Understanding what drives health care costs has become increasingly important across the health care system. Employers, patients, providers and policymakers are looking for clearer insights into spending, treatment options and strategies that can help make medications and care more affordable and accessible.
Key findings from the CVS Caremark-Employee Benefit News study on PBM transparency
Recent research conducted by CVS Caremark and Employee Benefit News (EBN) highlights the growing importance of transparency in pharmacy benefits management. In The State of Pharmacy Management survey, 87% of employers said improving cost transparency represents one of the biggest opportunities for pharmacy benefit managers (PBMs), reflecting growing demand for clearer information and greater predictability when managing pharmacy benefits.
For many employers, transparency is about making more informed decisions. While most employers report concerns about medication costs, only a minority believe they have significant influence over pharmacy spending. The survey also found that only 24% believe medication costs are fully transparent, highlighting the need for clearer information across the health care system.
As health care becomes more complex, employers increasingly want partners that can help them understand not only what they are spending, but what is driving those costs. In the survey, employers identified visibility into pharmacy spending, benefit navigation support and access to affordable medications as key areas where PBMs can provide additional value.
How CVS Caremark is bringing greater transparency to pharmacy benefits
CVS Caremark is addressing these needs through tools designed to provide more informed benefit decisions. One example is CVS Caremark TrueCost™, which offers a pricing model focused on predictability, accountability, and greater understanding of how pharmacy benefit dollars are spent.
Transparency also means giving employers better access to information. CVS Caremark's myPBM platform helps clients monitor pharmacy benefit trends, plan performance and cost drivers, helping identify opportunities for savings and optimize benefit strategies.
Transparency can also make health care easier to navigate for patients and providers. When prescribers and pharmacists have access to Real-Time Benefits information and lower-cost alternatives, they can help patients better understand their options before arriving at the pharmacy counter. CVS Caremark has also expanded reporting capabilities that provide clients with greater visibility into drug pricing, rebates, and member costs.
CVS CostVantage® and CVS Health's broader approach to transparency
Across CVS Health, similar efforts are helping bring greater simplicity to the broader health care system. CVS CostVantage®, for example, is designed to align pharmacy reimbursement more closely with the underlying cost of medications and the services pharmacists provide. CVS Health describes the model as an important step toward greater transparency and sustainability across the pharmacy ecosystem.
The CVS Caremark-EBN survey findings point to a broader trend across health care: employers are seeking more than cost management alone. They want clearer information, practical tools and greater confidence that they understand where health care dollars are going and how benefit decisions affect affordability, access and employee health.
As health care continues to evolve, transparency will remain an important part of helping employers navigate change. By combining data-driven insights, enhanced reporting, point-of-care cost information and solutions such as TrueCost™, CVS Caremark is helping bring greater transparency to pharmacy benefits and support more informed health care decisions.
