CVS Caremark Research Highlights How Innovative Plan Designs Help Clients Reduce Drug Spend and Improve Generic Dispen... (program implementation the average gross...)

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CVS Caremark Research Highlights How Innovative Plan Designs Help Clients Reduce Drug Spend and Improve Generic Dispensing Rates

Date:10/14/2010

program implementation, the average gross cost per claim for the 10 selected classes resulted in savings of 12.8 percent and the GDR rose from 57.5 percent to 72.8 percent after one year of the program. Furthermore, no escalated member complaints were reported by the client.

A third study highlighted the reduction in overall drug spend that can be achieved by implementing Maintenance Choice, an innovative plan design that provides members with options for how they can receive their 90-day maintenance prescriptions in a mandatory mail plan design. The plan design allowed the client – a health plan ASO employer group which manages 18,000 lives – to move from a voluntary mail plan to a mandatory mail plan that also provided members with the option to receive their 90-day maintenance prescriptions either through mail order or at one of the more than 7,100 CVS/pharmacy locations nationwide for the typically lower mail co-pay and cost. The study analyzed the group's cost and utilization for 15 months before and after the implementation of Maintenance Choice to assess financial impacts as well as changes in GDR. Results found that in the 15 months after moving from voluntary mail to Maintenance Choice, the client achieved a savings of 5.7 percent in average gross cost per day with eighty-two percent of eligible maintenance utilization (as measured by days supply) being dispensed at 90-day mail pricing. In addition the client's GDR increased from 59 percent to 68 percent as the result of combining Maintenance Choice with other plan design changes to drive generic utilization.

About CVS CaremarkCVS Caremark is the largest pharmacy health care provider in the United States. Through our integrated offerings across the entire spectrum of pharmacy care, we are uniquely positioned to provide greater access, to engage plan members in behaviors that improve their health, and to lower overall health care costs for health plans, p
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