Insights

Managing Diabetes

Our integrated, coordinated care approach

CVS Health is harnessing the power of its unmatched community connections and industry-leading data analytics to help people with diabetes better manage their day-to-day symptoms and lead healthier lives.

Our integrated approach is rooted in early detection and personalized, holistic care management, and offers our patients, customers and members an array of products and services that work seamlessly together, while improving access to care that is more local, more affordable and easier to navigate.

In Our Stores

With locations in 10,000 communities nationwide, our CVS Pharmacy stores are uniquely positioned to help patients manage their chronic conditions such as diabetes in between doctor’s visits. Our pharmacists provide one-on-one trusted counsel to patients daily, reviewing prescriptions to ensure patients are getting the most out of their medicines, while the providers in our more than 1,100 MinuteClinic locations offer screenings to monitor a patient’s vital signs and glucose levels.

We carry a wide variety of diabetes care products in our CVS Pharmacy locations to make it easier for patients to manage their condition.

MinuteClinic providers can identify conditions — including diabetes and hypertension — that a patient may not know about and develop an initial treatment plan with appropriate prescriptions and ongoing monitoring and counseling.

And with our new HealthHub? concept, a new, first-of-its-kind community-based store that offers a broader range of health services, new product categories, digital and on-demand health tools and trusted advice along with expanded capabilities in chronic disease care such as diabetes.

In addition, under our Reduced Rx prescription savings program, patients with diabetes can receive their insulin at a reduced cost at any of the more than 67,000 pharmacies in the CVS Caremark retail network, including our CVS Pharmacy locations.

CVS Pharmacy is partnering with the American Diabetes Association on their November #CountMeIn campaign to highlight the numbers that matter most when it comes to those living with, at risk for and supporting those with diabetes. More information can be found at diabetes.org/CountMeInADA.

For Our Members

We launched our Transform Diabetes Care program in 2017 to help simplify condition management and improve outcomes for members of our CVS Caremark pharmacy benefit manager.

The results so far have been significant: More than 50 percent of enrolled members with uncontrolled diabetes have moved to a controlled status by utilizing the solutions offered by the program, including personalized coaching, monitoring at MinuteClinic and CVS Pharmacy, testing supplies and a pharmacist-led clinical team that reviews blood glucose readings.

Learn more about our Transform Diabetes Care program.

Since launching, the program has expanded to identify members at risk for developing diabetes and related conditions.

Additionally, our Pharmacy Advisor program helps our members with chronic conditions like diabetes do a better job of taking their prescription medications through targeted counseling from pharmacists and monitored pharmacy claims to keep members on track with refills.

In the Community

CVS Health provides philanthropic support across the country to fund prevention efforts as well as education for those at risk for or living with diabetes.?

Through our partnership with the National Association of Free & Charitable Clinics (NAFC), the CVS Health Foundation has provided support to 57 clinics across the country to support expanded services to treat those with diabetes and hypertension.

We also bring free health and wellness screenings directly to local communities through our Project Health events. At these events, participants receive on-the-spot assessments of weight, blood pressure, blood glucose and cholesterol levels – tests that can help detect risk for chronic conditions such diabetes.

CVS Health also supports colleagues who volunteer on behalf of organizations associated with diabetes and also provides sponsorships for events. In 2019, CVS Health has provided over $120,000 to support diabetes organizations.

Find out more about the results of our Morning Consult survey on diabetes care.

Patient stories, features and related content

11.04.19

By the Numbers: Improving Diabetes Care

Bottom of the article
11.04.19
A man using diabetic testing equipment.

Diabetes is a costly and complex disease that burdens patients and the broader health care system. Today, more than 100 million U.S. adults are now living with diabetes or prediabetes and estimates show that medical costs for people with diabetes are twice as high as for people who don’t have diabetes.https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

In honor of American Diabetes Month, CVS Health recently partnered with Morning Consult to conduct a survey to better understand how people living with diabetes and the providers who deliver diabetes care are grappling with the disease. We also examined what tools and solutions would be most impactful in improving diabetes care.

