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Behavioral Economic-Based Incentives in the Pharmaceutical Value Chain
Episode 687

Kyle Wildnauer-Haigney is the Vice President of Strategy and Business Development at Sempre Health

Behavioral Economic-Based Incentives in the Pharmaceutical Value Chain

Healthcare provides many different challenges and not all of them are necessarily related to medicine, there can also be financial challenges. Our guest for today has experience across many different verticals and healthcare, but he has specialized in the pharmaceutical value chain.

Kyle Wildnauer-Haigney, Vice President of Strategy and Business Development at Sempre Health will share information on how text messaging can be a cost-efficient way to encourage healthy behavior and help patients save money. He will also give us some sight into Sempre’s focus on diabetes, cardiovascular and respiratory markets, and how it has been able to create savings for patients in about 45% a year.

Make sure you listen to our podcast to get really good nuggets of information on this market.

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Behavioral Economic-Based Incentives in the Pharmaceutical Value Chain

Episode 687

About Guest

Kyle Wildnauer-Haigney is the Vice President of Strategy and Business Development at Sempre Health, he has a BA in Economics and an MBA in Strategy and Finance from Northwestern University. 

He has been in healthcare for over 10 years and in areas involving innovation, product and strategy consulting. He is also passionate about using technology and innovative business models to align stakeholders to support. 

Behavioral Economic-Based Incentives in the Pharmaceutical Value Cain with Kyle Wildnauer-Haigney is the Vice President of Strategy and Business Development at Sempre Health: Audio automatically transcribed by Sonix

Behavioral Economic-Based Incentives in the Pharmaceutical Value Cain with Kyle Wildnauer-Haigney is the Vice President of Strategy and Business Development at Sempre Health: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket Saul Marquez is here again, and today I have the privilege of hosting Kyle Wildnauer-Haigney. He is the Vice President of Strategy and Business Development at Sempre Health. He has over 10 years of experience in healthcare, including innovation at DaVita HealthCare Partners, product at RxREVU and strategy consulting at L.E.K and Boston Consulting Group. While he has experience across many different verticals and healthcare, he specialized in the pharmaceutical value chain and ultimately working with all the key stakeholders to make pharmacy patient-centered. We know this is a key area of focus for many employers, but also helping pharma companies really drive efficiencies and optimize the opportunities for making the supply chain better. It’s super interesting to me and I know to many of you so I’m excited for our conversation with Kyle today on the podcast. Kyle welcome to the show.

Kyle Wildnauer-Haigney:
Hey, thanks for having me Saul, I really appreciate it.

Saul Marquez:
Absolutely. Now, before we dive into Sempre Health and what you guys are doing there to really focus on health plans and this pharma chain value chain. Talk to us a little bit about you and specifically what keeps your fire lit in healthcare.

Kyle Wildnauer-Haigney:
Thanks for asking that question. From an early age, I really learned about the impact that caregivers and the healthcare system can have on individuals. My father is a doctor in Maine and he would tell stories around the dinner table about his patients and the types of pain and specifically the suffering that he treated. More often than not, financial challenges were involved in those stories, not just the medical challenges. And so I was naturally preconditioned to go into healthcare when I graduated college. And from those early stories around the dinner table drawn to the complex problems of cost and affordability in the healthcare system. From my first job at DaVita healthcare partners, I realized how much opportunity there is to improve the healthcare system and how difficult it can be to enact change. That has set me on my current path and really what inspires me to keep pushing forward.

Saul Marquez:
Well, I think it’s great. And, you know, it sounds like it’s been in the family for a while. You’ve taken a different angle on it. But ultimately, you know, that monetary perspective that sort of rose to the top with conversations with your dad and just ultimately seeing how the system works is kind of what struck a chord with you, and that’s where you’ve focused your work. So obviously, RxREVUE and DaVita, two organizations focused on that. But now your work with Sempre Health is also focused on that pharma space. Talk to us a little bit about how you guys are adding value to the healthcare ecosystem there.

Kyle Wildnauer-Haigney:
Yeah, happy to. So, we think about Sempre Health. We essentially provide a good driver discount for prescription medications. We are adherence to intervention that reminds patients to pick up their medication and provides a point of sale discount on their copay when they pick it up on time. This discount is somewhat unique in that it grows as they continue to pick it up with each bill and they typically save about forty-five to fifty-five percent per year on their out-of-pocket costs. One thing that I think is important to note about Sempre Health is that we are only focused on single-source branded drugs. So these are products that don’t have a generic alternative. And we do this because it actually adds value to the healthcare system, rather than steering patients to an expensive branded product when there’s a generic alternative. The product is 100% text message-based. There is no ads, downloads, usernames or passwords. That could be friction points for the patients to receive their discounts. And to really illustrate what the product is, is once you’re enrolled in the program, you’ll get a text that might say, Saul, it is time to pick up your prescription drug.

