CVS sees drop in PBM prescription drug trend

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Pharmacy management solutions help clients rein in costs, company says

CVS PBM photo_featured

WOONSOCKET, R.I. — CVS Health reported a significant decrease in the prescription drug trend for its Caremark pharmacy benefit management (PBM) clients last year.

CVS said Tuesday that the prescription trend, a growth measure of prescription spending, came in at 5% for 2015, down from a high of 11.8% in 2014.

While the trend drivers — including branded, specialty and generic drug price inflation — were similar to those in 2014, CVS noted that price inflation in non-specialty brands outweighed all other drivers. Specialty, including the effect of new launches and rises in price and usage, had less of an impact than the inflation of brands in high-volume categories such as drugs used to treat diabetes, the company said.

Prescription drug trend gauges growth in prescription spending per member per month. The trend accounts for the effects of drug price, drug utilization and the mix of branded versus generic drugs, as well as the positive effect of negotiated rebates on overall trend.

CVS attributed the decline in its PBM prescription drug trend, in part, to proactive pharmacy management strategies that lessened the impact of escalating drug costs in what it called “today’s highly volatile prescription drug market.”

“The high cost of drugs that our clients are struggling with hurts everyone,” Troy Brennan, chief medical officer and executive vice president at CVS Health, said in a statement. “Millions of people depend on us for the prescriptions they need to stay healthy. At CVS Health, we work to help patients avoid unnecessarily expensive medications as part of our focus on making prescriptions affordable.”

For example, CVS Caremark offers clients flexible formulary options that, based on clinical evidence, help rein in costs while ensuring plan members have access to the medications they need. The company said that, on average, clients using the its value formulary last year saved $20 million or more, depending on the number of plan members they support. Recently published research from the CVS Health Research Institute also showed that more selective formulary design improves medication adherence and health outcomes.

“The double-digit drug trend increases we were experiencing in 2014 resulted in a call to action from our clients to help them ensure their plan members could access the medications they need to stay healthy, at an affordable price,” explained Jonathan Roberts, president of CVS Caremark and executive vice president at CVS Health. “Our programs were effective and successful, as shown by the dramatic drop in overall drug trend last year, and moving forward we will continue to focus on identifying key drug trend drivers in real time and quickly deliver flexible solutions to our clients that result in additional cost savings for clients while improving the health of their plan members.”

Overall, CVS Caremark serves more than 75 million plan members.



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