Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Evolving
g Health Care Market
Larry
y Merlo
President & Chief Executive Officer
Analyst Day
December 16, 2015
Forward-looking Statements
3
Key Accomplishments in 2015
Strong financial results Adj. EPS growth of ~15%; Free Cash Flow of ~$6.0B
Big wins in ’16 selling season $11.5B net new business; client retention of 98%
Enhanced generic sourcing Red Oak is hitting milestones and achieving goals
4
The Most Extensive Suite of Leading Assets…
Retail Mail
Long-term
Care
Retail Specialty
Clinics
Clinical
Infusion
Programs
g
5
Today’s Key Takeaways
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Expanding
p g core p
pharmacyy business while broadening
g
Broadening the Base reach into new health care channels
6
Today’s Agenda
Topic Speaker
M i i i Long-term
Maximizing L t Shareholder
Sh h ld Value
V l D
Dave D
Denton
t
7
Appendix
pp
Endnotes
1. Adj. EPS equals income before income tax provision plus amortization, less adjusted income tax
provision, and other, which is comprised of earnings allocated to participating securities, divided by
the weighted average diluted common shares outstanding.
2. Adj. EPS excludes a $521 million loss on early extinguishment of debt (approximately $0.27 per
dil ted share) d
diluted during
ring 2014
2014, and $52 million of acq
acquisition-related
isition related bridge financing costs and $147
million of acquisition-related transaction and integration costs during the nine months ended
September 30, 2015. relating to the acquisition of Omnicare, Inc., and proposed acquisition of the
pharmacies and clinics of Target Corporation. Adj. EPS also excludes any acquisition-related
transaction and integration costs for the acquisition of Omnicare, Inc., and the proposed acquisition
of the pharmacies and clinics of Target Corporation for the period from October 1, 1 2015 through
December 31, 2015.
3. Free Cash Flow as net cash provided by operating activities less net additions to properties and
equipment (i.e., additions to property and equipment plus proceeds from sale-leaseback
transactions).
4 Adj.
4. Adj EPS growth and Free Cash Flow are based on midpoints of 2015 guidance guidance.
5. Client retention rate is defined as: 1 less (projected 2016 lost revenues from known terminations
occurring after January 1, 2015, divided by estimated 2016 PBM revenues) expressed as a
percentage. Both terminations and PBM revenues exclude the individual PDP business.
6. The following trademarks appear throughout the 2015 Analyst Day presentations: : ,
CVS Health,
Health CVS/caremark
CVS/caremark, Omnicare,
Omnicare CVS/Omnicare
CVS/Omnicare, CVS/specialty
CVS/specialty, CVS/caremark
CVS/caremark, CVS,
CVS
Maintenance Choice, Coram, Navarro, Novologix, Omniview, MyOmniview, CVS/minuteclinic, Health
Engagement Engine, Accordant, RX Insights, ScriptSync, MinuteClinic and Specialty Connect. They
are trademarks or registered trademarks of CVS Pharmacy, Inc.
9
Maximizing Long
Long-term
term
Shareholder Value
Dave Denton
Executive Vice President &
Chief Financial Officer
Non-GAAP Financial Measures
Note:
1. CVS Health finances a portion of its store development program through sale-leaseback transactions. Use of sale-leaseback financing is subject to change
as a variety of financing vehicles for future development are evaluated. This may also result in changes to CVS Health’s definition of free cash flow.
2
Agenda
Marketplace Misconceptions
3
Continuing Focus on Enhancing Shareholder Value
Generating
Productive Op
Optimizing
g
Si ifi
Significant
t
Long-term Capital
Free Cash
Growth Allocation
Flow
Enhanced
Shareholder Value
4
Our Leadership in Multiple Competencies
Continued to Drive Shareholder Value in 2015
Note:
1. Earnings per share excludes acquisition-related bridge financing, transaction and integration costs.
5
2015 Guidance Reaffirmed
Full-year 2015
Notes:
1. Excludes acquisition-related bridge financing, transaction and integration costs.
2. Excludes $521 million loss on early extinguishment of debt recognized in 2014.
3. Free cash flow in 2014 was approximately $500 million above goal due to receipt of some early payments from CMS, benefiting 2014 and to the detriment of 2015.
