Sempre Health works with leading health plans and pharmaceutical companies to improve adherence and reduce out-of-pocket costs for patients. Through technology, behavioral science, dynamic pricing, and incentive alignment, Sempre allows patients to share in the cost savings their responsible health decisions are generating for insurers, care providers, and pharmaceutical companies.
There are two unique aspects of the Sempre model: 1) the two-sided marketplace, aligning health plans and pharma to drive adherence and affordability and 2) the novel way of engaging patients with dynamic discounts and accompanying SMS-based engagement. Together, these elements propel and accelerate Sempre’s flywheel effect: a) Patients receive nearly 60% off their out-of-pocket costs, on life-saving, chronic disease medications, with a lightweight product which boasts ~30% enrollment rates. → This drives Sempre’s 92 NPS and 25% improvement in adherence. b) When patients are happy and their adherence improves, health plans are attracted to and retained on the Sempre platform. Further, Sempre’s product is lightweight, clinically configurable, and free of cost to payers. → This drives an increased demand for additional medications on the platform. c) As more payers and patients increasingly utilize the product, pharma realizes substantial improvements in length of therapy and distribution, which combined with favorable unit economics, lead to outsized ROIs. → This drives increased investment of funds into the platform. The network effects realized by the Sempre platform create an increasingly differentiated and defensible offering on the market.
1 in 3 patients skips on their medications because of cost, and this underlying non-adherence is thought to drive nearly $290 billion in direct and indirect cost annually. At the same time, cost-sharing for these patients is largely one-size-fits-all with very little power to incentivize behavior change: affordability remains a huge barrier to adherence. Both health plans and life science companies seek to improve adherence to branded medications, when they are high-value and without a generic alternative. While pharma invests billions annually in traditional direct-to-consumer coupons, payers often lack the capital to affect affordability in a meaningful way. Sempre matches the supply of these existing pharma dollars to the demand for affordability and adherence from health plans and patients. By aligning these key stakeholders, Sempre has created a novel distribution channel for pharma manufacturers, who can now reach patients via their insurers, at a fraction of the cost required to market and distribute traditional coupons. This efficiency, combined with significant improvements in length of therapy, drive outsized returns for payers and pharma alike.
For payers: Sempre and a large regional health plan conducted a study to understand Sempre’s adherence intervention fully insured cardiovascular patients taking anti-platelet medication. The intervention period was from July 2017 to July 2018. Patients in the treatment group experienced a 16.5% increase in the proportion of days covered (PDC) and a 12.1% decrease in healthcare costs. Results show that medical utilization and emergency department admissions decreased by 13% in the treatment group and only by 4.6% in the control group. With Sempre’s intervention, UPMC was able to annually save an average of $1,400 in costs per patient. Depending on the medications selected, Sempre can deliver an ROI up to 4X for its payer partners. For manufacturers: Sempre drives clinical ROI by boosting population medication adherence, while simultaneously driving economic ROI by extending length of therapy and bringing patients back to therapy at a fraction of the cost associated with marketing and distributing traditional copay cards. A recent press release published with Sanofi showed the impact of Sempre’s dynamic pricing and text reminders on their diabetes portfolio: including a 25% increase in population medication adherence and more than 3 additional fills per patient. This increased length of therapy for actively-filling patients, along with the fact that ~15% of Sempre patients are recovered after having stopped filling in the past delivers substantial ROI to manufacturers.