WOONSOCKET, R.I., (September 8, 2015) – A new CVS Health (NYSE: CVS) Research Institute study published today in JAMA Internal Medicine is the first to evaluate the impact of narrow pharmacy networks on medication adherence. The analysis showed that this approach, which incentivizes plan members to use specific in-network pharmacies, is associated with improved medication adherence. In addition, the researchers observed an even greater impact on adherence when there were 90-day prescription programs also in place. Narrow networks have previously been criticized for limiting access and adversely impacting medication adherence.
“There are few opportunities in health care when we can improve both quality of care and health outcomes while helping to manage health care costs,” said William H. Shrank, MD, MSHS, senior vice president and Chief Scientific Officer, CVS Health and a study author. “This first-of-its-kind study suggests that narrow networks may be one such opportunity by providing clear evidence that these networks – already an established cost management strategy – also help optimize members’ adherence.”
The researchers reviewed de-identified pharmacy claims data for more than 200,000 patients on chronic therapies to treat high cholesterol, high blood pressure, diabetes and depression over a 12-month period. These patients received prescription drug coverage through CVS/caremark, the pharmacy benefit management (PBM) business of CVS Health. The study found that those patients in commercial drug plans with narrow pharmacy networks had improved medication adherence as indicated by their medication possession ratio (MPR), which measures patients’ available medication on hand over time and is commonly used as an indication of adherence. The researchers also found that if 90-day prescription programs, where patients receive a three-month supply of their chronic medication prescription during one pharmacy visit, were used in conjunction with a narrow network there was an even greater improvement in members’ adherence.
As a pharmacy innovation company, CVS Health is focused on improving health outcomes while lowering costs for CVS/caremark PBM clients and their members. In recent years, narrow and preferred pharmacy network strategies have become more prevalent as ways to help manage rising pharmacy costs and are a widely used feature of government-sponsored, Exchange and commercial health plans. However, their impact on patient health outcomes and quality of care had not previously been established. Concerns have also been raised that these networks may adversely affect medication adherence by reducing members’ geographic access to pharmacy care and choice. Many government-sponsored plans address this concern by requiring plan sponsors to have in-network retail pharmacies within close proximity of members’ residences. In addition, independent research shows that the majority of Medicare beneficiaries are satisfied with their preferred pharmacy network plan reporting that the in-network pharmacies are conveniently located.
“Despite common concerns that narrow pharmacy networks reduce access, we believe they can actually help encourage plan members to establish a pharmacy home where patients with chronic diseases can receive coordinated care and effective medication adherence support,” added Dr. Shrank. “This research suggests that narrow networks are one more way we can help encourage medication adherence and have an even greater impact as we help people on their path to better health.”
Research shows that half of people who have long-term prescriptions for chronic conditions do not take their medicines as prescribed, costing the U.S. nearly $300 billion and tens of thousands of lives each year. In addition to PBM plan designs that promote adherence and cost-savings, CVS Health is building a range of programs across the enterprise to meet the various challenges individual patients face when taking their medications. These include programs that synchronize prescription pick-up for patients with multiple medications, comprehensive medication reviews to help identify potential safety issues and adherence-improving interventions that can be delivered at the retail pharmacy, via digital tools and at the patient’s home.
The CVS Health Research Institute is focused on contributing to the body of scientific knowledge related to pharmacy and health care through research collaborations with external academic institutions, participation in federally-funded research, analysis and sharing of CVS Health data sources and coordination of pilot programs and initiatives. CVS Health Research Institute findings support a continuous quality improvement environment, which encourages product innovation and development to benefit CVS Health patients, clients and their members.
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About CVS Health
CVS Health (NYSE: CVS) is a pharmacy innovation company helping people on their path to better health. Through its 7,800 retail drugstores, nearly 1,000 walk-in medical clinics, a leading pharmacy benefits manager with more than 70 million plan members, and expanding specialty pharmacy services, the Company enables people, businesses and communities to manage health in more affordable, effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at www.cvshealth.com.