RxInsights - cusd.com · Prescription Benefit Review ... Jul 2014 - Jun 2015 RxInsights ® This analysis is an estimate for information purposes only. These estimates do not represent

©2015 CVS Health and/or one of its affiliates: Confidential & Proprietary

Prescription Benefit Review

CLOVIS UNIFIED SCHOOL DISTRICT

Jul 2014 - Jun 2015

RxInsights®

This analysis is an estimate for information purposes only. These estimates do not represent an existing or future contractual guarantee provided by CVS/caremark. This information may be subject to change and does not represent any specific offer by CVS/caremark of return on investment in the future. All data sharing complies with applicable privacy laws and is in accordance with our PBM agreements. The Maintenance Choice program is available to self-funded employer clients that are subject to ERISA. Non-ERISA plans such as insured health plans, plans for city, state or government employees, and church plans need CVS/caremark Legal's approval prior to offering the Maintenance Choice program. Prices may vary between mail service and CVS/pharmacy due to dispensing factors, such as applicable local or use taxes.

1

3

5

10

15

20

>20

CVS Health: A Purpose-Driven Company Helping People on Their Path to Better Health

• Expertise in serving more than 2,000+

clients, 63M+ members

• Innovative formulary and network solutions, including health-focused network

• “Mail at Retail” flexibility

• Digital innovation lab

• Face-to-face counseling at

7,700+ stores

• Home delivery*

• 90-day pricing for payor and lower copays for members

• Extensive consumer knowledge

• Expanding services and reach,

including telemedicine

• 970+ locations

• Affiliated with 50+

major health systems

• Health and wellness support

CVS/PHARMACY®

73.3%

5

of your members are within

mile(s) of

CVS/pharmacy

CVS/MINUTECLINICTM

CVS/CAREMARKTM PBM

• Range of cost management solutions

• High-touch clinical support and broad therapy offering for the treatment of complex chronic or genetic conditions

• Nurse part of core team

• Improved drug access through CVS/pharmacy locations**

CVS/SPECIALTYTM

MEMBER PROVIDER

PAYOR


5

of your members

are within

mile(s) of

MinuteClinic

0.3%

* Where allowed by law **In-store pick up is not available in Arkansas, Oklahoma and West Virginia. Some states require first fill prescriptions to be transmitted directly to the dispensing

specialty pharmacy. Other restrictions may apply.

