Health Innovators
Health Innovators

Episode 107 · 1 year ago

D2C: How to solve gaps in your path to commercial success w/ Elizabeth Ruzzo


The first rule of successful commercialization is mapping out your path. The second rule is understanding when you have to adjust direction.

Where to start; where to go; whether your product caters to consumers, providers, payers, or all three can change over the course of your commercialization journey.

Dr. Elizabeth Ruzzo knows this first hand and she’s bringing us the scoop on how her startup was able to not only meet a need, but make that solution enticing to both customers and payers alike.

Dishing on everything from out-of-this-world-crazy statistics to successfully weighing the pros and cons that line your commercialization path, Dr. Ruzzo delivers on key insights and strategies we know you’re looking for.

If you’re trying to figure out which commercialization journey is right for you, you’re not going to want to miss this episode!

Here are the show highlights:

  • The crazy research statistic you haven’t heard about (1:56)
  • Understanding where to start your commercialization journey (8:25)
  • How to empower consumers with consumer-first healthcare (12:39)
  • Weighing the pros and cons on your commercialization path (15:18)
  • Data’s influence on audience message mapping (23:10)
  • Influencer marketing - will it work for you? (25:01)

Guest Bio

Dr. Elizabeth Ruzzo is Founder and CEO of adyn, a company focused on bridging the medical research gap and making scientific discovery more inclusive.

After more than a decade immersed in the study of human genomics and medical genetics, Dr. Ruzzo began noticing large knowledge gaps in medical research and information. It was then that she decided to build a new standard of care and work to close gaps caused by historic inequity in medical research.

The recipient of many awards including the Charles J. Epstein Trainee Awardee for Excellence in Human Genetics Research, and the Jo Rae Wright Fellowship for Outstanding Women in Science, Dr. Ruzzo completed her graduate work at Duke University and postdoctoral research at UCLA.

If you’d like to contact Dr. Ruzzo directly, you can email her at, or find her on LinkedIn at Elizabeth Ruzzo, PhD. If you’d like more information about adyn, visit their website at

You're listening to health innovators, a podcast and video show about the leaders, influencers and early adopters who are shaping the future of healthcare. I'm your host, Dr Roxy. Movie Health Innovators. Welcome back to today's episode. I'm sitting down with Elizabeth Rousseau, who is the founder and CEO of aiden. Welcome to the show, Elizabeth. Hi, thanks for having me. I'm excited to talk to you. It is great to have you here today. So let's start off by sharing a little bit about your background and what you're innovating these days. Sure. So, my background is in genetics. I have a PhD in human genetics and genomics and I spent many years looking for genetic causes of diseases. I spent a lot of time looking at both epilepsy and autism, and a lot of what I realized in the course of that decade plus of research was that there were a couple of health in equities that I kept experiencing. So the first was that any time I went to do a genetic study in a non European population, I had less statistical power to make the science same kind of discoveries as I could in European population. So explain that a little bit. Sure. So basically, genetics in the early days did a lot of sequencing of European individuals, which meant that all of your healthy controls that you would compare disease population to would also be European. So if you wanted to do that in a non European population and look for in our case we're looking for a lot of rare variants, if you didn't see it in the controls, you didn't know if it was truly rare or if it only looked rare because we hadn't looked in enough well matched samples. Okay, that makes sense, Yep. Yeah. And the the second how the equity that we kept seeing was this medical research gender gap. So this became especially apparent when I was doing work in autism, which has four times as many males as females that get diagnosed with autism, and so we were working on understanding the biological basis of that and it became clear that there were just far less research studies done to understand women's biology and women were intentionally excluded from clinical trials for many years and not actually required to be included in them until one thousand nine hundred and ninety three. Okay, wait, yeah, it's crazy. So we even why aren't more people like even talking about this? I mean, I've never heard this before. It's a pretty outrageous statistic. Yeah, and I think that people are also other people and companies and...

