Addressing Rising Drug Prices

Addressing Rising Drug Prices
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Rising drug prices hurt patients and lead to negative and costly outcomes throughout our health care system. For example, data show that 40 percent of patients do not pick up their prescriptions when out-of-pocket costs per prescription exceed $200.CVS Health Internal Analysis. Completed December 2015, Retail RxDw; Analysis Timeframe of 1/1/15 – 12/28/15 When patients don’t take their medications as prescribed, the cost to our health care system is approximately $290 billion.https://www.nehi.net/writable/publication_files/file/pa_issue_brief_final.pdf

At CVS Health, we recognize that one of the most important things we can do is to help people afford and take their medications. That’s why we’re working to improve transparency and pioneering solutions to help patients get the right medicine at the lowest possible cost.

Providing Information across Multiple Points of Care

Information about how much a drug costs is not always readily available. According to a poll sponsored by CVS Health, more than half (57 percent) of patients do not know how much a drug will cost them, and nearly as many (54 percent) believe it would be helpful to have information about the cost before they fill their prescriptions.

CVS Health is working to expand visibility into drug cost information across multiple points of care.

  • At the physician’s office: Our real-time benefits technology – used by 100,000 prescribers nationwide – enables visibility into what a patient will pay for a specific drug under their benefits plan and presents up to five lower-cost, clinically appropriate alternatives for consideration by the prescriber.
  • At the pharmacy counter: Our more than 30,000 retail pharmacists use the Rx Savings Finder tool to search for potential savings opportunities.
  • For CVS Caremark members: About 230,000 times per month, CVS Caremark members search the Check Drug Cost tool to find lower-cost, clinically appropriate alternatives to more expensive medications.

Helping Control Costs While Promoting Better Health

As a Pharmacy Benefit Manager (PBM), we use every tool at our disposal to bring down drug prices. For example, we encourage the use of lower-cost, clinically appropriate generic alternatives, which data show can lead to a 3-percent decrease in overall mortality.https://www.ncbi.nlm.nih.gov/pubmed/2522238. We offer evidence-based guidelines to help prescribers connect patients to the most cost-effective medicines, resulting in more than $2.9 billion in savings.CVS Health White Paper. Current and New Approaches to Making Drugs More Affordable. Published August 2018 We also provide point-of-sale rebates and zero-dollar copay drug list options to clients, helping to deliver savings directly to patients at the pharmacy counter.

Keeping Costs Down for Patients, Employers and Government Programs

Our PBM strategies rein in costs across the health care system and also increase access to affordable medications for patients. While brand manufacturers have increased prices on average 9.2 percent annually from 2008 to 2016,https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05147 we have worked to stabilize drug costs for our clients and patients. In fact, CVS Health kept drug price growth to just 0.2 percent in 2017.

For more information on how CVS Health is working to expand access to more affordable and effective health care, check out our Cost of Care information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

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Moriarty Addresses Prescription Drug Affordability at Roll Call Live

Moriarty Addresses Prescription Drug Affordability at Roll Call Live
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In the midst of a very important discussion around prescription drug pricing in Washington, DC, CVS Health sponsored an event with CQ Roll Call titled “Empowering Patients as Partners in Health Care” to focus on the issue and the consumer experience in health care today. At the event, policymakers and health care policy experts discussed the progress being made to make the health care system work better and identified areas where more solutions are needed. Tom Moriarty, Chief Policy and External Affairs Officer, and General Counsel for CVS Health, addressed the affordability of prescription drugs – one of the most critical issues impacting patients today.

Moriarty emphasized how high drug prices can have an adverse effect on patients’ health. For example, when medications are above $200 in out-of-pocket costs per prescription, more than 40 percent of patients do not pick up their prescriptions. To ensure patients can afford their medicines and take them as directed, Moriarty outlined the importance of the pharmacy benefit management (PBM) tools and solutions CVS Health is pioneering to improve medication adherence and reduce patients’ out-of-pocket costs. He also highlighted policy ideas that can increase market competition and provide the transparency that consumers, providers and pharmacists need to get the most effective drug at the lowest cost.

