Express Scripts Announces New Program for Biologics

Reimbursement

On Thursday, September 8, Express Scripts introduced its Inflammatory Conditions Care Value Program, which it says is a “comprehensive approach to control costs and improve care for people with inflammatory conditions like rheumatoid arthritis, psoriasis and Crohn’s Disease.”  According to the Express Scripts press release announcing the program, approximately 10 million Americans live with inflammatory conditions.  It further states that these conditions are treated by biologic therapies, which, as of 2015, make up the “country’s costliest therapy class,” representing 9.8% of total pharmacy spending.

According to the press release, the Express Scripts program connects patients with the Rheumatoid Arthritis and Inflammatory Disease Therapeutic Resource Center®, which helps patients adhere to therapy 8% more than without this resource.  The program also provides for early discontinuation refunds of unused medication.

Express Scripts will also now use a new formulary for biologic drugs that provides for treatment with “niche,” single-indication products.  The older plan had funneled all patients into treatment with two broad anti-inflammatory biologics, which together represent 73% of patient costs for biologic therapies.

Download PDF

Comments are closed.