For a patient with a rare disease, the journey can be long and frustrating, and the costs staggering. A correct diagnosis can take years. And more than 50% of rare-condition patients are children, so managing a complex condition takes a toll on the whole family.
The skyrocketing costs of medication to treat rare conditions could be catastrophic for your plan. With prevalence on the rise, and new therapies being introduced, the risk is high that your plan may suddenly need to cover one of these medications for an employee or plan member.
30 million people in the U.S. are living with a rare condition4 — equivalent to the number battling diabetes.5 While significant resources have been devoted to conditions like diabetes, the market still lacks adequate solutions for rare conditions.
There’s an unprecedented opportunity to improve care and reduce costs for rare conditions now, before it’s too late. The SafeGuardRx suite of solutions, which combines specialized care with value-based strategies, has proven that you can put the right care within reach and limit your plan’s financial exposure.
Our newest solution – Rare Conditions Care ValueSM program – will proactively guide patients to the most effective care, while protecting plans against unexpected and staggering costs. Enroll by August 1, 2018 to start gaining benefits from this program upon launch (January 1, 2019).
One-on-one counseling with experts in rare conditions, in-home nursing services, drug-specific protocols and patient management programs
Financial protection for high-cost utilizers in select therapy classes and discounts on preferred products from Accredo® specialty pharmacy
Achieve maximum value by leveraging updates to our National Preferred Formulary or Utilization Management tools
Our partner, PinnacleCare®, engages top specialists who provide expert opinions for the treatment of serious or complex medical conditions
Value in healthcare goes beyond cost savings. That’s why the Express Scripts SafeGuardRx® suite of condition-specific solutions is designed to provide specialized, individualized care while reducing the cost of treatment and ensuring patients have access to the medications they need.Learn More
Get access to Second Opinion from specialists who advise on the patient’s specific condition, provide validation of diagnosis or make recommendations for the most effective, alternative treatment options. 77% of these engagements lead to more appropriate changes in diagnosis, therapy regimen or treating physician.6Learn More
Orphan drugs treat very niche populations – sometimes just a few hundred or a few thousand total patients – and are expensive. The high price tag is often justified to fund manufacturers’ research and development toward medical breakthroughs that might not otherwise happen. More information about orphan drugs is available on the U.S. Food and Drug Administration site.Close