CVS Moves Deeper Into Doctors' Turf
August 08 2017 - 04:26PM
Dow Jones News
By Sharon Terlep
CVS Health Corp., hit by slower store sales and the defection of
some big insurance providers, is moving ever more into doctors'
turf in a bid to win back business.
The company said Tuesday it will expand a program in which it
marshals pharmacists, hundreds of on-site medical clinics and its
vast data network to help people manage chronic diseases including
asthma and high blood pressure.
It is an extension of a test program launched earlier this year
to help improve the health of people with diabetes through close
monitoring of glucose levels, medication adherence and lifestyle
habits.
In taking on chronic disease, one of health care's most vexing
and costly problems, CVS sees an opportunity to wrest back business
from rivals in the pharmacy-benefits sector.
CVS last year lost contracts from Prime Therapeutics, which
manages pharmacy benefits for some Blue Cross and Blue Shield
plans, and Tricare, a Defense Department health-care program, to
Walgreens Boots Alliance Inc. At the time, the company said the
lost deals could cost it 40 million prescriptions this year.
Prescription volumes were flat for the most recent quarter, the
company said Tuesday, largely due to the loss of contracts to
Walgreens. Overall, profit and revenue rose as an increase in
pharmacy services offset declines in retail sales and pharmacy
same-store sales. Pharmacy services, such as managing drug claims
for health plans, accounted for $32.3 billion of the $45.7 billion
in second-quarter revenue.
The CVS program to manage chronic disease aims to bring down
costs both for patients and their insurance providers, the company
said. In order for a person to participate, they must belong to a
health plan that has a contract with CVS's pharmacy-benefit
business.
Drugstore chains have long deployed resources to help patients
combat chronic diseases. Walgreens has a program with Express
Scripts Holding Co., the largest U.S. administrator of
prescription-drug benefits, to improve medication adherence for
people with diabetes. But the CVS program is more extensive and
unusual in that it aims to lure back insurers to its
pharmacy-benefits management services.
"We tell our [insurance] clients that these members have to be
in one of our channels to get the value of these programs," said
Jonathan Roberts, CVS's chief operating officer. "There will be a
share shift that comes as clients adopt these programs, and we
demonstrate our ability to lower overall health care cost."
As store sales have slowed for both CVS and Walgreens, which
combined filled more than three billion U.S. prescriptions in 2016,
the two companies have worked to beef up their prescription-drug
businesses. The already pitched competition between the pharmacy
giants could intensify as new rivals look to enter the fray.
Earlier this year, Amazon.com Inc. was reported to have hired a
team to develop a strategy for breaking into the pharmacy
market.
Given that treatment of chronic diseases comprise roughly 70% of
the $4 trillion spent annually in the U.S. on health care, any
effort to combat the problem is welcome, said Mark Fendrick, a
University of Michigan physician and professor focusing on
chronic-disease management.
Getting patients to take their medications properly and
consistently is a major problem in managing the conditions, said
Dr. Fendrick, and one legions of experts over the years have failed
to solve.
"There is a lot upside given the low adherence, so it comes as
no surprise to see any large pharmacy to get more actively involved
in providing care," Dr. Fendrick said.
One concern of medical professionals is that providing medical
services outside a patient's regular network of doctors could lead
to gaps in their records. CVS said it shares the results with
patients' health providers that use the same record-keeping
network, provided the patient consents.
In addition to diabetes, CVS will roll out programs over the
next two years to manage asthma, hypertension,
hypercholesterolemia, or high cholesterol, and depression.
People in the diabetes program get one-on-one support and
coaching by phone and at CVS pharmacies and MinuteClinics,
generally staffed by physician assistants and nurse practitioners,
for no out-of-pocket cost. They also receive a glucometer that
measures and shares blood glucose levels digitally to CVS, which
can then help head off complications or intervene when issues
arise.
(END) Dow Jones Newswires
August 08, 2017 16:11 ET (20:11 GMT)
Copyright (c) 2017 Dow Jones & Company, Inc.
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