Express Scripts FoundationServices
Business Principles
Guided by our legacy of independence, we work with our clients to make prescription drugs safer and more affordable.
Our mission at Express Scripts is clear, as is our loyalty to our clients and their members. We lower the cost of prescription drugs for our clients and members, and we help plan members to use prescription drugs safely. We will earn the trust of our clients and plan members by conducting our business according to these principles.
We always promote high-quality pharmaceutical care for plan members.
At Express Scripts we promote high-quality pharmaceutical care. Financial considerations are not permitted to compromise the quality of the pharmaceutical care received by members of the plans we administer.
- In developing our formularies and making other pharmaceutical care recommendations to our clients and members, we rely on evaluations conducted by our Pharmacy and Therapeutics (P&T) Committee, which consists of 18 independent physicians who are experts in their fields of medicine. Members of the Committee must disclose any conflict of interest with any manufacturer and may not participate in decisions regarding drugs made by manufacturers where a conflict may exist. Our P&T Committee receives no information on our negotiated discount arrangements with manufacturers when it evaluates any drug, so financial considerations do not affect the clinical evaluation of a drug. The placement of every drug on our recommended formularies is consistent with the P&T Committee's clinical evaluation.
- We respect the physician's paramount role in healthcare. We never switch a patient to a different drug without the prescribing physician's consent. We will recommend a lower-cost, therapeutically equivalent brand-name drug when clinically appropriate, but in every case the physician's consent is obtained.
- The Express Scripts Pharmacy delivers the highest level of pharmaceutical care. Our state-of-the-art automated pharmacies dispense millions of prescriptions annually in a quality-controlled environment that exceeds that of any manual prescription dispensing system. But the high level of automation in our pharmacies doesn't mean that our Home Delivery customers can't obtain counseling on the use of their medications. Our pharmacists are available to consult with members about their medications via toll-free telephone service 24 hours a day, seven days a week, 365 days a year.
- We monitor the prescription drug use of our members to identify possible safety issues. Most members in plans that we administer see several physicians, and most use more than one pharmacy. We are the only entity maintaining a comprehensive record of these members' total prescription drug use. We send safety alerts to pharmacists on almost 12.5% of prescription claims (almost 40 million claims with an alert in 2010 resulting in nearly 1.4 million prescription changes for safety reasons).
Without compromising quality, we promote cost-effective prescription drug use.
- We aggressively promote the use of generic drugs. Generic drugs that are A-rated by the FDA have been scientifically demonstrated to be equivalent to their branded counterparts and offer great cost-saving opportunities to members and plan sponsors alike.
- Our recommended formularies promote lower-cost brand-name drugs, and we do not recommend therapeutic (brand-to-brand) substitutions to more expensive drugs. Whenever we recommend a specific therapeutic substitution, the recommended drug will cost less. Every drug on our recommended formularies stands on its own clinical and financial merits.
- We recommend plan designs that align our financial interest with that of our clients and their members. Our pharmacy benefit management programs are designed so that we benefit when savings to the client and the members increase. For example, our pricing strategy emphasizes increased use of generic drugs, which are less costly for clients and typically for individual members, and which are also more profitable for us. By aligning our financial interests in this way we ensure that our recommendations always promote the clients' and members' financial interests.
We will disclose our sources of revenue, and we will avoid conflicts of interest in the management of our clients' benefit programs.
- Our clients know our programs can deliver significant savings. We have long disclosed to our clients our sources of revenue. We will continue to do so and will enhance our disclosure to our clients to demonstrate clearly that our loyalty lies with our clients.
- Formulary Support Programs — Express Scripts does not receive manufacturer funding for product-specific PBM formulary support programs. Express Scripts will continue to provide formulary support programs to its clients but without targeted manufacturer funding for these services.
- Other Manufacturer Revenues — Certain subsidiaries of Express Scripts, including Phoenix Marketing Group, CuraScript Pharmacy, Inc. and Express Scripts Specialty Distribution Services, provide services to pharmaceutical manufacturers that are separate from the rebate and formulary support programs discussed above. Examples of these manufacturer services include product sample accountability and distribution, point-of-sale sample voucher administration, pharmaceutical care services and specialty pharmaceutical product distribution. In addition, Express Scripts occasionally provides educational seminars regarding the PBM industry to representatives of certain pharmaceutical manufacturers and others. Compensation paid to Express Scripts or any of its subsidiaries for these types of services is based on the fair market value of the services rendered.
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