CVS Caremark's integrated model drives positive outcomes, fuels 'terrific' Q1

WOONSOCKET, R.I. — CVS Caremark president and CEO Larry Merlo told analysts Wednesday morning that he was “very pleased” with the company's first quarter, as results across both the retail and pharmacy benefit management segments came in at the high end of expectations, and its integrated assets continue to demonstrate success and improve patient lives.

“Overall, this was a terrific quarter with strong results across the board, including our cash generation,” Merlo told analysts. During the quarter, the company generated $4.2 billion in free cash flow.

During the first quarter ended March 31, CVS Caremark achieved the expected benefit of 3 cents per share from Walgreens’ battle with Express Scripts. Should the impasse between Walgreens and Express Scripts remain unresolved, CVS Caremark will report the estimated impact on a quarter-by-quarter basis throughout the year. For the second quarter, it is projecting a benefit of 3 cents to 4 cents per share, should the situation remain unresolved.

“The benefit is expected to be slightly higher than the first quarter, primarily driven by greater operating efficiency in our pharmacies, and we’ll also see a full quarter’s run rate of ESI script volumes that transferred throughout the first quarter, as well as a modest ramp in the front-store benefit from these new customers,” Merlo said.

In light of this, as well as its solid first-quarter performance, CVS Caremark raised its earnings guidance for the full year 2012. The company raised full-year adjusted earnings per share to $3.23 to $3.33, with both ends of the range up 5 cents from its guidance issued earlier this year.

In looking at the PBM segment, Merlo told analysts that 2012 was a “terrific” selling season, and, while it remains early in the game, it is optimistic about the 2013 selling.

During the 2012 selling season it won $7.1 billion in net new business, on top of another $5.5 billion in incremental revenues related to the acquisition of the Universal American Medicare Part D business in 2011. So it expects to add $12.6 billion in net new revenues in 2012, with a 98% retention rate.

“We are bullish about the receptivity to our model, along with our proprietary programs,” Merlo said. “There is obviously a lot of change in the marketplace related to the Walgreens and Express [Scripts] impasse, as well as recent significant PBM consolidation activity, but the market continues to be competitive yet rational, and with our stable business and unmatched breadth of capabilities, we believe we are very well-positioned for success now and in the future.”

Merlo also touched upon its “integration sweet spots,” which are products and services that are unique to CVS Caremark because of its integrated model.

There are currently roughly 10.5 million lives covered under 850 plans that have implemented, or are committed to implement, Maintenance Choice. Under Maintenance Choice 2.0, which will be broadly available in January 2013, CVS Caremark expects to see the number of clients to increase dramatically in the coming years.

The company also made “very significant progress” with its Pharmacy Advisor program, with data demonstrating that it is identifying opportunities to improve costs savings, enhances medication adherence and closes gaps in care. For example, following one year on the program analysis showed that certain members using CVS retail experienced a 17.2% decline in gaps in care, while members using CVS Caremark mail experienced a 12.8% decline. This compares with a 0.4% increase in gaps in care for a controlled group of members not participating in Pharmacy Advisor.

There are now more than 16 million lives covered by nearly 900 clients committed to implement Pharmacy Advisor for diabetes, up from 12 million lives at year-end 2011. It is targeted to become available to both Medicare and Medicaid clients in 2013, and once that occurs, it is estimated that the program could potentially touch nearly 47 millions.

During the past month, CVS Caremark launched Pharmacy Advisor for a suite of cardiovascular conditions and plans to go live in January 2013 with five more programs for depression, asthma, COPD, osteoporosis and breast cancer.

Merlo also noted that its high-growth specialty pharmacy business experienced a 46.3% boost in revenues during the quarter. Excluding the addition of the Aetna specialty business, which it began filling in the second quarter of last year, revenues still experienced strong double-digit growth, climbing 34%.

Revenues in the pharmacy services segment rose 32.3% to $18.3 billion during the quarter. In turning to the retail business, same-store sales rose 8.4%. Pharmacy same-store sales rose 9.8%, while front-end same-store sales rose 5.3%. Revenues in the retail pharmacy segment increased 9.9% to $16 billion during the quarter. Merlo noted that the Walgreens and Express Scripts impasse added about 350 to 400 basis points to its pharmacy comps during the quarter, which equates to roughly 5.7 million to 6.5 million prescriptions.

“Overall, I am very pleased with our front-store sales this quarter. We saw increased customer traffic and a slightly higher average ticket. Our ExtraCare loyalty program continues to be a key differentiator for us. We’ve had the program in place for well over a decade, and now with 69 million active cardholders, we continue to find new ways to enhance the offering. As an example, our ExtraCare Beauty Club already boasts more than 12 million members and is helping to drive sales across the beauty business,” Merlo told analysts.

Meanwhile, MinuteClinic experienced nearly a 22% boost in revenues during the quarter, with about 86% of visits paid through third-party insurance.

Merlo said that, as part of its strategy to maintain break-even status while growing its clinic base, it closed some of its seasonal MinuteClinic locations during the quarter, while it plans to convert others to full-time status. As of the end of the quarter, it operated 570 clinics, including the opening of nine new clinics.

“It is important to note that, while MinuteClinic is a small business relative to the overall enterprise, it does receive a fair amount of airtime with PBM clients. It is an important piece of our integrated strategy, and our clients are very interested in how MinuteClinic can help them reduce costs while keeping their members healthy,” Merlo said. “We believe our plans to double our clinic count over the next several years should position us well to play an important role in solving the primary care physician shortage, especially with millions of newly insured individuals expected to the healthcare marketplace.”

Net revenues during the quarter increased 19.9 percent to $30.8 billion. Net income attributed to CVS Caremark totaled $776 million, or 59 cents per diluted share, compared with $713 million, or 52 cents per diluted share, in the year-ago period.

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