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Did you take your pill today? Express Scripts Inc. had its eye on people like you, and it plans to send reminders to absent-minded and reluctant patients.

The giant pharmacy benefit management company said Monday it is launching “ScreenRx,” a computer program that can predict which patients won’t take their medicine. The company, based in north St. Louis County, says the program is 98 percent accurate in fingering patients who are likely to skip medication over the course of a year.

If employers agree, those patients will get a call from Express Scripts offering help to stay on track.

Not taking medicine — pharmacists call it non-adherence — is expensive. Patients can end up sicker and needing more expensive treatment. By Express Scripts’ calculation, that adds $317 billion to the nation’s health bill – more than is spent for treating cancer, diabetes and congestive heart failure combined.

“Non-adherence is literally killing us,” says Bob Nease, chief scientist at Express Scripts. “Take a patient with diabetes. If they don’t adhere, they can have a heart attack, stroke, kidney failure, and possibly blindness and amputation.”

Forgetfulness and procrastination are the biggest reasons that patients don’t gulp their pills, accounting for 69 percent of non-compliance, according to an Express Scripts study.

The high cost of medicine causes 16 percent of non-compliance, according to an Express Scripts. Another 15 percent stems from patient concern about the side effects of the medicine itself.

Pharmacists sometimes have problems with new patients on high blood pressure medication.

“It lowers your blood pressure and you don’t feel as good,” says Miranda Wilhelm, assistant professor of pharmacy practice at Southern Illinois University Edwardsville.

Wilhelm, who wasn’t involved in the Express Scripts study, tells patients that the effect will go away if they keep taking the drug.

Some previously healthy patients are resist being “medicalized,” said Nease, who recently learned he had high blood pressure cheapest personal loan rates. “In the course of an office visit, I went from being an invincible 54 year old to being a hypertensive. I was a little blue. I did not want to be a patient,” he said.

Pharmacy benefit managers handle prescription programs for employer health plans. They can tell when a patient isn’t taking drugs from refill patterns. But predicting non-adherence in advance is harder.

Express Scripts says its program uses 400 factors to predict who will skip medicine. For instance, men are a little less likely to take their medicine if their doctor is a woman, and the effect is greater with lower income men, says Nease. Parents with young children are less likely to take their own medicine, as are younger adults.

Express Scripts says it will fit the solution to the reason. Forgetful customers may get daily reminders. Patients worried about side effects will be offered a chat with a pharmacist. Those with money problems will be told about payment assistance programs, or lower-cost drugs.

The company said it piloted the program on 600,000 people. It’s still to early to judge success in getting patients to comply, said Nease.

Express Scripts serves between 90 and 100 million patients.

This summer, the company will begin offering the program to employers, who will be charged a fee to participate. The program will focus on patients with high blood pressure, high cholesterol, diabetes, asthma and osteoporosis.

“It’s wonderful in concept,” said Terry Seaton, professor of pharmacy practice at the St. Louis College of Pharmacy. He noted others are also working on solutions. Missouri’s Medicaid program notifies pharmacists when patients haven’t refilled prescriptions.

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Negotiators for Iran and six world powers were making encouraging progress Saturday in bridging differences that have doomed previous meetings meant to reduce fears that Tehran intends to turn its atomic program into making weapons, a diplomat close to the talks said.

With the meeting just breaking for lunch, the diplomat cautioned against premature optimism about the outcome. But he said the unfolding dialogue between the two sides suggested they would find enough common ground for a second round in several weeks’ time.

Iran is under four sets of U.N. sanctions for refusing to stop uranium enrichment _ which can be used both to make reactor fuel and the fissile core of nuclear warheads _ and the international community continues to demand that Tehran stop the activity.

But the last set of nuclear talks broke up without result more than 14 months ago after the Iranian team had refused to even discuss enrichment. The six, thus had come to Saturday’s meeting with more modest expectations. Diplomats said before the meeting began that even general Iranian readiness to accept the need to discuss its enrichment program would be considered enough of a success to warrant a follow-up round.

The diplomat, who demanded anonymity because he was sharing information from a closed session, said the Iranians appeared to be moving toward that goal, engaging in discussion about the peaceful use of nuclear energy and the Nuclear Nonproliferation Treaty.

