- Programs & Services
- Cost Management
- Specialty Management
- Care Management
- Member Engagement
- Health Plan Client Engagement
Maximize savings by optimizing medication supply
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.
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.
of specialty patients signed up for digital communications
identifies when a patient may be accumulating excess supply
and digital capabilities help verify supply, suggest new ship date to prevent excess accumulation
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|
*A specialty pharmacy service performed by CVS Specialty for contracted payors and included in the contracted drug pricing.
Updated SMO statistic June 15, 2021.
CVS Health Analytics, 2021. *Targeted patients make up <2% of all specialty patients. SMO referenced savings are specific to the following top nine specialty therapies: rheumatoid arthritis, psoriasis, inflammatory bowel disease, hepatitis C, multiple sclerosis, growth hormone, oncology, hereditary angioedema and osteoporosis. As of June 15 2021, SMO is available across most specialty therapies. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.