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Patient-reported outcomes help ensure drug efficacy

Self-reported information brings pharmacies closer to patients and providers to help optimize therapy


Christine Sawicki, Executive Director of Product Development & Innovation, CVS Specialty


The average price for a specialty drug is just over $84,000.1 With such high prices for specialty brand medications, everyone involved in the care journey — patients, providers, payors and specialty pharmacists — wants to ensure costly treatments are working.

Patient-Reported Outcome (PRO) data can help evaluate the impact, appropriateness and quality of treatment.2


The value of health outcomes directly reported by patients

PROs are an increasingly important part of CVS Health's Intelligent Medication Monitoring (IMM) program. We're capturing patients' perspectives on their treatment and quality of care throughout the duration of therapy, which conveys important information about their health status, ongoing progress and outcome sustainability. This is crucial for people on specialty therapy, as not all responses to a medication have a lab finding — such as mobility, level of pain, sleep or mood.


Example (Rheumatoid Arthritis): The presence of certain biomarkers in blood samples can indicate RA or active inflammation but it doesn't help with optimizing medication dosing. So even with effective therapy, a patient may suddenly report they're feeling worse RA symptoms after two months of oral medication. Molecular testing can help identify whether the medication is working, and dose adjustment can help keep the patient on an oral or injectable form of methotrexate.

Patient-reported symptoms can inform and improve treatment plans and symptoms can be managed and reduced with support from the care team.


Digital innovation to collect and analyze patient data

Enabled by patients' increasing adoption of digital tools, IMM monitors and supports patients where and when they need it to inform therapy management for better outcomes, improved experience and lower costs.

Using a combination of wearable technology and patient surveying,3 we have access to a wide range of meaningful patient data — from prescription fill history and activity levels to disease activity and symptoms — in the patient's voice. Combined with external data from EHRs and intelligent data analytics, we can personalize care and optimize interventions for high-risk and high-cost patients.

In fact, we're connected to more than 90 percent of our chronic and complex patients digitally and can engage them in health care decisions when they're thinking about their health. This digital engagement has been especially valuable during the COVID-19 pandemic because patients can stay connected with their Care Teams from the safety of home.

We're meeting patients where they are — monitoring adherence, response to therapy, symptoms, and putting it together to provide a simple, personalized snapshot of how patients are doing in real time.


Using PROs to improve pharmacy care

By helping us better understand how a therapy is working, feedback shared by patients can improve affordability and treatment efficacy. When appropriate, pharmacists connect with patients to deliver education, assess progress and work with prescribers to optimize dosing or change or stop a medication.


23% stopped therapy or changed to another medication

saving clients an average of $2,350 per intervention


Our pharmacists are trained in these specialty medications and know when patients are likely to see benefits — and that it may take weeks or months for a drug to work. So, we engage patients at key points in therapy to ask how patients are doing and make sure they're seeing the improvements that we would expect. If not, it presents an opportunity to talk with them about what steps need to be taken next.


A diagnosis that requires specialty medications is overwhelming for patients. It's important they know what to expect when it comes to their condition and treatments. Often, many people stick with ineffective therapy because they don't want to bother their doctor or they're unaware of other ways to improve or feel better. That's why we've designed tools to do check-ins at appropriate times to ensure patients are on the right track.


In this way, PROs give patients a voice in their care, and help them better understand their journey with specialty medication.


What's next for Patient-Reported Outcomes?

We're building upon patient-generated data to improve pharmacy care and empower patients in their health. Soon we'll be delivering even richer connections between patients, providers and pharmacy teams at moments that matter to better inform and improve treatment plans and identify the right next steps.4

The key to this is getting this data stream into the hands of prescribers in a meaningful way. And that's where we're going — bringing this information to physicians within their workflow. Being able to see patient trends over time, in an automated, on-demand fashion can give doctors more impactful data points to optimize therapy.


Knowing healthier happens together, CVS Health continues to harness the power of patient data and digital engagement to connect people to more moments of health.

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The source for data in this document is CVS Health Enterprise Analytics, unless otherwise noted.

All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.

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