CVS Caremark Research Illustrates How Innovative Pharmacy Benefit Plan Design Optimizes Generic Utilization
WOONSOCKET, R.I., Oct. 13 /PRNewswire/ -- CVS Caremark (NYSE: CVS) presented data at the Academy of Managed Care Pharmacy (AMCP) Annual Educational Conference, which illustrates how innovative pharmacy benefit plan design can impact generic utilization. The study further underscores how pharmacy benefit managers (PBMs) can work with plan sponsors to manage costs and improve health outcomes by working to change plan participant behavior through increased engagement. The study found that implementing a $0 copay structure for generic medications can be an effective strategy to increase generic dispensing, with the generic dispensing rate (GDR) increasing to 60.8 percent (a 4.2 percent increase) during the study period.
"Our 2009 Benefit Planning Survey found that clients are more interested in identifying opportunities to change plan participant behavior, rather than shift costs," said Jack Bruner, Executive Vice President, CVS Caremark. "The data presented at AMCP illustrates an example of how we can work with our plan sponsors to change and optimize participant behavior in order to achieve increased generic utilization. These types of partnerships enable us to effectively reduce costs for both our client and their plan participants without compromising quality or access."
In addition to an improvement in GDR during the study period, the analysis found that the average participant cost share for generic medications decreased almost 10 percent (9.4 percent decrease). In addition, the average plan cost per 30 days of therapy also exhibited a slight decline, despite the reduction in generic copayment rates. Prevalence of use in three key preventative drug classes also increased significantly (participants on cholesterol lowering therapy increased 13 percent, on antihypertensive therapy increased seven percent and on diabetic therapy increased nine percent) as a proportion of eligible patients.
"While some plan designs work to drive generic utilization by increasing brand medication copayments, this study demonstrates that lowering the generic copayment can also be an effective strategy to increase GDR," said Mr. Bruner. "In addition, the data indicates that lowering the generic copayment may also be associated with an increase in participants taking key preventative drugs, which could positively impact adherence and overall health outcomes."
The study was designed to evaluate the results of plan design changes, including implementation of a $0 copay for generic medications, on the GDR, plan participant cost and impact of plan participant behavior changes on health outcomes. During the study period, participants were allowed to fill prescriptions for generic medications at a preferred retail pharmacy network at a zero dollar copay. The study included 15,000 plan participants covered by a self-funded employer group who were continuously enrolled under the benefit for the duration of the study period (12/1/2007 through 7/31/2009).
About CVS Caremark
CVS Caremark is the largest provider of prescriptions in the nation. The Company fills or manages more than 1 billion prescriptions annually. Through its unmatched breadth of service offerings, CVS Caremark is transforming the delivery of health care services in the U.S. The Company is uniquely positioned to effectively manage costs and improve health care outcomes through its more than 7,000 CVS/pharmacy and Longs Drugs stores; its Caremark Pharmacy Services division (pharmacy benefit management, mail order and specialty pharmacy); its retail-based health clinic subsidiary, MinuteClinic; and its online pharmacy, CVS.com. General information about CVS Caremark is available through the Investor Relations section of the Company's Web site, at cvscaremark.com/investors, as well as through the press room section of the Company's Web site, at cvscaremark.com/newsroom.