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CVS Health Hosts Tool Cutting Out-of-Pocket Patient Costs for Meds

A new CVS Health program will allow prescribing physicians, pharmacists, and patients identify low-cost drug options to lower out-of-pocket patient costs.

out-of-pocket patient costs drugs medication treatment

Source: Thinkstock

By Sara Heath

- CVS Health and its pharmacy benefits manager (PBM) CVS Caremark has launched a new tool that will help patients, payers, and providers connect patients with medications at the lowest possible cost, ideally reducing out-of-pocket patient costs for expensive drugs.

Patients are increasingly feeling the cost burden of high drug prices. Rising drug costs are keeping patients from meaningfully engaging with their treatment plans and causing undue stress for patients who are concerned about their ability to afford their medications.

Eighty-three percent of patients said they were concerned about the personal repercussions to increasing medication costs across the country, according to a recent survey commissioned by CVS Health.

A separate 2017 survey from Consumer Reports Best Buy Drugs showed that 14 percent of patients have not filled a prescription because of cost. Patients aren’t sure how they are going to continue paying for their treatments as one-quarter of patients say they are paying more for their medications than they ever have before.

"Today's consumers are faced with higher prescription drug prices than ever before and many of them are now paying for a larger share of their prescription drug costs out of their own pockets at the pharmacy counter due to growth in high deductible health plans," said CVS Health Chief Policy and External Affairs Officer Thomas Moriarty. "Until now, patients haven't had the appropriate tools available to them to help them manage these costs.”

The new CVS Health tool is intended to assist these patients in finding the lowest cost drug available to them, the company said. While CVS Health cannot do much about the price of drugs, they are creating a digital tool that will help patients identify the most effective drug for the lowest cost based on patient health and insurance information.

The CVS Pharmacy Rx Finder will help in-store CVS pharmacists identify which medication will create the lowest cost burden on patients. The tool will also help CVS Caremark beneficiaries by offering common drugs for common chronic illnesses available at a $0 copay.

“CVS Health is giving expanded tools to patients, prescribers and pharmacists so they can evaluate prescription drug coverage in real-time and identify lower-cost alternatives,” Moriarty added. “We are committed to finding the right drug at the lowest possible cost for patients to ensure they are able to access and stay on the medications they need. That's our promise."

The Pharmacy Rx Finder will allow in-store pharmacists identify which medication is the best and most effective drug for patients. The Finder will do the following:

  • First, if the prescribed medication is on the patient's formulary and is the lowest cost option available.
  • Second, if there are lower-cost options covered under the patient's pharmacy benefit – such as a generic medication or therapeutic alternative with equivalent efficacy of treatment.
  • Third, if the patient may be able to save money by filling a 90-day prescription rather than a 30-day prescription.
  • Finally, if neither a generic nor a lower-cost alternative is available, other potential savings options for eligible or uninsured patients where allowed by applicable laws and regulation.

The new drug cost savings program will also support CVS Caremark members and prescribing physicians. Prescribers will be able to view data related to drug cost, put in the context of the patient’s payer coverage, clinical needs, and other health factors. The tool will be embedded in the prescribing provider’s EHR.

Caremark members will also see greater drug cost price transparency via the Caremark app, which has been revamped to display this information.

These point-of-care improvements have already shown promise in lowering out-of-pocket costs for patients. Doctors with this information are usually able to switch patients to a more affordable medication, yielding an average $75 cost savings for patients.

CVS Health has seen success with its PBM members and Caremark programs, the company said. A rebate program launched in 2013 has allowed 10 million PBM members to receive their medications at lower costs. CVS Caremark’s programs have helped lower drug costs for members, even as national cost averages have increased.

The success with CVS Caremark programs have inspired these latest improvements, stated CVS Health’s Executive Vice President and Chief Medical Officer Troyen A. Brennan, MD.

"We have been working hard to keep prescription medications affordable for patients," Brennan said. "In fact, in 2017, nearly 90 percent of our PBM plan members spent less than $300 out-of-pocket for their prescription medicines. While this signals progress, for those patients that cost is not insignificant. That is why we are committed to doing even more across our enterprise to help patients find and access the lowest cost drug at the pharmacy which ultimately will help improve clinical outcomes and remove higher downstream medical costs from the system."

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