Mandolin lands $40M to accelerate access to life-saving specialty drugs with AI agent platform

In 2024, specialty therapies represented 75% of the FDA approval pipeline and $250 billion in drug spending, with projections to reach $1.5 trillion by the mid-2030s. These specialty therapies are different from small molecule-based prescriptions that are typically filled by a pharmacy, and many biologics require infusions administered by a healthcare provider.

Every patient referral for infusion therapy kicks off a cascade of manual workflows: referral intake, verifying insurance, chasing prior authorizations, appealing denials, and navigating outdated portals just to get a life-saving drug approved, administered, and reimbursed. Currently, infusion sites employ back-office teams that are often augmented with outsourced staff overseas to manage such intensive administrative workloads. It’s a system held together by overworked staff and duct tape. With the rise of specialty biologics, it’s only getting worse. Enterprise software has transformed how we manage CRMs, ERPs, and HRIS, but most of the healthcare system still runs on faxes, phone calls, and portals from the early 2000s, especially in the fast-growing world of specialty pharmacy and infusion.

The administrative workload required to get a life-saving drug infusion is not only slow but also unsustainable. Infusion centers often wait more than 30 days for treatment approvals or lose patients in the maze of paperwork.

Redefining specialty therapy administration

Mandolin is stepping into this administrative chaos with the leading AI automation platform uniquely built for the infusion and specialty pharmacy market. By automating manual workflows end-to-end, from referral to reimbursement, Mandolin is not only accelerating access to life-saving drugs for patients but also helping clinics speed up cash flow, reduce overhead, and ultimately treat more patients.

• The rapid rise of aging populations and biologics
• Growing payor resistance to skyrocketing treatment costs (often exceeding $100K)
• Potential to unlock value from the 80% of healthcare data that remains unstructured and siloed across fragmented manual workflows
• Regulatory shifts like CMS interoperability and prior authorization rules that are pushing the industry toward automation

Their team is building the digital workforce that infusion centers and specialty pharmacies desperately need today. They’re starting with one of the most overburdened parts of the U.S. healthcare system: infusion sites and specialty pharmacies. That’s why we were eager to lead Mandolin’s seed round alongside Maverick and are now doubling down on their Series A along with Greylock.

“Mandolin has been nothing short of transformational for our business. Tasks that used to take days now take less than an hour. We’ve automated key workflows across billing, patient communication, and insurance verification, driving real gains in better cash flow and reduced headcount as we scale. Mandolin acts as an AI employee integrated directly into our core systems. We just tell it what needs to get done, and it does the work.”

- Cannon Loughry, COO, TwelveStone

Mandolin has gained deep customer love across 700+ clinics, serves 250,000+ new patients a year, and is currently partnered with many of the largest U.S. infusion providers, pharmacies, and health systems, including Vivo Infusion, FlexCare Infusion, OI Infusion, TwelveStone Health Partners, and Amber Specialty Pharmacy.

Founders with speed, grit, and customer-obsession

Will Yin and Rohit Rustagi aren’t your typical startup founders. They’re scrappy repeat founders, but what really sets them apart is their combination of speed of learning, customer-centric mindset, and vision for an AI-native platform to accelerate access to physician-administered drugs. Their inspiration for this mission stems from their firsthand experience with unfortunate delays in life-saving therapy access for conditions like Alzheimer’s disease and cancer that have impacted their families.

From day one, they’ve been embedded in specialty infusion back-office workflows and mapping task-level datasets to build AI agents that solve real, urgent pain for customers. They’re creating a unified system of record for how physician-administered drugs are prescribed, approved, and reimbursed.

The infusion market is growing fast, and staffing shortages are hitting hard. Recent advances in LLMs and AI agents have made virtual back-office labor viable at scale. The market is moving, and Mandolin is out in front with the leading AI automation platform for specialty drug access.

If you’re looking to streamline back-office infusion and specialty pharmacy workflows, request a demo and see how Mandolin can transform your business. If you're interested in furthering Mandolin’s mission, check out these job opportunities.

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Our portfolio companies consider us an extension of their team that scales with them. Beyond our in-house Beacon AI for help with recruiting, we built our full-time Portfolio Success Team with world-class operators across various functions, including the former chief people officer at Netflix, the former chief marketing officer at Stripe, and the former editor-at-large at TechCrunch. Our XIR program pairs top industry leaders from leaders at Health & PharmaTech unicorns with high-potential startups as they scale. Since partnering with Mandolin, SignalFire has connected the founders to their largest $10M+ customer and more.

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