WOONSOCKET, R.I., Nov. 28, 2017 /PRNewswire/ -- CVS Health
(NYSE: CVS) announced today that its pharmacy benefits manager
(PBM), CVS Caremark, will begin providing real-time visibility to
member-specific medication costs and available lower-cost
therapeutic alternatives at the point of prescribing and at the
pharmacy. This enhanced visibility to the patient's benefit across
all points of care can help eliminate potential dispensing delays,
improve patient outcomes through increased medication adherence and
lower costs for members and payors.
"Patients often do not find out that the medication they were
prescribed is not covered or has higher than expected out-of-pocket
costs until they go to the pharmacy to pick up their prescription,
which can result in patients not filling a prescription,
non-adherence and, ultimately, higher downstream health care
costs," said Troyen A. Brennan, MD, Executive Vice President and
Chief Medical Officer of CVS Health. "Making detailed, real-time
benefit information available for our PBM members and their health
care team, whether it's the doctor or the pharmacist, can help
streamline the patient experience and improve health outcomes while
also lowering costs for both the patient and the payor."
Through visibility to "real-time benefits," prescribers can see
specific benefit information for patients supported by CVS Caremark
integrated directly into their e-prescribing workflow. Even before
they prescribe a drug, prescribers will be able to see the cost of
the drug based on the patient's coverage, including the patient's
remaining deductible, when applicable, and will be able to review
up to five clinically appropriate branded alternatives or
therapeutically equivalent generic medications specific to the
patient's formulary coverage. Prescribers will also have visibility
to requirements, such as prior authorization or step therapy,
enabling them to immediately submit an electronic prior
authorization request. In addition, pharmacists at all retail
pharmacies within the CVS Caremark network will have visibility to
the same list of clinically appropriate formulary alternatives
provided to the prescriber, and beginning in early 2018, CVS
Caremark members will be able to find lower-cost alternatives
within the Check Drug Cost tool on Caremark.com.
At CVS Pharmacy, this information will be integrated directly
into the pharmacist's existing workflow, making it easy for them to
engage CVS Caremark members about potentially lower-cost
alternatives, based on the members' specific formulary coverage.
CVS pharmacists will also be able to easily request a prescription
change from the prescriber – when needed – with a simple one-step
process. Beginning in early 2018, as part of the company's
ongoing, enterprise-wide focus on helping patients save money, CVS
pharmacists will also be able to see the associated out-of-pocket
costs for CVS Caremark members. This will help ensure alignment
with the member's plan design and enable them to access the lowest
cost medications within their benefit. For those members for whom
drug cost is still a concern, the CVS pharmacist will also be able
to share additional cost savings opportunities such as prescription
discounts, when available.
"Across the CVS Health enterprise, we are focused on providing
patients with the most convenient access to affordable medications,
and this innovation enables us to provide our PBM members and their
health care providers with direct, easy access to real-time benefit
information – throughout the health care continuum – whether they
are at their physician's office or at the pharmacy," said
Jonathan Roberts, Executive Vice
President and Chief Operating Officer of CVS Health. "No one else
provides this level of member-specific actionable drug benefit
information across so many points of care, which can help simplify
and streamline the process of getting a patient on the most
appropriate and affordable therapy and increase member engagement
and satisfaction with their care."
Medication cost can be a significant factor when a patient is
deciding whether or not to fill a prescription. Yet, research shows
that patients often feel they do not have adequate information
about the use of formularies or the drugs covered by their plan. In
addition, when required, the manual prior authorization process to
gain necessary approvals for a specific drug from both the insurer
and prescriber can be time-consuming for prescribers, patients and
pharmacists. In fact, approximately 80 percent of physicians said
manual prior authorization requests require extra work, rework and
follow up, which can also delay the start of an important therapy
or result in poor compliance. Altogether, this can result in
medication non-adherence, which can lead to poor health outcomes
and is estimated to cost the U.S. health care system nearly
$300 billion each year.
Real-time benefit information is enabled through functionality
from Surescripts® and is available to any provider using an
electronic health record system enabled with real-time benefits and
electronic prior authorization. Real-time benefits further build on
CVS Health's use of electronic health records, to support
MinuteClinic nurse practitioners and CVS Specialty's care
management programs.
About CVS Health
CVS Health is a pharmacy innovation
company helping people on their path to better health. Through its
9,700 retail locations, more than 1,100 walk-in medical clinics, a
leading pharmacy benefits manager with nearly 90 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/.
Contacts:
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Christine
Cramer
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Christina
Beckerman
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CVS Health
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CVS Health
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(401)
770-3317
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(401)
770-8868
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christine.cramer@cvshealth.com
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christina.beckerman@cvshealth.com
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SOURCE CVS Health