The Secrets To Improving Patient Access To High-Cost Medications with Julia Regan, co-founder and CEO of RxLightning

[00:00:02] Hey, everybody. Welcome back to the Outcomes Rocket. So glad you joined us once again today. I have the privilege of hosting Julia Regan on the podcast today. She is the CEO and founder of RxLightning. She's got 20 years experience in healthcare, connecting doctors, PBMs,

[00:00:23] and patients to improve the overall prescription experience. We know it's fragmented, and the opportunity for improvement there is large. And she's scoring home runs in this space. In 2023, last year, she was awarded the EY Entrepreneur of the Year Award. And her

[00:00:41] company, RxLightning, has also received the Mirror Award five times. So she is blazing trails and making waves. Julia, thanks for being with us today. Thanks, Saul, for having me. I'm happy to be here. Yeah, such a pleasure to have you here. We're going to talk about the prescription

[00:01:00] experience. We're going to have discussions around entrepreneurship. But hey, before we start, let us know what is it that got you into the business? So early on in my career, I graduated and nothing to do with healthcare and needed to find a job and landed in pharmaceutical sales.

[00:01:16] I think like a lot of people my age at the time landed into those roles and just fell in love with the healthcare industry in general. And then a couple years later, I had the opportunity to go

[00:01:28] in-house and really start evaluating how technology was going to impact drug manufacturers at the time and fell in love with technology. I was very fortunate over my career because I got into the healthcare technology at the early infancy when EHRs were just starting to evolve and be adopted

[00:01:46] to create a lot of point solutions that helped across that patient journey. Simultaneous to that, I had a personal experience where a lot of us do as consumers of healthcare that was fragmented with challenges of getting someone on a specialty medication and kind of having my career collide

[00:02:07] with personal impact had me start ARX Lightning with my co-founder Brad Allen just over four years ago. Amazing. Yeah, and thank you for sharing that. And we're connecting beforehand folks.

[00:02:18] And so you were in Indy at the time when you were a pharma rep? I was in Pennsylvania actually in the middle of nowhere in Williamsport, the Little League World Series. So people know it

[00:02:29] for that reason. And technology really wasn't used back when I started my healthcare journey, but it is today now it's everywhere. It is. And I just ask because Lily's there, but the East Coast

[00:02:42] has got plenty of pharma. So it was like inevitable, right? And then you start seeing all the crowds. You start seeing all the opportunities and then it hits you personally. And you and your founder

[00:02:53] said, Hey, we got to do something about this. Like what was the catalyst that you said, Hey, and this is more on the founder side, right? What inspires us to start companies?

[00:03:04] What inspired you to say, this is a problem big enough that I want to do something about it? I think it's twofold. We specifically focus around specialty medications. So when you look at the

[00:03:14] market, it's over 50% of the drug spend in the US, especially it only makes up about 3% of all prescription volumes. So it's huge costs, but very small, a number of patients, number of prescriptions actually on the medications. And then further looking at the

[00:03:32] market, there's just a huge shift on FDA drug approvals being in the specialty space. So when you look at that, and then have an experience knowing that like, it is very hard to get started

[00:03:46] on these medications. It's very costly to get on these medications. And as an educated consumer of healthcare, you've been fraught with challenges. You've stepped back and say, Hey, this needs to be done differently more for the just personal aspect of it. I think everyone listening,

[00:04:04] you and I could agree like a loved one of ours, not being able to get an oncology medicine that could really change the trajectory of the disease is really unacceptable. So being passionate around

[00:04:17] that experience, and then having the background to know, I know what we need to do differently in the industry to create a solution that works for providers, but most importantly, the patient,

[00:04:30] I think is what drove me towards it. I think anyone that started a company has to be a little bit crazy in a way and maybe a little bit naive to what that really means. And looking back on it,

[00:04:42] it's been a very crazy ride for us. We've touched a lot of patients lives. That's what keeps me grounded at continuing to go. But there's always ups and downs of business hurdles that

[00:04:53] you have to jump through. Yeah, totally. And kudos for doing this. It's a much needed space for innovation. And so let's unpack it a little bit. Tell us a little bit about how the company

[00:05:04] delivers value in this space. So when we say specialty meds, it's really high cost meds. It could be dispensed by a pharmacy. It could be administered in an office, buy and bill medications.

[00:05:19] It could even be your high cost retail drugs that are dispensed at any retail store. But traditionally, there's kind of two parts of the journey that require a lot of paperwork, a lot of

[00:05:30] phone calls and are traditionally handled with faxes. The first part is the access journey. So how much is this medication going to cost? Who's going to pay for it? Where could it be dispensed?

