Express Scripts program reduces diabetes spending, heart attack risk
Express Scripts has released new data showing significantly improved clinical outcomes and reduced drug spending for diabetes – one of America’s deadliest and most costly health conditions.
In its inaugural year, the Diabetes Care Value program – part of the technology-supported, value-based SafeGuardRx platform – reduced diabetes drug spending by 19 percent ($360 per member per year) for the more than 800 plan sponsors enrolled in the program, delivering a total savings of $42.6 million in 2017.
In addition, Express Scripts diabetes specialist pharmacists, using advanced clinical analytics, improved compliance with recommended treatment guidelines by starting an additional 15 percent of enrolled patients at risk for heart attack or stroke on statin therapy. If all Express Scripts plans were to similarly increase statin use among their members with diabetes for better cholesterol control, they could prevent an estimated 13,000 heart attacks over the next 10 years.
“By combining specialized diabetes pharmacy care with benefit strategies, such as utilization management and quality pharmacy networks, we are tackling the diabetes dilemma in ways others simply cannot,” says Glen Stettin, M.D., Express Scripts’ chief innovation officer. “Our SafeGuardRx clinical solutions provide the highest level of clinical care and more affordable healthcare benefits while helping to ensure our clients, who pay the majority of the cost of treatment, get the most value from the medicines their members take for this far too prevalent and devastating condition.”
According to “Diabetes Dilemma: U.S. Trends in Diabetes Medication Use,” a research report published by Express Scripts last year, diabetes has been the most expensive traditional therapy class for the company’s clients’ pharmacy plans for six consecutive years, costing payers about $9,000 more in total medical expenses per person with diabetes, nearly three times more than those without diabetes.
These costs will continue to escalate as more than 30 million people in the United States have diabetes and another 84 million, or one in three people, are prediabetic.
Continuing the fight to contain costs and enhance clinical care for patients with diabetes, earlier this year Express Scripts enhanced the Diabetes Care Value program with two patient engagement tools.
One of the tools is active and connected blood sugar monitoring, allowing Express Scripts diabetes pharmacists to track and analyze blood glucose readings to provide proactive and meaningful patient interventions.
The other tool is the Mango Health mobile platform, powered by Express Scripts, combining personalized messaging and reminders, innovative technology, gamification features and incentive rewards to promote adherence and adoption of better behaviors that can lead to improved health. These advanced capabilities are components of a comprehensive program that takes advantage of a novel quality-based pharmacy network of more than 10,000 U.S. pharmacies, and whole-patient clinical consulting and care from Express Scripts diabetes specialist pharmacists.
Using data and technology in innovative ways to facilitate the most appropriate and effective treatments, provide high-touch clinical support for patients, and apply value-based payment strategies, SafeGuardRx delivers better medication adherence, higher therapy completion rates, greater compliance with clinical guidelines, and substantially reduced wasteful healthcare spending.
In addition to diabetes, the suite of condition-specific SafeGuardRx solutions address some of the costliest therapy classes for payers, including cancer, hepatitis C, high blood cholesterol, inflammatory conditions, multiple sclerosis, pulmonary conditions and rare diseases. “By remaining diligent and continuing to innovate around value-based payment programs for prescription drugs, Express Scripts is turning theory into practice bringing patients the access to the clinical care they deserve, while reducing cost, waste, and inefficiencies for payers,” according to Stettin.
