How CVS Health boosted specialty medication adherence with secure messaging, digital engagement

After a pilot showed a 30% increase in medication adherence among cancer patients, CVS Health rolled out customized secure messaging to most patients taking specialty drugs. (Getty/Serenethos)

For the last year, CVS Health has been slowly integrating new digital tools to improve medication adherence for patients with serious conditions like cancer, cystic fibrosis and multiple sclerosis.

Using its mobile app, secure messaging and analytics, the retail pharmacy chain directed its efforts towards patients on specialty medications. By incorporating information from medication trials, CVS sends users customized alerts about potential side effects that coincide with the timing outlined in the clinical studies.

For example, if a cancer medication typically causes diarrhea three weeks into the regimen, the app times the alert at the three-week mark, and offers immediate access to a live care provider to answer additional questions, either through the app or on a phone call.

Similarly, CVS schedules medication reminders and lab draws customized to each drug.

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The effort began in 2017 with a pilot that sent secure two-way messages to patients with chronic myeloid leukemia (CML) taking a specialty medication that requires 90% adherence in the first year of diagnosis. Although CVS was already using digital tools to provide refill reminders, it was clear patients on specialty drugs needed additional resources.  

“The current digital interaction wasn’t enough,” Surya Singh, M.D., vice president and chief medical officer of specialty pharmacy for CVS Health, told FierceHealthcare. “The idea was, let’s try and be much more nuanced about the drug-specific and patient-specific side effects, lab monitoring, and reminders.”

The initial results were promising. Nearly 70% of the 1,000 CML patients enrolled in the pilot achieved optimal medication adherence—generally defined as taking medication as prescribed more than 85% of the time. That represented a 30% increase over the control group, with an adherence rate of 53%.

Adherence is particularly important for CML patients who need to maintain a strict medication regimen during the first year to avoid a bone marrow transplant. Engaging consumers through the digital app captures patients that might interact intermittently with their physician but lack a regular point of contact.

“Their pharmacist and pharmacy are often their most frequent point of contact, especially patients on these intense and expensive treatments,” Singh said.

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Since then, CVS has expanded the program to include 14 other conditions that require specialty medications, representing the majority of patients within CVS Specialty. The campaign has a two-fold impact, offering a deeper level of engagement for patients that are already connected with caregivers and providing a new pathway for those that had minimal interactions with their care team.

Since expanding the pilot to other conditions, CVS has seen a 20% increase in optimal adherence among CVS Specialty patients participating in the program.

“It’s hard to dispute the fact that patients want to use these supercomputers in our pockets to interact with care providers when it’s convenient for them,” Singh said.

The digital tools likely won’t expand beyond patients on specialty medications for the time being, but Singh says the approach “definitely has applicability” for those with chronic conditions like heart disease.

And if CVS’s merger with Aetna is approved by federal regulators, the company will have an even larger data pool to experiment with to create more customized messages using a platform that is “flexible enough to take on a variety of data sets,” Singh said.

“Suffice to say it’s not just having digital channels but being clinically sophisticated about how you use it,” he said.