First PBM to Apply Custom Interventions to Prevent Non-Adherent Behavior
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(HealthNewsDigest.com) – ST. LOUIS, Oct. 11 — Through a set of proprietary computer models, Express Scripts, Inc. (Nasdaq: ESRX), is now able to accurately predict up to a year in advance which patients are most at risk of falling off their physician-prescribed drug therapy — and to intervene in customized ways to improve those patients’ adherence.
Express Scripts announced today the completed testing of its therapy adherence predictive models. The findings from the tests demonstrate that the new predictive models are more accurate, informative, and actionable than any the industry has produced previously.
The patent-pending models apply to patient behavior in three key treatment classes: diabetes, high blood pressure, and high cholesterol. By being able to intervene in a highly targeted way, Express Scripts can help improve their overall health and reduce their need for increased medical expenditures in the future.
“The problem of non-adherence isn’t new – it’s easy to walk through a hospital and identify people who would not be there if they had simply taken their medications,” said Steven Miller, M.D., chief medical officer at Express Scripts. “But our new predictive models allow us to do something that wasn’t possible before: better identify those patients before they run into trouble, and tailor practical, patient-centric solutions that target the specific factors that put them at-risk for non-adherence.”
Interventions to improve adherence include reminders, consultations with a pharmacist, lowered co-pays, transition to home delivery of medications, auto refills and renewal assistance, and educational information.
In the company’s 2009 Drug Trend Report, Express Scripts found that $106 billion is wasted annually in the U.S. on increased medical costs that result from non-adherent patients.
“As our Drug Trend Report detailed, patients stop taking their medications for a variety of reasons: maybe the drugs are too expensive, maybe the retail pharmacy is inconvenient, maybe the side effects are difficult to tolerate, or maybe the patient is simply forgetful,” Dr. Miller noted. “Regardless of the reasons, the health and financial costs of these decisions are unsustainable. With our new predictive models, we’re proactively getting ahead of these issues. It’s a win-win for both patients and plan sponsors.”
The proprietary models incorporate past patient behavior and demographics, characteristics of the particular medical condition and prescription drug, and a number of other factors that Express Scripts has identified as relevant. The models are the result of over a year of concerted effort by the Express Scripts team of pharmacy-benefit researchers and predictive modelers.
“Previous industry attempts to predict therapy adherence were hampered by both the types and quantity of data available,” said David Tomala, director of advanced analytics at Express Scripts. “Our tens of millions of members, hundreds of millions of annual prescriptions, and advanced understanding of human behavior were key to ‘cracking the code’ on therapy adherence. We are now the first pharmacy benefit manager to be able to — with high fidelity — discriminate in advance and intervene in an effective manner. This approach addresses adherence problems among those patients who need our help the most. Improved adherence is the hallmark of better quality care, healthier patients, and reduced overall medical costs.”
About Express Scripts
Express Scripts, Inc., one of the largest pharmacy benefit management companies in North America, is leading the way toward creating better health and value for patients through Consumerology®, the advanced application of the behavioral sciences to healthcare. This approach is helping millions of members realize greater healthcare outcomes and lowering cost by assisting in influencing their behavior. Headquartered in St. Louis, Express Scripts provides integrated PBM services including network-pharmacy claims processing, home delivery services, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services. More information can be found at http://www.express-scripts.com/pressroom/ and http://www.consumerology.com/.
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