Health tech startup Forus, a company that automates prescription workflows with artificial intelligence, is partnering with the American Gastroenterological Association to improve medication access for patients living with digestive diseases.
Forus, formerly known as Tandem, built an artificial intelligence-powered network that connects doctors, pharmacies, payers and biopharma to automate the path from prescription to patient. Forus' technology handles the tedious back-end administrative work that often creates friction points, making it harder for patients to get the medications they need. The company automates prior authorizations, appeals, financial assistance and pharmacy routing across different stakeholders. It's free for both doctors and patients to use.
The company's aim is simple, according to Sahir Jaggi, CEO and founder: "We're focused on helping people get access to medicine faster, easier and cheaper, most impactful for folks with high cost and complex conditions.
With conditions like autoimmune diseases, COPD, psoriasis and cancers, drugs can be high cost without insurance coverage or financial assistance and often have complicated supply chains. "It might take a doctor and patient weeks of phone calls, research and paperwork to get the medicine on time and affordably. What we're doing is using AI to take on all that complexity and abstract it from them to get their medicine without any of the burden falling on their shoulders," he told Fierce Healthcare. "Our AI platform picks up exactly where the doctor's office writes the prescription and carries it all the way through until the medications are ready for pickup at the pharmacy or delivery, keeping both the patient and the provider informed along the way."
The company, launched three years ago, is used by thousands of medical practices and health systems in all 50 states and is expanding rapidly across specialties, according to Forus executives. Provider adoption grew 10x year-over-year for the last two years. Forus now supports people in nearly 80% of U.S. residential zip codes, including many patients with complex conditions, according to the company.
AGA sets evidence-based standards for digestive disease care and advocates on behalf of GI patients and the clinicians who treat them. The strategic partnership pairs AGA's clinical leadership with Forus's medication access platform to help GI patients get faster access to the therapies their physicians prescribe.
"As we've grown, gastroenterology, GI, has become one of our biggest and most quickly growing specialties in which we're supporting patients and physicians. We've been thinking a lot about different ways that we can expand the reach of our impact beyond what we're doing directly with providers and practices that use our platform," Jaggi said.
Patients with digestive diseases too often face delays or denials when trying to start the treatment their physicians recommend. The partnership combines AGA's clinical leadership with Forus's unique view of the medication access process to help AGA strengthen its advocacy for patients and deepen the value its clinical guidance delivers to members.
"We have obviously a lot of overlap in our goals, in particular, in helping physician practices operate more efficiently and successfully and then also in supporting medication access for GI patients," Jaggi said.
"The orientation there is understanding where are providers already taking advantage of the resources that AGA is producing and how are they helping them get their patients the right treatment at the right time, but then second, where are you seeing gaps in the system, and where are those concentrated?" Jaggi said.
Those gaps might be due to financial access barriers, practice patterns or payer policies, Jaggi noted.
"AGA exists to advance GI care and to advocate for the patients our members treat,” said Alison Kim, PhD, AGA vice president of clinical and scientific affairs. “We have long worked with our clinician members, patient partners, and other stakeholders in digestive health to better understand the barriers patients face getting their medications. Partnering with Forus strengthens that work by giving us another tool to identify and address these barriers, whether with payors, policymakers, or on behalf of our members," said Alison Kim, Ph.D., AGA vice president of clinical and scientific affairs.
The collaboration is built to grow over time, with joint findings and resources for the GI community expected as the partnership develops. The larger goal, the organizations say, is to illustrate how a leading medical society and a widely used AI platform can work together to advance access to medicine for an entire field.
"We have the benefit of being really focused on this problem of medication access and so we understand some of these nitty gritty pieces, ranging from prior authorizations to financial affordability and access challenges to even the dynamics of fulfillment. We also deeply understand the specific medications and conditions they're working in so we can connect the dots in a way that is a bit closer tied to infrastructure we've already built and expertise we've already built around these processes," Jaggi said.
The partnership with AGA also could potentially serve as a blueprint for future collaborations.
"I think there will be some opportunities for us to take what we learn here and bring those to other categories and specialties," he noted.
In May, the company raised $160 million at a $1 billion valuation to expand its AI-powered prescription processing platform. The startup is backed by Thrive Capital, General Catalyst, Accel, Bain Capital Ventures (BCV), Redpoint, BoxGroup and Pear VC.
In an interview in May, Jaggi told Fierce Healthcare the company planned to use the funding to accelerate growth in three key areas: expanding its platform to more physician practices and specialties, investing in AI and platform capabilities to better navigate complex prescription and treatment workflows and growing its team—particularly in engineering and operations—to support that scale and innovation.