Startup Stories

Joshua Kriger, class of 2018, is the founder and CEO of Picket Pharmaceuticals, a privately held company that, “uses modern data tools to identify undervalued essential medicines at risk for shortage. Then, using a network of industry partners and contacts, manufactures and commercializes these products before a shortage occurs.”

Picket Pharmaceuticals aims to augment the health and wellbeing of patients by expanding medication selection on the market, improving medication access, driving down prices, and refining medication formulation. Although private, the company centers its goals around a public health mission to create medicine that is accessible to “families, neighbors, and the country.” “We look at what matters to people when they have to engage the healthcare system,” Kriger noted, “to ensure access is there, price is stabilized, and quality is good. We consider this when looking at products that are at most risk to be undersupplied.”  

Previous studies reviewed over 1,800 medications that were approved over an 18-month period. Findings indicated that 39.1% of these had shortages in the last five years. “What’s even more surprising,” Kriger explained, “is that for every shortage that occurs, there are, on average, 3 approved licenses that could be but are not marketed. It’s quite a big issue that people don’t often hear about. At Picket, we look to reactivate these approved applications that are not being used. This allows us to act on our data signals more quickly and get products in the hands of hospitals and pharmacies faster than traditional pathways.”  

Prior to the creation of Picket Pharmaceuticals, Kriger attended Hampshire College where he received his B.A. in Entrepreneurship and Statistics.  Before completing his degree, he began his own mobile software company, and later worked as the head of U.S. operations for a Bangalore, India-based mobile software development company. After working as a partner there for two years, he completed his undergraduate degree and went on to complete his graduate degree. “I saw that data was starting to be used more, as this was around 2008, and this eventually led me to the department of biostatistics at Mailman.”  

“At the School of Public Health,” Kriger recalled, “I was fortunate to use the experience I had with those early companies to be a successful clinical trials statistician.” During this time, he worked as the lead clinical trial statistician on three phase II trials at CUMC and designed a continual reassessment dose finding trial at Baylor University through NAMDC. Through a contract with Novartis, Kriger became a program manager as a student of the biostatistics department. “I was later asked to work with ICAP on the largest biomarker assessment conducted by the CDC,” he stated. Following this, he joined the HPM department and completed his executive MHA degree. “During this time, I did expert statistical consulting, including for state attorney generals and insurance companies. All these experiences culminated and led me to the formation of Picket.”  

As CEO of Picket Pharmaceuticals, Kriger works to pull together expertise across the different areas of healthcare and therapeutics. His days consist of a wide array of tasks to achieve this, including administration, navigating regulatory requirements, coordinating with developing partners and manufacturers, and working to bring abbreviated new drug applications to market. The company’s teams utilize a robust data platform to improve product selection and enhance understanding of drug supply and risk of undersupply. They also develop new sets of mathematics and statistical procedures to better understand the generic markets. Currently, their teams are working on running R&D with machine learning A.I. models to predict shortages. “My days tend to be 10-12 hours, 5-6 days a week. The mental jump off point was when I realized that if I was going to do this, I wanted to do it right. Once you accept that, there’s always something to do. I consider it a marathon, not a sprint.”  

During the creation of this start-up, Kriger was no stranger to challenges. Entering the start-up space in pharmaceuticals and healthcare was a daunting task. The company decided to focus on a value proposition of utilizing available data resources, to ascertain risk of a shortage combined with the clinical durability of different drugs. “We had to have statistical inference and good evidence to prove this… and it sometimes felt like going into the unknown. When we started, we would ask ourselves, was it even possible to predict shortages?” The Picket team proved that yes, it is.  

However, when doubts arose, he attributed much of his perseverance to his professional family, both at Picket Pharmaceuticals and Mailman SPH. He found a professional support system amongst colleagues. “I was reassured by other folks on the front lines that my work was meaningful,” he said. “Doing something that’s meaningful and really trying to engage the world always requires a good fight. It comes down to how much you want it and what you’re willing to do and stand up for. That’s a question I have to ask myself every day.”  

Linda Nedell is a practicing physician assistant (PA) and the founder of SAYge Link, a digital peer-support platform that equips individuals to tackle real-life issues collectively. "SAYge Link enables women with shared experiences to connect and support one another through a private and convenient digital platform.”  

Prior to creating this online tool, Nedell noticed a lack of communication between healthcare providers that often resulted in the decline of care quality. To address this, she decided to attend the Mailman School of Public Health. By attaining a Master of Healthcare Administration degree at Columbia, she "hoped to explore healthcare from a system level and make a bigger impact as a clinician through leadership.” However, halfway through the program, Nedell decided to take a course that would unexpectedly shift her career trajectory and lead to the formation of SAYge Link.   

