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  • Scripta

Nice Try CVS, but We See You

May 31, 2018 –  What is the CVS e-prescription program? Is it a game changer for benefit advisers and their clients? Or is it just more of the same?

A year ago, CVS Health announced a new e-prescription program to help employees pay less for medications. The program provides doctors and pharmacists with real-time medication cost information, including lower cost alternatives. It’s a nice idea—Scripta’s program, which is similar, has been saving millions for clients for 10 years now—but when it comes to CVS, it is still a case of the fox guarding the hen house.

Back in April, Bruce Shutan provided a look inside the CVS program for Employee Benefit Adviser, and his article is no doubt worth your time. Benefit advisers should be aware of the CVS program. It’s probably better than nothing—and a step in the right direction. Just don’t expect it to “bend the cost curve” as cheer-leading CVS executives would have you believe.

The technology is interesting for sure. We know, because back in 2010 we deployed a similar program on behalf of a group of self-funded clients (each with a different PBM).

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, if one is available, while the patient is sitting right in front of them.

This might or might not reduce the cost to that patient’s employer, and the issue, of course, is that CVS Caremark is subsidiary of the pharmacy super-chain, and both companies answer to the same shareholders. Here’s our big question: when it comes to pharmacy benefits, if CVS Caremark is doing all it can to save money for its customers, why does it cover drugs that it knows have cheaper alternative therapies?


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