Among both people living with diabetes and providers, there is a desire to expand access to care locally, better manage and predict out-of-pocket costs and provide additional lifestyle support.

Expanding Access to Diabetes Care

Managing diabetes can be extremely time-consuming and complicated. Oftentimes, patients must visit different sites of care, facilitate multiple annual exams and communicate with various providers across their care team. The survey revealed that both people living with diabetes and providers believe the health care system could do more to expand access to diabetes care and services. For example:

  • A majority (64 percent) of people living with diabetes are not aware of extended hours for diabetes support, while 61 percent of providers do not offer extended hours.

  • The vast majority of people living with diabetes (89 percent) and providers (98 percent) believe that being able to receive testing and exams for diabetes in a single location would be beneficial.

  • Just 18 percent of diabetes patients see their primary care provider once or more a month, while 37 percent report that they see their primary care provider every two to three months and 35 percent report that they see their provider every four to six months.

This is where CVS Health is making a difference. Today, 71 percent of Americans live within five miles of a CVS retail location. And people come to their pharmacy frequently: Whereas a patient with diabetes might only see his or her physician four to five times a year, they will likely see their pharmacist as many as 18–24 times in the same year.

Through these touchpoints to care, we are expanding access to diabetes care locally. For example, our HealthHUB model provides a new, first-of-its-kind community-based store that offer a broader range of health services, new product categories, digital and on-demand health tools and trusted advice. In these locations, people living with diabetes are able to receive the coordinated care and services they need all within our own four walls.

Addressing Diabetes Costs

Cost is top of mind for both people living with diabetes and providers — and there is uncertainty on how to predict the out-of-pocket costs associated with diabetes management. When asked about managing diabetes, nearly half (47 percent) of providers do not feel they have the resources they need to predict out-of-pocket costs for their patients’ diabetes medications. On the other hand, nearly one-third of patients (32 percent) do not feel they have the resources they need to predict their own out-of-pocket costs.

CVS Health is working to expand visibility into drug cost information across multiple points of care. Through our real-time benefits program, we’re providing tools to doctors so they can see what a medicine is going to cost, and recommend lower-cost, clinically appropriate options to the patient. We’ve also pioneered digital tools, including the Rx Savings Finder, which helps our retail pharmacists find patients savings when they do reach the pharmacy counter.

Improving Disease and Lifestyle Management

People living with diabetes and providers would benefit from enhanced lifestyle support to better manage the disease, including nutritional counseling and access to public transportation. For example:

  • People living with diabetes (58 percent) and providers (80 percent) both report they are likely to utilize nutritional counseling services to help manage their diabetes.

  • Access to public transportation is seen as a barrier among both patients and providers. For example, people living with diabetes (27 percent) and providers (29 percent) rank access to public transportation as poor in their community.

CVS Health offers programs to provide people living with diabetes with personalized support when and where they need it — whether it be in the community, in the home or in the palm of their hand.

For example, our Transform Diabetes Care includes personalized pharmacist counseling and the support of a diabetes coach to help ensure members stay adherent to their care plans. Additionally, through our Pharmacy Advisor program, our members can get one-on-one counseling from pharmacists either in-person at a CVS pharmacy location, or through our URAC-accredited call center.

To learn more about our enterprise-wide approach to diabetes management and care, visit our Managing Diabetes with CVS Health page.

To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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Everyday Steps Are Critical for Managing Diabetes

Everyday Steps Are Critical for Managing?Diabetes
Bottom of the article
11.04.19
A woman receiving a blood pressure check.

Donna Castillo was running her usual errands when she stopped by her neighborhood CVS Pharmacy in Anaheim, California, to pick up her new type 2 diabetes medication. She wound up walking unexpectedly into a free health screening event – and didn’t hesitate to take advantage.

The 57-year old former hairdresser, who also suffers from rheumatoid arthritis in her hands and who lives on disability, understands the importance of taking small, everyday steps to manage her health.

“People tend to ignore things,” she says, “but I've learned how the little things matter.” In addition to taking medication, Castillo says living with type 2 diabetes has taught her to carefully monitor her diet. She makes sure to eat breakfast every morning and that her breakfasts always include protein. “Birthday parties are the hardest with all that cake,” she says. “I just take a little piece. I have to be really careful about my sugar.”

