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Express Scripts Establishes Industry's Most Comprehensive Specialty Benefits Organization; Enhances Patient Care and Guarantees Cost Savings
Date:11/18/2010

d for comprehensive specialty benefit services spanning both pharmacy and medical benefits. As a result, we are using evidenced-based methods to enhance patient safety and clinical care, while eliminating wasteful healthcare expenses."

Specialty drugs are used to treat chronic, complex conditions, such as cancer and pulmonary arterial hypertension. As noted in the Express Scripts 2009 Drug Trend Report, the pharmacy and medical costs for specialty drugs are expected to increase from 24% of national drug spend in 2009 to 40% by 2014. To control this upward climb of specialty spend and to help patients achieve positive health outcomes, Express Scripts Specialty Benefit Services encourages the use of the right therapy at the right time in the appropriate quantity, regardless of whether a patient receives the drug through the pharmacy or medical benefit.

Based on data from the MarketScan® Commercial Claims and Encounters Database, more than 55% of total specialty drug spend occurs within the medical benefit, as many of these drugs are administered in a doctor's office, clinic, ambulatory infusion site, hospital or by a home health agency.

Matt Totterdale, who heads Express Scripts Specialty Benefit Services, summarized the advantages that the new organization provides. "Traditionally, specialty drugs billed through the medical benefit have not received the same robust clinical and trend management programs as in the pharmacy benefit," he said. "By combining PBM, specialty pharmacy, and now medical benefit management, Express Scripts Specialty Benefit Services helps plan sponsors manage utilization, site of care and claims for medications billed under the medical benefit. Our comprehensive approach makes the use of specialty medications safer and more affordable."

By applying proven tools for specialty drug utilization, trend and claims adjudication, Express Scripts Specialty Benefit Services can forecast, guarantee and deliver mea
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SOURCE Express Scripts, Inc.
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