He said the Iranian team had mentioned supreme leader Ayatollah Ali Khamenei’s “fatwa,” or prohibition, of nuclear weapons for Iran, in the course of the plenary discussions. After lunch the meeting would go into bilateral sessions, he said _ a setup that will be closely watched to see if the Americans meet directly with the Iranians.

Such encounters are rare and would indicate a further thaw in tensions at the talks.

“I would say there was a very constructive atmosphere compared to last time … generally a positive vibe,” he said. “The principle seems to be there for future negotiations.”

Iran insists it has no nuclear weapons ambitions, but the international community fears it could use its uranium enrichment program not only to make reactor fuel but also the fissile core of nuclear weapons.

Ahead of the meeting, European Union Foreign Policy Chief Catherine Ashton, who is the facilitator for the six nations engaging Iran, expressed hope that it will be “the beginnings of a sustained process,” in a statement whose language reflected the meeting’s main goal _ establishing enough trust to keep the process going.

“What we are here to do is to find ways in which we can build confidence between us and ways in which we can demonstrate that Iran is moving away from a nuclear weapons program.”

For his part, chief Iranian negotiator Saeed Jalili said the talks “will serve the dignity of the Iranian nation, as he walking into the talks Saturday at one of Istanbul main conference venues overlooking the Bosphorus.

Officially, the international community’s long-term goal remains what it was when nuclear negotiations began eight years ago _ persuading Tehran to stop all uranium enrichment and thereby relieve fears that it will use that program to create the fissile core of nuclear warheads. Tehran has long denied any weapons-related nuclear goals.

A senior diplomat involved in the talks said however, that influential Western nations now are increasingly agreed that Iran should be allowed to keep some enrichment activity “under the right circumstances” _ sometime in the future, if all fears about possible Iranian plans to make nuclear weapons are put to rest. He demanded anonymity because his information was confidential.

The West’s strongest bargaining chip is linked to its sanctions on Iran, penalties that have been tightened in recent months as the U.S. and EU have taken aim at Iran’s main cash cow: oil. At the talks, it may specifically probe whether Tehran is ready to halting uranium enrichment at a level higher than it needs to make reactor fuel because higher-level material can be turned more quickly into warhead material.

Iranian officials have suggested scaling back on uranium enrichment while continuing to make nuclear fuel and ahead of the talks, Jalili, the chief Iranian nuclear negotiator, vowed to present new initiatives, without specifying what they might be.

“There have been signals that suggest to us they are more serious than the last time,” said Ashton spokesman Michael noting that Jalili’s letter to Ashton setting up the talks indicated Iran now was ready to talk about its enrichment program.

Preliminary encounters between the two sides reflected the relatively positive atmosphere unfolding at the talks, in an Istanbul conference center overlooking the Bosphorus.

Ashton and Jalili met for more than three hours over dinner Friday evening, in what participants who demanded anonymity because they were relaying confidential information said was a relaxed atmosphere.

They said discussions did not focus on nuclear issues. A member of the Iranian delegation told The Associated Press that when Jalili was reminded that the dinner had been planned for a shorter period, he replied, “we need to continue.”

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The European Central Bank will restart its controversial government bond purchases rather than offer banks another round of unlimited three-year loans as the sovereign debt crisis worsens, a survey of economists shows.

Of 22 economists polled this week, 17 predicted the ECB will be forced to resume the Securities Markets Program (ECBCSMP), while only one forecast it will offer another batch of three-year cash. Nine said the central bank may consider shorter maturity loans of one or two years.

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Instead of curbing government spending, President Barack Obama’s healthcare law could add up to $530 billion to the federal debt over ten years, a Republican expert on U.S. government benefit programs said on Tuesday.

A study by Charles Blahous, a George Mason University research fellow and the Republican trustee for the Medicare and Social Security entitlement programs for the elderly, challenged the administration’s contention that the 2010 law would reduce healthcare costs.

But the Obama administration defended the law as a cost-saver and sharply criticized the report by Blahous, an economic policy adviser under former President George W. Bush.

Known as the “Affordable Care Act,” or by conservatives as “Obamacare,” the measure to expand health insurance for millions of Americans is considered Obama’s signature domestic policy achievement.

The Supreme Court is weighing whether Congress overstepped its authority to regulate commerce in approving the law. The justices heard arguments in the high-stakes case two weeks ago.

Republican presidential candidates have promised to repeal the law if one of them wins the White House in the November election. Conservatives denounce the sweeping overhaul as an unwarranted government intrusion.

