Organon and Sempre Health collaborate on a pricing scheme that links patient copays to adherence

Eight years ago, Sempre Health introduced a pioneering text-based solution aimed at incentivizing patients to adhere to their medication regimens by offering financial rewards. The ultimate goal was to enhance medication adherence and affordability for patients, all the while establishing a two-sided network comprising payers and life sciences companies. Recently, Organon has joined Sempre Health’s growing list of partners. Patients who are eligible and consistently refill their prescriptions as prescribed for certain asthma therapies can now avail discounts on their medications throughout the course of their treatment.

Sempre Health has set its sights on Merck & Co.’s Dulera and Asmanex branded therapies as the primary focus for this program. Anurati Mathur, CEO of Sempre Health, highlighted two distinctive aspects of their approach: aligning stakeholders to drive affordability and adherence and engaging patients effectively through dynamic pricing based on behavioral economics and SMS communication.

The company offers a mobile text-based platform to insurers, allowing them to provide significant prescription discounts to their members who consistently fill their prescriptions on time.

Enrolled patients receive text messages with discount offers, encouraging them to promptly pick up their medications. The offers may provide lower copays for those who act quickly and higher prices for those who delay. Patients who meet the criteria are entitled to receive discounts during their purchase, and these discounts become more substantial as they maintain their therapy regimen. Additionally, the program integrates natural language text message interaction to personalize the experience for enrolled individuals.

The incentives and reminders provided by Sempre Health result in more on-time refills and help patients stay on their therapies for longer durations, as the company claims based on numerous studies. They assert that their program can boost medication adherence by more than 20% and has received a Net Promoter Score of 95

A comparison of 14,000 patients using the Sempre Health program with 58,000 patients not using it showed that 27% more patients in the Sempre cohort successfully refilled their 12th prescription compared to the other group. Over a 24-month period, the program has led to 36% more medication fills.

Patients who have benefited from the program have attested to the power of cash discounts in enhancing their medication adherence. Testimonials reflect patients’ newfound ability to afford their prescribed medications and use them regularly, positively impacting their health.

Sempre Health has expanded its reach, working with 18 health plans, including UPMC Health Plan, Cigna, Highmark, UnitedHealthcare, and several Blues plans. They currently offer 10 to 20 medications on their platform, with a focus on chronic disease medications addressing cardiovascular, metabolic, and respiratory conditions. They have particularly emphasized asthma, recognizing the challenges patients face in accessing and affording these vital medications.