Led by Professor Asha Saxena, the Healthcare Entrepreneurship course prompted Nedell to critically consider her passions and how to effectively apply them to the field of health. "On the first day of class,” she explained, “[Professor Saxena] asked, 'Has anyone ever had a business idea? If you have, raise your hand and share it with the class.” In response, Nedell explained her idea of digitally connecting women of different expertise to help one another navigate real-life issues.  

The idea had originally stemmed from a conversation with her cousin, who was able to successfully leave an unhealthy relationship with the guidance of an older woman who experienced a similar situation. "It truly inspired and empowered her… I remember thinking, 'We have technology. Why can’t we enable these invaluable conversations to happen for women when they need them?”  

With the help of Professor Saxena, Nedell turned her idea into a class project. She practiced pitching it to investors, and upon completion of the course was prompted by Saxena to bring the project to fruition. "It was the first time I thought about really going for it. Being just a healthcare [provider], I didn’t have the wherewithal until [coming to Mailman]. It really gave me the wings and resources to turn this idea into a platform.”  

Throughout product development, Nedell was able to create a technical network to refine her product, coordinate with designers, and work with leaders in technology like Saxena – and continues to do so. She has since witnessed clients cope with isolation during the COVID-19 pandemic, personal issues, and traverse career prospects using her product. With its unique ability to foster such conversations between women, SAYge Link now has members between seven different countries and continues to grow.  

While she implements what she learned at Columbia as a clinician in system quality initiatives, Nedell’s passion for SAYge Link is simultaneously a daily focus of hers. Although she once believed her interests only lay in healthcare improvement, she found herself realizing her "heart’s passion for the wellbeing of people, of women.” “SAYge Link,” she added, "is congruent to but definitely different from what I originally expected for my life. It truly is a lesson in following your heart and following what may not be the exact path you intended.” 

Dana Le is a Forbes 30 Under 30 recipient and the accelerator lead at KidsX, an international consortium that aims to streamline innovation in the pediatric field. "I always love being able to provide value and opportunities for others,” Le stated. "Here, I was able to build a path and an outlet for entrepreneurs to hospitals."

The pediatric field is broad in scope, consisting of different age groups, demographics, and specialized medical issues – as such, there are rarely 'one-size-fits-all' solutions for its hurdles. Consequently, many digital health founders can be deterred from entering the field and pediatric hospitals may find it difficult to innovate relative to generalized adult hospitals. Recognizing this gap, Le worked with her colleagues to help develop KidsX and address such issues. "We want to make it easier for those going into this already challenging field," she noted. "We want to provide them with the resources needed to scale their solutions to enterprises and hospitals around the world."

Prior to attending Columbia’s Mailman School of Public Health, Le was no stranger to bridging the gap between innovation and healthcare. She had previously co-founded a health leadership apprentice program geared towards community members in Austin, Texas, who sought to launch their own initiatives for city’s healthcare. Here, she connected program members with mentors to flesh out their initiatives among other projects. "This was very rewarding," she added, "because I was able to see ideas from scratch then come to life. What I did here really supported me in what I am doing now. The feeling of making an impact and supporting people’s dreams was what I wanted to continue to do."

Seeking greater expertise on the intersection of health and innovation, Le went on to complete her Master’s in Health Administration at the Mailman School of Public Health. Upon graduation, she began to work as a healthcare consultant in managed care. "Although I learned invaluable skills as a consultant… I knew I wanted to work at an incubator/accelerator to impact patients and healthcare entrepreneurs." Realizing she wanted to continue her entrepreneurial work, Le decided to reorient and search for new opportunities. Following a cold-call via Linkedin, she was connected to colleagues at KidsX who aligned with her mission and offered her a position in the program’s development. "I realized this was the perfect role – on my first day we hit the ground running! We fleshed out what the program would look like, how it would function, and how to work with early-stage start-ups."

"Now," Le added, "the KidsX program is the largest pediatric digital health accelerator in the world. We have a collaborative of 30+ hospitals that have agreed to pilot at least one company from our cohort." At the program, Le currently runs operations, supports daily functions, designs curriculum and programming, and helps provide support and mentorship to founders accepted into the program. "It has been such a fun journey, being able to support and develop this program, and build entrepreneurial ecosystems geared towards pediatrics."