Obama and the Democrats believe the law will control skyrocketing costs and curtail government “red ink.”

White House health adviser Jeanne Lambrew said Blahous’ analysis wrongly charges that some savings are “double counted low interest personal loan.” She said government estimates from the Office of Management and Budget and from the non-partisan Congressional Budget Office show the 2010 law would lower federal deficits over a 10 year period.

“This new math fits the old pattern of mischaracterizations about the Affordable Care Act when official estimates show the health care law reduces the deficit,” Lambrew, deputy assistant to the president for health policy, wrote in a blog post on the White House website.

But Blahous, who also served as the deputy director of the National Economic Council under Bush, said in his research that the law is expected to boost net federal spending by more than $1.15 trillion and add between $340 billion and $530 billion to deficits between 2012-21.

“Relative to previous law, the (healthcare law) both exacerbates projected federal deficits and increases an already unsustainable federal commitment to health care spending,” he concluded.

The analysis, first reported by the Washington Post late on Monday, also comes a month after the Congressional Budget Office cut the estimated net cost of the healthcare law by $48 billion to $1.08 trillion through 2021.

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The number of working Americans earning so little they lived in poverty reached 7.2 percent of the labor force in 2010, the highest level in at least two decades, the government said on Friday.

The Bureau of Labor Statistics counted 7.6 percent of women among the working poor, compared to 6.7 percent of men. In 2009, the working poor rate was 7 percent.

Education made a huge difference. Among workers who had not graduated from high school, 21.4 percent lived below the official poverty line against only 2.1 percent of those with a university degree. The highest rate was amongst the unemployed looking for work during the year at 35.1 percent.

The official poverty line in 2010 was an annual income of $10,830 for a single person and $22,050 for a family of four.

Overall, the United States had 46.2 million people living in poverty that year, or 15.1 percent of the population o f all ages. The working poor totaled 10.5 million.

The Bureau of Labor Statistics conducted a special survey in 2011 which it is used to calculate the figures, based on those who were in the labor force for at least 27 weeks either working or looking for work.

The rate for working poor was 5.5 percent in 1987, the furthest back that the BLS included in its report, and in 1999 it fell below 5 percent.

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The city of O’Fallon, Mo., hired Michael Hurlbert as its new economic development director.

Hurlbert is joining O’Fallon from the planning, architecture and design firm of Peckham, Guyton, Albers & Viets Inc., where he was senior project manager since September 2008.

Previously, he was the city planner and economic development administrator for Creve Coeur from 2004 to 2008, and a project planner for Chesterfield from 2000 to 2004 cash advance loan no fax.

Hurlbert has a bachelor’s degree in business management and a master’s degree in urban affairs, both from St. Louis University.

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U.S. stocks dropped Wednesday, rebounding somewhat into the close, as investors grew increasingly anxious about what the markets might look like without additional stimulus from the Federal Reserve.

Some investors had been hoping the Fed would move toward another round of quantitative easing, but those prospects seemed less likely following Tuesday’s release of minutes from last month’s meeting of the central bank.

"Markets don’t like living in a world where they don’t have an active Fed to support them," said Chris Beauchamp, an analyst at IG Markets in the United Kingdom.

Still, investors and analysts aren’t expecting the markets to suddenly crash if the Federal Reserve doesn’t renew its bond-buying program before it expires on June 30, 2012.

"As investors start pricing out the possibility of a QE3, it becomes easier for the Fed to cut the addiction," said Drew Matus, senior U.S. economist at UBS. "You’ll get to the point quickly enough that there will be few people expecting the Fed to do anything."

Meanwhile, adding to Wednesday’s anxiety, payroll processing firm ADP reported a lower-than-expected increase in private-sector jobs for March ahead of the opening bell.

And once again, Europe became difficult for investors to ignore, after Wednesday’s auctions for Spain’s debt failed to draw robust demand.

Wednesday’s sell-off was broad, with financial stocks leading the decline. Goldman Sachs (, Fortune 500), JPMorgan Chase (, Fortune 500), Citigroup (, Fortune 500), and Bank of America (, Fortune 500) all fell more than 2%.

Gold dropped more than 3%, hitting its lowest levels since early January. In a sign of increasing anxiety over the markets’ trajectory, the VIX also spiked roughly 10%. The index is still far below 30, though, the level that typically signals a high level of investor fear.

