CVS Health and UnitedHealth Group’s OptumRx last week announced a new pharmacy partnership. The program will permit eligible OptumRx members to fill their 90-day maintenance prescriptions at the same copay level whether they use OptumRx’s home delivery service or go to a CVS retail outlet drugstore.
In addition, the collaboration will allow CVS and OptumRx to share their pharmacy platforms, with the goal of increased consumer engagement and better health outcomes.
The program will be available in July 2017.
Our Take: This deal looks strikingly similar to the Walgreens-OptumRx partnership announced earlier this year, with a few exceptions that leave us scratching our heads.
In March, Walgreens Boots Alliance (WBA), the drug chain’s parent company, said eligible OptumRx members would have the option to fill 90-day prescriptions at prices equal to home delivery copay levels at any Walgreens location or through OptumRx home delivery. That agreement is set to take effect on January 1.
At the time, OptumRx CEO Mark Thierer told The Wall Street Journal that in exchange for preferential retail pharmacy positioning, Walgreens agreed to accept lower reimbursement for drugs from OptumRx.
CVS made no mention of such preferential positioning. In fact, it appears that OptumRx is offering consumers a choice between CVS and Walgreens as a preferred pharmacy—at least starting in July, when the two pharmacy networks will be in competition.
The WBA agreement also had several other elements not announced last week by CVS and OptumRx. Walgreens said it would give members round-the-clock access to a pharmacist, presumably by phone. The companies also said the collaboration “connects members to clinical guidance” for certain disease states, but did not specify how they intend to do that. Finally, companies and health plans who opt-in to the program will receive an insurance card co-branded with the OptumRx and Walgreens logos. The CVS alliance mentions none of these things.
Presumably there was no exclusivity clause to the Walgreens deal, but CVS’ partnership with OptumRx still must be infuriating to WBA executives.
Nonetheless, the partnership signals that CVS is done sitting on the sidelines. After getting hammered this year by WBA alliances like the one with OptumRx and a contract for the TRICARE program—as well as the Prime Therapeutics-Express Scripts deal that left CVS out of pharmacy networks—CVS executives realized that some reimbursement is better than nothing.
In a third-quarter conference call, CVS executives said aggressive partnering strategies from Walgreens and others would lead to more than 40 million retail prescriptions shifting away from CVS stores on an annualized basis. “Very recently, there have been a number of unexpected marketplace actions that will have a negative impact on our Q4 2016 results and a more meaningful impact on our outlook for 2017,” the company said.
This deal won’t get back all of those lost prescriptions, but it’s a start.