New Help for Patients with Complex Regimens

BRIEFING
October 4, 2017
Executive Vice President, Chief Medical Officer, CVS Health

Taking one prescription once a day seems simple. When a member is on multiple medications, say five or more, to be taken in different combinations at different times of the day, the process of keeping track — and therefore staying adherent — gets complicated fast.

When that happens, members are often confused about their regimens, and uncertain about — or unable to follow — their prescribed medication regimen. And the problem isn’t unique to a small number of members or a specific age group or demographic. It is common and pervasive.

The ScriptPath Prescription Schedule shows a patient exactly when to take all their medications.

About half of patients report being confused about how and when to take their medications. Patient confusion and lack of understanding contribute to our national problem of medication nonadherence, which has been called an epidemic in the United States. Studies have consistently shown that approximately 50 percent of medications prescribed for chronic diseases are not taken as directed. The epidemic is costly, contributing to poor outcomes and additional treatments and hospitalizations. The annual cost to our health system has been estimated at $290 billion.

CVS Health has made a long-term commitment to understand and help solve the nonadherence problem. Our data validates that there are many reasons for nonadherence; no single solution can adequately address all of them. That’s why we have developed a host of adherence solutions over the past decade and continue to do so today. Some, like Pharmacy Advisor Counseling, help to educate plan members and reduce misunderstanding about prescribed medications. Millions of patients use our digital tools to receive medication reminders, request refills, and even change their pick-up or delivery location when traveling. Maintenance Choice and Specialty Connect give patients a choice of where to pick up or receive their medications.* Each of these solutions has enhanced adherence for members.

Therapeutic complexity — regimens involving multiple medications — is an important contributing factor to nonadherence for a significant portion of the population. Research has consistently shown that greater regimen complexity and dosing frequency are related to poorer adherence.

Challenges of Do-it-Yourself Medication Management

When asked how they would space doses for a hypothetical seven-drug regimen

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85% of participants dosed themselves 5 or more times per day

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Approximately a third dosed themselves 7 or more times per day

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Some dosed themselves as many as 14 times per day

Introducing the ScriptPath Prescription Schedule

The ScriptPath Prescription Schedule, one of our newest solutions, is designed for members with multiple prescriptions. It provides a clear and concise dosing schedule and reduces the number of times a patient takes medication each day, thereby helping to improve adherence and ultimately, health outcomes.

Watch how the ScriptPath Prescription Schedule works

Morning, Midday, Evening, Bedtime
All doses are organized into four time periods

The schedule features all of a patient’s current CVS Pharmacy prescription information in one place— including which medications the patient takes, when the patient should take them, and how much of each medication should be taken in each dose. Using easy-to-understand icons, the new schedule was designed to improve patient understanding and enhance patient safety by simplifying how patients take medications and how caregivers give them.

Appropriate for a range of literacy levels, the schedule is available in both English and Spanish. While universal medication schedules have been under discussion for some years, the ScriptPath Prescription Schedule offers some distinct advantages. The schedule is generated by a robust scientific system, created by CVS Health, that automatically reviews all of a patient’s current CVS Pharmacy prescription information and prescriber’s instructions, and then, using clinical data, provides a schedule of the most effective times of day to take the medications. The result is a highly personalized, visual representation of the patient’s prescription regimen that helps to clarify the ideal time to take their medications and the appropriate dosage.

Learn more about the Prescription Schedule

Available at all the more than 9,700 CVS Pharmacy locations upon request, the ScriptPath Prescription Schedule will be most helpful for patients who take more than five medications each day. Those patients will be offered a consultation with the pharmacist when they pick up their prescriptions. The pharmacist will review the prescription schedule with the patient and answer any questions.

CVS Health partnered with designer Deborah Adler on the new ScriptPath prescription management system to ensure that all elements were easy for patients to read and understand. Core components of the solution set have been tested in select stores over several years and have been met with enthusiastic approval by both patients and pharmacists. Patients have also reported that the schedule is a valuable resource that they bring along to doctor appointments.

The ScriptPath Prescription Schedule is the first offering in our ScriptPath prescription management system. Other tools, including a new prescription label, will be available 2018. Watch Insights for more information.

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More Ways to Help Patients Improve Adherence

CVS Health has additional solutions specifically designed to help patients with complicated regimens. ScriptSync, for example, synchronizes a patient’s prescription orders to a single date so that they can be picked up conveniently during one visit to CVS Pharmacy. This helps patients to stay up-to-date with refills, contributing to improved adherence, while requiring fewer trips to the pharmacy. Accessed through a single login, our online Integrated Pharmacy Experience allows patients to view and refill any CVS Pharmacy, CVS Caremark Mail Service Pharmacy and CVS Specialty Pharmacy prescriptions for them and their family. These solutions make prescription management more convenient and increase visibility into the prescription fulfillment process, helping to identify opportunities to adjust the regimen, thereby reducing therapeutic complexity.

Other solutions help patients faced with taking multiple doses of different drugs throughout the day. Through our alliances with health systems, we are providing multi-dose packaging to a number of patients who take many medications. Multi-dose packaging organizes a patient’s medications in convenient packs, each labeled with the date and the appropriate time of day for the patient to take the drugs.

Our research has shown that nonadherence must be addressed on multiple levels, from patient education to clinical support to practical solutions that help make taking medicine easier for patients in everyday life. The solutions discussed here are available at no additional cost to patients and can work together to address many of the challenges that come with complex medication regimens. We’re confident the practical support provided by ScriptPath is an important step that will help people on their path to better health.

Do you have questions about helping patients with complex regimens stay adherent? Ask Us
BRIEFING
October 4, 2017
Executive Vice President, Chief Medical Officer, CVS Health

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Mail pricing at CVS retail for ERISA governed plans. The Maintenance Choice program is available to self-funded employer clients that are subject to ERISA. Non-ERISA plans such as insured health plans, plans for city, state or government employees, and church plans need CVS Caremark Legal's approval prior to offering the Maintenance Choice program. Prices may vary between mail service and CVS Pharmacy due to dispensing factors, such as applicable local or use taxes.

*Where allowed by law. In-store pick up is currently not available in Oklahoma. Some states require rst- ll prescriptions to be transmitted directly to the dispensing specialty pharmacy. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. Certain specialty medications may not qualify. Services are also available at Long’s Drugs locations.

Patients have the freedom to select the pharmacy of their choice. ScriptSync may not be covered by all insurance plans. Eligible prescriptions are 30-day medications taken on a regular basis. Excludes controlled substances and specialty medications. Drug costs may change when a prescription is transferred to a new pharmacy or changed from a 90-day prescription to a 30-day prescription. To align prescriptions on a 30-day cycle, one or more additional copays may be required by the patient’s plan. ScriptSync may not be covered by all insurance plans.

CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information rewall.

Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan. Client-speci c modeling available upon request.