CVS Caremark unveils new PBM services pricing

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CVS Caremark unveils new PBM services pricing

By David Salazar - 12/05/2018
As its integration with Aetna gets underway, CVS Health’s pharmacy benefit manager CVS Caremark is introducing a new pricing model aimed at offering better cost predictability. The Guaranteed Net Cost pricing model, CVS Caremark said, is meant to simplify financial arrangements that underlie PBM contracts and focus on such cost-management strategies as formulary, performance pharmacy networks and utilization management.

“We see a real opportunity to offer clients a simpler economic model that leverages proven PBM cost-management strategies to provide predictable drug costs,” said Derica Rice, CVS Caremark president. “As a result, CVS Health is introducing a straightforward, more holistic approach that enables plan sponsors to clearly see the net cost of their pharmacy benefit and select their PBM provider based on that criteria.”

The new model guarantees a client’s average spend per prescription — after rebates and discounts — across retail, mail-order and specialty channels. Additionally, under the model, CVS Caremark said it would pass 100% of rebates to plan sponsors and take responsibility for the impact of drug price inflation and changes in drug mix. The Guaranteed Net Cost model also will allow plan sponsors the option to implement point-of-sale rebates to offer plan members visibility into their medicines’ net cost.

"As a PBM, our job has always been to help our clients manage costs in the face of escalating drug prices without compromising clinical care, so they can continue to provide an affordable benefit to their members," Rice said. "By simplifying the PBM economic model, we can focus on maximizing the impact of PBM strategies that help reduce costs for clients and consumers, and continue to develop additional innovative tools and approaches."

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