Who is CVS Caremark?

Retail Pharmacy MinuteClin ic Pharmacy Benefit Management

Generation Health

Mail Order Pharmacy

Specialty Pharmacy

Greater Convenience and Choice Improved Health Outcomes Lower Overall Health Costs
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2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Better Pharmacy Care Leads to Better Health Outcomes, and Lower Total Cost

Help doctors get the right medicine

The most advanced approach to clinical and cost management

Help patients make the right choice

Members achieve better health outcomes and help reduce cost

Both are needed to improve health and reduce total cost.

22356 2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Pharmacy Care Economic Model Incorporates Our Value of Adherence Study

Cited by : New York Times LA Times Chicago Tribune Hartford Courant Baltimore Sun Orlando Sentinel Drug Store News Chain Drug Review
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2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Value of Adherence Study Results

Health Care Cost Savings : Adherent vs . Non - Adherent ( $PMPY ): All Individuals
$60 1 DYSLIPIDEMIA $656 DIABETES $4 , 41 3 $42 9 HYPERTENSION $1 , 058 $8 , 881 CHF ADDED RX SPEND HEALTH CARE COST REDUCTION

$1 , 86 0

$4 , 337

Clients can feel confident that additional drug spend will result in lower health care costs.

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Thomson Reuters Collaboration Helps Us Understand the Impact on Work Life

Study

Uses large average sample size: 1M+ patients 3 years claims: 2005-2008 Controlled for individual adherence behaviors

Results
- Total health care costs - Health services utilization

Validates effect of medication adherence on

Estimates effect of medication adherence on

- Productivity--absenteeism and disability

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Better Adherence Leads to Much Lower Costs for Disability and Absenteeism

Adherence Increases Productivity and Reduces Associated Costs

DIFFERENCE

- $1 , 987

DIFFERENCE

- $1 , 499

DIFFERENCE

- $1 , 923

DIFFERENCE

- $2 , 491

NON - ADHERENT ADHERENT

$9 , 277

$8 , 750

$7 , 290

$7 , 488

DIABETES

HYPERTENSION

DYSLIPIDEMI A

ASTHMA/COPD

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

$6 , 320

$8 , 987

$6 , 827

$8 , 811

Our Pharmacy Care Economic Model Demonstrates Better Quality and Lower Cost

Coronary Artery Disease ( CAD ); 100K population # Members w/ CAD % Non-Adherent Adherence Savings PMPY % w/ Gap Gaps in Care Savings PMPY Productivity (Absenteeism / ST
Disability)

3 , 600 35 % $1 , 020 4% $600 $1 , 800

CAD Outcomes Avoided: 16 Heart Attacks, 5 Strokes, 7 Deaths Total Savings Opportunity: $2,505,600

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Our Pharmacy Care Economic Model Predicts Results for An Employer

Cost Avoidance Opportunity in 100K Member Population 13 CHRONIC DISEASES BETTER PHARMACY CARE

INCREASE ADHERENCE using low-cost therapies $26 . 9 Million

INCREASE GAP CLOSURE $2 . 4 Million

INCREASE PRODUCTIVITY $24 . 6 Million

$54M HEALTH CARE COST AVOIDED

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Our Approach to Care is Best at Leveraging the Most Influential Advisor: Retail Pharmacist

Relative Effect of Intervention Approaches

More Influential

2 - 3X
3.1

6.4

0.3
Paper or Video

1.3
RN or MD at Work Site

2.2
Family Member at Home

2.7

Pharmacis t Call

Nurse at Hospital

Pharmacist at Pharmacy

2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

Pharmacy Advisor
Clinical Intelligence
Identify all members with , or at risk of , sub - optimal care Prescriber Coordination Trusted Advisor on gaps in care Outreach via phone and face - to face 55 % members engaged Follow - up , Ongoing Monitoring , DM Referrals

Sustained Behavior Change

6-8%
Persistency

60 %

90 %

16
Days on Therapy ( 6 months )

Gap Closure at Phone Gap Closure at CVS

All results shown are improvement over control group

Multi-channel intervention closes gaps, improves adherence, and so lowers health care costs.
Source: CVS Caremark Diabetes pilot data, 2010. 2011 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.

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