ClovisUSD, Jul 2014 to Jun 2015

Page 2 of 16

ELIGIBILITY JUL-JUN 14 % CHANGE JUL-JUN 15 PEER*

Average Eligible Members Per Month 11,251 3.5% 11,641

Avg. Monthly Utilizers as % of Members 30.7% 1.7% 31.2% 32.8% 34.8%

Average Member Age 37 1.1% 38 37 38

COST

Total Gross Cost $15,040,843 11.6% $16,790,971

Total Net Cost $13,525,241 12.7% $15,244,202

Gross Cost PMPY $1,337 7.9% $1,442 $1,219 $1,387

Net Cost PMPY $1,202 8.9% $1,310 $1,060 $1,261

Member Cost Share 10.1% -8.6% 9.2% 13.0% 9.1%

DRUG MIX

% Single Source Brands 19.7% -10.3% 17.7% 16.2% 17.8%

% Multi Source Brands 1.5% -0.7% 1.5% 1.6% 1.5%

Generic Dispensing Rate 78.8% 2.6% 80.9% 82.3% 80.7%

Generic Substitution Rate 98.2% 0.1% 98.2% 98.1% 98.1%

UTILIZATION

Total Prescriptions 87,888 5.9% 93,095

% Retail Prescriptions 54.2% 1.8% 55.2% 78.1% 72.3%

% Mail Prescriptions 6.9% -10.9% 6.1% 21.9%** 27.7%**

Days' Supply PMPY 405.92 1.1% 410.30 389.74 421.12

SPECIALTY

Specialty Total Net Cost $2,802,652 34.8% $3,777,864

Specialty Utilizers as % of Members 1.2% 9.1% 1.4%

Specialty Net Cost PMPY $249 30.3% $325 $355 $397

Specialty % of Total Net Cost 20.7% 19.6% 24.8% 33.5% 31.5%

Specialty % of Total Prescriptions 0.8% 15.0% 0.9% 0.9% 0.9%

% Specialty Member Cost Share 0.9% -12.7% 0.7% 2.8% 1.0%

EMPLOYER

BOB

8.9%

12.8% 12.1%

TOTAL NET TREND

PEER* NET TREND

EMPLOYER NET TREND

Key Metrics at a Glance

** Includes Maintenance Choice® Claims

30.3%

3.4%

SPECIALTY TREND NON-SPECIALTY TREND

YOUR SPECIALTY VS. NON-SPECIALTY TREND

BOB Trend information is based on trend data ending YTD Mar 31, 2015

SNAPSHOT

* Peer: School Systems


YOUR NET TREND


Page 3 of 16

0% 1% 2%

19%

55%

21%

2%

< 66% 66% - 70% 71% - 75% 76% - 80% 81% - 85% 86% - 90% > 90%

PERCENT OF CLIENTS

GDR RANGE

GENERIC AND BRAND PERFORMANCE

Reduce Unnecessary Pharmacy Cost: GDR Distribution


CVS/CAREMARK BOB GDR DISTRIBUTION

MULTI SOURCE BRAND

DISPENSING RATE

SINGLE SOURCE BRAND

DISPENSING RATE

80.9% 80.7%

82.3%

GENERIC DISPENSING RATE

CLOVISUSD PEER* EMPLOYER BOB

PERCENT OF CLAIMS

17.7% 17.8%

16.2%


PERCENT OF CLAIMS

1.5%

1.5%

1.6%


PERCENT OF CLAIMS


PROJECTED SAVINGS FROM JUL 2015 - JUN 2016 GENERIC LAUNCHES

RANK DRUG NAME UTILIZERSTOTAL

RXSJUL-JUN 16 JUL-JUN 17 JUL-JUN 18 TOTAL

1 CRESTOR 22 65 $9,152 $140,787 $204,645 $354,584

2 GLEEVEC 1 3 $18,619 $120,870 $140,681 $280,170

3 NASONEX 76 139 $26,757 $50,770 $58,568 $136,096

4 WELCHOL 21 52 $25,354 $47,921 $55,282 $128,556

5 GLUMETZA 2 6 $5,967 $43,878 $53,372 $103,217

All Other 121 297 $86,659 $210,576 $249,410 $546,645

243 562 $172,509 $614,803 $761,957 $1,549,269

PROJECTED SAVINGS FROM JUL 2016 - JUN 2017 GENERIC LAUNCHES

RANK DRUG NAME UTILIZERSTOTAL

RXSJUL-JUN 17 JUL-JUN 18 TOTAL

1 ZETIA 54 151 $32,588 $142,471 $175,059

2 AXIRON 14 38 $9,530 $82,829 $92,360

3 BENICAR 22 74 $15,013 $49,534 $64,547

4 AZILECT 4 13 $5,652 $41,770 $47,423

5 NUVIGIL 8 41 $16,850 $28,096 $44,946

All Other 231 320 $56,381 $191,753 $248,133

333 637 $136,014 $536,453 $672,468

TOTAL

TOTAL

Projected Savings from New Generics

GENERIC OUTLOOK

CVS/caremark can help you maximize generic utilization with formulary and clinical management strategies including step therapy and DAW** designs.

INSIGHTS

*Impact of future generic launches has been calculated by drug strength and rolled up by drug name. GDR impact and savings are reported under brand name and launch date of the first available generic within each drug name.

** DAW may not apply to all client types.

This page contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS/caremark.

Significant Pending Patent Expirations:

Compiled using Generic Prospective Pipeline Analysis Summary, December 5, 2014. Information related to prospective drug launches is subject to change without notice due to market events and other factors.

BRAND (GENERIC)

Abilify (aripiprazole)

Copaxone (glatiramer)

Crestor (rosuvastatin)

Gleevec (imatinib)

Namenda (memantine)

Nexium (esomeprazole)

Seroquel XR (quetiapine)

Zetia (ezetimibe)

PRIMARY USE

schizophrenia

multiple sclerosis

high cholesterol

cancer

Alzheimer’s disease

gastric reflux

schizophrenia

high cholesterol



Page 5 of 16

Trend Analysis by Net CostCOST

UTILIZATION

DRUG MIX/

INFLATION

THERAPEUTIC CLASS GDR

TOTAL

RX NET COST UTILIZERS

NET

COST

(PMPM)

NET

PMPM

DAYS'

SUPPLY

PMPM

NET COST

PER DAY UTILIZERS

DAYS' SUPPLY/

UTILIZER

5 5 1 Dermatologicals 70.2% 4,442 $1,247,288 1,975 $8.93 45.9% 6.3% 37.3% -5.0% 11.8%

