Express Scripts 2011 Annual Report Download - page 13

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Express Scripts 2011 Annual Report 11
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 assist our clients in an effort 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.
Personalized Medicine and Pharmacogenomics. We apply the behavioral sciences to prescription drug usage,
quantifying both behavioral factors and market forces related to pharmaceutical spend. We view personalized medicine and
pharmacogenomics as more than using a few genomic tests to predict the effectiveness of medications. Instead,
personalized medicine requires an advanced understanding and application of medical, pharmacy, and behavioral data. A
patient’s age, lifestyle, overall health, and genes can all influence how the patient responds to medications. We utilize our
capabilities in behavioral science principles and pharmacogenomics to offer our clients a comprehensive suite of programs.
Patient Assistance Programs. We provide fulfillment of prescriptions to low-income patients through
pharmaceutical manufacturer-sponsored 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 operate integrated brands that service the patient through multiple paths.
CuraScript Specialty Distribution provides specialty distribution of pharmaceuticals and medical supplies direct to
providers and clinics and operates a Group Purchasing Organization for many of our clients. ConnectYourCare (―CYC‖)
provides healthcare account administration and implementation of consumer-directed healthcare solutions. During 2011,
2.8% of our revenue was derived from EM services, compared to 2.6% and 4.4% during 2010 and 2009, respectively.
Payor Services. We provide 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 CuraScript Specialty Distribution 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.
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 CYC line of business. During the third quarter of 2011 we reorganized our FreedomFP line of
business from our EM segment into our PBM segment. All related segment disclosures have been reclassified, where
appropriate, to reflect the new segment structure. Information regarding our segments appears in Note 12 – Segment
information 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.