CVS Caremark and Aetna have signed a 12-year contract to provide pharmacy benefit management services to Aetna's 9.7 million customers and members, representing more than $9.5 billion in annual drug spending.
As part of the deal, Aetna will retain its PBM and manage clinical programs, protocols and oversight of its pharmacy benefits business.
"Through this strategic agreement, we retain our PBM and our ability to integrate medical care with clinical and pharmacy programs and actionable data," said Ronald A. Williams, Aetna's chairman and CEO. "We will add CVS Caremark's best-in-class clinical capabilities and broad market reach, enabling us to deliver better drug discounts and improved pricing and service to our customers."
Under the terms of the deal, CVS will apply its pharmacy care delivery model to the administration of Aetna's retail pharmacy network, while also providing customer and member service. CVS will also manage purchasing, inventory and prescription fulfillment for Aetna's mail-order and specialty pharmacy operations.
According to the two companies, the new PBM contract will include:
- Enhanced clinical capabilities that include integrated clinical programs focused on medication adherence intended to improve health outcomes while reducing overall expenses;
- Improved pricing and products via cost and quality management measures, and;
- Improved customer service through the use of technology to integrate pharmacy data into care management systems.
Aetna officials say working with CVS will allow the company to further leverage its HIT capabilities.
"This relationship enables us to capitalize on our health information technology capabilities so that we can communicate important clinical guidance to our members at the point of care," said Lonny Reisman, MD, Aetna's senior vice president and chief medical officer. "Under this agreement, members will be provided with customized information about drug safety, evidence-based protocols and relevant clinical programs at the point of service."
The deal should help solidify CVS as the PBM market-share leader. Research conducted by Atlantic Information Systems showed CVS owning a 15.36 percent share of total prescriptions filled in 2009, amounting to nearly 600 million prescriptions. Other PBMs close on its heels include Medco Health Solutions, with a 15.13 percent share, and Argus Health Systems, at 14.92 percent. In all, these three PBMs fulfilled more than 1.7 billion prescriptions last year.