A ConversAtion with
Nissan
October 21, 2021
Elevating health for all
© 2021 Express Scripts. All Rights Reserved.
Executive Sponsor Vice President, Account Management
Leslie Achter
Senior Account Executive
Kathryn Reitz
Account Manager
Kyra Garrison
Senior Implementation Project Manager
Dave Schlobohm
Director, Clinical Strategy
Melisa Spicer, PharmD
Vice President, National Accounts
Michelle Connelly
Your experience working with us should be too
healthcare is personal
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What we'll cover
Express Scripts' Business Model and Partnership Commitment
Account and Member Services
Implementation
Clinical and Specialty management
Why partner with us and Q&a
Your goals are our guide
We're driven to earn you back
Positive member experience
Cost containment strategies
Strategic planning and execution
Account team involved from day one Experienced implementation manager Minimize disruption High-touch on-boarding Flexible formulary to accomodate Nissan's exclusions
Tailored and targeted interventions Putting Nissan employees first Specialized care, no matter the destination Collaboration with Premise Health
Waste free formulary management Affordability and predictability Predictive data analaytics Ongoing, data-driven recommendations to meet Nissan's goals
Strategic and experienced account team Managing healthcare costs Our lab is Nissan's lab Creating a strategic roadmap
Seamless and easy implementation
Affordable. Predictable. Simple.
Express Scripts' business model and executive commitment
Unlocking new value in pharmacy and beyond to further total health for all
Top 50 Companies Diversity Inc. 2018-2021
Best Places to Work for Disability Inclusion 2014-2020
Military Friendly Employer 2020 and 2021
National Alliance of Healthcare Purchaser Coalitions eValue8 Innovation 2019
Excellence Award in the Opioid Management Category Pharmacy Benefit Management Institute 2018 and 2020
Silver Military Friendly Spouce Employer 2020
98M
lives served
98%
member satisfaction with Therapeutic Resource Centers
4%
2020 drug trend
TM
Meet your executive sponsor: Leslie Achter
Leslie's focus is to ensure that you will receive
Express ScriptS' business model and executive commitment
Highest visibility and level of attention
Client advocate
Relationship building at higher levels within your account
Designated account team to provide strategic direction
Collaboration on future products and programs
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Direct access to senior management
A team designed around Nissan's needs and aligned to your goals
account management and member service
Experts specializing in supporting your LiveWell program and maximizing value for Nissan
Meet your team
Leslie Achter Executive Sponsor Vice President, Account Management
Kathryn Reitz Senior Account Executive
Tracey Caldiero Senior Director, Account Management
Karen Warren, RPh Senior Clinical Account Executive
Kyra Garrison Account Manager
“Our Account Manager Kyra is great. Very responsive and proactive. Great asset...” “Our day to day contact is great, always very responsive and jumps right on anything we give her.”
“Our team is a well-oiled machine of combined strengths, skills, and experience and we have worked together successfully with clients for years. We bring out the best in each other and we will deliver the best to Nissan. You can count on us to be your champions here at Express Scripts.”
Click on a team member to learn more:
“I have a very well-rounded background with a wide array of experience. This provides me with the ability to think about issues from multiple viewpoints, ask pertinent questions, and obtain the required information to make smart recommendations that my clients can feel confident acting upon.”
“I bring over 30 years of PBM experience and passion for client service to my role in National Accounts. I strive to be a trusted partner, and define success as delivering on commitments, providing innovative solutions to clients and driving high performance from my team."
"Our experienced multidisciplinary team will consistently deliver on your expectations and provide proactive consultative solutions. As a tenured member of the Express Scripts' leadership team, I define success as innovative collaboration with our clients to bring aligned and value based results."
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5
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Client satisfaction survey testimonial
"The current team has been very helpful in auditing our plans, and bringing options to us that may help us manage our population."
"Team is responsive AND thoughTful in reSPONSES."
"The account team is very dedicated to helping us meet our objectives."
"I truly appreciate the partnership and committment of our team."
"Team is responsive, informative, proactive. Strong relationship built from the beginning. Listens and reacts accordingly."