The Dow Jones industrial average () ended the day down 124 points, or 0.9%.

The S&P 500 () fell 14 points, or 1%. The Nasdaq () slipped 45 points, or 1.4%.

"Today is definitely a pullback from recent runs," said Joe Cogan, vice president of international equities at Topeka Capital. "Investors are very hesitant. Volumes have been up on days where things have sold off, and light on the days when the market has rallied."

Stocks: Brace for a bumpy ride higher

U fast payday loans.S. stocks closed lower Tuesday, with momentum stalling after the Fed minutes were released.

Looking ahead, investors will be closely monitoring the Labor Department’s jobs report for March, which is due out Friday. However, U.S. markets will be closed in observance of Good Friday, and bond markets will close early.

Companies: Yahoo (, Fortune 500) announced 2,000 job cuts, as the Internet giant continues to restructure.

JPMorgan Chase said the Commodity Futures Trading Commission fined the bank with a $20 million civil penalty to settle issues stemming from its work with Lehman Brothers before its bankruptcy.

Agricultural tech firm Monsanto (, Fortune 500) raised its guidance and reported quarterly earnings that beat analyst expectations before Wednesday’s open.

Burger King announced Tuesday that it planned to re-list on the New York Stock Exchange within 90 days, after its owners sold 29% of the company to a U.K. investment fund.

General Electric (, Fortune 500) shares fell, after rating agency Moody’s announced that it had downgraded the company’s debt due to risks associated with its finance subsidiary, GE Capital Corp.

Shares of IBM (, Fortune 500) and cruise ship operator Carnival Corp. () both dropped on reports of analyst downgrades.

Shares of disk drive company SanDisk (, Fortune 500) fell sharply, after the company cut its outlook.

Why Obama shouldn’t tap U.S. oil reserves

Currencies and commodities: The dollar gained against the euro and the British pound but fell against the Japanese yen.

Oil for May delivery slipped $1.94 to $102.07 a barrel.

Gold futures for April delivery fell $51.80 to $1,620.20 an ounce.

World markets: The European Central Bank said Wednesday that it was holding its main interest rate steady at 1%.

Eyes on Spain

European stocks closed down sharply. Britain’s FTSE 100 () dropped 2.3%, the DAX () in Germany stumbled 2.8%, and France’s CAC 40 () fell 2.7%.

In Asia, Japan’s Nikkei () tumbled 2.3%. Markets in Hong Kong and China were closed for the Tomb Sweeping holiday.

Bonds: The price on the benchmark 10-year U.S. Treasury rose, pushing the yield down to 2.23%. 

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While the rest of us have to wait until June, the justices of the Supreme Court will know the likely outcome of the historic health care case by the time they go home this weekend.

After months of anticipation, thousands of pages of briefs and more than six hours of arguments, the justices will vote on the fate of President Barack Obama’s health care overhaul in under an hour Friday morning. They will meet in a wood-paneled conference room on the court’s main floor. No one else will be present.

In the weeks after this meeting, individual votes can change. Even who wins can change, as the justices read each other’s draft opinions and dissents.

But Friday’s vote, which each justice probably will record and many will keep for posterity, will be followed soon after by the assignment of a single justice to write a majority opinion, or in a case this complex, perhaps two or more justices to tackle different issues. That’s where the hard work begins, with the clock ticking toward the end of the court’s work in early summer.

The late William Rehnquist, who was chief justice for nearly 19 years, has written that the court’s conference “is not a bull session in which off-the-cuff reactions are traded.” Instead, he said, votes are cast, one by one in order of seniority.

The Friday conference also is not a debate, says Brian Fitzpatrick, a Vanderbilt University law professor who worked for Justice Antonin Scalia 10 years ago. There will be plenty of time for the back-and-forth in dueling opinions that could follow.

“There’s not a whole lot of give and take at the conference. They say, `This is how I’m going to vote’ and give a few sentences,” Fitzpatrick said.

It will be the first time the justices gather as a group to discuss the case. Even they do not always know what the others are thinking when they enter the conference room adjacent to Chief Justice John Roberts’ office.

By custom, they shake hands. Then Roberts will take his seat at the head of a rectangular table. Scalia, the longest serving among them, will be at the other end. The other seven justices also sit according to seniority, the four most junior on one side across from the other three.

