Prescription drug overdose deaths are up. "Diversion" of drugs for recreational use costs the health care system $72.5 billion a year, according to National Drug Intelligence Center report. And yet there are obviously literally billions of legitimate prescriptions that help sick people, which come through our nation's pharmacies. How do you crack down without falsely accusing people of fraud?
One company, Express Scripts, sits at an interesting spot within the nation's health care system, right between pharmacies and health care plans. That means they see 1.4 billion prescriptions a year, each one of which generates adds a little more data to their pile. They now have 100 people sorting through that information trying to detect fraud. They've got nurses and pharmacists and forensic accountants, along with a group of data nerds investigating thousands of cases of shady dealings a year.