Medco 2014 Annual Report Download - page 10

Express Scripts 2014 Annual Report
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Products and Services
Pharmacy Benefit Management Services
Overview.OurcorePBMservicesinvolvemanagementofoutpatientprescriptiondrugutilizationtodrivehigh
quality,cost-effectivepharmaceuticalcare.Weconsultwithourclientstoassistintheselectionofplandesignfeaturesthat
balanceclients’requirementsforcostcontrolwithmemberchoiceandconvenience.Wefocusoursolutionstoenablebetter
decisionsinfourimportantandinterrelatedareas:benefitchoices,drugchoices,pharmacychoicesandhealthchoices.Asa
resultofthesesolutions,webelievewedeliverhealthieroutcomes,highermembersatisfactionandamoreaffordable
prescriptiondrugbenefit.During2014,97.5%ofourrevenuewasderivedfromourPBMoperations,comparedto97.8%and
97.4%during2013and2012,respectively.
Clinical Solutions. Weofferinnovativeclinicalprogramstodrivebetterhealthoutcomesatlowercost.Our
physicianconnectivityprogramfacilitateswell-informedprescribingbydeliveringbenefitandformularyevaluationand
medicationhistory,bothelectronicallyandinreal-time,asphysicianswriteprescriptions.RationalMed®evaluatesmedical,
pharmacyandlaboratorydatatodetectcriticalpatienthealthandsafetyissueswhicharethenaddressedthroughtimely
notificationtophysicians,pharmacies,patientsandcasemanagers. ScreenRx®usesproprietarypredictivemodelstodetect
patientsatriskfornonadherenceandproactivelyaddressestheproblemthroughinterventionstailoredspecificallyforthat
patient.ExpressAlliance® offerspatientcarecoordinationservicesthatenableclient-authorizedhealthcareprofessionalsto
shareacommonviewofapatient’shealthrecordandcoordinatepatientoutreachandcounseling.Personalizedmedicine
programscombinethelatestadvancesinpharmacogenomicstestingwithpatientandphysicianoutreachtohelpproviders
understandwhichdrugsordosagesworkbestforindividualpatients,empoweringthemtomakemoreinformedandcost-
effectivedecisionsthatimprovepatientcareandsafety.
Specialized Pharmacy Care. AtthecenterofExpressScripts’condition-specificapproachtocareareTherapeutic
ResourceCenterservices,pharmacypracticesthatspecializeincaringformemberswiththemostcomplexandcostly
conditions,includingcardiovasculardisease,diabetes,cancer,HIV,asthma,depressionandotherrareandspecialtyconditions.
TherapeuticResourceCenterservicesaredesignedtooptimizethesafeandappropriatedispensingoftherapeuticagents,
minimizewasteandimproveclinicalandfinancialoutcomes.
Home Delivery Pharmacy Services. Wedispenseprescriptiondrugsfromoursixhigh-volumeautomated
dispensinghomedeliverypharmaciesandonenon-automateddispensinghomedeliverypharmacy.Inadditiontotheorder
processingthatoccursatthesehomedeliverypharmacies,weoperateseveralnon-dispensingorderprocessingfacilitiesand
patientcontactcenters.Wealsomaintainonenon-dispensinghomedeliveryfulfillmentpharmacyforbusinesscontinuity
purposes.Ourpharmaciesprovidepatientswithconvenientaccesstomaintenancemedicationsandenableustomanageour
clients’drugcoststhroughoperatingefficienciesandeconomiesofscaleaswellasprovidegreatersafetyandaccuracy.
Throughourhomedeliverypharmacies,wearedirectlyinvolvedwiththeprescriberandpatientand,asaresult,research
showswearegenerallyabletoachieveahigherlevelofgenericsubstitutions,therapeuticinterventionsandbetteradherence
thancanbeachievedthroughtheretailpharmacynetworks.
Specialty Pharmacy Services.Specialtymedicationsareusedprimarilyforthetreatmentofcomplexdiseases.
Thesemedicationsarebroadlycharacterizedtoincludethosewithfrequentdosingadjustments,intensiveclinicalmonitoring,
theneedforpatienttraining,specializedproductadministrationrequirementsand/orthoselimitedtospecialtypharmacy
networks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.
OursubsidiariesAccredoHealthGroupandCuraScriptSpecialtyPharmacy(whichiscurrentlyintheprocessof
beingrebranded),collectivelyreferredtoas“Accredo®,”arefocusedondispensinginjectable,infused,oralorinhaled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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.
Oursubsidiary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doevenmoretocontrolthecostofspecialtydrugsandmakehealthcaremoreaffordableand
accessible.Approximatelyhalfofallclientspecialtydrugspendisprocessedonthemedicalbenefit,withtheotherhalf
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