CVS CareMark Retained by GIC

Reduces Costs by $145m Over Three-Years

FEBRUARY 18, 2015: Following an extensive search process, the state’s Group Insurance Commission (GIC) voted to retain CVS CareMark for at least another three-years beginning July 1, 2015. The Rhode Island-based firm has been the pharmacy benefits manager (PBM) for the GIC’s UniCare plans since 2010.

Therefore, CVS is the PBM for both the Optional Medicare Extension (OME) Plan, as well as the GIC Indemnity Plan. Since most retirees insured by the GIC are enrolled in one of these UniCare plans, CVS plays a key role with our members.

According to the GIC, the new CVS contract will save approximately $145 million over the coming three-years. This is accomplished through better management of specialty drugs, as well as the creation of a list of certain prescription drugs that require prior approval for dispensing.

This new provision was inserted into the contract by the GIC. While controversial, an alternative proposal would have created a list of certain medications that were to be “excluded” from approved formularies.

In a separate divided vote, the GIC did approve an increase in prescription drug copayments beginning July 1, 2015. While this marks the first increase in drug copayment costs in over 5-years, the multi-million cost shift is of great concern to the Association.

“Our Association joined with the union representation on the GIC in opposing this increase. We view it as a cost shift onto retirees who simply cannot afford these new costs,” says Association Senior VP Bill Rehrey. “Prior to the vote, Frank Valeri and Shawn Duhamel both articulated to the Commission our Association’s opposition. We do believe this had a positive impact, as the GIC’s original proposal was greatly scaled back when the vote took place.

“None-the-less, we stand by our position that increased drug and healthcare costs are not the fault of retirees. The problem rests with the pharmaceutical industry and the prices being charged for healthcare services in general. Shifting costs onto retirees does nothing to resolve the bigger problem.”

CVS will also manage the upcoming Employer Group Waiver Program (referred to as EGWIP). This program, which is run through Medicare, begins January 1, 2016 for GIC OME plan members. It will save the plan, including retirees, up to $28 million a year by utilizing federal discounts and reimbursements.

For further information, members should look to the March 2015 Voice, which is now being mailed.