Express Scripts selects first crop of tech tools to include on new digital health formulary 

Express Scripts
Express Scripts has picked first tech tools to include on its new digital health formulary. (Express Scripts)

Express Scripts has selected the first 15 technology tools to include in its new digital health formulary, which launches next month. 

The initial batch on the formulary—or curated list of technology- and software-enabled healthcare applications and devices—focuses on tools for members with diabetes, hypertension, asthma or chronic obstructive pulmonary disorder and mental health conditions such as depression and anxiety. 

Express Scripts intends to add additional solutions to the formulary in 2020.

The nation’s largest pharmacy benefit manager announced in May that it intended to create an industry-first digital health formulary to make it easier for health insurers to vet the tools for their members, especially as the number of solutions available in the market continues to grow. 

Mark Bini, vice president for innovation and member experience at Express Scripts, told FierceHealthcare that health plans are innundated with pitches for digital tools, and navigating the diverse marketplace is a pain point that they're really seeking help with.

"This is an unmet need in the marketplace," Bini said. "[Insurers] are hungry for solutions that work, but they don’t have the resources—the time, the effort—to go through and figure out which ones work."

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The formulary includes preferred options for diabetes, cardiovascular and pulmonary care management tools, but allows for alternatives as well. The full list of tools includes: 

  • Diabetes care management: Livongo Health for Diabetes as the preferred option with Omada Health for Diabetes and LifeScan’s One Touch Reveal Plus, powered by Welldoc's Blue Star platform, as alternatives. 

  • Diabetes preventive tools: Livongo Health for Pre-Diabetes as the preferred option and Omada Health for Pre-Diabetes as an alternative. 

  • Hypertension care tools: Livongo Health for Hypertension as preferred and Omada Health for Hypertension as an alternative. 

  • Asthma/COPD: Propeller Health, offering individual programs for both asthma and COPD.

  • Mental health: Learn to Live Cognitive Behavioral Therapy or SilverCloud Health Cognitive Behavioral Therapy, each offering programs targeting depression, anxiety and insomnia specifically. 

These digital health companies are offering an array of solutions, including remote monitoring and digital therapeutics, according to Express Scripts. As the formulary evolves, the PBM intends to also include tools targeting other conditions, such as musculosketal conditions, immunological diseases, cancer and women's health needs.  

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Express Scripts used a multi-step review process to analyze hundreds of submissions from digital health companies for formulary inclusion. This included having clinical experts review research and claims on clinical effectiveness, conducting member experience testing and determining financial value. 

"That is essentially how we manage our medication formularies," Bini said.

The inital group of about 100 submissions was whittled down to 70, eliminating tech solutions that were too young or that did not meet data and privacy standards. From there, the multistakeholder panel narrowed it down to 15 options.

In addition to making it easier for health plans to contract with these digital health companies, Express Scripts will provide supports to partners who select a program on the formulary to ensure that members are using the technology correctly, the company said.