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Something you might already know: Express Scripts is a national leader in the prescription medication industry. Something you might not know: This is due in large part to its culture of innovation. In both 2014 and 2015, Forbes named the St. Louis-based company as one of the most innovative companies in the US. But for the pharmacy management behemoth, innovation is more than just a buzzword—it’s the driving force in developing solutions that, first and foremost, meet the needs of its clients and members.

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Mark Bini, vice president of new solutions for Express Scripts, leads a team meeting in the Lab. This year, the $10 billion pharmacy benefits manager celebrates 30 years of business. | Photo courtesy of Express Scripts

“To me, innovation is about identifying and prioritizing problems that are worth solving,” says Mark Bini, vice president of new solutions. “We listen to our clients and understand their challenges. We also listen to what the data is telling us to develop insights that inform our strategies. We’re constantly generating new ideas and testing vigorously for their effectiveness and feasibility, and clients play a big role in this process.”

Betting on Behavior

An important part of that process is Express Scripts’ behavior-centric approach, and Bini is a key contributor, working closely with plan sponsors to help cultivate positive patient behavior. As he keeps a keen eye on the emerging science around human behavior and decision-making, his main focus is helping plan sponsors to enable better health and value for their members.

The goal is always to improve healthcare and make it more affordable and accessible, but the team at Express Scripts knows they can’t hit those goals without identifying and understanding the issues most critical to their clients and members.

“We work together with our clients to come up with solutions that are easy, simple and effective,” he says. “To do that, we have to first listen to the voice of our customer and then understand their pain points.” These “pain points” include the high costs of specialty medications, preserving member choice, non-adherence to necessary drugs and closing the gaps in care.

Learning with The Lab

Client and member input aside, Bini and his team put high value on data collection to discover and identify trends in healthcare and patient behavior. This all takes place in the Express Scripts Lab, run by Bini. The Lab is the nucleus where targeted research studies, innovative pilot programs and Therapeutic Resource Centers® (TRCs) all contribute to smarter healthcare solutions that address specific challenges facing Express Scripts’ clients and members.

Bini likens the The Lab to the relationship between the right and left sides of the brain: “The right brain drives the creative ideation and innovation of new solutions. The left brain is full of logical thinkers, data scientists, researchers, statisticians who figure out how to make those creative ideas happen at scale.”

Bini explains that as ideas are crystalized, they develop into pilot programs. Then those programs are tested. More than 300 clients, accounting for 6 million members, currently participate in pilot programs where concepts, messaging and new market technology are tested. This way, they figure, clients are confident in what the company brings to market.

One successful pilot program is Pharmacist at Home, which leverages face-to-face interactions via smartphones and tablets so patients can directly engage with an Express Scripts specialist pharmacist to learn how to administer their medication.

Similarly, the Remote Patient Monitoring programs have been useful in encouraging patient care with more historically non-adherent medical conditions. Express Scripts partners with its clients to test new tech devices for real time, remote monitoring and tailored interventions for patients living with asthma. By utilizing their TRCs and the clinical specialization, support and education, Express Scripts proved they can reduce the use of rescue inhalers by 50 percent and increase patient adherence to using regular asthma medication.

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The Express Scripts recently expanded the Express Scripts Lab to add a mobile and web development team to the current threesome of research and analytics, decision and design, and clinical specialists. Photo courtesy of Express Scripts

As groundbreaking as the programs coming out of The Lab are, they’re viewed as an outgrowth of the culture within Express Scripts’ walls.

“Our Lab is a village of sorts, a community,” Bini says. “The vast majority of our company is represented under one roof. That makes it easier for us all to work together every day in identifying problems and coming up with new ideas to solve for them.” But again, Bini reiterates that at the heart of Express Scripts is empathy: The patient is the focus.

“One of the biggest barriers to innovation is lack of focus,” Bini says. “Even with all of the varying departments and all of our diversity, we’re ultimately all aligned and focused on solving the same important problems. We never take for granted that we serve 85 million members, which accounts for one in three Americans. And we attract talented, passionate employees that are focused on driving better outcomes for our members.”

Bini places importance on giving employees a voice and the tools to create their own success. Express Scripts even has an internal “Shark Tank,” an annual innovation competition where employees can pitch their ideas and gain resources and seed money to see their ideas come to life.

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Looking Outside

Recently, the push for new ideas led to new collaborations. “We have an open innovation model,” says Bini. “We know there are some problems that we may not solve on our own. But there are both startups and established companies with which we’ve collaborated to solve them.”

With an active presence in the Cortex Innovation Community, Bini says Express Scripts is making a commitment to be a part of St. Louis’ growing ecosystem through mentorship and collaboration. The company recently announced a $25-million, multiyear commitment to Lewis & Clark Ventures as a way to supplement efforts in developing smart pharmacy in the Midwest, particularly in St. Louis.

“We’re not afraid to fail, and we’re willing to take bold actions on behalf of our clients and members,” says Bini. In driving better clinical and financial outcomes, those bold actions often disrupt the status quo. A major example: Express Scripts’ efforts to make a curative treatment for hepatitis C accessible and affordable. The initiative had an industry-wide ripple effect that saved the U.S. healthcare system more than $4 billion annually.

Putting a premium on patient behavior; leaning into innovation and an open workplace culture; and not being afraid to try out new and unique collaborations has kept Express Scripts a leader both in pharmaceutical innovation and for the St. Louis region. And as the company celebrates its 30th anniversary, Bini says there’s still a contagious excitement to see the industry grow and innovate.

“We are a Fortune 25 company today that began as a startup 30 years ago,” says Bini. “From an innovation perspective, we’ve very much maintained that startup mentality.”

Read more about how Express Scripts fosters a culture of innovation and hear from the company’s Chief Innovation Officer Glen Stettin here.