The Project Health screening event taking place that day was one of 93 community health fairs across the greater Los Angeles region from September through December, with nearly 600 total events in CVS Pharmacy locations across the country. The free screenings monitor such vitals as blood pressure, blood sugar, and body mass index. CVS Health practitioners also offer advice on how to quit smoking, and give referrals to nearby primary care doctors and other resources.

Since it began in 2006, Project Health has delivered more than $127 million in free health care services to nearly 1.7 million people in multicultural communities with a large number of uninsured or underinsured Americans.

These screenings are particularly critical for people with chronic conditions, like diabetes, which can trigger other health problems such as heart disease and stroke if not monitored and maintained.

Castillo is very familiar with the risks. She was diagnosed around age 50, and the condition runs on both sides of her family, although she is relieved her three grown sons have all tested negative. She stopped by CVS that day to pick up a new medication her doctor had recently prescribed, canagliflozin, which she now takes in addition to daily doses of Metformin.

Type 2 diabetes affects one in 10 Americans, or about 30 million people, according to the Centers for Disease Control and Prevention. While the disease typically surfaces in people over age 45, young adults, teens and children are increasingly being diagnosed.

Nurse Practitioner Elsie Parra, who was onsite at the Anaheim CVS to provide screening tests, has been with Project Health for the past five years, and says too often, patients don’t know they have symptoms that could be red flags for serious health conditions.

“Diabetes, blood pressure, and high cholesterol are all silent killers,” says Parra. “These community screenings are a convenient way for patients to get a fast check-up without an appointment or feels the nervousness some might have when going to a doctor’s office.”

To learn more about our enterprise-wide approach to diabetes management and care, visit our Managing Diabetes with CVS Health page.

To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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Accordant: Holistic Support for Patients with Complex Conditions

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10.29.19
A photo of a doctor putting hand on patient’s shoulder.

Managing rare or complex conditions can often be challenging for patients. They can feel overwhelmed by the condition, medication side effects, complex dosage instructions, comorbidities, complicated provider directions, and experience challenges trying to navigate the health care system.

Health plans and employers, can adopt and offer our Accordant program for their plan members. Accordant provides holistic support for patients with rare conditions through targeted interventions designed to meet each patient’s unique needs.

The specialized care team is composed of registered nurses, pharmacists, social workers, and a medical director – all backed by a medical advisory board. These skilled practitioners set mutually agreed-upon health goals with the patient, discuss symptom management, explain proper use of medications, and even deal with resource issues such as lack of transportation to doctors’ appointments or cost of care. In addition, social workers help patients with community resources such as negotiating utility bill payments, identifying support groups, and grants for home modifications.

In a recent Blue Cross Blue Shield blog post, Accordant Medical Director Dr. Andrew Krueger discusses the importance of comprehensive care management services for patients with complex conditions such as multiple sclerosis and the difference this kind of care can make.

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Convening Local Experts to Address the Social Determinants of Health

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10.09.19
A group of panelists discuss local health solutions.
Panelists at the CVS Health-sponsored POLITICO event discuss the benefit of local health solutions.

CVS Health recently brought together a group of health leaders in Philadelphia, Pennsylvania, to explore how local solutions can have a big impact on residents who are grappling with environmental factors that impact health such as housing, education, transportation and food. The event was part of the POLITICO Health Care Innovators series, which CVS?Health sponsors.

Following opening remarks from Tom Moriarty, chief policy and external affairs officer, and general counsel at CVS Health, the expert panel discussed how the social determinants of health are fundamentally changing the way we think about health care delivery. Among the experts, there was consensus that we must put patients at the center of their care, utilize a combination of high-tech and high-touch solutions and realize the power of public-private partnerships.

Experts included:

  • Teresa Miller, Secretary, Pennsylvania Department of Human Services

  • Ezekiel Emanuel, MD, PhD, Chair, Department of Medical Ethics and Health Policy, University of Pennsylvania;

  • Katherine Kinsey, PhD, Director, Philadelphia Nurse-Family Partnership; and

  • Katie McPeak, MD, Medical Director of Health Equity, Primary Care Network, Children’s Hospital of Philadelphia

View a video of the full POLITICO Health Care Innovators panel discussion.

