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Rare and complex

Rare diseases, sometimes referred to as orphan diseases, likely affect only a small percentage of your health plan population. But these complex medical conditions can bring significant emotional and physical challenges for plan members, their families, and their caregivers. Specialized care and support can help to enhance the well-being of those affected by rare diseases.

While representing only 1 to 3 percent of the member population, members with rare and complex conditions incur costs 7 times greater than the average member. However, they still aren’t getting the support they need:

  • 3 in 5 members are being treated for multiple conditions
  • 2 in 5 take a specialty medication and may take multiple medications
  • 1 in 5 visit the emergency room each year.


Costs for members with rare and complex conditions are 7x higher


Through our condition-specific solutions, we can identify members with opportunities for better condition management and support to reduce spend and prevent cost escalation. CVS Caremark offers proactive, whole-person support for members with these rare and complex conditions:

  • Amyotrophic lateral sclerosis
  • Chronic kidney disease
  • Chronic inflammatory demyelinating polyneuropathy
  • Crohn’s disease
  • Cystic fibrosis
  • Epilepsy
  • Gaucher disease
  • Hemophilia
  • Hereditary angioedema
  • Human immunodeficiency virus
  • Multiple sclerosis
  • Myasthenia gravis
  • Myositis
  • Parkinson's disease
  • Pulmonary arterial hypertension
  • Rheumatoid arthritis
  • Scleroderma
  • Sickle cell disease
  • Systemic lupus erythematosus
  • Ulcerative colitis

These programs are delivered by more than 300 nurse clinicians with rare condition experience and expertise, overseen by a medical advisory board of more than 30 physicians.

We use our deep domain knowledge and rare disease understanding to design a disease-specific model that supports comprehensive care. Our powerful one-on-one connections help empower members to improve their health and manage their complex needs.


  • Decreases in ER visits
  • Decreases in hospitalizations
  • Reduces health care spend


  • Reduces A1C
  • Reduces pharmacy costs

Chronic Kidney Disease

  • Reduces unplanned start to dialysis
  • Increases planned dialysis starts

Our approach for rare conditions goes beyond drug therapy, counseling members on all facets of care. Our whole-person approach focuses on a range of challenges faced by members with complex conditions.


Featured solutions

Accordant and Accordant Flex

Nursing support for rare and complex conditions


High-quality infusion therapy services in a variety of settings

Centers of Excellence

Dedicated teams that focus on specific disease states

Learn more how the right managed network solution can provide savings for you