Monday, June 3, 2019

CVS's Push Into Your Doctor's Office

Drug-pipeline-FINAL
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Over the entrance of what looks like a regular, aging CVS drugstore outside Houston, a billowing blue banner announces “HealthHUB Come Inside!”The HealthHUB section at the far end goes far beyond what you’d find at a typical walk-in clinic. They offer testing and treatment for chronic conditions, and boast four consultation rooms equipped with exam chairs and retinal cameras for diabetes screening. Video screens display prices for popular services: Today’s rates are $100 for diabetic retinopathy imaging and $89 for a cholesterol screening.

Tyrone's Commentary:

I wrote about this back in December. Non-fiduciary PBMs hidden cash flows aren't so hidden any longer so how will they continue to grow revenues? One answer, shift lost retail prescription drug revenue to the medical Rx spend. When you see inflated AWP discounts over 20% for retail brand and 25% for mail brand then something stinks (if not on a cost plus model). If these discounts are accurate then costs likely have been shifted elsewhere. Pharmacies simply don't make any money at these price points. But, take a look at prescription drug costs on the medical spend, for example, and you might discover the non-fiduciary PBMs who either own or are owned by an insurance carrier are printing money. They have taken a loss on the retail side only to double-up on the medical Rx spend. Buyer beware. 

Employees from the Texas Department of Transportation get full physicals here. At the pharmacy adjacent to the HealthHUB, pharmacist Alex Ybarra counsels patients in a private office as part of the new high-touch approach; the previous day, she spent an hour advising a senior who needed help measuring the effect of his six diabetes medications on his blood sugar.

The HealthHUB is Jacqueline Haynes’s destination for wellness. She was given a blood test for hypertension by a nurse practitioner, who wrote a prescription for beta-blocker Bystolic that Haynes filled at the pharmacy, steps away. She credits the full-time dietitian with helping her shed 72 pounds since January. “That brings my weight to 167.7,” says Haynes, who frequents a CVS “gentle yoga” class on Tuesdays. “I was addicted to avocados and chocolate. He got me eating healthy by doing things like substituting low-cal cacao nibs when I craved candy bars.”

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