Sempre Health, a San Francisco, CA-based startup has officially launched a new behavior-based healthcare pricing platform that empowers consumers to lower their own medication costs over time. Founded in 2015, Sempre works with health plans and pharma manufacturers to dynamically adjust any patient’s co-payment based on individual adherence and behavior, seamlessly at the point of fill.
Matching the right patient to the right price for the right therapy is a data problem, and in the 21st century, price should no longer be “one size fits all”. All people with a given health plan have the same deductibles and copayments, regardless of individual behaviors or specific clinical needs. At the same time, 1 in 3 patients has skipped or delayed medically necessary care because of cost. These patients go on to be less healthy and more expensive to the health system and its payers.
After graduating the Alchemist Accelerator and concluding a favorable randomized controlled trial in 2016, Sempre Health is now partnering with a large regional health plan. This Sempre program will enroll heart patients and engage them over SMS, using the principles of behavioral economics to incentivize healthy decision-making.
Behavior-based, Dynamic Pricing Overview
Similar to a “good driver discount” with car insurance, if a patient is adherent and takes her medications regularly, she will pay less when filling her prescriptions. Patients can bring their own costs down over time, thereby supporting long-term behavior change and saving healthcare dollars, while addressing affordability in a unique way. Sempre’s technology parses millions of prescription records to predict the right price, for the right patient, at the right time. Then their data integrations deliver that price at any pharmacy in the US. Via SMS, patients have 24/7 access to their current discounts, why they got those discounts and guidance on how to improve.
“Patients who are committed to making healthy choices improve their own outcomes and bring significant savings to the system, yet they rarely get any financial benefit for doing the right thing. What kind of healthy behaviors might we have if it weren’t expensive to have them?”, said Anurati Mathur, Sempre Health CEO in a statement. “With Sempre, your behavior is currency, and it counts towards the health expenses you face every day.”
Sempre recently raised a $2.5M seed round last year from Social Capital, a top-tier Silicon Valley investor in consumer healthcare.