How Big Data Can Catch Oxycontin Abusers and Bad Docs

The Atlantic

A team of forensic experts are trying to stanch the flow of prescription drugs into the black market.

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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. 
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Express Scripts is going to continue improving their tools, which obviously save them a lot of money. What they're rolling out next are predictive models that might tip them off early that a particular pharmacy or doctor had a high-risk profile for fraud. 




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