Proactive, strategic planning and review to help Nissan stay ahead of trend
Nissan's Strategic Planning and Review Consultation
Review results: monitor your success
Better together: achieving your goals
Your future: market trends
A look back: analyzing your data
Plan, member costs, and demographics Book-of-business/ peer benchmarking Trend components, including specialty Top drugs and indications
Market trend forcasting Industry insights Upcoming patient expirations Generic opportunities Therapy class pipline Gene therapy forecast
Identify opportunities and goals Explore solutions that effectively manage your trend Build an action plan that fits with your overall strategy
The best full- and self-service tools in the industry Ongoing strategy and performance review sessions Annual master planning and review session(s)
Member experience innovation
95.6% patient satisfaction
97% first call resolution
26-39% increased adherence
Net promoter score - 40+
250K daily digital users
Highest quality care at lowest possible costs
Outcomes that matter
Web AND Mobile app innovation
Customer service innovation and resolution
"Chelsea S. did such a great job of servicing our member that I wanted to recognize her efforts. Chelsea did everything she could and then some to make sure our member received his medication. I really appreciate that she was willing to go the extra mile and follow up repeatedly until the issue was resolved. She provided excellent service to our member and that kind of service needs to be commended." - Express Scripts client
"I am so pleased with what Brant did for me today! He truly went the extra mile to resolve my medication refill problem. Brant also called the pharmacy and I was able to pick up my medicine. I wanted to make sure someone knew about the exceptional service Brant provided today." -Express Scripts member
Working shoulder to shoulder from day one
account management and Implementation
years of implementation excellence
35
Implementations annually
500+
Implementations supporting 1.8M lives from Optum DURING the last three years
216
Implementation satisfaction since 2018
performance guarantees met since 2018
"1/1 has been beautifully boring." 2021 National Account
"Things are going better than we could have expected. We are very pleased! Customer service has been extremely helpful...thank you!" 2021 National Account
"The report from my team about the partnership from Express Scripts has been very positive. Thanks so much for all of your involvement!!!" 2020 Health Plan
"Great job by Dave and team. I really enjoyed working with the implementation team and think it went very smootly." 2020 National Account
"This is the smoothest implementation I've been invloved with. Thank you!" 2016 National Account
Your 'adventure starts where the road ends' and we are here to help you navigate
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usa.nissannews.com
click the icons to learn how Express Scripts will manage these key drivers
How we ensure a successful implementation
Prior authorization file from Optum
Prior authorizations
Mirror existing formualry exclusions and formualry tier change management
Formulary
Open refill file from Optum
Mail and specialty prescriptions
Broadest network access and onsite pharmacy setup
Out of 14 pharmacies in Canton, Mississippi - 12 are in the Express Scripts' network
Retail network access
Match your existing plan design and structure
Plan design
Key drivers of disruption and how Express Scripts will manage
UNDERSTAND
PATIENT
SUPPORT
EDUCATE
your requirements
centric culture
the smooth transition
your employees
Flexible, cost-containment strategies
Formulary Management
Drives out waste by excluding multi-source brand and "me-too" drugs
Express Scripts knows that drugs with high cost and low clinical value deeply impact our clients and their members
We help our clients solve for this issue by providing an extensive amount of options that best suit you and your members
Flexible cost-containment strategies
Brand for generic copay Excluded drug list Exclude at launch Utilization management solutions are optional Counter strategy drug list
Only 1% of Nissan's maintenance Rxs are excluded on Express Scripts' National Preferred Formulary (NPF) Only three drugs have >100 Rxs impacted: Lantus (Semglee* insulin), Ventolin inhaler, Premarin Only 0.33% of Rxs are moving to non-preferred on NPF and 0.58% are moving to non-preferred on Basic Formulary
First FDA-approved interchangeable biosimilar insulin product is covered
Specializing in focused clinical care
Therapeutic Resource centers (TRCS)
96% of Nissan's total drug spend is targeted by TRCs
TRC disease state
Nissan's spend
