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The Power of Integration
Learn more about how the power of integration can work for you.
The truth is, a sound pharmacy benefit strategy cannot be carved out. Niche vendors that offer various carve-out services may promise dramatic savings, but their claims are overstated. Pharmacy carve-out arrangements raise the risk of cost increases and unexpected fees, and can bring administrative complexities that no payor wants to navigate. And carve-outs often lead to poor member outcomes and experiences due to lack of access and critical support.
Our connected model means that our programs work together to help optimize value:
Integration helps connect care across every step in therapy to maximize savings and improve member outcomes.
1. Up to 47% savings on overall pharmacy spend and $103 PMPM with full program adoption. CVS Health Analytics, 2023. CVS Health Q4 2022 commercial cohort that have implemented ACSF (>95% of plan lives), Exclusive Specialty (>95% of plan lives), and Standard SGM (>95% of activity in standard criteria), Jan 2023 – Jun 2023. Savings consider PA, Formulary, and Quantity Limit Outcomes with 0.5% pricing discount for Exclusive Specialty and full rebate yield attributed to ACSF. PrudentRx savings are actual outcomes for clients with adoption on or prior to 1/1/23 and > 70% members eligible and used as a proxy for clients that currently do not have adoption. Total $ savings by program is for all commercial clients with adoption. 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.
2. 96% member satisfaction: Member Experience Survey - CVS Caremark, 2022. P1012460822
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