Express Scripts 2013 Annual Report Download - page 10

Express Scripts 2013 Annual Report 10
We also support health plans that serve the newly insured Public Exchange members, which is a population
expected to grow with the implementation of the Affordable Care Act. This business is driven by both federal and state
requirements and we earn revenues based on transaction-related activity. We offer an array of pharmacy benefit solutions that
can be leveraged in plan design to align with any exchange strategy to achieve desired cost and clinical objectives.
Specialty Benefit Services. Specialty medications are used primarily for the treatment of complex and potentially
life-threatening diseases. These medications are broadly characterized to include medications with frequent dosing adjustments,
intensive clinical monitoring, the need for patient training, specialized product administration requirements and/or are limited
to specialty pharmacy network by manufacturers. Through a unique combination of assets and capabilities, Express Scripts
provides an enhanced level of care and therapy management for patients taking specialty medications, increased visibility and
improved outcomes for payors, as well as custom programs for biopharmaceutical manufacturers.
Accredo Health Group and CuraScript Specialty Pharmacy, which is currently in the process of being rebranded
(“Accredo®”), are focused on dispensing infused, injectable, inhaled and oral drugs that require a higher level of clinical
services and support compared to what typically is available from traditional pharmacies. Accredo is able to achieve better,
healthier outcomes and reduced waste through a disease-centric organization, specialty trained clinicians, a nationwide
footprint, a network of employed and contracted in-home nursing services, reimbursement and patient assistance programs, and
bio-pharma services.
Freedom Fertility (“FreedomFP”) is the nation’s leading specialty pharmacy focused on the needs of fertility
patients and providers. Through FreedomFP we provide insurance assistance and patient education and support.
Specialty Benefit Management is our next-generation approach to managing total specialty drug spend and
enhancing patient care. By integrating medical benefit management, pharmacy benefit management and our pharmacy and
distribution services, we offer flexible solutions that control the cost of specialty drugs and make healthcare more affordable
and accessible. Approximately half of specialty drug spend is on the medical benefit. As such, it is critical to provide our clients
a toolset that can manage specialty spend, regardless of the benefit. Our capabilities include guaranteed savings through
medical benefit management services, ensuring the safe and appropriate use of high-cost specialty drugs, redirecting patients
and medications to the lowest-cost and most appropriate channel, verifying claims are paid at the contracted rate, improving
opportunities to achieve rebates and, where clinically appropriate, moving drug coverage from medical to pharmacy benefit and
to lower-cost sites of care.
Administration of a Group Purchasing Organization. We operate a group purchasing organization (“GPO”) that
provides various administrative services to participants in the GPO. Services provided include coordination, negotiation and
management of contracts for group participants to purchase generic pharmaceuticals and related goods and services from
pharmaceutical manufacturers and suppliers, as well as providing strategic analysis and advice regarding pharmacy
procurement contracts for the purchase and sale of goods and services.
Consumer Health and Drug Information. Express Scripts empowers member decision-making through online and
mobile tools that help guide members in making informed drug, pharmacy and health choices.
Express Scripts’ digital solutions provide easy access and clear, simple functionality. The Express Scripts Member
Website (www.express-scripts.com) and mobile app are designed to help keep members’ medication information instantly
available on their computers or mobile devices. When members use self-service tools, it results in lower administrative costs,
better drug therapy adherence, reduced waste and fewer doctor visits, leading to savings for both clients and members.
Information included on our website and mobile app are not part of this annual report.
Other Business Operations Services
Overview. Through our Other Business Operations 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. United
BioSource LLC (“UBC”) develops scientific evidence to guide the safe, effective and affordable use of medicines. During
2013, 2.1% of our revenue was derived from Other Business Operations services, compared to 2.4% and 2.8% during 2012 and
2011, respectively.
Provider Services. CuraScript Specialty Distribution is a specialty distributor of pharmaceuticals and medical
supplies direct to healthcare providers for office or clinic administration. 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. Headquartered in Lake Mary, Florida, CuraScript Specialty Distribution operates three distribution centers to