have risen to prominence in recent years for their work on America’s “deaths of despair.” They discovered Americans between the ages of 25 and 64 have been committing suicide, overdosing on opioids or dying from alcohol-related problems like liver disease at skyrocketing rates since 2000. (see: Every American family basically pays an $8,000 ‘poll tax’ under the U.S. It seems to me that there has been relatively little written about the current major public heath crisis in the U.S., the opioid epidemic and deaths of despair. It makes perfect sense for the PBMs to promote digital health startups, particularly those with a focus on the need for behavioral changes necessary to increase the effectiveness of prescription drugs. Many digital health companies are failing (see: 10 Reasons Why Digital Health Start-Ups Go Bust). To restate the obvious, all of this activity by PBMs and health insurance companies is designed to drive the most effective and efficient use of medications, is a very suitable goal. It's worth noting that Express Scripts parent company, health insurance giant Cigna, is also getting involved in the health apps business (see: (see: Cigna Unveils App to Monitor and Improve Medication Adherence). It plans to unveil further categories in the coming year, as other digital health companies tackle a range of diseases and conditions, including musculoskeletal pain, fertility and tobacco cessation. To prove that these treatments work, some companies have invested in clinical studies and other evidence.The Express Scripts program kicks off in January with a formulary that will include 15 programs via companies that treat conditions including depression, anxiety, asthma and diabetes. Their goal is to help people make behavioral changes so they can better manage their condition, and not just to prescribe a pill or device.
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Who’s on the formulary? Many digital health companies provide a combination of medical devices and software apps to people with chronic ailments. By categorizing digital therapies into medication-like tiers, PBMs can make the case that payers are protected from higher costs while providing better access to the new treatments. Doctors typically use this information to help figure out which medication to prescribe and will often try to start with lower-tier therapies. They weigh factors like efficacy and cost, and place medications into tiers that are differentiated by the amount of cost-sharing or copayments required from patients.
It is vetting companies offering cutting-edge treatments for certain conditions, such as diabetes management or respiratory health, then putting them into a “formulary” of recommendations for health insurance plans and doctors.Express Scripts and other PBMs like CVS Caremark essentially decide which medications should be covered by health plans. So Cigna’s Express Scripts.is throwing them a much-needed lifeline. Below is an excerpt from the article:ĭigital health companies are getting funded in droves, but many are struggling to get traction. Now comes news that Express Scripts is taking some measures to assist selected digital start-ups with apps and devices that can be used to optimize the use of prescription drugs (see: Express Scripts throws a lifeline to digital health start-ups).
I have blogged extensively about pharmacy benefit managers (PBMs) in the past (see, for example: Pharmaceutical Companies and PBMs Helped to Create Our Opioid Crisis CVS's Caremark Expands Its Diabetes Care Program with Analytics and Coaching Amazon-PillPack Pushes Against CVS with Prescription Deliveries Also Seeking PBM Status).
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