Specialized Care Apr 2, 2013

Health Decision Science

Health Decision Science is the approach Express Scripts applies to understand how we can enable better decisions and ensure healthier outcomes

Bad health decisions are killing us – our families, our friends, our plans for our lives.

Literally, bad health decisions are killing people, compromising our quality of life and making healthcare unaffordable, causing more than $400 billion in pharmacy-related waste every year. These decisions come in three general areas:

  • Drug Choices: People unwittingly choose more expensive yet less effective medications.
  • Pharmacy Choices: Physicians and local pharmacists – time-pressed and frequently overloaded during decisive moments – make and fail to catch serious mistakes. In addition, patients fail to choose the most cost-effective and accurate pharmacy alternatives.
  • Health Choices: Patients fail to take their essential medications as prescribed.

We at Express Scripts are obsessed with these bad health behaviors – why they occur and what we can do about them, together with our clients.

Healthier outcomes demand better decisions, and for that, we require Health Decision Science℠.

Health Decision Science is the approach we apply to understand why people make the decisions they do, why they tend to adopt behaviors that compromise their health and the affordability of our healthcare, and what we can do about it.

graphic explains the three main aspects of Express Script's health decision science

Health Decision Science is the synthesis of three necessary and complementary scientific disciplines, enabled by the merger of Express Scripts and Medco Health Solutions (which occurred exactly one year ago).

  1. Behavioral Science: Express Scripts is known for Consumerology®, the advanced application of the behavioral sciences to healthcare. For the past five years, we have piloted and deployed strategies to leapfrog engagement techniques and advance better decisions and actions across a broad member population.
  2. Clinical Specialization: Medco pioneered Therapeutic Resource Centers℠ (TRCs), proving the value of clinical specialization in pharmacy across 15 different therapeutic specialties, including cancer, diabetes and heart disease. Since 2007, specialist pharmacists and nurses in the TRCs have applied disease-specific expertise to help individual patients and their doctors make better decisions for treating their chronic and complex conditions.
  3. Actionable Data: We process well over a billion prescriptions a year. We warehouse more than 100 million life years of integrated medical and pharmacy claims. We now manage an unprecedented amount of data. Advanced analysis of that data gives us significant potential to provide greater insights and stronger solutions from both a clinical and a behavioral perspective. We can make safety, savings and service opportunities readily apparent and actionable for more patients, caregivers and providers.

Working together, these three distinctive capabilities form the foundation for a unique, innovative approach to pharmacy benefit management. It is our commitment to the use of Health Decision Science, to the understanding of how health decisions get made, and to the creation of ever better solutions for our patients and our clients.

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