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Zach Reitano - Building Ro and Why Healthcare Should Be 50% of GDP - [Invest Like the Best, EP.500]

November 11, 2026
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Invest Like the Best with Patrick O'Shaughnessy

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My guest today is Zach Reitano, the co-founder and CEO of Ro, the country’s leading provider of GLP-1s. In four years, Ro has grown from a $250 million run rate to over $3 billion, with fewer people than it had in 2021. The heart of our conversation is what he sees as the central flaw in American healthcare, which is that the patient is not the customer. He points to GLP-1s and LASIK as examples of what’s possible when patients pay directly, and he thinks AI could bring healthcare down to the price of a Netflix subscription. But to capture that opportunity, Zach first had to rebuild Ro's culture around high performance and a big heart. It shows in the stories Ro shares from people like Serena Williams, which help patients get past the stigma of seeking treatment. The inspiration behind it all is his father, a doctor whose care Zach wants to recreate in software. Please enjoy my conversation with Zach Reitano. For the full show notes, transcript, and links to mentioned content, check out the episode page ⁠here⁠. ----- Become a Colossus member to get our quarterly print magazine and private audio experience, including exclusive profiles and early access to select episodes. Subscribe at ⁠⁠colossus.com/subscribe⁠⁠. ----- ⁠⁠Ramp’s⁠⁠ mission is to help companies manage their spend in a way that reduces expenses and frees up time for teams to work on more valuable projects. Go to ⁠⁠⁠ramp.com/invest⁠⁠⁠ to sign up for free and get a $250 welcome bonus. ----- Trusted by thousands of businesses, ⁠⁠Vanta⁠⁠ continuously monitors your security posture and streamlines audits so you can win enterprise deals and build customer trust without the traditional overhead. Invest Like the Best listeners get a special offer of $1,000 off Vanta when you go to ⁠⁠vanta.com/invest⁠⁠. ----- ⁠WorkOS⁠⁠ is the infrastructure B2B and AI-native companies use to sell to enterprise. It covers everything enterprise security requires: SSO, SCIM, RBAC, Audit Logs, AI governance, and more. Trusted by 2,000+ fast-growing companies, including OpenAI, Anthropic, Cursor, and Vercel. ----- ⁠Rogo⁠ is the AI platform for finance. They're building agents for Wall Street that are trained to understand how bankers and investors actually do work: from diligence and modeling, to turning analysis into deliverables. To learn more, visit ⁠rogo.ai/invest⁠. ----- ⁠⁠Ridgeline⁠⁠ has built a complete, real-time, modern operating system for investment managers. It handles trading, portfolio management, compliance, customer reporting, and much more through an all-in-one real-time cloud platform. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ridgeline.ai⁠⁠. ----- Editing and post-production work for this episode was provided by ⁠The Podcast Consultant⁠. Timestamps: (00:01:35) Why Healthcare Spending Should Rise (00:05:39) Putting Patients in Control (00:10:37) Inside Ro's GLP-1 Business (00:16:29) How GLP-1s Could Reshape Society (00:23:15) The Hidden Cost of Protecting Jobs (00:28:35) Rebuilding a Zombie Company (00:36:33) What Drove Ro's 10x Growth (00:43:49) Where Healthcare Goes Next (00:46:27) Zach's Personal Health Stack (00:54:07) Finding the Work You Were Born For (01:00:15) Ro's Consumer Playbook (01:04:39) Breaking Medical Taboos (01:12:54) The Kindest Thing