Hyperinflation
Comprehensive surveillance to identify and address hyperinflated drugs
Some manufacturers artificially inflate the price of drugs when clinically equivalent and more cost-effective alternatives are readily available. These hyperinflated drugs are wasted spend for clients and their members because they offer no greater clinical efficacy or safety compared to lower-cost medications and raise overall costs for everyone.
CVS Health is taking a stand against unjustifiably high drug prices that impact our clients’ pharmacy spend and members’ out-of-pocket costs. On a quarterly basis, products with significant cost inflation are evaluated for continued inclusion on our formularies.*
$555.5M+ client savings in just 8 months1
These strategies help eliminate unnecessary spend while promoting appropriate drug utilization.
- Identify hyperinflated drugs and quickly remove them from the formulary
- Ongoing removals help ensure cost savings in real time
- Surveillance includes pharmacies dispensing large volumes of hyperinflated drugs
- Agile approach keeps clients ahead of rapidly changing market trends
93.2% drop in utilization of drugs that were price outliers2
Case study
Hyperinflation management in action
A state government wanted to decrease spend without member disruption. See what happened when the client turned to CVS Caremark’s hyperinflation management strategy.
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CVS Caremark.
Employer Case Study: Demonstrating the value of our cost-saving strategies.
Situation.
A government employer was reluctant to adopt cost-saving strategies, concerned about member disruption.
Upon learning about hyperinflation, the organization was inspired to take action.
The client took CVS Caremark's recommendation to identify targeted savings opportunities.
Solution.
CVS Caremark convened a Bad Actor Summit to identify hyperinflated drugs.
Our teams demonstrated needless client spend on hyperinflated drugs and potential savings from exclusions.
Caremark reports bad actor pharmacies and considers removing them from our network.
Results.
140 drugs excluded.
$80.7 million hyperinflation savings in two years.
$347 million total savings in three years.
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Contact your account team to discuss formulary options that complement your plan strategies.
Contact us
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1 CVS Health internal analysis, January - July 2023.
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2 CVS Health, 2023. Book of Business, Commercial Clients enrolled in managed template formularies: January 2023-July 2023. Hyperinflation Exclusions from 2020-2023. Baseline Rx calculated based on one month prior to exclusion month. Actual results may vary.
*not available for clients with custom formularies, Medicare or Medicaid plans