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Merlo: CVS Caremark positioned to ‘effectively compete’ in PBM industry

BY Antoinette Alexander

WOONSOCKET, R.I. — CVS Caremark posted second-quarter results that were at the high end of its guidance and narrowed its 2011 outlook on continued confidence. But it was the pharmacy benefit management business — and the potential merger of PBM rivals Express Scripts and Medco Health Solutions — that was top of mind for many industry observers, and was a topic that CVS Caremark president and CEO Larry Merlo hit head-on at the start of Thursday morning’s conference call.

“Before getting into the business update, I want to give you our perspective on the recent PBM industry news. Many of you have been asking about the implications of two of our largest peers combining into one company. … Assuming that the proposed transaction is completed, I am more confident than ever that CVS Caremark can and will effectively compete in this vibrant industry,” Merlo told analysts during the quarterly conference call.

Merlo told analysts that CVS Caremark’s “suite of assets uniquely positions us to assist payers in controlling costs, while enhancing member access and improving health outcomes.”

Furthermore, with the evolution of U.S. healthcare to a more consumer-directed care model, the company’s multiple consumer touch points — which include more than 7,200 retail drug stores and nearly 600 MinuteClinic locations — ideally position the company to promote cost-effective and healthy behaviors, Merlo explained.

As widely reported, PBM giants Express Scripts and Medco Health Solutions announced on July 21 plans to merge in a deal worth $29.1 billion. The deal, if approved, would create the country’s largest PBM, followed by CVS Caremark.

However, whether antitrust regulators will approve such a merger has yet to be seen, and retail pharmacy trade groups have since come forward to voice their objections, claiming that such a deal would “exacerbate [PBM’s] detrimental effect on pharmacy patient care.”

Despite the outcome of the proposed merger, Merlo’s optimism clearly remains high — and it’s with good reason. “The success that we’re having in both the 2011 and 2012 selling season clearly demonstrates that our model is resonating with payers. So I’m confident that we can continue to gain share, add value for our clients and their members and deliver healthy, long-term returns to our shareholders,” Merlo said.

During the second quarter ended June 30, revenues in the pharmacy services segment rose 23.2% to $14.6 billion. The increase primarily was associated with the addition of the previously announced contract with Aetna, as well as new activity resulting from its acquisition of the Medicare prescription drug business of Universal American Corp.

With a “terrific” 2011 selling season under its belt, the 2012 selling season also has proven successful to date, according to Merlo, with more than 50% of the contracts scheduled for renewal completed, in line with last year at this time, and the retention rate standing at 98%.

The PBM business also has secured some significant wins. As of mid-July, on a 2012-impact basis, the PBM has won $4.8 billion in net new business, including the Federal Employee Program mail-order and specialty pharmacy services contracts.

“As we sit today, we will see net new [2012] revenues in excess of $10 billion. And while many of the large contracts out for bid in 2012 have been decided, there are still opportunities for new business,” Merlo said. “Obviously, we are all very pleased [with] the progress we’ve made in both the [2011] and [2012] selling seasons and our significantly improved client retention rate.”

Merlo also said that the company has made progress on its previously announced five-point plan for PBM profit improvement, which includes:

  • Achieve continued momentum in new business wins and strong client retention;
  • Continue to develop and up-sell its unique clinical offerings;
  • Drive growth in 90-day mail choice and generic dispensing rate;
  • Focus on high-growth areas, especially Medicare Part D, specialty pharmacy and Aetna; and
  • Execute successfully on the PBM streamlining initiative.

The retail segment experienced growth during the second quarter. Revenues in the retail pharmacy segment rose 3.6% to $14.8 billion. Same-store sales rose 2%, as pharmacy same-store sales rose 2.6%. Front-end same-store sales benefited from the shift in Easter holiday and rose 0.8%.

Net income for the quarter totaled $815 million, or 60 cents per share, compared with $821 million, or 60 cents per share, in the year-ago period. Excluding some items, earnings per share from continuing operations were 65 cents in the current quarter.

“We are relying on our ExtraCare loyalty program to drive profitable sales as opposed [to] what we call ‘empty sales’ — sales without a profit flow through. So while sales were at the lower end of our guidance range, I’m pleased with our performance since we achieved higher front store margins in the quarter and record second-quarter retail operating margins,” Merlo said.

Merlo noted that CVS’ retail adherence program, internally known as the Patient Care Initiative, is now in its fourth year and, in the first half of this year alone, pharmacists performed nearly 30 million adherence interventions across the store base with “compelling results.” With first-fill counseling, patients are 15% more likely to get to the second fill; with adherence outreach, patients are 25% more likely to obtain their refill; and with new script pickup reminders, 20% of scripts are picked up that may have otherwise been returned to stock.

CVS Caremark’s MinuteClinic business — which in recent weeks surpassed 10 million patient visits since opening its doors in 2000 — experienced a 28% increase in revenues during the second quarter and is on track to break even by the end of this year. There currently are 598 clinics in operation and the company plans to open 100 new MinuteClinic locations annually for the next five years.

