CVS Health will launch a new model for pharmacy reimbursements designed to bring greater transparency and simplicity to the system. CVS CostVantage, which the company plans to launch in 2025, will define the drug cost and related reimbursement with contracted pharmacy benefit managers (PBMs) and payors, using a transparent formula built on the cost of the drug, a set markup and a fee reflecting the care and value of pharmacy services.
The retailer also has introduced TrueCost, an innovation that offers client pricing reflecting the true net cost of prescription drugs, with visibility into administrative fees. Simplified pricing will help consumers have confidence that their pharmacy benefit is providing them with the best possible price. CVS plans to implement the program in 2025.
“We are leading with an approach that will shift how our retail pharmacy is compensated by implementing a more transparent and sustainable model that fairly aligns pharmacy reimbursement to the quality services we provide,” said Prem Shah, EVP, Chief Pharmacy Officer and President, Pharmacy and Consumer Wellness at CVS Health in a statement.
CVS competitor Walgreens recently introduced an Rx Savings Finder to provide consumers with easier access to discounted prescriptions. Many retailers, including Amazon and Best Buy, have embraced the “medtail” movement that seeks to combine retail’s reach with a range of medical services, including mental health care.
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Additionally, CVS has grouped its Health Services under the name of CVS Healthspire, which the retailer will begin to roll out this month and advance throughout 2024. Under the Healthspire umbrella, divisions including Caremark, Cardavis, Oak Street Health, Signify Health and MinuteClinic will continue to focus on integration across the company’s assets to deliver connected patient care, pharmacy benefits and innovative provider support solutions.
“Delivering care in a more integrated way — especially for complex patients with chronic health conditions — improves health outcomes and the patient experience,” said Mike Pykosz, CEO of Oak Street Health and interim president of Health Care Delivery in a statement. “We are already seeing the benefits of our value-based model to lower the total cost of care for customers, clients and patients, and we believe we will build on those results as we more fully integrate with our core businesses.”