Innovative Solutions to Address Rising Drug Costs

The status quo of rising drug prices is not acceptable. Moriarty highlighted how CVS Health is implementing solutions to mitigate the effects of manufacturer-driven price increases. We are:

  • Pioneering the use of point-of-sale rebates and started by offering them to our CVS Health colleagues. As a result, we’ve seen adherence improvements of four to six percent. Additionally, we offer point-of-sale rebates to our clients – making this benefit available to 10 million people covered by CVS Caremark plans.

  • Utilizing preventive drug lists for colleagues to make medications for common chronic conditions, including diabetes, hypertension and asthma, available at a zero-dollar copay. Data show that this can lead to better adherence and provide medical cost savings and productivity gains.

  • Expanding visibility into prescription drug costs – starting at the doctor’s office and culminating at the pharmacy counter. At the doctors’ office, we provide real-time benefits to ensure prescribers have information on patients’ covered benefits and what patients will pay out-of-pocket under their plan for a specific drug. At the pharmacy counter, our retail pharmacists are using the Rx Savings Finder to help members save, in some instances, an average of $420 per year.

Rebates are Discounts that Help Lower Costs for Patients and the Government

There has been a lot of discussion about the role of rebates in the drug pricing system, which are discounts used to reduce costs for patients and government programs. Moriarty debunked the myth that drug companies increase prices as a result of having to pay rebates, pointing to the fact that there is no correlation between manufacturer-driven price increases and these rebates and discounts. In fact, list price is increasing faster for drugs with little competition than it is for medications with competition and substantial rebates and discounts.

Despite the fact that brand drug manufacturers increased list prices by an average of 9.2 percent annually between 2008 and 2016,QuintilesIMS Institute, Medicines Use and Spending in the U.S. (May 2017). https://structurecms-staging-psyclone.netdna-ssl.com/client_assets/dwonk/media/attachments/590c/6aa0/6970/2d2d/4182/0000/590c6aa069702d2d41820000.pdf?1493985952 CVS Caremark has been able to keep drug price growth nearly flat at 0.2 percent by negotiating rebates and discounts and encouraging the use of lower cost, clinically appropriate medicines.

Policy Solutions to Lower Drug Costs for Patients

PBMs are very effective at lowering drug prices when there is competition, but there is still a substantial number of products that face limited to no competition. In addition, due to the increased enrollment in high-deductible health plans, the deep discounts being driven by PBMs are not being seen at the pharmacy counter by patients when they are in their deductible phase. To address these challenges, Moriarty presented four patient-centric solutions:

  • Medicare should drive the adoption of real-time benefits to give patients and their physicians visibility into lower costs and offer an option for a point-of-sale rebate Part D plan.

  • For plans associated with health savings accounts, policymakers can take immediate action to change Internal Revenue Service (IRS) rules to allow those plans to provide first-dollar coverage for drugs outside of the deductible, even for maintenance medications intended to treat an existing chronic condition.

  • By prohibiting pay-for-delay agreements and passing the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act to stop Risk Evaluation and Mitigation Strategy (REMs) abuse, we can curb anti-competitive practices and help bring lower cost, clinically equivalent generic medications to market more quickly.

  • Lastly, we must accelerate the pathway to bringing biosimilar drugs to market. Biosimilar drugs have the potential to save the health system $54 billion dollars over ten years, but our country is far behind in accessing these medicines. In Europe, 53 biosimilar medicines have been approved. In contrast, only seven are on the market in the U.S. today.

CVS Health will continue to innovate and use every tool at our disposal to bring down the costs of drugs while also advocating for effective policies that increase access to affordable medications.

For more information on how CVS Health is working to expand access to more affordable and effective health care, check out our Cost of Care information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

Tom Moriarty speaks at a recent CQ Roll Call event
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A New Approach to Pricing of Pharmacy Benefit Management Services

A New Approach to Pricing of Pharmacy Benefit Management Services
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Across our CVS Health enterprise, we are transforming the way we deliver care to help more people on their path to better health. As part of this, our pharmacy benefit management (PBM) company, CVS Caremark, today introduced the new Guaranteed Net Cost pricing model, which will help redefine the industry by offering drug cost predictability and pricing simplicity for our clients.