...institutions are working on it, but it's shocking. And so we even had this problem not just in humans, but even down to animal studies. Like animal studies were focused on only, you know, male mice, for example, because it was thought that there was a lot more variability in females, including because of their hormone fluctuations, which is part of what I now interested in studying. Right, and turns out hormone fluctuations have been in and out of a controlled study. So you want to actually understand that variability and and use it to your advantage to understand what's actually going to happen when you bring something to market, especially and in the case of drug development. So when you said intentional, it wasn't necessarily intentional to be biased or sexist in the medical research. It was just more of like ruling out so maybe the additional complexities or variables within the study. So kind of simplifying the data or the study exactly like it makes your life easier to have a really homogeneous sample set. This happens a lot with clinical trials. To, though, have a very long list of requirements for what it takes to be eligible for that clinical trial, and it turns out later, when you go and look at those data, that in fact you can maybe have helped a whole lot of a broad oder subset of people, more heterogeneous population, but it just was easier to start with that homogeneous that yeah, which I do see that very often. Why that real world evidence, post marketing surveillance, is so critical, because it's more of a regular population instead of whatever was for that example, in that particular clinical trial. Okay, exactly. So one thousand nine hundred and ninety three. So what happened then? So then they created requirements in the US that required that women were included in every clinical study, and so we have slowly been getting better and better at this. But what aidence? So now you ask what my innovation was. I found it a company called Aiden, and our mission is to make scientific discovery more inclusive, and so in order to do that, we're starting with working on things that were previously ignored. Primarily working on helping individuals in need of birth control find the right birth control for their biology. So we've created the first test that's designed to prevent birth control side effects. And why is that important issue? So there are well, maybe I'll have you gas. Do you want to guess how many birth control options are available in the US? Well, my husband had a vasectomy, so that was my rout. Lucky, so I have not stay tuned into the both world of birth control, but I imagine they're quite...

...a few. Yeah, so there are nearly two hundred options available in the US. Ever, guess that? And you know, women use birth control for thirty years on average in the US. And the other important thing to remember is that birth control is not just used for preventing pregnancy. It's also used as medicine to treat a number of reproductive disorders, or at least manage their symptoms, for things like endometriosis and pcos. So the problem right now is that doctors have no way to predict ahead of time which patient is going to experience which side effect, which is why the majority of women have to try for or more methods to find one that works for them. HMM, okay. So so then let's swear you in the innovation process. Now. So we are currently running our pilot study and we are basically starting with two of the most dangerous side effects, so risk for depression and risk for blood clots. And so the way I can describe a little bit about how we've developed the product. So it some at home test kit that's ordered by our doctors that then get set to your home. You Take US saliva sample for us to analyze DNA and a small finger spot of blood for us to analyze hormone levels, and then we generate our report that includes your readoubts, some from both your genetic risk and your your hormone levels, and then we also provide a way for you to understand the pros and cons of all the available birth control options that are out there, and we provide a tele medicine visit with with providers that we've trained specifically to not only understand the biological readoubts we're giving, but also help you understand what your how that fits in with your own reproductive goals and priorities. Right. So the other really interesting thing about birth control is there's preference involved. You know, some people hate having to remember to take a pill at the same time every day. Some people hate the idea of having something permanently implanted. So our providers are really focused on making sure that the patient feels empowered with now having all the information at their disposal that they have to make the best possible decision and hopefully avoid that that long arduous process of trial and error. So I think you know there's never a only one commercialization path for any organization. So kind of just take us back to maybe some of the earlier days, depending on whether that was sixty days ago or six years ago, when you were determining, you know, which path you were going to take, who it's going to be your target...

