About Armando Polanco, CEO
Armando is also the CEO of Apollo Vanguard that offers three main services which include medical tourism of 13 years, prescription outsourcing program and pharmacogenomics, which entails genetic testing to identify drug interactions with patients. These services are offered within self-insured health programs to provide valued options in lowering costs while maintaining quality outcomes. Fortunate to have traveled to 23 countries so far with many on Medical Fam Tours and often providing presentations on issues of medical/pharmaco tourism and pharmacogenomics.
With a unique background of experience and education Armando has focused on strategic ideas to improve health conditions and bring financial stability. Armando graduated from St. Mary’s University with studies in biology and chemistry. Has had work experience in microbiology, breast cancer research and pharmaceutical sales. Retired as a Lieutenant Commander with the US Navy after 23 years of service and held a number of positions such as Directorate and Department Head of Occupational Health, Industrial Hygiene, and Preventive Medicine in a Naval Hospital. Also, acted as consultant in Quality Improvement Processes under the Navy Medical Command, Washington, DC.
Armando’s financial background includes credit analysis and commercial lending with the largest regional bank in Central Texas. This experience provided Armando with an ability to understand employer needs to improve cashflow and retained earnings. The financial perspective along with his medical experience laid a path to his current involvement to international medical resources, strategic thinking and biotechnology solutions.
Enjoys his time with two wonderful sons. Armando used to sky dive but now looks forward to scuba diving with his new gear. As part of his travels he always makes sure to taste the local beer, wine, coffee and local foods to get the true flavor of the country. Understanding their music, architect and culture is also always sought. In this way, Armando is able to tell a better story to those interested in medical travel.
About Apollo Vanguard
Apollo Vanguard understands the health insurance industry with its complexities and utilization of the services from physicians, hospitals, pharmaceuticals and other related expenses. We have made it our mission to diligently search for best quality of health practices with low but reasonable cost.
A number of industry publications agree that prescriptions and hospital charges are the two highest cost drivers for any health plan …Specialty Prescriptions being the highest cost. While almost every US health and insurance professional focuses on what they can do to market their focused area we at Apollo Vanguard provide a global reach with over 12 years of experience. While we offer multiple services the three areas of greatest impact are International Pharmaceutical Sourcing, Pharmacogenomics and Medical Travel.
International Pharmaceutical Sourcing offers the lowest cost Specialty Name Brand Prescriptions with access to the same manufacturers/wholesaler as in the US. These prescriptions are priced to the global market unlike the US market with multiple layers of resellers. Basically, we’ve removed the Prescription Benefit Management (PBM’s) system giving patients and self-insured employer sponsored health plans savings of 35% to 75% as compared to traditional US health plan access. Our pharmacy facility is considered an overlay (embedded) in your current health plan as an optional source for these cost saving prescriptions. The program can be implemented anytime without waiting for the health plan effective date therefore realizing immediate savings.
Pharmacogenomics is testing individuals for a geno-type that determines how genes react to certain prescriptions. The aim is to identify what medications work best and at what dosage. It also prevents adverse reactions or even death because of certain genes and how they interact with other prescriptions. Specialty prescriptions are costly so it makes sense to personalize the right medication at the right dose at the right time.
Medical Travel allows a patient to seek treatment in other parts of the country or internationally for reasons such as higher quality, lower cost, shorter waiting period or specific treatments not available. Apollo Vanguard can assist in identifying these facilities and doctors. With 23 countries and countless of credentialed facilities reviewed, a patient can feel comfortable knowing safety and successful outcomes are at the forefront.
Medical Travel & Digital Health News (MTDHN): Please tell our readers how you got involved in the medical travel industry.
Armando Polanco (AP): I spent 32 years as an insurance broker and focused on retirement plans. But I was also licensed to serve additional market segments, including workers comp, general liability and health insurance. My primary interest was in the healthcare and benefits side for fully insured and self-insured companies.
