Express Scripts Wants Retail Partners to Fight Diabetes

The nation’s largest pharmacy benefits manager (PBM), Express Scripts, seeks retail partners that do the best job at keeping patients with diabetes healthy.

That’s what Express Scripts’ Chief Medical Officer Steve Miller, MD, said at the company’s annual client conference, where he also repeated the PBM’s tough position against high prices for the hepatitis C virus (HCV) therapy Sovaldi. Miller’s remarks were reported by CNBC.

As reported at the recent conference, Patient-Centered Diabetes Care, presented by The American Journal of Managed Care and Joslin Diabetes Center, consumer demand is driving more people with diabetes in retail settings like grocery stores and pharmacies for care.

But unlike its closest PBM rival, CVS Health, which operates Minute Clinics in 49 states, Express Scripts is not paired with a similar retail healthcare delivery infrastructure. According to the CNBC report, Miller said that given the way consumers make choices, Express Scripts will need to respond to changing times.

“Right now, people don’t differentiate and don’t prefer retailers based on their quality; it’s usually just a cost equation,” he said. “We think this is going to be huge in the marketplace, because you’re going to be able to get millions of patients higher quality care and lower cost on diabetes.”

The experts at the Patient Centered Diabetes Care meeting, including Kristene Diggins, DNP, of CVS Health’s Minute Clinic, said the retail setting meets needs of patients who cannot take time from work for the regular monitoring that diabetes requires. Diggins said 56% of the patients who come to the clinics do not even have a primary care physician.

According to the CNBC report, Miller said Express Scripts will work with a mix of chains and independent pharmacies, and the PBM is creating the network right now to unveil by the end of the year. He said there’s a need to “change the paradigm” and that “pharmacies are the way to do that.”

Prescription drugs are such a huge component of healthcare, especially in Medicare, that the current Express Scripts-Anthem litigation could result in Anthem taking back its pharmacy unit.