Proven Savings with Real-Time Benefits

The Key Components of a Solution That Delivers Results

FEATURE
August 22, 2018
Senior Vice President, Pharmacy Benefit Management Innovation, CVS Health
The real deal about real-time benefits

The Real Deal about Real-Time Benefits

Learn the four fool-proof questions to ask to see if your real-time benefits solution will deliver real savings for your members.

Download Overview >

In 2017, approximately 43 percent of U.S. adults were enrolled in a high deductible health plan (HDHP), and the portion of health care costs shouldered by consumers is rising.https://www.hfma.org/Content.aspx?id=56905. In a recent survey 84 percent of Americans said it would be helpful to know their prescription cost before they go to the pharmacy, and 64 percent said they would use prescription cost information to find lower-cost alternatives instead of foregoing treatment.CVS Health Morning Consult poll, July 23-25, 2018.

CVS Health launched real-time benefits to help make it easier for plan members to afford their prescription drugs and stay on their path to better health. Even though there are several versions of real-time benefits available in the market today, and many claim to have the same capabilities, they are not all created equal.

CVS Health's Real-Time Benefits Solution Other
Checkmark Significant, demonstrable savings
  • Theoretical/possible savings
Checkmark Specific to the member’s formulary
  • Broad therapeutic equivalents
Checkmark Script Intelligence engine powers database of clinically mapped drugs by strength/dose, across 90% of Rxs*
  • Directionally lower-cost alternatives
Checkmark Connected to Surescripts, integrated into electronic health records (EHRs) or e-prescribing workflow
  • Only built into 1-2 EHR systems
Checkmark All members have access to our Check Drug Cost tool, which averages 230K searches per month
  • Requires separate prescriber portal
Checkmark Across 9,800+ CVS Pharmacy locations and at Customer Care
  • Prescriber-focused only
CVS Health's Real-Time Benefits Solution Other
Checkmark Significant, demonstrable savings
  • Theoretical/possible savings
Checkmark Specific to the member’s formulary
  • Broad therapeutic equivalents
Checkmark Script Intelligence engine powers database of clinically mapped drugs by strength/dose, across 90% of Rxs*
  • Directionally lower-cost alternatives
Checkmark Connected to Surescripts, integrated into electronic health records (EHRs) or e-prescribing workflow
  • Only built into 1-2 EHR systems
Checkmark All members have access to our Check Drug Cost tool, which averages 230K searches per month
  • Requires separate prescriber portal
Checkmark Across 9,800+ CVS Pharmacy locations and at Customer Care
  • Prescriber-focused only

Real Savings Through Real-Time Benefits

CVS Health has one of the most comprehensive solutions in the market today, which has proven to save members money. We make actionable, up-to-the-minute, member-specific information available across multiple points of care. This helps members and their providers make more informed decisions about their prescription medication and lower out-of-pocket costs.

For prescriptions written by physicians using real-time benefits information, which are filled by the member, when a lower-cost preferred alternative is presented, physicians are switching to the lower-cost alternative 40 percent of the time. In these cases, the member cost was $130 lower per fill, on average, compared to the original non-preferred drug selected. 

For members searching for their prescription(s) using our Check Drug Cost tool, when a lower-cost preferred alternative is presented, members are filling lower cost alternatives 20 percent of the time. In these cases the member cost was $120 lower per fill, on average, compared to the original drug they searched.

Our retail pharmacists are using Rx Savings Finder to help members save an average of $420 per year.**

Member-Specific, Actionable Information

Our proprietary engine, Script Intelligence, powers our unique database of clinically mapped drugs. When physicians, pharmacists or members search for a specific drug, the database provides:

Checkmark Up to five clinically appropriate brand alternatives or therapeutically equivalent generics specific to the member’s plan design
Checkmark Drugs with equal or better formulary status on the member’s specific plan

This means members, prescribers and pharmacists can to see — and select — the most relevant clinically appropriate alternative drugs that are lowest cost, based on the member’s plan.

Access to Information Across Multiple Points of Care

Our real-time benefits solution connects with more stakeholders through numerous touchpoints.

Checkmark At the Physician’s Office: Real-time benefits information is integrated into the EHR system, which makes it convenient for physicians to use. This connectivity gives us the ability to expand the number of physicians we engage over time. By year-end, we expect to be connected to more than 130,000 physicians and more than 250,000 by the end of 2019.
Checkmark At the Pharmacy Counter: Nearly 30,000 CVS pharmacists use the Rx Savings Finder tool to identify savings opportunities when members present their prescriptions.
Checkmark In the Check Drug Cost Tool: Members have direct access to real-time benefits information through the Check Drug Cost tool on the CVS Caremark member portal or app where they can search for their prescription drug(s) and find clinically appropriate, lower-cost alternatives. On average, members are conducting more than 230,000 searches per month.

Ease of Use for Prescribers

Real-time benefits help ensure the right prescription is written from the beginning. When physicians use real-time benefits they get:

Checkmark A response on alternative therapies within 1 second, on average
Checkmark A decision on an electronic prior authorization request in as little as 6 seconds
Checkmark Brand and generic alternatives, clinically mapped for 90 percent of drugs written for our members*

This helps get more affordable medications to members faster.

Real-time benefits is delivering real results. We will continue to enhance our real-time benefits capabilities to make them even easier to use and help lower costs for members.

Want to learn about how up-to-the-minute member-specific information can help lower out-of-pocket costs? Ask Us
FEATURE
August 22, 2018
Senior Vice President, Pharmacy Benefit Management Innovation, CVS Health

Explore Programs

Member Engagement

Our success in helping people on the path to better health depends on how well we engage members and encourage them to take the right steps.

Adherence

Investing in adherence helps reduce overall health care costs and drive better health outcomes.

Cost Management

Controlling costs is most payors’ primary concern. Our market-leading solutions help clients get ahead of trend drivers and achieve lowest net cost.

The Morning Consult poll was conducted from July 23-25, 2018, among a national sample of 2,201 registered voters. The interviews were conducted online and the data were weighted to approximate a target sample of registered voters based on age, race/ethnicity, gender, educational attainment, and region. Results from the full survey have a margin of error of plus or minus 2 percentage points.

*Projected as of end of 2018.

**When members present their prescriptions.

Data source: CVS Health Enterprise Analytics, 2018, unless otherwise noted.

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

Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.

Image source: Licensed from Getty Images, 2018.

This page contains trademarks or registered trademarks of CVS Pharmacy, Inc. and/or one of its affiliates.

©2018 CVS Health. All rights reserved.