Prescription Access and Affordability

CVS Caremark is committed to making pharmacy services accessible and affordable. We work closely with patients and physicians to help identify affordable treatments, share information on innovative therapies, and manage a safe and effective pharmaceutical formulary.

Generic Utilization

A generic drug contains the same active ingredients as its brand name counterpart, often at a lower cost. CVS Caremark has extensive generic substitution programs to provide clinically-appropriate medications that save consumers money, facilitating patient adherence to prescribed therapies. Our retail and PBM Pharmacists are trained to counsel patients about generic medications and recommend generic alternatives where appropriate. We also have a number of initiatives aimed at educating customers about the benefits of choosing generics, including our Caremark Count on Generics® Program.

We advocate for cost savings through generics by participating in the Coalition for a Competitive Pharmaceutical Marketplace—an organization committed to improving consumer access to high-quality generic drugs; restoring a vigorous, competitive prescription drug market; and supporting legislation to eliminate legal barriers that prevent timely access to affordable, equally effective generic drugs.

Informing Physicians about New Therapeutic Options

We provide physicians with information about the newest therapeutic options to help them determine the best treatment for their patients. At times we suggest the substitution of a brand name equivalent, or recommend a different therapeutic option for patients. Other than a permitted generic substitution, we obtain authorization by the patient’s physician before making any change in the prescribed treatment. We understand and respect that physicians are in the best position to make treatment decisions regarding their patients.

Maintaining an Effective Pharmaceutical Formulary

Access to life-saving medications is the heart of our business and we strive to provide CVS Caremark plan participants with a safe and effective prescription drug formulary.

We follow rigorous standards to maintain an independent, patient-first approach when deciding which drugs to place on CVS Caremark’s approved drug lists. Our Pharmacy and Therapeutics (P&T) Committee is charged with conducting a clinical review of all drugs, including generics, that are selected for inclusion on – and deletion from – the CVS Caremark Preferred/Primary Drug List. Our formulary list is typically updated every three months.

The decision to add or remove any drug is based first and foremost on the clinical merit of that product. A drug must be FDA approved (or exempt from FDA approval) to be considered for inclusion. The P&T Committee does not have access to, nor does it take into consideration, any information regarding rebates or negotiated discounts with pharmaceutical manufacturers or the net cost of the drug. The Committee does, however, consider drug utilization information in order to evaluate potential disruption to plan participants.

P&T Committee members consist of a diverse cross-section of actively practicing physicians and pharmacists as well as a medical ethicist. Voting members of the P&T Committee may not be CVS Caremark colleagues and they must disclose to the company any financial relationship or conflicts of interest with any pharmaceutical manufacturers. Committee members receive a flat compensation rate for their time and do not benefit from manufacturer rebates or other negotiated discounts.