Putting Patients at the Center of their Care

Each patient has their own unique health care needs. Oftentimes, those needs are determined by where they live and work. According to Dr. McPeak, “It’s not as simple as screening for social stress among families. We have to create interventions in places where they are already getting care.”

Dr. McPeak further noted that we must understand the intricacies of each patient and be embedded in their community to fully be able to address the factors that are impacting their health. This is where CVS Health can make a difference. We serve as a front door to health care in nearly 10,000 communities nationwide and are utilizing our community footprint to expand access to high-quality health care services.

High-Tech to Enable High-Touch

To maximize the impact of high-tech solutions, such as mobile apps and connected tools, the panelists agreed that they must be matched with personal touchpoints to care. According to Dr. Kinsey, “We’re all very interested in high-tech today, but it is really the relationships that we establish with patients over time that help us address the social determinants of health. We want to be high-touch and use our high-tech tools to better connect with people.”

This type of?integration between technology and patient engagement?is key to the model of care CVS Health is leading. We’re using technology to support our efforts to provide real-time and trusted counseling on adherence and lifestyle management, increase communication between doctor visits and improve care connectivity.

The Power of Public-Private Partnerships

Partnering with organizations that are on the front lines of addressing the social determinants of health every day is key. According to Secretary Miller, “Health care is a piece of what determines our overall health, but it is just one piece. With our managed care organizations, we’re seeing a handful of really creative partnerships addressing the social determinants of health.” In turn, these partnerships improve outcomes and impact overall health care spending.

Secretary Miller highlighted the Metropolitan Area Neighborhood Nutrition Alliance (MANNA) – an organization providing medically appropriate meals and nutrition counseling to those who are battling life-threatening illnesses – as one example of success. For example, data show that members receiving services from MANNA saw a 30 percent decrease in inpatient admission. Since 2016, we have been proud to support MANNA in its mission to improve access to healthy food.

The panel agreed that housing has the greatest impact on health and well-being and we must do more to support vulnerable patient populations. Aetna Better Health of Pennsylvania recently contributed $4 million to the Inglis Methodist Gardens project to support the development of a four-story, 47-unit apartment building in West Philadelphia – serving a mixed population of long-term care recipients and people at risk for homelessness.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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POLITICO Partnership Elevates Discussion on Social Determinants of Health

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10.02.19

Tom Moriarty, chief policy and external affairs officer, and general counsel, recently spoke to 100 health care and policy influencers at a POLITICO Live event in Philadelphia, Pennsylvania, about the importance of local and personalized solutions in addressing the social determinants of health. The event was part of the Health Care Innovators series, sponsored by CVS Health, which showcases leading voices and practices in health care innovation.

Watch the full remarks here.

Understanding Community Health Care Needs

Most of our health and well-being happens outside of the doctor’s office where we live, learn and work. Furthermore, data show that 60 percent of our life expectancy is determined by factors such as housing, transportation, education and food.

Moriarty noted that these factors underscore why we must understand and analyze how local environments impact health—and the importance of data in the U.S. News & World Report Healthiest Community Rankings. In Philadelphia, nearly one in five residents smoke and more than one-fourth are grappling with obesity. According to Moriarty, our communities are ripe for health care innovation and we have an opportunity to improve health outcomes by creating meaningful touchpoints to care.

Expanding Access to Care Locally

Access remains a key challenge in helping patients manage their conditions. According to Moriarty, community health care access can be defined by two tracks: the availability of primary care and the ability to get to where care is offered.

To demonstrate how CVS Health can address these tracks, Moriarty shared an example of “Diane,” a single mother of two who recently received a diabetes diagnosis. There could be a number of obstacles in her way. First, it may be hard for her to take time off during business hours for appointments. Next, she may face difficulties in getting the testing and labs she needs for diabetes. Research shows 40 percent of physician-ordered lab tests aren’t completed—oftentimes as a result of facilities not having extended hours and the patient lacking access to public transportation to that facility.

