COVID-19 and the Need for Health Care Affordability | Evernorth

COVID-19 and the Need for Affordable Health Care

With businesses and individuals facing new realities and financial strain due to COVID-19, the need to find savings has never been greater.
COVID-19 and the Need for Affordable Health Care

COVID-19 is having a dramatic impact on the world, and every plan sponsor is faced with tough decisions on how to keep the doors open while giving their employees and families access to the health care they need during a pandemic.

A key part of Express Scripts’ focus is on greater affordability for plan sponsors and their members. Individuals need to stay healthy, productive, and able to access and afford their medications. Payers need the ability to continue offering a competitive benefit by controlling drug costs, particularly for specialty and complex conditions.

The specific capabilities each plan sponsor needs to deploy may be different. Here are a few to consider.

Providing uninterrupted access to medication

As counties across the United States go in and out of quarantine, it’s important for people to be able to easily get their medications without leaving home, like getting them shipped to their doors with home delivery. This allows them to avoid or lessen possible exposure to COVID-19 while reducing the risk of complications from existing conditions that could lead to costly medical care if members aren’t picking up medications and becoming non-adherent.

With network solutions like Smart90SM and our Delivery Network, members can reduce the number of times they need to fill prescriptions and choose the pharmacy most convenient to them, whether at retail or home delivery through Express Scripts Pharmacy®.

Making drug costs predictable

The ability to afford medications is critical to keeping people healthy, and avoiding surprise charges is a key to making ends meet.

With the Express Scripts Patient Assurance Program, people with diabetes know they will not pay more than $25 for a 30-day supply of preferred diabetes medications. To optimize trend management overall, plan sponsors can select our National Preferred Formulary (NPF), one of the industry’s most powerful ways of providing access to affordable medications and prescription drugs while preserving member choice. By preferring clinically appropriate, lower-cost medications and excluding high-cost alternatives that don’t provide additional clinical value, the NPF has saved plan sponsors $14.5 billion since 2014.

Finally, millions of Americans are newly unemployed and uninsured as a result of COVID-19, so may no longer be able to afford medications for themselves and their families. Express Scripts Parachute Rx helps them secure many of their medications at affordable and predictable prices if they lose their pharmacy coverage.

Bringing down drug costs and providing safe care for specialty and complex conditions

Long before COVID-19, we were looking for ways to bring down costs for the most costly conditions, and this challenge hasn’t disappeared. In a way, it’s become more urgent since many specialty and chronic diseases put patients at higher risk of  complications should they become infected with COVID-19, making virtual care a convenient, affordable, safe, and popular option. In fact, since COVID-19 was declared a pandemic, we’ve seen a five-fold increase in patients leveraging our telehealth nursing services and a 47 percent increase in medications filled using the Accredo app.

On the flip side, for those who are not infected with COVID-19 but potentally face fragmented care for chronic diseases or are in need of behavioral health care, Health Connect 360SM and InMynd are specifically designed to make care more predictable and accessible.

Finally, our value-based platform SafeGuardRx® leverages multiple channels, including digital therapeutics, to unlock better health outcomes and lower costs to prevent plan sponsors from leaving savings on the table. In 2019 alone, participating plans saved $4.3B and experienced lower overall drug trend.

Avoiding costly errors

Patient safety and medication adherence are clinical imperatives, in and out of a pandemic. They can also generate significant savings for plans, but only if they are addressed in a timely and personalized way that encourage members to engage. Some of our most trusted clinical solutions, including Health Connect 360 and ScreenRx®allow plan sponsors to provide tailored, proactive interventions before non-adherence becomes a significant issue.

Health care affordability is always top of mind for plan sponsors and Americans at large, but it’s of particular importance during the pandemic. Congress is currently negotiating its fourth COVID-19 relief package; schools are wrestling with how to pay for equipment to reopen safely; and millions of Americans are trying to make ends meet without compromising on their health. Our solutions can help lift the burden.


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