- CVS Health pharmacy benefits managers (PBMs) within CVS Caremark will now provide real-time, member-specific prescription benefit information and lower-cost therapeutic alternatives at the point of prescribing through Surescripts functionality.
The prescription benefit information and lower-cost therapeutic alternatives will be made available to prescribers and patients in an effort to reduce medication dispensing delays and improve patient health outcomes. The Surescripts-enabled tool is available to any provider using an EHR system with real-time benefits and electronic prior authorization.
“Patients often do not find out that the medication they were prescribed is not covered or has higher than expected out-of-pocket costs until they go to the pharmacy to pick up their prescription, which can result in patients not filling a prescription, non-adherence and, ultimately, higher downstream health care costs,” said CVS Health Executive Vice President and CMO Troyen A. Brennan, MD in a list serv.
“Making detailed, real-time benefit information available for our PBM members and their health care team, whether it’s the doctor or the pharmacist, can help streamline the patient experience and improve health outcomes while also lowering costs for both the patient and the payer,” he added.
Prescribers will be able to see benefit information for patients part of CVS Caremark integrated directly into their e-prescribing workflows. Prescribers will have access to the cost of the medication based on the individual patient’s coverage and the patient’s remaining deductible.
Additionally, prescribers will be able to review up to five therapeutic alternatives specific to the patient’s formulary coverage and choose the least costly option.
Prescribers will also be able to see requirements – including prior authorizations – to expedite the process of electronically submitting prior authorization requests. Additionally, pharmacists at all pharmacies in the CVS Caremark network will be able to see the same list of formulary therapeutic alternatives provided to the prescriber.
CVS pharmacists will be able to request a prescription change from the prescriber through a one-step process. Starting in early 2018, CVS pharmacists will also be able to see the out-of-pocket costs for CVS Caremark members to ensure patients can access the lowest cost medication available within their benefit.
Earlier this month, Surescripts unveiled the real-time prescription benefit tool as well as expanded prior authorization solutions. The tools integrate directly into physician EHR systems to streamline prescription decision-making.
Surescripts teamed up with Allscripts, Cerner, Epic, Aprima Medical Software, and GE Healthcare to bring the real-time prescription benefit tool to 53 percent of the country’s physician base. The tool leverages data from PBMs, CVS Health, and Express Scripts to deliver the patient-specific benefit and price information to providers in real-time.