CVS Caremark unveils new pharmacy model

July 14, 2008

At the AHIP annual meeting, CVS Caremark announced a new approach to managing patients' medication needs.

"We are redefining the pharmacy continuum of care," pharmacist Mitch Betses, CVS Caremark VP, health services, told AHIP. "As a combined retail pharmacy and PBM, our Proactive Pharmacy Care model enables us to inform and engage consumers in ways that are personalized, convenient, and accessible so that we can positively impact health outcomes."

CVS Caremark told AHIP attendees it has developed six new programs to close those gaps. First Fill Counseling uses PBM data to target new-to-therapy patients with expanded counseling.

Adherence Outreach tracks patient refills through PBM data. If expected refills do not appear, a CVS pharmacist from the store where the last refill was made phones the patient to discuss adherence.

Maintenance Choice is a drug benefit option that lets patients choose a 90-day supply from mail order or a local CVS retail outlet at the same cost or co-pay.

Specialty Medications represent an optional benefit that lets patients in certain markets choose between delivery of specialty medications to the home or delivery to a CVS retail store for pickup. A specialty medications research team also works with patients whose reimbursement claims have been denied to find alternative funding sources.

ExtraCare Health is a card plan for CVS Caremark members that provides a 20% discount on specific CVS-branded products. Drug benefit plan sponsors can use the card to track patient purchases or offer special incentives to reward specific behavior, such as refilling scripts on time or meeting health goals.

"We're really talking about a pharmacy relationship that delivers the same messages in the pharmacy, on the phone, by mail, or on the Web. It is all about engaging consumers across the continuum of care," Ally said.

Early results suggest the program works. Julie Slezak, VP, analytics & outcomes, reported 77% therapy adherence for diabetes across the CVS Caremark patient population and 82% in the best responders. That compares with 64% compliance across all payer groups, she said.

The high-touch approach also boosts generic use to 67%, compared with a 63% national average. An internal study based on 2007 data indicated potential cost savings of 7% on generic conversions by mid-2009.