Diabetes Care Value Program
Every five minutes, 14 adults are newly diagnosed with diabetes,1 the most costly traditional therapy class for plan sponsors for five consecutive years.2 We forecast an estimated 52% spending increase for diabetes medications over the next three years.2
Patients with diabetes often have other conditions such as high cholesterol, high blood pressure and depression. Additionally, 43.7% of patients on diabetes medication do not take their medication as prescribed, which contributes to the reported $176B in direct medical costs related to diabetes in the U.S. each year.4
The Diabetes Care Value ProgramSM will protect your plan with cost-containment tools and improve patient outcomes through a higher standard of pharmacy care.
Key Benefits
- Guaranteed annual cost cap protects your plan from increasing prescription spending on your diabetes patients.
- The preferred quality retail pharmacy network that includes Express Scripts PharmacySM, Walgreens, or other participating pharmacies helps avoid unnecessary medical expenses by closing gaps in care and improving adherence.
- 24/7 access to a team of specialist pharmacists through the Diabetes Therapeutic Resource CenterSM provides specialized care.
- National Preferred Formulary and utilization management tools drive use of the lowest cost diabetes medications to achieve maximum value.
Highlights
- Preferred quality pharmacy network includes pharmacies committed to higher quality care for patients with diabetes.
- Members will be required to receive their diabetes medications with a 90-day supply, and will have the choice to fill a 90-day supply at the Express Scripts Pharmacy or at a preferred quality pharmacy, including Walgreens.5
- Clients on our National Preferred Formulary will continue to receive formulary updates; clients on other formularies will be enrolled in preferred step therapy programs.
1 Centers for Disease Control and Prevention (CDC).
2,3 2015 Express Scripts Drug Trend Report.
4 American Diabetes Association, Fast Facts, Data and Statistics about Diabetes.
5 Patients enrolled in the preferred quality pharmacy network can fill two 30-day courtesy fills at any network pharmacy, then must move to 90-day supply AND use the Express Scripts Pharmacy, Walgreens or other participating preferred pharmacy.
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