Express Scripts' New Plan: Prescription Drugs Go to Employees' Homes

New program takes the decision-making out of signing up for home delivery of prescribed medications.


With 401(k) accounts being a bit of a sore spot these days, this might not seem like a good time to consider a prescription drug program that takes its inspiration from a successful 401(k) participation strategy. But it turns out that in some ways, encouraging people to invest regularly in a 401(k) is not unlike encouraging people to stick to a regular medication regimen. In both cases, it's important to overcome the individual's tendency to procrastinate, either by not bothering to enroll in the employer's 401(k) on the one hand or by not getting around to signing up for an employer's prescription drug home-delivery program on the other.

Back in the mid-1990s, researchers discovered that one way to overcome people's natural tendency to put off signing up for a 401(k) was to enroll them automatically, deducting a certain amount from their paychecks on a regular basis unless they specifically asked their employer not to do so. That way, by doing what came naturally—putting off doing anything—employees ended up acting, or actually not acting, in their own best interests. Under automatic enrollment, participation in 401(k)'s jumped from around 35 percent to more than 80 percent, says David Laibson, an economics professor at Harvard University who has been studying these "opt out" programs for years.

Now Express Scripts, one of the nation's largest pharmacy benefit managers, has developed a program that applies similar behavioral economics principles to prescription drug benefit plans. For participating employers, the Select Home Delivery program automatically enrolls their employees in the home delivery program unless they specifically opt out of it. "Moving from retail to home delivery may be the most powerful intervention we have today to improve therapy adherence," says Bob Nease, chief scientist for Express Scripts, referring to patients who follow their prescribed drug regimens. Home delivery also saves patients money, typically up to a third of the prescription cost for a 90-day supply.

So far, about two dozen companies have signed up for the Select Home Delivery program. Home improvement retailer Lowe's has seen the percentage of prescriptions filled through home delivery rise from about 14 percent to 40 percent since the company signed on, says Nease.

Even if your employer doesn't make getting your drugs delivered to your home completely effortless, signing up for home delivery is usually a pretty simple process. You'll save money and time and be more likely to take the drugs you need. So what are you waiting for?

Check out my other recent posts on drug samples and discount plans.