Flagship programs promote drug adherence

With its sights firmly fixed on delivering innovative solutions that address emerging customer needs that no stand-alone PBM or stand-alone retail pharmacy could provide, CVS Caremark is seeing growing interest in its proprietary programs — or integration sweet spots — known as Maintenance Choice and Pharmacy Advisor.


Having the ability to offer patients a choice between picking up maintenance medications at a pharmacy location or having them shipped to the home, with no increase in co-pay or payer pricing, is clearly proving to be a winner for CVS Caremark, which broadly introduced the Maintenance Choice program in 2009.


There are currently about 10.7 million lives covered under 880 plans that have implemented or committed to implement Maintenance Choice and, according to CVS Caremark, it is seeing more new clients adopt Maintenance Choice right out of the gate. To put it into perspective, 63% of the lives adopting Maintenance Choice in 2012 were from new clients, compared with 14% back in 2009.


“We also have compelling data demonstrating that Maintenance Choice has been successful in broadening access while reducing costs and improving prescription adherence,” Larry Merlo, president and CEO of CVS Caremark, told analysts during the company’s second-quarter conference call in early August. “As we’ve discussed previously, we’re making enhancements to the program to provide a more transformative member experience that will further differentiate CVS Caremark in the marketplace.”


What Merlo is referring to is Maintenance Choice 2.0, the next generation of the program that will significantly increase its potential. This newest version includes a less restrictive or voluntary plan design option — tripling the number of potential customers who might want to use the program. It is currently in pilot and expected to be broadly available in January 2013. 


“Management says Caremark could end up with 30 million patients covered by Maintenance Choice once 2.0 is rolled out and fully adopted, though again, management expects adoption to be initially slow and then accelerate as the value of the program becomes well-understood in the marketplace,” stated Barclays Capital analyst Meredith Adler in a recent research note. “For the customer and the patient, [Maintenance Choice] provides a lower cost and has been demonstrated to improve adherence.”


Another flagship program in CVS Caremark’s arsenal is Pharmacy Advisor, a significant program driven by the fact that face-to-face counseling between pharmacists and patients can be two to three times as effective as other forms of communication in driving adherence to prescription drug regimens.


Powered by the company’s proprietary Consumer Engagement Engine, the Pharmacy Advisor program places critical information into the pharmacists’ workflow, whether they are at a PBM call center, mail-order pharmacy or in a CVS retail pharmacy. The program started last year with just one disease state — diabetes — but expansion plans are well-underway. 


“We now have 16.2 million lives covered by more than 900 clients committed to implement Pharmacy Advisor for diabetes. And additionally, I’m pleased to report that we have 10.7 million lives covered by 550 clients already enrolled in Pharmacy Advisor for cardiovascular conditions, which we launched this past April,” Merlo told analysts during its second-quarter conference call. “And given our success to date, we expect to go live next year with five more Pharmacy Advisor programs addressing additional 
chronic diseases.”


While the Pharmacy Advisor is currently free, Adler indicated that the company eventually may charge for it. Most likely, a base level of services will be offered for no cost, but additional capabilities will require payment, she stated in a research note.


“As Maintenance Choice prompts more patients to visit the pharmacy, its combination with Pharmacy Advisor represents another opportunity to improve patient health,” the company stated in its most recent annual report. “Together, the two programs can drive a significantly higher percentage change in optimally adherent members than either program on its own.”