Annual Report 2011

Trailblazer embarks on new chapter BY ANTOINETTE ALEXANDER nual meeting of shareholders in May. • Enhancing value for all of its sharehold- The decision to select Merlo as the new CEO ers in ways such as improving dividend Over the years, CVS Caremark has grown came as little surprise, as he has played a key payouts and share repurchases. from a go-getting New England-based regional role in the evolution of the company and has an “We certainly have the right assets in place player to a nearly $100 billion pharmacy health- impressive track record of integrating major ac- to continue to be a very successful company for care giant known for its vertically integrated quisitions. Under Merlo’s leadership, CVS com- years to come, and that is a real credit to [Tom pharmacy-PBM model via the 2007 acquisition pleted some of the most successful acquisitions Ryan’s] vision of the future of pharmacy health of Caremark, its highly successful loyalty card in the history of retail pharmacy — including care. Throughout his tenure, Tom has built a program and its innovative beauty concepts. Longs Drug stores, Osco/Sav-on, Eckerd and culture that is focused on innovation, customer Now, the industry trailblazer is embark- Revco — and delivered signifi cant organic C ONTINUED ON PAGE 2 ing on a new chapter with a new leader at the growth in major markets across the country. helm and a keen eye on driving medication Merlo has indicated that under his watch three Headquarters: Woonsocket, R.I. adherence, curbing rising healthcare costs and things will defi ne the company’s future success: 2010 sales: $96.4 billion* improving the health outcomes of its patients • Flawless execution of its strategy, which % change vs. 2009: -2.3% CVS nationwide with its far-reaching store network is lowering healthcare costs while im- No. of stores: 7,266* and arsenal of products and services. proving the health of its consumers and No. of MinuteClinic locations: 600+ Larry Merlo took the reigns as CEO on March leveraging its integrated pharmacy ser- 1, becoming CVS’ fourth CEO in the company’s vices model; * Includes pharmacy services segment revenue of $47.8 billion, total retail sales of $57.3 billion history. Tom Ryan retired as CEO after spending • Stressing more cross-functional thinking ** Retail stores as of June 30, 2011 36 years with the company, and had remained and action across the company, producing Source: Company reports nonexecutive chairman until the company’s an- even higher levels of customer service; and

1 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011

New chapter C ONTINUED FROM PAGE 1 service and fl awless execution, and I certainly look forward to building upon his legacy,” Merlo told analysts in February. Merlo has clearly hit the ground run- ning, quickly extinguishing conjecture in the market place of potential plans to split up the company, outlining a fi ve-point plan for PBM profi t improvement and emphasizing the com- pany’s ability to “effectively compete” in the PBM industry. Year 2011 is slated to be the year the com- pany will break trends on top-line growth in the PBM, and 2012 is expected to be the year it breaks trends on profi t growth. “There are many reasons for optimism about our PBM’s long-term prospects, starting with its performance in 2012. First and fore- most, 2012 is expected to be the strongest year in generic [drug] launch history. ... Second, the streamlining benefi ts will begin to outweigh our investment costs; third, we will see a ramp in accretion from the Aetna contract; fourth, CVS Caremark will continue to focus on lowering healthcare costs while improving the health of its consumers and leveraging we anticipate continued growth in both spe- its integrated pharmacy services model. cialty and the Medicare Part D businesses; and fi fth, our focus on client service and satisfac- physician shortage. Just the Basics; the completion of more than tion, along with our innovative products and Aside from expanding its footprint and 200 Urban remodels in the past year; and the services, will provide continued momentum scope of service — through such offerings as implementation of the expanded consumables in renewal and new sales success,” Merlo told its monitoring services for patients with diabe- planogram in about 4,000 stores. analysts during February’s conference call. tes, high cholesterol, high blood pressure and Charged with integrating all the company’s Furthermore, CVS Caremark’s acquisition asthma — MinuteClinic also is forming a num- capabilities in branding, communications, of the Medicare Part D business of Universal ber of strategic affi liations with health systems healthcare-reform strategy, etc., to forge even American not only more than doubles the size to enhance the high-quality, affordable health- stronger partnerships and further improve of CVS Caremark’s Medicare Part D program, care services provided to patients and commu- pharmacy care delivery is ExtraCare loyalty but the move came just as the fi rst baby boomers nities across the country. program architect Helena Foulkes, who was turned 65 years old. However, that’s not to say that the front of recently named EVP and chief healthcare strat- MinuteClinic, which by 2015 is estimated to the store is not of great importance, as evi- egy and marketing offi cer. operate about 1,060 clinics in 100 markets, also denced by the continued focus on and success Clearly, Ryan’s retirement earlier this year will take on added signifi cance going forward of CVS’ ExtraCare loyalty program, which has marked not an end of an era, but rather the be- as 32 million uninsured gain coverage begin- been expanded with the new ExtraCare Beau- ginning of a new chapter for the Woonsocket, ning in 2014, amid an ongoing primary care ty Club; the rollout of a new store brand called R.I.-based powerhouse. “There are many reasons for optimism about our PBM’s long-term prospects, starting with its performance in 2012. First and foremost, 2012 is expected to be the strongest year in generic [drug] launch history. ” Larry Merlo, CVS Caremark