[00:05:42] Is it in office? Is it at pharmacy? What restrictions are there by the PBM to work through from a prior authorization standpoint? That's all the access component. And it's not just about the prior auth. It's also about leveraging support programs. Manufacturers have a lot of

[00:05:59] organizations that are specifically designed to help go through these processes. Well, it's still paper, phone calls, faxes. And then after that access journey is done, you really have, is it affordable for the patient? And there's grants and foundations out there for patients

[00:06:18] to tap into. Most people don't know that they exist or you have to Google search everything. There's low-income subsidy programs. There's copay card programs. There's free drug programs, all again, very manual in nature. So Arx Lightning was designed to create a platform

[00:06:36] that works through all of those processes digitally while creating a CRM tool for providers. Because today when they're using paper, they're either using homegrown Excel or Post-its or something scarier, which is nothing to track the patients. And as a result, gaps just happen

[00:06:56] with transfer of information. Yeah. I love this. And I'm thinking about all the faxes and does all that go away or do you guys digitize it and then still send the facts to help us understand that?

[00:07:10] Yeah. So our goal is for it all to go away. Obviously in order for it to go away, we need to work with the payers and the PBMs. We need to work with the drug manufacturers and their

[00:07:21] hub programs, which is their patient support programs or services. We need to work with the specialty pharmacies and their operations teams as well. So Arx Lightning, when we launched, we support over 1600 medications and it's drug agnostic, but it's also destination agnostic.

[00:07:39] So today we're not partnered with all of those destinations and all of those drugs, but we've created a digital experience for all of that. So when we're not connected to a partner, it's eFax on the backend. When we're connected to a partner, everything, the fax goes away.

[00:07:57] It's fully digital and seamless regardless of if it's connected or not. It's still creating such a great experience for the providers and more importantly for their patients. We've seen patients go from a couple weeks to a month down to sometimes the same day of getting

[00:08:14] their medicines. Unbelievable. That's huge. That's just enormous. And we talk about adding value to people, to patients. Going from months to weeks to days or a day is game changer. Oh yeah. It's game changer. Yeah and it's exactly what going back to that personal experience,

[00:08:35] what you would want for your loved one. I think that specialty medications, the operational process of access and affordability is complicated and there's always going to be barriers and obstacles that we need to work together to overcome for that patient. But when you connect all those

[00:08:53] organizations together digitally, it becomes much easier for people that are educated in what to do next to help facilitate overcoming that barrier on behalf of the patient and it just naturally speeds up the process. Totally and that's the power of the network and congrats on building such a

[00:09:12] robust network. How long did it take for the network to be viable, Julia? Because there's a lot that's the network play, right? Yeah. It's not easy. It's taken years to grow and we're still growing.

[00:09:27] We're up to about 1,200 organizations use our platform. So when we say an organization that's not a doctor, a single doctor, it could be anything from a large ambulatory community-based oncology practice that spreads over multiple states to a large health system. That's one organization.

[00:09:46] But when we launched our platform in January of 21, we knew what we were building. We knew what the problem was, but we needed to get people to use it. And I remember telling my lead BD director

[00:09:59] in the provider space, it was like, well, it's not just good enough to get the providers interested in using it. Like they actually have to use it and to sit here three years later going from no

[00:10:10] providers to 1,200 organizations. It's great to see that it's being used. It's working. It's solving problems, but there's still a lot more that we need to grow. 1,200 is still a fraction of the healthcare organizations in the industry. Totally. And as a founder, you're always like, man,

[00:10:28] we could do better. We could do better. This is great. However, we could be doing better. Yeah. And one of the fascinating things that we've done is we've really taken a technology first. My background is product and product design, and I don't code anything. I've got a brilliant

[00:10:43] engineering team for that. But we knew from the beginning, it can't just be the standalone portal because you won't get adoption on it. So we do have our standalone portal. We do single sign-ons with provider platforms. We do EHR integrations with provider platforms as well. But we're also

[00:11:02] able to take the entire platform and white label it and have our partners drive their providers to use and to register for the platform, which has really created a nice flywheel for us.

[00:11:16] Because people are looking... When you're going from a form and you could have a digital solution, they're going to go to a website for the form. So when they go to the website for the form,

[00:11:26] instead of filling out the form, they're redirected to a white-labeled version of our platform for them to now do it digitally. And when we have one partner driving adoption, it helps really every single partner because we support the 1600 shows.

