Early results from CVS e-prescribing effort show real-time data nudges prescribers toward cheaper drugs

CVS Pharmacy
A new effort by CVS to integrate drug coverage information into EHRs has prompted physicians to switch patients to lower-cost drugs. (Mike Mozart/CC BY 2.0)

Initial data from a push by CVS Health to integrate new e-prescribing tools at the point of care shows the ability for prescribers to access benefits information through an EHR prompted them to switch patients to a lower-cost drug.

Late last year, CVS launched an initiative through its pharmacy benefit manager, CVS Caremark, to build real-time pricing data into the e-prescribing workflow. Launched the beginning of the year, the new tools provided physicians with member-specific medication costs based on each patient’s coverage and allowed CVS pharmacists to see a list of clinically appropriate alternatives to medications, along with the associated out-of-pocket costs.

While it's still early, initial data released by CVS this week shows prescribers that accessed the real-time information switched to a drug covered under the patients plan 85% of the time. Prescribers using the tools switched patients to a lower cost alternative 30% of the time, saving an average of $75 for each prescription.

According to CVS, 90% of PBM plan members spent less than $300 in out-of-pocket costs in 2017, but the e-prescribing tools are an added effort to further reduce those costs. The retail giant says it has limited drug cost growth despite soaring inflation by utilizing low-cost generic drugs.

RELATED: CVS Health adds real-time, member-specific drug pricing into e-prescribing

“While this signals progress, for those patients that cost is not insignificant,” Troyen A. Brennan, M.D., executive vice president and chief medical officer at CVS Health said in a statement. “That is why we are committed to doing even more across our enterprise to help patients find and access the lowest cost drug at the pharmacy which ultimately will help improve clinical outcomes and remove higher downstream medical costs from the system.”

As CVS eyes a controversial deal with Aetna, it has touted efforts to bring down drug costs using analytics and digital tools. Last year, the company announced a partnership with six EHR vendors to build drug pricing into patient records.

RELATED: Aetna whistleblower accuses CVS of false claims, unsealed lawsuit reveals

At the same time, a recently unsealed lawsuit reveals accusations that CVS Caremark billed Medicare for more than it charged retail pharmacies and kept the difference, despite federal requirements for pharmacy benefit managers to report “pass-through” prices.

The complaint, filed in 2014, comes from Aetna’s head actuary, creating an awkward situation for a pair of companies in the midst of finalizing a $69 billion deal.