We sat down with CVS Caremark President Derica Rice to learn more about the company’s innovative new PBM pricing model and how it will deliver value to the health care system.

Why is CVS Health introducing the Guaranteed Net Cost pricing model?

The pharmaceutical market continues to be highly dynamic and managing costs effectively can be challenging for payors, patients and the entire health care system. PBM strategies such as preferred formulary placement and drug exclusions have helped create, and keep up, the pressure on pharmaceutical manufacturers and have been successful in keeping drug prices in check.

However, as the marketplace has continued to change at a rapid pace, it is clear that the PBM model must also evolve to continue to deliver value to the health care system, while also optimizing the quality of care. And, the time is right for change.

We believe the Guaranteed Net Cost pricing model will better serve our payor clients by providing them cost predictability and to help them clearly see the net cost of their pharmacy benefit, ultimately enabling them to select their PBM provider based on who can deliver lowest net cost. This also helps plan sponsors continue to provide an affordable benefit.

How is this new model different than what is currently in the market?

While current pricing models offer discounts and rebates, they do not provide net cost predictability, and the variability between PBMs can make it difficult for plan sponsors and PBM consultants to draw direct comparisons.

Our new model more closely aligns PBM incentives with plan sponsors’ objectives by focusing on a simple concept – net cost per drug claim. It simplifies the financial arrangements underlying PBM contracts by guaranteeing the average net spend, after discounts and rebates, per prescription for each distribution channel. Overall this model will help provide our clients more predictability related to their drug spend and eliminates the need for clients and consultants to project drug price inflation, shifts in drug mix and the total value of rebates.

In addition, under this new model, we will also pass through 100 percent of the rebates to clients. Clients also continue to have the option to implement point-of-sale rebates for their members, as CVS Health does for its own employees. In turn, this can help to lower out-of-pocket costs for consumers.

How will Guaranteed Net Cost change the PBM industry?

At CVS Health, we are working to help redefine the PBM industry in a way that better serves payors, patients and the entire health care system by helping to lower prescription drug costs and maximize payor cost savings.

We believe guaranteeing the net cost is in the best interest of the client, and we are confident clients and consultants will also see it that way. We think this model is the right choice for any PBM that wants to demonstrate the value of its cost-control strategies and alignment with clients’ objectives. As such, we believe that other PBMs will also want to adopt this model, which will help to collectively deliver even greater value to the entire health care system over time.

We are confident that this new model is the right thing to do and the right approach for the future and believe that payors, consultants and other PBMs will agree that a simpler approach to PBM pricing can deliver better drug cost predictability and ultimately, help better show the value of a PBM.

What’s next for CVS Caremark and the PBM industry?

By simplifying the way we contract with our clients, we can focus on maximizing the effective PBM tools we already employ to reduce costs for the client and the consumer, and direct our energies toward developing additional innovative tools and approaches.

We anticipate that PBMs will continue to play an invaluable role in the health care system in the coming years and are working with partners and stakeholders across the industry to continue to find new ways to help improve access to care and lower overall health care costs.

Learn more.

For more information on how CVS Health is working to expand access to more affordable and effective health care, check out our Cost of Care information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

12.05.18

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Proven Savings with Real-Time Prescription Benefits

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CVS Health’s real-time prescription benefits solution helps lower member out-of-pocket costs. Powered by our proprietary engine Script Intelligence™, we can offer actionable, up-to-the-minute, member-specific plan information across multiple points of care – at the doctor’s office, at the pharmacy and at the member’s fingertips – and provide visibility to lower cost, clinically appropriate brand and generic alternatives.

When members switch medications using real-time prescription benefits, they are saving an average of $120 to $130 per fill.

The solution also helps improve the member and provider experience by streamlining the prescribing process and getting more affordable medications to members faster.

For more of the actionable ideas, strategies and expertise we provide payors to help lower drug costs and improve health outcomes, visit CVS Health Payor Solutions

CVS Caremark | Drug Focus
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Looking Ahead: 2019 Health Care Trends

Looking Ahead: 2019 Health Care Trends
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The year 2018 was a transformative one for CVS Health as the enterprise played a lead role in advancing positive change in the health care system through our combination with Aetna and the launch of innovative solutions, such as Rx Savings Finder, MinuteClinic video visits and our PBM’s Guaranteed Net Cost pricing model. As we build on this momentum, we reviewed some of the trends that are expected to move the health system forward this year.

