Hard, measurable outcomes drive Express Scripts digital formulary

Express Scripts’ first digital formulary sets evidence bar for reimbursement

“I think that is reflective of how Express Scripts is moving forward.”

The demonstration of hard clinical benefits and ROI for Express Scripts were the key elements that landed 10 digital platforms a spot on the PBM’s inaugural digital formulary. The selection process can serve as a road map for other companies seeking to gain uptake and demonstrate the commercial potential of digital health technology.

On Dec. 12, 2019, the Express Scripts unit of Cigna Corp. (NYSE:CI) unveiled its first digital formulary, a list of digital tools that the payer will reimburse for in 2020.

The list largely comprises mobile technologies for disease management aimed at improving therapeutic compliance and patient outcomes, and reducing total healthcare costs.

Digital technologies have recently gotten the attention of biopharma companies as a means to deliver solutions to patients that go beyond a drug. A handful of these tools have been available to patients and healthcare providers for over three years (see "Back to School 2019: Rules of the Road for Digital Health").

Reimbursement has been a challenge, however, because payers and PBMs haven’t understood the value proposition. They’ve viewed these tools as just another expense with no measurable benefit to the patient or the healthcare system.

“As we look out at the healthcare ecosystem

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