Intelligent Medication Monitoring for Targeted Specialty Interventions

Innovative digital solution improves outcomes, experience while lowering costs

A smiling pharmacist talks on the phone
BRIEFING
March 23, 2021
Executive Vice President, Specialty and Product Innovation, CVS Health

Specialty therapies are complex and patients often face challenges including side effects or ineffective treatment, which require active monitoring and personalized engagement to ensure patients stay adherent. If the side effects are significant, or if the patient no longer feels they are getting the benefit of the medication, they may stop taking them. The right monitoring to detect if this is happening, and appropriate interventions are critical to saving payors money.

50% of surveyed rheumatologists have patients try on average three medications in the first year to treat rheumathoid arthritis (RA)2020 CVS Specialty and/or one of its affiliates rheumatologist survey April 2020, CVS Caremark Market Research | Enterprise Insights Project #: 2020-0030. 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. (P1006260820)

Our Intelligent Medication Monitoring* solution uses data analytics and our digital infrastructure to identify when patients may no longer be benefitting from their treatment and intervene appropriately. Our proactive surveillance enables us to identify gaps in care, and monitor efficacy, symptoms, pain, and exacerbations. Given our high level of digital engagement we can adapt our message to members and reach them through a channel of their preference. When appropriate, we can work with providers to deliver targeted interventions, including stopping treatment or changing to a different therapy.

Clinical interventions helped save
~$2K
 
per targeted patient in 90 daysCVS Health Analytics, 2020. Data source from RxNav, SPARCS and SPEDM. All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Savings projections are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client-specific modeling available upon request.
Following intervention
23%

stopped therapy or changed to another medication in the 90 days
Clinical interventions helped save
~$2K
 
per targeted patient in 90 days2
Following intervention
23%

stopped therapy or changed to another medication in the 90 days

Proactive efficacy assessment helps uncover the need to change psoriasis therapy

Personalized clinical efficacy review

When calling for a refill, a CareTeam representative asks patient how well managed his psoriasis is.

Patient responds that he has visible red patches and itching which are impacting his daily activities.

Pharmacist intervention

Based on the patient's response, a pharmacist consults with the patient and discovers the pain from his rash is causing difficulty with daily activities like typing on his computer or using his hands.

Provider clinical outreach

Pharmacist contacts the provider to discuss the patient's current psoriasis treatment being ineffective and to discuss alternatives.

Alternative drug therapy prescribed

Provider reviews documentation and clinical notes and prescribes an alternative treatment.

Patient reports improvement in daily activities after starting new therapy.

Measurable outcomes

Intervention and outcomes reporting help track impact on clinical outcomes and reduction in wasteful spending.

Personalized clinical efficacy review

When calling for a refill, a CareTeam representative asks patient how well managed his psoriasis is.

Patient responds that he has visible red patches and itching which are impacting his daily activities.

Pharmacist intervention

Based on the patient's response, a pharmacist consults with the patient and discovers the pain from his rash is causing difficulty with daily activities like typing on his computer or using his hands.

Provider clinical outreach

Pharmacist contacts the provider to discuss the patient's current psoriasis treatment being ineffective and to discuss alternatives.

Alternative drug therapy prescribed

Provider reviews documentation and clinical notes and prescribes an alternative treatment.

Patient reports improvement in daily activities after starting new therapy.

Measurable outcomes

Intervention and outcomes reporting help track impact on clinical outcomes and reduction in wasteful spending.

Curious how Intelligent Medication Monitoring can help you save money on specialty costs? Ask Us
BRIEFING
March 23, 2021
Executive Vice President, Specialty and Product Innovation, CVS Health

*CVS Specialty pharmacy patients only.

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