2 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011

Merlo takes the helm Cosby ready to BY ANTOINETTE ALEXANDER markets across the country. Merlo, a pharmacist by train- lead retail biz CVS Caremark’s annual ing with more than 30 years in As of Oct. 1, Mark Cosby offi cially meeting of shareholders in May pharmacy health, joined CVS/ stepped into the role of president of was of special importance as it pharmacy in 1990 through the CVS/pharmacy. Cosby’s new stint at marked the offi cial retirement company’s acquisition of Peo- 1 CVS Dr. is a far cry from his prior of former chairman and CEO ple’s Drug. He began his career in role as president of Macy’s stores. Tom Ryan, who left the grow- chain pharmacy in 1978 with Peo- But Cosby’s reputation as an innova- ing company in the hands of a ple’s Drug in Washington, D.C. tor is bound to tie in nicely with the strong, capable new leader — Prior to being named presi- Woonsocket, R.I.-based trailblazer. Larry Merlo. dent and COO in May 2010, As president, Cosby will have “I’m passing [the company Merlo served as EVP of the com- responsibility for all aspects of the over] to a great leader, one pany and president of CVS/ company’s retail bus- whom I respect and who knows Larry Merlo pharmacy retail operations, iness, including its this business. Larry will take overseeing a portfolio of more more than 7,200 retail this company to great heights,” Ryan told share- than 7,000 CVS/pharmacy locations. stores, 19 distribu- holders in May. “After more than 20 years, I know this or- tion centers and e- The decision to select Merlo as the new CEO ganization, its values and our people’s pas- commerce site, as well came as little surprise, as he has played a key role sion for serving our customers,” Merlo said. as retail merchandis- in the evolution of the company and has an im- “We are building on a strong foundation. ing, supply chain, pressive track record of integrating major acquisi- CVS Caremark is the leader in providing in- marketing, real estate, tions. Under Merlo’s leadership, CVS completed tegrated pharmacy health care. No one else front store and phar- some of the most successful acquisitions in the has our combination of the largest chain of Mark Cosby macy operations. history of retail pharmacy — including Longs retail stores, a leading PBM, the fastest-grow- Prior to joining Macy’s in 2006, Drug stores, Osco/Sav-on, Eckerd and Revco — ing retail health clinics and a strong track re- Cosby served as president of full- and delivered signifi cant organic growth in major cord of healthcare innovation.” line stores for Sears Roebuck & Co., and earlier as COO of KFC . While at KFC, Cosby initiated the co-brand- Visionary Foulkes assumes new position ed stores with two eateries under Helena Foulkes, one of the brightest, fastest- ness results and stronger partnerships. the same roof. rising stars of the retail pharmacy industry for Building on her previous role as chief more than a decade, earlier this year assumed marketing executive of both retail pharmacy the newly created position of EVP and chief and the pharmacy benefi t manager , Foulkes healthcare strategy and marketing offi cer. brings insight from sales and operations into Bloom exits, This role undoubtedly is signifi cant as she her new role to engage an even broader array is charged with bringing together the compa- of external stakeholders. Sansone steps in ny’s capabilities in enterprise branding, com- She is widely regarded as one of the most As this issue went to press, EVP munications, community visionary marketers in modern drug store re- merchandising and supply chain relations, charitable giv- tailing, even a bit of a retail prodigy in a sense, Mike Bloom announced he was leav- ing, healthcare-reform given that she was just 35 years old when she ing the company to become president strategy, government took on the massive challenge of building what and COO of Family Dollar. Judy San- relations and market- has become one of the most successful loyalty sone, VP merchandising, will assume ing into one integrated programs in all of retailing — from scratch. To- responsibility for the merchandising organization in an day, the ExtraCare loyalty program boasts more organization at CVS/pharmacy. Ron effort to deliver than 67 million active members. Link, SVP logistics, and Richard Wid- even better busi- Foulkes joined CVS Caremark in 1992 and dowson, VP inventory replenishment, has held positions of increasing responsibility in will report to Scott Baker, EVP opera- Helena Foulkes the retail pharmacy, PBM and corporate areas. tions, real estate and supply chain.

