GigaOM Highlights Our Actionable Data

May 1, 2013
Find out what technology blog GigaOm says about Express Scripts' use of actionable data in the fight against two of healthcare's biggest challenges.

GigaOM, a leading technology blog, published an article yesterday afternoon highlighting Express Scripts’ fight against two of healthcare’s most expensive challenges: medication nonadherence and prescription drug fraud and abuse.

The writer Derrick Harris summarizes our strategy as being "all about data."

He goes on to describe several examples of abuse and misuse identified and investigated by the Express Scripts fraud, waste and abuse team, including one that hits particularly close to home for all parents:

In one instance, Express Scripts’ models helped Klein and his team identify a husband-and-wife team that had obtained approximately 7,000 pills – worth about $150,000 in total – by using 17 doctors and pharmacies in different cities. They had actually signed multiple exclusivity contracts with doctors, stating they would only get narcotics prescriptions from those doctors. In another case, an Express Scripts flagged an individual who had received 808 days’ worth of narcotics in one year, with the pills spread across 21 pharmacies, 19 doctors and multiple schedule 2 controlled substances.

Pivoting to the country's other serious drug problem – medication nonadherence – Harris outlines how Express Scripts is using data from 1.4 billion annual prescriptions to predict which patients are likely to become nonadherent within the next 12 months:

Those models turn out to be pretty interesting, however, taking into account about 400 variables including classic demographic information, the types and numbers of prescriptions someone is getting, and even whether people respond to Express Scripts’ letters and phone calls.

There are many Americans who clearly are taking prescription drugs when they shouldn't be. On the other hand, there is a sizable group of patients who are failing to take the medications that they should. Express Scripts is leveraging predictive, actionable data to address both issues.

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