Using available evidence to facilitate the most appropriate and effective treatments, providing high-touch clinical support to help patients manage complex conditions, and value-based payment systems, SafeGuardRx has delivered better medication adherence, higher therapy completion rates, greater compliance with clinical guidelines and has substantially reduced wasteful healthcare spending.
“Our SafeGuardRx clinical solutions provide the highest level of care while helping ensure clients get the most value from the medicines their members take for high-cost, complex conditions,” said Glen Stettin, Express Scripts chief innovation officer. “While there’s been a lot of theorizing about the benefits of value-based payment programs for prescription drugs, Express Scripts has successfully pioneered innovative approaches, giving patients peace of mind through improved clinical care and greater access while reducing costs, waste and inefficiencies for payors.”
Improved Outcomes at a Lower Cost
For clients enrolled in SafeGuardRx programs, particularly, significant improvements were seen in 2017 in the areas of inflammatory diseases, cancer, hepatitis C, diabetes and high cholesterol.
• One quarter of enrolled clients saw decreased specialty medication spending for patients with inflammatory conditions even while utilization of medication in this class increased. Early discontinuation of therapy rates were 15% lower in 2017 compared to 2016.
• A 5% increase in optimal adherence was achieved for cancer patients treated through Accredo’s high-touch care model compared to retail. The program also resulted in a significant step forward for oncology spend management by including even more therapies that are the largest contributors to oncology spend. In 2017, with the addition of a multiple myeloma therapy, the program included therapies that accounted for 25% of clients’ 2017 pharmacy oncology drug spend; in 2018, it will include therapies that account for nearly 60% of clients’ 2018 pharmacy oncology drug spend.
• Through expanded hepatitis C treatment options in 2017, access to curative therapy was provided to more people than ever before, curing 96% of patients who completed therapy. At the same time, the program continued to lower costs for plan sponsors: the average cost of a 30-day prescription in 2017 decreased by 13% for the entire hepatitis C class from 2016.
• In just one year, per-patient spend for diabetes patients declined and greater compliance with recommended treatment guidelines was achieved. Specialist clinicians at our Diabetes Therapeutic Resource CenterSM started an additional 15% of enrolled patients at risk for heart attack and stroke on statin therapy. If all plans were to similarly increase statin use among at risk diabetes patients to help them better control their high cholesterol, we estimate that nearly 13,000 heart attacks would be prevented over the next 10 years.
• Promoting clinically appropriate use of PCSK9 inhibitors for patients with high cholesterol and providing patient support through Accredo resulted in 14% more patients achieving optimal adherence to these high-cost biologic drugs with specialized care versus retail. Beginning July 1, 2018, as part of a new agreement with Regeneron Pharmaceuticals and Sanofi, makers of Praluent (alirocumab) Injection, our Cholesterol Care Value program will provide even greater accessibility and affordability of PCSK9 therapy by simplifying the coverage approval process and providing a portion of the Praluent rebate discount directly to the patient at the time of dispensing.
Earlier this year, Express Scripts reported that it held the overall rate of growth in prescription drug spending in 2017 to 1.5 percent, the lowest growth rate they company has measured since they started tracking this metric in the early 1990s. Fully 44% of its clients saw negative trend in 2017. Express Scripts delivered $32 billion in savings to our clients in 2017 through its comprehensive services and clinical programs, including SafeGuardRx.