Outside of her entrepreneurial work, Le continues to seek out opportunities to consistently grow herself. In order to maintain a balanced life, she spends time outside of work as a boxing coach and professional model. "These open up my creative side and support my physical and mental health," she emphasized. "The activities I do motivate me to get up every morning… With a balanced life, you look forward more to the work that you do. It gives you more perspective and color to life and has helped a lot with my own work."

When asked about her advice to students now navigating public health careers, Le emphasized the importance of self-reflection and active opportunity engagement. "Be honest with yourself," she stated, "and if there’s an opportunity that isn’t there, build it yourself. Don’t wait around and think the perfect opportunity will come to you. Everyone can take control of their own life. If there’s something you’re passionate about, use the resources around you to build new opportunities and invest in yourself."

Lauren Driscoll is the founder and CEO of NourishedRx, a food-as-medicine platform designed to provide personalized food solutions for vulnerable individuals, specifically those with diet sensitive chronic health conditions and at risk of nutritional insecurity. "Along with personalized meals and food sourced from our marketplace, [NourishedRx] provides education and encouragement to individuals to create lasting behavior change."  

Today, the team at NourishedRx consists of 30 people who interface directly with members. By collecting information on individuals, such as preferences, functional status, diet attitudes, and clinical needs, they craft personalized food solutions. The company utilizes a marketplace where it partners with several local and national healthy food partners to provide ready-to-eat meals, meal kits, and grocery/produce bundles. "Together our wellness associates and clinicians directly work with individuals to coordinate personalized food plans and provide educational materials, delivery access, and address any issues that arise," said Driscoll.  

Prior to the creation of NourishedRx, Driscoll had always been interested in healthcare. "In college, I pivoted from the pursuit of a clinical career to a more system and public health focused career," she stated. "I ended up becoming fascinated with the international arena… I shifted my focus to history, politics, and how it shaped culture, and eventually zeroed in on healthcare." Throughout her life, she maintained a focus on healthcare and vulnerable populations. Following public health schooling, she supported the Clinton administration’s healthcare reform taskforce as policy staff, supporting the long-term care work group. "We focused on dual-eligibles, people who were on Medicare and Medicaid. As such, I developed a real passion for vulnerable populations, and in particular, older adults. "By the time she left this position, Driscoll then finished her master’s degree at Columbia and went on to work for Oxford Health Plans, where she ran their Medicare business. "It was a very entrepreneurial environment," she added.  

It was here that the social determinants of health became extremely apparent. Realizing this, Driscoll began a program that screened members for non-medical needs. "This time, the late 90s," she noted, "was before the private sector of health care really recognized the importance of the social determinants of health. By screening the members, I was able to apply a public health mindset to managed care." Her work continuously exposed her to the hurdles faced by vulnerable populations, among which included resource inequity, travel limitations, and food insecurity. Outside of work, she then experienced a self-taught importance of food for health and wellbeing while navigating her child’s extreme diet sensitivity. 

"I quickly came to the belief that, among the different social determinants of health, although all critical, food and nutrition ranked highest," Driscoll stated. In 2018, the passing of the 2018 Balanced Budget Act would finally provide a formal mechanism by which Medicare Advantage plans could pay for solutions to non-medical needs. "I realized I was now able to productize interventions and make it easy for government sponsored health plans to offer aid to members who needed it the most." When Rebecca Sale, Senior Director of Education in HPM, then reached out to share that Mailman was supporting alumni in the Start-Up Lab, Driscoll decided to actualize her mission. "I was so passionate about the opportunity that I couldn’t not jump in and take the plunge."  

Together, they discussed productizing interventions that addressed the social and structural deficits in health. "I saw food as more actionable and impactful," she stated. "There are many food solutions out there, but they tend to be single stream… There were not many personalized solutions that were correct for an individual’s life. "With this mission in mind, Driscoll began her company, Project Well, later renamed NourishedRx. Adopting a lean-launch approach, she learned to overcome the challenges of beginning a new company by networking with similarly mission driven people. "I had to roll up my sleeves and be face-to-face with customers to understand exactly what was needed before building and investing," she added.  

"I never set out to be an entrepreneur," Driscoll clarified. "But my mission drives me to get up every day. I see such an opportunity with value-based care [because] there’s so many people that need help." She advises students now traversing public health to take time for self-reflection and understand their individual missions. "If you’re personally grounded in a mission, it will just put such wind in your sails and pull you through hard work in challenging times. And don’t forget to find such like-minded people to join you on the journey!"