The Alto Advantage: Invested in Impact

Interview with Nick Smith, CFO
December 2, 2022
Alto Advantage

The Alto Advantage is a five-part series that covers the company’s guiding principles for pioneering precision psychiatry and, ultimately, establishing a new treatment paradigm in mental health.

The Alto team is driven by purpose and united in their mission. While this mission carries potential to reach millions worldwide, the impact that can be made in even one life should the team realize success keeps them motivated each day.

For Nick Smith, Chief Financial Officer, Alto’s potential impact is deeply personal. “My wife's uncle committed suicide in between treatments for his depression, so I know first-hand what it would mean for people living with depression, as well as their loved ones, to find the right treatment faster,” Smith shared.

“I knew after my first meeting with Amit that he is the right person to lead the revolution in neuropsychiatric drug development, and was building a company that I wanted to devote my professional efforts to. While he is a renowned psychiatrist and neuroscientist, it goes much deeper for him. Amit’s entire life’s focus and personal mission has been dedicated to impacting this field in a way that could entirely transform the way we treat mental health conditions,” he said. 

Smith has been in the CNS field his entire career, with experience launching several successful drugs and, likewise, witnessing numerous failures in the space. For Smith, being a part of the team that has potential to truly revolutionize CNS drug development, and thus the treatment paradigm for CNS disorders, is compelling.

Smith notes “Invested in Impact” as a core Alto value can be viewed from two different angles: “There is the overall business impact, which includes the impact for patients and the CNS treatment landscape as a whole, but there's also the financial impact generated through efficient use of our capital resources.” 

In everything the company does, “Invested in Impact'' is the thread that ties the work together. 

If an activity or approach doesn’t create a near-term impact for Alto and its key stakeholders (namely patients, clinicians, or shareholders), the company is likely to reevaluate or forgo this entirely.

Impact through Innovation

The field of psychiatry, defined by a trial-and-error approach for decades, has been plagued by a lack of innovation. Alto’s impact through bringing innovation forward will ultimately be recognized by new medicines that could shift the treatment paradigm for patients. 

Equally as important is the potential to change future drug discovery and development in the field through leveraging Alto’s proprietary Precision Psychiatry Platform™. 

“In looking to create transformative treatments, we choose to invest in what matters most for improving outcomes, both scientifically and clinically,” said Smith. “As a nimble biotech, we decide each day how to best invest our time and energy to achieve our ultimate objective.” 

“We strive to create value in everything that we do as a team, so prioritization is crucial to our long-term success,” he added.

Alto’s impact through innovation carries obvious relevance to patients, clinicians, and investors, but also has potential to cause a dramatic effect on the payor dynamics in this space. 

Should Alto reach its ultimate goal of getting a drug through FDA approval with its precision approach, “For insurance companies, the efficient identification of treatment benefit means they will only pay for treatment when it is appropriate to do so. This is in stark contrast to the approach today, and objectively guiding treatment decisions shows potential to drive a positive economic benefit,” said Smith.

Impact through Efficiency

“From early on working in the life sciences industry, I have held the belief that if we do the right thing to create impact for patients, this will lead to desired business results,” said Smith. 

“As a venture-backed company, we do not have endless capital which requires us to strongly consider how each dollar spent impacts our mission,” he continued. 

The company’s efficient deployment of capital extends to both the way Alto conducts its clinical trials and expands its data science efforts.

“We build a lot of solutions in-house that some companies might choose to outsource,” Smith shared. “We do this not only because it’s cost-efficient, but because it is also efficient in terms of data capture and quality control.”

In the near-term, Alto is focused on leveraging capital raised to date to achieve important clinical milestones; The company will readout multiple Phase 2a studies in early 2023 and expects to read out large placebo controlled studies in biomarker defined patient populations in early 2024.

“When someone invests in Alto, they're not just investing in another drug or a single asset,” Smith assures. In contrast, he notes, “They're investing in an approach that leverages capital more efficiently to get multiple shots on goal, with multiple first- or best-in-class assets moving forward.” 

“This approach is quite different,” Smith concluded. 

Aligning in Impact

In wrapping up the conversation around the importance of “Invested in Impact,” Smith highlighted that this guiding principle can mean something different to each person on the team. 

“This is the beauty of a value. Even though each person and role at Alto is impacting a different aspect of our business, we’re always moving towards the same ultimate goal.”


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