Experts suggest that three key trends will shape the industry in 2019:

  1. The use of analytics to inform care;
  2. Growing demand for digital health tools; and
  3. Increased focus on value-based care.

 

The Use of Analytics to Inform Care

This year, experts predict that data analytics will continue to evolve and improve care. For example, analytics capabilities have the power to promote earlier intervention and create efficiencies in health management.https://hceg.org/healthcare-executives-rank-the-top-10-for-2019/ This trend will also be supported by the expanded use of artificial intelligence (AI), which can quickly and seamlessly help patients and their providers identify appropriate care or treatment.https://consultqd.clevelandclinic.org/cleveland-clinic-unveils-top-10-medical-innovations-for-2019/?_ga=2.27776436.927803239.1540401678-1723484835.1539897327

As a newly combined company with Aetna, CVS Health will be able to couple digital analytics with face-to-face interactions to develop more personalized treatment plans for patients.  Furthermore, our partnership with Buoy Health – a technology company that utilizes advanced AI – provides consumers with real-time health assessments and then refers them to one of our 1,100 MinuteClinic locations nationwide, if appropriate.

Growing Demand for Digital Health Tools

Experts see digital health as a key area that will increasingly support chronic disease management and the aging population. According to Forbes, expansion of digital health technology will be spurred by the growing use of wearable devices, telehealth platforms and mobile health applications in 2019.https://www.forbes.com/sites/reenitadas/2018/11/13/top-8-healthcare-predictions-for-2019/#2e71122a700e

CVS Health aims to transform the consumer health care experience through a combination of digital tools and – importantly – complementing that technology with high quality, easily accessible care. Our model delivers integrated care, while offering consumers the ability to interact with trusted and familiar health care experts where they are. It also arms consumers with convenient, easy-to-use technology that enables them to manage their care at any time from any place.

Increased Focus on Value-Based Care

Experts predict that the volume of value-based care models will continue to grow in 2019, as the industry focuses on reining in costs while improving outcomes. These models will increasingly prioritize quality data and risk-sharing frameworks to make health care more efficient and patient-centric.https://hceg.org/healthcare-executives-rank-the-top-10-for-2019/ At CVS Health, we believe that a focus on outcomes can help avoid unnecessary costs by connecting patients to the right care at the right time.

CVS Health’s value-based purchasing is part of our commitment to helping patients access appropriate medicines at the lowest cost. Additionally, our value-based management programs are targeted at the most costly and complex disease states, aiming to help control spend and improve health.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

In your opinion, which 2019 health care trend has the greatest potential to impact quality of care?

Choices
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By the Numbers: The State of U.S. Health Care

By the Numbers: The State of U.S. Health Care
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With a presence in 10,000 communities nationwide, CVS Health is focused on bringing positive change to Americans’ health care. As part of this effort, we are committed to understanding how Americans perceive the current system and identifying potential solutions to their most pressing needs.

CVS Health recently partnered with Morning Consult to gauge how Americans view aspects of the health care system. Consistent with findings from our 2017 survey, more than half of Americans (59 percent) believe that the health care system does not work well for them. And while 87 percent are currently satisfied with their health plans, most say they would like their care to be less expensive, simplified and more innovative.

At CVS Health, we believe that by putting patients at the center of their health care, we have the ability to improve engagement and drive down costs. As we work to transform health care, we’ll continue to seek opportunities to reduce the complexity and cost burdens that Americans face today.

Addressing Rising Health Care Costs

The cost of care is cited as the primary reason Americans don’t believe the health care system is working well, with just 31 percent of Americans reporting that their health care is affordable. What’s more is that 41 percent of Americans rank the affordability of prescription drugs as their most pressing concern with the health care system – a seven percentage point increase from 2017. At CVS Health, we recognize that one of the most important things we can do is help people adhere to their medications, which improves overall health and lowers costs.