1 3 2 Antidiabetics 59.2% 2,892 $1,223,226 578 $8.76 24.2% 6.8% 16.2% -0.4% 7.3%

6 1 3 Antihyperlipidemics 86.5% 6,168 $1,165,223 1,643 $8.34 1.2% 0.4% 0.8% -2.2% 2.7%

2 4 4Analgesics - Anti-

Inflammatory86.2% 2,528 $1,002,037 1,230 $7.17 7.3% 3.7% 3.5% 4.8% -1.1%

7 6 5Antiasthmatic And

Bronchodilator Agents22.4% 3,741 $864,137 1,499 $6.19 3.6% 2.9% 0.7% 2.5% 0.4%

4 7 6Psychotherapeutic And

Neurological Agents - 30.0% 317 $861,094 83 $6.16 23.0% -1.9% 25.4% -14.7% 14.9%

8 8 7 Antineoplastics 90.1% 517 $639,073 122 $4.57 12.4% 10.6% 1.6% 7.2% 3.1%

11 9 8 Ulcer Drugs 88.8% 3,390 $507,271 1,137 $3.63 -5.7% -0.4% -5.3% 1.6% -1.9%

9 12 9Adhd/Anti-

Narcolepsy/Anti-65.9% 2,317 $491,899 476 $3.52 11.7% 10.2% 1.4% -6.7% 18.1%

3 20 10 Antivirals 79.9% 1,122 $484,172 686 $3.47 129.6% 0.5% 128.4% 13.3% -11.3%

69.9% 27,434 $8,485,418 $60.74 17.6% 2.8% 22.5%

85.4% 65,661 $6,758,784 $48.38 0.0% 0.3% -0.3%

TOTAL 80.9% 93,095 $15,244,202 8,470 $109.13 9.1% 1.1% 7.9% -1.6% 6.3%

55.7%

COST COMPONENTS

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TOP 10 THERAPEUTIC CLASSES AS A PERCENT OF NET COST

UTILIZATION COMPONENTS

DENSITY OF USE

ALL OTHER CATEGORIES

SUBTOTAL OF TOP 10

Your Top 10 Therapeutic Class Review

* Employer BOB information is based on the most recent year ending Jun 30, 2015.

PERCENTAGE CHANGE OVER TIME



Page 6 of 16

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DRUG NAME

DISPENSE

TYPE THERAPEUTIC CLASS

GENERIC

LAUNCH

DATE**

NET

COST

TOTAL

RX UTILIZERS

NET COST

PER RX

NET COST

PER DAYS'

SUPPLY

AWP

INFLATION

18 9 1 Revlimid Specialty Assorted Classes NA $293,016 36 6 $8,139.33 $316.77 9.4%

26 4 2 Atorvastatin CalciumGeneric Antihyperlipidemics NA $277,730 2,791 896 $99.51 $1.15 0.8%

2 NA 3 Harvoni Specialty Antivirals NA $259,854 8 2 $32,481.80 $1,160.06 NA

11 3 4 Advair Diskus Brand Antiasthmatic And Bronchodilator AgentsNA $254,954 434 217 $587.45 $8.51 6.9%

9 10 5 Tecfidera Specialty Psychotherapeutic And Neurological Agents - Misc.NA $244,905 38 4 $6,444.88 $177.47 8.8%

6 5 6 Abilify Brand Antipsychotics/Antimanic Agents NA $241,664 123 44 $1,964.75 $27.50 15.2%

3 2 7 Enbrel Sureclick Specialty Analgesics - Anti-Inflammatory NA $237,214 48 10 $4,941.97 $105.90 17.8%

NA 1 8 Multi-Ingredient CompoundsBrand Multi-Ingredient Compounds NA $203,501 310 127 $656.45 $25.77 NA

139 74 9 Absorica Brand Dermatologicals NA $181,419 154 38 $1,178.04 $39.27 3.3%

4 8 10 Crestor Brand Antihyperlipidemics Q2-2016 $172,415 386 130 $446.67 $5.16 12.0%

13 13 11 Januvia Brand Antidiabetics NA $169,113 210 61 $805.30 $8.98 16.8%

232 24 12 Doryx Brand Tetracyclines NA $167,815 198 76 $847.55 $27.91 21.2%

1 23 13 Humira Pen Specialty Analgesics - Anti-Inflammatory NA $157,826 42 8 $3,757.77 $106.93 21.8%

684 52 14 Apokyn Specialty Antiparkinson Agents NA $153,890 2 1 $76,945.00 $854.94 NA

