Express Scripts focuses on non-adherent patients

Express Scripts has launched a proprietary software system that determines which of its enrollees are most likely to stop using their medications in the middle of a prescribed regimen, the St. Louis-based pharmaceutical benefits manager announced Monday.

The system will focus primarily on diabetes, hypertension and high cholesterol patients, and is intended to cut down on hospitalizations and hospital readmissions. Those considered to be at risk for having their regimens derailed will be given telephone and email reminders, mailed automatic refills and other forms of assistance.

"Our new predictive models allow us to do something that wasn't possible before: better identify those patients before they run into trouble, and tailor practical, patient-centric solutions that target the specific factors that put them at-risk for non-adherence," Dr. Steven Miller, Express Scripts' chief medical officer, said in a statement.

The software focuses on variables such as the patient's medical history, the amount of the co-payment required by their health plan, and whether they have children at home.

Although keeping patients on their drugs seems an incidental part of healthcare delivery, it is often one of the biggest reasons patients with chronic diseases wind up in the hospital. According to Express Scripts' own research, patients who do not adhere to their medication regimens cost the healthcare system $106 billion a year. Several accountable care organization models focus on making sure hospital patients are connected with their prescriptions prior to discharge.

For more:
- read the St. Louis Business Journal article
- read the Express Scripts press release

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