Recently, CVS Caremark, a health and wellness franchise, announced that they were eliminating co-pays for diabetes medications. Research showed that the average customer spent about $467 dollars per year, with some even paying as much as $1,000 in annual out-of-pocket costs. Customers with limited finances began to opt-out of purchasing their medications, which have adverse consequences..
Type 1 diabetes is an autoimmune disease that occurs when the pancreas cannot produce adequate amounts of insulin to keep blood sugar naturally under control. Failing to take medications initially causes mild-to-moderate symptoms, including anxiety, excessive sweating, and dizziness. Overtime, these symptoms progress into confusion, fatigue, and in severe cases, coma and even death.
CVS executives understand this risk and have created a program to minimize the amount of patients who can’t afford their medication. With RxZERO, workforce employees and people insured through health insurance firms associated with CVS have the opportunity to purchase their medications without additional costs. Program participants are required to purchase approved generic medications, saving an average of $170 per member. This lowers the amount of people unable to purchase their diabetes medication, causing the company to pay an estimated $2,000 in liability costs per employee. With RxZERO, the company saves around $1,2000 dollars per employee.
This plan was the best solution in comparison to previous coverage options. Prior to the implementation of RxZERO, CVS utilized higher co-payments and coinsurance costs with higher deductibles, making it difficult for lower-income employees. Even when there were available rebates, employers would reinvest that money into their healthcare plans to minimize copay and coverage costs. They also tried to balance out health plan costs by lowering the deductibles and increasing the premiums to accommodate their employees with chronic diseases, but it was not a cost-effective solution for healthy employees. Employers finally decided to increase the deductible and lower the premiums so employees with these illnesses would be responsible for those additional costs.
Because only five percent of people are diagnosed with type 1 diabetes, this condition is federally recognized as preventative. Not all diabetes medications qualify for this program, however, this program is also creating affordable solutions for employees with type 2 diabetes. Employees are also granted access to CVS Health’s five-step clinical support program that teaches diabetes management and preventative care.
CVS’s health care modifications are to include zero out-of-pocket costs for diabetic medication as well as alternative care to keep their healthcare participants healthy with more affordable overall costs. Be sure to research which RxZERO medications quality for these price reductions for better long-term savings.