CBS News Investigation Uncovers Compound Scheme

Feb 24, 2015
By taking the industry’s most aggressive action to close the compounding loophole, Express Scripts will save our clients and members approximately $1.9 billion in 2015.
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  • Compound Medications

Last night, CBS Evening News aired an investigative segment about certain compounding pharmacies that have exploited industry loopholes to bill thousands of dollars for topical pain creams that don’t provide any clinical benefit.

As our chief medical office, Dr. Steve Miller, pointed out in the piece, “this is really abuse in the marketplace.”

Dr. Steve Miller  

Stories just like this one are part of the reason why we announced last year our solution to exclude coverage for more than 1,000 compounding ingredients that have not been proven to be any more effective than much more affordable options already available on the market.

Some patients have a true clinical need for a compounded medication. For example, a patient who cannot swallow a tablet and may need it liquefied. And in these instances, we ensure that patients maintain access to the customized products they need.

However, our research has shown that more than 95% of the country’s spend on compounded drugs is waste – more money spent, but no extra health benefit. And that needs to stop.

By taking the industry’s most aggressive action to close this compounding loophole, Express Scripts will save our clients and members approximately $1.9 billion in 2015 that would have been otherwise wasted on these unproven products.

View the entire CBS Evening News segment here.

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