Nearly one-third of Americans never fill the prescriptions their doctors write. This isn’t just a statistic; it represents a massive inefficiency in healthcare that costs billions and leaves patients without critical treatments. Enter Forus, a startup that has reached a $1 billion valuation by applying artificial intelligence to the unglamorous, yet vital, administrative backend of pharmacy management.
The Problem: A Broken “Last Mile”
The journey from a doctor’s prescription pad to a patient’s medicine cabinet is fraught with logistical hurdles. While artificial intelligence often grabs headlines for drug discovery, its current impact on Forus is solving what investors call the “last-mile problem.”
When a physician prescribes a medication, particularly high-cost specialty drugs for conditions like cancer or autoimmune diseases, the script must navigate a complex web of insurance restrictions, prior authorizations, and pharmacy availability. Patients frequently face denials, confusing paperwork, and prohibitive costs.
“The most common experience patients have is getting a prescription. But despite how common it is, it is prohibitory for patients to get the medications they think they need.”
— Kareem Zaki, Partner at Thrive Capital
This friction has severe consequences. A recent KFF poll found that 40% of U.S. adults did not take their medication as prescribed in the past year due to costs. Lower-income individuals, women, and minority groups are disproportionately affected, often resorting to dangerous measures like splitting pills or substituting over-the-counter drugs.
The Solution: Automating the Admin
Founded in 2023 by Sahir Jaggi (originally named Tandem), Forus uses AI to intercept prescriptions the moment they are written. The software instantly processes the script, checking for:
- Insurance compatibility: Determining the best pharmacy for coverage.
- Patient history: Reviewing previous medications and potential interactions.
- Affordability programs: Identifying assistance options for expensive specialty drugs.
- Real-time tracking: Providing visibility to both doctors and patients on the status of the prescription.
By automating these tasks, Forus eliminates the “headache, paperwork, and phone calls” that typically delay treatment. The result is a significant increase in prescription fill rates for medical practices using the platform.
Rapid Growth and Industry Adoption
Forus has achieved remarkable growth, driven largely by word-of-mouth among healthcare providers. Key metrics include:
- Valuation: $1 billion.
- Total Funding: $160 million, with rounds led by Thrive Capital, General Catalyst, and Accel.
- Revenue: Annualized revenue surpassed $10 million by the end of last year and has quintupled this year, tracking above $50 million.
- User Base: Thousands of medical practices and health systems, with a 10-fold annual increase in adoption over the past two years.
The company’s business model is distinct: it does not charge doctors or patients. Instead, Forus partners with pharmaceutical giants. With half of the top 10 global pharmaceutical companies now on board, the startup helps pharma firms launch new drugs by ensuring that when a doctor writes a prescription, the insurance is processed and the pharmacy is stocked.
“Too few drugs make it to market and too few eligible patients receive treatment. Science should be the only limit to medicine.”
— Sahir Jaggi, Founder of Forus
Why This Matters
The stakes are high. Prescription drug spending in the U.S. is expected to surpass $1 trillion this year. According to Ken Frazier, former CEO of Merck, up to 35% of new prescriptions go unfilled. This represents more than $300 billion in therapies that never reach patients, leading to worse health outcomes and higher long-term healthcare costs due to preventable emergencies.
Jaggi, a Columbia University biomedical engineering graduate and former product leader at health insurer Oscar, founded Forus after witnessing the systemic inefficiencies from the inside. He notes that changing the system from within an insurer was difficult, prompting him to build an external solution.
Conclusion
Forus demonstrates that AI’s most immediate impact in healthcare may not be in discovering new cures, but in ensuring existing ones actually reach patients. By removing administrative barriers, the company is helping to bridge the gap between medical innovation and patient access, turning a broken logistical chain into a streamlined pathway for care.
