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Our cost-effective model enhances value for payors and plan members alike

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We’re helping clients and patients manage costs in the treatment of chronic conditions while new formulary strategies tie reimbursements to effectiveness.

Chronic conditions account for 86 percent of health care spending in the United States. Our Transform CareTM programs help members manage these conditions effectively by drawing on the full range of CVS Health assets and identifying personalized improvement opportunities. Transform Diabetes CareTM has delivered nearly $3,000 in medical cost savings per enrolled diabetes patient since its launch just over a year ago. It also limits payors to single-digit price increases annually for anti-diabetic drugs. Among other innovations, our value-based contracting approaches maximize payor value by aligning a drug’s reimbursement to the actual health outcome it delivers. A drug’s value is determined by such factors as survival rates, quality of life, and the ability of patients to complete the course of therapy. CVS Health’s approach lessens the overall cost impact for payors and enables more favorable formulary placement for the most effective treatment options. Utilizing this strategy can help deliver the most cost-effective pricing per drug, per condition, and lower prices for all drugs within a category.

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More than

$13 billion

in aggregate client savings achieved from formulary strategies since 2012

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Up to

8%

in pharmacy spend savings through formulary strategies

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Up to

$2,800

PMPY* in potential savings for each 1% improvement in A1C levels through Transform Diabetes Care

* per member per year