Sempre Health

What Sempre Health does

Sempre Health is a San Francisco-based digital health company that operates a behavior-based dynamic pricing platform for prescription medications. The platform dynamically adjusts patient copay costs based on adherence behavior — patients who refill on time receive growing discounts over time, while those who refill late pay more — with discounts applied automatically at the point of sale at retail pharmacies. Members enroll via SMS using a four-letter code with no app, download, or account required, and receive text reminders with expected copay amounts before each refill. The company holds a patent on its automatic refill submission technology and offers a real-time web analytics dashboard for health plan partners.

The company's two-sided business model aligns pharmaceutical manufacturers, health plans/PBMs, and patients. Pharmaceutical manufacturers fund the discounts in exchange for improved adherence, longer therapy duration, and guaranteed exclusion from copay accumulator and maximizer programs (ensuring 100% of manufacturer dollars reach patients). Health plans and PBMs contract with Sempre to deliver the affordability and adherence program to their members, targeting chronic conditions in diabetes, cardiovascular, and respiratory therapeutic areas. The program is free to members and distributed exclusively through channel partners — health plans, PBMs, and manufacturer partnerships — not directly to consumers.

As of 2026, Sempre reports reaching 125+ million eligible commercially insured lives across the United States, has raised approximately $45.5M in disclosed venture funding, and operates with 11-50 employees. Key partnerships include Blue Cross Blue Shield of North Carolina (flagship pilot with 19,500+ patients), Blue Shield of California, UPMC Health Plan, Regence, Prime Therapeutics (PBM for nationwide expansion), Navitus, and manufacturers including Novo Nordisk and Organon. The company recently expanded into Medicare populations and launched in-store location-based savings notifications via smartphone digital wallet integration.

Name

Sempre Health

Legal name

Sempre Health, Inc.

Website

https://semprehealth.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

11–50 employees

Short description

Sempre Health operates a behavior-based dynamic pricing platform that adjusts prescription copays based on refill adherence, serving health plans, PBMs, and pharmaceutical manufacturers targeting commercially insured and Medicare members with chronic conditions.

Ownership category

akta.pro rank

Product category

Digital Health / Pharmacy Benefit Technology

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medication Pricing, Copay Assistance & Patient Financial Support Tools (HLACAKAN)

akta.pro secondary industries

Medication Adherence, Packaging & Fulfillment Services (Blister/Unit-Dose) (HLAFALAJ), Chronic Condition Management & Remote Monitoring (e.g., diabetes, HTN) (HLALADAD)

Keywords

• Medication adherence platform
• Behavior-based drug pricing
• Pharmacy benefit technology
• Patient affordability solutions
• Digital health engagement

Headquarters

HQ city

San Francisco

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Others

Revenue model

1. Manufacturer-funded discounts: Sempre contracts with pharmaceutical manufacturers to provide discounts to health plan members. Manufacturers fund the discounts in exchange for improved adherence, longer therapy duration, and guaranteed 100% of dollars reaching patients without accumulator/maximizer interference.
2. Health plan/PBM partnerships: Contracts with payers (health plans and PBMs) who want to improve affordability and adherence for branded medications. Health plans select formulary-aligned brands and fund the program structure, paying Sempre for the technology platform, enrollment services, and outcomes delivery.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels9 records

Core offering

Sempre Health operates a behavior-based dynamic pricing platform that adjusts patient copays based on medication refill adherence. The platform enrolls members via SMS, delivers automatic point-of-sale pharmacy discounts that grow with on-time refills, and provides real-time analytics dashboards to health plan partners. It aligns pharmaceutical manufacturers, payers, and patients to improve medication affordability and adherence for chronic conditions such as diabetes, cardiovascular disease, and asthma.

Product overview

Sempre Health offers a single, unified behavior-based medication pricing platform centered on dynamically adjusting patient copay costs based on adherence behavior. The platform consists of an SMS-based enrollment and reminder system, a pharmacy point-of-sale discount delivery mechanism, a real-time analytics dashboard for health plan partners, and a manufacturer affordability module — all aligned to drive medication adherence in cardiovascular, diabetes, and respiratory therapeutic areas. The company has also launched in-store location-based savings notifications (2025) and expanded into Medicare populations (2024), with clinical outcomes validated through managed care case studies.

Differentiator

Problem solved

Functional benefit

Products and services

• Behavior-Based Medication Pricing Platform A digital health platform that dynamically adjusts patient copay costs based on medication adherence behavior, rewarding on-time prescription refills with growing discounts over time. The platform aligns health plans, pharmaceutical manufacturers, and patients to improve medication affordability and adherence in cardiovascular, diabetes, and respiratory therapeutic areas.
• Health Plan Real-Time Analytics Dashboard

Quantifiable outcome

• 45-65% reduction in patients' out-of-pocket medication costs on average over 12 months
• +9 more outcomes

Named customers8 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature6 records

Partnerships

13 partnerships are on record, tiered core, flagship and minor.

