CVS Health Fights Back on High Cost Drugs by Launching Industry’s Most Comprehensive Approach to Saving Patients Money

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New CVS Health initiative seeks to solve one of the nation’s most pressing problems and a major source of consumer financial worry.

Recognizing the threat of rising drug prices and high out-of-pocket costs, CVS Health providing most advanced solutions for prescribers, pharmacists and patients.

CVS Pharmacists are key resource for patients in identifying opportunities to maximize their prescription benefits and save money at the pharmacy counter in communities nationwide.

CVS Caremark mitigating impact of high drug costs by providing members and prescribers with robust information and innovative tools to choose lower-cost prescription drugs.

The high cost of prescription drugs is one of the nation’s most pressing problems and a major source of financial worry for consumers across the nation. While CVS Health (NYSE: CVS) has made significant progress in mitigating the impact of high list prices set by pharmaceutical manufacturers, for too many Americans annual out-of-pocket drug costs are still significant. In response, CVS Health announced today that it is fighting back by launching the most comprehensive program in the industry to help patients save money on their medications.

According to a recent national poll, commissioned by CVS Health, 83 percent of Americans said they were concerned personally about the impact of rising prescription drug prices.[1] As prescription drug prices continue to rise and enrollment in high deductible health plans grows, many patients are shouldering higher costs for their prescription medicine.

CVS Health will address this problem with a robust set of initiatives, including the new CVS Pharmacy Rx Savings Finder, which will enable the company’s retail pharmacists for the first time to evaluate quickly and seamlessly individual prescription savings opportunities right at the pharmacy counter. This new tool further enhances existing savings opportunities the company’s pharmacy benefit manager (PBM) CVS Caremark is currently offering its clients such as the preventive drug lists that make medications for many common, chronic conditions available at a $0 copay. In addition, CVS Caremark provides real-time, member-specific drug costs and lower-cost alternatives to prescribers through their electronic health record system and to CVS Caremark members through the member portal and newly updated app. These programs are part of CVS Health’s commitment to helping consumers find the lowest cost prescription drugs by offering more pricing transparency for prescribers, pharmacists and patients.

“Today’s consumers are faced with higher prescription drug prices than ever before and many of them are now paying for a larger share of their prescription drug costs out of their own pockets at the pharmacy counter due to growth in high deductible health plans,” said Thomas Moriarty, Chief Policy and External Affairs Officer, CVS Health. “Until now, patients haven’t had the appropriate tools available to them to help them manage these costs. To address this, CVS Health is giving expanded tools to patients, prescribers and pharmacists so they can evaluate prescription drug coverage in real-time and identify lower-cost alternatives. We are committed to finding the right drug at the lowest possible cost for patients to ensure they are able to access and stay on the medications they need. That’s our promise.”

At the Pharmacy Counter

The new CVS Pharmacy Rx Savings Finder enables the retail pharmacist to quickly and seamlessly review a patient’s prescription regimen, medication history and insurance plan information to determine the best way for them to save money on out-of-pocket costs – with the primary goal of helping the patient find the lowest cost alternative under their pharmacy benefits plan.

“Our direct experience is that patients who are confronted with high out-of-pocket costs at the pharmacy counter are less likely to pick up their prescriptions and are less likely to be adherent to their prescribed therapy,” said Kevin Hourican, Executive Vice President, Retail Pharmacy, CVS Pharmacy.

“Armed with the information available through our Rx Savings Finder, our more than 30,000 CVS pharmacists can play an important role by helping patients save money on their medications, providing advice on how and when to take them, and ultimately helping them achieve better health outcomes,” Hourican added. “We are beginning this process with our CVS Caremark PBM members and expect to roll it out more broadly throughout the year.”

