CVS Health offers pharmacists, prescribers real-time benefit info for Caremark members

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CVS Health offers pharmacists, prescribers real-time benefit info for Caremark members

By David Salazar - 11/28/2017

CVS Health’s pharmacy benefits manager will now offer real-time information about patient-specific medication costs, the company announced Tuesday. CVS Caremark will offer visibility of costs and lower-cost alternatives at point of prescribing and at the pharmacy in an effort to cut down on dispensing delays and improve patient outcomes, the Woonsocket, R.I.-based company said.

“Patients often do not find out that the medication they were prescribed is not covered or has higher than expected out-of-pocket costs until they go to the pharmacy to pick up their prescription, which can result in patients not filling a prescription, non-adherence and, ultimately, higher downstream health care costs,” CVS Health executive vice president and chief medical officer Troyen Brennan said. “Making detailed, real-time benefit information available for our PBM members and their health care team, whether it's the doctor or the pharmacist, can help streamline the patient experience and improve health outcomes while also lowering costs for both the patient and the payer.”

For pharmacists at CVS Pharmacy, the patient information will be integrated directly into the existing workflow to allow for pharmacists to discuss lower-cost alternatives with CVS Caremark patients based on their formulary coverage. It also will make requesting a prescription change from prescribers easier, the company said. Starting 2018, CVS pharmacists will be able to see a CVS Caremark patient’s out-of-pocket costs for their medication. CVS Health said that this would facilitate better alignment with the member’s plan design and help them work to share additional cost savings information with patients whose costs are still a concern.

“Across the CVS Health enterprise, we are focused on providing patients with the most convenient access to affordable medications, and this innovation enables us to provide our PBM members and their health care providers with direct, easy access to real-time benefit information throughout the health care continuum whether they are at their physician's office or at the pharmacy," CVS Health executive vice president and COO Jonathan Roberts said. “No one else provides this level of member-specific actionable drug benefit information across so many points of care, which can help simplify and streamline the process of getting a patient on the most appropriate and affordable therapy and increase member engagement and satisfaction with their care.”

The new real-time information offering will also offer prescribers better visibility of a drug’s cost based on a patient’s coverage, with the opportunity to review as many as five clinically appropriate branded alternatives or generics that are specific to a patient’s formulary coverage. Pharmacists will also be able to see formulary alternatives with the option to find lower-cost alternatives through set to roll out in early 2018.

CVS Health noted that the real-time benefit information was possible through a functionality from Surescripts and builds on the organization’s use of electronic health records to support MinuteClinic providers and CVS Specialty’s care management programs.

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