General Catalyst's Chris Bischoff sits down with Forus’s founder and CEO Sahir Jaggi to unpack why one in three patients never get their first dose of prescription medication, how LLMs cut through the complexity stalling the drug supply chain, and how a network built at scale can make scientific progress the only limit on the medicine that people have access to.
This interview has been edited and condensed. Watch the full video below.
Chris Bischoff: Tell us what Forus is solving.
Sahir Jaggi: We help people get access to medicine faster, easier, and cheaper. One out of three patients with a medication for a high-cost or complex condition never get their first dose, and even those who do often wait weeks or months. The reason is that so much complexity sits on the shoulders of doctors and patients: insurance coverage, affordability, supply chain navigation. It takes a doctor and their whole staff to stay on top of it while running a clinic and seeing patients, so people end up on suboptimal therapies or never get the medicine they need.
One out of three patients with a medication for a high-cost or complex condition never get their first dose, and even those who do often wait weeks or months.
Chris Bischoff: Who suffers most in the system as it works today?
Sahir Jaggi: Counterintuitively, it affects people across the board. Even patients with resources and top facilities face the same complexity, because these aren't $50 medications, they're often $50,000 a month, and the hoops are the same for almost everyone with one of these conditions. That said, the less education, familiarity, or resources you have, the harder the process becomes.
Chris Bischoff: Is there a problem upstream, where physicians avoid prescribing these drugs at all because of the paperwork and the uncertainty?
Sahir Jaggi: Yes, and it's not just the workload. Imagine you've diagnosed a patient with leukemia or a serious autoimmune disease. The last thing you want is to tell them about a life-changing treatment and then watch their hopes come crashing down when they can't get it. So doctors avoid it, not because they're sure it will fail, but because they don't want to roll the dice. Instead, they prescribe a medication that came out ten years ago, because it's safe in terms of actually reaching the patient, even if the science is older and less effective. So a drug that already took ten years to reach the market waits another ten years to become mainstream, and there's an enormous lag between what's biologically possible and what people actually benefit from.
Imagine you've diagnosed a patient with leukemia or a serious autoimmune disease. The last thing you want is to tell them about a life-changing treatment and then watch their hopes come crashing down when they can't get it.
Chris Bischoff: There's huge investment going into AI-driven drug discovery. It sounds like the supply of drugs is growing, but the demand-side problem of getting them to people is what you're solving.
Sahir Jaggi: Exactly. All that discovery translates into more and more hypothetical molecules, but the bottleneck is turning those molecules into in-market medicines, and then making them mass-market so everyone who needs them can get them. We're building a network that accelerates the process from the point you have a drug ready to test in people to the point where everyone who needs it has it.
Chris Bischoff: How did you come to this problem?
Sahir Jaggi: I spent time before this at Oscar, building a health insurance company from the ground up. It was a crash course in every point of friction in the system. But I realized that, as a single insurer, we could only solve some of the problems, for some of the people, some of the time. I wanted to pick a slice of this challenge and solve it durably for everyone who needed help. Around then, LLMs started to click, and they have two properties we use: they can digest a huge amount of heterogeneous information and treat it all the same, and they can brute-force through processes that are hard or impossible to scale with people. Together, those properties let us build what we think of as an advocate layer on top of a messy, complicated problem. We picked medication access because it's the most common interaction people have with the system, it recurs for the rest of their life, and it runs through a complicated multi-step supply chain where neither the doctor nor the patient is in control. Both are on the same side, and both are lost in the process.
Chris Bischoff: Healthcare is famous for misaligned incentives across payer, provider, patient, and pharma. How did you create alignment?
Sahir Jaggi: The more stakeholders there are, the less any one party controls or is even aware of what's going on. In many of these transactions, there are almost ten parties: the doctor, the patient, the insurer, the PBM (pharmacy benefit manager), the pharmacy, the wholesaler, the manufacturer, and the patient-assistance foundations that exist to help people afford these drugs. When we studied it, most of the friction wasn't because people had different goals. So we built a platform that connects the dots and lets all that complexity exist without any individual stakeholder having to navigate it. Every time someone selects a therapy on our platform, we carry it all the way through until the patient has the medication in hand.
Chris Bischoff: There's a chicken-and-egg problem in a business like this. Where did you start?
Sahir Jaggi: On the provider side, because the network is built from providers, patients, and the prescriptions moving through it. That's part of why we made the platform free to providers. We started with friends of friends, someone's brother or mother or cousin, and word spread. We've grown 10x over the last two years almost entirely through word of mouth, and we're now serving patients in 80% of US zip codes, with tens of thousands of patients coming to the platform every week and millions this year, growing exponentially.
We're now serving patients in 80% of US zip codes.
Chris Bischoff: How do pharma and life sciences companies fit in?
Sahir Jaggi: Building this network gives us unprecedented visibility into what people are being treated for, where medications are most and least effective, where people get stuck on both the doctor and patient side, and what makes a medication successful clinically, financially, and administratively. We use that to help the companies making these medicines design better research, launch more efficiently, respond to physician and patient needs faster, and stop wasting resources where they won't move the ball, so they can focus on unlocking access for new groups of patients.
