Inspiration

Even after a medication is authorized, patients still hit confusing shocks: high pharmacy prices, coupon rules, deductible issues, Medicare restrictions, and unclear next steps. I work in medication access on a prior authorization platform serving 100,000+ patients per month, and wanted to build something a regular person could use to navigate that complexity.

What it does

CopayGuard helps patients check medication cost risk before pickup, investigate high pharmacy quotes, avoid bad coupon paths, and find safer next steps. It routes users through insurance-aware options like cash prices, copay support, patient assistance programs, Medicare options, appeals, and prescriber follow-up.

How we built it

We built a React frontend with a FastAPI backend, Postgres persistence, and a Grok-powered agent workflow. The app uses structured intake, demo cases, curated medication affordability resources, and agent-generated next steps.

Challenges we ran into

Healthcare pricing data is fragmented, incomplete, and often not available until a pharmacy claim is actually run. The hardest part was keeping recommendations eligibility-correct, especially around Medicare, copay cards, deductibles, and out-of-pocket rules.

Accomplishments that we're proud of

We built a working demo that turns a confusing medication cost problem into a clear action plan. We also expanded beyond post-authorization sticker shock to include pre-fill price checks and coupon-risk detection.

What we learned

Medication access does not end at prior authorization. A patient can technically be “approved” and still be unable to afford or understand the medication path.

What's next for CopayGuard

A real version would need deeper connectivity to fragmented data sources: pharmacy claims, benefit checks, formularies, plan documents, assistance programs, and patient-specific cost data.

The next step is turning the demo into a connected affordability navigator for real patients.

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