The cost-management programs adopted by clients of pharmacy benefit manager Express Scripts typically required consumers in their drug-benefit plans to use a low-cost, equally effective generic first before stepping up to a higher-cost brand drug.
Use of this cost-management program, called step therapy, has nearly tripled among the employer, managed care, government and labor union clients of Express Scripts in just three years, covering 13 million consumers, up from 4.5 million in 2002. This high rate of adoption has helped to elevate Express Scripts' generic dispensing rate to 54% -- best among the nation's pharmacy benefit managers.
"Step therapy programs are proven tools that lower prescription-drug costs for benefit sponsors and for patients in the form of lower copayments, without compromising health outcomes," said Brenda Motheral, vice president of research and trend management, Express Scripts.
One of the first step-therapy programs introduced by Express Scripts involved the COX-2 anti-inflammatory drugs and required use of a generic non-steroidal anti-inflammatory drug (NSAID) before brand-name NSAIDs like Celebrex or Vioxx were used.
Adoption of the COX-2 step-therapy program rapidly accelerated in 2002 after Express Scripts presented award-winning research at its annual Outcomes Conference documenting that COX-2s were over-prescribed. Now, the company offers 22 step-therapy programs and a sponsor using most of the programs can reduce overall drug costs by 10 percent.
Express Scripts offers benefit sponsors a variety of other programs aimed at encouraging consumers to choose lower-cost, therapeutically equivalent generic drugs.
Contact: Derrell Carter
Express Scripts, Inc.