Startup Reaches $1 Billion Valuation Processing Prescription Drug Paperwork With AI

Nearly one third of Americans never fill the prescriptions their doctors order. The company developed AI software that automates the administrative work required to process those prescriptions so patients can receive the medications. The system activates the moment a physician writes a prescription.

It determines details such as medications a patient has tried previously and any restrictions on which pharmacy can fill it. Both the doctor and the patient can track the status in real time. "We reduce a huge amount of headache, paperwork and phone calls," the founder said.

The company reported that thousands of medical practices and health systems now rely on its technology. Usage has grown through a 10-fold annual increase for the past two years driven almost entirely by word of mouth. Medical practices using the software have seen prescription fill rates rise over time.

The company announced today that it reached a $1 billion valuation after raising $160 million in total funding. Investors include Thrive Capital, General Catalyst and Accel each of which led a previously unannounced round. The company said its annualized revenue surpassed $10 million by the end of last year.

Revenue has roughly quintupled so far this year putting the annualized run rate above $50 million.

A former product leader at a health insurer the founder observed the complexities of prescription drug coverage. Once a medication is prescribed it must be routed to the appropriate pharmacy based on insurance. Patients may also require assistance with affordability programs for high-cost specialty drugs or appeals when coverage is denied.

The company noted that specialty drugs for cancers and autoimmune diseases often cost thousands or hundreds of thousands of dollars. These therapies typically require processing through specialty pharmacies and additional approval layers. The software addresses those administrative steps.

The company works primarily with pharmaceutical manufacturers rather than charging doctors or patients. It has partnerships with half of the top 10 global pharmaceutical companies as well as several fast-growing startups. The company is supporting several large drug launches this year by handling insurance processing and ensuring pharmacy stock levels.

Prescription drug spending is expected to surpass $1 trillion this year according to a report from the American Society of Health-System Pharmacists. That would leave more than $300 billion in therapies unfilled. One executive who previously led a major pharmaceutical company said that nearly 50 percent of prescriptions were not adhered to and 35 percent of new scripts went unfilled while he was in that role.

About four in 10 U.S. adults reported not taking medication as prescribed in the past year due to costs according to a recent KFF poll. Larger shares among lower-income, uninsured, women, Black and Hispanic adults said they took measures such as switching to over-the-counter drugs or splitting pills.

Taking medications as prescribed can reduce broader healthcare costs by preventing serious complications that lead to emergency care or surgery. The founder stated that too few eligible patients receive treatment even when drugs reach the market. The company positions its technology as addressing the last-mile problem in getting approved therapies to patients.