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Express Scripts, Inc.

File:Express scripts logo.png
Type	Public company S&P 500 Component
Traded as	NASDAQ: ESRX
Industry	Healthcare services Pharmaceuticals
Founded	St. Louis, Missouri (1986)
Headquarters	St. Louis, Missouri, U.S.
Key people	George Paz, President and CEO Jeffrey Hall, CFO
Products	Prescription Benefit Management, Specialty Prescription Management
Revenue	$44.9732 billion USD (2010)[1]
Net income	$1.2046 billion USD (2010)[1]
Employees	13,170 (2010)[1]
Website	express-scripts.com/

Express Scripts, Inc. (NASDAQ: ESRX) is a Fortune 100 company^[2] and the largest pharmacy benefit manager headquartered in St. Louis, Missouri.

The company processes pharmaceutical claims for members at network pharmacies and at their own mail order pharmacies. Headquartered in St. Louis, Express Scripts provides integrated pharmacy benefit management services including network-pharmacy claims processing, home delivery services, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services to manage drug plans for government agencies (both as administrator of employee benefits and public assistance programs), corporations, and unions. One of their largest clients is the United States Department of Defense's TRICARE program.^[1]

On April 16, Express Scripts announced that it was launching a new product that aims to help patients stay on their meds by predicting who will stop taking prescriptions before the person actually does it. ^[3]

The pharmacy benefits manager is launching ScreenRx, a program that uses a computer to sift through hundreds of factors that affect patients and forecast who is most likely to forget a refill or simply stop taking their drugs. The company then plans to contact those patients to help them stick with their doctor's orders.

Medco Acquisition[link]

On July 21, 2011, Express Scripts announced that it was acquiring Franklin Lakes, New Jersey-based Medco Health Solutions.^[4] On April 2, 2012, Express Scripts announced that it gained regulatory approval from the FTC for its 29.1-billion-dollar acquisition of Medco Health Solutions Inc. Together, it is estimated that the new combined company will cover prescription benefits for one in three Americans. ^[5] After an eight month review period, the FTC concluded that the Express Scripts-Medco merger would not “unduly increase” the company’s pharmacy bargaining power or harm consumers and patients with rare, complex, or chronic conditions. The Commission majority stated the following in demonstrating approval for the merger amid a characteristically competitive and innovative market:

“The acquisition of Medco by Express Scripts will likely not change these dynamics: the merging parties are not particularly close competitors, the market today is not conducive to coordinated interaction, and there is little risk of the merged company exercising monopsony power. Under these circumstances, we lack a reason to believe that a violation of Section 7 of the Clayton Act has occurred or is likely to occur by means of Express Scripts' acquisition of Medco." ^[6]

History[link]

Express Scripts began in 1986 in St. Louis, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems. Express Scripts was purchased by New York Life Insurance Company in 1989 and became a publicly traded company in 1992. In 1994, the company announced a two-for-one stock split and in 1996, established Express Scripts Canada. The same year, the company began the Annual Drug Trend Report and launched the Outcomes Conference.^[7]

Through expansion of its client base, product lines and several acquisitions (ValueRx, Diversified Pharmaceutical Services, and National Prescription Administrators (NPA)) Express Scripts currently employs over 13,000.^[1] In 1994, the company announced a two-for-one stock split.

Express Scripts purchased ValueRx on April 1, 1998.^[8] ValueRx was formed in Detroit, Michigan in 1987 through the merger of Medicost, a small prescription drug claims processor and Health Information Design, a specialty drug utilization review company. The company was purchased by Value Health in 1988. After a series of mergers and acquisitions, ValueRx became the largest Value Health subsidiary, employing 1,400 people across the United States. On February 25, 2002, Express Scripts completed the acquisition of the assets of Phoenix Marketing Group (Holdings), Inc. Phoenix Marketing Group is the largest full-service prescription drug sample fulfillment provider in the United States.

In the first quarter of 2004 Express Scripts acquired CuraScript, Inc, a specialty pharmacy located primarily in Orlando, Florida. Specialty medicines - medication for complex, chronic conditions - are the fastest growing segment of prescription drugs. They are also among the most expensive. ^[9] CuraScript employs more than 2,500 people and is headquartered in Orlando, Fla. In addition to a dispensing facility in Orlando, it has a network of satellite distribution pharmacies. In November 2010, Express Scripts announced that it had established a comprehensive benefits organization for the specialty space, Specialty Benefit Services, which includes: Pharmacy benefit management, Specialty Pharmacy and Distribution, Medical Benefit Management. Medical benefit management is offered through the company's long-standing subsidiary, Care Continuum. ^[10]

On October 14, 2005 Express Scripts Completed the Acquisition of Priority Healthcare and now has integrated the line of business with its wholly owned specialty pharmacy subsidiary CuraScript.

In late December 2006, Express Scripts made a proposal to purchase Caremark. Express Scripts lost the race to acquire Caremark to CVS Corporation, which became CVS/Caremark Corporation on March 22, 2007.

In October 2007, Express Scripts acquired ConnectYourCare, and now handles FSA, HRA and HSA accounts for companies such as Suntrust, Zions Bancorp and Allegis.