...audience and what was going to be that business model around your commercialization strategy. Yeah, so I went back and forth, to be honest, about if this was best to try to start in a clinical setting or direct to consumer, but what I realized was that it was ideal to kind of have the best of both worlds. So we're having physicians involved in the process from the beginning so that they can which is why we built in that Tele Medicine visit, so that we can have the medical community see that what we're doing is scientifically robust and accurate and that it will actually make their lives easier. You know, the average contraceptive counseling appointment is thirteen minutes in the US. So they don't have the amount of time or the amount of information that we are going to provide for them making that decision. Wow. So we're starting direct to consumer, also in part because you can get the prescriptions by mail order right now and a lot of people are doing that. There's also a push in the US in a number of stays it's I believe it's already thirteen states where you can get birth control over the counter from your pharmacist. And so to imagine, you know, birth control is kind of in flux where people need it, they might need to be able to get it discreetly, they might not have the resources to be able to go out of their way to visit a doctor, and so we're really thinking about accessibility and also thinking longer term about how do we partner with those those doctors and clinics to help make their job of prescribing the best we can. So so essentially, the the entire experience is being triggered by the consumer instead of by the physician in the normal or traditional healthcare model. Correct, Yep, okay, and so the consumer is triggering that. And then, of course, in states where they can't, whether they can get it over the counter or whether it's prescription base, they're still going. The next step is, you know, you've built awareness and demand with a consumer. They raise their hand, they say yes and then they tell a health visit or the quest they order the test. Technically it's ordered on the back end. We basically collect enough information that the doctor needs to agree that they are a good candidate for getting this test. So that's all kind of behind the scenes, ordered for them, and then the test results also get approved by that clinician before the customer sees it again. So then after the customer sees their results, they have the option to schedule that tell medicine visit and go through the test results and make that contraceptive counseling appointment. So who's paying for it? The Tele Medicine visit, what...

...the test and the town? So a lot of times when we're talking about director consumer, we're talking about cash pay. Yeah, and this seems to be somewhat of a unique model. Possibly so we yeah, so right now we're starting as cash pay but, as I mentioned earlier, we're really focused on accessibility. So what I think is unique about aid and as compared to a lot of tests that are out there, is that it is providing medically actionable results, and so our hope is that, because you're actually making an impact, that helps have economic outcome that's favorable for the insurance companies, which is what really matters to get coverage, that they would be interested in covering this test for their customers. So that is definitely what we are working towards. I think it's innovative, I think it's an innovative business model and I think that the timing is well, I guess your data will tell us right and then in the near future, but I think the timing is really ripe for Consumer First Healthcare, where you know, as consumers, we're making different choices than the healthcare system would make for us, and more choice, more empowerment and, frankly, willing to put some money out of pocket to be able to express that choice. I think we're seeing more and more of that happen. Yeah, absolutely, I think it's I think it's more important than ever that people can make and formed and personalized choices about their sexual and reproductive health, and I think that one benefit of this nightmare that we've been in, which is Covid, is the availability and comfort that people have adopted with telemedicine and with at home testing. Right people are giving themselves covid tests at home or getting them quite frequently, and so I think people see that that is is freedom, right to be able to understand what's happening, and we're hoping to do the same thing with with birth control. I've ordered blood tests online. I have you. Yeah, and how is your experience? Excellent, good, and it was so quick, so confident and I got the panel that I wanted instead of the panel that the you know, that came with my insurance. Yea. And then I've done the hormone testing online and I've done the allergy testing. Now we'll say actually, not the allergy testing. It was more of it wasn't what you're allergic to, but it was what like works with your DNA. O, cool, different way to describe it, anyway, and I identified all of these things that I shouldn't eat and I was like, yeah, I'm not given that up. So I I mean so the whole test model worked. But then I was like yeah, no, right, I mean they yeah. It's interesting how sometimes knowledge...

...of that information still doesn't change behavior. Now, if they had told you that, you know, you had super high risk of breast cancer and there were more frequent screenings you could do or things like that, you might have been more motivated to do that. Then, you know, give up tracolate camp almonds. Oh, such a stable exactly. So as you were kind of wrestling with this idea, when you were saying that you went back and forth. What were some of those things where you were looking at the pros and cons? You know, we kind of touched on some of them, but, you know, is there anything else that would be valuable to our audience on some of the pros and cons that you weighed as you were looking at the different commercialization paths you could take? I think there were two that really pushed me over the edge. So when I thought about what it would look like to do it and in existing health systems, it required that you were confident doctors had written down birth control side effects. HMM, which, as someone who was gas lit by my medical professional and told that I was not having birth control side effects when I was. There's no there's a very low likelihood that that's captured and it's definitely unlikely to be captured as structured data, meaning it might be written in notes, but that becomes a natural language processing, you know, data mining nightmare. Yeah, so that was that was definitely in the cons category and in the pros category, or con for going in the the Bab route and and pro for the direct consumer route. is also that ability to consent them to participate in research and to be able to recontact them. So what I mean by that is, with our mission of making scientific discovery more inclusive, we're hoping to that people will understand the importance of that larger mission, that they will recognize that we are trying to make up for decades of people not studying diseases that primarily affect a war majority effect women and girls. And so by opting in, you can help us by letting us do things like reach back out and say hey, have you ever experienced Dur and fibrines? Have you ever experienced this other thing, and really be able to help make discoveries that we will then publish for the larger medical community for everyone to benefit from. Yeah, Yep, okay, that makes sense. Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in the new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the...

...covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy and DNACOM backslash kit. So you know, kind of thinking about this. You know, gender gap one of the topics that often comes up. When it does, it's not always the case, but one of the topics that often comes up when I have female guests on the show. Show is what is it like to be an innovator in healthcare, as a female entrepreneur and a we're making progress, but on a, you know, highly dominated, male dominated environment, especially in the reason why I want to talk about this, even more so with you, is especially when you're talking about a highly female based company like you have. Yeah, I mean I think the Times it is most obvious has been when I was talking to investors. So if I was talking to male investors, who are still the majority of investors in in the US, I would basically see that if they understood the problem, they were likely interested to continue the conversation, but if they didn't understand the problem, it was such a barrier because they didn't have a partner or sister, you know, daughter who had experienced this and so they even though I had stats, even though, you know, they just didn't they didn't believe it, or they didn't see the need to fix it or they thought, oh, but you know, their doctor can already do that, that's what doctors do. So I think that that has been one of the big as challenges. Okay, and I think that that's I mean there's some part of that that's just inherit right, like where, you know, investors aren't going to be passionate about solving everyone's, you know, problem. There's serciually some kind of missional purpose, but behind those investments that are being made. And then I think you kind of circumventing the traditional healthcare system certainly eliminates some of those gender encounters that you might...

...would have to deal with traditionally and bring an innovation to market, being able to go directly to consumers. Yeah, yeah, exactly. Okay, so let's talk about your go to market strategy. Where are you now in that process? And and then what are some of the strategies that you're deploying that you've had success with, and what are some of the things that have been challenges or barriers for you? Yeah, so right now we are have launched our pilot, so we're going through the full experience with these individuals, from filling out their medical history and getting the task all the way through to generating the report, having it signed off on by the physician and then scheduling those Tele Medicine visits and all the way through to potentially getting a mail orders description if the patient chooses to do that. And so meanwhile we have been in a early access stage. So on our website we launched away for people to come, tell us a little bit about who they are and sign up, and then we also included a rewards program in that. So if you referral rewards program so if you tell one, three or five of your friends, you can potentially you get different rewards at those levels. And part of what we're hoping to do with that is really also make it an easy way to start a conversation about side effects, which is, you know, something that is sometimes still stigmatize. Side effects are on birth control. So about like a new hair product that I have at a party? Is that something me different than talking about my birth control? Yeah, right, exactly, exactly. So we've had some success with that already and we've been just now really starting to think about our digital strategy on different channels where our customers are. And I think one of the biggest challenges, since you asked, is just thinking about how do we market a product that applies to three decades of individuals. So that is a challenge that I had to apply your same business model to your marketing strategy, recognizing that you don't want to do trial and era healthcare, but you also don't want to do trial and are marketing because your target audience, that is they're all different too. Yep, yeah, exactly. And and you know thing, they are at different life stages right. So it comes from people who have never been on birth control before, but seven and ten teens use birth control to manage symptoms of PMS. So it's important to understand where everyone is finding. or it's somebody who's, you know, in their mids late s and has had a bunch of bad experiences with side effects, a lot of trial and error and is sick of it. Or maybe it's someone postpartum who's just had a baby and wants to not have...

