As specialty pharmacy becomes an increasing focus for cost management, CVS has deployed a number of digital tools aimed at improving adherence and patient outcomes.
The results of its first pilot of remote monitoring for patients with chronic myeloid leukemia (CML) were released late last week. And so far, researchers say, they've found participants in the two-way secure texting program were 22% more likely to be optimally adherent to their medications.
CML patients must maintain 90% or better adherence to their medication regimens in the first year after diagnosis to significantly boost their chances at readmission. In the program, patients were offered education and coaching on their medication through secure messaging.
“What we’re able to do is engage with patients differently,” Prem Shah, executive vice president for specialty pharmacy and pharmacy benefit management (PBM) product innovation at CVS Health, told FierceHealthcare. “They can engage when they want to be engaged.”
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As a result of the pilot’s early successes after its 2016 launch, CVS has expanded the program to cover 29 other conditions that require specialty medications.
The specialty drug market has been a key concern for the healthcare industry of late, as several products are coming through the development pipeline with sky-high price tags. Zolgensma, the world’s most expensive drug, was approved by the Food and Drug Administration and garnered a $2 million price.
As the prices for these products claim, so too does specialty pharmacy’s share of healthcare spending. A recent study found that these products accounted for 40% of employer drug spending in 2018 despite accounting for less than 1% of prescriptions.
Dea Belazi, CEO of PBM AscellaHealth, said that the traditional cost containment strategies deployed by insurers—prior authorization, step therapy and others—work for this new frontier of drugs, but they must be adapted to the times.
He told FierceHealthcare that it’s like comparing the upkeep of a budget sedan to souped-up Tesla.
“It’s still got four wheels, but it’s completely different,” Belazi said.
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Shah said the patients in need of specialty drugs are increasingly tech-savvy—32% overall are digitally engaged. When looking specifically at patients who are using these drugs to manage chronic illnesses, instead of taking a one-time prescription, that number rises to 55%.
So it’s critical to start the process with a platform that offers individualization but is also easy to use when patients need it, he said. Using tech, PBMs like CVS can more effectively monitor the effectiveness of specialty products.
In addition, CVS announced in September that it would launch a pair of tech tools aimed at making it easier for patients to access specialty medications—one app is patient-facing, while the other targets providers. Shah said having the two applications together unites touch points to keep everyone in the loop.
“We create an ecosystem in which we can engage the providers and the patients in a way that’s connective,” he said.
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CVS’ specialty pharmacy team is also targeting wearables to improve adherence and outcomes, it said in a brief released Monday.
It launched a pilot using smartwatches with 27 patients with multiple sclerosis (MS), with 90% of the test patients using the watches actively over the course of a year. CVS found that 86% of participants regularly used the watches to report symptoms, and 75% took part in a walk test, which is a key way to monitor how well-managed an MS case is.
“It’s a really exciting time to be our industry,” Shah said. “We’re at the crossroads of tech playing a much bigger role.”