Innovations necessary to achieve better health outcomes

WHAT IT MEANS AND WHY IT'S IMPORTANT During the Academy of Managed Care Pharmacy 2010 Educational Conference held Oct. 13 to 15, CVS Caremark shared data to further demonstrate ways to curb drug costs. This is important because what these studies, and others like it, continue to illustrate is that there are a variety of ways to reduce prescription drug costs beyond simply cutting prices to levels that could compromise a pharmacy's ability to deliver the high-quality service necessary to achieve better health outcomes.

(THE NEWS: CVS Caremark highlights ways clients can save money, improve generic dispensing rates in three new studies. For the full story, click here)

As the article states, the company shared results from a handful of client experiences that demonstrate how by adapting such traditional plan design approaches as step therapy and 90-day prescription mail pricing, clients can reduce drug spend, improve generic dispensing rates and minimize member disruption. Judging by these scenarios, innovation and ingenuity are critical and not to be underestimated.

For example, rather than implementing a traditional plan design in which drugs in the class would be shifted to a higher tier or the member cost-share would be increased, the client opted to provide members with first-line access to generic options and a preferred brand, which was due to become available as a generic (lansoprazole) within six months of implementation. In addition, members received the CVS Caremark ExtraCare health card, a pharmacy discount card that provided them with a 20% discount on FSA-eligible store brands to help manage the costs of over-the-counter alternatives. Members and their prescribing physicians also received proactive communications about the new plan design three months prior to implementation. The result, as the article stated: a reduction in drug spend, an increase in generic dispensing rates and a decrease in potential member disruption.

This proved to be a win-win-win situation, and it didn't come at the expense of pharmacy and its ability to deliver high-quality service.

Developing innovative ways, and thinking outside of the box, to further improve health outcomes and curb costs only will become increasingly important as some 30 million Americans gain coverage under healthcare reform.