“This report from the Arkansas Insurance Department (AID) relies on incomplete and misleading data for several findings that do not accurately represent our work on behalf of consumers in the Arkansas Works program.
“This first-of-its-kind audit was originally intended to focus on spread pricing. And, under that remit, the results of the audit are sound, reinforcing what we have long said: we did not use spread pricing in the Arkansas Works program.
“We fully support and comply with all formalized pharmacy benefit manager (PBM) audits, as long as they are conducted fairly, designed with a clear objective, and utilize a standardized and unbiased methodology. Unfortunately, in this case, the scope of the audit was expanded to include additional analyses using methodologies that simply don’t hold up to scrutiny. As the report itself notes, CVS Health raised a number of concerns with the expanded scope, the methodologies used and its additional findings. It is disappointing that the auditors have not addressed these flaws, and it is equally concerning that the report seems to attempt to reinforce several false narratives about PBMs from the independent pharmacy lobby. In fact, the report validates that CVS Caremark reimburses Arkansas’ independent pharmacies up to 33 percent more than CVS Pharmacies in their network.
“For decades, CVS Health has proudly served Arkansas families and communities. We will continue the critical work of lowering prescription drug prices for patients in the Arkansas Works program and the rest of our clients across the state.”
Additional points include:
CVS Health strongly supports transparency that helps deliver better health outcomes and lowers drug costs at the pharmacy counter for patients – and we recognize that audits are one way for clients, government regulators and the public to have confidence in the integrity of our services.
However, this audit does not adhere to standards established by the National Association of Insurance Commissioners (NAIC) for market conduct and financial examinations, and the findings suffer as a result.
The analysis surrounding a standard and contracted reconciliation process between independent pharmacies and CVS Health relies on an insufficient data set: one contract. It is not possible, or methodologically sound, to rely solely on a single contract, which cannot be extrapolated to demonstrate how reconciliations are done across a CVS Caremark network of more than 700 pharmacies and hundreds of contracts in Arkansas.
Contrary to their misleading claims about PBMs, local, independent pharmacists make up an outright majority of CVS Caremark’s network in Arkansas. We reimburse them fairly and at a significantly higher rate on average than our own pharmacies, in accordance with the terms of the contracts we sign with them and their PSAOs, which they enter freely.