Express Scripts introduces programme in the US to lower inflammatory drug spending

Express Scripts on Thursday launched the Inflammatory Conditions Care Value Program, an initiative aimed at reducing costs and improving care in the treatment of inflammatory conditions. "Painful inflammatory conditions like rheumatoid arthritis can cripple patients and obliterate payer budgets," remarked Glen Stettin, chief innovation officer at the pharmacy benefits manager, adding that "by finding creative ways to take better care of patients and protect our clients' budgets, Express Scripts is uniquely tackling one of the biggest health challenges facing our country today." 

Under the programme, Express Scripts said it will refund as much as $6000 to plan sponsors if a patient discontinues treatment with any preferred anti-inflammatory drug within 90 days, resulting in potential annual savings of $250 million across its customer base. "While Express Scripts has previously offered refunds for early discontinuation of a single medication, this new reimbursement approach is the country's first value-based refund to span multiple preferred medications that treat a group of diseases," the company said.

Meanwhile, Express Scripts indicated that it will now also manage a formulary category centred on each individual inflammatory condition. According to the pharmacy benefits manager, this will allow "niche, single-indicationproducts" to directly compete with nonspecific anti-inflammatory drugs, which should favour additional competition and "make this therapy class more affordable for participating plans."

"The high price for these medications has always been a budgetary challenge, but one of employers' growing frustrations is paying for an expensive medication that doesn't ultimately help a patient get healthier," Stettin said. However, he suggested that "by sharing risk and pursuing novel solutions, Express Scripts is minimising our clients' financial exposure if a patient needs to switch medications or discontinue treatment early." 

The new programme follows recent criticism directed at Mylan from US lawmakers regarding the company's price increases for its EpiPen (epinephrine) auto-injector. Mylan has since expanded access to a patient discount programme for EpiPen, and also unveiled plans to roll out a generic version of its anaphylaxis treatment. 

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