The Facts About Express Scripts

As a leading pharmacy benefits manager (PBM), Express Scripts manages pharmacy services and lowers drug spend for health plans, employers, labor unions and government agencies. Each year, Express Scripts saves approximately $32 billion1 for the nearly 100 million Americans and thousands of clients we serve—who choose Express Scripts for our proven track record of delivering significant savings and better clinical outcomes.

 

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1. Average annual savings generated from client participation in Express Scripts’ cost-containment programs over the reporting periods 2018-2021

Customer and Pharmacist review paper and digital prescription

Express Scripts lowers the cost 
of prescription drugs in four ways:

1

We create safe, affordable access to medications across our network of nearly 64,000 pharmacies—all within 15 minutes of a person’s home or through home delivery in all 50 states

2

We negotiate with pharmaceutical manufacturers who set the price of prescription drugs—driving competition
to deliver lower net costs for clients  and consumers

3

We support clients on the creation of formularies—or lists of drugs—that include safe, effective and affordable medications for their covered populations

4

We provide clinical expertise and programs that help people get and stay on the medications they need—preventing disease progression and helping people live their healthiest lives

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Express Scripts, and other PBMs, are essential partners across the drug supply chain—helping clients drive down drug spend, lower consumer out-of-pocket costs, and improve medication access.
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Key Topics

Find detailed information about how Express Scripts works, how we add value and how we ensure transparency with all stakeholders.

Express Scripts fights to ensure clients and consumers have access to safe, effective and affordable medications and life-sustaining or life-saving therapies.

 

The Value Express Scripts Delivers

Express Scripts, and other PBMs, are essential partners across the drug supply chain—helping drive down drug spend and improve medication access for clients and customers.

 

How PBMs Work

Studies and analyses clearly show drug price increases are not caused by PBMs like Express Scripts.

 

The Truth About High Drug Prices

PBMs use generic and biosimilar competition to accelerate lower drug costs

 

Driving Drug Competition to Lower Cost

Rebates are just one tool to lower drug costs—in direct response to skyrocketing prices set by big pharmaceutical companies.

 

The Reality of Rebates

Express Scripts builds industry-leading, clinical-first formularies that equal greater value.

 

Driving Drug Savings Through Formularies

PBMs build networks of pharmacies to provide consumers convenient access to prescriptions at discounted rates.

 

Building Purposeful Pharmacy Networks

Express Scripts negotiates discounts with retail pharmacies and other providers

 

The Skinny on Spread Pricing

In a pass through pricing model, the client chooses to pay the exact discounted value that Express Scripts negotiates.

 

Breaking Down the Pass Through Pricing Model

 

Express Scripts receives fees from clients for PBM administrative services.

 

A Look at Administrative Fees

PBMs must adhere to strict governance standards that are contractually binding

 

PBM Governance

A prescription doesn’t work if it is priced out of reach for consumers

 

Delivering Value and Affordability to Consumers

A group purchasing organization combines purchasing volume to achieve discounts

 

A Word on Group Purchasing Organizations and Ascent

Services to support patients and caregivers navigating complex and chronic conditions.

 

Specialty Pharmacy Deep Dive

HDHPs are growing in popularity among plan sponsors and participants

 

High-deductible Health Plans and Drug Costs