3 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011 Urban stores, ExtraCare bolster front end BY ANTOINETTE ALEXANDER

CVS Caremark may be highly focused on driving medication adherence, curbing rising healthcare costs and improving the health out- comes of its patients, but there’s no doubt that its retail segment remains a critical part of its business, as evidenced by the innovative ini- tiatives playing out at the front end. CVS/pharmacy always has prided itself on convenience, but the retailer clearly is raising the bar with its Urban Cluster store concept, which is in its second year of rolling out and is helping to fuel both top and bottom lines. Ac- cording to CVS, it plans to complete more than 200 stores this year, on top of the roughly 200 it completed last year. “Our urban stores continue to post very strong results, and our test earlier this year in California yielded especially exciting results. We expect California to be a key expansion market for our urban layout later this year,” Larry Merlo, president and CEO, told ana- lysts during the second-quarter conference call in August. The Urban Cluster store concept can in- C ONTINUED ON PAGE 5 CVS Caremark is raising the bar with its Urban Cluster store concept. Getting down to ‘Just the Basics’ pays off Private-label penetration at CVS/phar- through her day. up 70 basis points from the prior year, as macy locations is expected to grow to more Just the Basics offers shoppers a large se- shoppers remain value- conscious. than 20% in the next two to three years, lection of practical items from a and to help drive that growth, the retailer variety of categories through- has developed its new Just the Basics line of out the store, including store-brand products. household, beauty, baby and Offi cially launched in February 2011, personal care. The products the brand represents a functional, value- start at 67 cents and can priced, smart-simplicity positioning. It is be found at store loca- comprised of nearly 100 items, and there are tions nationwide and on- plans to expand the line going forward. line at CVS.com. In developing the line, CVS/pharmacy At CVS/pharmacy, conducted customer focus groups where store-brand and propri- it identifi ed the need for an opening price etary products made point value brand. It then defi ned that up 17.2% of front-store the brand would consist of everyday es- sales as of the second sential products that would help get her quarter ended June 30, CVS’ Just the Basics store brand

