Startup embraces innovation and tackles the stigma of ED by offering online treatment

Zachariah Reitano calls erectile dysfunction (ED) the male equivalent of a car’s “check engine” light.

“It’s the first sign of a much more serious underlying condition,” Reitano said. “It’s not sexual, but it manifests in that moment because there are so many systems in the body that have to work together to get an erection.”

Reitano, who first experienced ED at age 17, understands the embarrassment associated with the problem, and he wants nothing more than to remove the stigma and help other patients who have experienced ED. He acknowledges that he is lucky to have a father who is a doctor and sexual health expert who helped him deal with the problem. He also realizes that not everyone has access to those resources.

To that end, he and 2 business partners joined forces and founded Roman, a cloud pharmacy for ED.

“It’s so stigmatized that men will often wait for less embarrassing symptoms to reveal themselves because a diminished erection is one of the first signs,” Reitano said. “It’s the only muscle in the body that grows that way, and it’s visually recognizable. You will notice it first before the heart reduces its functionality.

Why ED?

Reitano and his co-founders, Saman Rahmanian and Rob Schutz, founded Roman as an end-to-end men’s health service, handling everything from online diagnosis to treatment. They are driven by the knowledge that less than a third of men experiencing ED seek treatment, and by the realization that 80% of Viagra purchased online is counterfeit.

Most importantly, though, they recognize that ED can signal serious conditions such as high cholesterol, high blood pressure, obesity, depression, diabetes, and heart disease.

“These are, in fact, the leading causes of death in the US,” Reitano said. “For us, it’s about starting a conversation with someone as early as possible, when we can make a huge impact.”

Novels design

Roman begins by asking patients a few questions about medical history and sexual health. Patients submit a photo and ID, as well as any medication preference. Within 2 hours, a physician licensed in the patient’s state of residence will determine if a prescription is appropriate. If so, the drug will be shipped to the patient’s home the next day. Patients also have the option to talk to a doctor if they wish.

Roman is currently available in 14 states and is accessible to 58% of the US population. Because doctors must be licensed in the patient’s state, Roman is only available in those states where the doctors are already licensed.

Additionally, because there are layers of regulations dictating telemedicine, pharmacy, insurance, and drugs, Roman must meet several state regulations before launching in other states.

For example, if a state requires video chat to establish a patient/doctor relationship, Roman will expand to that particular state when it can meet that requirement. Since Roman does not accept insurance, the team can focus on other regulations.

“It’s complicated,” Reitano said, “but I think it shows that unfortunately most of the time the patient gets complications. Our goal is to work hard to ensure we understand the regulatory landscape and remove patient issues and confusion. We want to put all that burden on Roman to make sure the patient has a unified experience.

Reitano said the trend toward higher deductibles and lower insurance premiums is creating unprecedented benefits for customers who will pay more out of pocket. They will pay attention to how long they wait and whether the doctor follows up on time. In addition, he said that in specialties where payment generally comes out of pocket, such as lasik, for example, improved technology has led to lower costs.

Which Roman is not

Roman is not a guaranteed place to get ED medication.

Some patients are not even prescribed medication because their case is too complicated, or because treatment would not be appropriate, or because the symptoms do not require it.

Reitano said the system is designed so that no one is financially incentivized to make a medical decision that does not benefit the patient. The doctors are completely disconnected from the pharmacists and they are compensated for their treatment of the patient regardless of the outcome.

In the case of patients who are not on medication, they will be referred to local qualified health centers specializing in men’s health, regardless of insurance.

“We don’t care what happens as long as we take care of the patient,” Reitano said. “The goal of our company is to remove every barrier for patients. Any health problem is a speed bump that prevents you from getting where you want to go. Roman’s mission is to remove those roadblocks as quickly, seamlessly and affordably as possible.”

Pharmacists at Roman

For pharmacists, the beauty of life at Roman is that no day is the same. Because the entire process is designed to make use of technology, certain parts of the treatment can be automated, allowing pharmacists to spend more time on the nuances of their profession.

“They get advice, research on behalf of the patient and make recommendations to optimize care,” Reitano said. “By using software, pharmacists can spend time with patients instead of tasks.”

He hopes Roman will be exciting for pharmacists as it gives them the chance to demonstrate the valuable medical expertise they have gained.

“When people ask questions about ED through Roman, they learn that it’s not as simple as popping a pill to solve a problem,” Reitano said. “They talk to pharmacists about overall health and different lifestyle choices, and it’s amazing to see that a pharmacist can spend 20 minutes helping a patient feel comfortable and safe.”

He also said that pharmacists are not defined by their ability to bottle and ship pills. In fact, he believes that’s the least interesting part of their job.

“Automation will take that off their plates,” said Reitano, “and they should be excited about that. It allows them to focus on the reason they got into healthcare: taking care of people. Amazon is great at shipping things, but it won’t be great in what makes a pharmacist a pharmacist.”

He said that while he is not a pharmacist, he believes the key to future success for the field is a focus on unique skills and value.

“Monitor the innovation to see where you fit in, and look for things that fit into that can not be automated.”

Startup embraces innovation and tackles the stigma of ED by offering online treatment

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