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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?


Click here to read more from Scripta about the CVS e-prescription program.

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Scripta™ is neither a pharmacy nor a doctor. The benefit service does not tell you what drug to take and does not participate in the drug selection process. Only your physician can determine the medications that are right for you. These alternative medications are options for less costly drugs that physicians may prescribe in place of the medications you are taking now. Scripta has reviewed your current medications only for the purpose of identifying potential cost savings for you to consider with your physician. Scripta has not analyzed the effectiveness or other therapeutic aspects of these medication alternatives. Accordingly, this report and any other forms of communication received from Scripta are not, nor should they be interpreted as, any form of treatment, drug regimen review, or provision of counseling or consultation by a prescriber, pharmacist or pharmacy. Do not stop taking your medication, change your medication, or start taking a new medication without being directed to do so by your physician and filling the prescription under the oversight of a licensed pharmacist. The alternatives set forth above may not be equivalent to your current medication, may interact adversely with your other medications, may not be indicated in light of your other conditions, may cause different or severe side effects, or may be less effective at treating your condition. Medication prices are approximate based on information provided by your pharmacy benefits manager, insurance plans, and/or employer, and may vary from pharmacy to pharmacy. Check with your insurance plan to obtain a full list of pharmacies where your prescriptions can be filled. All information herein is HIPAA protected, treated as highly confidential, and never shared with your employer.

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