Making Prescription Drugs Safer and More Affordable

Express Scripts Canada
Written by Jessica Ferlaino

Express Scripts Canada, is headquartered in Mississauga, Ontario and has administrative, pharmacy and customer service operations throughout Canada. Its parent company, Express Scripts Inc. in St. Louis, Missouri, manages drug benefits for forty percent of Americans. In Canada, the company has expanded to support over seven million Canadians nationwide.
Express Scripts Canada works with the public sector, insurance carriers, third-party benefit administrators, plan sponsors and plan members to provide drug, dental, extended health adjudication and processing services, as well as Active Pharmacy services based on US best practices. In the relatively short time that Express Scripts Canada has been in operation, it has become the leading provider of integrated health benefits management and Active Pharmacy services in Canada.

According to Express Scripts Canada President Michael Biskey, the reason for the company’s success is simple. “Drug benefits in the US look very much like they do in Canada, so we decided to add the best practices used by our parent company to manage drug benefits and patient health on top of the traditional drug benefit management tools that Canadian employers have been using for years. We picked the best practices that make sense with the Canadian health care system and traditional Canadian drug benefits offered by employers. The result is a service, that can be easily added to an employer’s drug benefit plan, that reduces costs for patients and employers and supports improved health outcomes for patients.

“We’re the largest, most advanced pharmacy benefits manager (PBM) in the world. In Canada, we’re the only benefits manager applying proven best practices to make the drug benefit better for the employer and their employees,” says Biskey.

An important element of the company’s strategy is to help patients help themselves. Express Scripts Canada’s research shows that as much as one-third of prescription drug benefit spending is wasted: patients use more costly medications than necessary, skip doses or delay refills and pay more than they have to for prescription fees. The company empowers patients to make better decisions about their medications and their health by providing services that helps them understand their choices while considering benefit plan implications, available medication alternatives and costs.

In 2011, Express Scripts Canada adopted a new business model that expanded its PBM solutions by adding specialized services that include Canada’s first Active Pharmacy program.

Leveraging the company’s trademarked Health Decision Science® (HDS®), the expanded PBM services apply research and proven practices to enable plan sponsors to sustainably manage benefits and employee wellbeing. HDS® combines actionable data (integrated clinical, patient, therapy and benefit data), behavioral science and clinical experience to provide solutions that empower patients. For example, the Express Scripts Canada’s Active Pharmacy Benefit provides pharmacy initiatives that engage patients to help them better manage their medications and conditions, and to manage their prescription supplies so they never run out of their maintenance medications.

Helping patients make informed decisions leads to better choices and, ultimately, better health. The result is a sustainable prescription drug benefit that strengthens the ability of employers to attract and retain the best talent, optimizing employee health and maximizing employer return on benefits investment.

Express Scripts Canada’s innovative solutions deliver value to Canadians by improving the way health benefits are administered. “Traditional adjudication tools are reactionary,” says Biskey. “They react to incoming claims without helping plan members make more effective decisions about costs and their health.”

Administering Express Scripts Canada services are health professionals with extensive training and experience. The company employs many licensed pharmacists, regulated pharmacy technicians and individuals who are specially trained to help patients over the phone and online to better spend their health benefit dollars and avoid waste, saving time and money.

Biskey says that these services and benefits can be made available to even more Canadians. “We encourage employers to take a step back and find ways to make their drug benefit better for their employees in a way that is affordable and sustainable. They can pick up the phone and ask one of our benefit advisors.”

Express Scripts Canada’s patient-first approach continues to transform drug benefits in Canada. “We are very proud of what we stand for as an organization,” shares Biskey. “We have a set of guiding principles that have created a strong employee culture, a great working environment and a drive to put the patient first in everything we do.”

Built upon values of integrity, mutual respect, passion, collaboration and service, Express Scripts Canada is continually innovating to ensure that it is providing the best service with a patient-first emphasis. It is no wonder its parent company has experienced rapid growth since its inception, going from “zero to Fortune 20 in twenty-six years.”

Although still relatively unknown in Canada, the company has been recognized with two very significant honours. It was named one of the 2014 World’s Most Ethical Companies by the Ethisphere Institute, an independent centre promoting the best practices in corporate ethics and governance. In May, 2014, Forbes Magazine ranked Express Scripts as one of the top 100 innovative companies in the world.

“We are still one of the best-kept secrets in Canada despite the fact that we are one of the fastest growing companies in North America,” says Biskey.



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