What got me interested in medical travel stems back to my years in the Navy and my international travel experiences. I was always interested in the field of medicine, so I was a Reconnaissance Corpsman with the Marines. Later, I was able to get a Commission as an officer. I have a degree in Biology and Chemistry, so I’ve worked in hospital settings. Going into the insurance world, I started to recognize that the cost of medical claims was exceedingly high.
It didn’t take long for me to figure out that U.S. medical costs were exorbitant, and I knew there had to be better bets somewhere else. I took a trip down to Monterrey, Mexico and about two dozen countries for “fam” tours where I learned about international healthcare. Over the years, I’ve visited and toured hundreds and hundreds of hospitals.
My insurance business was tailing off with the onset of COVID-19 so I transitioned the remaining accounts to a larger agency. It was a good run and I decided to put my passion for medical tourism into a business model. It was a good time for me personally to launch into true medical tourism.
MTDHN: Are you still passionate about and enjoying the medical travel industry?
AP: Medical tourism isa tough business.
My approach has been to help people go to other countries for simple procedures – mostly for dental or plastic surgery. There’s not enough money in arranging for those procedures so I simply refer people to hospitals or providers that I know will deliver good care. I do not charge a fee.
Where I do earn money is in pharmaceuticals. If you really understand the healthcare industry itself and health insurance, there’s three major cost centers: doctors, hospitals and pharmaceuticals – and the latter is the one that consumes the most dollars. That’s where the money is.
And when you really look at pharmaceuticals, half of the revenues are being made on specialty meds.
Fortunately, I have a background and understanding of claims, so I did a pivot and went to Tijuana, Mexico about seven years ago. I began sending patients to San Diego, picked them up at the airport and transported them to Tijuana — right across the border. They got their meds at a fraction of the cost and traveled back home.
It was a smart growth business but then COVID hit big time and again I was stymied. Nobody was flying and travel was at a standstill. From that point, I just looked across the industry and I thought, “I can’t do it from Mexico since nobody’s traveling, but I can do mail order from Canada.”
I did some homework, looked at different pharmacy operations and I finally settled on one pharmacy out of Vancouver. At the first opportunity, I flew up there and visited with the operation. I did my due diligence, looked at the licenses and studied the operation.
I have an agreement with this particular pharmacy, which does a really good job in mail orders for specially meds. And here I am today: I’m still doing medical tourism, but I’m really a “drug dealer” from Canada.
MTDHN: Are you going direct to consumers or are you going to employers?
AP: There are two different markets when you talk about pharmaceuticals. I look at employer groups, business risk managers, HR executives, comptrollers, Chief Financial Officers, etc. They are the money people – they get it.
I’m trying to entice them to add one pharmacy to their network. When you look at a health plan and if you understand health insurance, you have doctors, hospitals and you have a network of pharmacies.
In the plan designs of insurance, you can go out-of-network to see a doctor. The patient would pay more money but they would still have some benefit. You can do the same thing with an out-of-network hospital.
So why couldn’t you do that with an out-of-network pharmacy and save a ton of money? You can!
My challenge is to try to convince employer groups that they are already doing it with doctors and hospitals – just add one pharmacy.
It’s growing little by little and it takes a little bit of time. You need to get to that critical mass, meaning I have enough accounts, and it will take off all by itself.
People hear about the opportunity and think it’s a great idea. It saves a lot of money and it’s easy to do. That’s the direction this is going.
MTDHN: Are self-insured employers the real target?
AP: When you talk about pharmaceuticals, I’m targeting self-insured plans.
You have to start out with smaller ones – not too small – but you have to start out with smaller ones and then try to grow from there.
You have to prove that it works and that it’s viable. So it does take time.
Once I have a certain number of accounts I can drop some names as references. Now I have to go through 6 approvals to finally get one employer to say YES.
It starts with approaching a consultant or a broker, then there’s the stop loss carrier, the TPA and the employer group. Then eventually there’s going to be the patient who can always say NO.
Every step of the way, there is another person to convince. An attorney might be involved, so there’s a layer of people that all have to approve because any one of them can just say no.
MTDHN: Where are those groups located — any specific geographic area of the country?
