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CVS Health Kept Drug Price Growth Nearly Flat and Improved Medication Adherence for PBM Clients in | CVSHealth

Although manufacturer-driven price inflation for specialty drugs measured 8.3 percent in 2017, CVS Health was able to keep specialty drug cost growth at just 3.7 percent for clients. This was achieved through effective formulary strategies, indication- and outcomes-based contracting and cost-cap based rebates.

CVS Health also offers PBM clients a variety of formulary strategies, which are some of the most effective means of leveraging market competition. For clients aligned with the company’s managed formularies, drug price actually declined – by 0.1 percent, in 2017, as compared to the minimal 0.2 percent drug price growth seen across the commercial cohort. Also, despite greater utilization, clients aligned to the company’s formulary approach also had lower per member per month costs. The company’s formulary management approach includes careful, ongoing assessment of the marketplace, effective negotiations to be able to offer competitive pricing to clients, and the development of more targeted approaches, such as indication-based formularies, in which prices and rebates for a drug are negotiated based on its effectiveness to treat a specific diagnosis rather than at a therapy class level.

To further enhance affordability and price transparency, in late 2017, CVS Health introduced real-time benefits enabling prescribers to see the member-specific out-of-pocket costs of a prescribed medication as well as the costs of clinically appropriate alternatives in real-time allowing prescriber to make more informed decisions and offer members medication options that may be more affordable.

Prescription drug trend is the measure of growth in prescription spending per member per month. Trend calculations take into account the effects of drug price, drug utilization and the mix of branded versus generic drugs as well as the positive effect of negotiated rebates on overall trend. The 2017 trend performance is based on a cohort of CVS Health commercial PBM clients – employers and health plans.

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CVS Health Kept Drug Price Growth Nearly Flat and Improved Medication Adherence for PBM Clients in.