The nation's biggest retail pharmacy chains are wasting no time in expanding their options as the Medicare Part D plan selling season gets under way.

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Retail News Breaks

Retail pharmacy giants eye more Part D business

October 3rd, 2011

NEW YORK – The nation's biggest retail pharmacy chains are wasting no time in expanding their options as the Medicare Part D plan selling season gets under way.

Walgreen Co., Walmart and Target Corp. have signed on as preferred pharmacy providers for a new Medicare Part D prescription drug benefit plan (PDP) from Coventry Health Care Inc., the Bethesda, Md.-based health care services firm said this weekend.

Meanwhile, CVS/pharmacy and Aetna on Monday said they have launched a new co-branded Medicare Part D plan, and Humana Inc. announced that for 2012 it will again offer a co-branded Medicare PDP with Walmart.

Under their partnership with Coventry, Walgreens, Walmart and Target will participate in the preferred pharmacy network for the new First Health Value Plus PDP, which Coventry said is the nation's the lowest premium, zero-dollar deductible Part D plan.

The plans offers lower member co-payments for prescriptions filled at any of the nearly 14,000 combined pharmacy locations of Walgreens (7,760), Walmart (over 4,400, including Sam's Club) and Target (1,610). According to Coventry, the preferred network model enables members to receive free Tier 1 formulary prescriptions (most generics and certain branded drugs) when filled at any Walgreens, Walmart or Target pharmacy before reaching the Part D "doughnut hole" coverage gap.

As a result, First Health Value Plus could provide hundreds of dollars in annual savings to Medicare beneficiaries and be an alternative to the lowest-premium, stand-alone Part D plan with a deductible, Coventry noted.

"As the nation's largest drug store chain, Walgreens is excited about joining with Coventry as a key preferred pharmacy partner through our thousands of retail locations to participate in a new kind of prescription drug plan for America's seniors," Kermit Crawford, president of pharmacy, health and wellness at Walgreens, said in a statement. "Today's Medicare beneficiaries are looking for a community pharmacy in their neighborhood that offers value in combination with other well-being products. That makes First Health Value Plus with access to Walgreens pharmacies across the country an attractive option for them."

The First Health Value Plus plan carries an average premium of $25.60 per month, with a range of $21.70 to $30.10, and has no annual deductible. There's no co-pay on Tier 1 formulary prescriptions (most generics and select branded drugs) at preferred pharmacies during the Part D initial coverage period, a $7 co-pay on Tier 1 formulary prescriptions at other contracted pharmacies, and lower co-pays on Tier 2 and Tier 3 formulary prescriptions when filled at preferred pharmacies, Coventry said.

Also offered in the plan are a 90-day supply of prescriptions through retail pharmacies and access at Walmart and Target to preferred value generic drugs ($4 generics), which Coventry noted will help members who enter the coverage gap. In addition, plan members will be mailed vouchers for health and wellness products, such as multivitamins and calcium tablets, that can be redeemed at any preferred pharmacy.

"In these challenging economic times, we believe our new Part D plan brings great value to beneficiaries and the Medicare program by establishing broad access to prescriptions through the most recognized names in the pharmacy and retail business, low monthly premiums and no deductible, all of which are important to seniors. For the first time, we've also included value-added well-being items that are available only through our preferred partners," stated Nancy Cocozza, senior vice president of Medicare at Coventry Health Care.

"Our First Health Value Plus plan demonstrates an innovative new approach to Part D by combining affordable coverage; wide access to preferred pharmacies in urban, suburban, and rural locations; and the extra well-being items that seniors want, Cocozza added. "As a result, we believe that Value Plus will be a very competitive and compelling Part D option for many beneficiaries."

The new Aetna CVS/pharmacy Prescription Drug Plan, available in 43 states and Washington, D.C., carries a $26 monthly premium and has no deductible for generic drugs. According to Aetna and CVS, Medicare beneficiaries who sign up for the plan and fill their prescriptions at a CVS/pharmacy also will see savings on out-of-pocket prescription drug costs.

"We are pleased to join with Aetna Medicare to offer Medicare beneficiaries a Part D plan that provides outstanding value along with the ease and convenience of filling their prescriptions at their neighborhood CVS/pharmacy," Josh Flum, senior vice president of retail pharmacy at CVS/pharmacy, said in a statement. "This plan allows members to build a relationship with their CVS pharmacist along with the opportunity to realize savings on their prescriptions."

By filling prescription drugs at one of the 7,200 CVS stores, instead of at a nonpreferred network pharmacy, Aetna CVS/pharmacy plan members will pay a $3 co-pay for preferred generic prescriptions and save $10 on co-pays for non-preferred generic and preferred brand prescriptions. Other CVS/pharmacy benefits include Care 1on1 pharmacist counseling and the ExtraCare Health Card, which entitles members to discounts on thousands of over-the-counter CVS/pharmacy-brand health-related items.

In addition to CVS/pharmacy locations, members can continue to access any of the more than 65,000 pharmacies in the Aetna Medicare network.

"We are committed to providing value to our Medicare beneficiaries, and this new plan is not only affordable, it increases our members' access to one of the premier pharmacy chains in the United States," stated John Chomeau, head of Aetna Medicare. "With 75% of the U.S. population in the markets in which CVS/pharmacy operates living within three miles of a CVS drug store, Medicare beneficiaries will have convenient access to the prescription drugs they need through this plan."

Since being launched last fall, the Humana Walmart-Preferred Rx Plan has enrolled more than 1 million seniors and people with disabilities, Walmart and Humana said Monday.

For 2012, the co-branded Medicare PDP will offer one monthly plan premium of $15.10, which Walmart and Humana said is the lowest plan premium next year for a stand-alone Medicare Part D plan offered in all 50 states and Washington D.C., according to the Centers for Medicare & Medicaid Services. Co-pays for preferred generics from preferred pharmacies will be as low as $1 in 2012 (after deductible), down from $2 in 2011, and co-pays are as low as $0 after deductible for prescriptions filled via Humana's RightSourceRx mail-order service.

"We value affordability and are excited that our partnership with Humana can help Medicare beneficiaries get access to medications at a low cost," commented John Agwunobi, president of Walmart's health and wellness division. "At a time when people are looking for ways to save money and live better, at Walmart we are committed to supporting seniors and people with disabilities on the journey toward a healthier life."

Late last month, Argus Health Systems Inc. announced a preferred pharmacy network arrangement Walmart that can be used for commercial, Medicaid and Medicare networks. 

Starting on Oct. 15 and running to Dec. 7, the Medicare Part D enrollment period for 2012 begins earlier than in previous years. And competitive stakes among retail pharmacies have intensified as the population ages and a larger number of people — notably baby boomers now turning 65 — become eligible for Medicare prescription drug benefits.

Earlier this year, CVS Caremark Corp. closed its acquisition of the Medicare Part D business of Universal American, a leading Medicare prescription drug plan sponsor. CVS Caremark said the deal will more than double the size of its Part D program.

For Walgreens, Part D business has become more critical as the drug chain's stand-off with pharmacy benefit manager Express Scripts Inc. continues.

"Management expects Express Scripts to account for $5.3 billion (about 7%) of Walgreens' fiscal 2011 sales. Of the 11% of sales related to Express Scripts' Medicare Part D, Walgreens intends to educate customers about their pharmacy options in the fall sign-up period, which may allow the company to retain a large portion of this business," analyst Mark Miller of William Blair & Co. said in a research note following early August investor meetings with Walgreens chief financial officer Wade Miquelon.  

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