The Power of Fifty Bits

Feb 10, 2016
The new science of turning good intentions into positive results

Bob Nease

In every industry, nothing happens until someone does something. In other words, behavior matters… a lot. And it’s hard to think of a more important set of behaviors than those related to our health.

Consider three relatively simple pharmacy-related behavioral hiccups:

  • People not taking their medications as prescribed,
  • People taking more expensive drugs rather than equally effective, less expensive drugs,
  • People getting their medications from more expensive but less convenient (and often less safe) pharmacies.

Poor choices in these three areas cost hundreds of billions of dollars in waste each year along with untold medical complications and unnecessary suffering. Programs such as Select Home Delivery and ScreenRxSM are great examples of how applied behavioral science provides practical and proven methods to improve these behaviors.

Why Behavior is Critical for Managing Prescription Drug Prices

Drug prices in the U.S. are most effectively managed by injecting vigorous competition into the supply chain. Making this happen requires three interlocking pieces:

  • A robust regulatory pathway that allows clinically comparable products and services to go head to head in the marketplace. Without such a pathway, the number of competitors dwindles and competition flags.
  • A pharmacy benefits manager laser focused on pitting entities in the supply chain. It’s the PBM’s job to ensure that manufacturers of clinically equivalent medications compete on price. Similarly, most patients have access to multiple high-quality pharmacies; these should compete on price as well.
  • A deep, practical understanding of human behavior. At the end of the day, competition is meaningless unless patients shift from one medication to another, or from one dispensing option to another. The ability to effect positive behavior change among patients is both difficult and critical.

Based on its business model of alignment and reflecting its longstanding corporate DNA, Express Scripts has demonstrated time and time again a willingness to wring waste out of even the biggest players in the supply chain. Furthermore, when it comes to understanding patient behavior – which is mission critical to making the use of prescription medications safer and more affordable – Express Scripts stands alone.

How You Can Crack the Behavior Change Code

My new book, “The Power of Fifty Bits: The New Science of Turning Good Intentions into Positive Results” (HarperCollins) is a practical, how-to guide for improving behaviors among our customers, our coworkers, our loved ones and ourselves.

It’s based on a fascinating fact about how our brains work: of the 10 million bits of information that our brains each process per second, the conscious part of our brains run at on only 50 bits per second. That means that our brains are pretty much wired for inattention and inertia. Over time, this limitation creates a gap between what we want to do (our intentions) and what we actually do (our behaviors). This “intent / behavior” gap is what’s at the heart of most of our poor choices.

“The Power of Fifty Bits” provides seven specific strategies that readers can apply every day to close this gap, improve almost any type of behavior, and enjoy more positive results. It’s chock full of examples, highly accessible, designed for people who want to begin changing behaviors immediately. I hope you’ll take a look; I know that you’ll enjoy and benefit from the material.

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