Solving Problems, Improving Lives: Mesfin Tegenu ’88M.S.’s Journey from Ethiopia to Pharmacy Leadership

Mesfin Tegenu ’88M.S., was originally accepted to medical school in his native Ethiopia, but a revolution and change of government disrupted the curriculum so much that he decided it was not feasible to continue. He pivoted to pharmacy and found a school in the US, where a friend recommended St. John’s University. 

Today, Mr. Tegenu is Chief Executive Officer and Chairman of RxParadigm, Inc a health-care technology company focused on improving transparency and efficiency in the pharmaceutical supply chain. His company works with hospitals, insurers, and pharmaceutical manufacturers to streamline complex reimbursement processes while ensuring compliance with evolving federal regulations, including new Medicare drug-pricing initiatives.

Mr. Tegenu experienced culture shock upon arriving in to the US from the developing world, but instantly felt at ease when he set foot on the University’s Queens, NY, campus. “I took a taxi from the airport to St. John’s, where the international admissions people were waiting for me. They helped me secure an apartment and ease my transition.”

He added, “Sitting in the campus gardens and meeting students from all over the world—that camaraderie is something I still fondly remember.”

Rather than continuing his education and earning a Ph.D. degree, Mr. Tegenu opted to obtain his New York State pharmacy license. During the yearlong process, he worked as a graduate assistant, completed an internship, and was grateful to St. John’s faculty members for the guidance they provided him. 

“I have fond memories of the great professors and mentors who guided me during my time at St. John’s.” One moment that has always stayed with Mr. Tegenu was asking Andrew J. Bartilucci, Ph.D. ’44P, ’98HON, former Dean of the College of Pharmacy, if he could apply to the Doctor of Pharmacy program.

“He looked at me and said, ‘Mesfin, you can apply—you can apply to be the president of the university. Just go for it.” That encouragement left a lasting impression on me.”

Mr. Tegenu also cited Somnath Pal, Ph.D., Professor, the late Anthony Buatti, Professor, and Robert Sause, Ph.D, R.Ph., Associate Professor, as mentors. “Their influence has remained with me well beyond my years at St. John’s.”

After being licensed, Mr. Tegenu enjoyed several opportunities before settling in the world of managed care. “Managed care pharmacy was something we were never taught in school—but it looked interesting, so I decided to try it.” 

Managed care, which integrates clinical decision-making with cost oversight across large patient populations, appealed to Mr. Tegenu because it offered a broader platform for problem-solving. Instead of practicing pharmacy for one patient at a time, he saw an opportunity to redesign systems and improve care on a much larger scale.

Eventually, a Pennsylvania health-care program that was hemorrhaging money recruited Mr. Tegenu. He developed a new pharmacy benefit management program that turned losses into profits, dramatically righting the financial ship. “We turned a pharmacy program that was losing money into one that helped grow the company across the country.”

After this initial success, Mr. Tegenu began receiving calls from other companies hoping for a similar turnaround. “After three years of losing money, that company became profitable,” he explained. “People started asking how we did it.” 

In 2003, he launched PerformRx, a pharmacy benefit manager that works with insurers and health plans to design drug benefits, negotiate pricing, manage formularies, and process prescription claims while controlling costs and improving patient outcomes. 

At the same time, Mr. Tegenu used the program to address the ballooning opioid crisis. “That was the time when certain prescription medications were killing kids in inner city streets and later in suburban America.” 

He described working on the front lines of the crisis in heavily affected states, saying his team’s efforts “resulted in closing so many opioid mills” and helped stop inappropriate prescribing through broader system initiatives.

After nearly two decades, Mr. Tegenu left PerformRx and founded RxParadigm. “When a company becomes routine and stops solving problems, it’s time to build something new.”

He added, “I’m motivated by solving problems. That’s what drives everything I’ve done.”