63 17 15 Solodyn Brand Tetracyclines NA $148,640 144 42 $1,032.22 $32.17 10.7%

14 22 16 Victoza Brand Antidiabetics NA $147,427 110 40 $1,340.25 $15.90 17.4%

17 11 17 Enbrel Specialty Analgesics - Anti-Inflammatory NA $146,962 25 6 $5,878.50 $128.02 17.7%

130 15 18 Omeprazole Generic Ulcer Drugs NA $144,349 1,399 531 $103.18 $1.30 2.1%

20 21 19 Novolog Brand Antidiabetics NA $128,243 98 39 $1,308.60 $15.01 22.0%

16 19 20 Novolog Flexpen Brand Antidiabetics NA $128,017 115 47 $1,113.19 $13.74 20.6%

134 6 21 Betaseron Specialty Psychotherapeutic And Neurological Agents - Misc.NA $126,790 8 2 $15,848.72 $182.17 13.8%

22 16 22 Gleevec Specialty Antineoplastics And Adjunctive TherapiesQ1-2016 $124,184 6 2 $20,697.30 $240.67 20.0%

28 31 23 Norditropin FlexproSpecialty Endocrine And Metabolic Agents - Misc.NA $123,475 17 2 $7,263.22 $248.44 35.7%

30 27 24 Zetia Brand Antihyperlipidemics Q4-2016 $120,760 249 89 $484.98 $5.47 19.5%

114 20 25 Niacin Er Generic Antihyperlipidemics NA $120,745 213 73 $566.88 $6.29 6.3%

$4,474,909 7,164 1,920 $624.64 $8.20

$10,769,294 85,931 8,391 $125.32 $2.55

$15,244,202 93,095 8,470 $163.75 $3.19

SUBTOTAL OF TOP 25 DRUGS

ALL OTHERS

TOTAL

BY NET COST

Your Top 25 Drugs

This page contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers that are not affiliated with CVS/caremark.


Specialty drugs are those drugs filled through specialty pharmacy. ** Generic launch date is based on numerous market factors and is an estimation. "NA" means that no estimate launch date is available at the time of this report.



Page 7 of 16

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PR

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CU

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EN

T

RA

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DRUG NAME

DISPENSE

TYPE THERAPEUTIC CLASS

TOTAL NET

COST

% TOTAL

DAYS'

SUPPLY

TOTAL

RXS

TOTAL

UTILIZERS

NET

COST

PER RX

NET COST

PER DAYS'

SUPPLY

AWP

INFLATION

1 1 1 Atorvastatin Calcium Generic Antihyperlipidemics $277,730 5.1% 2,791 896 $99.51 $1.15 0.8%

6 2 2 Levothyroxine SodiumGeneric Thyroid Agents $1,033 3.1% 1,751 521 $0.59 $0.01 11.0%

5 4 3 Omeprazole Generic Ulcer Drugs $144,349 2.3% 1,399 531 $103.18 $1.30 2.1%

2 3 4 Lisinopril Generic Antihypertensives $10,758 2.3% 1,323 430 $8.13 $0.10 1.3%

10 5 5 Metoprolol Succinate ErGeneric Beta Blockers $16,898 2.0% 1,132 345 $14.93 $0.17 0.9%

3 6 6 Simvastatin Generic Antihyperlipidemics $76,721 1.7% 912 294 $84.12 $0.95 0.5%

8 7 7 Synthroid Brand Thyroid Agents $18,346 1.6% 885 245 $20.73 $0.24 16.8%

4 8 8 Amlodipine Besylate Generic Calcium Channel Blockers $23,138 1.5% 836 263 $27.68 $0.32 0.6%

12 11 9 Losartan Potassium Generic Antihypertensives $36,367 1.5% 836 267 $43.50 $0.51 0.9%

14 13 10 Fluticasone PropionateGeneric Nasal Agents - Systemic And Topical$40,345 1.4% 1,547 847 $26.08 $0.59 -0.6%

7 12 11 Metformin Hcl Generic Antidiabetics $21,234 1.4% 787 252 $26.98 $0.32 -0.1%

15 9 12 Escitalopram OxalateGeneric Antidepressants $70,679 1.4% 884 288 $79.95 $1.08 0.6%

11 10 13 Sertraline Hcl Generic Antidepressants $40,790 1.4% 854 275 $47.76 $0.63 -0.1%

