Pharmacy Benefit Manager Launches Program for Lung Disease, Multiple Sclerosis

Express Scripts recently launched 2 new programs that seek to improve care for patients with pulmonary disease and multiple sclerosis (MS).

The SafeGuard Rx programs — The Pulmonary Care Value Program (PCV) and The Multiple Sclerosis Care Value Program – integrate a personalized care model strategy with a goal of overcoming adherence issues common among patients with asthma, COPD, and MS, according to the pharmacy benefits manager (PBM).

The PCV is directed at patients with asthma or COPD, which is commonly diagnosed among Americans. These conditions can place a significant burden on patients and the healthcare system, especially COPD, which was named the third leading cause of death in the United States.

Through the program, Express Scripts plans to overcome adherence barriers faced by these patients. Through a collaboration with Mango Health and a pharmacy network, the program features remote monitoring and patient engagement and will likely result in improved outcomes, Express Scripts reported.

High-risk patients with asthma or COPD are often offered remote monitoring services to ensure that they remain adherent to therapy. If clinicians at the Pulmonary Therapeutic Resource Center find that patients are nonadherent to their treatment, they will offer personalized care to urge them to take their drugs as prescribed.

During pilot testing, individuals were observed to have a 60% to 80% reduction in rescue inhaler use and a 10% improvement in adherence, which suggests that patients are experiencing less difficulty breathing, according to Express Scripts.

Patients are also able to access a comprehensive application that includes monitoring, caregiver support, and rewards for making healthy choices.

Similar high-touch care is offered to patients with MS through the Multiple Sclerosis Care Value program. The goal of the program is to improve adherence and outcomes, while reducing costs associated with discontinued therapy.

In 2016, MS was the fourth costliest drug class. While approved drugs are increasing therapy options for patients, there is still a high rate of discontinuation, potentially due to adverse events or costs. These factors all contribute to the 10% increase in projected annual spending over the next 3 years, according to Express Scripts.

The Multiple Sclerosis Care Value program features early discontinuation reimbursement, meaning that payers will receive reimbursement if a patient discontinues treatment within 3 fills.

Additionally, the PBM’s specialty pharmacy, Accredo, encompasses a Multiple Sclerosis Therapeutic Resource Center. In terms of MS drugs, the pharmacy has achieved a 5% higher adherence rate compared with other pharmacies, according to Express Scripts.

Through Accredo, patients can also receive reviews of safety, efficacy and affordability; depression screening and counseling; and patient-friendly tools, such as phone calls, text refill reminders, and support from the MS community, Express Scripts wrote.

Not only do both programs address medication adherence, they lower the overall cost of treatment through the National Preferred Formulary and other management programs, Express Scripts concluded.