AP: Yes, I have done quotes for groups out of the Carolinas, Virginia, Ohio, Florida and Texas, where I’m located. I’m trying to focus on Texas but I’ve done some quotes with some groups throughout different parts of the country.
I am also working with brokers or consultants. One consultant is in Florida and he’s trying to open up doors over there. I have another consultant up in Ohio, so he’s trying to open up that area, including the Midwest and a small portion of Indiana.
It’s a tough business and not that simple, but they’re trying to open the door, set up a conference call and try to persuade the potential customer. Again, it takes 6-7 “yesses” to finally get one going, but I have enough accounts right now — enough to sustain myself.
MTDHN: How else do you market your services?
AP: I focus my efforts on networking through attendingsome conferences and meeting new people. Emails are not effective since nobody yet knows who I am. If I make a phone call, they never answer because they get tons of calls every single day.
I’ve learned one thing through the years: you have to be able to go in and see the prospect. Face-to-face meetings and handshakes are more effective.
The other thing I learned is to be bold, a little bit more intrepid and try to maneuver myself to meet the right person. I will go to a city and simply tell folks that I am meeting with other groups and would like to meet with them.
MTDHN: Are you approaching the public sector?
AP: Yes! I’m finding it’s easier to break into the public sector than the corporate world since corporations really rely upon the broker. They always want to say, “Talk to my broker.”
Again, I’m willing to talk to brokers or consultants but at times I do go after the public sector I own since they’re having rough financial times or having a very difficult time on their budget. I think they’re listening to me a little bit more intently because their financial conditions are strained.
MTDHN: Is there another market for medical tourism apart from employers?
AP: The other market for medical tourism is everybody who wants to save on medical care. I would really like to get that going on all medical and dental services operated but also recognize that most activities are focused on cosmetic surgery and dental care. This may be the most lucrative sector for medical travel and where the action is, so I want to focus more of my efforts on promoting this.
I eventually want to visit some countries that I’ve been to and present their capabilities to the public via audio and visual presentations or social media.
For now, Apollo Vanguard will focus on pharmaceutical drugs. From there, I’ll go into the retail side and then start showing medical tourism.
I do want to go back to most of those countries I’ve been to before and showcase what they’ve got. I’m still very much involved. That’s the business I’m in and staying in — this is my last journey and I’m passionate about it. I love to travel and I know the kinds of questions to ask when I visit the hospitals and what to highlight.
Today, I profit from pharmaceuticals and I will not charge a person for connecting him/her to treatment — whether it dental, plastic, etc. They are calling me for a reason – usually to save money. I’d rather take the position of not charging them anything and just educating them.
I learned a long time ago, even with the best surgeons in the United States, whether they are from Mayo Clinic or Cleveland Clinic, something can go wrong. I try to avoid that liability so I act as more of an educator and I will not take a penny from the patient.
MTDHN: Is there anything else our readers should know about getting pharmaceuticals from another country?
AP: I think it’s important to keep in mind that prices do change from time to time because there is a cycle.
The caveat is that six months from now, prices will be different. Even in the U.S., these drug prices from different PBMs have different prices throughout the country. It just depends on where they’re located and what the PBM is charging.
There are 21 different algorithms on how PBMs make money — discounts, rebates, spread pricing, clawbacks, etc. When people ask me, “How did you get your prices so low?”
I say it’s really simple.
I’m not a PBM, so this spread price is the PBM. That’s where they make their money. Basically, I represent the pharmacy – I am the pharmacy but I don’t own it.
Here’s the interesting point though. I’m not a cost center.
People ask me what percentage do I up-charge up on these meds? My answer is if you go to Canada and you get the same med that I’m offering you, you’ll pay exactly the same amount to the penny — the same amount if you’re in Canada, buying it from them directly, as you would get it from me.
Then they ask how I am making money. The answer to this is that every true operation has expense besides payroll and paying rent, namely education and marketing. So I take a piece of that.
