Why we’re betting on physician practices to improve patient access to some of the most effective drugs available.
After 12 months of quietly assembling a world-class team and initial product, we’re excited to publicly launch House Rx, a healthcare technology and services company dedicated to making specialty medications more accessible and affordable.
What are specialty medications, you might ask? They’re some of the most miraculous, life saving drugs out there, including the most innovative treatments for cancer, autoimmune disease and other debilitating and life-threatening diseases. They are also the most expensive drugs in the world, running tens or hundreds of thousands of dollars annually per patient.
The specialty pharmacy market is one of largest segments of healthcare yet it is one of the least visible and most poorly-understood. In part for this reason, it is also largely untouched by competition. The market has been “rolled up” by three very large – and bureaucratic – pharmacy benefit management (PBM) companies. The resulting experience both for patients and doctors is underwhelming, to say the least.
Olivia Webb, author of a great blog called acutecondition.com, recently posted about her experience calling into a large specialty pharmacy. She was trying to fill a prescription for Humira, an incredible drug that treats many different conditions, including her Crohn's disease:
“As a Humira user, every month I have to call into a phone tree, suffer the Muzak, talk to a bored call center representative who knows nothing about Crohn’s disease or Humira.”
My House Rx co-founder, Tesh Khullar, described his own experience dealing with specialty pharmacy roadblocks when his mother was battling breast cancer in 2007.
The way this market works is in stark contrast to the everyday pharmacy experience most of us are accustomed to. Once your doctor prescribes a “specialty” medication, you will soon find yourself down the specialty pharmacy rabbit hole, in a strange new land with new and confusing rules.
Here’s how it goes: To start off, you cannot simply bring the script to your local pharmacy. You must first have endless phone conversations to navigate prior authorization and a series of maddening hoops to confirm coverage. Once you’ve spent weeks running through that gauntlet, you will learn that you can only get the drug via mail order, and perhaps most unbelievably, only directly from a pharmacy owned by your insurance company! Yes you heard that right, not your local pharmacy, not your doctor, not an online pharmacy of your choice, but your insurance company, the same one your employer most likely chose for you.
So what’s that experience like? Well, the patient stories say it all. Search “specialty pharmacy” on Twitter and you will see no shortage of frustrating, often heartbreaking stories of patients struggling to get access to the medications they need.
The experience for the doctors and the care teams is no better. Frustrated patients typically call their doctor’s office to let them know they’re having a hard time cutting through the red tape to get their hands on the treatment they were prescribed. In response, clinics hire full time staff to do nothing but help their patients battle the bureaucracies of large insurance companies. Unlike their clinical work, this work is not reimbursable. They do it at a loss to help their patients access medically-necessary medications.
What’s even worse, is that after obtaining all the approvals, doctors have no visibility into whether their patient ever received the medication, nor whether they took it, had any side effects, or kept taking it. Patients return months later with their conditions worsened or inflamed, all because the patient was never able to begin their prescribed treatment.
In short, the system is broken. House Rx’s vision for the future of specialty pharmacy is one where patients get to choose both their providers and their pharmacy, interacting with an integrated and trusted care team to improve a serious condition or illness.
The cornerstone of our model is “medically integrated dispensing” - a simple yet radical idea where the doctors, nursing staff, pharmacist and technicians work together as one team, under one proverbial roof.
This approach was pioneered in oncology, out of sheer life and death necessity. It largely side-steps the bureaucracies and enables physicians, with the help of an “in-house” pharmacy team, to dispense key medication directly to their patients. By leveraging the existing infrastructure of thousands of clinics across the countries, specialty pharmacy can become a local, more intimate, more trusted experience.
Backed by Bessemer Ventures and First Round Capital, House Rx is building the first technology platform specifically designed to enable medically integrated dispensing. Complemented by our expert specialty pharmacy team, we augment the staff of existing clinics to quickly help them add this capability to their repertoire. This helps patients get on therapy faster, and stay on therapy more successfully, which leads to much better outcomes.
At the few clinics who have already adopted medically integrated dispensing, the results have been incredible:
10+ days faster time to therapy 25% better adherence rates 50% better patient satisfaction score
Our vision is to make the medically integrated model the new normal in specialty pharmacy. We want to help many more clinics successfully implement this approach and assist clinics who have bravely started doing this on their own, do it better, more efficiently and more effectively.
If you’re a specialty clinic or a patient in need of specialty treatment, we look forward to meeting you soon.