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. . . 2011 Caremark All rights reserved CVS Caremark proprietary and confidential information Not for distribution without written.permission from CVS Caremark

Who is CVS Caremark?

etailPharmacyharmacy BenefitManagementMinuteClinic

enerationHealth ail OrderPharmacy

Greater Convenience and ChoiceImproved Health OutcomesLower Overall Health Costs

pecialtyPharmacy


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Better Pharmacy Care Leads to Better Health Outcomes, and LowerTotal Cost

Both are needed to improve health and reduce total cost.

elp octorset theightmedicine

elp atientsake heightchoice

Members achievebetter health

outcomesand help reduce cost

The most advancedapproach to

clinical and cost management

22356


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Pharmacy Care Economic Model Incorporates Our Value ofAdherence Study

:ited by New York Times LA Times Chicago Tribune Hartford

Courant Baltimore Sun Orlando Sentinel Drug Store News Chain

Drug Review


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Value of Adherence Study Results

Clients can feel confident that additional drug spend will result inlower health care costs.

: . -ealth Care Cost Savings Adherent vs Non Adherent( ):PMPY All Individuals DDED RXSPEND EALTH CAREOSTREDUCTION,1 860DYSLIPIDEMIA

,4 413DIABETES

,8 881CHF

,4 337$601 $429

$656

HYPERTENSION

,1 058


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Thomson Reuters Collaboration Helps UsUnderstand the Impact on Work Life

Study : +Uses large average sample size 1M patients

: -3 years claims 2005 2008

Controlled for individual adherence behaviors

Results Validates effect of medication adherence on

- Total health care costs

- Health services utilization

Estimates effect of medication adherence on

- --Productivity absenteeism and disability


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Better Adherence Leads to Much Lower Costsfor Disability and Absenteeism

dherence Increases Productivity and Reduces AssociatedostsDIFFERENCE- ,1 987 DIFFERENCE- ,1 499 DIFFERENCE- ,1 923 DIFFERENCE- ,2 491

DIABETES HYPERTENSION DYSLIPIDEMIA

/ASTHMA COPD

ADHERENT-ON ADHERENT


7/10. . . 2011 Caremark All rights reserved CVS Caremark proprietary and confidential information Not for distribution without written

.permission from CVS Caremark

Our Pharmacy Care Economic Model Demonstrates Better Quality and Lower Cost

CAD Outcomes Avoided: 16 Heart Attacks, 5 Strokes,7 Deaths Total Savings Opportunity: $2,505,600

( );oronary Artery Disease CAD00K population

% -Non Adherent %5

Adherence Savings PMPY ,1 020% /w Gap %

Gaps in Care SavingsPMPY

$600

# /Members w CAD ,600

,1 800Productivity ( /Absenteeism ST)Disability




Our Pharmacy Care Economic Model PredictsResults for An Employer

3 CHRONIC DISEASES

$54M HEALTH CARECOST AVOIDED

ETTER PHARMACY CAREost Avoidance Opportunity in 100K Member Population

INCREASE GAPCLOSURE.2 4 Million

INCREASEPRODUCTIVITY.24 6 Million

INCREASE ADHERENCE-using low cost

therapies.26 9 Million




Our Approach to Care is Best at Leveraging theMost Influential Advisor: Retail Pharmacist

elative Effect of Intervention Approaches

Nurse atHospital

.1

Pharmacist Call

.7

FamilyMember

at Home

.2RN or MD

at Work Site

.3

-3X oreInfluential

.3Paper or

VideoPharmacist

atPharmacy

.4



.permission from CVS Caremark0

Pharmacy Advisor

Multi-channel intervention closes gaps, improvesadherence, and so lowers health care costs.

16

linical Intelligence, , -dentify all members with or at risk of sub optimal care

ustained Behavior Change- , ,ollow up Ongoing Monitoring DM Referrals

rescriber Coordinationn gaps in carerusted AdvisorOutreach - -ia phone and face toface%5 members engaged

- %8 %0ays on Therapy( )monthsap Closure at Phoneersistency

%0ap Closure at CVS

ll results shown are improvement overo nt ro l g ro up

: , .Source CVS Caremark Diabetes pilot data 2010

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