- CVS lowers 2023 earnings outlook on Oak Street, Signify deal costs (healthcaredive.com)CVS closes $10.6B Oak Street Health buy (healthcaredive.com)
CVS reported first quarter financial results premarket Wednesday fresh off closing some of its biggest acquisitions since its $70 billion megamerger with insurer Aetna in 2018...The retail health giant tied up its $10.6 billion acquisition of value-based medical group Oak Street Health...and completed its $7.8 billion acquisition of home care provider Signify Health in March. The acquisitions are meant to advance CVS’ value-based strategy in primary care and home health...READ MORE
- States Move to Ban Accumulators (drugtopics.com)The State of Employers’ Pharmacy Benefits: A Review of 2022 and the 2023 Outlook for Copay Programs (drugchannels.net)How Copay Accumulators and Maximizers Have Changed Payers’ View of Copay Support (drugchannels.net)
Sixteen states have banned a pharmacy benefit management practice that involves not counting the value of drug copay assistance from manufacturers toward patient deductibles...Drugmakers use copay assistance programs to shield patients from out-of-pocket expenses — and build market share for their products in the process. But pharmacy benefit managers have cried foul, saying the copay programs undercut formularies and wind up increasing the use of expensive drugs that are not any better than less expensive ones. They have pushed back with “copay adjustment programs,” especially “copay accumulators,” which are designed to blunt the effect of the copay assistance programs by not counting their value toward patient deductibles...READ MORE
- Amazon’s latest push into digital health: a virtual clinic for common conditions like allergies and hair loss (fiercehealthcare.com)
Amazon has rolled out a new virtual medical clinic that aims to treat common conditions like allergies, hair loss and skin conditions...The message-based virtual health service connects consumers with licensed clinicians who can diagnose, treat and prescribe medication for a range of common health and lifestyle conditions...Amazon Clinic partners with third-party telehealth providers including SteadyMD and HealthTap, powered by Wheel, to provide virtual consultation services. Consumers will see upfront pricing for care and an estimated response time. The service creates synergies with Amazon Pharmacy to fill and deliver any medications Amazon Clinic users are prescribed...Amazon Clinic will be cash pay and does not yet accept insurance...READ MORE
- EmpiRx touts savings from value-based approach to behavioral health therapy management (fiercehealthcare.com)
EmpiRx Health saw a significant increase in pharmacy claims for behavioral health therapies but found managing these treatments in a value-based approach can mitigate the costs...The pharmacy benefit manager saw claims for behavioral health treatments grow 9.4% between 2020 and 2021...Utilization of antidepressant medications grew by 12% year over year, and use of treatments for attention-deficit/hyperactivity disorder increased by 20.2%...However, per claim spend for antidepressants declined by 1.8% between 2020 and 2021, and per claim spend for ADHD drugs decreased by 9.1%...“We published this data to shed light on this mental health tsunami as well as to demonstrate the successful outcomes of a financially aligned healthcare model," EmpiRx CEO Karthik Ganesh said...READ MORE
- PBM Formulary Exclusions List Reaches All-Time High (drugtopics.com)
The number of drugs excluded from the three largest pharmacy benefit manager formularies reached an all-time high in 2023, despite concerns that profits are being put ahead of patient access. This year, CVS Caremark, Optum Rx and Express Scripts — which together handle 80% of all prescriptions in the United States — each have roughly 600 medications on their standard formulary exclusion lists...Exclusions leave patients with fewer options for treatment unless they can afford the out-of-pocket costs of buying drugs that are not covered by the insurer. What is even more disturbing are the trends within the trend of formulary exclusions, critics say,,,READ MORE
- 2023 forecast: Pharmacists push to take on a greater role in patient care (fiercehealthcare.com)New CVS Health report highlights need for expanded role of the retail pharmacist (cvshealth.com)
When people needed critical COVID-19 testing and, later, vaccinations, many visited their local pharmacy to secure those services...As the healthcare industry continues to grapple with labor shortages and staffing issues, experts argue pharmacists are an underutilized resource that could play a much greater role in patient care. Pharmacists have high levels of trust with patients, who visit their local pharmacy more frequently than they go to other sites of care; pharmacists see patients three or four times more often than primary care doctors...A survey from CVS Health and Morning Consult, released in October, found that 61% of people would like to get a broader range of services at their local pharmacy. It also found that 74% of people trust their local pharmacist and agree they should be able to step in when primary care is not available...READ MORE
- Walgreens will stop judging its pharmacy staffers by how fast they work (nbcnews.com)
As retail pharmacies have struggled with staffing shortages, pharmacy workers across the U.S. have been sounding the alarm about dangerous working conditions, pushed by quotas and other metrics...Walgreens will no longer evaluate its pharmacy staffers based on speed and other metrics amid complaints from pharmacists across the industry that pressure to meet targets like the number of filled prescriptions is leading to dangerous mistakes and staff burnout...Walgreens, the country’s second-largest pharmacy chain, announced...that it is eliminating “task-based metrics” from performance evaluations to allow its pharmacy staffers to “place even greater focus on patient care.” They will now be evaluated “solely on the behaviors that best support patient care and enhance the patient experience,”...READ MORE
- Walgreens won’t sell abortion pills in GOP states after legal threats from state officials (fiercehealthcare.com)
Walgreens will not dispense abortion pills in nearly two dozen states after legal threats from GOP lawmakers, the retail pharmacy chain confirmed...The Walgreens decision stems from a letter written by nearly two dozen Republican state attorneys general at the beginning of February that threatened legal action if the company began distributing mifepristone in their states...Walgreens...spokesperson saying “we are not distributing mifepristone at this time. We intend to be a certified pharmacy and will distribute mifepristone only in those jurisdictions where it is legal and operationally feasible.”...READ MORE
- Walgreens plots ‘aggressive’ strategy to build out healthcare services, CEO Roz Brewer says (fiercehealthcare.com)
On the heels of several high-profile acquisitions, Walgreens aims to be a point of entry for consumers for healthcare services ranging from urgent care to specialty care and even in-home health...Walgreen's VillageMD unit recently announced it was buying another urgent and primary care chain, Summit Health-CityMD, in a deal worth close to $9 billion. The VillageMD-Summit Health deal will expand Walgreen's reach into primary, specialty and urgent care. Combined, VillageMD and Summit Health will operate more than 680 provider locations in 26 markets...READ MORE
- CVS reports $3B loss to cover global opioid settlement but Q3 earnings beat Wall Street estimates (fiercehealthcare.com)
CVS reported a quarterly loss of more than $3 billion to cover its share of a global opioid settlement, but its third-quarter earnings blew past Wall Street estimates...The pharmacy retail giant said that it had a $5.2 billion charge in the third quarter for a settlement relating to its role in the opioid crisis. The settlement resolves "substantially all opioid lawsuits and claims filed by other states, political subdivisions and tribes against the company to be paid over 10 years, beginning in 2023...READ MORE