According to Moriarty, this is where CVS Health is making a difference. Today, 71 percent of Americans live within five miles of a CVS Pharmacy location. And people come to their pharmacy frequently: whereas a patient with diabetes like “Diane” might only see her physician four to five times a year, she will likely see her pharmacist as many as 18-24 times in the same year.

Moriarty highlighted how we’re utilizing our community footprint to provide timely and targeted interactions with patients like “Diane.” For example:

  • Our MinuteClinic offering is complementary and collaborative to primary care—and helpful to the system overall. We offer treatment for 125 conditions from trusted providers. Furthermore, our extended hours and broad community reach can help address gaps in care.

  • To build on our MinuteClinic services and improve care coordination, we recently piloted HealthHUB—a new, first-of-its-kind concept offering new product categories, digital and on-demand health tools and trusted advice. This concept will be brought to the Philadelphia and Southern New Jersey market in the coming months.

Improving Health Care Affordability

Along with access to care, affordability is a top health care priority for patients. Moriarty emphasized how CVS Health is doing more to help ensure patients get the medications and care they need at the best possible cost.

For example, data show that 40 percent of patients do not pick up their prescriptions when out-of-pocket costs per prescription exceed $200. Moriarty noted that if patients are unable to afford their medications, they get sicker and their care becomes even more expensive. CVS Health has developed solutions to change that.

  • Through our real-time benefits program, we’re providing tools to doctors so they can see what a medicine is going to cost, and recommend lower cost, clinically appropriate options to the patient. More than 100,000 prescribers are using this program—leading to an average of $90 savings per prescription.

  • We’ve also pioneered digital tools, including the Rx Savings Finder, which help our retail pharmacists find patients savings when they do reach the pharmacy counter.

We look forward to continuing to address the social determinants of health in the communities we serve.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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HEROs Give a Voice to Foster Care Solutions

HEROs Give a Voice to Foster Care Solutions
Bottom of the article
10.01.19
Foster youth participate in a workshop.
Foster youth participate in a two-day Helping Everyone/Each Other Reach Out (HERO) workshop in Charleston, WV.
A foster care consultant speaks to caregivers and staff.
Foster care consultant Dan Martin speaks to caregivers and staff during a breakout session for adults.

Foster care can be a lonely and confusing experience, especially as youth approach adulthood and prepare to age out of the system. To help ease concerns, Aetna Better Health of West Virginia and KVC Health Systems held the first Helping Everyone/Each Other Reach Out (HERO) foster youth workshop in Charleston, West Virginia.

The two-day powerful workshop focused on equipping and empowering teens with the tools and resources they will need to navigate the transition safely and effectively. It featured sessions on building relationships, identifying social supports for housing, food security and employment, and preparing for life without a guardian. Attendees learned how vulnerability, courage and worthiness can lead to opportunities, bravery and pride in one’s self.

Advancing our social determinants of health efforts and reducing social isolation

Like our recently announced “Destination: Health” platform, the workshop advances our efforts to build healthier communities by positively impacting social determinants of health — those economic and social factors outside a doctor’s office affecting our health.

According to Frank Angotti, Aetna Better Health of West Virginia’s medical director, “The workshop’s goal was to expand the meaningful connections young foster children have in the community, with the hope of reducing the health risks associated with long-term social isolation.”

Scientific research 1,2 shows that social isolation leads to negative health behaviors, negative health conditions and increased health care utilization, including:

  • A 25-30 percent increased risk of mortality (Holt-Lunstad 2015)Hold-Lundstad (2015). Loneliness and social isolation are just as much a threat to longevity as obesity. Science Daily. https://www.sciencedaily.com/releases/2015/03/150311160521.htm

  • Loneliness has been equated to the effects of smoking 15 cigarettes a day (Holt-Lunstad 2010)Holt-Lundstad (2015). Relationships improve your odds of survival by 50 percent, research finds. Science Daily. https://www.sciencedaily.com/releases/2010/07/100727174909.htm

Peer training inspires foster youth

Foster care consultant Dan Martin, a former manager with Child Protection Services in Ontario, Canada, modeled the workshops after the Family Finding strategy associated with the National Institute for Permanent Family Connectedness. The HERO program has grown throughout the US, Canada and other countries with positive results for foster youth and their families.

