June 8, 2018 – The CVS E-Prescription Program is a Step in the Right Direction, Just Don't Expect it to “Bend the Cost Curve.”
A year ago, CVS Health announced a new e-prescription program to provide doctors and pharmacists with real-time medication cost information, including lower cost alternatives.
The CVS platform marries a clinical database and an “adjudication engine” to determine a patient’s out of pocket costs and prior-authorization status. Doctors and pharmacists whose electronic medical record (EHR) systems are connected with the CVS program will have an opportunity to change a prescription to a lower-cost alternative, with the patient sitting right there.
Sounds like a plan. But Scripta Co-Founder Mindy Bradley has got a few insights (and a few questions) regarding the program:
SURESCRIPTS, COUPONS, DOCTOR’S ORDERS, AND MORE:
Anything that provides more cost information to doctors and patients is a step in the right direction, but the technology that underpins the CVS application is provided by the Surescripts, and Surescripts has been communicating this same information to doctors for years. They didn’t create the problem of skyrocketing prescription prices, but in all these years they haven’t yet solved it either.
The CVS/Surescripts program is focused on sticker-shock. The goal is to improve patient adherence. There’s nothing to indicate that the program might bring overall prescription healthcare costs down for self-funded employers. Scripta’s therapeutic alternatives address both health plan costs and the costs to patients.
The CVS e-prescription program doesn’t account for the coupons that pharmaceutical companies use to market their drugs. Coupons are Big Pharma’s way of negating key PBM plan design elements like step therapy and formulary tiers. Their coupon programs have actually served to drive the aggregate cost of medicines up, even as they shift the burden from the patient to plan sponsor.
CVS is principally a pharmacy, of course. It would be interesting to know how they developed their clinical database, since pharmacists think about medications differently than the doctors who prescribe them. Scripta’s Medication Mapping Database is sourced from a group of 60 doctors, including primary care doctors and specialists in every medical discipline.
Don’t forget that pricing varies from pharmacy to pharmacy—sometimes dramatically. Scripta ensures that patients know where to shop for the best price for a given medication, even if that is at Walmart or other CVS competitors.
Finally, there is value in any conversation between a doctor and his or her patient about medications, but whereas CVS provides access only to doctors and pharmacists with connected EHR systems, at Scripta, we have found that it’s best to arm both the doctor and the patient with cost and co-pay information.