Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. Express Scripts had 2016 revenues of $100.752 billion. Since December 20, 2018, the company has been a direct subsidiary of Bloomfield, Connecticut-based Cigna.
The term "Scripts" in the company title refers to the widely used clipped version of prescription.
Headquartered in Greater St. Louis within unincorporated North St. Louis County, Missouri, Express Scripts provides integrated pharmacy benefit management services including network-pharmacy claims processing; home delivery pharmacy services; specialty pharmacy benefit management, through its subsidiary Accredo; benefit-design consultation; drug-utilization review; formulary management; and medical and drug data analysis services to manage drug plans for health plans, self-insured employers and government agencies (both as administrator of employee benefits and public assistance programs). One of its largest clients is the United States Department of Defense's Tricare program.
Express Scripts also offers pharmacy benefit management services for workers' compensation insurance programs. The program is accredited by URAC, the nation's largest accrediting body for pharmacy benefit management companies.
The company processes pharmaceutical claims for members through a network of retail pharmacies. Its own automated pharmacies dispense medications for chronic long-term diseases, such as diabetes or heart disease, directly to members by home delivery.
On March 7, 2018, it was announced that Cigna would buy Express Scripts in a $67 billion deal.
The deal closed on December 20, 2018 at $54 billion, allowing Cigna to start offering new Express Scripts products to its corporate health insurance customers in 2019.
History
Founding
Express Scripts began in 1986 in St. Louis County, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems.
Sanus traces its history to Bradford Systems and Administrative Services which was founded in Boston in 1968. Bradford had a contract for computer processing of Medicare and Medicaid payments. It was acquired in 1981 by McDonnell Douglas through its McDonnell Automation Company (McAuto) subsidiary for $11.5 million.
In 1983, two of McDonnell Douglas' former principals Joseph T. Lynaugh (a former director of NYC Health + Hospitals in New York City), the McAuto's project manager of the Bradford takeover, and Howard L. Waltman, a long time Bradford's employee, formed the Sanus Corporation with substantial investments and ownership from McDonnell Douglas including a McDonnell Douglas whole ownership of the St. Louis office. General American Life Insurance Company invested in Sanus's future largest part based in New York. Sansa was a health maintenance organization and it merged with the General America Life Insurance preferred provider organization. Sanus rapidly grew and by 1986 it had 200,000 clients and $100 million in revenue operated in the St. Louis, Dallas, Fort Worth, Houston, and Washington, D.C. markets. It created a subsidiary called GenCare to fill prescriptions.
In late 1986, Sanus announced a deal with St. Louis based pharmacy Medicare-Glaser for fulfilling prescriptions that would be 50-50 split ownership between Sanus and Medicare-Glaser called Express Scripts (scripts being medical industry jargon for prescriptions). Initial plans called for Missouri and Illinois clients to get their prescriptions at the Medicare-Glaser brick and mortar pharmacies while those in other cities could get their prescriptions via mail order—an innovation at the time. The initial report of the creation said that Charles H. Ridings, formerly in charge of McDonnell Douglas mergers and acquisitions, was named the first chief executive, although he was quickly replaced by Waltman.
Sanus remained the dominant early insurance customer but Express Scripts began marketing to other providers. With increased investment by New York Life, Sansus change its name to NYL Cares and in 1998 was sold to Aetna for $1.05 billion.