24 14 14 Zolpidem Tartrate Generic Hypnotics/Sedatives/Sleep Disorder Agents$56,750 1.0% 982 246 $57.79 $1.24 -1.4%

9 16 15 Hydrochlorothiazide Generic Diuretics $110 0.9% 545 185 $0.20 $0.00 3.8%

26 15 16 Hydrocodone/AcetaminophenGeneric Analgesics - Opioid $44,654 0.9% 2,801 1,207 $15.94 $1.01 30.9%

33 17 17 Amos Levothyroxine SodiumGeneric Thyroid Agents $369 0.9% 490 170 $0.75 $0.01 10.9%

31 26 18 Proair Hfa Brand Antiasthmatic And Bronchodilator Agents$52,937 0.9% 1,403 1,055 $37.73 $1.29 5.6%

13 42 19 Montelukast Sodium Generic Antiasthmatic And Bronchodilator Agents$49,135 0.9% 536 231 $91.67 $1.21 -0.1%

17 18 20 Pantoprazole SodiumGeneric Ulcer Drugs $39,210 0.8% 517 197 $75.84 $0.97 1.7%

32 21 21 Bupropion Hcl Xl Generic Antidepressants $48,276 0.8% 489 155 $98.72 $1.27 -3.6%

34 30 22 Losartan Potassium/HydrocGeneric Antihypertensives $25,610 0.8% 429 129 $59.70 $0.67 -0.6%

35 24 23 Tamsulosin Hcl Generic Genitourinary Agents - Miscellaneous$38,009 0.8% 443 155 $85.80 $1.06 0.0%

22 19 24 Atenolol Generic Beta Blockers $2,498 0.7% 408 114 $6.12 $0.07 -3.1%

16 25 25 Pravastatin Sodium Generic Antihyperlipidemics $29,550 0.7% 409 134 $72.25 $0.85 -3.2%

$1,165,497 36.83% 25,389 4,842 $45.91 $0.66

$14,078,705 63.17% 67,706 8,127 $207.94 $4.67

$15,244,202 93,095 8,470 $163.75 $0.01

SUBTOTAL OF TOP 25 DRUGS

ALL OTHERS

TOTAL

©2008 Caremark. All rights reserved.

Your Top 25 Drugs


Specialty drugs are those drugs filled through specialty pharmacy.

This page contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers that are not affiliated with

BY DAYS' SUPPLY



Page 8 of 16

ww

Managing Specialty Pharmacy


Page 9 of 16

JUL-JUN 14 % CHANGE JUL-JUN 15 JUL-JUN 15 JUL-JUN 15

Specialty Prescriptions 670 21.8% 816 EMPLOYER BOB PEER*

% of Specialty Total Prescriptions 0.8% 15.0% 0.9% 0.9% 0.9%

% CVS Caremark Specialty Pharmacy

Prescriptions60.9% -9.4% 55.1%

Specialty Utilizers 140 12.9% 158

Specialty Utilizers as % of Utilizers 1.6% 14.7% 1.9%

Average Age Per Specialty Utilizer 52.4 0.8% 52.8

JUL-JUN 14 % CHANGE JUL-JUN 15 JUL-JUN 15 JUL-JUN 15

Specialty Gross Cost $2,826,866 34.6% $3,806,343 EMPLOYER BOB PEER*

Specialty % of Total Gross Cost 18.8% 20.6% 22.7% 30.0% 28.9%

Specialty Net Cost $2,802,652 34.8% $3,777,864

Specialty % of Total Net Cost 20.7% 19.6% 24.8% 33.5% 31.5%

Specialty Member Cost $24,214 17.6% $28,479

% Specialty Member Cost Share 0.9% -12.7% 0.7% 2.8% 1.0%

Gross Cost Per Specialty Utilizer $20,192 19.3% $24,091

Specialty Utilizers as % of Members 1.2% 9.1% 1.4%

Specialty Pharmacy Trend, Cost and Utilization Metrics

Use Multiple Strategies to Manage Specialty Spend in the Pharmacy Benefit:

•Help control PRICE with Exclusive Pharmacy Network**

•Help manage UTILIZATION with Specialty Guideline Management

•Help control MIX with Preferred Drug Formulary Strategy

UTILIZATION

SPECIALTY NET TREND

PRICE INFLATION

DRUG MIX

3.8%

11.6%

12.4%

30.1%

YOUR SPECIALTY UTILIZATION METRICS

YOUR SPECIALTY COST METRICS



30.3%

** Subject to state law restrictions.


Page 10 of 16

BO

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SPECIALTY CLASS NET COST*

% OF

SPECIALTY

NET COST

NET COST

PMPM UTILIZERS

% CHANGE

IN

UTILIZERS

NET COST

PER

UTILIZER TOTAL RXS

PRIOR YEAR %

RXS CVS/

SPECIALTY

% RXS CVS/

SPECIALTY

1 1 1 Rheumatoid Arthritis $870,192 23.0% $6.23 32 -13.5% $27,193 196 71.9% 77.0%

