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Express Scripts Announces Enhancements to Industry Leading SafeGuardRx Programs

LOUIS, Dec. 12, 2016 /PRNewswire/ — As part of its ongoing mission to put medicine within reach, Express Scripts (NASDAQ: ESRX) today announced enhancements to its landmark SafeGuardRxSM programs focusing on hepatitis C and cancer.

Beginning Jan. 1, 2017, the company’s Hepatitis Cure Value Program® will now include both Viekira Pak/XR™ (dasabuvir, ombitasvir, paritaprevir, and ritonavir) and Harvoni® (ledipasvir 90 mg/sofosbuvir 400 mg) as preferred products.  With this update, Express Scripts leverages the success of the Hepatitis Cure Value Program to negotiate better pricing for Harvoni and thereby expand treatment options for patients and physicians in 2017, while continuing to lower the cost of treatment by nearly 50 percent.

Coincident with this change to the Hepatitis Cure Value Program, Express Scripts’ National Preferred Formulary, covering more than 25 million Americans, is extending preferred coverage of hepatitis C treatments to include both Viekira Pak/XR and Harvoni.

“Since this program began in 2015, we’ve helped more than 50,000 patients gain access to curative therapy across the Express Scripts customer base,” said Glen Stettin, M.D., Senior Vice President and Chief Innovation Officer at Express Scripts. “Without our program, the cost to cure these patients would have been substantially greater and many payers would have needed to aggressively ration care to ensure the ongoing affordability of their pharmacy benefits.”

Key to the Hepatitis Cure Value program’s success has been the care and attention provided by the specialized pharmacists and nurses at the Hepatitis Therapeutic Resource Center at Accredo®.  A recent analysis examining the sustained viral response among patients treated by Accredo shows a cure rate of greater than 95 percent for patients in the Hepatitis Cure Value program treated with Viekira Pak therapy in 2015 with follow-up hepatitis C testing in late 2015 or early 2016. The analysis also shows a similar cure rate for patient who completed Harvoni therapy in 2015.

 

Expanding Indication-Based Management for Oncology

In 2017, Express Scripts Oncology Care Value ProgramSM will expand its novel, value-based approach to managing oncology spend to additional medications, offering a solution that addresses 23 percent of all oncology pharmacy spend, up from five percent in 2016.  Indications covered by the program include multiple myeloma, non-small cell lung cancer, prostate cancer and renal cell carcinoma.

Patients will continue to receive best-in-class care through Accredo, supported by our Oncology Therapeutic Resource Center, which delivers five percent greater adherence for cancer medications vs. other pharmacies.

“Previously, the same medication was used to treat different types of cancers, although often with varying levels of success and still at the same price,” said Stettin. “The Oncology Care Value Program aligns the cost of medication by indication, enables varied drug price by efficacy and guarantees plan refunds for early discontinuation of treatment.”

Superior Adherence for PCSK9s

The Cholesterol Care Value Program®, which uses a rigorous clinical review process and specialist pharmacist support to ensure PCSK9 inhibitors are accessible when clinically appropriate, has demonstrated industry leading medication adherence rates among patients cared for by Accredo.

Specifically, members who filled a prescription for Praluent® (alirocumab) or Repatha® (evolocumab) via Accredo, as part of the Cholesterol Care Value Program, demonstrated an adherence rate of 89.3 percent compared to 82.1 percent for the same time period at retail and other specialty pharmacies combined.

“This program protects payers from unnecessary spend by ensuring the appropriate use of PSCK9 inhibitors by only those patients who are not responsive to lower-cost statin therapy, and by ensuring that those who do use this therapy achieve an optimal outcome,” said Dr. Stettin.  “Given the cost of these medications, and the severity of disease among patients who use them, it’s important to see high medication adherence rates.”

Express Scripts SafeGuardRx Solutions

In addition to these three SafeGuardRx programs, Express Scripts has implemented other novel solutions to help payers address the latest and most significant challenges to affordable pharmacy care:

  • The Diabetes Care Value ProgramSM combines a novel quality-based pharmacy network, a holistic approach to diabetes patient care and cost management, and financial guarantees that will significantly reduce participating plans’ anticipated increase in diabetes-drug spend for 2017.
  • The Inflammatory Conditions Care Value Program℠ is a comprehensive approach to control costs and improve care for people with inflammatory conditions like rheumatoid arthritis, psoriasis and Crohn’s Disease, through a combination of indication-specific formulary management and refunds for early discontinuation of therapy to better align a drug’s price with the value that drug provides a patient.
  • The Market Events Protection ProgramSM leverages our data solutions to identify and address targeted opportunities in an effort to protect payers from unexpected drivers of drug spending, such as hyperinflated generics, significant average wholesale price (AWP) increases on brands, or captive pharmacy arrangements that drive up spend.

“Together with our clients, we’ve changed the industry by actively taking steps to address increasing cost trends while delivering the highest standard of care,” said Stettin. “We will continue to develop innovating solutions that protect both our clients’ and patients’ best interests.”

About Express Scripts

Express Scripts puts medicine within reach of tens of millions of people by aligning with plan sponsors, taking bold action and delivering patient-centered care to make better health more affordable and accessible.

Headquartered in St. Louis, Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing, home delivery pharmacy care, specialty pharmacy care, specialty benefit management, benefit-design consultation, drug utilization review, formulary management, and medical and drug data analysis services.  Express Scripts also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services.

For more information, visit Lab.Express-Scripts.com or follow @ExpressScripts on Twitter.

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