The digital health landscape is booming, and so is the need for regulation. To meet changing consumer and payer needs, pharmacy and medical benefits giant Express Scripts will introduce the industry's first, stand-alone digital health formulary, according to an announcement last month.
"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," Mark Bini, the vice president for innovation and member experience at Express Scripts, said in a press release.
"This formulary will help ensure developers do right by payers and consumers, while increasing patient access to technology that can help improve their health."
"We see a need to put mechanisms in place to help carefully manage these innovations, and are proud to lead again by being the first health services organization to establish a formulary of this nature," Bini added. "This formulary will help ensure developers do right by payers and consumers, while increasing patient access to technology that can help improve their health."
Payers using the new formulary will be able to evaluate the safety, effectiveness and usability of various digital health technology tools made available to their members. Per the company’s statement, the digital health formulary will comprise “a curated list of technology- and software-enabled applications and devices that help patients prevent, manage or treat a medical condition."
Companies included on the formulary will be vetted by Express Scripts’ team of physicians, pharmacists and experts in health research and user experience, who will determine whether clinical outcomes and therapeutic benefit data are satisfactory. The formulary will measure each digital solution's therapeutic value, effective usability, stringent security privacy standards and cost effectiveness.
The formulary is also intended to have other benefits, including reducing the administrative burden for plan sponsors when it comes to contracting and managing digital health companies, and making digital health products more affordable thanks to Express Scripts' size and scale.
The initial launch will focus on digital health solutions for diabetes, cardiovascular, behavioral health and pulmonary conditions. The company says it will cover more complex conditions later, as the formulary expands.