potential of patient-specific pharmaceutical manufacturing.We would love your feedback, especially if you have built pharmacy, manufacturing, clinical infrastructure, EHRs, or any other regulated software. There are a lot of assumptions in this model that should be tested.
33 points by lloydarmbrust - 42 comments
I write a GLP1 newsletter and would love to learn more about what you’re building and how you see the landscape.
Reta looks like it will make it out by early next year but I personally think they’ll squeeze in to end of this year — there will likely never be a undersupply of GLP1s again and I wonder if the customization loopholes will hold (Lilly will certainly fight Reta compounders harder than they have others), interested to hear your thoughts and chat.
Point taken that RUO people are just yoloing this, I was one of them. Now, I can tell you that having a doctor in the loop with my health is very helpful.
The investment is peanuts to the fund. You’re missing the full-story deck and if they’ve shown traction it seems like a no brainer.
(btw for Lloyd the founder, Jason hired me right here from HN for ownlocal. It was my first professional software job. You guys made my career. Thank you)
At the same time, nothing is stopping you from hiring a fractional medical director and doctors alongside NP. I ran the numbers and 50k is is all you need to get a service agreement with a compounding pharmacy, back office tasks, incorporation, social media marketing policy to essentially drop ship your product as you use off the shelf products for charting and then begin expanding state coverage.
The July Medicare glp1 coverage also makes this most opportune.
Biggest barrier I thought was / is the credit card processing. You need to carry a certification for that.
HIPAA not an issue, BAA with most orgs that offer a saas products.
So damn. The glue isn’t really hard. Really didn’t think this would qualify as an ycombinator mvp. But here I am used To pitch decks promising exponential growth of subscription for cloud services.
As for personalized peptides in general, are you going to be marketing non FDA approved ones?
Or just stick with what’s already popular, generic wegovy, zepbound, etc. the market seems highly thin as a new MSO appears everyday using smartiq alongside med spas that offer more questionable inpatient services.
While manufacturing controls supply chain / logistics, the external pressure from every compounding pharmacist scaling into peptides now makes me wonder the longevity abo it this. You can literally pop on subreddits and see the flavor of the month telemedicine practice offer teaser rates of $99 for 60mg/month tirezepatide.
Oh and not forgetting the elephant in the room, gray market and china manufacturing which allows anyone with a telegram account to directly order whatever chemical name they read with no doctor oversight. It’s what, sub $1/mg now from the major vendors for tirezepatide?
I was Stripe's first customer in 2010, so we solved the credit card processing issue :) it turns out that being in YC is good for more than just money.
You are right about HIPAA, everyone thinks this is much harder than it actually is, but GCP, OpenAI, Linq, everyone has given us a BAA.
We're definitely not trying to go after the market of people that are comfortable buying from Chinese suppliers and risking their health. When I built my mask factory, our masks were absolutely more expensive than Chinese masks, but what people were buying was a guarantee that it would meet certain filtration requirements. Some people are willing to pay for safety, but it's not important to everyone.
The only thing I really disagree with with you on is that this isn't a YC-scale company.
We are growing 56% compounded week -over-week, and I have every expectation we'll do $10 million this year, $100 million next.
We are making something that people are already buying and getting it to them in a safer, more cost-effective way.
https://en.wikipedia.org/wiki/Ro_(company)
My experience with semaglutide has been incredible. I went on it to help lose weight while waiting 6 months to get an appliance for newly diagnosed sleep apnea. My primary care didn't have appetite to prescribe it so I went through a telehealth. The telehealth at least gets you a prescription but it's a really impersonal funnel. Then you get locked into a really rigid process. The 1.5 mg oral was amazing. But then I hit the plateau. The obvious things to do was up the dose. I did that - the next dose was 4 mg and after a couple weeks had total gastroparesis and vomiting for 1-2 weeks. During this time I couldn't take the drugs, had to drop the dose to titrate back up, and gained some weight back over the next month or so. I was able to up the dose again but you can't cut the pills due to the coating so I instead alternated 1.5 mg and 4 mg pills for a couple weeks. I had to do this by not taking the 1.5 mg pills for a few weeks to build up enough of a reserve. The company I was using was totally inflexible with regard to helping me gradually ramp the dose up. The alternating eventually got me to 4 mg and I was steady on that for a while but ultimately had a couple incidents of puking. I really need something like a 3mg pill. I tried skipping a day every few because the long half life should in theory make that a reasonable way to lower the daily average dose, but then the food noise comes right back. I really need like a 3 mg pill but I cannot get one. I decided that I was done with it and went to cancel but found out that if I cancel early I need to pay $450 cancellation fee. :)
Despite having a PhD and working in obesity drug r&d I have found this one of the most complicated, stupidly inflexible, frustrating spaces I've ever seen. If I'm getting my ass kicked like this, I can only imagine what everyone else is experiencing.
The frustrating thing is I really want to be on this drug. I have latent/sub clinical HS which results in chronic low grade armpit pain - I have not had that on glp1s, my sleep apnea has improved, I've lost weight, my anxiety and ADHD have improved. But I just can't get the right dose.
There are some messages here complaining about the website being claude(ish). I know HN has people that care about this. They should. Mostly they would be right. But i don't see it being relevant here. Complaining about this business's website is like fluid-mechanics engineers at NASA complaining about friction dynamics on office floor-carpeting instead of rockets.
I've led building an EHR totally from scratch at one company and currently advising another as they build their EHR, both totally integrated approaches in industries where you usually have lots of disconnected care (adolescent serious mental illness and ABA/autism care). The state-by-state regulatory challenges are very real! If you want to chat, my email is in my profile!
BTW: when you say you manufacture the drugs, I assume that means you're buying from an API supplier, but do you actually mean you're synthesizing it yourself?
The legal cutout that we have is on the personalization front, which is very well protected. The trick is that most compounders are not actually personalizing, and we are. Our feedback loop allows us to do real personalization on a week-by-week basis.
edit: I see significantly lower pricing than e.g. LilyDirect. Does this work with HSA/FSA reimbursement, too?
Good luck with your venture!
I think the only thing that separates us is that we manufacture the drugs and probably own more of the supply chain than they do. But they're doing a much better job on the front end.
Yeah, they are pretty polished. But I've been with them for a few years and in the beginning their site was very much not polished, however, their products, service, and focus were a beacon.
Also is there a way to contact you? I have some personal questions as a fellow pep user.
I wouldnt step inside the building, its probably going to fall down every other sprint for the first few years.
Your website sucks though. We can tell you vibe coded it quickly and didn't put much thought into it.
These messages are very helpful, though, to help motivate me to get our team to fix this, so I do appreciate it.
This is a poor diet, where are the carbs and fats? So you dieted badly, and your conclusion from this is to use GLP drugs?
Did you ever try a moderate deficit over long periods of time?
We run a public benefit app called macrocodex which is completely free, no paywall, no subscription, and it produces guaranteed weight loss or gain within 2 to 4 weeks.
Most people never see a weight loss plateau; you can read the reviews if you are skeptical of the claims.
Problem with GLP-1 agonists is that it's very easy for a person to crash their diet.
In GLP-1s drug use, the primary cause of weight loss by reduction in appetite/desire to eat -> you eat less -> calorie deficit -> weight loss
Deficit doesn't really go away! So it's funny when people say "calorie deficit doesn't work but GLP drugs do", I wonder if they believe GLP-1 have secret fat melting property or something.