The Rx Savings Finder will show pharmacy teams:

  1. First, if the prescribed medication is on the patient’s formulary and is the lowest cost option available.
  2. Second, if there are lower-cost options covered under the patient’s pharmacy benefit – such as a generic medication or therapeutic alternative with equivalent efficacy of treatment.
  3. Third, if the patient may be able to save money by filling a 90-day prescription rather than a 30-day prescription.
  4. Finally, if neither a generic nor a lower-cost alternative is available, other potential savings options for eligible or uninsured patients where allowed by applicable laws and regulation.[2]

Pharmacists can also help patients enroll in the ExtraCare Loyalty Program and sign them up for Pharmacy and Health Rewards. Through Pharmacy and Health Rewards, patients receive $5 in ExtraBucks for every 10 prescriptions filled, earning up to $50 in ExtraBucks annually.

At the Doctor’s Office

Another component of the company’s comprehensive savings approach is the recently launched real-time benefits program, which helps bring greater drug price transparency to prescribers and CVS Caremark members. At the point-of-prescribing, providers are able to see the member-specific cost for a selected drug, based on a member’s coverage, along with up to five lowest-cost, clinically appropriate therapeutic alternatives based on the patient’s formulary. PBM members have access to the same information on the CVS Caremark app and member portal. Early results show that prescribers accessing the real-time benefits information through their electronic health record switched their patient’s drug from a non-covered drug to a drug on formulary 85 percent of the time. In addition, when the patient’s drug is covered, prescribers using real-time benefits switch their patient to a lower-cost alternative 30 percent of the time. When the prescriber switched to a lower-cost drug, the difference was approximately $75 per prescription.
“We have been working hard to keep prescription medications affordable for patients,” said Troyen A. Brennan, M.D., Executive Vice President and Chief Medical Officer, CVS Health. “In fact, in 2017, nearly 90 percent of our PBM plan members spent less than $300 out-of-pocket for their prescription medicines. While this signals progress, for those patients that cost is not insignificant. That is why we are committed to doing even more across our enterprise to help patients find and access the lowest cost drug at the pharmacy which ultimately will help improve clinical outcomes and remove higher downstream medical costs from the system.”

Using Pharmacy Benefit Management Solutions

CVS Health is also making a variety of PBM solutions available to help further drive down drug trend for its PBM clients and drug costs for the patients they support. The company’s Point of Sale (POS) rebate offering allows the value of negotiated rebates on branded drugs to be passed on directly to patients when they fill their prescriptions – and the savings from this program can be significant. In 2013, CVS Health led the industry with the introduction of POS rebates to clients, and today nearly 10 million members are covered by and able to benefit from the program.

In 2017, despite manufacturer brand list price increases on drugs near 10 percent, CVS Health PBM strategies reduced drug trend for CVS Caremark commercial clients to the lowest level in five years, keeping drug price growth at a minimal 0.2 percent. In fact, 42 percent of CVS Caremark commercial clients spent less on their pharmacy benefit plan in 2017 than they had in 2016. CVS Caremark helped members reduce monthly out-of-pocket costs and improve adherence to its highest level in seven years in key categories such as diabetes, hypertension and hyperlipidemia.

Prescription drug trend is the measure of growth in prescription spending per member per month. Trend calculations take into account the effects of drug price, drug utilization and the mix of branded versus generic drugs as well as the positive effect of negotiated rebates on overall trend. The 2017 trend performance is based on a cohort of CVS Health PBM commercial clients, employers and health plans.

About CVS Health

CVS Health is a pharmacy innovation company helping people on their path to better health. Through its more than 9,800 retail locations, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with more than 94 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a leading stand-alone Medicare Part D prescription drug plan, the company enables people, businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at https://www.cvshealth.com.

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[1] The Morning Consult poll was conducted from February 22-26, 2018, among a national sample of 1992 registered voters. The interviews were conducted online and the data were weighted to approximate a target sample of registered voters based on age, race/ethnicity, gender, educational attainment, and region. Results from the full survey have a margin of error of plus or minus 2 percentage points.

[2] Prescriptions submitted for reimbursement to Medicare, Medicaid or other federal or state programs are not eligible.

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