Chris Bischoff: How much time and friction have you taken out?
Sahir Jaggi: When we start with a provider, the goal is that they only spend time making clinical decisions, none of the paperwork, phone calls, data entry, or navigation. We've cut that complexity by 90% or more, and cut the time it takes patients to get their medication by two to three times, so they get it in a day or two instead of waiting weeks.
Chris Bischoff: You were at Oscar, a company famous for attracting talent. What did that teach you about building your own team?
Sahir Jaggi: How important it is to invest in talent and then cultivate it. Oscar was uncompromising about the caliber of people across every function, effective generalists who could play multidisciplinary roles and push the level of ambition. The most impactful part for me was that we never talked about our decisions as if they only affected our company. We talked about them as decisions for the country, with an underlying belief that we would inevitably be how the country's healthcare operating system worked. That put real gravity on the work and gave us a moral imperative. It made me feel that every moment at work was moving society forward, and that's what I wanted to bring to Forus.
Chris Bischoff: Historically, technology hasn't delivered in healthcare the way it has elsewhere. Is the unlock that the technology is finally good enough?
Sahir Jaggi: A lot is changing. The first shift is that this wave of technology is so impactful that even historically conservative customers are jumping out of their seats to get access, which is why tools like ours grow rapidly through word of mouth, because people feel joy using them and see the impact. You always hear that a certain industry or customer doesn't believe in technology. The wake-up call is that the technology just wasn't good enough before. Now they can see the benefit, and they're moving with their feet at an unprecedented rate. The second shift is that people, even early in their careers, are pushing founders on durability: how do you still exist in two or five years, why won't you get digested by the frontier AI labs?
Chris Bischoff: Share how every additional prescription improves the business.
Sahir Jaggi: The obvious part is that more volume makes the product smarter, which is true of a lot of products. What's more interesting is the network. Our durability doesn't come from having slightly better models than the next company, it comes from the network we've built, hundreds of thousands of physicians and tens of millions of patients all pushing transactions through it. That scale earns us relationships with every other stakeholder, from insurers and PBMs to pharmacies, distributors, and manufacturers, and lets us give everyone unprecedented visibility: a physician can know which medications are appropriate, likely to reach the patient, and what they'll cost, in real time. It compounds like any great network business, so it doesn't really matter whether our software is fully or only partly dependent on the frontier models.
Chris Bischoff: Tell me about your own path to entrepreneurship. You studied biomedical engineering.
Sahir Jaggi: I always wanted to do something big, and I assumed I'd be in medicine, but not by building a business. I studied biomedical engineering because I thought I'd be a researcher working on organ printing and regenerative medicine, creating miracles in the lab. Then an enterprising advisor in college opened my eyes to how much complexity, time, and luck it takes to get something from the lab into real people's hands. Even a genius piece of research was a total dice roll on whether and when it would reach patients. So I joined Oscar to move to the opposite end of the ecosystem, right at the nodes of delivery, and it showed me how much sits between these inventions and the people who need them, and how much ambition you needed to have to change the system. A few years before Oscar existed, no one would have considered starting it, everyone assumed the decades-old incumbents were permanent. I was also lucky to work with many of the same investors who backed Oscar, including GC, which helped kickstart this business.
A few years before Oscar existed, no one would have considered starting it, everyone assumed the decades-old incumbents were permanent.
Chris Bischoff: Being a founder takes ambition and vision, but also courage. Looking back, was there a fork in the road that took courage?
Sahir Jaggi: The business model itself, from the very beginning. We didn't make a dollar of revenue for the first two years, because we were still building the network and making sure the product was genuinely useful for physicians and patients. We were forgoing obvious monetization while other companies, often selling to the same stakeholders, were picking up tens of millions in revenue, and people scratched their heads: good investors, good team, no revenue, is this a pipe dream? We'd done the research and were clear there was a huge, overlooked opportunity, and that not taking the easy money was what would let us reach real scale. We're not chasing short-term value extraction. We're chasing ubiquity. We turned down opportunities worth millions, in some cases tens of millions, that weren't consistent with how we viewed the world, and even some of our team questioned it. Being uncompromising about that is what allowed the rapid acceleration and kept our message consistent.
Chris Bischoff: Roll forward five years. Where do you want the business to be?
Sahir Jaggi: Near term, we want our platform to be in every doctor's office in the country, from small dermatology practices to large cancer centers, rural clinics to New York City academic systems. The complexity compounds as we scale across zip codes, states, insurance plans, and specialties, so we're continually re-generalizing what we build while adding the functionality each type of physician and patient needs, so the same platform that supports someone getting pills at a gastrointestinal clinic can support someone getting chemotherapy. Longer term, we want to be the core partner to every life science company bringing a drug to market, cutting the time and cost so much that big companies can launch hundreds of drugs instead of a few, and biotechs that today wait to be acquired can go commercial themselves. What we really want is to make it so science is the only limit to the medicine people have access to.
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