How does your international experience inform your leadership of Express Scripts Canada?

As a Canadian who has earned my international stripes by immersing myself in the countries where I have worked, I can tell you that the need for healthcare is something universal. But, having worked in healthcare in Canada, Asia, Africa, and the United States, I know that Canadians should be very proud of the healthcare system we have. But we can also learn from their example and find ways to move faster and spur innovation, especially as it relates to better healthcare.

Healthcare is a vast industry around the world. To succeed within it, organizations increasingly need innovative ideas, the right technologies, and scale. Express Scripts Canada understands that a comprehensive approach to health services is what will make our lives better. Today, we are the only health benefits manager in Canada that combines the benefits of Canadian scale and access to all the resources of a parent company with global reach. We take proven strategies from around the world and tailor them for the Canadian market to deliver made-in-Canada solutions.

Are there strategies you’ve learned abroad that can help plan sponsors manage pharmacy benefits more effectively?

In other countries, there is an accepted practice to make continuous, small incremental changes—little improvements here and there—to enhance healthcare systems and improve outcomes. In Canada, we often aim too high—for example, holding out for a complex, expensive strategy to try to save 10% off the bottom line. This kind of home run isn’t always attainable. Companies should accept that a more consistently effective approach is sometimes to hit singles and doubles. In isolation, tools like managed formularies, prior authorizations, and step therapy may not deliver enough savings, but, when combined, these tools can have a dramatic effect on benefits plan savings.

I have also learned that taking a patient focused approach is better than taking a one-size-fits-all approach to benefit plan design. This is especially true with the rising concern over the long-term affordability of prescription drug plans. In Canada, we know that 20% of claimants drive almost 80% of spending. A strategy that understands the needs of these high-cost members and focuses on helping them with timely support to manage their conditions and drug therapies can have a powerful impact on the majority of costs while continuing to deliver better health outcomes. The only way a health benefits manager can help a plan sponsor accomplish this is by investing significantly in its clinical services, infrastructure, and multichannel communications. This is what Express Scripts Canada has done and will continue to do.

What kinds of solutions does Express Scripts Canada offer to help with medication adherence?

In order for medications to work, they have to be taken as directed. Our research shows that many patients don’t take medications as prescribed. Good medication adherence begins with a well-designed benefits plan that is affordable for the plan sponsor and has reasonable co-pays.

We have additional tools to assist plan sponsors. For example, we use our sophisticated analytics to create adherence reports that identify areas where a plan is performing well and areas where it can be improved. Once you have identified the needs of a plan, you can set up programs to specifically target them. Common strategies that help with medication adherence include channel management, utilization management, and patient health management. We have new strategies that use behavioural science, analytics, artificial intelligence, and apps that will allow us to help members take more ownership of their own health effectively and efficiently, and keep them engaged with their treatments.

We all need to be part of the solution—and when we’re able to improve medication adherence, even by small amounts, it can result in significant savings and better outcomes for members.

How about approaches to control costs and keep plans sustainable?

Providing targeted, timely support to help members make decisions that optimize cost and care is essential. These goals can be accomplished by adopting a comprehensively managed plan that aligns member and plan sponsor interests through intelligent plan design solutions.

These plans incorporate multiple plan management techniques—including formulary, utilization, and clinical management tools—to provide the best possible patient care at the lowest possible cost.

For example, our home delivery service pharmacy helps both control costs and improve adherence. In today’s busy world, time is at a premium, and convenience is more important. Our pharmacy ensures patients receive a three-month supply of medication delivered directly to their homes, which saves time, helps those who may have difficulties getting to a pharmacy, and reduces the average dispensing fee costs. We also offer an auto-refill service, which ensures members don’t have to rely on their memories to get their refills on time. Eliminating gaps in continuity of care helps people stay adherent, improving their treatments and reducing costs.

Overall, what do you aim to achieve for Express Scripts Canada’s clients?

Express Scripts Canada is committed to working through its insurer and third-party administrator clients to deliver the best results to plan sponsors so they can continue to be the best in their business.

What support do you look for from your executive team as you implement your vision?

I am excited about our future. We have an elite leadership team with a great deal of experience, so it’s a matter of getting all the smart people in a room together and coming up with the innovations that our clients and plan sponsors want and need. Our talented and experienced employees at Express Scripts Canada have decades of experience and knowledge that we will leverage, and, combined with our world-class technology and best-inclass processes, we will help our clients grow. Our employees are aligned with our clients to improve the health of Canadians. The future is looking bright!