CVS Caremark's RxZero offers PBM members no-cost diabetes medications

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CVS Caremark's RxZero offers PBM members no-cost diabetes medications

By Sandra Levy - 01/29/2020

CVS Health is taking a step to ensure long term-affordability of diabetes medications. The company announced RxZero, a program that eliminates out-of-pocket costs associated with all diabetes prescription medications, including insulin.

Offered through the company's pharmacy benefit manager, CVS Caremark, RxZero enables employers and health plan sponsors to leverage formulary and plan design approaches to offer all categories of diabetes medications at $0 out of pocket for their members without raising costs for the plan sponsor or increasing premiums or deductibles for all plan members.

"Eliminating out-of-pocket costs for diabetes medications ensures long-term affordability, improves adherence, and most importantly, puts patients on the path to better health," said Troyen Brennen, CVS Health chief medical officer. "A person living with diabetes is required to take many tasks to manage their condition annually. Unfortunately, that can include making difficult decisions about whether they can afford their medications and fill their prescriptions."

A CVS Caremark analysis shows that members taking branded diabetes medications spend on average, $467.24 out-of-pocket per year, with nearly 12% spending over $1,000 annually. The new RxZERO plan design enables plan sponsors to eliminate member out of-pocket costs for the entire diabetes therapeutic area including oral medications for Type 2 diabetes and fully adhere to American Diabetes Association standards, the company said.

"There are more than 30 million Americans living with diabetes, and far too many of them are struggling to manage their diabetes because of the high cost of diabetes prescription medications," said Kelly Mueller, American Diabetes Association vice president of community impact. "We are hopeful that by eliminating out-of-pocket costs for diabetes medications, CVS Health will remove one of the barriers many people face that prevent them from managing their diabetes successfully."

Brennen added, "Traditionally, the focus of affordability for diabetes medications has been on insulin, which is the cornerstone of therapy for the five percent of people with diabetes who are living with Type 1 diabetes, However, the new CVS Caremark solution expands affordable options to include the entire range of diabetes medications improving affordability for the 95% of people with diabetes who are living with Type 2 diabetes."

CVS Health said it believes that eliminating out-of-pocket costs for diabetes drugs could be an important feature to all insurance plans, to help address the growing diabetes epidemic without increasing other costs such as deductibles and premiums. CVS Caremark research demonstrates that by leveraging formulary and plan design approaches, plan sponsors can eliminate member out-of-pocket costs for all categories of diabetes medications without raising costs for the plan sponsor, or increasing premiums or deductibles. 

This solution, detailed in a CVS Health white paper, "A Prescription for Better Diabetes Management", is part of CVS Health's integrated approach to chronic care management and commitment to making care more affordable, local and easier to navigate.  

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