As a pharmacy benefit manager, we work diligently to negotiate discounts from drug manufacturers, and to deploy a variety of tools to ensure our members receive high-quality pharmacy care at the lowest possible cost. For example, drug price growth for our own clients was only 0.2 percent on a per capita basis in 2017, despite list price inflation of nearly 10 percent.

We have also deployed solutions to expand visibility into prescription drug costs to ensure patients are getting the most appropriate medicine at the lowest cost – starting at the point of prescribing and culminating at the pharmacy counter. Our real-time benefits program gives prescribers access to covered benefits and the price patients will pay out-of-pocket under their benefits plan for a specific drug, providing average savings of $120-$130 per filled prescription. In our 9,800 CVS Pharmacy locations nationwide, our Rx Savings Finder tool helps patients save $420 annually by enabling our pharmacists to review their prescription regimen, medication history and benefit plans to identify the lowest cost, clinically appropriate medication available.

Making Health Care Easier to Use

Navigating health care can be complex. Sixty-eight percent of Americans state that the current system is confusing or difficult. We believe that health care cannot be simplified with a one-size-fits-all approach. The integration of CVS Health and Aetna will enable us to make health care more personal and easier to use for patients. 

Through our combination of data and expertise, we can make an often complicated and confusing system more connected and simple. By fully integrating Aetna’s medical information and analytics with CVS Health’s community locations, we’ll have a strengthened ability to provide Americans with counseling and guidance they need to need to navigate their health care.

For example, when a patient living with a chronic disease comes to pick up their medications, we will be there with additional resources and counsel to help them better manage their overall health and well-being in a much more coordinated fashion.

Innovative Solutions for the Future Health Care System

When asked about the future health care system, 47 percent of Americans believe it is important to develop innovative health care solutions. By delivering the combined capabilities of CVS Health and Aetna, we have the ability to transform Americans’ health care experience and build healthier communities through a new health care model that is more patient-centric and less expensive.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

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The Top 5 Stories from the Second Half of 2018

The Top 5 Stories from the Second Half of 2018
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Throughout 2018, our readers were most captivated by issues that shaped the national health care dialogue – from the opioid epidemic to drug pricing transparency to health care transformation. These were the most prominent topics in our round-up of most read articles from January to June, and once again they top the list for the second half of the year.

Here are the top five most read articles from July through December:

  1. Making Progress in the Fight Against Opioid Misuse and Abuse: This article provided updates on our enterprise-wide efforts to address the abuse and misuse of prescription opioids, including supporting safe medication disposal, educating patients at the pharmacy and teens and parents in communities, encouraging appropriate utilization, expanding access to life-saving antidotes and supporting local recovery programs.

  2. Transforming Health Care for Americans: At Town Hall Los Angeles, CVS Health President and CEO Larry Merlo shared his vision for bringing transformative change to health care access and delivery. Here, we recapped Merlo’s explanation of how the combination of CVS Health and Aetna has the potential to make health care easier and less expensive for the consumer.

  3. Our Impact on the Health of America: CVS Health reaches more than 100 million Americans annually in 10,000 communities nationwide. This article highlighted the new CVS Health Impact Dashboard, which showcases how we’re delivering high-quality and affordable care, promoting healthier and safer communities and driving economic impact both locally and nationally.

  4. The Truth Behind Drug Rebates and How to Help Make Drugs More Affordable: CVS Health debunked the myth that rebates are linked to higher drug prices by demonstrating how cost containment strategies from pharmacy benefit managers help offset rising list prices. This article summarized a white paper detailing our innovative tools and solutions that enable CVS Health to provide patients with the right medicine at the lowest possible cost.

  5. Protecting Against the 2018-2019 Flu Season: CVS Health partnered with the Harris Poll to conduct the annual flu survey, which revealed that 22 percent of consumers who didn't get a flu vaccine last year say that knowledge of the 2017-2018 flu season makes them more likely to get vaccinated. This article highlighted why the severity of last year’s flu vaccine serves as a motivating factor to get vaccinated this season.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

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Promoting Competition to Reduce Drug Spending

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CVS Health Chief Policy and External Affairs Officer and General Counsel Tom Moriarty weighed in on a panel that examined the pharmaceutical supply chain.

