Why the health giant wants to alert customers in the doctor’s office and at the pharmacy.
CVS Health is banking on real-time prescription information—and alternative treatments—to lower patient costs and raise medication adherence.
The company announced this week that its pharmacy benefits manager (PBM), CVS Caremark, plans to highlight “member-specific medication costs and available lower-cost therapeutic alternatives” both in the prescriber’s office and the pharmacy. CVS officials believe the tech-fueled initiative will “help eliminate” delays in delivering drugs, cut costs for all stakeholders, and reap better patient outcomes.
Too often, patients learn that their insurance plans don’t cover a medication—or of its high out-of-pocket costs—until reaching the pharmacy, Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Health, said in a statement. That breeds a number of problems, including nonadherence and higher costs downstream, he said.
“Making detailed, real-time benefit information available for our PBM members and their healthcare team, whether it’s the doctor of the pharmacist, can help streamline the patient experience and improve health outcomes, while also lowering costs for both the patient and the payor,” Brennan said.
As a result, prescribers may access information from CVS as they digitally write prescriptions. The data include the price of a drug, a patient’s remaining deductible, and 5 “clinically appropriate branded alternatives or therapeutically equivalent generic medications,” according to the company. What’s more, prescribers may see whether prior authorization or step therapy is necessary and then electronically file such requests.
CVS pharmacists, meanwhile, may view the same drug alternatives and request prescription changes, processes also slated to blend into their workflows, the organization noted. In 2018, these employees may check out a patient’s out-of-pocket costs and, in some cases, offer prescription discounts.
Come next year, Caremark members may use CVS’s online Check Drug Cost tool to seek out less-expensive alternate medications.
“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,” said Jonathan Roberts, executive vice president and chief operating officer of CVS Health.
Surescripts, the digital prescription company, laid the technological foundation for the CVS initiative. Earlier this month, Surescripts trumpeted plans to integrate its Real-Time Prescription Benefit solution into electronic health records (EHR) throughout the country, reaching 53% of American physicians.
The business partnered with CVS Health and Express Scripts to assess the point-of-care software over 1 year, according to Surescripts. The pilots generated 3.75 million transactions.
Any healthcare provider who uses an EHR with real-time benefits and electronic prior authorization may access the information from CVS, according to the company.
It noted that the innovation expands its use of EHRs, supporting healthcare projects across its 9700 retail outlets and 1100 walk-in clinics.
Last month, CVS described plans to partner with the EHR vendor Epic Systems to tackle a project with similar goals but a greater emphasis on sharing data and boosting communications.