ScreenRx: The Cure for the Costliest Health Care Problem

Nonadherence to medication continues to be our nation’s costliest healthcare challenge. The U.S. wastes hundreds of billions of dollars annually from treating medical complications that could have been avoided if patients had taken their medications as prescribed. Emergency room visits, hospitalizations and extra tests not only add zeros to healthcare bills, but often result in poorer health outcomes for patients. Breakthrough and even curative drugs won’t work if patients don’t take them.

Curing America’s Costliest Healthcare Problem

Express Scripts is committed to fighting nonadherence. ScreenRx^® leverages machine learning algorithms to uncover more than 300 features about patients, physicians, diseases, and prescribed therapies to identify the individuals most likely to stop taking their medications.

But it’s not enough to know who is going to be nonadherent. It also requires proactive member intervention. ScreenRx provides members a variety of channels including automated telephone calls, live calls from a TRC specialist pharmacists, our member website, our mobile app and – coming soon – emails to determine their personal barrier to medications adherence.

Once we have identified patients' personal barriers to nonadherence, we provide tailored interventions to support them. If a patient identifies behavioral factors such as procrastination or forgetfulness (the most common barriers), Express Scripts may send the patient a medication adherence device, offer 90-day fills, or suggest auto-renewals.

If a patient has clinical questions or concerns about the medication, the patient can speak with a pharmacist. If cost is the primary concern, the patient can speak with a benefit specialist regarding payment assistance programs, lower cost medication alternatives and lower cost pharmacy options such as home delivery.

To date, ScreenRx has closed 37% of medication adherence gaps and has recorded $188.6 million in total healthcare savings for our clients.

Disease Specific Targeting

ScreenRx has helped patients manage asthma/COPD, diabetes, hypertension, cholesterol, osteoporosis, depression and anticoagulants. This year, we’ve expanded coverage to include antiretroviral or antiviral medications for HIV and Hepatitis C (HCV).

Adherence to an HIV medication regimen prevents the disease from destroying the immune system, allowing people with HIV to live longer, healthier lives, while reducing the risk of transmission. Poor adherence makes it more difficult for the body to fight off infections and certain cancers, while increasing the risk of drug resistance and treatment failure. For patients with hepatitis C, the key goals are viral eradication and decreasing the risk of re-infection. It is important that patients obtaining a sustained virologic response complete the intended duration of therapy with no significant gaps.