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      Transforming pharmacy benefits: How CVS Caremark delivers clinical innovation

      Briefing

      We’re shaping the future of pharmacy benefits

      At CVS Caremark, we’re a catalyst for change and are transforming what it means to be a pharmacy benefits manager (PBM) by connecting to health plans, pharmacies, providers and people. We leverage tech that’s smart, but not so smart it forgets the human on the other end of the phone or tablet. We use data and the reach of our network to deliver on what helps people, lowers costs and makes life easier.

      From leading the biosimilars movement to pioneering innovative benefit models, we’re paving the road forward to build the next chapter in pharmacy benefits — simpler, smarter and focused on better outcomes for every member. Here’s more of what sets us apart.

      We get members the right drug, at the right time, for the right reason

      That means we rely on highly specialized clinicians who develop and inform programs tailored to members’ needs and designed to strengthen engagement. It’s not just about better outcomes — it’s about building trust, one member at a time. Our strategies let you design your benefits the way that’s best for your members. We help you find the right option — solutions that reduce hospitalizations and improve outcomes while lowering total cost of care.

      One example is our clinical-led approach to combat diabetes. When our Transform Diabetes Care program found 73% of members had two or more gaps in care,1 clinical-led interventions improved A1C levels in 80% of uncontrolled members.2

       

      Clinical outcomes with CVS Caremark include better care, lower costs, expert guidance and proven solutions.

       

      We innovate to simplify

      Our easy-to-use app and member portal put members’ benefits, support and guidance all in one place, so no more hunting for answers, yelling at robots or waiting endlessly on hold. We automate the stuff that slows people down, so members can start therapies faster with a lot less frustration.

      CVS Caremark does more than support your business. We build a true strategic partnership. By aligning with your business objectives and benefit strategy, we help you design benefits that fit your unique member population. Our approach combines smart data and clinical insights with proactive analytics to uncover cost drivers, inform holistic care solutions and guide smarter benefit designs.

       

      CVS Caremark member experience includes easy app, smart benefits, real-time updates and reduced wait times.

       

      Bold enough to make big moves

      Our national network, including more than 25,000 independent pharmacies, means local, convenient access to medications. The numbers tell a powerful story: integrating our services leads to 44% lower spend. That’s roughly $91 saved per member per month.3 For a 10,000-employee company, that could be more than $10 million a year saved.4

      Our plan design options help lead to better health outcomes, lower costs and a smoother, more connected health care experience. Your members understand their benefits, and you gain a trusted partner that designs smarter plans and supports the health of your organization. 

       

      CVS Caremark delivers savings through large pharmacy network, 44% lower spend and $91 savings per member.

       

      At CVS Caremark, we’re committed to delivering integrated pharmacy benefits that drive better, smarter, healthier outcomes — for your business and the lives who rely on you.

      Want more from your PBM?

      Our mission is to make health care simpler one person, one family and one community at a time. Let’s build smarter benefits that lower costs and lift the member experience. 

      Contact us

      Related tags

      • 1 CVS Health Analytics, 2022. Data from Commercial group members using Transform Diabetes Care since 2021 January program expansion. 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. P1011260222

      • 2 CVS Health Analytics, 2022. Data from Commercial group members using Transform Diabetes Care since 2021 January program expansion. 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. P1011260222

      • 3 CVS Health Analytics, 2024. CVS Health Q4 2024 commercial cohort that have implemented Advanced Control Specialty Formulary (ACSF) (>95% of plan lives), Exclusive Specialty (>95% of plan lives), and Standard Specialty Guideline Management (SGM) (>95% of activity in standard criteria), January 2024-December 2024.  Savings consider prior authorization, formulary, and quantity limit outcomes with 0.5% pricing discount for Exclusive Specialty and full rebate yield attributed to ACSF. PrudentRx savings are actual outcomes for clients with adoption on or prior to Jan. 1, 2024, and > 70% members eligible and used as a proxy for clients that currently do not have adoption.  Total $ savings by program is for all commercial clients with adoption.  All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Savings projections are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client-specific modeling available upon request. P1018231025

      • 4 Example only based on average pharmacy savings, results may vary.