...another one right away and think about what that option looks like and reevaluate, or, you know, all the way through to someone starting to go through paramenopause. So how do we talk to them? How do we communicate what we're doing in a way that resonates with with those somewhat disparate needs? Yeah, so, you know, it sounds like you guys are taking your targeting strategy to another level, which I think is really important when you're talking about direct to consumer. You know you've identified a gender, you've identified an age range, but recognizing that, like we said, not everybody in that gender, in that age range is going to be this homogeneous group. They're all going to be experiencing problems or use cases in a different way. So what are some of the things in and maybe you're still figuring that out, but what are some of the things that you're putting in place, because you're not going to be the only one out there that's trying to figure out this like audience message mapping, if you will. Yeah, and a really broad scale. Yeah, going to identify those different cases use cases, as well as being able to match your marketing to that specific audience and that specific situational triggers, if you will. Data is the goal. But so anything from thinking about surveys to, you know, paid out experiments to also just recognizing what's already in the data about demographic people. It on different channels, you know, ticktock versus facebook. Age Ranges are very different. Yeah, things like that. So trying to to focus on what we can to understand those, those different groups and also get in more traditional media outlets that might have like a user group that would resonate. You know, I have a suspicion that. You know, we want people who believe in science, who understand, or maybe they don't care, what we're doing, but they trust that we know what we're doing. I think that that's going to be likely to get faster adoption. Yeah, and definitely influence our marketing. Yeah, because they will know their tribe. They would probably be able to help you identify those those use cases within their tribe and being able to cultivate those messages and match that exactly. Yeah, and I think that's a good point. I think we're trying to start thinking about how we can leverage influencers, not just to reach those audiences, but also let those influencers do the messaging they think they've found in a way that would resonate, you know, kind of partnering with them to that. I'm not saying, Oh, here's this script, here's this, we want you to do exactly this, because I don't think that's this. This that's not making the best use of their their knowledge about their own audience. Well, and certainly, you know, you've kind of got the movement energy, the cause behind this, you know. So it's you...

...won't find it too difficult to find a group of social media influences or just participants that want to rally the cause of the disparities and medical researcher, wound plunder, Yep, Yep, and we need more people to be shouting about it from the rooftop. So I hope you're right about that in order for that to change faster. Yeah, I mean you could probably come up with like a dream one hundred list of influencers that have some really big, big voices and big influence around these specific topics. Yeah, absolutely, I think you're think you're right on about that. Would that be your primary go too? would be influencers, or do have any other secret tricks? When you think about that broad of an audience? I definitely think the influencers. Yeah, sometimes it's it's the you know, and it also depends. Okay, so when you're going a director consumer, obviously it's going to be a lot more expensive than doing be tob right. So there's some kind of grass roots approaches that you can take. And so you know, those people with you, fifteen million followers, are going to be priced very differently than someone that has, you know, let's say a million, and so it's not necessarily always the best proach, especially for an early stage. Come down to get those, you know, most prominent influencers. So Heaven Second Tier or even third tier influencers can be the right approach. They and then it could be there's a number of different factors. You know, brand alignment. You know, is your brand bold and you know, like what's the attitude and personality of your brand, and then making sure that you're finding influencers that share that common attitude and personality. I think that's really important. So if you're going to be like this science based type of brand, that's going to be very different than if you're out there and you're, you know, rallying around gender issues. You know, like you do that. You could do that same thing and two completely different ways. So I think that brand alignment is is going to be really important and I'm a huge advocate. If anyone's listen to this show, you probably are like, I know what she's going to say. She's gonna say co creation. Says that on every episode. But Co creation, you know, is getting co creating what the influencers and bringing them into the conversation, putting some tools in place to be able to co create what this launch. So a lot of times when we're thinking about involving customers in the process, we're usually thinking about design. So the thinking or human center designed, we design somethin and we go like hey, look at this, tell me what you think. We Really, as a whole in the industry miss out on co creating the launch. And you know, we might hire marketing agencies or teams, internal or external, and come up with this, you know, marketing plan of channels and messages and audiences and whatnot, and most often we do those very siload with including the target customers. And...

