Woonsocket, RI— While the challenge of non-adherence is far from news in our industry, CVS Health has nonetheless focused multiple work streams on quantifying, qualifying and reversing its impact on healthcare costs. Two years ago, the company published a study in the American Journal of Managed Care that revealed:
“Among those with 3 or more conditions, annual savings associated with becoming adherent were $5,341, $4,423, and $2,081 for patients with at least diabetes, hypertension, and high cholesterol, respectively.”
Additionally, the study found that falling into non-adherence had an equal but inverse impact on costs:
“The increased costs for patients in this group who became non-adherent were $4,653, $7,946, and $4,008, respectively.”
Ultimately, the researchers determined that preventing non-adherence is more cost-effective than establishing adherence in patients who are already off the wagon and a worthwhile investment for the company to make. According to Jonathan Roberts, EVP and COO of CVS Health, "Short-term changes in adherence can have a meaningful and immediate impact on health care costs."
Armed with these insights, CVS Health has gradually integrated more and more digital tools into its mobile app to drive adherence, and it has focused recent pilots on high-cost specialty products. Last year, the app combined secure messaging and analytics tools with insights gleaned from medication trials, product package inserts and other sources. The result is a substantial step beyond simple refill reminders—instead offering push notifications for better expectation setting and proactive behavioral nudges to drive proper dosing, prompt lab monitoring, and preempting discontinuation.
For example, if an oncology therapy frequently causes nausea two weeks into treatment, the app proactively offers support tools at the proper interval, giving access to a live care provider who can answer related question either directly through the app itself or via a phone call.
In a 2017 pilot for chronic myeloid leukemia (CML) patients, the results were strong. Almost 70 percent of the 1,000 patients who used the app achieved optimal adherence— that’s 30 percent higher than what they saw in the control group.
Surya Singh, M.D., VP and CMO of specialty pharmacy for CVS Health told FierceHealthcare that the pilot revealed that they realized “the current digital interaction [simple refill reminders] wasn’t enough…The idea was, let’s try and be much more nuanced about the drug-specific and patient-specific side effects, lab monitoring, and reminders…The pharmacist and pharmacy are often [a patient’s] most frequent point of contact, especially patients on these intense and expensive treatments.”
Why This Matters—
Digital adherence tools have been a hot topic in nearly all of the healthcare innovation workshops I’ve run over the past couple years. I’ve lost track of how many marketers have longed to crack the code on finding a high-impact yet cost-effective method to improve medication adherence. Driving patient adoption of a new tool or platform has consistently been a key obstacle for them. The good news? CVS’s approach may circumvent their challenge—according to 2018 data, the company already serves more than 5 million customers every day. Here’s my question for CVS—can pharma brands partner with the pharmacy giant to tap into its app that many of its customers already have on their mobile devices? Let’s all hope so.