CVS Caremark touts cost-containment in new report

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CVS Caremark touts cost-containment in new report

By Sandra Levy - 08/28/2019
CVS Caremark's recently released "Blunting the Impact of Hyperinflated Drugs" report is highlighting the results of its hyperinflation drug removal program, launched in 2017. Per the report, CVS Health pharmacy's benefit manager said it saved clients more than $15 per 30-day supply, spending $88.30 on average per 30-day supply compared with $102.58 for those on formularies without drug removals in 2018.

All told, the report said CVS Caremark kept the impact of price growth to 3.1% despite drug price inflation of more than 25%.

The company said its strategies include hyperinflation drug removals — drugs that see very high price inflation or those with big price tags compared with clinically equivalent alternatives — as well as ongoing monitoring of data for suspected fraud, waste and abuse, and utilization and specialty guideline management.

“Introduced in 2017, this strategy was designed to help blunt the impact of drugs with significant inflation from one year to the next," the company said. "We continually review and identify drugs that are seeing high price increases and those that are outliers based on price, including new market entrants."

CVS Caremark removed five drugs from its template formularies in April. Utilization of the removed drugs dropped by 99% in the months following the move. These removals are projected to save clients 38 cents per member per month or $4.60 per member per year.

The five drugs removed from its formulary in April were priced significantly higher than other clinically equivalent alternatives. For instance, the muscle relaxant Chlorzoxazone, one of the removed drugs, costs an average of $2,903 for a 30-day prescription compared with an average cost of $1.76 for the alternative, Cyclobenzaprine, according to the company.

CVS Caremark has since removed additional drugs that were significantly higher priced from its template formulary, including Metformin ER, Fenoprofen, Lidocaine tetracaine cream and Ortho DF.

In 2018, 44% of clients saw their net prescription drug prices decline. Two out of three members spent less than $100 out of pocket on prescriptions, while adherence in such key categories as cholesterol, depression and diabetes increased, CVS Caremark said.

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