Pharmacy benefit managers and insurers are going all “Minority Report” — they’re attempting to predict when people will stop taking their meds or develop medical problems before they even do so.
As the WSJ reports, Express Scripts is announcing a new initiative that will analyze factors including prescription history, whether the patient has kids living at home, the amount of the co-pay and disease-specific issues to predict who’s likely to skip doses or stop taking their meds. (No word on whether, like Tom Cruise’s crime-predicting team in the movie, they’ve also got three psychics in a swimming pool helping them out.)
Once those folks are identified, the PBM will reach out to them via phone or letter to offer them ways to stick to the medication plan, say, by ordering via mail.
And other PBMs and insurers are also data-diving in order to figure out who’s likely to skip meds or develop complications or new problems down the line, the paper says. UnitedHealth’s Ingenix unit sells a diabetes-prediction service; among other things, it uses mole-removal stats to pinpoint people who spend time outdoors and therefore who aren’t likely sedentary. CVS Caremark is preparing to launch its own predictive prescription adherence efforts.
On a similar note, we wrote recently about a study suggesting that offering care-management services to a broader swath of the patient population — not only to those facing a big treatment decision or chronic-disease patients, but also “chaotic users of the health-care system” — may save money.
A bioethicist tells the WSJ companies must tread lightly because of privacy concerns; insurers and PBMs say they would never share the info with outside parties.
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