Rising drug prices is one of today’s most discussed healthcare topics, and with good reason: double-digit price hikes for brand-name drugs are becoming more commonplace and can jeopardize access to medications and put financial strain on patients.

Pharmacy benefit managers (PBMs), like CVS/Caremark, provide a check on rising drug prices by using competition to negotiate discounts and promote the appropriate use of lower-cost, clinically equivalent medicines.

PBMs use various strategies for helping patients keep their out-of-pocket and premium costs low, while ensuring drug quality and safety. These are some examples:

  • Providing access to medications and pharmacist advice through network facilities—either retail or mail-order.
  • Identifying when lower cost, clinically equivalent medicines can be used instead of high-cost brandname drugs.
  • Maintenance medication programs, which give members access to 90-day supplies of maintenance medications at retail or through mail-order programs.
  • Using industry expertise to negotiate discounts with manufacturers, which are passed on to plan sponsors like the Trust and can be used to lower premiums or reduce cost-sharing for consumers.
  • Promoting medical adherence to make sure members are taking the drugs they need to control their conditions.
  • Developing innovative prescription savings programs, including providing discounts directly to patients on certain essential medications.

Our relationship with CVS/Caremark follows many of these best practices and we continue to work with CVS/Caremark to improve your benefits, reduce your costs and those of the Trust, and improve your health.