I’m not changing the price, I’m not a line item cost. I’m built into the price already and I make a small amount. The key is to sell volume, but you can’t make a killing on a single drug sale. I just have to make sure that I’m selling quite a bit of it in order to keep it going.
MTDHN: Are there any regulatory issues?
AP: There is Section 804 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) that allows the FDA to establish a program to import certain prescription drugs from Canada. The program, called the Section 804 Importation Program (SIP), is intended to reduce the cost of these drugs for American consumers without posing a risk to public health and safety.
This provides verbiage applicable for Canadian drug imports – it doesn’t talk about Australia, New Zealand or Great Britain.
Some people say it’s safe to get drugs from all these other tier one countries. But the law doesn’t say anything about those other countries. It only talks about Canada.
I have the ability to be able to contract with those other countries but I will not do that. I don’t want to muddy the waters. I want to be pure with what I have to offer. Why go someplace else when I can get the drugs from Canada and know for a fact that they were all manufactured in Canada?
There are also States within the U.S. that have actually codified their state laws to allow for Canadian drug importation, including specialty meds. So that’s helped me to open up the doors and say, “Hey, this is real. It’s legal now and we can start it right now.”
As of May 28, 2024, seven states have passed legislation to establish importation programs for prescription drugs from Canada:
Colorado
Submitted a revised version of its State Importation Program (SIP) to the FDA in February 2024.
Florida
In January 2024, the FDA approved Florida’s plan to import millions of dollars worth of medications from Canada, including treatments for HIV, AIDS, diabetes, Hepatitis C, and psychiatric conditions. Florida estimates that the program could save up to $150 million in its first year.
Maine
Has enacted prescription drug affordability review boards.
New Hampshire
Has enacted prescription drug affordability review boards.
New Mexico
Submitted a proposal to the FDA in December 2020 and is still awaiting a response.
North Dakota
Has enacted laws to establish importation programs.
- Texas
Has enacted laws to establish importation programs
Vermont
Was the first state to pass drug importation legislation in 2018.
MTDHN: Are there any competitors in this space?
AP: When I first started, there were no competitors whatsoever.
Since then, I’ve seen a few appear. I see them more as a cost-plus model and I am not. I’ve not met one that has actually beaten the prices that I have because they have brick and mortar operations, overhead and payroll. I work out of my home office and am very efficient.
I run a low-cost operation. So as far as a true competitor, there are very few that I’ve come across who operate the way I do. I’m very flexible on how clients want reports and I’m good at what I do because I’ve got many years of experience in the insurance industry. I know the vernacular of self-insured plans.
Not a lot of people have that background, so I feel very confident and very fortunate that I’m in the position I’m in.
I have two counties and one city in Texas that are on board and I’m talking to some school districts. I’ve met with a number of other cities and counties and feel that there are viable interests on their part to learn more.
MTDHN: We’ve talked about specialty pharmaceuticals but what about those multi-million-dollar new cell and gene therapies? Is there any opportunity for that?
AP: Yes. This is going to another phase for me to go back and see what other countries are doing. It’s somewhat new and some of it is being tested.
I see that there are certain countries that do offer gene therapy as well as stem cell therapy. Naturally, the costs are much lower than the U.S. – those regions don’t have the US federal government on their backs.
I’ve seen some opportunities, but I’m not prepared to really promote it quite yet.
I need to go back out there and do my homework to really understand how they are administering and monitoring the drugs and how they are manufactured. Then I will be able to market these services with confidence that everything is ethical.
The marketplace is having a very difficult time just allowing for specialty prescriptions so this would be challenging to put into place. But if I can get my foot in the door, it’s next on my list. I’d rather walk in with something a little bit easier and within time start to promote gene therapies. It also takes a long time for the FDA to open that door and recognize the cost barriers in the U.S.
I anticipate that countries like Panama, Colombia, Thailand and others can provide the treatments a lot less expensively. Perhaps, that will be a place to start.
Overall, I see that healthcare in the United States is costing more and more with no relief in sight. Apollo Vanguard sees beyond the obvious with international solutions to offer quality healthcare, quick access, all at low cost.