Express Scripts to launch first digital health formulary

Express Scripts, a Cigna company, plans to launch the industry's first stand-alone digital health formulary.

The new formulary will help payers ensure the safety, effectiveness, and usability of digital health technology tools made available to their members, the PBM said in a statement. The digital health formulary, available in 2020, will be a curated list of technology-and software-enabled applications and devices that help patients prevent, manage, or treat a medical condition.

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"We are in an exciting age when technology is giving people even greater control of their own health and well-being. However, much of this technology is still emerging, and there are many digital health solutions that require clinical review and validation," said Mark Bini, vice president of Innovation and Member Experience for Express Scripts, in a statement from the PBM.

"We see a need to put mechanisms in place to help carefully manage these innovations…This formulary will help ensure developers do right by payers and consumers, while increasing patient access to technology that can help improve their health,” Bini added.

Similar to a medication formulary, Express Scripts will employ a comprehensive process overseen by physicians, pharmacists, and experts in health research and user experience, who will review clinical outcomes and therapeutic benefit data to determine whether the technology should be included in the formulary.

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“Each digital solution included on the formulary first must demonstrate therapeutic value, effective usability, and stringent security and privacy standards, followed by cost effectiveness,” Express Scripts said.

The PBM said the Digital Health Formulary will also help improve affordability by leveraging Express Scripts' size and scale in purchasing of digital health products. It is also designed to “create a pathway to cover the increasing number of prescription-only digital therapeutics that are coming to market”.

"We want to create a level playing field for inventors and entrepreneurs to encourage continued innovation in this space, and to ensure a pathway to deliver those innovations to patients with assured safety, accuracy and affordability,” Bini said.

Initially, the digital health formulary will include solutions for diabetes, cardiovascular, behavioral health, and pulmonary conditions, and will later expand to include tools for other chronic and complex conditions.

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