Express Scripts maps plans for inaugural digital health formulary

The formulary aims to be a central forum in which technologies that are shown to be effective can be managed and made available to plan members.

The good news about digital health? There are plenty of new, promising technologies emerging. The bad news? It’s hard to know what to choose.

Bringing order to the dizzying array of personal health technologies and interventions is the aim of Express Scripts, which is introducing a standalone digital health formulary, which it expects to make available next year.

Executives of Express Scripts—a Cigna company—say the new formulary will help payers ensure the safety, effectiveness and usability of digital health technology tools made available to their members. It will be a curated list of technology- and software-enabled applications and devices that help patients prevent, manage or treat a medical condition.

The idea builds on the notion of medication formularies, which help standardize a range of drugs based on their efficacy and cost-effectiveness. In building out the digital health formulary, Express Scripts will employ a comprehensive process overseen by physicians, pharmacists and experts in health research and user experience.

The panel of clinical and technical experts will review clinical outcomes and therapeutic benefit data to determine whether digital health technologies should be included in the formulary. Each digital solution included on the formulary first must demonstrate therapeutic value, effective usability, and stringent security and privacy standards, as well as cost-effectiveness.

“There are many digital health solutions that require clinical review and validation," says Mark Bini, vice president of innovation and member experience for Express Scripts. "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."

The company defines digital health technology as including software-driven tools that help patients take better control of their health—this includes tools that promote fitness, wellness and the prevention of chronic conditions; mobile health interventions; telehealth solutions; remote monitoring devices; and FDA-approved digital therapeutics that work with specific medications or medical devices.

While most apps and tools are available to all people, some require a prescription from a physician, and the number of prescribed digital health products is expected to grow in the coming years, Bini believes.

"In addition to helping payers manage currently available digital health solutions, our digital health formulary lays the groundwork to manage new solutions and tools that have yet to be invented," he adds. "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."

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