4 2 2 Oncology $850,639 22.5% $6.09 22 4.8% $38,665 123 57.0% 45.5%

2 3 3 Multiple Sclerosis $673,389 17.8% $4.82 13 -7.1% $51,799 73 93.8% 83.6%

3 NA 4 Hepatitis C $259,854 6.9% $1.86 2 NA $129,927 8 0.0% 75.0%

26 10 5 Movement Disorders $153,890 4.1% $1.10 1 0.0% $153,890 2 100.0% 100.0%

7 6 6 Psoriasis $147,718 3.9% $1.06 7 250.0% $21,103 15 100.0% 60.0%

6 4 7 Growth Hormone And Related Disorders $123,475 3.3% $0.88 2 -60.0% $61,737 17 100.0% 100.0%

5 5 8 Human Immunodeficiency Virus $97,541 2.6% $0.70 5 0.0% $19,508 23 0.0% 0.0%

11 7 9 Transplant $85,620 2.3% $0.61 18 20.0% $4,757 146 0.0% 0.0%

15 9 10 Asthma $75,436 2.0% $0.54 4 0.0% $18,859 25 100.0% 100.0%

14 NA 11 Seizure Disorders $65,242 1.7% $0.47 1 NA $65,242 1 0.0% 100.0%

39 14 12 Urea Cycle Disorders $54,873 1.5% $0.39 1 0.0% $54,873 4 100.0% 100.0%

21 13 13 Hormonal Therapies $54,215 1.4% $0.39 8 33.3% $6,777 13 77.8% 100.0%

10 8 14 Inflammatory Bowel Disease $52,540 1.4% $0.38 3 0.0% $17,513 18 46.7% 33.3%

33 11 15 Immune (Idiopathic) Thrombocytopenic Purpura$49,709 1.3% $0.36 2 100.0% $24,855 13 100.0% 92.3%

18 16 16 Osteoporosis $47,896 1.3% $0.34 10 100.0% $4,790 25 80.0% 56.0%

12 15 17 Infertility $34,526 0.9% $0.25 17 54.5% $2,031 51 79.4% 74.5%

37 NA 18 Pulmonary Disorders - Other $16,031 0.4% $0.11 1 NA $16,031 2 0.0% 100.0%

20 NA 19 Neutropenia $14,176 0.4% $0.10 2 NA $7,088 9 0.0% 11.1%

45 26 20 Alcohol Dependency $8,345 0.2% $0.06 3 200.0% $2,782 7 100.0% 100.0%

24 19 21 Renal Disease $8,163 0.2% $0.06 2 -33.3% $4,082 5 20.0% 40.0%

9 25 22 Pulmonary Arterial Hypertension $7,161 0.2% $0.05 4 100.0% $1,790 16 0.0% 0.0%

34 24 23 Anemia $6,786 0.2% $0.05 2 100.0% $3,393 14 100.0% 100.0%

46 NA 24 Retinal Disorders $6,187 0.2% $0.04 1 NA $6,187 3 0.0% 100.0%

35 NA 25 Pre-Term Birth $3,492 0.1% $0.03 1 NA $3,492 1 0.0% 100.0%

99.72%

24.97%

BY NET COST

PERCENTAGE OF TOP 25 SPECIALTY THERAPEUTIC CLASSES NET SPEND/TOTAL SPECIALTY NET SPEND

PERCENTAGE TOTAL SPECIALTY NET SPEND/TOTAL NET SPEND

Your Top 25 Specialty Class Review

*Represents pharmacy claims only. NA = No prior data available Source: CVS/caremark Data Warehouse and Internal Sources



Page 11 of 16

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DRUG NAME SPECIALTY CLASS

TOTAL NET

COST

% OF

SPECIALTY

NET COST

TOTAL

UTILIZERS

TOTAL

RXS

NET COST

PER RX

NET COST

PER DAYS'

