Dive Brief:
- Express Scripts, a large pharmacy benefit manager, announced Wednesday it is putting another program in place to help manage costs for patients—this time for diabetes drugs.
- The latest installation of the Express Scripts SafeGuardRx program will put a cap on out-of-pocket spending for diabetes drugs, cutting in half the increase in costs to patients (according to the company).
- Diabetes drug costs rose by 14% in 2015 and another 18% in 2016, with another increase of 17.7% expected in 2017. Patients will only see part of that increase, with Express Scripts assuming the costs for any patients who go over the cap.
Dive Insight:
The diabetes program is expected to help increase adherence to diabetes medications—one of the biggest problems in this therapeutic area. Express Scripts expects to increase adherence by 5% per patient. The PBM said patients spend $4,690 each on unnecessary costs that could be avoided if patients took their medications regularly.
"Nearly 9 of 10 people with diabetes also have high blood pressure or high cholesterol, and one out of every four is currently taking an antidepressant," said Express Scripts Chief Innovation Officer Glen Stettin in a statement. "Our Diabetes Care Value Program surrounds each person with the specialized knowledge and support needed to manage increasingly complex therapies that treat diabetes and related conditions."
The diabetes program is the latest in a series of initiatives taken by Express Scripts to lower costs to patients. The company already has programs in place for hepatitis C, cholesterol and oncology drugs. The diabetes program will go into effect on March 1, 2017.
Express Scripts recently published its formulary exclusion list for 2017 that favors certain drugs and excludes other high-priced alternatives. Express Scripts currently excludes NovoLin, Apidra and NovoLog from its insulin category, but includes insulins from former market leader Sanofi.
The PBM has long excluded Novo Nordisk's market-leading GLP-1 Victoza (liraglutide) from its national formulary lists, but has several other GLP-1s on the preferred list.