Express Scripts Throws Lifeline to Some Digital Health Startups

I have blogged extensively about pharmacy benefit managers (PBMs) in the past (see, for example:Pharmaceutical Companies and PBMs Helped to Create Our Opioid Crisis;CVS's Caremark Expands Its Diabetes Care Program with Analytics and Coaching;Amazon-PillPack Pushes Against CVS with Prescription Deliveries; Also Seeking PBM Status). Now comes news thatExpress Scripts is taking some measures to assist selected digital start-ups with apps and devices that can be used to optimize the use of prescription drugs (see:Express Scripts throws a lifeline to digital health start-ups). Below is an excerpt from the article:Digital health companies are getting funded in droves, but many are struggling to get traction. So Cigna ’s Express Scripts....is throwing them a much-needed lifeline.It is vetting companies offering cutting-edge treatments for certain conditions, such as diabetes management or respiratory health, then putting them into a “formulary” of recommendations for health insurance plans and doctors....Express Scripts and other PBMs like CVS Caremark essentially decide which medications should be covered by health plans.They weigh factors like efficacy and cost, and place medications into tiers that are differentiated by the amount of cost-sharing or copayments required from patients. Doctors typically use this information to help figure out which medication to prescribe and will often try to start with lower-tier therapies.By categorizing digital therapies i...
Source: Lab Soft News - Category: Laboratory Medicine Authors: Tags: Healthcare Innovations Healthcare Insurance Medical Consumerism Pharmaceutical Industry Quality of Care Source Type: blogs