CVS study: Narrow networks aid Rx adherence

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Research gauges preferred pharmacy impact on medication compliance


WOONSOCKET, R.I. — Members of drug benefit plans with narrow pharmacy networks show improved medication adherence, according to a new study by the CVS Health Research Institute.

CVS Health said Tuesday that the research, published in JAMA Internal Medicine, is the first to gauge the impact of narrow pharmacy networks on medication adherence. Narrow networks incentivize plan members to use specific, in-network pharmacies — also known as preferred pharmacies — by offering reduced out-of-pocket costs for prescriptions.

However, the narrow network model has faced criticism for limiting patients’ pharmacy access and, in turn, adversely impacting their medication adherence, CVS noted.

“There are few opportunities in health care when we can improve both quality of care and health outcomes while helping to manage health care costs. This first-of-its-kind study suggests that narrow networks may be one such opportunity by providing clear evidence that these networks — already an established cost management strategy — also help optimize members’ adherence,” study author William Shrank, senior vice president and chief scientific officer at CVS Health, said in a statement.

In the study, researchers reviewed de-identified pharmacy claims data for more than 200,000 patients on chronic therapies to treat high cholesterol, high blood pressure, diabetes and depression over a 12-month period. The patients received prescription drug coverage through CVS/caremark, CVS Health’s pharmacy benefit manager (PBM). The findings revealed that patients in commercial drug plans with narrow pharmacy networks had improved medication adherence, as indicated by their medication possession ratio (MPR), which measures patients’ available medication on hand over time and is a commonly used barometer of adherence, CVS said.

In addition, researchers found that if 90-day prescription programs were used in tandem with a narrow network, there was an even greater improvement in members’ adherence, according to CVS.

“This research suggests that narrow networks are one more way we can help encourage medication adherence and have an even greater impact as we help people on their path to better health,” Shrank stated.

CVS noted that in recent years, narrow network and preferred pharmacy models have become more prevalent to help manage rising pharmacy costs and are a widely used feature of government-sponsored, exchange and commercial health plans, although their impact on patient health outcomes and quality of care hadn’t been previously established. The company said concerns have also been raised that these networks may discourage medication adherence by reducing patients’ geographic access to pharmacy care and by limiting their choice of pharmacies.

However, many government-sponsored plans address such concerns by requiring plan sponsors to have in-network retail pharmacies within close proximity of members’ residences, according to CVS. The company also said there’s independent research showing that most Medicare beneficiaries are satisfied with their preferred pharmacy plan and report that the in-network pharmacies are conveniently located.

“Despite common concerns that narrow pharmacy networks reduce access, we believe they can actually help encourage plan members to establish a pharmacy home where patients with chronic diseases can receive coordinated care and effective medication adherence support,” Shrank added.


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