“With this continued expansion, MinuteClinic will increase its role as a collaborator in developing integrated health networks and accountable care organizations. Over the past couple of years, we have formed some valuable affiliations with a number of leading health systems,” Merlo said.

Taking into account the solid results reported to date, the company narrowed its earnings per share guidance for the full year 2011. The company now expects adjusted earnings per share from continuing operations to be between $2.75 and $2.81, compared with its previous guidance of $2.72 and $2.82.

“I am very pleased with our second-quarter results, which came in at the high end of our guidance. We reported adjusted earnings per share from continuing operations of 65 cents with the PBM segment in line with our expectations, and the retail segment exceeding our expectations benefiting from solid expense control and higher-than-expected generic utilization positively impacting our gross margin,” Merlo said. “Additionally, we generated more than $800 million in free cash flow quarter and $2.4 billion year-to-date. So we are very confident that we will generate between $4 billion and $4.2 billion for the full year.”

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B.Barrett says:
Aug-18-2011 07:19 am

However, whether antitrust regulators will approve such a merger has yet to be seen, and retail pharmacy trade groups have since come forward to voice their objections, claiming that such a deal would 'exacerbate [PBM's] detrimental effect on pharmacy patient care.' This, of course, if the same reasoning behind the complaints voiced by PBMs in the Nineties and 00's as pharmacy retailers consolidated. The bargaining power of a larger entity provides benefits in negotiation, something Walgreen's, CVS, and other retailers have known and used for years. The true downside of PBM consolidation will come down on subscribers, increasing co-pays, premiums, and mail-order regulations in a market with little alternatives. Additionally, independent pharmacies will have even less ability to negotiate fair reimbursement, if they can gain a contract at all. I also shudder to think of the next round of Medicare pharmacy programs offered in a world with Medco and Express Scripts operating in conjunction as opposed to in competition. CVS's purchase of Caremark in 2006/2007 was a unique combination of formerly opposing facets of the pharmacy business, with promises of increased patient care and access. Those dreams have yet to come to fruition, the decreased costs have not lowered premiums but have instead increased profits. Instead of fully integrating the mail order and retail pharmacies, they are completely separate from each other. With the Boomer population coming into retirement, greater access and convenience married to education and adherence will be the marks of a truly successful merger of the two. Still waiting.

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Durex launches Facebook contest hosted by model Bridget Marquardt

BY Michael Johnsen

PARSIPPANY, N.J. — Reckitt Benckiser on Wednesday announced that its Durex brand has partnered with Playboy model Bridget Marquardt on a new contest hosted on the brand’s Facebook page.

Beginning Aug. 1 through Sept. 12, adults will have an opportunity to blog in conjunction with a national online "Get a Room" contest housed on Durex’s Facebook page.

Winners will be chosen by popular vote from Facebook fans of Durex. The grand prize winner will receive an all-expenses-paid, two-night stay for two at an exclusive hotel in New York.

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Club comps strong again in July

BY Mike Troy

ISSAQUAH, Wash., and WESTBOROUGH, Mass. — Costco and BJ’s Wholesale Club continue to produce solid sales growth, aided by high gas prices, shoppers’ desire to save money and the clubs’ ability to pass through the cost of food price inflation.

A 10% same-store sales increase at Costco during July looks impressive on the surface, although there is a fair amount of noise surrounding that headline number that require further dissection. For starters, the company said its July reporting period included one fewer day this year and that caused total sales and same-stores sales to be negatively affected by 3% worldwide, or 3.5% in the United States. The impact of one less selling day due to the closure of U.S. clubs on July 4 was offset by high gas prices and a weak dollar that also distorted comps.

For example, the company reported a U.S. comp increase of 6%, but that figure is cut in half to 3% if the beneficial effect of higher year-over-year gas prices are excluded. Internationally, the impact of the weak U.S. dollar is even more pronounced. Costco reported international comps of 22%, but on a constant currency basis the figure dropped to a still very respectable increase of 12%.

The company’s monthly results are further muddied by inclusion of sales from a Mexican joint venture. Costco noted that sales for July increase 15% to $6.7 billion, but that figure includes results from a Mexican joint venture without which the increase would have been 12%. Through the first 48 weeks of the company’s fiscal year Costco’s sales rose 14% to $80.2 billion, but take out results from the Mexican joint venture and the increase would have been 11%.

The sales picture at BJ’s Wholesale Club is a lot clearer as its 190 units are all located in the United States, so the only distorting factor is the price of gasoline. BJ’s said its July same-store sales increased 9.2%, but excluding gasoline sales, the comp figure was 5.4%. Total sales at BJ’s increased 12.4% to $854.8 million.

The second quarter now is in the bag at BJ’s, and total sales for the period ended July 30 increased 11% to nearly $3 billion and comps increased by 7.8%, including a contribution from sales of gasoline of 4%.

Costco’s fiscal year will ended on Aug. 28. Between now and then, the company plans to open five new clubs that will push its total close to 600 units worldwide. The company ended July with 587 clubs, consisting of 428 in the United States and Puerto Rico, 81 in Canada, 32 in Mexico, 22 in the United Kingdom, eight in Japan, seven in Korea, six in Taiwan and three in Australia.

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