4 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011

The company recently has bolstered the pro- Front end gram by launching a new digital coupon op- C ONTINUED FROM PAGE 4 tion for ExtraCare and the ExtraCare Beauty clude slight variations to appeal to the local Club for its beauty shoppers. With the new area. For instance, at the CVS Urban Clus- “Send to Card” digital savings option unveiled ter store in New York’s Union Square area, in August, cardholders can send select Extra- a more extensive wine selection appeals to Care coupons received by email directly to tourists and guests staying at the W Hotel a their ExtraCare card for automatic, digital in- few blocks away. store redemption. This eliminates the need to The key element of the Urban Cluster con- print those coupons at home and submit paper cept is a signifi cant focus on consumables, copies at the register. which in the reset was expanded and moved In January, CVS launched its ExtraCare closer to the door — a prominent location that Beauty Club, which provides ExtraCare card- makes the section impossible to overlook and holders who register their cards with ad- easy to access. There’s also an expansive Grab ditional rewards on beauty purchases and & Go prepared foods section; a greater offer- other beauty-specifi c benefi ts. CVS/pharma- ing of grocery items, such as cereal and pasta; cy Beauty Club members receive a 10%-off- household items; and baby products. The beauty shopping pass upon enrollment, $5 in Urban Cluster format is how CVS will play in ExtraBucks rewards with every $50 beauty food desert markets. purchase and $3 in ExtraBucks rewards on the As for its pharmacy dominant cluster, the member’s birthday, as well as special beauty retailer is focused on re-merchandising stores offers throughout the year. Members also re- that are primarily shopped for pharmacy and ceive monthly email newsletters with exclu- related products. “We’ve seen exciting results sive coupons, tips from experts and new prod- from our fi rst wave of test stores that we com- uct information. pleted late last year, demonstrating that it is To further enhance member benefi ts, CVS possible to signifi cantly reduce SKU comp introduced in late June its “Beauty Board,” a inventory while growing sales and margin,” panel of beauty and style experts who provide Merlo said during the fi rst-quarter conference interactive content and advice for the CVS in May. “We are being very careful and delib- Beauty Club Facebook page. As of late June, erate to fi nd the right balance. We’re conduct- there were more than 8 million ExtraCare CVS’ ExtraCare Beauty Club, launched in January, provides Extra- ing lots of customer research, so we’ll test this Beauty Club members. Care cardholders who register their cards with additional rewards format longer than others. We’re going to be Speaking of beauty, CVS continues to add on beauty purchases and other beauty-specifi c benefi ts. expanding the tests to an additional group of to its exclusive product offerings and now has stores in the second half of this year, and we partnered with actress Salma Hayek to offer cept, which, aside from its high-end beauty hope to scale the model beginning in 2012.” the exclusive beauty collection Nuance Salma offerings, makes a major statement with its Meanwhile, the company’s highly success- Hayek. The collection is comprised of more upscale decor and layout, which includes a ful ExtraCare Rewards loyalty program, which than 100 products within four categories — separate entrance. As of press time, there were is in its 10th year and has more than 67 million skin care, cosmetics, hair care and body — 25 Beauty360 stores in operation, primarily lo- active cardholders, continues to be a major fo- and marks the fi rst complete beauty line de- cated in California. The fi rst location was un- cus to help drive profi table sales, as opposed to veloped by an actress in partnership with a veiled in November 2008 at a Capitol district what the company refers to as “empty sales,” national retailer. CVS store in the center of Dupont Circle in or sales without a profi t fl ow-through. Then, of course, there’s the Beauty360 con- Washington, D.C. “Our urban stores continue to post very strong results, and our test earlier this year in California yielded especially exciting results. We expect California to be a key expansion market for our urban layout later this year. ” Larry Merlo, CVS Caremark

5 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011 PBM postioned to ‘effectively compete’ BY ANTOINETTE ALEXANDER the addition of the Aetna contract and the ac- billion of branded products coming off patent quisition of the Medicare prescription drug between now and 2016,” Merlo told analysts. At press time, the industry was weighing the business of Universal American — but the “So I remain very confi dent that 2012 will be potential merger of pharmacy benefi t manager company continues to make progress on its the year that our PBM breaks trend and dem- rivals Express Scripts and Medco Health Solu- fi ve-point PBM growth plan, which includes: onstrates healthy operating profi t growth.” tions, but executives at CVS Caremark remain • Achieving continued momentum in new Broadly available for implementation begin- more confi dent than ever that its PBM business business wins and strong client retention; ning Jan. 1, 2012, will be a new medical benefi t is ideally positioned to “effectively compete,” re- • Continuing to develop and up-sell its drug management service for the company’s gardless of what federal trade regulators decide unique clinical offerings; PBM and specialty pharmacy clients. “This offer- for ESI-Medco. And there’s good reason why. • Driving growth in 90-day mail choice and ing will enable CVS Caremark to identify the un- “With the evolution of U.S. health care to generic dispensing rate; recognized specialty pharmacy spend currently more consumer-directed care, our multiple • Focusing on high-growth areas, especially billed through the medical benefi t for oncology consumer touchpoints make us best-posi- Medicare Part D, specialty pharmacy and patients,” explained Per Lofberg, president of tioned to promote cost-effective and healthy Aetna; and CVS Caremark’s PBM business. “We can provide behaviors. And the success that we’re having • Executing successfully on the PBM stream- our clients with an opportunity to better manage in both the 2011 and 2012 selling seasons clear- lining initiative, with a goal to deliver more these expensive drugs while also improving the ly demonstrates that our model is resonating than $1 billion in related cost savings from quality of care for their members.” with payers,” Larry Merlo, president and CEO 2011 through 2015. One year ago, Jonathan Roberts, EVP Rx pur- of CVS Caremark, told analysts in August. “In addition to the anticipated benefi ts from chasing, pricing and network relations, also Not only did the PBM business experience this fi ve-point plan for PBM growth, 2012 also was named COO of the PBM business, assum- double-digit revenue gains during the second begins the generic wave, which will carry ing leadership of PBM operations, mail-service quarter ended June 30 — due in large part to through the next several years with about $100 pharmacy and specialty pharmacy. MinuteClinic passes 10 million visits CVS Caremark’s MinuteClinic continues In fact, MinuteClinic, which als do a better job of managing to evolve and play a greater role in the U.S. currently operates more than 600 chronic health conditions,” healthcare system as evidenced by its expand- locations, already has taken steps stated MinuteClinic chief nurse ing footprint, broadening scope of service and to broaden its suite of services. practitioner Paulette Thabault, growing roster of strategic affi liations. For example, in 2010, it launched who joined MinuteClinic in Since opening its doors in 2000, MinuteClinic a health condition monitoring July 2010. has surpassed 10 million patient visits and re- service for patients with diabe- Over the past few years, mains on course to add about 100 clinics annu- tes, high cholesterol, high blood MinuteClinic has formed affi li- ally over the next fi ve years — putting the clinic pressure and asthma. In 2011, it ations with a number of health operator in an ideal position to play an impor- began offering vitamin B12 injec- systems and, since the end of the tant role in the U.S. healthcare system. tions and the human papilloma- MinuteClinic plans to add about fi rst quarter 2011, it has added “Healthcare reform is a positive develop- virus vaccination Gardasil. 100 clinics annually over the fi ve strategic affi liations to its next fi ve years. ment for retail clinics because there are about To help with patient educa- roster. The company announced 30 million people who are currently unin- tion, it launched earlier this year the Ask Me No. 11 in August, when it announced its part- sured who will have healthcare coverage,” 3 program, which is designed to enhance com- nership with Indiana University Health, the said Andrew Sussman, president of Minute- munication between healthcare providers and state’s largest health system. Clinic and SVP and associate chief medical patients in order to improve health outcomes. In addition to patient education and disease offi cer of CVS Caremark. “Add to that the “Research shows that patients who un- state management programs, these partner- aging of the population and the shortage of derstand health instructions get well sooner, ships also share the common goal of integrat- primary care practitioners, and the opportu- tend to take their medication regularly and ing electronic medical records to streamline nity for services such as those provided by make fewer mistakes with their care. In par- communication around a patient’s care for MinuteClinic has the potential for growth.” ticular, clear communication helps individu- providers on either side of the partnership.

