Eliminate Specialty Waste by Preventing Excess Accumulation

Effectively controlling spending on high-cost specialty medications and saving payors money requires not only ensuring that the right patients start on the right treatments at the most appropriate time, but also eliminating waste throughout the course of therapy. In fact, the largest portion of plan costs on specialty medications – 89 percent – is driven by ongoing therapy for members already on specialty treatments.CVS Health Analytics, 2021. Data from Q1-Q3 2020. All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.

89% of specialty pharmacy spend is during ongoing therapy for existing utilizers

Given that these therapies often cost thousands of dollars, even a small amount of excess supply can add additional costs across the plan member population. We have made significant investments in enhanced data science and digital member engagement to optimize supply management, and help prevent excess drug accumulation over the course of a year.A specialty pharmacy service performed by CVS Specialty for contracted payors

85% of specialty patients signed up for digital communications	Automated monitoring identifies when a patient may be accumulating excess supply	Advanced analytics and digital capabilities help verify supply and suggest a new ship date to prevent excess accumulation
~$1,200 savings per targeted specialty patient in first 10 weeks of managing excess supply.*

85% of specialty patients signed up for digital communications
Automated monitoring identifies when a patient may be accumulating excess supply
Advanced analytics and digital capabilities help verify supply, suggest new ship date to prevent excess accumulation
~$1,200 savings per targeted specialty patient in first 10 weeks of managing excess supply.*

*Targeted utilizers make up less than 2% of all specialty utilizers

We use automated monitoring to trigger interventions during the refill process encouraging patient behavior change to reduce waste, without impact to benefit design. We also have a high level of digital engagement from members – 85 percent of eligible specialty patients opt-in to digital communication — which helps increase the effectiveness of our clinical programs by engaging members through their preferred communication channel. Supply management optimization is currently available for select classes, including autoimmune conditions and oncology. Intervention and outcomes reporting help track impact on clinical outcomes and cost savings.

Utilizing analytics and personalized engagement to help reduce waste
Supply Management Optimization*
Joe has psoriasis and is taking Otezla		Joe fills his Otezla 5 days early each month; over time he accumulates an extra month of medication		Joe receives a refill reminder and goes online to refill his Otezla		The CVS Specialty mobile app takes Joe through the refill process showing the preferred fill date		Joe selects the preferred date displayed on the calendar, helping improve appropriate drug therapy and reduce waste

Utilizing analytics and personalized engagement to help reduce waste
Supply Management Optimization*
	Joe has psoriasis and is taking Otezla
	Joe fills his Otezla 5 days early each month; over time he accumulates an extra month of medication
	Joe receives a refill reminder and goes online to refill his Otezla
	The CVS Specialty mobile app takes Joe through the refill process showing the preferred fill date
	Joe selects the preferred date displayed on the calendar, helping improve appropriate drug therapy and reduce waste

*A specialty pharmacy service performed by CVS Specialty for contracted payors and included in the contracted drug pricing