Peers, made up of former foster youth who’ve previously trained with the HERO program in Canada, led the workshop and inspired the attendees to develop their own personal networks — ones that will provide them with the support they need to have a lifetime of connectivity to the people they care about and those who care about them.

Peer facilitator Alisia Johnson shared with the group, “A year ago you would never have found me in front of a group running a workshop like this. I have really grown in my confidence.”

Both the West Virginia foster youth and visiting peers made an instant connection. Having the opportunity to share common experiences gave these teens a platform to voice their ideas. Together they were able to talk about solutions to many of the challenges found in foster care.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

About Aetna Better Health? of West Virginia

Aetna Better Health of West Virginia uses an integrated model to address the behavioral health and medical needs of its Medicaid membership. This biopsychosocial model recognizes the strong correlation between physical and mental health and the impact of trauma on members’ health and life trajectory. In addition, a person-centered approach allows care management staff to cultivate relationships with members and their families, caregivers, providers, advocates, peer and family organizations and community groups to meet members where they are. The payoff to members comes in the form of increased quality of care and quality of life.

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CVS Health Reports Dramatic Drop in Prescription Drug Trend to 5 Percent, Despite Rising Drug Prices

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02.23.16

WOONSOCKET, R.I., Feb. 23, 2016 /PRNewswire/ --CVS Health (NYSE: CVS) today announced that prescription drug trend, a measure of growth in prescription spending, for CVS Health pharmacy benefit management (PBM) clients dropped dramatically to 5 percent in 2015 from a high of 11.8 percent in 2014. While the trend drivers including brand, specialty and generic price inflation were similar to what was seen in 2014, CVS Health's proactive pharmacy management strategies were successful in mitigating the impact of rising drug costs in today's highly volatile prescription drug market.

Price inflation in non-specialty brands outweighed all other trend drivers. As a driver, specialty overall, including the impact of new launches and increases in price and utilization, had less impact than inflation of brands in high volume categories such as drugs used to treat diabetes.

"The high cost of drugs that our clients are struggling with hurts everyone," said Troyen A. Brennan, MD, Chief Medical Officer and Executive Vice President of CVS Health. "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."

CVS Health is a health care company with innovative products and services that improve patient outcomes and make health care more affordable for patients, employers, health plans and government payers. CVS Health is uniquely positioned to address cost drivers across the health care continuum, enhance access to affordable medications, drive better health outcomes and reduce costs for the millions of patients the Company serves.

CVS Caremark, the Company's PBM, applies a variety of these solutions to help manage pharmacy costs and is focused on ensuring patients have access to the right drugs at the lowest cost. For example, CVS Caremark offers flexible formulary options, based on clinical evidence, that help deliver lower costs for clients while ensuring their members have access to the medications they need. On average, CVS Caremark clients utilizing the Company's value formulary in 2015 saved $20 million or more depending on the number of plan members they support. In addition, recently published research from the CVS Health Research Institute showed that along with cost savings, 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," said Jonathan Roberts, President of CVS Caremark and Executive Vice President of 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."

Prescription drug trend is the measure of growth in prescription spending per member per month (PMPM). Trend calculations take into account 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.

About CVS Health

CVS Health is a pharmacy innovation company helping people on their path to better health. Through its approximately 9,600 retail pharmacies, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with more than 75 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, and expanding specialty pharmacy services, the Company enables people, businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at http://www.jihe36.com.