On April 13, 2009 it was announced that Indianapolis based WellPoint had reached a definitive agreement under which Saint Louis based Express Scripts will acquire WellPoint's NextRx subsidiaries for $4.675 billion4^[11] Express Scripts, the United States third largest PBM, closed the transaction in December 2009.^[12]

As of 2010, Express Scripts employed over 13,000 people.^[1] The corporate headquarters is located in Cool Valley, Missouri with major North America sites in Albuquerque, NM; East Hanover, NJ; Bensalem, PA; Bloomington, MN; Orlando, FL; New Castle, DE; Farmington Hills, MI; Harrisburg, PA; Pueblo, CO; St. Marys, GA; Tempe, AZ; Troy, NY; Mason, OH; Indianapolis, IN; Oldsmar, FL; West Hills, CA; Washington, DC Mississauga, Ontario; and Montreal, Quebec.

Express Scripts also offers pharmacy benefit management services for workers' compensation insurance programs. The program is accredited by URAC, the nation's largest accrediting body for healthcare. .^[13]

Relationship with Walgreens[link]

Walgreens, one of the nation's largest pharmacy chains, decided in 2011 to end their relationship with Express Scripts after the two companies failed to reach an agreement over payment rates.^[14] For much of 2011, the two giants were embroiled in a very bitter and public contracting dispute. Express Scripts claims Walgreens was demanding a 20 percent increase in its reimbursements, an assertion Walgreens denies.^[15] For its part, Walgreens says Express Scripts was offering "below-average" reimbursements for the more than 80 million prescriptions it fills annually for Express Scripts' members.^[16] In ending their contract with Express Scripts, Walgreens faces potential losses of $5.3 billion in annual sales.^[17]

With more than 56,000 pharmacies remaining in Express Scripts' pharmacy network,^[18] rival pharmacies are wasting no time in trying to attract their business. CVS ran an advertisement in 49 million of its circulars distributed in newspapers and other publications.^[19] In addition, retail giants Wal-mart and Safeway are running radio and television advertisements seeking to woo Walgreens customers.^[20][21]

Civil Rights Groups Rally to Support[link]

The dispute between Walgreens and Express Scripts attracted the attention of prominent civil rights groups who were concerned that Walgreens no longer accepting Express Scripts coverage would disenfranchise poor and minorities. A coalition of minority groups, led by Reverend Al Sharpton's National Action Network,^[22] sent letters urging Gregory Wasson, CEO of Walgreens, to reconsider. Other groups sending letters were National Hispanic Christian Leadership Conference,^[23] the Congress of Racial Equality,^[24] Hispanic Leadership Fund^[25] and more.

Fraud allegations[link]

On August 4, 2004, New York state Attorney General Elliot Spitzer filed a lawsuit against Express Scripts alleging that the company had kept tens of millions of dollars in drug rebates owed to the state. The suit was filed in the state Supreme Court in Albany County.^[26] The lawsuit further claimed that Express Scripts had overstated the cost benefits of switching to certain preferred medications. In 2008 the company settled the lawsuit, agreeing to pay $9.3 million to Pennsylvania and 28 other states to resolve claims of deceptive business practices. As part of the settlement, the company also agreed to change its business practices and pay up to $200,000 in reimbursement to patients.^[27]

Information Breach[link]

in October 2008, the St. Louis headquarters received an anonymous letter that contained names, Social Security numbers, birth dates and some prescription information of 75 members.^[28] The cyberextortionist stated that they had millions more of similar records and would release them if the company failed to pay an unspecified amount of money. Clients associated with the company also received similar threatening letters. A $ 1 million award was offered by the pharmacy benefits management firm for any information that would lead to the conviction of the individual or group.^[29]

By November, about 700,000 clients were notified that their information may have been compromised. A consumer class action lawsuit against Express Scripts was brought on by John Amburgy, a Missouri man who accused the company of negligence in protecting customer records. He also accused the company of breach of contract, breach of implied contract, and violations of data breach notification laws in various states. Amburgy claimed that due to the data breach, he and various others affected by the incident were at increased risk of identity theft and extortion. However, Amburgy failed to show how he was directly affected by the breach and the lawsuit was dismissed.^[30]

Illegal HGH distribution[link]

On September 19, 2007, Specialty Distribution Services Inc., a subsidiary of Express Scripts Inc., under an agreement with federal prosecutors, agreed to pay a $10.5 million penalty and cooperate with ongoing law enforcement investigations for distributing human growth hormone to "well known athletes and entertainers".^[31]

[edit] Consumerology^® Advisory Board

Express Scripts Consumerology^® Advisory Board was founded to advance the company's understanding of human behavior and assist with the translation of this understanding to improve health outcomes. The Advisory Board tracks emerging findings from the allied fields of the behavioral sciences. This board consists of national academics with expertise in consumer behavior related to the pharmacy benefit, and conduct research into employee communications, health benefits design and health care delivery rooted in behavioral economics.

Currently, the Consumerology^® Advisory Board is engaging employees in pilot projects that explore healthcare purchasing and consumer behavior issues. The company states that the goal of these tailored programs is improved health outcomes and lower-cost care.^{[32][33][34][35][36][37]}

Headquarters[link]

This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2011)

On June 8, 2007, Express Scripts opened its new world headquarters at the campus of the University of Missouri-St. Louis.^[38] The new building houses nearly 2,500 employees http://www.umsl.edu/about/pop.html^{[citation needed]} and is used concurrently with the former corporate site in the Riverport Business Complex,^{[citation needed]} which is located in Maryland Heights.^[39][40] near the unincorporated St. Louis County community of Earth City.^[41]

References[link]

External links[link]

• Corporate Site
• Curascript Site
• Pharmaceutical Marketing Site
• Connect Your Care site

Companies portal

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