5 Key Takeaways for Senate HELP Committee

Jun 13, 2017
As policymakers look for ways to rein in drug costs and improve patient care, they need look no further than what pharmacy benefit managers like Express Scripts do every day. PBMs help employers, unions and health plans provide affordable benefits to American families.

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Pharmacy benefit managers (PBMs) put employers and health plans in control of the benefits they provide, and as a result, patients get better, more cost-effective care.

The healthcare landscape is complex, and employers, health plans, unions and other plan sponsors need a partner like Express Scripts who drives down costs and improves care.

The debate about drug pricing centers on how to ensure patients get the medicines they need at a cost they can afford. For more than 30 years, Express Scripts has put medicine within reach of American families. As healthcare becomes increasingly complex, Express Scripts delivers on one simple belief: everyone deserves access to medicine.

As the Senate Health, Education, Labor & Pensions Committee (HELP) Committee holds a hearing on prescription drug prices, Express Scripts highlights the value only we can deliver:

1. Express Scripts lowers the cost of prescription drugs. In 2016, we lowered drug trend – a combination of cost and utilization -- by 27% from 2015, uniquely improving affordability and access. In addition, more than one-third of the clients who depend on Express Scripts had decreased trend in 2016. Express Scripts is driven to ensure every patient gets the medicine they need. PBMs exist to make medicine more affordable. What other part of the prescription drug supply chain can say the same?

2. Express Scripts shares rebates with employers and health plans. Rebates are not unique to Express Scripts, pharmacy benefits, or even health care. Rebates are a form of negotiated discounts. Express Scripts returns approximately 90% of rebates we negotiate with drug manufacturers directly to our clients. Our clients, 100% of the time, decide how the rebates will be returned to them. In turn, clients determine how they will use rebates to lower patient premiums, cost-sharing, and deductibles.

3. Express Scripts leads the fight against opioid addiction. Last week, we announced a new Advanced Opioid ManagementSM solution that will fight our nation’s opioid-addiction epidemic by addressing every touchpoint in patient care to reduce early opioid exposure while preventing overuse and abuse. By combining data analytics, specialized pharmacy care, fraud, waste and abuse management capabilities and our application of behavioral science, we will uniquely help stop abuse before it starts.

4. Express Scripts helps the uninsured access medicines they need. Earlier this year, Express Scripts launched InsideRx, in which we convened 8 drug makers, 40,000 drug stores, and a technology partner to deliver, on average, a 34% discount for 40 commonly used prescription medications to the 30 million Americans paying full cost. These savings go directly to patients at the point of sale.

5. Express Scripts creates breakthrough value-based agreements to make specialty drugs more affordable. Indication-based pricing, remote patient monitoring, and early discontinuation reimbursement all can lower costs for drugs treating diseases like diabetes, multiple sclerosis, cancer, inflammatory diseases, and pulmonary conditions.

As policymakers look for ways to rein in drug costs and improve patient care, they need look no further than what pharmacy benefit managers like Express Scripts do every day. PBMs help employers, unions and health plans provide affordable benefits to American families.

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Lab Staff
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