Pharmacy Network Offerings
We place a premium on convenience, and offer plan participants the option to get their medicines at one of our more than 55,000 participating retail pharmacies or through Caremark’s mail service operation for home delivery of maintenance medicines.

A Pioneer in Mail Service
Caremark is the first PBM to offer the convenience and savings of mail service pharmacy. Our fully integrated delivery model provides quick turnaround, free delivery, and competitive pricing.

We own and operate two state-of-the-art, primary mail service pharmacies in Pittsburgh, Pennsylvania and Largo, Florida. In addition, we own and operate a mail service specialty pharmacy in Pittsburgh, Pennsylvania, and operate specialty distribution pharmacies in Birmingham, Alabama; Kailua, Hawaii; Baltimore, Maryland; Arden Hills, Minnesota; Ronkonkoma, New York; and Columbia, South Carolina. Each of our mail service pharmacies uses state-of-the-art automation that ensures safety and accuracy in dispensing, reduces paperwork and customizes order forms and patient-education materials.

Comprehensive Specialty Services
With over 1.2 billion in sales, CVS Caremark Specialty Pharmacy Services is the nation’s largest, full-service provider of biotech and specialty pharmaceuticals, providing clinical services for a broad range of diseases, including Hemophilia, Infertility, Hepatitis C, Multiple Sclerosis, Growth Hormone Disorder, Rheumatoid Arthritis, Psoriasis, Respiratory Syncytial Virus, Immune Deficiencies and Oncology.

This program is designed to achieve a single source for injectable medications and manage their high costs through integrated cost controls, reporting and clinical support. Through a set of comprehensive disease-specific care management programs called ProtoCall™, we’ve incorporated the use of treatment guidelines, coordination of care, physician and patient education, outcomes measurement and reporting to optimize quality and manage overall treatment costs.

Our unique flexible access model enables patients to receive their medications via mail order or local access. Our mail facility, located in Pittsburgh, Pennsylvania employs Caremark’s largest staff of clinical pharmacists and dispenses the majority of our specialty prescriptions. For patients that prefer walk-in service, this convenience is available in most metropolitan areas.

Member Services
Since our goal is to exceed our customers’ expectations for providing timely and accurate responses to inquiries, we have developed state-of-the-art call centers in Texas and Pennsylvania. Participants are able to contact our customer service representatives through a toll-free number for specific information regarding their retail and mail service programs. In addition, pharmacists are available for immediate consultation 24 hours a day, 365 days a year.

Professional Account Management
Our approach to client management is designed to recognize the uniqueness of an individual client’s needs on an on-going basis. To address changing daily demands, provide prompt and effective account management, and achieve our strict Total Quality Management and guaranteed performance standards, we have developed key account service teams.

Management Reporting
PharmaView is a robust platform that serves as the hub of Caremark’s standard financial and statistical reporting capabilities. The technology also provides additional modeling and ad-hoc reporting capabilities.

Central to PharmaView is a flexible and easily updateable data warehouse where information can be added from either internal or external sources. All data is available for analysis and reporting. This capability ensures that report updates, modifications and enhancements can occur on a timely and cost effective basis.

DURNow™
At its core, DURNow™ is a proactive clinical intervention program using Drug Utilization Review. By analyzing a range of data and purchasing patterns for high-risk classes of drugs, DURNow™ is a proven strategy for reducing pharmacy costs.

The program alerts physicians, pharmacists, and patients when the potential for abuse or adverse events exists, or treatment enhancements and lower cost options are possible. Our proprietary analysis engines identify claims and patients needing attention, then our clinical staff communicates with the patient and health care professionals when appropriate. Our correspondence recommends alternatives and outlines actions to modify patient behavior and encourage good decisions.

Through this ongoing, coordinated monitoring and analysis, we educate patients on potential drug hazards, overuse and misuse, and build their awareness of pharmaceutical cost-drivers and opportunities for cost saving. The result: healthier, better-informed patients and overall pharmacy benefit savings.

We Are Patient-Centric Through and Through
To empower members to take a greater role in their health care and build their awareness of the factors driving health care costs and how they can help control them, CVS Caremark was the first PBM to develop a patient-centric approach. As a result, members are better equipped to make informed decisions that will improve their health and lower drug spending.

Among our initiatives to educate members are PatientALERT™ and GENesis™, which aim to promote generic utilization by alerting members about cost-effective equivalents; ScripCheck™, which reveals likely inappropriate use and advises patients of the plan’s responsibility to pay only for drug quantities consistent with proper use; QuickStart™, which increases cost-effective enrollment in mail service pharmacy; and ScriptSummary™, an explanation of benefits that reveals the cost of the pharmacy benefit borne by the plan sponsor, the patient’s contribution, and opportunities where cost savings were available but not achieved – a program proven to increase the perceived value plan members place on the prescription benefit and lower costs by encouraging judicious use of the benefit.

We also recruit physicians to help us educate members about potential savings. Our therapeutic substitution program educates physicians about the availability of lower cost formulary alternatives for their patients. The program is voluntary and members are notified that their prescribers have agreed to convert them to alternative medications. Our mail-service facility encourages formulary alternatives through outbound physician calls in an effort to transition members to lower cost formulary alternatives.

MyHealth Advocate™
MyHealth Advocate provides individualized disease management-style programs for each enrollee that consider the total health of the patient, rather than solely the treatment of one specific illness. High-risk patients are identified as potential candidates through a review of claims data. Our clinical pharmacists work directly with patients to develop a customized care plan that focuses on compliance, education, and drug therapy concerns. MyHealth Advocate includes personal consultations, customized care plans, health line support and results tracking.

ProtoCall™ Care Management Program
ProtoCall™ programs provide disease-specific, comprehensive care management for a broad range of conditions, including most of the conditions treated by specialty medications. ProtoCall™ programs offer all of the critical components of disease management including: establishment and utilization of treatment guidelines; coordination and education of physician and support providers; patient education and support; and outcomes measurement and reporting, including patient and physician satisfaction, clinical outcomes, and health care costs.

RxWatch™
RxWatch™ is a therapeutic safety program in which newly introduced drug therapies are recommended for a six-month coverage delay by a vote of the CVS Caremark Pharmacy and Therapeutics Committee before a drug’s market availability. The delay period is intended to assess a drug’s efficacy outside of clinical trials.