Media Contact

Christine Cramer
CVS Health
(401) 770-3317
christine.cramer@cvshealth.com

Christina Beckerman
CVS Health
(401) 770-8868
christina.beckerman@cvshealth.com

Logo - http://photos.prnewswire.com/prnh/20140905/143585

SOURCE CVS Health

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CVS Health PBM Clients Achieved Lowest Prescription Drug Trend in Four Years, Despite Rising Drug Prices

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03.15.17

CVS Caremark's PBM management solutions helped reduce drug trend from 5.0 percent in 2015 to just 3.2 percent in 2016

Member out-of-pocket costs dropped 3.0 percent

WOONSOCKET, R.I., March 15, 2017 /PRNewswire/ -- CVS Health (NYSE: CVS) today announced that, in 2016, its pharmacy benefit management (PBM) clients achieved the lowest drug trend in the past four years, despite rising drug prices. CVS Caremark clients saw their prescription drug trend drop to an average of 3.2 percent compared to 5.0 percent in 2015. In addition, 38 percent of CVS Caremark commercial clients achieved a negative trend which means they actually spent less on their prescription benefit in 2016 than they did in 2015, despite rising drug prices. Out-of-pocket costs for members also dropped 3.0 percent compared to the previous year.

"No one is more concerned about the high cost of prescription drugs than CVS Health," said Troyen Brennan, M.D., Executive Vice President and Chief Medical Officer, CVS Health. "Our very favorable drug trend results for 2016 demonstrate that we have been able to deliver best-in-class value to clients and their members."

Unmanaged drug trend for 2016 was 11.0 percent, driven primarily by price inflation for branded specialty and traditional drugs, as well as increased utilization due to an aging population. CVS Caremark was able to reduce trend for clients by 7.8 percentage points to 3.2 percent through PBM management solutions that include price protection and the negotiation of rebates, of which more than 90 percent are passed back to clients. CVS Caremark also encouraged the use of less expensive generic drugs through managed formularies and applied targeted approaches to addressing high-spend drivers such as hyper-inflating drugs. On average, clients who selected the CVS Caremark standard managed formulary achieved a trend of 2.2 percent, which was less than half the trend of 4.5 percent for clients who used a custom formulary and opted out of drug removals. Additionally, clients who chose our generic-focused value formulary had the highest generic dispensing rate (GDR) at 88.2 percent and the lowest baseline cost at $81.86 per member per month.

Although overall drug price inflation was lower in 2016, it still accounted for almost 80 percent of the unmanaged trend. The relative impact of inflation on specialty branded products continued to increase relative to traditional branded medications. At the same time, overall specialty products grew to nearly 36 percent of overall gross spend. Three of the top five categories contributing to gross trend were specialty drug categories, including anti-inflammatory medications for rheumatoid arthritis and psoriasis; antineoplastics and adjunctive therapies used to treat cancer; and psychotherapeutic and neurological agents, including multiple sclerosis therapies. Meanwhile, generic utilization growth kept costs low for members as well as clients and drove a 3.5 point overall cost reduction for clients.

CVS Caremark offers a variety of solutions, including flexible formulary options based on clinical evidence, to help manage pharmacy costs while ensuring patients have access to the medications they need. In addition, CVS Caremark's strategic assessment of the pharmaceutical marketplace enables the company to negotiate aggressive rebates and help to lower costs for clients. More than 90 percent of brand manufacturer contracts also include price protection, a critical element in protecting clients in a market characterized by significant drug price increases.

Prescription drug trend is the measure of growth in prescription spending per member per month. Trend calculations take into account 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. The 2016 trend performance is based on a cohort of CVS Health PBM commercial clients employers and health plans.

To learn more about the CVS Caremark 2016 drug trend, click here.

About CVS Health

CVS Health is a pharmacy innovation company helping people on their path to better health. Through its more than 9,700 retail locations, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with nearly 90 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a leading stand-alone Medicare Part D prescription drug plan, the company enables people, businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at http://www.jihe36.com.

Media Contact

Christine Cramer
CVS Health
(401) 770-3317
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CVS Caremark Reports Traditional Drug Trend Increased by Just 0.8 Percent in 2013 While Overall Prescription Drug Trend is Up 3.8 Percent

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04.10.14

WOONSOCKET, R.I., April 10, 2013 /PRNewswire/ -- CVS Caremark (NYSE: CVS) today released its annual Insights report, which reviews drug trend and highlights key issues in pharmacy care. In 2013, prescription drug trend grew 3.8 percent compared to nearly flat growth (0.1 percent) in 2012. This growth was driven by significant price inflation for traditional brand drugs, specialty drugs and generics as well as a significant increase in utilization as members filled more prescriptions in the slowly improving economy. The CVS Caremark Insights report analyzes these trends and outlines a number of strategies health care payers can adopt to help manage prescription drug spending. Prescription drug trend is the measure of growth in prescription spending per member per month. Trend calculations take into account the effects of drug price, drug utilization and the mix of branded vs. generic drugs.