[00:11:41] Yeah, that's really interesting, Julia. So would you say that because it's white-labeled, people feel ownership and it's like they're giving them that facile capability that they're promoting it more? Is that right? Yeah. And it's one of those tools that when we started launching our platform,

[00:12:02] we have amazing relationships with our offices because of the value we've given to their team, because we've removed paperwork out of the equation for this. Oh, huge, yeah. So when we're partnered and white-labeling it on behalf of one of our partners,

[00:12:16] they're going to get that extra value in the offices with their provider groups to differentiate themselves as an organization as well, which we like to see. And it's driven more adoption for their brands or their pharmacy because of that experience and that,

[00:12:35] hey, we acknowledge you have these challenges and it's not just for our drugs. We're going to create a solution that helps us but also helps you in general. That's awesome. And I'm glad you mentioned it's pharmacists, pharma that can white-label this,

[00:12:52] but it's a network of patients and providers that get to benefit from the platform. Correct, yeah. Love it. So cool. Well, look, none of this stuff happens without setbacks. Talk to us about one

[00:13:09] that comes to mind that you guys learned a ton from and you've become better because of. Yeah, there's always setbacks that happen. For us, we've been very fortunate that the vision and the platform that we wanted to create was established very early. I think one of the

[00:13:27] biggest challenges for us, though, is we started with, I think, 600 medications. And as more people were using it, they wanted to support more medication. So we went from launching in 21 with 600 to now supporting over 1600 medications. And some of the challenges and setback is just

[00:13:46] you're a small team, you've got to so much funding and capital that you can't necessarily grow your team out. But you want to, especially in a network where providers and physicians use the platform for free, you want to be able to deliver the value to them while financially

[00:14:04] being responsible to continue to grow. So those were some of the challenges in like the early days, just organization structure and how do we, what do we deliver and build for the providers who are getting an enormous amount of value, but we're not generating revenue to

[00:14:21] substantiate the business while staying true to the way we're going to monetize and that balance aspect of we want providers to keep using it, but we can't necessarily over index on that side.

[00:14:37] I think that the team's done a really good job looking at that equation and stepping into how we continue to evolve and solve more for the provider, but ensuring that it does stay true to

[00:14:49] how we're going to be able to monetize the platform and the network because we never sell any of our data. It's all provider choice. So when we get asked necessarily to create solutions that we

[00:15:02] can't monetize, there's a balance of what's the right thing to do for the patient in the industry, but balancing we are a business that needs to grow to ensure that we stay in the market. Those have been challenges that we've been navigating over the last several years.

[00:15:18] Sure. Yeah. And so it's a data thing, which is a, which on the one hand, it's a benefit for people using your platform. They know that their data is not going anywhere. So that's a plus

[00:15:29] that, that then for everybody listening, if you're looking for a platform to make prescriptions easier, to help improve outcomes for your people, this is one to look at. I think you got to

[00:15:41] consider all aspects of a tech stack and a service. And I think that's a really important one. What's the best way that you connect with your ideal customers right now? Anyone can reach out to us on our website. It's RxLightning.com. There's a contact or an info

[00:15:58] request on that, and it could come in and get to the right person within the organization, depending on if it's the provider or the pharmacy or the drug manufacturer. LinkedIn, anyone could

[00:16:10] reach out to me on LinkedIn as well. So we get a lot of inbound that way. And then we're at a lot of conferences. Our provider base, we try to go to large health system conferences. We go to a lot

[00:16:21] of the oncology conferences as well, just because oncology makes up about 60, 40 to 50% of the drugs on our platform are in the oncology space. So people could find us. So 40 to 50% of that 3% is oncology?

[00:16:38] Yeah, at least from a number of drugs, maybe not necessarily a drug spend perspective or number of patients on it, but yeah. Sure, sure, sure. Awesome. Well, folks, you know where Julia and her team is now. And in the show

[00:16:53] notes, we're going to leave ways for you to get in touch with her and her team. So make sure you do that. This will also be posted on LinkedIn. We're starting Instagram now. We're doing a little bit

[00:17:03] more on Instagram. So yeah, check all this stuff out. There's opportunities for you to put a lightning speed on prescriptions. And that's what Julia and her team are all about. So Julia, thank you so much for being with us today and for doing what you do.

[00:17:19] Yes. Thank you for having me. And thank you for doing what you do. My pleasure. See you all later.