Express Scripts Canada is committed to driving better health outcomes. We are flexible, responsive and utilize superior adjudication technology. We have a unique advantage in the industry – as a leading health benefit manager in Canada, we understand claims better than anyone. 

Our innovative adjudication services for pharmacy, dental and extended health benefits support faster delivery and increased speed to market. Our state-of-the-art rules-based adjudication system offers the flexibility to provide a virtually unlimited range of drug plans, improve your operational efficiency in the setup and maintenance of plan designs and increase the nimbleness and specificity of claim adjudication.  

Our technology, innovation and people set us apart from others – we are more than just a claims adjudicator. We tap into and actively leverage key learnings and solutions from our global parent company and apply that expertise to meet the specific and unique needs of our clients and Canadians. We are known for our industry-leading data analysis, which we turn into actionable insights for our clients in both the public and private sectors.

We are proud to be the partner of choice to insurance carriers, third party administrators and government. We actively manage escalating plan costs and provide reliable, sustainable solutions to clients and plan members in Canada. Proudly Canadian, we believe in a partnership business model to help our clients set themselves apart from their competitors. 

Learn more about our products and services focused on providing our clients with targeted solutions to address pain points in the areas of: 

  • Cost - Drive lower trend and decrease cost with proper use, selection and optimal plan design
  • Care - Increase drug safety, improve plan member adherence and deliver disease-state specific care
  • Service - Drive lower costs and optimal service with reporting and insights

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Cost Containment Programs

Our programs offer an unlimited range of plans and access to the right therapies for plan members.

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Formulary Management

We offer formularies that feature clinical expertise and balance cost and access.

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Disease Management

We offer targeted disease or therapy-based solutions that enhance plan member experience.

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Digital Services

Integration with web services provides increased convenience and savings. 

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Data Insights

Data insights provides opportunities to guide decision making for plan design.

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Downloads & Resources

A comprehensive offering of the most common forms, lists and manuals.

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Ideas & Insights

The health benefits landscape is ever evolving and complex. Stay up to date on the latest trends, developments, opportunities and risks with meaningful content.

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Express Scripts Canada’s prescription drug trend analysis provides comprehensive, cutting-edge research and insights on the use of prescription medications in the Canadian private sector.