Coverage intelligence for rare and specialty therapies
Know where coverage is heading, and whether the evidence supports it.
Marigolds forecasts how coverage is likely to be set for a new therapy, then watches it for the life of that therapy. When a policy changes, we show the exact language, hold it against the current evidence, and say whether it moved closer to the evidence or further from it.
Watch. Assess. Act.
What we do, for each therapy we follow.
Watch
Coverage policies, formularies and utilization management criteria for specialty therapies change often, across many sites and formats. We catch the changes that touch your therapy soon after they are published.
Assess
Most changes are routine. A few change who gets treated. We hold each one against the current evidence and how that payer decides, and say which way it moved and what it means for access and revenue, with the source attached.
Act
Each finding reaches the team that owns it, reviewed by people who know the work, with what the evidence supports, whichever way the policy needs to move.
Forecast before launch. Anticipate after it.
What a finding looks like
Short, sourced, and grounded in both directions.
Illustrative. Real findings stay with the team that owns them.
Routine
Wording, references or format change. Who qualifies does not.
Notable
A step is added or removed: documentation, a test, a review, a renewal.
Material
Who qualifies changes, or for how long.
Each change is read in both directions: closer to the evidence, or further from it. Some criteria are well founded, and the finding says so. Where the evidence is unsettled, it says that too.
What changes
Less time reading policy. More time acting on it.
In every engagement we measure how quickly changes are caught, how many were previously unknown, and, of those acted on, whether coverage changed.
source + evidence
Weeks of reading become a sourced finding.
Analysts stop searching, reading and comparing policy documents by hand. Each finding arrives with the exact language and the evidence beside it.
You hear first, not last.
Changes surface soon after publication, not when a patient, prescriber or customer asks why access changed.
Your team spends its time where it counts.
Which changes matter, at which accounts, and what the evidence supports, known before anyone books a meeting.
Every team works from the same picture.
Market access, HEOR, medical affairs, trade, field and patient services teams each see the same finding, source and evidence, instead of keeping their own version.
Patients reach the right therapy sooner.
Policies that hold back patients who should get through, and policies that let through patients who will not benefit, are both caught early.
Founded by Samta Shukla, PhD, formerly of BCBS Minnesota and CVS Health.
About Marigolds →Working on a rare or specialty therapy, or the policy that covers one?
Tell us what you are looking at. We will tell you where we would start.