The Military Coalition Tours Express Scripts Factory and Innovation Center

By Anna Selman, Programs and Public Relations Coordinator

Members of the Healthcare Committee of the Military Coalition (TMC) got an opportunity to tour Express Scripts’s Factory and Innovation Center at its headquarters in St. Louis, MO.  For those of you unaware with Express Scripts, they fill mail-order prescriptions for our active duty, veterans and their families.  They fill about 1.2 billion prescriptions a year for about 80 million patients.

The chief impetus for this invitation was recent changes to TRICARE, especially for our retirees.  For those of you who were unaware, Congress passed new legislation regarding TRICARE that took effect on January 1, 2018.  TRICARE Standard was renamed TRICARE Select, and with the new name, comes new changes.  The first major change is that there is an annual enrollment period.  If you miss the window to enroll, you will have to wait until the next year.  Currently, there is no enrollment fees, but in 2020, enrollment fees will begin.  The second major change is the pricing.  For example, there is now a standard price for prescriptions throughout TRICARE, regardless of where you get your prescription filled.

This is the major reason why Express Scripts invited the Military Coalition to their facility in St. Louis.  They wanted to see what our members had to say about the changes, and they wanted to see if there was any suggestions on areas they should be working on.

From their own data, Express Scripts found out that most beneficiaries were unaware of the changes in TRICARE, even though they led a massive information campaign.  They also found a huge trend of beneficiaries moving their prescriptions to Military Treatment Facilities (MTF) pharmacies and to retail pharmacies.  As with every change, people tend to move to what is familiar, but from what our trip showed, familiar might not always be better.

Their St. Louis facility was very impressive.  Their assembly line was remarkably efficient, and you could see thousands of prescriptions being filled within the hour that we toured the facility.  Throughout the line, you could see thousands of checks being done from the name of the bottle, the pill size, the pill color, the weight of the bottle and so much more!  Their main prescription errors came in the shipping process, but they were overall lower than the average error rate for your retail pharmacy.

In the afternoon, we got to see the Express Scripts Innovation and Technology Center, where they were inventing some really great advances in the pharmacy world.  One of the products that I found interesting was a “narcotic deactivator.”  Basically, it was a small charcoal-activated bag that you could put your leftover narcotics in, and once sealed and crushed in the bag, would completely deactivate all the narcotics.  This could be an amazing advancement in our opioid crisis.  Currently, Express Scripts is working on patenting the product before it can be available to the public.

The second advancement that I found interesting was the Kiosk system that is currently being rolled out in the Arizona area.  Basically, it would be a glorified pill-vending machine.  Your physician could send the prescription into the system, and all you would have to do is scan the code you received from your provider and pay through an ATM-like card reader.  Then, the pills would dispense, and you could go on with your day.  If you had any questions on your prescriptions, there would be a calling system where you could speak with a live pharmacist.  Currently, Express Scripts is looking to market the product to military bases, where the machines could drastically improve wait times.

The day ended with the members of their team asking the members of TMC where they should focus their efforts in the future.  A large portion of the Committee suggested that they should be looking at the effects of prescription pills and suicide – possibly looking into doing a study with DOD and the VA.

One suggestion that I made was looking into helping the VA with its female health care issues.  For those of you that were not aware, a piece of legislation recently passed that guaranteed female veterans the right to fertility care if their ability to conceive was affected by their service.  Currently, women are lucky enough if they can find an OB/GYN at their local VA.  They are going to have a tough time finding a fertility specialist and getting their specialty medications.  This is really an area in which Express Scripts can help our female veterans.

Overall, I found the trip very informative.  If you have not heard about the changes in your TRICARE benefits, I highly suggest you visit the VA website for more information and make sure you do not miss the 2019 enrollment period.  In addition, you should look at your TRICARE plan and see what the best plan is for you and your family.

Volume 72. Number 2. Summer 2018