CVS gives pharmacists, doctors tools to cut drug spending
- Drugstore chain CVS Health on Wednesday launched a new tool designed to enable the 30,000 pharmacists who staff its stores find patients the cheapest option for their prescription drugs.
- Dubbed "Rx Savings Finder," the tool will allow pharmacists to search for lower-cost options under a patient's insurance plan, including therapeutic alternatives with equivalent efficacy as well as generic drugs, CVS noted.
- The chain is also working with EHR vendors like Epic and Cerner to provide drug-specific information to doctors at the point of prescribing to keep costs down.
Debate between pharma and payers has spilled over into the pharmacy, as two sides of the healthcare industry spar over the other's hand in the rising drug costs directly borne by patients.
That back and forth has drawn scrutiny on a wide range of previously little known practices, such as the "gag clauses" imposed by some to prevent pharmacists from informing patients when paying cash would be cheaper than using insurance.
The program looks to be an effort to cut through some of that fog, handing pharmacists the information they'd need to guide a patient to the cheapest out-of-pocket option.
"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," Kevin Hourican, head of retail pharmacy at CVS, said in a statement.
CVS pharmacists can use the tool to review whether a drug is on a patient's insurance formulary and if other lower-cost options exist. Notably, CVS said its tool would show pharmacists when a cheaper and therapeutically equivalent alternative was also covered by a patient's pharmacy benefit.
A pharmacist could also see whether patients could save money by filling a 90-day prescription rather than a 30-day prescription.
The software will be available first to CVS Caremark PBM members, but CVS plans to roll out the program more broadly throughout this year. The drug chain giant is also in the midst of a bid to buy insurer Aetna for $69 billion.
By giving pharmacists more information at the point of sale, CVS reinforces its existing efforts to provide physicians with more visibility into patient costs when they are writing prescriptions.
In a related move, through a deal with Epic, CVS can provide doctors with member-specific costs for a given drug, along with five therapeutic equivalents on that member's formulary. The drug chain says providers who used the real-time benefits information switched patients to an on-formulary drug 85% of the time.
"There are also options that are not on benefit to help save the patient money," Casey Leonetti, SVP of PBM Innovation at CVS, told Healthcare Dive. "Toward the goal of overall finding the lowest costs, we starting by helping the patient maximize their covered benefit, and then if that does not provide adequate or affordable coverage, then there are options that are off benefit."
The real-time benefit connectivity at the point of prescribing has been live since November, but Cerner and Epic have been starting to implement the tool early this year, according to Leonetti. Allscripts is set to do so later this year, she added.
"Right now, [active EHRs] represent a single-digit portion of transactions, but by the end of the year, the schedule we have, it will represent I believe 15-25% of e-prescribing transactions. It's an adoption curve that we're monitoring and working with EHRs and health systems to accelerate," Leonetti said.
CVS already boasts one of the largest pharmacy chains in the U.S., as well as a top PBM. In December, it announced its offer for Aetna, which could give the company unparalleled scale and a hand in each stage of drug supply chain.
Boosting patient adherence by lower out-of-pocket costs would help any larger insurer, as would steering patients toward lower-cost generics or therapeutic equivalent.
- CVS Health Press release
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