SUPPLY

8 3 1 Revlimid Oncology $293,016 7.76% 6 36 $8,139.33 $316.77

2 0 2 Harvoni Hepatitis C $259,854 6.88% 2 8 $32,481.80 $1,160.06

6 4 3 Tecfidera Multiple Sclerosis $244,905 6.48% 4 38 $6,444.88 $177.47

3 1 4 Enbrel Sureclick Rheumatoid Arthritis $237,214 6.28% 10 48 $4,941.97 $105.90

1 9 5 Humira Pen Rheumatoid Arthritis $157,826 4.18% 8 42 $3,757.77 $106.93

178 17 6 Apokyn Movement Disorders $153,890 4.07% 1 2 $76,945.00 $854.94

7 5 7 Enbrel Rheumatoid Arthritis $146,962 3.89% 6 25 $5,878.50 $128.02

43 2 8 Betaseron Multiple Sclerosis $126,790 3.36% 2 8 $15,848.72 $182.17

10 8 9 Gleevec Oncology $124,184 3.29% 2 6 $20,697.30 $240.67

14 11 10 Norditropin Flexpro Growth Hormone And Related Disorders $123,475 3.27% 2 17 $7,263.22 $248.44

9 10 11 Stelara Psoriasis $116,765 3.09% 4 11 $10,615.01 $150.47

12 6 12 Humira Rheumatoid Arthritis $110,377 2.92% 4 21 $5,256.04 $106.34

4 12 13 Copaxone Multiple Sclerosis $104,791 2.77% 2 7 $14,970.13 $178.22

13 14 14 Gilenya Multiple Sclerosis $98,351 2.60% 3 6 $16,391.91 $190.60

80 0 15 Nexavar Oncology $89,906 2.38% 2 8 $11,238.31 $374.61

56 7 16 Sutent Oncology $87,856 2.33% 1 7 $12,550.92 $313.77

26 13 17 Simponi Rheumatoid Arthritis $87,412 2.31% 4 19 $4,600.63 $116.86

57 28 18 Pomalyst Oncology $78,292 2.07% 2 7 $11,184.64 $466.03

17 15 19 Xolair Asthma $75,436 2.00% 4 25 $3,017.42 $81.64

28 35 20 Orencia Rheumatoid Arthritis $72,760 1.93% 2 25 $2,910.38 $103.94

31 30 21 Aubagio Multiple Sclerosis $71,249 1.89% 2 6 $11,874.86 $181.76

11 19 22 Atripla Human Immunodeficiency Virus $68,279 1.81% 3 12 $5,689.95 $63.22

87 0 23 Inlyta Oncology $65,542 1.73% 2 6 $10,923.67 $364.12

18 0 24 Acthar H P Seizure Disorders $65,242 1.73% 1 1 $65,242.06 $4,660.15

292 27 25 Buphenyl Urea Cycle Disorders $54,873 1.45% 1 4 $13,718.23 $152.42

$3,115,250

82.46%

BY NET COST

TOTAL TOP NET SPECIALTY DRUGS

TOTAL TOP NET SPECIALTY DRUGS/OVERALL BIOTECH SPECIALTY DRUGS

This page contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers that are not affiliated with CVS/caremark.

Your Top 25 Specialty Drugs

Source: CVS/caremark Data Warehouse and Internal Sources




Page 12 of 16

ww

Reduce Overall Health Care Costs


Page 13 of 16

Diabetes Hypertension HyperlipidemiaHeart

Failure

Coronary

Artery

Disease

DepressionAsthma/

COPDOsteoporosis

Breast

Cancer

Other

Behavioral

Health

Parkinson's

Disease

Benign

Prostatic

Hyperplasia

NEW TO

THERAPY8 38 32 7 0 17 5 1 0 1 0 0

FIRST FILL

DROP OFF4 25 16 4 2 22 8 1 0 0 0 0

OFF

THERAPY17 98 80 3 2 25 28 5 2 0 0 0

REFILL

REMINDER58 284 238 12 17 69 34 13 8 2 0 9

Managing Chronic Conditions: Your Adherence Measures

PRESCRIPTION ADHERENCE CAN

HELP LOWER HEALTH CARE

COSTS

2. Pharmacy Care Economic Model 3.0 Enterprise Analytics 2014

1. Optimal: ≥ 80% MPR

INTERVENTION SUMMARY - PHARMACY ADVISOR SUPPORT



Conditions are ordered by importance. "Total intervention counts include successful interventions only."