While spending for traditional medications was up just 0.8 percent in 2013, this compares to a trend that actually declined 3.8 percent in 2012. The driver of overall trend in 2013 was specialty medications which grew by 15.6 percent. Specialty drugs treat more complex diseases such as multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer. Overall, specialty drugs now represent nearly 22.5 percent of total drug spend among CVS Caremark clients, a relative increase of more than ten percent in a single year.

"As our clients are faced with the pressure of rising prescription drug trend, CVS Caremark is well-positioned to help them manage this impact through a variety of unique programs that encourage the use of lower-cost generics; improve the management of specialty medications across the medical and pharmacy benefit and site of care; and control price inflation through aggressive formulary management and use of narrow networks," said Jon Roberts, president of CVS Caremark's pharmacy benefit management business.

The company also reported a record generic dispensing rate (GDR) of 81.4 percent in 2013. While the generic pipeline is dwindling over the next few years, CVS Caremark analysis indicates that not every client has truly maximized their existing generic opportunities, leaving continued room for improvement and savings.

"This year's Insights report outlines seven sure things that our clients should keep in mind," Roberts added. "These include: prescription trend is up, generics have peaked, specialty drives trend, price is king, money matters to members, adherence is the answer and past performance is no guarantee of future results. This is not just a catchy list of factors that impact drug trend, these are key concepts for our clients to consider when determining how to maximize their prescription drug benefit in the complex and changing health care landscape."

The Insights report highlights five specific strategies to help clients save money and improve the health of their patients in the years ahead:

  1. Double Down on Generics: Analysis of generic utilization, managed formulary options and new specialty generics can help slow overall trend.
  2. Look Across Benefits at Specialty: Recent research commissioned by CVS Caremark found transitioning targeted specialty medication spend from the medical to the pharmacy benefit can save an average of 19 percent.
  3. Tackle Price: Narrow pharmacy networks can help lower costs for payers, particularly when combined with convenient options like mail service delivery.
  4. Be Strategic About Cost Share: Member cost-share can affect where prescriptions get filled, which drugs members ask for and even if members fill their prescriptions. Clients should align their cost-share strategies with their overall plan goals and provide support to help their members understand their prescription therapy.
  5. Keep the Big Picture in Mind: Helping members stay healthy can help reduce prescription trend and overall cost growth. In addition, managing the whole patient can help reduce hospitalizations, readmissions and emergency department visits, helping manage overall costs.

The CVS Caremark Insights report addresses prescription drug use for members with prescription benefits provided by CVS Caremark during the 2013 calendar year. The 2013 cohort studied includes 22.9 million members across the commercial segments (health plan and employer) as well as Medicare Part D and Medicaid plans.

Access the full CVS Caremark Insights report at: https://cvshealth.com/insights-adherence2014.

About CVS Caremark
CVS Caremark is dedicated to helping people on their path to better health as the largest integrated pharmacy company in the United States. Through the company's more than 7,600 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than 60 million plan members; and its retail health clinic system, the largest in the nation with more than 800 MinuteClinic locations, it is a market leader in mail order, retail and specialty pharmacy, retail clinics, and Medicare Part D Prescription Drug Plans. As a pharmacy innovation company with an unmatched breadth of capabilities, CVS Caremark continually strives to improve health and lower costs by developing new approaches such as its unique Pharmacy Advisor program that helps people with chronic diseases such as diabetes obtain and stay on their medications. Find more information about how CVS Caremark is reinventing pharmacy for better health at info.cvscaremark.com.

Media Contact:
Christine Cramer
CVS Caremark
(401) 770 3317
christine.cramer@cvscaremark.com

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