Recently, I participated on a panel at The Brookings Institution on Fostering Competition in the Pharmaceutical Distribution Chain. The panel included:

  • Matthew Eyles, executive vice president, policy and regulatory affairs at America’s Health Insurance Plans;

  • B. Douglas Hoey, CEO of the National Community Pharmacists Association; and

  • Christine Simmon, senior vice president, policy & strategic alliances at the Association for Accessible Medicines, as well as executive director of the Biosimilars Council.  

We discussed our reactions to a proposal focused on fostering competition in the generic drug marketplace, and I raised four points that are key to driving greater competition and better value in our health care system:

1. Generic Drugs Help Control Drug Spend

Although generic drugs account for the majority of drugs dispensed, they only account for a fraction of drug spending overall, helping to keep prices down for payors and consumers. Multiple data points from a variety of researchers and drug trend reports have supported this, including research from the U.S. Food and Drug Administration (FDA).https://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm129385.htm

We’ve also seen the positive impact of increasing generic drug utilization for our clients and members. In fact, our 2017 Drug Trend report showed that generic utilization was a moderating force on overall drug trend – the year-over-year measure of prescription drug spending.

2. Competition from Generics and Biosimilars is Key

An important way to continue driving down drug spending is to support reforms that promote competition via generic and biosimilar market entries. Currently, there is a considerable backlog of generic drug applications pending review and approval at the FDA. Clearing this backlog would allow thousands of generic drugs to enter markets in therapeutic categories where there is little to no competition, which will in turn help to drive down drug prices.

In addition, we need to also address the application pathway itself, as there were fewer generic manufacturers filing new generic applications last year. Creating a more efficient pathway will help incentivize generic manufacturers and speed entry to market.

Finally, biosimilars, which are commonly thought of as generic versions of biologic drugs, have great potential for bringing down costs of these often expensive, specialty therapies. Compared to other countries, the U.S. is lagging behind in bringing these drugs to market, but we see great potential and believe they can have a similar impact that they’ve had in global markets, such as Europe and Japan. That said, it is vital that we work to streamline the biosimilar approval pathway now, so we can better support competition in biologic markets going forward.

3. Generics and Driving Value for the System

Our health system needs to find ways to increase value for patients, like efforts to promote competition with generics and biosimilars. At CVS Health, we are exploring ways to ensure our clients are getting the highest possible value from drug spend relative to the outcomes the drugs deliver. This includes our strategic formulary approach that optimizes the use of clinically equivalent alternatives to branded drugs, and supporting policies that help drive market competition.

4. Pharmacists Play an Important Role

Our pharmacists engage with patients every day, and pharmacy care will become increasingly important as our system continues to move toward value-based care, with a greater focus on patient outcomes. In fact, studies have shown that pharmacist engagement improves medication adherence, which can lead to better health outcomes, fewer (often costly) adverse events and lower overall health care costs.

For more information on how CVS Health is working to ensure consumers have access to affordable medicines, visit our Rising Drug Prices information center. And to stay informed about the most talked-about topics in health care, register for content alerts and our bi-weekly health care newsletter.

 

CVS Health’s Tom Moriarty participated in a drug prices panel at The Brookings Institution.
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Promoting Access to More Affordable Medications

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With more than half of U.S. adults regularly taking at least one prescription medication, and a large number taking several,https://www.consumerreports.org/prescription-drugs/too-many-meds-americas-love-affair-with-prescription-medication/ drug affordability continues to be top of mind for Americans. Generic drugs and biosimilar medicines, which can offer lower-cost and clinically equivalent alternatives to brand name prescription drugs and biologics, are one way patients can lower their drug costs. In fact, a recent CVS Health public opinion poll found that eighty-five percent of respondents report that switching to a generic saved them money and was also effective in treating their condition.

Addressing Rising Drug Prices: Streamlining the Generic Approvals Process

The U.S. Food and Drug Administration (FDA) has worked to improve competition in the marketplace for generic drugs by reducing the backlog of applications awaiting review at FDA, and most recently, releasing a set of statements as part of its Drug Competition Action Plan in support of increased generics in the marketplace. This three-step plan to boost the rate at which generic drug applications are reviewed, processed and approved includes to:https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm591184.htm

  • Reduce gaming from branded companies;
  • Resolve scientific and regulatory checks on drugs; and
  • Streamline the generic review process.