72.0

%

76.2

%

70.4

%

60.7

%

77.1

%

65.5

%

65.9

%

72.4

%

68.0

%

52.7

%

70.3

%

60.2

%

64.8

%

71.6

%

67.4

%

52.9

%

70.0

%

57.2

%

63.0

%

69.6

%

66.3

%

49.5

%

66.6

%

52.7

%

DIABETES HYPERTENSION HYPERLIPIDEMIA HEART FAILURE CORONARY ARTERY DISEASE

DEPRESSION

PERCENT OPTIMAL1 ADHERENCE BY CHRONIC CONDITION

CLOVISUSD AGE ADJUSTED PEER* AGE-ADJUSTED EMPLOYER** MANDATORY MAINTENANCE CHOICE® CLIENTS

Research shows

that adherent

members spend

less on total care

than those who are

non-adherent,

offsetting increased

pharmacy costs.2

**Age-adjusted BOB benchmark provides Book of Business projected spend and utilization if the peer had the same age demographics as the client.

28.1

%

65.1

%

70.7

%

60.2

%

87.5

%

75.9

%

30.8

%

61.3

%

64.5

%

56.8

%

73.5

%

62.1

%

30.9

%

59.6

%

60.6

%

52.6

%

67.3

%

61.7

%

30.3

%

56.9

%

58.0

%

47.8

%

66.2

%

59.4

%

ASTHMA/COPD OSTEOPOROSIS BREAST CANCER OTHER BEHAVIORAL HEALTH

PARKINSON'S DISEASE

BENIGN PROSTATIC HYPERPLASIA


Page 14 of 16

CONTRACEPTIVE DRUG CLASS

SUMMARYGDR UTILIZERS GROSS COST NET COST GROSS PMPM NET PMPM

DAYS' SUPPLY

PMPMUTILIZERS

Barrier Contraceptives - Cervical Cap 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Barrier Contraceptives - Diaphragm 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Combination Contraceptives - Transdermal100.0% 8 $4,410 $4,104 75.7% 93.2% 80.9% 100.0%

Combination Contraceptives - Vaginal 0.0% 39 $28,402 $23,386 17.2% 21.2% -1.3% -11.4%

Contraceptives - OTC 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Emergency Contraceptives 100.0% 3 $88 $61 140.6% 4707.9% 189.9% 200.0%

Progestin Contraceptives - Implants 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Progestin Contraceptives - Injectable 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Progestin Contraceptives - IUD 0.0% 0 $0 $0 0.0% 0.0% 0.0% 0.0%

Progestin Contraceptives - Oral 73.6% 647 $228,689 $178,260 9.9% 12.4% 3.7% -6.9%

TOTAL CONTRACEPTIVE 70.1% 690 $261,589 $205,811

Cost of Coverage: Contraceptive Drugs



$1.87

$1.47

$2.33 $2.24

$1.82 $1.73

GROSS NET

CONTRACEPTIVE PMPM COMPARISON




Page 15 of 16

PREVENTIVE DRUG CLASS

SUMMARYUTILIZERS GROSS COST NET COST GROSS PMPM NET PMPM

DAYS' SUPPLY

PMPMUTILIZERS

0 $0 $0 0.0% 0.0% 0.0% 0.0%

39 $34,164 $32,391 -18.3% -14.8% -11.2% 8.3%

146 $12,071 $8,349 -13.7% -9.6% 22.4% -18.9%

10 $109 $27 -27.4% -21.1% -58.5% -50.0%

0 $0 $0 0.0% 0.0% 0.0% 0.0%

0 $0 $0 0.0% 0.0% 0.0% 0.0%

0 $0 $0 0.0% 0.0% 0.0% 0.0%

15 $5,864 $5,039 -29.9% -28.7% -43.5% -34.8%

1 $205 $205 0.0% 0.0% 0.0% 0.0%

0 $0 $0 0.0% 0.0% 0.0% 0.0%

211 $52,413 $46,011

TOTAL COST OF COVERAGE SUMMARY 901 $314,003 $251,822

Vitamin D (Fall Prevention)

TOTAL

Aspirin

Breast Cancer Prevention

Colonoscopy Prep

Fluorides

Tobacco Cessation RX

Vaccines

Folic Acid

Iron

Tobacco Cessation OTC

Cost of Coverage: Preventive Drugs



$0.38 $0.33

$0.51 $0.48 $0.49 $0.45

GROSS NET

PREVENTIVE PMPM COMPARISON




Page 16 of 16

Documents

RxInsights - cusd.com · Prescription Benefit Review ... Jul 2014 - Jun 2015 RxInsights ® This analysis is an estimate for information purposes only. These estimates do not represent