Advocates, Clinicians Urge CVS Caremark to Reverse Dangerous Formulary Change
Effective January 1, national pharmacy benefit manger would eliminate coverage for medications that prevent stroke and cardiovascular events
WASHINGTON, Dec. 16, 2021 /PRNewswire/ -- The nonprofit Partnership to Advance Cardiovascular Health, along with allied organizations, sent a letter urging CVS Caremark to reverse its "dangerously disruptive" decision to remove all but one direct oral anticoagulant from its commercial pharmacy benefit plan. The move would force stable patients to switch medications, a practice known as non-medical switching, and increase their risk of stroke and death.
Direct oral anticoagulants treat blood clots, deep vein thrombosis and pulmonary embolism. The medications require careful, personalized management, and indiscriminate switching can cause severe side effects and lead patients to discontinue treatment altogether. Studies about the discontinuation of these drugs have shown that:
- Patients who abandon anticoagulant therapy have a risk of ischemic stroke that is two-three times higher than those who continue therapy
- For atrial fibrillation, patients are five times more likely to experience an ischemic stroke
- For pulmonary embolism patients, the risk of venous thromboembolism (the third most common cardiovascular disease in the United States) in the first year of discontinuation is 10%
This new formulary change will be dangerously disruptive for patients who rely upon a previously covered direct oral anticoagulant to manage their cardiovascular risk. Patients who are stable on a medication and are forced to switch medications by their insurance plan can suffer complications including disease progression and hospitalization.
Supported by 14 cardiovascular patient and provider organizations, the letter outlines the concerning changes to the formulary, how non-medical switching endangers patients and compounds existing disparities and how reversing this ill-advised decision will protect at-risk patients.
STATEMENT FROM DHARMESH PATEL, MD, STERN CARDIOVASCULAR CENTER, MEMPHIS TENNESSEE AND PRESIDENT, PARTNERSHIP TO ADVANCE CARDIOVASCULAR HEALTH:
"The removal of these critical therapies from CVS Caremark's formulary is putting lives at risk. It is reckless and irresponsible, especially because the decision is not based in science and evidence, but on budgets. Patients and their health care providers, not insurance companies, need to be trusted to determine what medication is best."
The Partnership to Advance Cardiovascular Health is a nonprofit cardiovascular stakeholder coalition of patient, provider and advocacy organizations dedicated to advancing public policies and practices that accelerate innovation and improve cardiovascular health for patients. As a platform for patients and providers, PACH advocates at the federal, state and health plan levels for reforms that increase access and personalized care for patients with cardiovascular and related conditions.
SOURCE Partnership to Advance Cardiovascular Health
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