WOONSOCKET, R.I., April 14, 2011 /PRNewswire/ -- CVS Caremark Corporation (NYSE: CVS) today announced a new medical benefit drug management service for the company's pharmacy benefit management (PBM) and specialty pharmacy clients. The offering is the first of its kind to provide a comprehensive management solution for the buy-and-bill drug model currently used by physicians (whereby the physician purchases specialty medications, administers them to the patient and directly bills the payer). The payer-centric offering will employ both prospective and retrospective drug utilization management strategies to drugs billed under the medical benefit, while ensuring minimal disruption to the physician's workflow and facilitating the delivery of evidence-based care. CVS Caremark will work with New Century Health, a specialty care management company, to offer its clients integrated evidence-based medicine, treatment care pathways, quality improvement programs, and peer-to-peer review through an innovative web-based decision support platform. This offering will be broadly available to CVS Caremark customers for implementation beginning January 1, 2012.
Management of specialty drugs under the medical benefit poses a significant challenge to health plans and employers today. In fact, more than 50 percent of specialty drugs are billed under the medical benefit, many of which are administered in a physician's office. Payers are less able to identify and apply effective clinical and cost management strategies, similar to those applied to specialty drugs billed under the pharmacy benefit, due to current medical claims, processing limitations and limited visibility to its clinical applications. Through analysis of CVS Caremark data, it was found that among the company's PBM clients, cancer and associated supportive care specialty drugs -- such as hematopoietics for anemia and neutropenia -- account for approximately 53 percent of the total specialty drug spend billed to the medical benefit. As a result, CVS Caremark's new offering will initially focus on improving the quality, safety, and management of oncology drugs billed under the medical benefit. Estimated savings of up to 15 percent of a payer's oncology spend are expected.
"This offering will enable CVS Caremark to identify the unrecognized specialty pharmacy spend currently billed through the medical benefit for oncology patients," said Per Lofberg, President of CVS Caremark's pharmacy benefit management business. "By systematically tracking and analyzing this activity, we can provide our clients with an opportunity to better manage these expensive drugs while also improving the quality of care for their members."
About CVS Caremark
CVS Caremark is the largest pharmacy care provider in the United States with integrated offerings across the entire spectrum of pharmacy care. We are uniquely positioned to engage plan members in behaviors that improve their health and to lower overall health care costs for health plans, plan sponsors and their members. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics, and is a leading provider of Medicare Part D Prescription Drug Plans. As one of the country's largest pharmacy benefits managers (PBMs), we provide access to a network of approximately 65,000 pharmacies, including more than 7,100 CVS/pharmacy® stores that provide unparalleled service and capabilities. Our clinical offerings include our signature Pharmacy Advisor™ program as well as innovative generic step therapy and genetic benefit management programs that promote more cost effective and healthier behaviors and improve health care outcomes. General information about CVS Caremark is available through the Company's Web site at http://info.cvscaremark.com/.
About New Century Health
Headquartered in Brea, California with operations in Florida, Ohio, and Indiana, New Century Health delivers specialty care management solutions that leverage technology and evidence-based medicine at the point-of-care, with a focus on oncology and cardiology. Our services promote the most effective treatment, reduce variability, improve clinical outcomes, and optimize cost-effectiveness. Our vision is to lead the specialty care management industry by harnessing the knowledge, technology, and innovation that power a higher quality of care and life. The customers of New Century Health include both payers and providers working in all lines of business (including Medicare and Medicaid). New Century is a company of Water Street Healthcare Partners, a strategic private equity firm focused exclusively on health care. To learn more about New Century Health, visit www.NewCenturyHealth.com.