Express Scripts Simplifies Health Tech Marketplace
To make it simpler for consumers and payers to navigate the hundreds of thousands of currently available personal health technologies and interventions, Express Scripts, a Cigna company, will introduce the industry’s first, stand-alone digital health formulary.
“We are in an exciting age when technology is giving people even greater control of their own health and well-being. However, much of this technology is still emerging, and there are many digital health solutions that require clinical review and validation,” said Mark Bini, Vice President, Innovation and Member Experience, Express Scripts. “We see a need to put mechanisms in place to help carefully manage these innovations, and are proud to lead again by being the first health services organization to establish a formulary of this nature. This formulary will help ensure developers do right by payers and consumers, while increasing patient access to technology that can help improve their health.”
The new formulary will help payers ensure the safety, effectiveness and usability of digital health technology tools made available to their members. Available in 2020, the digital health formulary will be a curated list of technology- and software-enabled applications and devices that help patients prevent, manage or treat a medical condition.
Similar to a medication formulary, Express Scripts will employ a comprehensive process overseen by physicians, pharmacists and experts in health research and user experience, who will review clinical outcomes and therapeutic benefit data to determine inclusion on the formulary. Each digital solution included on the formulary first must demonstrate therapeutic value, effective usability, and stringent security and privacy standards, followed by cost effectiveness.
By adopting a digital health formulary, plan sponsors can confidently deploy a digital health product to their members knowing it has been through a uniform review process to ensure its safety, quality, usability and affordability. The digital health formulary also will:
- reduce the administrative burden for plan sponsors associated with contracting and managing digital health companies,
- help improve affordability by leveraging Express Scripts’ size and scale in the purchasing of digital health products, and
- create a pathway to cover the increasing number of prescription-only digital therapeutics that are coming to market.
Initially, the digital health formulary will include solutions for diabetes, cardiovascular, behavioral health and pulmonary conditions, and will later expand to include tools for other chronic and complex conditions.
Clients still will have the ability to choose which digital solutions they provide or cover for their members; inclusion on the digital health formulary will not guarantee that a plan will cover a certain technology.
The Digital Health Landscape
Digital health technology includes software-driven tools that help patients take better control of their health. The marketplace is broad and growing exponentially, and includes tools that promote fitness, wellness and the prevention of chronic conditions, mobile health interventions, telehealth solutions, remote monitoring devices, and FDA-approved digital therapeutics that work with specific medications or medical devices. While the majority of apps and tools are available to all people, some require a prescription from a physician. The number of prescribed digital health products is expected to grow in the coming years.
“In addition to helping payers manage currently available digital health solutions, our digital health formulary lays the groundwork to manage new solutions and tools that have yet to be invented,” said Bini. “We want to create a level playing field for inventors and entrepreneurs to encourage continued innovation in this space, and to ensure a pathway to deliver those innovations to patients with assured safety, accuracy and affordability.”
About Express Scripts
Express Scripts is a health care opportunity company. Empowered by our legacy as an industry innovator, we dare to imagine — and deliver — a better health care system with greater choice, predictability, affordability and improved outcomes. From pharmacy and medical benefits management, to specialty pharmacy care and everything in between, we uncover opportunities to make health care better.
We stand alongside our clients and partners, collaborating to develop personalized solutions that make a meaningful difference in the lives of those we serve, whenever and wherever it’s needed. We believe health care can do more.