Post by mannmade on Aug 31, 2016 13:28:41 GMT -5
If only Express Scripts understood how AFREZZA could make it so much easier to improve patient compliance, achieve the desired "quality metrics" for a patient population at a significantly overall cost both short term AND long term... What a shame today but there is hope for tomorrow...
Business
Express Scripts promises clients caps on diabetes spending
By Samantha Liss St. Louis Post-Dispatch 14 hrs ago (2)
Editor's note: An earlier version of this story incorrectly stated that a specific type of insulin was excluded from CVS 2017 coverage.
Express Scripts Holding Co. is rolling out a new program with the goal of lowering the cost of diabetes care for its clients by implementing spending caps.
The program, which launches March 1, introduces a multifaceted approach to cut spending — and makes bold promises to the company’s clients, including employers, insurance carriers and government agencies.
“We’ll pay them back if their costs exceed the cap,” Dr. Glen Stettin, the company’s chief innovation officer, said Tuesday.
Diabetes remains one of the biggest drivers of overall drug spending at Express Scripts. In 2015, spending on diabetes medications rose 14 percent, according to the company’s annual report.
With the new program, Stettin expects the year-over-year increase clients face in diabetes drug spending to be cut in half.
To achieve those savings, Stettin said Express Scripts has partnered with Walgreens and more than 1,200 other independent pharmacies to help patients stay on track with their prescriptions.
Express Scripts will establish “quality metrics” it and the other pharmacies should meet when it comes to caring for diabetic patients.
For example, Express Scripts is expecting to improve adherence rates — a measure of how well patients comply with directions on medications, mainly taking pills on time.
To accomplish that goal, Express Scripts and the partnering pharmacies will fill 90-day prescriptions for diabetes medications instead of the 30-day standard.
One of the reasons patients are not adherent to their medication is because they may forget or don’t retrieve their refills on time.
With 90-day supplies, Stettin said, now there’s “four chances to be late instead of 12.”
Patients may also have more interaction with the pharmacists if they’re chronically late to pick up prescriptions. The pharmacist may start a conversation about what barriers those patients are facing to retrieving medicine on time.
Express Scripts, the nation’s largest pharmacy benefit manager, is able to purchase the drugs at discounted prices, which lowers the overall cost.
Because of that, diabetic patients will have broad access to a range of insulin products including Sanofi’s Lantus and Eli Lilly’s version, Basaglar.
Express Scripts’ rival CVS Caremark will not cover Lantus in 2017.
While many other areas of health care are moving toward payments that emphasize quality over quantity, Express Scripts really hasn’t taken on risk like this before, said Vishnu Lekraj, an analyst with Morningstar who covers the company.
“Health care is all about value-based payments and moving away from a fee-for-service model, and being able to better manage the expenses for health care for clients,” Lekraj said.
Business
Express Scripts promises clients caps on diabetes spending
By Samantha Liss St. Louis Post-Dispatch 14 hrs ago (2)
Editor's note: An earlier version of this story incorrectly stated that a specific type of insulin was excluded from CVS 2017 coverage.
Express Scripts Holding Co. is rolling out a new program with the goal of lowering the cost of diabetes care for its clients by implementing spending caps.
The program, which launches March 1, introduces a multifaceted approach to cut spending — and makes bold promises to the company’s clients, including employers, insurance carriers and government agencies.
“We’ll pay them back if their costs exceed the cap,” Dr. Glen Stettin, the company’s chief innovation officer, said Tuesday.
Diabetes remains one of the biggest drivers of overall drug spending at Express Scripts. In 2015, spending on diabetes medications rose 14 percent, according to the company’s annual report.
With the new program, Stettin expects the year-over-year increase clients face in diabetes drug spending to be cut in half.
To achieve those savings, Stettin said Express Scripts has partnered with Walgreens and more than 1,200 other independent pharmacies to help patients stay on track with their prescriptions.
Express Scripts will establish “quality metrics” it and the other pharmacies should meet when it comes to caring for diabetic patients.
For example, Express Scripts is expecting to improve adherence rates — a measure of how well patients comply with directions on medications, mainly taking pills on time.
To accomplish that goal, Express Scripts and the partnering pharmacies will fill 90-day prescriptions for diabetes medications instead of the 30-day standard.
One of the reasons patients are not adherent to their medication is because they may forget or don’t retrieve their refills on time.
With 90-day supplies, Stettin said, now there’s “four chances to be late instead of 12.”
Patients may also have more interaction with the pharmacists if they’re chronically late to pick up prescriptions. The pharmacist may start a conversation about what barriers those patients are facing to retrieving medicine on time.
Express Scripts, the nation’s largest pharmacy benefit manager, is able to purchase the drugs at discounted prices, which lowers the overall cost.
Because of that, diabetic patients will have broad access to a range of insulin products including Sanofi’s Lantus and Eli Lilly’s version, Basaglar.
Express Scripts’ rival CVS Caremark will not cover Lantus in 2017.
While many other areas of health care are moving toward payments that emphasize quality over quantity, Express Scripts really hasn’t taken on risk like this before, said Vishnu Lekraj, an analyst with Morningstar who covers the company.
“Health care is all about value-based payments and moving away from a fee-for-service model, and being able to better manage the expenses for health care for clients,” Lekraj said.