Kyle Wildnauer-Haigney:
Usually, you pay fifty dollars, but with Sempre, you’ll just pay forty dollars. If you fill on time, your next fill will just be thirty-five dollars. So that discount grows over the course of each fill. These text messages are highly personalized. So the username they have all the background of your pharmacy and medical history. And the core tenet of Sempre is that we believe that patients should get to participate in the savings that are accrued by their healthy behaviors. So to directly answer your question of how we add value, it’s really threefold. So first, we improve adherence by over 15% for patients on the Sempre program, which translates into thousands of dollars in a reduction in the total cost of care. Second, we drive affordability for patients and typically save them 45% per year. And then finally, we create a really high-value member experience. We have a ninety-two net promoter score, which we’re very proud of.

Saul Marquez:
That’s fantastic. And the simplicity of the program, the, you know, the incentives that can drive behavior are are in place. What would you say makes you guys special and different than other services that might be available like this out there?

Kyle Wildnauer-Haigney:
That’s a great question. So, first of all, I’ll walk you through kind of how Sempre works at a very high level and then kind of call out the two unique innovations of Sempre. So first, we go to pharma manufacturers, have them put a drug on the platform and allocate a discount budget that we will distribute to those members. Second, we go to plans and have them select from the menu of drugs which ones they want to turn on discounts to their members. And that’s the first key innovation of Sempre Health, is that the plan is in complete control and has complete agency on turning on those discounts. Once the plan selects which medications they want to offer to their members. We do all the heavy lifting of enrolling the members into the program. So it looks like the mailer-email, text message in some case, reach out to the members and have them enroll in the program. They start receiving text messages, as I illustrated before. And then finally, we see the benefit of improvement in adherence to NPS and reduction in downstream medical costs. The second innovation that I think is unique to Sempre is really at the product level and it’s that dynamic discount. So we have some really sophisticated technology that we’ve built in-house to understand what discount to offer each patient to help them be adherent to that prescription that they are on.

Saul Marquez:
Fascinating. That’s really, really interesting and the approach empowers the patient. You give them the opportunity to decide, you give them a product to act and the opportunity to save. And now with so much money getting siphoned out of the actual consumer through larger co-pays and, I’m blanking on the deductible. Exactly. You know, any opportunity to save is going to be acted on. And so talk to us a little bit about those. Let’s drill into them. You talked about net promoter scores, you talked about 15% improvement. Let’s dive into those deeper. Talk to us about those results.

Kyle Wildnauer-Haigney:
Yeah, I think one thing that we have seen is that text message is just a fantastic medium to engage patients in pharmacy type questions and sending them reminders. And, you know, this is really based upon a lot of experience that the CEO and I have from DaVita healthcare partners. So dealing with the diabetes population, there are many different socioeconomic challenges that that population faces. And many times, they might not have the latest updated phone or app downloaded to help them engage in their health and to be healthy numbers. So we thought, let’s design a program that is accessible to all. So that’s why we chose text messages. I think the high NPS is really driven because we’re a free program that helps members save forty-five to fifty-five percent per year on their out-of-pocket costs. We send them reminders saying it’s time to pick up. You can say you’ve saved five hundred dollars or more for some patients and that creates a lot of goodwill with the patient and a lot of that positive NPS that we capture transfers back to the plan. So they get really positive feedback as well when partnering with Sempre Health.

Saul Marquez:
Fascinating. Thank you for that. By the way, Kyle, very interesting. And you know, we think about the different subpopulations of the insured. You’ve got those being insured by employers. You’ve got Medicare Advantage. Tell us where you’re where your niche is right now and how specifically you’re able to help them out and what makes you excited about it?

Kyle Wildnauer-Haigney:
Currently we only focus on commercial insured, whether that’s fully insured or self-insured. The three disease states that we specialize in today are diabetes, cardiovascular and respiratory. Probably not a surprise for you and the listeners. That list of drugs and disease states that we focus on is really driven by our payer partners, so we don’t contract with any pharmaceutical manufacturer where there isn’t already demand from our payers, so we will talk to them, say hey, you know, what other disease states would you like us to add to the platform? And then we do that across all of our partners and aggregate that list and then go to our pharmaceutical manufacturers and say we have ten plus plans that are interested in receiving discounts for your product and it would increase adherence and ultimately no frills by X percent. So it is really quite a nice niche that we operate within because the pharmaceutical manufacturer, the payer and the patient are all aligned. And to go back to your earlier question, I think that’s something that’s somewhat unique in healthcare is when you find aligned incentives across all key stakeholders, something that’s really exciting.

