How can Evernorth enhance its Express Scripts pharmacy benefit management services to improve medication adherence rates?

Introduction

To enhance Express Scripts' pharmacy benefit management services and improve medication adherence rates, we need to take a comprehensive approach that addresses the core challenges faced by patients, healthcare providers, and the healthcare system as a whole. I'll outline a strategic plan to tackle this critical issue, focusing on user-centric solutions, leveraging technology, and aligning with Evernorth's broader healthcare objectives.

Step 1

Clarifying Questions (5 mins)

• Looking at the product context, I'm thinking about the current state of Express Scripts' digital ecosystem. Could you provide more information on the existing digital touchpoints patients have with Express Scripts, such as mobile apps, web portals, or SMS reminders?

Why it matters: Understanding the current digital landscape will help us identify gaps and opportunities for improving adherence through technology-driven solutions. Expected answer: Express Scripts has a mobile app and web portal for prescription management, with basic reminder functionality. Impact on approach: If the digital ecosystem is robust, we'll focus on optimizing existing touchpoints. If it's limited, we may need to consider developing new digital solutions.

• Considering user behavior, I'm curious about the demographics of Express Scripts' patient base. Can you share insights on the age distribution, tech-savviness, and common health conditions of our users?

Why it matters: Different demographic groups may have varying needs and preferences for medication management, influencing our solution design. Expected answer: A diverse patient base with a significant portion of older adults managing chronic conditions. Impact on approach: If we have a large older population, we might prioritize solutions that are simple to use and potentially involve caregivers.

• Regarding pain points and market position, how does Express Scripts' medication adherence rates compare to industry benchmarks, and what are the primary reasons identified for non-adherence?

Why it matters: This will help us understand the scale of the problem and focus on the most impactful areas for improvement. Expected answer: Adherence rates are slightly below industry average, with cost, forgetfulness, and side effects as primary reasons for non-adherence. Impact on approach: If cost is a major factor, we might focus on financial incentives or cost transparency. If forgetfulness is key, we'd prioritize reminder systems.

• In terms of company alignment, what are Evernorth's broader strategic goals for Express Scripts, and how does improving medication adherence fit into these objectives?

Why it matters: Ensures our solution aligns with the company's overall direction and can leverage other initiatives. Expected answer: Evernorth aims to reduce healthcare costs and improve patient outcomes, with medication adherence as a key driver. Impact on approach: We'd focus on solutions that not only improve adherence but also demonstrate clear cost savings and health outcome improvements.