Rare/specialty Diabetes Cardiovascular Oncology HIV/immunology
$25.3M $12.8M $7.0M $6.9M $5.5M
2M+
clinical interactions with patients in 2020
600+
home infusion nurses
150K
nursing vsits in 2020
Supported by the Health Action Plan
Support far beyond filling medications
clinical and Specialty management
Two of Nissan’s members have bleeding disorders totaling $890K in plan spend
Close monthly monitoring for breakthrough bleeds (47% decrease in annual bleed rates), planned procedures, emergency room/hospitalizations
Specialist pharmacist engages prescriber on clinical concerns
Nursing visit to assess home and teach age-appropriate independence
Monthly refills and home inventory review as well as matching assays
Specialist pharmacist consults with new member with emphasis on education to limit bleeding episodes
Social worker provides proactive copay assistance and important resources available in the community to maximize health
Monitor routine internal reports to focus on at-risk members for non-adherence
Prevention of central line infections and avoidance of costly complications
A mother's story
Expanding the reach of specialized care
Digital Health Formulary
Remote monitoring solutions integrated with Express Scripts' Therapeutic Resource Centers
SM
Specialty trend management
A Comprehensive Approach
Data from 2020 Express Scripts (DTR) client sample for plans >10K lives enrolled in all specialty management strategies
Nissan's specialty spend: $35M or 52% of total pharmacy costs
three-tier specialty plan design, utilization management for biosimilars, 99.9% access to all specialty medications
-4.4%
2020 specialty trend
$49B biosimilar pipeline
9.2%
2020 DTR peers
$25B specialty generics pipeline
FORMULARY
UTILIZATION MANAGEMENT
REBATES
SAFEGUARDRX PROGRAMS
COPAY SOLUTIONS
ACCREDO SPECIALIZATION + ACCESS
Drug Trend Report
Exposing more opportunity in top specialty conditions
SafeGuardRx trend for enrolled versus not enrolled
Inflammatory: 12.4% versus 19%
NISSAN'S INFLAMMATORY CONDITIONS #1 driver of spend: 16.6M
In 2020 alone, member adherence INCREASED BY ALMOST 10%
Multiple Scerosis Care Value
Inflammatory Conditions Care Value
Hepatitis Cure Value
Rare Conditions Care Value
Oncology Care Value
Rx
Innovative copay offset savings program
saveonsp
Net of program shared savings fee. Savings based on sponsor’s utilization, the most restrictive state benchmark and Express Scripts National Preferred, Basic and High Performance Formulary. Savings may vary based on sponsor’s actual utilization or a different benchmark or formulary. PMPM = per member per month
ABOUT THE PROGRAM
Target 300+ specialty drugs in 20 therapy classes
Securing copay assistance ONLY happens AFTER any clinical requirements, such as proir authorization, for the requested medication have been met
Reduces patient's responsibility to zero
Provides out of pocket protection for Nissan
-7.2% first-year specialty trend in 2020 for enrolled plans versus 9.6% for book of business not enrolled
$4M SAVINGS ESTIMATED ANNUALLY FOR NISSAN
NISSAN'S SUMMARY
BENEFIT FOR PATIENTS AND NISSAN
41K 528 3,304
$338K $8.15 $0
total lives utilizing members impacted claims
remaining member cost
monthly plan savings PMPM client savings
75% PMPM Guarantee
market-leading capabilities and solutions
Advanced Utilization Management
Reduce unnecessary spend with specialty and traditional utilization management
$12M in savings
SaveOnSP
Helping patients afford their medications
$4M in savings
Medical Channel Management
Specialty cost management by carving out specialty drugs from the medical benefit
$1.5M in savings
Advanced Opioid Management
Nationally recognized program focused on education and abuse prevention
$770K in savings
RationalMed
Patient safety solution leveraging data integration
$338K in savings
SafeGuardRx
Combines multiple, effective cost-containment strategies into a single platform
$337K in savings
ScreenRx
Predicitve adherence modeling
$248K in savings
Delivering in year-one clinical and financial value to Nissan
$19.2M
Inferred medical savings
Your satisfaction is guaranteed
why partner with us
SafeguardRx platform, Therpaeutic Resource Centers - Center of Excellence and more
Included innovations
Access to
Contract equally aligned with proposal and follow-up commitments
Aligned and guaranteed price points to minimize trend
$0.39 per member per month value
$500K
Invoice credit:
$20 per member
PMF fund:
$1.2M
Total at risk:
$20 per member, up to $820K at risk
Performance guarantees
$10 per member, up to $410K at risk
Implementation guarantee
measured by account management service satisfaction and core service deliverables
our Digital Health Formulary
Q&A