Saul Marquez:
Yeah, it’s interesting because and correct me if I’m wrong, but there’s also sort of a GPO play here where you’re you’re aggregating purchasers and presenting them to the seller and creating opportunities on both sides of that chain.

Kyle Wildnauer-Haigney:
Definitely. We have been very disciplined in our approach to the market thus far. You know, I really think that so much of the success of startups is based on the ability to focus on one problem, on one solution. Right now, we are partnering with payers and farm manufacturers with our current kind of go to market strategy, as I described. In the future though, there are a number of different channels that we could leverage to really expand the footprint, although currently we are still focused on the payer and pharma manufacturer.

Saul Marquez:
Fascinating. I love it. And I think it’s it’s one of those win, win-wins and I’ve been seeing a lot more successful businesses and the ones that succeed are the ones that don’t ignore any of the stakeholders. Right. like you really have to give value to every stakeholder in the value chain.

Kyle Wildnauer-Haigney:
No, I think I’ve experienced that firsthand, that Sempre by nature we kind of view ourselves as a two-sided marketplace. So we contract with pharma and payers on either side of the market. And when we create value for pharma, it’s really driven by signing up a number of plans on one side of the value. We create value for plans by having a robust portfolio of drugs that we can offer them. And I think these platform or marketplace business models really do a great job of aligning incentives and allocating resources efficiently. So that’s what we’re experiencing that temporary, there’s a whole host of startups currently out in the marketplace, not just in the pharmaceutical value chain, but across healthcare that are leveraging this sort of business model to just really provide benefit to all those key stakeholders.

Saul Marquez:
Yeah, that’s super interesting. And so you’re obviously excited about the progress and the work and the results. But what would you say is, is that cherry on top? What are you most excited about?

Kyle Wildnauer-Haigney:
Yeah, that’s a great question. There is a number of trends that are going on in the pharmaceutical value chain that I think really will precipitate a lot of change for good across all those key stakeholders. Right now, what I’m most excited about is the proliferation of value-based contracts for pharmaceuticals. I see this as a game-changer for the industry that will better align incentives between all key stakeholders and lead to higher-value care. From Sempre’s perspective too, I think this will be a huge driver because, you know, often in these value-based contracts, there is an adherence clause in them that means the drug must have a minimum, no amount of adherence for the contract to actually have teeth in exchange value. We have found success in being that insurance intervention in these value-based contracts to ensure that the patient is taking the drug. And you can actually study how the drug performs in that population.

Saul Marquez:
That’s interesting. Very, very exciting too to think about that. And, you know, and this applies in clinical trials as well, I mean, there’s so many things you could do, but the power of focus is key.

Kyle Wildnauer-Haigney:
Yeah, absolutely.

Saul Marquez:
Kudos to you and your team for staying focused here and providing that value across the chain. What do you want us to walk away from this conversation with Kyle? Give us a closing thought here and the best place that the listeners could reach out to you if they want to continue the conversation or learn more about Sempre.

Kyle Wildnauer-Haigney:
Yeah, happy to. So you want to think about all the change that is happening in the healthcare system? I genuinely believe that we’re still in the early innings of innovation, kind of this great unlock that we’re seeing the healthcare system. I believe in this next stage, we will only see exciting new technologies be implemented, but also the alignment of incentives, the reshuffling of key stakeholders to add more value to the overall healthcare system. And I believe as we move forward, we have to keep the patient at the front of our minds. I’m confident that if we do have designed all these solutions to implement these new technologies with a patient at the center, we will create the world’s best healthcare system that we can all be really proud of. If anyone would like to contact me, LinkedIn is a great place, but you can also reach me at kyle@semprehealth.com.

Saul Marquez:
Outstanding Kyle and folks for Kyles’ email, for a link to his LinkedIn, link to Sempre Health, which is SempreHealth.com just go to OutcomesRocket.health. Type in Sempre S-E-M-P-R-E. Our search bar it’s updated and it’s amazing. You could find any episode you want on there, but for this one type in Sempre, you’ll find the entire transcript, show notes, links everything we’ve talked about there with Kyle. Kyle what a great and interesting conversation. Really appreciate the insights you’ve shared and also the neat work that you guys are doing at Sempre to help improve that supply chain and value to the consumer.

Kyle Wildnauer-Haigney:
Thanks for having me. It’s been great.

Saul Marquez:
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Things You’ll Learn

  • There is great value in providing good driver discounts for prescription medication. 
  • Members’ experience and affordability for patients are always important and will provide benefits to your net promoter scores. 
  • The ability to focus on one problem and one solution is key to success. 

 

Resources

https://www.linkedin.com/in/kylewildnauerhaigney/

kyle@semprehealth.com 

https://www.semprehealth.com/