Express Scripts, the prescription drug provider for the A&M Care plans, has several value-added programs. These, and other Express Scripts programs, can be found on the System Benefits Administration website at https://www.tamus.edu/business/benefits-administration/prescriptions-express-scripts/.
Pulmonary Care Value Program
Express Scripts (ESI) created the Pulmonary Care Value (PCV) program to improve adherence since a large majority of asthma patients fail to take their medication as directed.
- Patients must fill all pulmonary care maintenance medications as 90-day prescriptions from Walgreens, home delivery, or certain other local pharmacies. Express Scripts provides access to one-on-one support from a team of extensively trained clinicians through their Pulmonary Therapeutic Resource CenterSM (TRC).
- High-risk patients will be offered remote monitoring devices to help optimize medication use and maximize their health. When monitoring shows that patients overuse their rescue inhalers or are not adherent to controller medications, pulmonary TRC pharmacists will reach out with individualized support.
- Some members will also be offered the Mango Health app – a patient engagement solution that gamifies health and rewards patients for making healthy decisions
Diabetes Care Value Program
The Diabetes Care Value Program combines a quality-based pharmacy network and a holistic approach to diabetes patient care. The program applies to all A&M Care health plan members who purchase oral and injectable diabetes drugs as well as the diabetes blood glucose test strips. The program requires that:
- diabetes-related prescriptions be filled with a 90-day supply rather than a 30-day supply, and
- diabetes-related prescriptions be filled through Express Scripts Home Delivery (mail-order) or a Walgreens pharmacy (retail).
The two main goals of the program are better patient adherence to diabetes medications and control of rapidly increasing costs. Aside from specialty medications used to treat debilitating diseases such as multiple sclerosis or HIV, spending on diabetic medications is the next highest spend. Controlling health plan costs helps offset premium increases and benefit reductions.