6 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011

CVS explores cause, Patients with complex therapies cost of nonadherence struggle to stay adherent Patients with chronic heart disease are likely to have several BY ANTOINETTE ALEXANDER Caremark inked a multiyear col- doctors and take nearly a dozen medications that are fi lled in at laboration with Harvard Univer- least two different pharmacies, resulting in many patients strug- CONTINUED ON PAGE 22 Industry members would like- sity and Brigham and Women’s gling to keep their medications straight, according to a study con- ly agree that those patients who Hospital to better understand ducted by researchers from Harvard Medical School, Brigham and are adherent to their prescription patient behavior and how the Women’s Hospital, and CVS Caremark. medications use less health care healthcare system can improve it Among the potential solutions: Create a “pharmacy home” to and have lower overall costs; — especially as it relates to medi- coordinate pharmacy care from a single point of contact. Research- however, how much adherence cation adherence. Excess health- ers also said there is a need to synchronize medication regimens for lowers total costs, why some pa- care costs due to nonadherence in patients because “those who make numerous trips to the pharmacy tients do not take their medica- the United States are estimated to to pick up their medications, or fi ll prescriptions at different phar- tions as prescribed and whether be as much as $300 billion annu- macies, may have diffi culty taking their medications as prescribed.” what’s saved in health care offsets ally. To date, researchers have un- Researchers found that during a three-month period, “10% of higher drug costs are among the earthed a great deal of invaluable patients fi lled prescriptions for 23 or more medications ... and 11 or questions that have not been as data aimed at curbing medication more different drug classes, had prescriptions written by four or clearly understood. nonadherence. Some highlights more prescribers, fi lled these prescriptions at two pharmacies and To answer such questions, CVS appear on the following pages. made 11 or more visits to those pharmacies.”

Pharmacists, nurses prove most effective in promoting Rx adherence A CVS Caremark-sponsored study looking The research, based on a review of more than tients on the telephone. at in-person, electronic, telephone, fax and mail 40 years of studies published in medical jour- Researchers also found that nurses talking communications that counsel patients to stay on nals, found that pharmacists engaged in face- with patients as they are discharged from a their medications found that pharmacists in a to-face discussions with patients in a store were hospital are the second most infl uential voice retail setting are the most infl uential healthcare twice as effective in boosting adherence rates as in getting patients to take their medications “voices” in promoting medication adherence. programs in which pharmacists talk with pa- as prescribed.

