Lupin 2024

Express Scripts simplifies pharmacy experience

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ST. LOUIS — A suite of high-impact, data-driven engagement programs from Express Scripts are said to be simplifying the prescribing experience for physicians and providers. The new programs are said to be able to help them both make better clinical and cost-effective decisions with their patients right at the point-of-care.

The solutions are part of the industry’s most comprehensive effort to champion a simpler pharmacy experience by improving connectivity and easing the administrative burden for physicians and their staff.

 “Our industry leading technology platforms, powered by data and analytics from billions of claims, are the cornerstones of a physician-minded portfolio of programs and digital tools that streamline and improve the prescribing process,” said Dr. Lynne Nowak, Express Scripts chief physician experience officer. “Through the use of machine learning and AI, coupled with high-touch interactions with our pharmacists, we are helping physicians make the most appropriate, cost-effective prescribing decisions with significantly reduced administrative burden.”

Digital solutions, such as electronic prior authorizations, clinical direct messaging and real-time prescription benefit information improve connectivity and reduce costs for both members and plans. Using real-time data, we inform prescribing decisions by sharing the patient’s out-of-pocket cost, formulary coverage, therapy options, generic vs brand pricing and pharmacy channel pricing differences. The information also helps physicians address safety concerns, such as drug interactions, over-utilization and adherence gaps for patients who are late to fill a medication.

Prescribers who use Express Scripts’ digital solutions have noted improved experiences with the removal of old, administrative hurdles such as faxing and phoning. “New digital platforms provide us — and the patient — with drug pricing transparency and real-time plan information in the exam room, simplifying the experience for the entire care continuum,” said Dr. Alan Braverman, professor of medicine, Washington University and member of the Express Scripts Medical Advisory Board. “These tools and enhancements clearly have a physician’s workflow in mind, and are helping our patients get to the right medication for them at the right price.”

More than 85%t of physicians use electronic health record (EHR) technology in their practice, and increased adoption of this technology has allowed Express Scripts to further innovate in this space. In 2016, Express Scripts was first in the industry to collaborate with Surescripts to bring real-time prescription benefit information directly into the physician workflow via the EHR. By the end of 2018, we expect more than 100,000 prescribers will have access to this information.

“Prescription price transparency helps lower costs for patients and prevents prescription abandonment at the pharmacy,” said Tom Skelton, chief executive officer of Surescripts. “With real-time access to patient benefit information, plus the ability to quickly and easily process prior authorizations electronically, we’re enabling better care decisions and improving the patient-provider experience.”

Express Scripts also has comprehensive electronic prior authorization (ePA) technology for physicians, with more than half of all prior authorizations coming in electronically. Using ePA is 11 times faster than traditional prior authorization processes, with decisions returned to prescribers in under two minutes. Nearly 80 percent of prescribers who treat Express Scripts members are submitting prior authorization requests electronically. Greater adoption of this technology is critically important as new, high-cost therapies come to market and require plans to better manage appropriate use via prior authorization.

In addition to Express Scripts’ efforts to inform prescribing decisions before the patient reaches the pharmacy counter, the company is working with physicians to inform future patterns of prescribing.

Express Scripts’ high-touch approach to prescriber engagement is led by a team of more than 200 pharmacists and physician engagement specialists who interact in-person with prescribers and their office staff. “Our pharmacists help physicians stay well-informed about lower-cost therapy options, and help identify patients who have critical gaps in care or other medication concerns. The team also assists physicians with optimizing their EHRs and Express Scripts’ digital tools to make prescribing simpler, faster and more cost-effective for patients and their plan,” said Dr. Nowak.

“We know physicians’ time is limited, so we tailor our interactions with them based on data from our proprietary provider analytics platform, MediCUBE, and our predictive modeling and population health analytics tool, HealthPredict,” added Dr. Nowak. “With this information, we can optimize our time with each physician and pinpoint the greatest opportunities to help them and their patients.”


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