At long last, the market check process for improvement of our CVS Caremark Master Contract is complete. Improvements will take effect January 1, 2020. A process that started in March took much longer than usual due to a variety of marketplace dynamics and negotiation complexities.
For January 1, 2020, the market check will yield an additional 3.3% savings for the average member. This is in addition to the 2.9% already scheduled to take effect as a result of the 2019 request for proposal (RFP) process. More than 6% savings in total over 2019 pricing will have a significant impact on offsetting trend and lowering prescription drug costs for our members.
Highlights of the 2020 contract improvements include:
3% in additional savings
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- 1/3 coming in the form of pricing improvements
- 2/3 coming in the form of higher rebate guarantees
Strengthened language to require clinical rationale of changes in specialty class
Acknowledgement and enhancement of National CooperativeRx plan exclusions
Although it took longer to accomplish than we anticipated, we are very proud of the outcome. National CooperativeRx is providing improvements to our membership without any additional commitment to the pharmacy benefit manager (PBM). These enhancements are possible due to changes in the prescription drug marketplace and the strong membership growth of the Cooperative.
Rebates continue to be a necessary evil of the current prescription drug pricing dynamic. Although we would welcome a world without them, an alternative mechanism for negotiation with Pharma in the marketplace would be needed. As long as the current dynamic continues, we will continue to fight for this rebate revenue to be returned to members as quickly as possible, with 100% being returned over time.
As a result of our 2019 RFP, we incorporated an annual market check process to keep pricing current. Without this process, members would pay more for prescription drugs and PBM services until their next formal RFP.
No action is required on the part of membership to realize this savings. If you have questions about the market check, or anything else, please contact your National CooperativeRx account representative.
