Express Scripts Holding Company is an American Fortune 100 company. As of 2017, the company is the 22nd-largest in the United States as well as the largest pharmacy benefit management (PBM) organization in the United States. Express Scripts had 2016 revenues of $100.752 billion.
Headquartered in St. Louis, Missouri, Express Scripts provides integrated pharmacy benefit management services including network-pharmacy claims processing; home delivery pharmacy services; specialty pharmacy benefit management, through its subsidiary Accredo; benefit-design consultation; drug-utilization review; formulary management; and medical and drug data analysis services to manage drug plans for health plans, self-insured employers and government agencies (both as administrator of employee benefits and public assistance programs). One of its largest clients is the United States Department of Defense's Tricare program.
Express Scripts also offers pharmacy benefit management services for workers' compensation insurance programs. The program is accredited by URAC, the nation's largest accrediting body for pharmacy benefit management companies.
The company processes pharmaceutical claims for members through a network of retail pharmacies. Its own automated pharmacies dispense long-term, chronic medications-like those for diabetes or heart disease-directly to members by home delivery.
History
Express Scripts began in 1986 in St. Louis, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems. Express Scripts was purchased by New York Life Insurance Company in 1989 and became a publicly traded company in 1992. In 1993, Express Scripts signed on both FHP International and Maxicare Health Care and corporate clients Lockheed, Service Merchandise, and Ingersoll-Rand. In 1994, the company expanded its services by adding workers’ compensation prescription services and reinsurance. In 1994, the company announced a two-for-one stock split, and in 1996 established Express Scripts Canada. The same year, the company began the annual Drug Trend Report and launched the Outcomes Symposium Conference.
In April 1998, Express Scripts acquired ValueRx, the PBM business of Columbia/HCA Healthcare Corp. The following year, in April 1999, the company purchased Diversified Pharmaceutical Services from SmithKline Beecham Corp for $700 million. That same year, the company purchased stock in PlanetRx.com. This partnership offered members options for purchasing prescriptions and over-the-counter health products online.
In 2000, the company had to write off its $165 million relationship with PlanetRx.com when the startup experienced financial difficulties. In 2001, Express Scripts partnered with Merck-Medco and Advance PSC to form RxHub LLC.
In late December 2006, Express Scripts made a proposal to purchase Caremark. Express Scripts lost the race to acquire Caremark to CVS Corporation, which became CVS/Caremark Corporation on March 22, 2007.
In October 2007, Express Scripts acquired ConnectYourCare, and now handles FSA, HRA and HSA accounts for companies such as Suntrust, Zions Bancorporation and Allegis. However, Express Scripts divested ConnectYourCare in August 2012.
On April 13, 2009, it was announced that Indianapolis-based WellPoint had reached a definitive agreement under which Saint Louis based Express Scripts purchased WellPoint's NextRx subsidiaries for $4.675 billion. Express Scripts, the United States third largest PBM, closed the transaction in December 2009.
In April 2012, Express Scripts completed a $29.1 billion acquisition of Medco Health Solutions. The Federal Trade Commission gave formal approval on April 2, 2012 after an anti-trust investigation. The acquisition positioned Express Scripts Holding Co. as the largest pharmacy benefit manager, filling 1.4 billion annual prescriptions.
Express Scripts has 30,000 employees worldwide. Most employees in the St. Louis area are located in its new 220,000-square-foot building. Two other buildings for employees exist, along with a Technology Innovation Center, which houses a pharmacy. The company plans expansion to add another 1,500 employees over the next five years contingent on state and local tax incentives, with the new building a $56 million project that could start later in 2013, and be completed by early 2015.
In 2017, Express Scripts launched Inside Rx, a partially owned subsidiary that provides discounts on medications for the uninsured and underinsured.
Drug Trend Report
Published annually since 1993, the Express Scripts Drug Trend Report provides detailed analysis of prescription drug costs and utilization. Now a web-based version, the Drug Trend Report is developed and published by the Express Scripts Research & New Solutions Lab with contributors from researchers, clinicians and others. This type of research is designed to understand consumer behavior relative to healthcare benefits.
Health decision science
Health science is the study of how people make decisions, and how to help them make better ones. Upon the merger of Express Scripts and Medco Health Solutions, the company came up with its own approach to understand its members health concerns, which it has dubbed Health Decision Science. This involves looking at three scientific disciplines: behavioral science or “consumerologyâ€, clinical specialization, and actionable data. Because of its position between pharmacies and health care plans, Express Scripts sees 1.4 billion prescriptions a year, and it uses this information as part of its research data to create better solutions for clients and patients.
Controversy
Fraud allegations
On August 4, 2004, New York State Attorney General Eliot Spitzer filed a lawsuit against Express Scripts alleging that the company had kept tens of millions of dollars in drug rebates owed to the state. The suit was filed in the New York Supreme Court in Albany County. The lawsuit further claimed that Express Scripts had overstated the cost benefits of switching to certain preferred medications. In 2008 the company settled the lawsuit, agreeing to pay $9.3 million to Pennsylvania and 28 other states to resolve claims of deceptive business practices. As part of the settlement, the company also agreed to change its business practices and pay up to $200,000 in reimbursement to patients.
Information breach
In October 2008, the St. Louis headquarters received an anonymous letter that contained sensitive information about 75 members. The extortionist stated that they would release more of similar records if the company failed to pay an unspecified amount of money. A consumer class action lawsuit against Express Scripts was brought on by John Amburgy, a Missouri man, who accused the company of negligence in protecting customer records. The case was dismissed when Amburgy failed to show how he was directly affected by the breach.
References
External links
- Official website
- Research site
- CuraScript SD site
- Drug Trend Report
- Accredo site
- UBC
