The infrastructure layer specialty care never had.
A $400B market with no dominant infrastructure.
The specialty pharmacy market processes over $400 billion in drug spend annually and is growing at 12% CAGR as biologics, cell & gene therapies, and rare disease drugs become the backbone of pharmaceutical revenue.
Yet the infrastructure coordinating this market remains stuck in the 1990s: phone calls, fax machines, and point-to-point integrations that break with every EHR upgrade. Prior authorization alone consumes 16 hours of staff time per week per physician practice. The cost of these inefficiencies exceeds $265 billion annually in wasted administrative spend.
Regulatory tailwinds, including CMS's 2024 prior authorization transparency rule, the 21st Century Cures Act, and the Da Vinci FHIR implementation guides, are mandating interoperability at exactly the moment Medesto is ready to deliver it.
Three forces converging to make Medesto inevitable.
Regulatory Mandate
CMS's 2024 Prior Authorization Transparency Rule, the 21st Century Cures Act, and the Interoperability and Patient Access Final Rule are forcing every major payer and health system to open their data to FHIR APIs. Medesto is built natively on these standards while competitors built on legacy HL7 v2 cannot easily follow.
AI & LLM Maturity
Large language models have crossed the threshold where natural language query of clinical data is both accurate and defensible. Medesto Fetch, our AI layer, can surface a patient's full medication history, labs, and prior auth status from a plain-language question in under two seconds. This was not technically possible 18 months ago.
Payer & Pharma Pressure
Pharmaceutical manufacturers are under intensifying pressure to demonstrate therapy adherence and patient outcomes, or face formulary exclusion. Specialty pharmacies are being squeezed on margins while being asked to deliver more clinical services. Both need the infrastructure Medesto provides, and both are willing to pay for it.
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