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Express Scripts signs a deal with start-up Propeller Health as it ups investment in digital health

CNBC. Express Scripts welcomes Amazon's consideration to make a push into the multibillion-dollar pharmacy market.

Express Scripts (ESRX), the largest pharmacy benefits manager in the U.S., has struck a deal with a Bay Area start-up to better treat patients with chronic respiratory problems. The start-up, called Propeller Health, has an FDA-approved set of apps and tools for people with asthma and chronic obstructive pulmonary disease, or COPD, such as a connected inhalers that are synced up to a user's smartphone. The idea behind the program is to help patients avoid over-using their so-called "rescue inhalers," which could worsen symptoms over time, and to make sure they don't neglect their controller medications that can be taken at anytime to prevent flare-ups. Essentially, it's about saving money by helping patients prevent bad and expensive outcomes, like trips to the emergency room. Propeller also provides insight into other factors that might make symptoms worse for people with these conditions, like weather changes. And as part of the deal, Express Scripts has said it will provide dedicated pharmacists to support patients by reviewing the data and providing real-time feedback. The companies plan to launch the service to patients enrolled in Express Scripts' Pulmonary Care Value Program in early 2018. The goal is to make a dent in the estimated $1.3 billion annual cost of treating asthma and COPD, said Express Scripts' chief innovation officer Glen Stettin. It's unclear how many patients will sign up to the program, he said, but about 5 million are eligible -- and about 12 to 15 percent of those are likely afflicted with one of these conditions. So it could be as many as 750,000 people. This partnership comes at a time when many suspect that Amazon will someday compete with Express Scripts and other pharmacy benefits managers, as it moves into the multibillion dollar pharmacy market. Express Scripts sits between payers, like employers, and the rest of the health system, and will negotiate prices with drug manufactures. Some believe that Amazon (AMZN) can undercut this set of companies, automate processes and ultimately bring down drug prices. But Express Scripts, which currently counts Amazon as a customer, said the timing is purely coincidental. "Considering that we've been working on this for the past three years, I wouldn't say it's related to any recent news events," said Stettin. Express Scripts CEO Tim Wentworth has also stressed that becoming a pharmacy benefits manager is "a lot more than dispensing drugs," and therefore, it has a strong position in the market. Both companies declined to share the financial terms of the deal. But they did say that Express Scripts will pay Propeller as patients start to use its offering, rather than the insurers themselves. The partnership is part of a broader trend of insurance companies, employers and pharmacy benefits managers looking for ways to reduce health costs by leveraging digital tools from Silicon Valley companies, like apps and sensors. Propeller is one of a small group of start-ups that refer to themselves as " digital therapeutics ," meaning they use technology to augment or replace traditional medicines. "Through this partnership we're getting to a size and scale we haven't before," said Propeller Health CEO David Van Sickle.

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