Highmark Health partners with tech platform, looks to streamline member access to specialty medications 

Highmark Health is working with a Pittsburgh-based health care technology startup to streamline member access to prescription drugs from specialty pharmacies. 

Free Market Health, a cloud-based marketplace created to make it easier for insurers to authorize specialty medications to the pharmacy, and ultimately the patient, announced that it has raised $13.5 million in Series A Funding. 

Highmark’s capital investment arm, Highmark Ventures, was one of a number of companies, including 653 Investment Partners and Alta Partners, to support the funding round. 

Highmark has worked with Free Market Health’s market platform to remove pain points in the specialty pharmacy process, said Sarah Marche, senior vice president of pharmacy services for Highmark Inc. 

“Our collaboration with Free Market Health means that Highmark members will enjoy quicker access to prescription drugs for chronic, high-cost health conditions, from specialty pharmacies tailored to serve their particular condition,” Marche said in a press release. “Working with Free Market Health advances our goal of transforming the pharmacy experience for our members and ensuring they have access to proven, affordable prescription drugs that help them be at their best.” 

Specialty drugs make up just under half of Highmark’s $5 billion in annual drug spending, while specialty drugs make up less than 1% of the insurer’s claim volume, according to Marche. 

“A very small percentage is driving a large percentage of our spend,” she said, adding that Highmark is currently collecting data to see what savings it can see under the platform. “We are not at the point of having a full savings report.” 

Free Market was founded in 2019 with the goal of balancing the cost of care and the value that care provides. The company wrote in its release that it has a year of full scale operating under its belt and in that year, it has facilitated a match of thousands of specialty medication referrals and has hundreds of millions of dollars in specialty medication spend under management. 

“Until now, no model seamlessly matched patients to the specialty pharmacy best suited for their care needs, let alone enabled the type of value orientation under a market-driven and dynamic reimbursement framework,” said Pete Hudson, managing director at Alta Partners, a health care venture capital firm. “Free Market Health sits at the intersection of price, value, and efficiency, for the ultimate benefit of the patient.”