Express Scripts 2009 Annual Report Download - page 25

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Express Scripts 2009 Annual Report
23
Bio-Pharma Services. Each year, more specialty drugs become available, and the number of patients using these
drugs rises. For new biopharmaceuticals being launched, we can provide biotech manufacturers product distribution
management services. Our trend management programs allow us to drive out wasteful spend in the specialty pharmacy
benefit. We design strategies tailored to each product’s needs with a focus on identifying opportunities to educate the
marketplace regarding drug effectiveness, proper utilization and payor acceptance.
Patient Assistance Programs. We provide fulfillment of prescriptions to low-income patients through
pharmaceutical manufacturer-sponsored and company-sponsored generic patient assistance programs. We offer centralized
eligibility, enrollment and fulfillment services tailored to meet the needs of each client, product, practitioner and patient.
Emerging Markets Services
Overview. Through our EM segment, we provide services including distribution of pharmaceuticals and medical
supplies to providers and clinics, distribution of fertility pharmaceuticals requiring special handling or packaging,
distribution of sample units to physicians, verification of practitioner licensure, healthcare account administration and
implementation of consumer-directed healthcare solutions. During 2009, 5.2% of our revenue was derived from EM
services, compared to 6.4% and 7.0% during 2008 and 2007, respectively.
We operate integrated brands that service the patient through multiple paths: Payors, Providers, and Pharma.
CuraScriptSD provides specialty distribution of pharmaceuticals and medical supplies direct to providers and clinics and
operates a Group Purchasing Organization (“GPO”) for many of our clients. FreedomFP provides fertility services to both
providers and patients. ConnectYourCare (“CYC”) provides consumer-directed healthcare solutions. HealthBridge
provides outsourced distribution and verification services to pharmaceutical manufacturers.
Payor Services. A comprehensive case management approach to manage care by fully integrating pre-certification,
case management and discharge planning services for patients. We assist with eligibility review, prior authorization
coordination, re-pricing, utilization management, monitoring and reporting.
Provider Services. Through our CuraScriptSD business unit we provide distribution services primarily to office
and clinic-based physicians treating chronic disease patients who regularly order high-dollar-value pharmaceuticals. We
are able to provide competitive pricing on pharmaceuticals and medical supplies.
Other Services. We also provide a range of centralized supply chain services which can include sampling
programs and clinical trial assistance as well as specialized shipping and storage and customized dosing.
Segment Information
We report segments on the basis of services offered and have determined we have two reportable segments: PBM
and EM. Our domestic and Canadian PBM operating segments have similar characteristics and as such have been
aggregated into a single PBM reporting segment. Our EM segment primarily includes the Specialty Distribution operations
of CuraScript, and our FreedomFP, CYC, and HealthBridge lines of business. Information regarding our segments appears
in Note 14 of the notes to our consolidated financial statements and is incorporated by reference herein.
Suppliers
We maintain an inventory of brand name and generic pharmaceuticals in our home delivery pharmacies and
biopharmaceutical products in our specialty pharmacies and distribution centers to meet the needs of our patients whether
they are being treated for rare or chronic diseases. If a drug is not in our inventory, we can generally obtain it from a
supplier within one business day. We purchase pharmaceuticals either directly from manufacturers or through authorized
wholesalers. Generic pharmaceuticals are generally purchased directly from manufacturers.
Clients
We are a provider of PBM services to several market segments. Our clients include HMOs, health insurers, third-
party administrators, employers, union-sponsored benefit plans, workers’ compensation plans and government health
programs. We provide Specialty services to customers who also include HMOs, health insurers, third-party administrators,
employers, union-sponsored benefit plans, government health programs, office-based oncologists, renal dialysis clinics,
ambulatory surgery centers, primary care physicians, retina specialists, and others.