CVS Caremark, the pharmacy benefit management business of CVS Health, is working with clients to implement new measures to balance the burgeoning interest in off-label use of certain medicines to treat COVID-19 pneumonia with the ongoing needs of members who use these drugs for chronic conditions. These medicines include hydroxychloroquine, azithromycin, one protease inhibitor and albuterol inhalers, which are approved for treatment of lupus, bacterial infections, HIV, rheumatoid arthritis and asthma.
“Pharmacy benefit managers play an important role at the center of the pharmaceutical supply chain,” said CVS Caremark President Alan Lotvin, M.D. “Our advanced analytics allowed us to quickly identify changes in prescribing patterns and enabled us to take proactive steps to help ensure the integrity of the supply chain. We are taking additional steps today to limit stockpiling that could result in future shortages and gaps in care. We will continue to anticipate and support the needs of our clients, who collectively provide prescription drug coverage for more than 90 million members.”
With client consent, CVS Caremark is setting appropriate limits on the quantity of each of these medicines for potential use in treating COVID-19. Members who already take these medicines for approved uses will be able to bypass the new quantity limits.
“We continue to proactively study the latest clinical literature and consider what additional measures may be needed to help facilitate access to any other newly identified treatments as they emerge during this extraordinary public health situation,” said CVS Caremark Chief Medical Officer Sree Chaguturu, M.D.
Understanding that it may be harder for members to see their health care providers during the COVID-19 outbreak, CVS Caremark is extending previously-approved prior authorizations for most medications set to expire before June 30. For example, if a current prior authorization is set to expire on May 15, the expiration date will be extended to August 15. This step will enable members to refill most medications without renewing an existing prior authorization — not only providing them peace of mind, but also helping to reduce the volume of phone calls and other administrative burdens on physicians’ offices and pharmacies.
Measures already in place to help ensure ongoing access
These additional steps build on actions previously taken by CVS Caremark to protect the drug supply and enhance members’ ability to refill and access their prescriptions from the comfort and safety of their own homes.
For example, CVS Caremark recently worked with clients to make it easier for members to refill most 30-day prescription maintenance medications earlier than usual — by waiving commonly used early refill limits, which require members to use most of the medication on hand before obtaining a refill. Since CVS Caremark announced this new policy on March 10, it has assisted more than 239,000 members in refilling their 30-day prescription maintenance medications.
In addition, most plan members have the ability to obtain 90-day prescriptions of maintenance medications delivered to their homes, or another location of their choice, at no extra charge. CVS Caremark and plan sponsors have been proactively reminding members of this plan option since the COVID-19 outbreak began. CVS Caremark expects to see a 20 percent increase in members receiving a 90-day prescription supply of prescription medicines in the coming weeks.
CVS Caremark also continues to closely monitor the global manufacturing environment. At this time, CVS Caremark does not see any disruptions to the supply chain, as a result of COVID-19, that will affect our ability to fill prescriptions.
CVS Caremark clients and other payors can access information about steps CVS Caremark has taken to support their plans and members during the outbreak, as well as useful turnkey resources for member communications, at the PBM’s COVID-19 PBM Partner Resource Center.
More information on steps that the CVS Health enterprise is taking to address the COVID-19 pandemic is available at the company’s frequently updated COVID-19 resource center.
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