Relative effects of pharmacist intervention approaches

Two to three times more infl uential 6.4

3.1 2.7 2.2 0.03 1.3 Paper or RN or MD Family member Pharmacist Nurse at Pharmacist video at worksite at home phone call hospital at pharmacy

Source: CVS Caremark analysis. “Reconsidering the Costs of Preventing Cardiovascular Disease in a Time of Low-cost Generic Therapy.” 2010.

7 • OCTOBER 2011 DRUGSTORENEWS.COM Annual Report 2011

Medication adherence leads to lower healthcare costs Patients with one or more of four chronic dis- EVP and chief medical offi cer of CVS Caremark Annual per person savings for eases who take their medications as prescribed and a study author. adherent chronically ill patients may save the healthcare system as much as $7,800 Among the disease-specifi c fi ndings are: per patient annually, according to the fi ndings of • People with congestive heart failure spent a CVS Caremark study analyzing annual phar- $39,076 on average annually and had an macy and medical costs over a three-year period. average of 11.9 days in the hospital. Those for congestive The study fi ndings revealed robust reductions with congestive heart failure were older, $7,823 heart failure in emergency department visits and in-patient averaging 77 years of age; hospital days from medication adherence. By • Diabetes costs per patient on average were avoiding those costly events, there were substan- $17,955 annually, and these patients had an $3,908 for hypertension tial savings in overall healthcare costs. The study, average of 4.26 days in the hospital; “Medication Adherence Leads to Lower Health • Hypertension patients spent $14,813 on av- Care Use and Costs Despite Increased Drug erage annually and had 3.29 days on aver- for diabetes Spending,” was released in the January 2011 is- age in the hospital; and $3,756 sue of Health Affairs. • The annual spend for a person being Company researchers analyzed pharmacy treated for dyslipidemia was $12,688 on and medical claims data of 135,000 patients with average. Hospital stays for these patients $1,258 congestive heart failure, diabetes, hypertension were 2.24 days on average. for dyslipidemia and dyslipidemia to determine the direct effect of Pharmacy costs for the patients ranged from Source: Health Affairs, January 2011 adherence on costs, according to Troyen Brennan, $2,867 to $3,780 per year. Dispense-as-written Caregivers likely to be prescriptions exacerbating nonadherent with own Rxs About half of people who provide care and support to loved healthcare costs ones said they are more likely to be nonadherent to their own per- “Dispense-as-written” prescriptions are exacerbating medi- sonal medication regimen than to neglect providing medications cation nonadherence and costing the U.S. healthcare system to those they are caring for, according to a study by researchers up to $7.7 billion annually, according to a study by researchers at Harvard University, Brigham and Women’s Hospital, and CVS at Harvard University, Brigham and Women’s Hospital, and Caremark. Given this, there’s a signifi cant opportunity for phar- CVS Caremark. macists and doctors to identify and work with caregivers to im- Researchers estimated that patients in the study would have prove medication adherence and chronic disease management. saved $1.7 million and health plans would have spent $10.6 mil- For the study, published in the Journal of the American Pharma- lion less for the medications if effective generic alternatives had cists Association, the research team conducted an online survey been provided in place of brand-specifi c medications. Assuming of 2,000 retail pharmacy customers of which 38%, or 762 respon- a similar rate of dispense-as-written requests for the more than dents, described themselves as caregivers. Of that group: 3.6 billion prescriptions fi lled in the United States annually, pa- • 45% said they somewhat or strongly agreed that they are more tient costs could be reduced by $1.2 billion, and overall health likely to forget to take their own medications, even though system costs could be reduced by $7.7 billion. they provide family members with their medicines; and Researchers also found that when starting new essential ther- • When comparing caregivers with noncaregivers, caregivers apy, particularly among chronically ill patients with dispense- said they are 10% more likely to forget taking their medicines, as-written prescriptions, patients were 50% to 60% less likely to 11% are likely to stop taking their medications if they feel bet- actually fi ll the more expensive brand-name prescriptions than ter and 13% said they are likely to forget to fi ll their refi lls. they were to fi ll generics. More than 65 million Americans describe themselves as The study reviewed 5.6 million prescriptions adjudicated by caregivers, and as the U.S. population ages, that number is ex- CVS Caremark for 2 million patients from Jan. 1 to 31, 2009. pected to grow.

8 • OCTOBER 2011 DRUGSTORENEWS.COM