How UCHealth and a Denver Startup are Partnering to Make Sure Patients can Afford Their Prescriptions


How UCHealth and a Denver Startup are Partnering to Make Sure Patients can Afford Their Prescriptions

As reported in the Denver Business Journal, by Jensen Werley.

What started as a book of pharmaceuticals organized by efficacy and cost has been built into a Denver startup that has recently raised $15.9 million through its partnership with UCHealth.

RxRevu has developed a platform that helps doctors prescribe medication that is covered by a patient’s insurance. The program is embedded into a health system’s electronic medical records, so they know exactly what insurance a patient has, whether the medication they want to prescribe is covered and if not what equally effective medication they could prescribe instead that is covered by the patient’s provider.

The startup was founded in 2013, when Chief Medical Officer Kevin O’Brien put together a book of drugs organized by their clinical efficacy and cost. He was looking to publish the book when he met Carm Huntress, a 20-year technologist who thought the research would be more effective as a technology solution rather than a static book.

Carm Huntress, CEO of RxRevu, with Dr. Richard Zane, chief innovation officer at UCHealth.

“He and I came together and started the company from that book and built it into the platform,” Huntress told Denver Business Journal.

Transforming a book into a tech solution took time, Huntress said. They started with building a taxonomy of drug information using public sources and purchasing some content to build a large database of drug names and durations. Then they layered in their own intellectual property around the drugs’ clinical efficacy and realtime pricing.

It eventually turned into a software-solution aimed at doctors, that would provide cost transparency and go on to save patients and insurance providers money. The platform is called SwiftRx.

The solution also caught the eye of UCHealth’s innovation program, who was looking to help its doctors make effective prescribing decisions that would be affordable to patients. Before RxRevu’s solutions, doctors would prescribe what they thought would be the most effective drug with no knowledge of whether the patient could afford it. That could kick off a multi-step process of the pharmacist catching that the drug wasn’t covered and connecting with the doctor to get the prescription changed, the patient having to call the doctor to ask them to prescribe a similar medication they could afford, or even situations where the patients just don’t pick up their medication because they can’t pay for it.

“We at UCHealth want to help providers make better decisions in how we deliver patient care,” Dr. Richard Zane, chief innovation officer at UCHealth, told DBJ. “If we see you as a patient and you have high blood pressure, we need to pick a medicine for you. We want a medicine to be compatible with your other medicines, but we also want to see if it’s covered by your insurance and can you afford it. There’s no utility in me picking up the right medicine if you’re not going to pick it up from the pharmacy.”

UCHealth, which led RxRevu’s Series A funding round of $15.9 million, worked with the startup to integrate its platform directly into UCHealth’s electronic medical record system. When doctors prescribe medication, a patient’s coverage information is right there next to all their medical history.

“Getting it embedded was incredibly daunting,” Zane said, adding it took more than 2 years. “We started with writing the application, which was not part of the native electronic medical record but integrated so it appeared to be part of it. Then we worked with the electronic medical provider to have it embedded within the native system. It was an enormous deal, especially for one system and startup to accomplish this.”

The platform is free to hospitals, Huntress said. Because the savings go to the patient and the insurance company, the insurers pay RxRevu a transactional fee to get the data to the doctors because it’s the insurers that see the return on investment.

“It’s a small transaction fee to save hundreds of thousands of dollars on a per patient basis,” Huntress said. “So we give it free to doctors.”

The $15.9 million will be used for growing the company, Huntress said. The company has 24 team members, and the round will be used to add more staff. It will also be used to expand where RxRevu’s platform is available.

The next step will be to get more health systems on board, said Zane, who is also on the Board of Directors for RxRevu. Huntress added that as of now, only 10% of doctors have access to the data RxRevu provides.

“It has to continue to grow and become ubiquitous and seamless,” Zane said. “It has to go to other medical records. It’s not just applicable to us but the other 400 health systems in the U.S.”

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