Laven’s complementary insurance will provide access to innovative therapies

Sep. 1st, 2021

Intensive research and development in medical technology and pharmacology is bringing significant advances in the treatment methods and tools available to patients. For example – in 2020, the European Medicines Agency has recommended that 97 new medicines and 37 new active substances be approved for the treatment of patients, thirteen of which are considered to make an outstanding contribution to public health and represent significant progress in their therapeutic areas. However, for many patients in Poland, access to modern therapies remains theoretical – of the newly approved medical technologies, more than 50% are not reimbursed in Poland or their reimbursement is narrowed down in relation to their registration indications. The costs of drugs not reimbursed by the National Health Fund have to be covered in full by the patient, while in many cases it is not possible, as the most expensive drugs and procedures cost even more than a million PLN.

According to the INFARMA report “Financing health care in the context of socio-economic effects”  innovative drugs account for about 0.3% of the drug market in Poland, while in Italy, for example, their share reaches 2.9%, and among European countries only in Romania this share is lower than in our country. As the authors of the cited report state: “As a result, many therapies that are currently the standard of treatment in EU countries are not available to patients in Poland or are available only to a small group of patients. The moment when patients gain access to treatment is also often delayed. In the case of many diseases, this translates into treatment effects, as delayed implementation of therapy results in disease progression, which is often irreversible”.

A solution to ensure access to innovative medicines and effective medical devices used in various diseases is a complementary medical insurance offered by Laven. It is intended to complement the currently available forms of financing treatment on the market: National Health Fund, medical insurance and health subscriptions (supplementary insurance). It covers modern drugs and medical devices used for medical indications in accordance with their registration in the EU, which in Poland are not covered by reimbursement from public funds.

Laven’s complementary insurance covers several areas. The first is diagnostics, i.e. e-consultation with a doctor in Poland and the international program of second medical opinion – remote medical consultation, under which the patient, based on the supplied medical documentation, receives an opinion on the appropriate treatment plan prepared by specialists from the world’s leading clinical centers. The second area of coverage is the cost of drugs or medical devices, including the cost of administering them to the patient. The treatment is carried out in facilities in Poland, without queues and additional fees. The third area of insurance is modern prosthetic limbs. The ranges of individual insurance packages have been prepared after consultation with industry specialists and doctors, to meet the real needs of patients. Laven’s packages are available in group insurance offerings so that employers have the option to offer them to their employees as part of their benefits packages.

The profitability of Laven’s business model depends not only on an attractive and useful product and the right way to distribute it, but also on the correct calculation of the insurance premium. Therefore, it is essential to accurately determine the probability of occurrence of diseases and the resulting future costs of treatment. A key element of Laven’s business model is an advanced actuarial model. Advanced algorithms for modeling stochastic processes based on the methodology of assessment of individual medical technologies provide effective forecasting and allow the construction of even very complex insurance packages characterized by high profitability.

“Laven’s business profile fits perfectly with the competencies and experience of the INNOventure fund. In our investment portfolio we already have companies developing medical technologies and algorithms used in health insurance. We are able to recognize promising solutions in this area, and we consider the business model of Laven very rational. Raised capital will allow the company to conduct further development of the mathematical actuarial model and to scale their sales” – Marcin Bielówka, managing partner at INNOventure fund, comments on the investment.