Prescription Drug Coverage
Express Scripts, Inc.
What is a PBM?
Express Scripts, Inc. (ESI) is a Pharmacy Benefits Manager. ESI works with Christian Brothers Services to provide benefits that delivers the best clinical outcomes and the lowest possible costs.
This means making sure the right medication gets to the right patient at the right time.
ESI works on the Plan's behalf to negotiate with drug manufactures so no one pays more than they need to. Any dollar spent that doesn’t improve health is a dollar wasted. PBMs drive waste out of the system, while ensuring patient safety.
When a patient fills a prescription, Express Scripts pharmacists are working behind the scenes to review prescription history, ensure correct dosing, check for potential drug interactions and make sure the medication is affordable. And, compassionate care is just a phone call away – any day, any time.
Another way PBMs add value is by reviewing the thousands of drugs that have been approved for use. An independent panel of physicians and pharmacists takes a close look at the drugs and provides a formulary – a list of medications proven to provide the best clinical results for all conditions. By delivering smarter solutions to patients and clients, PBMs provide better care and lower cost with every prescription, every time.
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Specialization Elevates Patient Care and Adherence to Medications
A generalist pharmacist may need to keep up with thousands of medications from many different disease states while finding time to wait on customers at the retail counter and fill up to 30 prescriptions an hour. This leaves little time to provide specialized, personalized attention. On average, patient conversations with retail pharmacists last less than two minutes, and they often can be overheard.
Express Scripts’ approach is different. Conversations with specialist pharmacists are private. They average 12 minutes, but the pharmacist will stay on the line for as long as the patient needs.
ESI pharmacies provide specialized and personalized care for patients with chronic and complex conditions. ESI operates 20 condition-specific Therapeutic Resource CentersSM, each staffed with specialist pharmacists, nurses and other clinicians. This approach helps close gaps in care and leads to increased patient adherence and better health outcomes. Specialist pharmacists are trained in behavioral practices that engage patients and encourage them to talk openly about their illnesses, their challenges and obstacles to staying on track. By taking the time to personalize the conversation, our specialist pharmacists tailor their approach to each patient.
Click Here to Learn How Express Scripts Practices Pharmacy
Christian Brothers Services is continually on the lookout for ways to improve our members’ health. ScreenRx is a new service being added through Express Scripts, Inc. (ESI) at no additional cost to you or your plan participants. ScreenRx® is the industry’s first adherence screening solution that applies behavioral science, clinical specialization and actionable data to help patients make better decisions that improve health and financial outcomes. For those who live with an ongoing condition, it’s important that they take medication exactly as prescribed by their doctor. There are many reasons why someone may miss a dose from time to time, but too many missed doses could negatively impact their health, and even lead to more serious medical complications. Express Scripts uses tailored patient engagement solutions to reach out to patients who are at an elevated risk before non-adherence becomes a problem. Most patients will require behavior-based interventions, including renewal assistance and reminder devices. When at-risk patients have clinical concerns, such as side effects, specialist pharmacists have the expertise to intervene and help patients overcome obstacles to adherence.
Exactly how are patients in the U.S. using narcotic pain medications known as opioids? Can we identify potential ways to improve the safe prescribing of these medications?
To gain a deeper understanding of these concerns, Express Scripts conducted an in-depth examination of more than 36 million de-identified pharmacy claims from 6.8 million insured Americans of all ages who filled at least one prescription for an opioid to treat short-term or longer-term pain from 2009 through 2013. Read the full report below.
As a result of this study, ESI is conducting a pilot program that will test a new opioid education and intervention strategy to assist members in understanding the importance and danger of prolonged opioid use. By increasing member touch points, via an educational letter and neuroscience specialist pharmacist outreach when applicable, ESI anticipates reducing member’s days supply when taking an opioid. This solution aims to nudge members into making better decisions when taking these powerful medications.
A Nation In Pain.pdf
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