...and I go okay, let's stop that right now. And Coke, I mean every company, should be co creating yeah, with those target customers. It will save you lots of headaches, lots of money and also, you know, help you with your window of opportunity, because you know when you don't, you're kind of guessing along the way, guessing wrong. You might run out of money and you might have actually then, you know, took you two years to figure out what that formula was going to be, what was that corversion path going to be? And now you know there's five more competitors in the space then started. Yeah, yeah, absolutely, no, I think that's I think that's spot on. And, of course, influencers, that's they're in there d that's in their DNA where they use that word co creation or not, like that's what they're passionate about doing. So there's there's a bunch of tools and things that you can do to kind of bring them in and remove the guesswork and help formulate your entire go to market strategy. Yeah, thanks, I think that's really true. You're welcome. So, as you kind of just think about where you are now, are there any other lessons learned or any other tips to be aware of or things for people to watch at pitfalls, to watch out fought for as they're either making that decision between be to be and B Toc or if they choose the be to be be Toc route? Is there anything that you've already learned of like stay away from this or do this? Huh, that's a very good question. I don't know if I have any real stay away from or do this, but I will say I think part of what, part of what made it feel less scary to go the direct consumer route was like, well, I'm a consumer, so I understand like somewhat inherently what that might look like or how I might figure out messaging, and I know that it would involve social and these kinds of things. But there's so many things. There's so much more to it than that. Like I never thought I would be thinking about key terms and see and you know, so it's been fun. I like all that stuff, but I think it's just being aware of, yeah, how those, how those are going to look super different. And I think on the on the be to B side, you know, you just have a different, different set of problems with then maybe you need a sales team and the sales strategy, and so I think, I guess my advice would be like, don't over agonize the route. If, if you think you have a you need to figure out what prop what the product needs, what makes more sense to make it a reality. Yeah, yeah, you know, and your spot on the marketing piece can be so complicated. You know, if you ask someone, what do you do? Oh well, I'm in marketing. Well, that could mean and different things, right. There's so many different domains of expertise, there's so many different channels. I mean it's just the world of marketing and let's just say that it's also dynamic.

Right. So if you're like Oh, social media, okay, well, what twenty? What? What of the twenty channels are you talking about? Up and next month there's a new one up, and then the algorithms change as a huge undertaking, you know, and so you know, you just partner with experts and those different areas. Maybe sometimes you have a blend of generalists that know a little bit about different things, but then at some point being able to make the INVAL devestment in those specialists, yeah, around specific things. The other thing that I would just say what you're talking about is I think sometimes when people are going direct a consumer, it can be it's really easy to get it caught up in like, how would I say this, like Shiny Marketing Syndrome and the sense of like do I need? Oh, we'll tick tocks really hot right now, so I need to be on ticktock and got to be on Youtube, and I'm I guess you got to be an instant and you know all of these different things and then all of a sudden you know you've got you had fiftyzero a month to work with, but now you've spread yourself out so thin right at none of it's really effective and you're like, Oh, maybe this director consumer path isn't going to work. Well, actually, it could have work. So starting off with a couple of channels, yeah, and making those very successful. Yeah, and we're having some restraint with the temptation when someone goes Oh, you definitely need to be on whatever that is. Yeah, and taking the time to like analyze your own learnings from whatever you did, try to understand what's what might be working and what's not before you go throw a bunch of money at a new channel thinking that's going to be some kind of magic. If you never like figured out a message that resonates, doesn't matter where you're going. Yeah, yeah, absolutely. I mean it could be that you think. I mean I see this all the time with clients, you know, thinking that the the channel doesn't work for me and it's really not the channel. It's more of the ads or it's more of the message, exactly what you're talking about. So getting that that alignment between the audience, the message and the channel or the offer is always, you know, that's the fun part, right, it's that experimentation. Yeah, I think so. I'm like, Oh, another data problem. I can do that. Oh well, Elizabeth, this has been so wonderful. Thank you so much for joining me. If there's anyone in the audience that would like to get a hold of you to learn more about aiden or just connect with you about your founder's journey, how would they get in touch with you? Yeah, you can email us at hello at aiden a dy ncom and myself or someone else will get back to you. Someone else is better at poking my calendar then reaching out to my inbox directly. Thank you so much for joining me today. Thank you so much, Roxy. Thank you so much for listening. I know...'re busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who shared the show with friends and colleagues. See You on the next episode of Health Innovators.

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