Dive Brief:
- Top pharmacy benefit manager CVS Health aims to lower drug costs for patients through a new collaboration with existing partner Epic Systems Corp., tapping the electronic health records (EHR) provider's data software to improve dispensing patterns and medication adherence.
- Through Epic's "Healthy Planet" population health and analytics platform, CVS Heath hopes to provide prescribers with better visibility around lower-cost medication alternatives as well drugs' formulary status.
- CVS Health manages pharmacy services for health plans covering nearly 90 million members. One of the main levers for controlling drug costs is through its formulary, or a tiered list of covered prescription drugs.
Dive Insight:
Medication adherence usually falls when patients are forced to bear a greater share of medication costs, research has found. Data from the QuintilesIMS Institute, for example, shows patients are 2.5 times more likely to abandon a brand prescription when their costs are still in a deductible.
Lower adherence, in turn, can be linked with poorer health outcomes and unnecessary healthcare spending, such as through extra hospital admissions and lost productivity.
Epic's electronic health records are used by hospitals, medical centers, pharmacies and delivery networks to support a range of patient services. The company had previously partnered with CVS on the PBM's MinuteClinic system and specialty care management programs.
CVS plans to use Epic's tools to give healthcare professionals real-time benefit information and point-of-prescribing electronic prior authorizations. With this information, prescribers could better steer patients to covered drugs available for the lowest out-of-pocket cost
"Together, our two companies will also examine opportunities to streamline and improve data sharing and linkages across the health care system to enhance communication and connectivity among patients, their physicians, the pharmacy and health insurers," said CVS Health's Chief Information Officer Stephen Gold in a Oct. 17 statement on the new initiative.
The collaboration also aims to develop a clinical database for use in medication counseling, as well as a "digital store front" whereby over-the-counter medications can be added into the patient's EHR.
While CVS Health didn't directly link the deal to its formulary management, improving prescriber's awareness of drugs' formulary status could help reinforce the PBMs work in that area.
Earlier this year, CVS Health announced its 2018 formulary, which included an outcomes-based management program targeting drugs for breast cancer, non-small cell lung cancer, obesity and chronic obstructive pulmonary disease. This will require manufacturers to cover costs over a prespecified threshold if patients don't reach specific outcomes.