Busting 4 myths of disaggregation

When it comes to pharmacy benefit management, there's a lot of buzz around disaggregation. Disaggregation sounds great on paper. More vendors, more control –– right? But the truth is that breaking PBM services into separate parts often leads to more work and responsibility for you, and it leads to more confusion, gaps in care and frustration for your members.

Let's bust the first myth about disaggregation and show why integration is a better solution for your team and your members. Myth one: Integration isn't aligned to the customer's needs. Actually, integration is all about alignment. We connect the dots using data from pharmacy and medical claims to lab results to demographics and biometrics.

This is how we personalize care, close gaps and improve outcomes. The results? A 12% reduction in unnecessary emergency room visits. Up to 1.28% annual drug spend savings.

For example, if an employer has a drug spend of 1 million annually, integrating their medical and pharmacy benefits would save them $12,800. Disaggregated vendors may specialize in one area, but they don't see the whole picture. We combine data and clinical expertise to make it easy for members to get what they need. This leads to fewer ER visits, better adherence and lower drug spend.

With over 64,000 pharmacies in our network –– the largest in the industry –– clients choose the network and members choose where and how they get their meds. Through interventions and counseling, every pharmacist in every pharmacy in our network plays an important role in helping members close gaps in care. Disaggregated plans leave members wondering who to call when they have questions. We keep it simple, connected and focused on better outcomes.

Visit business.caremark.com to learn how integration drives savings and connects care.

When it comes to pharmacy benefit management, there's a lot of buzz around disaggregation. Disaggregation sounds great on paper. More vendors, more control –– right? But the truth is that breaking PBM services into separate parts often leads to more work and responsibility for you, and it leads to more confusion, gaps in care and frustration for your members.

Let's bust the second myth about disaggregation and show why integration is a better solution for your team and your members. Myth two: Vertically integrated PBMs are more incentivized to push pricey drugs than to find the safest, most affordable options. Not true. Our goal is better health, not more profits or fills.

Clinical experts guide our utilization management and formulary decisions, not pharmacy sales. We build clinical checks into every claim and formulary asking: Is it safe? Is it right for the condition? Is it cost effective without compromising care?

And because we see the full picture, we catch things that could fall through the cracks like adding supplies a member needs to stay on track. Disaggregated vendors only see their piece of the puzzle. Visit business.caremark.com to learn how integration drives savings and connects care.

When it comes to pharmacy benefit management, there's a lot of buzz around disaggregation. Disaggregation sounds great on paper. More vendors, more control –– right? But the truth is that breaking PBM services into separate parts often leads to more work and responsibility for you, and it leads to more confusion, gaps in care and frustration for your members.

Let's bust the third myth about disaggregation and show why integration is a better solution for your team and your members. Myth three: Disaggregation gives you best of breed in all areas. Disaggregated vendors may be good at one thing, but they can't see the whole picture. We can.

CVS Caremark already brings together best-in-class services, and integration makes them even stronger. By connecting medical, pharmacy claims and care data across our organization, we deliver tailored support that helps members better manage their conditions and keep symptoms in check. Our data connectivity powers smarter care and lower costs for you and your members. Programs like Transform Diabetes Care and CVS Weight Management help members manage conditions, reduce meds when appropriate and avoid complications.

We create customized interventions across five clinical impact areas to help improve outcomes. Programs like these really work, increasing adherence by 6.1% and reducing clients' GLP-1 spend by 42%. Disaggregated vendors only specialize in one area, but our in-house expertise is as wide and broad as our network. And our businesses are connected, so however a member chooses to interact with us –– online, at a retail store, or on the phone –– we can help them.

Visit business.caremark.com to learn how integration drives savings and connects care.

When it comes to pharmacy benefit management, there's a lot of buzz around disaggregation. Disaggregation sounds great on paper. More vendors, more control –– right? But the truth is that breaking PBM services into separate parts often leads to more work and responsibility for you, and it leads to more confusion, gaps in care and frustration for your members.

Let's bust the fourth myth about disaggregation and show why integration is a better solution for your team and your members. Myth four: Integrated PBMs are working for pharma, not for you, making money off rebates instead of prioritizing clients. That's a common misconception. We pass back over 99% of rebates to clients.

This helps lower overall costs. Plus, 90% of the drugs we dispense are generics, which typically don't have rebates, and PBMs operate on slim margins––around three to five percent –– which is far lower than pharmaceutical companies and other healthcare industries. Clients can choose how they want to handle rebates and pricing, giving them more transparency and control over their costs. They may choose a spread pricing model where PBMs bill payors a higher price than it reimburses the pharmacy.

Many think we profit off spread pricing, but the truth is the average spread is just 1.5% –– far, far lower than the average EBIT margins of the top six US pharmaceutical companies, which is 37%. We advocate for our clients and their members by negotiating directly with manufacturers, using our scale to secure the lowest possible prices. We've also created CVS Caremark TrueCost™, the industry's first acquisition based pricing model. True Cost is more transparent for clients, more predictable for members and more reliable for pharmacies.

Our goal isn't to profit on rebates. Instead, we're focused on driving real value through transparency, affordability and better outcomes. Visit business.caremark.com to learn how integration drives savings and connects care.