MISSISSAUGA, ON, May 23, 2012 /CNW/ - Express Scripts Canada, one of the largest providers of health benefits management services in Canada, today announced the findings of the Express Scripts Canada 2011 Drug Trend Report, an annual report produced by Express Scripts Canada that provides one of the country's most comprehensive analyses into the use of prescription drugs and related trends in the private sector throughout Canada.
Among the primary findings of the report is that while drug spend remained flat in 2011, private drug plans in Canada wasted approximately $5 billion in drug spend for the calendar year ended December 31, 2011. The newly released Express Scripts Canada 2011 Drug Trend Report defines waste as "spending that does not result in improvements to health outcomes". The report will be presented to interested parties via Webinars later this morning in French and this afternoon in English.
"Effective health care begins with clinicians who diagnose patients and design treatment plans to deliver the best health outcomes," said Michael Biskey, President of Express Scripts Canada. Plan sponsors - the organizations that provide drug plans to their employees - need to engage members and help them change their behaviour to effectively control and, where possible, eliminate all forms of waste.
"The key to reducing waste is to actively engage plan members and help make it easy for them to consistently choose a lower-cost, clinically effective medication from a lower-cost delivery channel while encouraging and facilitating adherence to their medication therapy. Optimal outcomes for the patient and the plan sponsor are only possible by changing the behaviour of patients."
Dealing with Waste at Multiple Levels
The Express Scripts Canada 2011 Drug Trend Report further categorizes waste as follows:
Other Key Findings
The Express Scripts Canada 2011 Drug Trend Report also quantifies changes in drug trend on a year-to-year basis, using de-identified claims data from millions of patients across Canada. More specifically:
Team Effort Required to Reduce Waste
To eliminate waste from the pharmacy benefit, plan sponsors need to drive significant member behaviour changes. Express Scripts research shows that while plan members have good intentions, their actual behaviour creates waste within drug plans. Private plans must engage members to unlock their good intentions and, where necessary, encourage and help them to change their behaviour.
Patients have a tremendous opportunity to help reduce waste while maintaining and possibly improving their health outcomes. Express Scripts Canada believes that this can be accomplished by engaging in three simple pharmacy-related behaviours:
Innovative solutions are required to create behaviour change to achieve optimal behaviour. Efforts to drive out behaviour-related overspending can be significantly enhanced by applying the insights and proven strategies of behavioural sciences.
Better Care, Zero Waste Go Hand-in-Hand
Over the past few years, Express Scripts research has repeatedly demonstrated that better care and zero waste often go hand-in-hand - the most effective care can often costs the least. Thus the challenge is not simply to make these two goals compatible, but rather to do so in a manner that is acceptable to both members and plan sponsors. Surprisingly, the biggest gap is not between what plan sponsors want and what patients want, but rather between what patients want and what patients actually do.
This insight is crucial. As patients do not act on their existing good intentions, increased education and adjustments to financial incentives are of limited effect - a disappointing result consistent with the experience of many plan sponsors. Even more important, such a gap illustrates that many patients want exactly what plan sponsors want. In this case, the issue is not as much about convincing patients to align their behaviours with the interests of the plan sponsors, but rather helping them act upon their own underlying intentions.
Solutions that Drive Better Behaviour
To activate good intentions, Express Scripts, Express Scripts Canada's parent organization, leads the way in the convergence of the behavioural sciences and health care - an approach it calls Consumerology®. This unique approach provides plan sponsors with practical solutions that deliver better health and lower costs while preserving individual choice.
Express Scripts Canada knows that while people have good intentions, they are wired for inattention and inertia - people are creatures of habit. Therefore, traditional tools, such as education and financial incentives, will not close this gap between intent and behaviour because they focus on changing patients' minds rather than activating the good intentions that already exist.
The advanced application of the behavioural sciences to health care leverages proven strategies from the behavioural sciences to activate consumer intent. Express Scripts Canada's expanded pharmacy benefit management (PBM) service uses proven engagement and intervention tools that apply behavioural sciences to health-care decision-making to influence plan-member behaviour, and ultimately, the decisions that affect the prescription-drug benefit. As part of the service plan members, with the support of their physician, as appropriate, are proactively encouraged to interact with a team of highly qualified professionals to learn about their maintenance medication alternatives so that they can make more informed choices. The result aims at decisions that offer the best possible health outcome while reducing costs for both the plan member and the plan sponsor.
With Express Scripts Canada's expanded PBM service, Canadian plan sponsors finally have access to proven tools to better manage the cost of the prescription drug benefit while actually providing plan members with an enhanced prescription drug service.
Express Scripts Canada 2011 Drug Outcomes Report
Password-protected versions of the full Express Scripts Canada 2011 Drug Trend Report, in portable document format (PDF) in both English and French, will be posted later today to the Express Scripts Canada Website at www.express-scripts.ca/research/drug-trend-reports. Passwords can be requested by sending an EMAIL to Express Scripts Canada at ExpressScriptsCanadaOutcomesConferenceTOR@express-scripts.com.
2012 Pharmacy Outcomes Webinar
Later today, Express Scripts Canada will hold Webinars for customers, selected broker consultant partners and members of the media at which the findings of the Express Scripts Canada 2011 Drug Trend Report will be presented. The French-language Webinar will begin at 10 a.m. ET; the English-language Webinar will get under way at 1 p.m. ET. Interested parties may access the live Webinars from the Express Scripts Canada Web site at www.express-scripts.ca. Following the call, an audio archive and the replay-on-demand versions of the Webinars will be available on the Website at www.express-scripts.ca/research/drug-outcomes-conferences. To request a password for live or archived versions of these Webinars, send an EMAIL to ExpressScriptsCanadaOutcomesConferenceTOR@express-scripts.com.
About Express Scripts Canada
Express Scripts Canada, a registered business name of both ESI Canada and Express Scripts Canada Services, each an Ontario partnership, indirectly owned by Express Scripts, Inc., is one of Canada's leading providers of health benefits management services. From its corporate headquarters in Mississauga, Ontario, just outside Toronto, Express Scripts Canada provides a full range of integrated pharmacy benefit management (PBM) services to insurers, third-party administrators, plan sponsors and the public sector, including health-claims adjudication and processing services, Home Delivery Pharmacy Services, benefit-design consultation, drug-utilization review, formulary management, and medical and drug-data analysis services, to better facilitate the best possible health outcomes at the lowest possible cost. For more information about Express Scripts Canada, visit its Web site at www.express-scripts.ca.
About Express Scripts
Express Scripts manages more than a billion prescriptions each year for tens of millions of people. On behalf of our clients — employers, health plans, unions and government health programs — we make the use of prescription drugs safer and more affordable. We innovate to enhance patient care, reduce pharmacy-related waste and increase therapy adherence. Building on a strong clinical foundation, we apply our understanding of the behavioural sciences — an approach we call Consumerology® — to make it easier for people to choose better health.
Headquartered in St. Louis, Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing, home delivery, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services.
For more information, visit www.Express-Scripts.com
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This press release contains forward-looking statements, including, but not limited to, statements related to the Company's plans, objectives, expectations (financial and otherwise) or intentions. Actual results may differ significantly from those projected or suggested in any forward-looking statements. Factors that may impact these forward-looking statements can be found in the Management's Discussion and Analysis of Financial Condition and Results of Operations in the Company's Form 10-Q filed with the SEC on May 10, 2012. A copy of this form can be found at the Investor Relations section of Express Scripts' Web site at http://www.express-scripts.com/corporate.
We do not undertake any obligation to release publicly any revisions to such forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.