Health

Blues plans banking on Sempre Health’s gamified approach to slash medication costs

Sempre Health has locked up another $15 million in financing as it looks to expand the company’s program to trim costs for behavioral health medication and cut skyrocketing healthcare system losses when patients skip their medications.

The series B funding was led by the Blue Venture Fund—a collaboration of Blue Cross Blue Shield companies, the Blue Cross Blue Shield Association and Sandbox, to which 35 BCBS companies have committed more than $890 million across four funds.

UPMC Enterprises and existing investors Rethink Impact, LifeForce Capital and Industry Ventures also participated.

Sempre Health plans to use the fresh capital to advance its two-sided network of payers and pharma manufacturers nationwide and to increase the number of chronic disease patients Sempre can help better afford and access their medications.

The company provides a mobile text-based platform to insurers to offer large prescription copay discounts to members for filling their prescriptions on time. It’s a similar approach to “good driver” programs offered by car insurance companies. Sempre Health sends enrolled patients text messages offering discounts that encourage them to fill and pick up their medications quickly. A text message might offer a patient a discounted copay to pick up the prescription within the week and another, higher price if he or she waits.

That collection of new investors backing the series B round is like a light shining the way for Sempre, Anurati Mathur, co-founder and CEO of Sempre Health, told Fierce Healthcare.

RELATED: Novo Nordisk tackles outcomes and affordability with pilot tying copays to adherence

They serve, she said, “as a preview into where we are really focused in this round. Our lead investor, the Blue Venture Fund, represents those 35 Blue Cross Blue Shield entities across the country, and we are really excited about what that means for the payer side of the marketplace and our ability to bring on more health plans and patients.”

San Francisco-based Sempre’s aim since its founding at the end of 2015 has been to connect behavioral health patients, health plans and pharmaceutical companies to help with the affordability of medications and ensure that patients fill their prescriptions on time.

“One in 3 patients skip care because it is unaffordable,” Mathur said. “Then the patients are sicker and go on to more expensive therapies. Health plans and the health system are paying nearly $300 billion unnecessarily a year because of this, and there is a revenue impact to pharma as well.”

Despite the money the pharmaceutical industry spends—to the tune of almost $13 billion a year on direct-to-consumer coupons—“they don’t reach the right patient, they are low ROI and lacking personalization and engagement with a one-size-fits-all approach,” Mathur said.

She added, “Sempre was born out of what appeared to be a really inefficient use of those dollars.”

RELATED: Johns Hopkins spinout Emocha Health closes $6.2M series A for video-based medication adherence

Sempre’s success so far has been measured in a 15% jump in adherence overall, a 92 net promoter score and significant savings for patients and healthcare.

“Patients can save 45% or more on their out-of-pocket costs in over 12 months,” Mathur said. “Adhering to these high value, clinically effective medications reduces the total cost of care and medical spend downstream as well.”

Indeed, patients opted in to the Sempre program at industry-leading enrollment rates, with more than 1 in 3 invited patients choosing to enroll. Over a two-year period, enrolled patients who were offered incentives to refill and pick up their diabetes medications on time saved on average of $300 per year on their out-of-pocket costs and filled their prescriptions on time at a 94% rate. 

In all, Sempre has raised $26.5 million. In August 2018, Sempre closed on $8 million in series A financing.

“Sempre sits at a key intersection between payors, pharma, and patients,” said Matt Downs, managing director of the Blue Venture Fund, in a statement. Sempre, he said, is “uniquely positioned to tackle the challenge of patient drug affordability and adherence.”

Sempre also is likely to add employees as it presses forward, Mathur added. Today, the company has 25 employees.

The team, she said, “will grow pretty rapidly to reach that next level of patient volume.”

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