Express Scripts FoundationResearch & Consumerology
Driving Out Waste
Waste is any avoidable healthcare cost that provides no additional health benefit.
In 2010 alone, pharmacy-related waste in healthcare spending exceeded $403 billion. Because that number is not only huge but growing, it is increasingly important to structure interventions and solutions that help protect members and plan sponsors from overspending.
The good news is that patients have a great deal of power to help drive out waste while improving or maintaining their health outcomes, by engaging in three simple pharmacy-related behaviors:
- Using the safest, most cost-effective delivery channels. For maintenance medications, that means using a highly accurate and lower-cost home-delivery pharmacy. For acute medications, it means using lower-cost retail pharmacies. For specialized therapies, it means using specialty pharmacies that are optimized for appropriately treating complex conditions. Â
- Using the lowest-cost clinically effective medications. Patients and plan sponsors should not pay higher prices for medications that generate no additional health benefit. Instead, it's better to take advantage of any available savings from generics and lower-cost brands. Â
- Taking medications as prescribed. Adherence to therapy is an extremely important behavior: getting your prescription filled, following dosing instructions and renewing/refilling as directed. While helping you improve your health outcomes, it also helps protect you from an escalation of costs, things like unnecessary hospital stays, avoidable emergency room visits, additional physician visits, extra laboratory tests and needlessly prolonged therapy.
Efforts to drive out behavior-related overspending can be significantly enhanced by applying the insights and proven strategies of the behavioral sciences.
