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CVS Caremark to Offer Medical Benefit Drug Management Services to Clients
Date:4/14/2011

WOONSOCKET, R.I., April 14, 2011 /PRNewswire/ -- CVS Caremark Corporation (NYSE: CVS) today announced a new medical benefit drug management service for the company's pharmacy benefit management (PBM) and specialty pharmacy clients.  The offering is the first of its kind to provide a comprehensive management solution for the buy-and-bill drug model currently used by physicians (whereby the physician purchases specialty medications, administers them to the patient and directly bills the payer).  The payer-centric offering will employ both prospective and retrospective drug utilization management strategies to drugs billed under the medical benefit, while ensuring minimal disruption to the physician's workflow and facilitating the delivery of evidence-based care.  CVS Caremark will work with New Century Health, a specialty care management company, to offer its clients integrated evidence-based medicine, treatment care pathways, quality improvement programs, and peer-to-peer review through an innovative web-based decision support platform.  This offering will be broadly available to CVS Caremark customers for implementation beginning January 1, 2012.

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Management of specialty drugs under the medical benefit poses a significant challenge to health plans and employers today.  In fact, more than 50 percent of specialty drugs are billed under the medical benefit, many of which are administered in a physician's office.  Payers are less able to identify and apply effective clinical and cost management strategies, similar to those applied to specialty drugs billed under the pharmacy benefit, due to current medical claims, processing limitations and limited visibility to its clinical applications.  Through analysis of CVS Caremark data, it was found that among the company's PBM clients,
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SOURCE CVS Caremark
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