Transcript Slide 1
Bipartisan Policy Center “The Leaders’ Project” April 24th, 2008 Washington DC Jonathan Roberts SVP & CIO E-Prescribing CVS Caremark $76+ billion in revenue ~ Fortune 20 #1 provider of prescriptions in the nation Over 1 billion filled or managed #1 in Store Count and #2 in Mail Order #1 Specialty Pharmacy #1 Retail Clinic Operator #1 Retail Loyalty Program #1 Retail Pharmacy Sales per Square Foot #1 or #2 in 75% of the top 100 markets in which we operate -2- e-Prescribing Unique industry positioning We have a large and unique presence in driving patient value through e-prescribing Physician software Retail pharmacy PBM Minute Clinic -3- Payor connectivity Pharmacy connectivity e-Prescribing ePrescribing solves many quality and operational challenges Challenges the community faces -4- How e-Prescribing addresses • Patient safety • • • • • Patient and payor costs • Generics • Formulary • Preferred • Patient health outcomes through Compliance & persistency • Proven C&P impact for several reasons - New data drives interventions - Cost and convenience drive C&P • Physician costs • Eases clinical administrative burden - Data capture - Time on phone - Ease of e-Refills • Patient convenience • Script gets head start to pharmacy • Emergency preparedness • Katrina example Script legibility Automated data entry Point-of-care interventions Reduced phone calls e-Prescribing While adoption is growing rapidly… E-Prescription Transactions 120,000,000 100,000,000 100,000,000 80,000,000 60,000,000 35,000,000 40,000,000 13,000,000 20,000,000 700,000 4,400,000 0 2004 2005 2006 2007 2008 Estimated Source: Pharmacy Health Information Exchange, operated by SureScripts (December 2007). -5- e-Prescribing … Other key indicators of e-Prescribing maturity tell a mixed story Pharmacy network and regulation are maturing . . . . . . but physician adoption is low -6- January 2004 July 2005 January 2008 1% 36% 95% 5 45 50 January 2004 July 2005 Have access to ERx software 1% 17%+ 29% Actively e-prescribing 0% 0.7% 6.1% Pharmacies Receiving ERx States that Allow ERx January 2008 e-Prescribing Is cost really a barrier to adoption? • Non-adopting Physicians cite cost as the top barrier • However, several top solutions are provided free to physicians e.g. iScribe, Prematics, NEPSI • In our experience, only a small percentage “take” the free tool Cost is a perceived barrier; reality less clear -7- e-Prescribing Other barriers to robust adoptions • Lack of incentives • Controlled substances • Workflow and training in the physician’s office • Confusion between EMR and standalone ePrescribing solutions -8- e-Prescribing PHRs could provide value-added services directly to patients that address gaps in care Many players interested in space, but no clear vision has emerged What does this mean? • Why be excited Multiple players playing in PHR space • Dedicated PHR Providers • Why be cautious • Stakeholder landscape • Technology Vendors • View on players • CVS Caremark role Pharmacy, PBM, and clinic data seen as key to driving adoption — due to availability, consolidation and value to patient -9- • Web Content Providers • Payers • Employers e-Prescribing What can be done in Washington to promote health IT? - 10 - • Create incentives for physicians to e-prescribe under Medicare • Eliminate the barrier to e-prescribe for controlled substances • Create grants and tax incentives to encourage broader adoption by assisting providers in purchasing of equipment • Ensure strong patient privacy by enforcing existing federal privacy laws (HIPAA) • Support private-public partnerships on standards, including security e-Prescribing More broadly, what can be done from a policy perspective to improve health care? - 11 - Patient Access to Care and Information Improving Quality and Lowering Costs • Patient access to catastrophic coverage • Create a pathway for generic biologics • Design benefits that lower drug costs for patients – E.g. Expanded drug discount card for the uninsured • Educate consumers about available generic drug substitutes – Publish data on the safety and efficacy of generics or low-cost brand alternatives • Coverage of preventative services • Promote medication therapy management (MTM) and disease management services • Comparative efficacy e-Prescribing