Blues plans to leverage Semper Health’s gamified approach to reduce drug costs


Semper Health has blocked another $ 15 million in funding as it seeks to expand the company’s program to lower behavioral health drug costs and reduce dizzying losses to the healthcare system when patients skip their medications.

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

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

Semper Health plans to use the new capital to advance its bilateral network of payers and pharmaceutical manufacturers nationwide and to increase the number of chronic disease patients that Semper can help better afford and access their medications .

The company provides a text-based mobile platform for insurers to offer significant co-payment discounts for members to fill their prescriptions on time. This is a similar approach to the “good driver” programs offered by auto insurance companies. Semper Health sends text messages to enrolled patients offering discounts that encourage them to refuel and collect their medications quickly. An SMS can offer a patient a reduced co-payment to pick up the prescription within the week and another higher price if they wait.

This collection of new investors supporting Series B is like a light shining the way for Semper, said Anurati Mathur, co-founder and CEO of Semper Health, at Fierce Healthcare.

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They serve, she said, “as a preview of where we’re really focused on this tour. Our lead investor, the Blue Venture Fund, represents these 35 Blue Cross Blue Shield entities across the country, and we’re really excited about what this means for the pay side of the market and our ability to deliver more health plans and patients. “

The goal of San Francisco-based Semper since its founding in late 2015 has been to connect behavioral health patients, health plans and pharmaceutical companies to help drug affordability and ensure patients meet their prescriptions on time.

“One in 3 patients skip care because it is unaffordable,” Mathur said. “Then the patients are sicker and follow more expensive therapies. Health plans and the health care system pay nearly $ 300 billion unnecessarily per year because of this, and there is an impact on pharmacy revenues as well. “

Despite the money the pharmaceutical industry spends – to the tune of nearly $ 13 billion a year on direct-to-consumer coupons – “they don’t reach the right patient, their return on investment is low and lacks personalization. and engagement with one size fits all – one size fits all, ”said Mathur.

She added: “Semper was born out of what seemed like a really inefficient use of those dollars.”

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Semper’s success to date has been measured by a 15% overall increase in membership, a Net Promoter Score of 92, and significant savings for patients and healthcare.

“Patients can save 45% or more on their personal expenses over 12 months,” Mathur said. “Adhering to these high value, clinically effective drugs also reduces the total cost of care and downstream medical expenses. “

Indeed, patients have opted for the Semper program at industry-leading enrollment rates, with more than one in three guest patients choosing to enroll. Over a two-year period, enrolled patients who received incentives to refill and pick up their diabetes medications on time saved an average of $ 300 per year on out-of-pocket expenses and filled their prescriptions on time at a rate of 94%.

In total, Semper raised $ 26.5 million. In August 2018, Semper closed an $ 8 million Series A financing.

“Semper sits at a key crossroads between payers, pharmacy and patients,” Matt Downs, managing director of the Blue Venture Fund, said in a statement. Semper, he said, is “ideally placed to meet the challenge of accessibility and adherence to medications for patients.”

Semper is also likely to add more employees as he moves forward, Mathur added. Today, the company has 25 employees.

The team, she said, “will grow fast enough to reach this next level of patient volume.”

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