When Michael Holmes presented the idea to spin off the RX Outreach prescription assistance program from Express Scripts as a separate not-for-profit organization, he thought it was the right strategic move for the company and the community. Holmes now realizes it is the right move for him as well.
“I didn’t originally start with the concept that I was going to run this thing, but when I saw the potential impact it could have on the community, I was really led to come do this,” said Holmes, who is executive vice president of strategy, human capital and emerging markets at the pharmacy benefit management giant.
After four years in his leadership role, Holmes is retiring from Express Scripts to run RX Outreach full time.
Holmes has a master’s degree in business from Webster University, holds a triple major bachelor’s degree from Washington University in St. Louis and is a graduate of Berkeley High School in St. Louis County.
He has a long history with non-profit organizations, including the national board for sickle cell, the Herbert Hoover Boys and Girls Club, the United Way, the advisory board for Harris-Stowe State University’s School of Business, Webster University’s Board of Trustees, Missouri Baptist Hospitals and the Regional Commerce and Growth Association.
When Holmes looked at the concept, the spin-off made sense.
“We buy the vast majority of drugs, and there are tax incentives for pharmaceutical companies to donate their drugs if we are a not-for-profit,” Holmes explained.
By “spinning this out as a not-for–profit,” he said, the company can achieve several things.
“We can better partner with some of the big disease associations out there in getting the word out. We’d be able to customize the products for some of the free clinics, so that we could meet their needs more exclusively. And we can increase the percentage of drugs that are actually donated to the business or to this organization and then further lower our cost of providing drugs for low-income people.”
RX Outreach will continue to operate through Express Scripts until its new structure is established, Holmes said, some time in the second quarter of the year. Its new offices will be located in Earth City, and he is bringing two key people from Express Scripts to help him run it. Darryl Lunden will become the chief operating officer and Jeff Clark will head the IT function.
Express Scripts is also donating the entire business (including the pharmacy) of RX Outreach to the new not-for profit, which is a $10 million business.
“The scale of this business is not significant. Because Express Scripts, quite frankly, is going to be in excess of $40 billion,” Holmes said.
“It’s a little piece of the pie, but it has significant growth opportunities and so Express Scripts is willing to invest this into the community.”
Most pharmaceutical companies have their own prescription assistance programs (PAP) through their own foundations. One way Holmes said RX Outreach will be more effective is by cutting down on the red tape for pharmaceutical companies.
“We think there is an easier way to do that, to simplify the process that will save the clinics time and possibly save some of the pharmaceutical companies some more money,” Holmes said.
“They actually pay people to administer the programs, and under this model, if they are willing to facility-test it, they could actually not have to pay for an expensive PAP program and administer them through us.”
For consumers, RX Outreach is available to families and individuals who earn up to 300 percent of the federal poverty limit.
“A family of four can make up to $66,150 and still participate in this program. A family of two (in the 48 contiguous states) making $43,710 a year or less can participate in this program. A single person making $32,490 a year or less can participate in this program,” Holmes said.
“And it’s a simple one-page enrollment form.”
Like Express Scripts, RX Outreach delivers prescription medications to the home.
“You get a six-month supply, and we don’t have the same restrictions that you get in a lot of retail areas, in terms of the number of days and dosages or the strength. We typically have same pricing for any dose,” Holmes said.
Holmes said he wrote this proposal when it looked like health care reform would be passed by Congress.
“Even if health care reform would go through, there are still over 20 million people who will not be covered, and it wasn’t going to all be in place until 2018, so there would still be a need for this,” he said.
For a list of medications available or more information on RX Outreach, go to www.rxoutreach.com or call 1-800-769-3880.