These strategies will work in tandem to curtail the multiple cycles of review that typical drug applications are subject to and in the process ease the backlog of thousands of generics pending approval. These efforts will build off of already strong progress last year. In November, for example, FDA saw the highest number of generics approved in a single month, and 2017, as a whole, brought significant decreases in the amount of time it takes to review and approve generics.

Increasing Accessibility of Biosimilar Products

Generics have helped save billions of dollars in drug costs, and biosimilars have similar potential – estimates say the U.S. could save up to $250 billion over ten years.http://lab.express-scripts.com/lab/insights/industry-updates/the-$250-billion-potential-of-biosimilars The full potential of the biosimilar market has not been realized yet, but FDA and CVS Health are working to change that. FDA has worked to help providers understand the valuable role of biosimilarshttps://blogs.fda.gov/fdavoice/index.php/2017/10/fda-taking-new-steps-to-better-inform-physicians-about-biosimilars-through-education-about-these-potentially-cost-saving-options/  in reducing costs for consumers, and as part of its Drug Competition Action Plan it hopes to increase the number of biosimilars on the market.  CVS Health has been successful in advocating for reimbursement policies that encourage the development of biosimilars, and we have also encouraged FDA to finalize industry guidance so biosimilar developers have a consistent approval process.

Helping Consumers Access Lower-Cost Alternatives

We are encouraged by FDA’s progress and commitment, and will continue to work toward ensuring all Americans have access to affordable medicines. For instance, our pharmacy benefit management strategies work to create multiple avenues that connect our members to lower-cost, clinically equivalent options, including encouraging the use of generic medicines through our formulary strategy. Additionally, our strategic partnership with Epic increases the visibility of patients’ drug benefits at the point of prescribing, including information about clinically effective options at the lowest out-of-pocket cost for the patient, to facilitate better prescription-related decision-making for patients and their care teams.

For more information on how CVS Health is working to ensure consumers have access to affordable medicines, check out our Rising Drug Prices information center. And to stay informed about the most talked-about topics in health care, register for content alerts and our bi-weekly health care newsletter.

CVS Health is working to promote more affordable medications for patients
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Private Sector Solutions to America’s Health Care Challenges

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“Our job is to ensure the right care for consumers and to lower costs … to extract costs from the [health care] system, not add to them.”

This was the message CVS Health Chief Policy Officer and General Counsel Tom Moriarty shared at the 2017 Bloomberg Intelligence Health Care Summit, an event that brings together thought leaders from across the health care spectrum to discuss the industry’s most pressing issues.

The discussion was particularly timely, noted Moriarty, as policymakers on Capitol Hill debate changes to the health care system. “It’s an exciting and eventful time to be in the health care arena,” he said, adding that “there are still many more challenges all of us must grapple with as we move forward – regardless of how events in Washington play out.”

Assessing the Current Landscape

Health care spending continues to account for a growing share of the economy, and if current trends continue, family budgets, job creation and other important investments could be constrained. This scenario is avoidable, but according to Moriarty, “we need to understand how we got here in order to fix it.”

Moriarty highlighted four characteristics of the American health care system:

Leading the Way to Better Health Outcomes and Lower Costs

As a company that touches consumers and patients at multiple points along the care continuum, CVS Health has learned valuable lessons on how to drive better patient outcomes and lower health care costs. As examples, Moriarty pointed to the company’s efforts aimed at addressing the most pressing challenges in the health care system:

Moriarty acknowledged that there is no one strategy to address the growing health care challenges, but stressed that while we don’t have all the answers, every part of the health care system has a role to play in finding solutions that can help drive down costs and improve patient care.

Read the full text of Tom Moriarty’s remarks at the Bloomberg Intelligence Health Care Summit.

Private Sector Solutions to America's Health Care Challenges from CVS Health

 

For more information about CVS Health’s efforts to improve pharmacy care, visit our Health Care Innovation & Delivery information center. And to stay informed about the most talked-about topics in health care, register for content alerts and our bi-weekly health care newsletter.

CVS Health is at the forefront to address challenges across the health care landscape.
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