Case study: Bringing transparent solutions and member affordability to life
The challenge
One of our big national health care clients wanted to lower pharmacy costs and gain more visibility to help themself and their members better manage their benefits. With our guidance, they decided to adopt three solutions to support their goals: Caremark Cost Saver*, point-of-sale (POS) rebates and CVS Caremark TrueCost®.
Cost Saver: Saving members money at the pharmacy counter
First, the client rolled out Cost Saver, a program that helps members save money on their non-specialty, non-rebate-eligible generic medications.
How it works
We compare members’ cost share with discounts from vendor partners. If a discount is available, Cost Saver automatically gives members the lower price at the point-of-sale.
The advantages
- Keeps members on benefit
- Helps them meet their deductibles and out-of-pocket maximums
- Supports better health outcomes through care management and adherence programs that promote their whole-body health
- Takes work off of the member (no need to shop around)
POS rebates: Even more savings for members
Next, the client implemented point-of-sale rebates.
How it works
POS rebates pass along up to 100 percent of rebate dollars to members based on what their plan offers and where they are in meeting their deductible.
The advantages
- Helps members pay less at the pharmacy
- Increases member satisfaction
- Improves medication adherence
- Leads to better health outcomes
TrueCost: Offering deeper transparency into what drugs really cost
But the client didn’t stop there. They wanted more transparency into what drugs actually cost. So, they became an early adopter of TrueCost.
How it works
The TrueCost pricing model removes cross-subsidization – where losses on brand-name drugs are offset by profits on generics – and makes sure pharmacies are paid appropriately.
The advantages
- Provides greater visibility with acquisition-cost based pricing guarantees to guide strategic decision-making
- Delivers financial predictability via drug-level, multi-year net cost guarantees across all drugs
- Strengthens the value of members’ pharmacy benefits by removing the incentive to shop around
Overall pharmacy benefit results
- 94% member satisfaction
- 10/10 client satisfaction
Cost Saver savings
- 40,000 members experienced lower costs
- 1/3 of members saved between $5-$50 per claim
The big picture
Reducing costs and providing transparency are top priorities for many clients. CVS Caremark’s Cost Saver program and POS rebates are great tools for managing expenses. And the TrueCost pricing model is more transparent for clients, more predictable for members and more financially viable for pharmacies.
To learn more about our transparency goals and the importance of transparency in pharmacy benefit management, read our latest report.
Interested in lowering pharmacy costs and understanding them better? Contact us today.
*Cost Saver may not operate at pharmacies in all states.
