WOONSOCKET, R.I., Jan. 17, 2018 /PRNewswire/ -- CVS Health
(NYSE: CVS) today introduced Transform Rheumatoid Arthritis Care™
to help the company's pharmacy benefit management (PBM) clients
better manage care and costs for Rheumatoid Arthritis (RA). The
program is the latest addition to the company's suite of
condition-specific, highly personalized Transform Care™ programs
and adds value-based management strategies including outcomes based
contracts and a new indication-based formulary for autoimmune
conditions to CVS Health's integrated pharmacy care model. Given
that the cost and utilization of drugs to treat RA are a top drug
trend and spend driver, accounting for nearly half of overall
specialty drug trend, this new multi-pronged approach also includes
a trend guarantee based on the program's ability to improve both
clinical care and cost management for RA.
"Rheumatoid arthritis is a complex condition and is one of the
top drivers of specialty drug trend for our PBM clients," said
Troyen A. Brennan, M.D., executive vice president and chief medical
officer of CVS Health. "By leveraging our integrated pharmacy care
model, we can provide highly personalized, whole-patient support
through our specialty pharmacy and embedded AccordantCare nurses,
while harnessing the power of our PBM's tools to encourage
appropriate use of and adherence to lower cost therapies."
The Transform RA Care program is designed to help encourage
appropriate use of lower-cost therapies through pharmacy network
and utilization management tools along with value-based management
strategies such as outcomes-based contracts and a new
indication-based formulary for autoimmune conditions.
Outcomes-based contracts tie reimbursement for a drug to achieving
a specific target or goal. If the target is not met – for instance
if the patient discontinues therapy, indicating the drug was not
well tolerated – the manufacturer may be required to provide
additional value. In addition, the indication-based approach
determines formulary placement for drugs based on the specific
diagnosis rather than for the therapy class as a whole. This
multi-pronged approach is designed to help clients better manage
trend and receive a trend guarantee for these expensive drugs.
"Treating Rheumatoid Arthritis costs the U.S. health care system
$19 billion a year. Both spend and
trend have also been rising for the autoimmune category in recent
years and market analysts expect this category to be the
fastest-growing drug class over the next five years," said
Alan Lotvin, M.D., executive vice
president of CVS Specialty, the specialty pharmacy of CVS Health.
"Our program is unique in that we can pull together resources –
enabled by our integrated pharmacy care model – to deliver both a
truly member-focused clinical management program while also helping
to manage the rising costs within the autoimmune category through
new approaches to contracting and formulary management."
Members enrolled in Transform RA Care will continue to receive
proactive, personalized care and disease-specific expertise from
the RA CareTeam, a team of specially-trained pharmacists and
Accordant nurses in our RA Center of Excellence. The RA CareTeam
provides a range of support specific to the member's needs
including symptom, comorbidity and side effect management; care
coordination; and coaching and education. The RA CareTeam also
offers initial clinical assessments, benefits verification and
medication dispensing and distribution. In addition, proactive
patient outreach can help improve engagement rates, improve
adherence to medication, and reduce complications, such as hospital
and emergency room visits. Members with RA also have access to
innovative digital tools to help them start and stay on their
therapies and, through Specialty Connect, the ability to pick up
their medication at a local CVS Pharmacy or have it delivered to
their home or office by mail.
Clients enrolled in the Transform RA Care program could expect
to see savings of up to 5 percent on their annual spend for RA
drugs. For example a client that manages 100,000 lives could
see up to $500,000 in annual
savings.
RA is the second most common form of arthritis, impacting more
than 1.5 million people in the U.S. It is characterized by chronic
inflammation of the joints and, over time, can lead to bone
deformation. The disease is also complex and hard to manage, and
our research shows that approximately one quarter of patients who
start on an autoimmune drug discontinue therapy within 180 days,
which can lead to poor health outcomes and higher costs for payors
and members. Those with RA can benefit from holistic disease
management, which can help improve medication adherence, address
gaps in care, and reduce condition-related complications and visits
to the hospital and ER. In addition, cost management strategies can
create additional value for both payors and patients.
About CVS Health
CVS Health is a pharmacy innovation company helping people on
their path to better health. Through its more than 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.
Media
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