It’s the same old battle over money and as far as I can remember Express Scripts has a lot of cash but like everyone else out there they are looking to maximize the bottom line and back in October of 2010 they were using Ingenix algorithms to predict who may not be taking their meds.  Is this something new here now with the new “evils” out there not taking their medications now to be blamed for contracts?  It sure is starting to look that way and I think the truth of the matter is due to economic times many are flat not being able to afford them and non compliance is due to that factor, which can’t be over looked.  It’s not the evil lazy patients out there, they flat out can’t afford the drugs.   Maybe these algorithms need some adjustments to take that into consideration. 

Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop

Walgreens still has the pay for performance program with United being expanded and recently the Atlanta area was added on for pharmacists to be able to collect pay for performance if they are able to sign patients up with selected programs.  imageWalgreens said not too long ago their data business of selling our prescription data and maybe some retail profiles collected was worth $749 million too. 

UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreens and the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools

Bottom line here is that Walgreens doesn’t want to accept what Express Scripts wants to pay so if you are a patient, off to CVS, Rite Aid or some other drug store you go that has a contract with Express Scripts after January 1st.  7 percent of a 72 billion dollar a year is what Express Scripts will lose and the articles said they are ready to move on without Walgreens. 

So who’s next on the healthcare contract debate?  BD 

June 21 (Bloomberg) -- Walgreen Co., the largest U.S. drugstore chain, fell the most in three months in New York after failing to renew a contract with benefits manager Express Scripts Inc., valued at more than $5 billion in annual sales.

The agreement, which ends as of Jan. 1, collapsed partly because Express Scripts wanted to cut reimbursement rates to “unacceptable levels,” Walgreen said today. St. Louis-based Express Scripts responded that it’s “prepared” for a pharmacy network without Walgreen, now its largest retailer, and that the change will have little impact on patients.

“We would prefer that Walgreens participate in our network, but only if its costs are in line with other participating pharmacies,” David Whitrap, a spokesman for Express Scripts, said today in an e-mailed statement. The company has more than 60,000 pharmacies in its network, giving customers ample choice, he said.

Walgreen declines after split with Express Scripts on contract - The Washington Post


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