Exploring the Healthcare Sector

This past week, we have been conducting needfinding interviews and prototyping some of our solution ideas. We are thrilled to announce that we finalized our project scope, and we are very excited to start diving deeper in this area.

Before we state our problem statement, let’s give a bit of a background. In the U.S. healthcare sector, employers insure their employees through health care plans. There are thousands of insurers that are in this market. Each of insurers create healthcare plans and formularies, which essentially specify the list of drugs and the copays that the healthcare plan covers. Insurers then work with Pharmacy Benefit Managers (PBMs) to negotiate deals from the pharmaceutical companies and distributors.

Since there are very many insurers that need to interact with many pharmaceutical companies, and the larger the buyers are the lower the price can be, PBMs play a very large role in the healthcare sector. Here is a fun fact about the PBMs: PBM companies that collectively bring in almost $300 billion in revenues each year and engage more than 210 million Americans through their services.

It is odd to us that there have been very few efforts in the past to replace this functionality of PBM services. So our problem statement is to create a distributed marketplace where we aggregate the buying power of many insurers for each of the drugs they are planning to cover and negotiate prices with the pharmaceutical companies. Our end goal is to distribute this profit to make prescription drugs in the US more affordable.