• RegencecoreStrategic or Co-development Partner · 16 June 2026Health plan partnership (2026) for commercial members covering medications for chronic conditions including diabetes, heart disease, and asthma. Regence members receive invitations after employer group annual renewal.
• Prime TherapeuticsflagshipStrategic or Co-development Partner · 30 October 2025PBM expanding Sempre's behavior-based pricing model nationwide following successful pilot with Blue Cross NC (19,500+ patients, $4.7M savings, 70,000+ prescription fills). This is a core strategic partnership enabling national distribution through Prime's commercial client base.
• Blue Cross Blue Shield of North CarolinaflagshipStrategic or Co-development PartnerPilot program launched in 2022 that enrolled 19,500+ patients, supported 70,000+ prescription fills, generated $4.7M in member savings, achieved NPS of 98, and increased adherence by 15 percentage points. Results served as proof of concept for Prime Therapeutics nationwide expansion.
• UPMC Health PlancoreStrategic or Co-development PartnerExpanded partnership launched in 2018 and further expanded in 2020 to better serve patients with diabetes. UPMC is cited as a thrilled partner with consistently surprised member response.
• Blue Cross Blue Shield of ArizonacoreStrategic or Co-development PartnerCollaboration launched February 2021 to further improve medication adherence and affordability for BCBSAZ members.
• Navitus Health SolutionscoreStrategic or Co-development PartnerPartnership launched July 2020 to help Navitus members save on and adhere to medications through SMS engagement. Navitus is a pharmacy benefit manager.
• Novo NordiskcoreStrategic or Co-development PartnerPartnership launched April 2018 to improve medication costs for patients with diabetes, focusing on making insulin and other diabetes medications more affordable.
• OrganoncoreStrategic or Co-development PartnerCollaboration announced November 2023 to help eligible patients save money and stay on their medication as prescribed. Organon is a global healthcare company focused on women's health.
• MaxorPlusminorStrategic or Co-development PartnerPartnership launched November 2018 to lower patient out-of-pocket costs on prescription drugs through Sempre's discount program.
• AllumaminorChannel Partner/ Reseller/ DistributorHealth plan partner offering Sempre's adherence and affordability programs to their members. Alluma provides technology solutions for health plans.
• Blue Care Network of MichiganminorChannel Partner/ Reseller/ DistributorHealth plan (BCBS affiliate) partnered with Sempre to offer behavior-based medication pricing to members.
• Ambetter HealthminorChannel Partner/ Reseller/ DistributorHealth plan partner offering Sempre's medication affordability and adherence program to eligible members.
• Blue Shield of CaliforniacoreChannel Partner/ Reseller/ DistributorPresented research at AMCP national meeting (April 2024) demonstrating that Sempre's program improves medication adherence and clinical outcomes for BSC members.

Scale indicators15 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• AdhereHealth: AdhereHealth provides medication adherence solutions and pharmacy-related services to health plans, combining predictive analytics with outreach to improve adherence for chronic disease patients. It is comparable to Sempre because it sells into the same payer/PBM buyer, targets the same chronic-condition populations, and pursues improved PDC as the primary outcomes metric.
• RxAnte: RxAnte is a medication adherence analytics and intervention platform serving health plans and PBMs. It is the most direct analog to Sempre Health's adherence-focused, payer-facing analytics and intervention model, with both companies targeting PDC improvement through predictive analytics and targeted patient engagement.
• PharmaCord: PharmaCord is a patient access and affordability company that delivers copay assistance, patient services, and adherence support on behalf of pharmaceutical manufacturers. It is comparable to Sempre because both operate manufacturer-funded patient affordability programs designed to bypass accumulator programs and drive therapy adherence, and both serve as intermediaries between manufacturers and the payer channel.
• RxSense: RxSense is a healthcare technology company offering enterprise pharmacy benefits technology and consumer-facing prescription savings through SingleCare. It is comparable to Sempre because it operates at the intersection of PBM technology, manufacturer-funded savings, and consumer medication affordability — although with a consumer-direct savings layer (SingleCare) that Sempre does not currently offer.
• Capital Rx: Capital Rx operates a modern, technology-first PBM (Judi Health) with transparent pricing and value-based contracts for health plans and employers. It is comparable to Sempre because it is a tech-enabled PBM challenger focused on improving pharmacy benefit affordability and outcomes, with overlapping buyer relationships in Blues plans and self-funded employers.
• Rx Savings Solutions: Rx Savings Solutions (acquired by McKesson) provides prescription savings and adherence solutions primarily to health plans and employer-sponsored populations, identifying lower-cost alternatives and driving member engagement. It is comparable to Sempre because it operates in the medication affordability and adherence space with payer channel distribution and member-facing engagement tools.
• Arrive Health: Arrive Health (formerly RxRevenge) delivers real-time pharmacy benefit and cost information to prescribers at the point of prescribing, integrated with EHR workflows. It is comparable to Sempre because it operates in the medication affordability and benefit transparency space, connecting payers, PBMs, and providers to drive better medication selection and adherence.

Broad incumbents

• GoodRx: GoodRx is a publicly traded consumer prescription savings platform that connects consumers with discounted pricing and a telemedicine platform through GoodRx Care. It is comparable to Sempre as a broader incumbent in the medication affordability space with significantly larger scale, though it serves consumers directly and through a different business model (consumer marketplace rather than behavior-based payer channel).
• OptumRx: OptumRx is the PBM arm of UnitedHealth Group and one of the three largest PBMs in the United States, serving health plans, employers, and government programs. It is comparable to Sempre as a broad incumbent that administers pharmacy benefits at massive scale and operates its own copay assistance and adherence programs, competing for both pharma manufacturer dollars and payer relationships.
• CoverMyMeds: CoverMyMeds (a McKesson business) provides electronic prior authorization, benefit verification, and medication access solutions to providers, payers, and pharmacies. It is comparable to Sempre as a broader incumbent in medication access and affordability infrastructure serving payers and manufacturers, with overlapping value propositions around ensuring patients can obtain and stay on prescribed therapies.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/sempre-health
• Xx.com/semprehealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds4 records

Investors10 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Sempre Health