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How Big Data Can Catch Oxycontin Abusers and Bad Docs

Alexis Madrigal

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

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Edited from flickr/grump puddin

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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