“They generally find out how the votes line up at the conference,” said Orin Kerr, a George Washington University law professor who worked for Justice Anthony Kennedy nine years ago.

The uncertainty may be especially pronounced in this case, where the views of Roberts and Kennedy are likely to decide the outcome, Kerr said in an interview Thursday. “I don’t think anyone knows. I’m not sure Justice Kennedy knows.”

No one’s vote counts more than the others’, but because they speak in order of seniority, it will become clear fairly quickly what will become of the health care overhaul.

That’s because Roberts speaks first, followed by Scalia, then Kennedy. If the three men hold a common view, the Obama health care overhaul probably is history. If they don’t, it probably survives.

If Roberts is in the majority, he will assign the main opinion, and in a case of this importance, he may well write it himself, several former law clerks said. If Roberts is a dissenter, the senior justice in the majority assigns the opinion.

The court won’t issue its ruling in a case until drafts of majority opinions and any dissents have circulated among the justices, changes have been suggested and either accepted or rejected.

“These justices aren’t locked in. Minds have changed during the drafting process and minds have changed after opinions have been circulated,” said Rick Garnett, associate dean and professor of law at Notre Dame Law School who worked for Rehnquist 15 years ago.

In one celebrated case decided in 1992, Rehnquist initially assigned Kennedy to write a majority opinion for five justices allowing prayers at public school graduations. In the end, Kennedy ended up writing the opinion for a different five-justice majority striking down the graduation prayers. According to several accounts, Kennedy simply changed his mind during the writing process.

No one will know precisely when decisions on particular cases will be coming, until perhaps Roberts ends a court session in late June by announcing the next meeting will be the last until October. Then it’s a safe bet that whatever hasn’t been decided will be on the last day. And decisions in the biggest cases very often aren’t announced until that last day of the term.

Supreme Court opinions rarely find their way to the public before they are read in the marble courtroom, although the court inadvertently posted opinions and orders on its website about a half hour too soon in December.

The last apparent security breach occurred more than 30 years ago when Tim O’Brien, then a reporter for ABC News, informed viewers that the court planned to issue a particular opinion the following day. Chief Justice Warren Burger accused an employee in the printing shop of tipping O’Brien and had the employee transferred to a different job.

Sometimes, though, the justices themselves manage to let people know something big is coming.

On May 17, 1954, the attorney general, secretary of state and Nina Warren, wife of the chief justice, were in the courtroom when Earl Warren read the historic, unanimous opinion in Brown v. Board of Education outlawing school segregation.

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Dubai’s shipyard operator DryDocks World has filed a claim with a special tribunal in the city-state as part of an effort to push forward its $2.2 billion debt restructuring.

Court records show the Dubai World Tribunal is scheduled to hear a case Monday filed by the company involving Decree No. 57, a law issued by Dubai’s ruler in 2009. The company made the filing Sunday.

The legislation allows subsidiaries of state conglomerate Dubai World such as DryDocks World to apply for protection from creditors through the court. It also includes a provision that a restructuring plan approved by two-thirds of lenders can become binding on all creditors.

DryDocks World is expected to release more details of the restructuring later Monday.

On Saturday, the company said a “significant majority” _ but not all _ of its creditors had signed on to the debt restructuring plan.

DryDocks Worlds has been wrangling with lenders for months to hammer out new terms on the debt. The negotiations have been complicated by a lawsuit by one of its creditors, Monarch Alternative Capital, which was seeking about $45 million. A British court ruled in Monarch’s favor earlier this year.

By turning to the tribunal, DryDocks World appears to be trying to secure legal approval for its turnaround effort despite the objections of some creditors easy pay day loans. Its chairman, Khamis Juma Buamim, said Saturday he is confident the lack of support from a minority of creditors will not affect the restructuring effort.

DryDocks World operates the Middle East’s largest shipyard in Dubai, where it builds and repairs ships and oil drilling rigs. It also owns shipyards in Singapore and Indonesia, as well as other Asian businesses including a fleet of more than 100 vessels, including tankers, cargo ships, tugboats and barges.

Its parent company, Dubai World, sent markets reeling in 2009 when it acknowledged it couldn’t pay back billions it owed. It signed an agreement to restructure some $25 billion in debt last March, but DryDocks World was excluded from that process.

A panel of three judges from Britain and Singapore preside over the Dubai World Tribunal, which was set up in 2009 to handle cases involving the finances of the debt-laden conglomerate.

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