6
Original Steady State Targets
Enterprise Growth Model from 2010
Five-year CAGR
2010 - 2015
Net Revenue 8% to 11%
Operating Profit 8% to 10%
Adjusted EPS From Cont Ops 7% to 9%
* Cash available for enhancing shareholder value = Free cash flow +/- change in net debt 7
Enterprise Expansion Has Happened
as Originally Targeted
Operating Profit Adjusted EPS
($, billions) ($)
9
9.8
8 5
5.18
18
to to
9.7 5.14
10% 14%
CAGR CAGR
2.68
6.1
2010 2011 2012 2013 2014 2015E 2010 2011 2012 2013 2014 2015E
8
Strategic Capital Deployment with Acquisitions of
Omnicare and Target Pharmacies and Clinics
OMNICARE TARGET
9
Well-laddered Debt Maturities Remain Core to
Strong Balance Sheet
Debt Maturity Profile (Bonds)
($, billions)
1.7
1.2 1.1 1.3 1.2 1.3
1.0
0.7 0.8
0.5 0.6 0.5 0.5
2016 2017 2018 2019 2020 2021 2022 2023 2024 2027 2039 2041 2043
10
Well-laddered Debt Maturities Remain Core to
Strong Balance Sheet
Debt Maturity Profile (Bonds)
($, billions)
3.5 3.5
3.2 3.2
3.0
2.0
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2027 2035 2039 2041 2043 2045
11
Committed to Maintaining a Healthy Balance Sheet
Adjusted Debt-to-EBITDA
As expected
expected, new debt
increased leverage ratio above
3.4 3.30 target of 2.7X
3.2
2.94 • Committed to returning to a
3.0
leverage ratio at target
2.8 Target = 2.70
– Driven mostly by strong EBITDA
2.6 growth
2.66
2.4 – Will also pay down debt with
2.39 upcoming maturities
22
2.2
'13 '14 '15E '16E
12
$41 Billion Available to Enhance
2014 Through 2018 Returns
$10
~$39 ($8) billion
billion
billion
~$31
$31 $41
billion billion
13
Efficient Cash Deployment 2014 Through 2018
$41 billion
Dividends Share
Return on
Repurchases
Target payout ratio
Invested Capital
of 35% by 2018 $4 billion to $5
Drive ROIC with
billion per year
value-enhancing
~18% implied
projects
dividend CAGR Value creating
14
~$23 Billion Available for Returns in 2014 and 2015
15
Solid History of Enhancing Returns Using All Three
Pillars for Efficient Cash Deployment
Annual Dividend Acquisitions Share
per Share and Ventures Repurchases
($) ($ billions))
($,
Apr ’11 Apr ’12
Deployment
p y of capital
p in line with long-term
g targets
g
16
2016 Capital Deployment to Include
Dividend Increase and Further Repurchases
2016 Annual
Dividend
• Increasing 21%,
21%
from $1.40 to $1.70
$1 70
$1.70 2016 Share
Repurchases
• Currently $7.7 billion authorized
and remaining from 2014 share $4
repurchase program billion
More than $
$5 billion expected
p to be returned to shareholders in 2016
17
Agenda
Marketplace Misconceptions
18
MYTH #1
ALL SPECIALTY
PHARMACIES ARE
SIMILAR IN PRACTICE TO
THE CAPTIVE
“SPECIALTY”
PHARMACIES THAT
HAVE COME UNDER
RECENT SCRUTINY
19
FACT #1
TRUE SPECIALTY
PHARMACIES LIKE
CVS/SPECIALTY HAVE
A DIFFERENT BUSINESS
MODEL THAN THESE
CAPTIVE
PHARMACIES
20
Misconceptions in Marketplace Are Creating Noise
FACT #1: CVS/specialty
p y Is Different
21
MYTH #2
THE RxCROSSROADS
BUSINESS COULD BE A
BIG RISK FOR CVS
HEALTH GIVEN THAT
IT IS AT ODDS WITH
CLIENTS
CLIENTS’
OBJECTIVES
22
FACT #2
THE RxCROSSROADS
BUSINESS IS ALIGNED
WITH OUR FOCUS ON
COST, QUALITY AND
ACCESS, AND IS
IMMATERIAL TO OUR
FINANCIAL RESULTS
23
Misconceptions in Marketplace Are Creating Noise
FACT #2: RxCrossroads Is Aligned
g
24
MYTH #3
ALWAYS PARTICIPATE IN
PREFERRED NETWORKS
FOR OPTIMAL SUCCESS
IN MEDICARE PART D
25
FACT #3
26
Misconceptions in Marketplace Are Creating Noise
FACT #3: Med D Networks Are Not Equal
q
27
MYTH #4
UNDERLYING GROWTH
IN EACH SEGMENT IS
WHAT ULTIMATELY
FUELS THE CVS HEALTH
VALUE-CREATION
ENGINE
28
FACT #4
CVS HEALTH’S
SUCCESS WILL BE
DRIVEN BY ENTERPRISE
GROWTH … SOMETIMES
AT THE EXPENSE OF
ONE OF THE
SEGMENTS
29
Misconceptions in Marketplace Are Creating Noise
FACT #4: Enterprise
p Growth Drives Success
30
Agenda
Marketplace Misconceptions
31
2016 Guidance: Healthy Enterprise Growth
Full-year 2016
Notes:
1. EPS growth estimates exclude acquisition-related transaction and integration costs.
2 Year
2. Year-over-year
over year growth based on midpoint of 2015 guidance
guidance.
3. Estimates assume that the acquisition of Target’s pharmacies and clinics closes at year-end 2015.
4. EPS estimates assume completion of approximately $4 billion in share repurchases in 2016.
5. EPS estimates include dilution of $0.01 in 2016 related to the termination of pension plans. The impact on 2017 is expected to be between $0.10 and $0.15.
32
2016 Guidance: Substantial Free Cash Flow …
Growth Impacted by Acquisitions
Notes:
1. Year-over-year growth based on midpoint of 2015 guidance.
2 Estimates assume that the acquisition of Target’s
2. Target s pharmacies and clinics closes at year-end 2015
2015.
3. Guidance includes approximately $500 million of cash outflows from acquisition-related transaction and integration expenses.
4. CVS Health finances a portion of its store development program through sale-leaseback transactions. Use of sale-leaseback financing is subject to change
as a variety of financing vehicles for future development are evaluated. This may also result in changes to CVS Health’s definition of free cash flow.
33
Healthy Enterprise Growth Expected to Continue
8.0 3.96
34
2016 Guidance: Strong Growth in Retail/LTC
Full-year 2016
35
2016 Guidance: Even Stronger Growth in PBM
Full-year 2016
36
Key Drivers of 2016 Expectations
37
Mix of Business Lowers Gross Margin %, but
Drives Volumes and Gross Profit $ Over Time
38
Acquisitions Expected to Help Fuel Growth
39
While the Level of Generic Introductions Ebbs
and Flows Over Time …
Enterprise
E t i profit
fit growth
th
will continue to benefit
f
from generics
i
40
Generics Drive Financial Performance at CVS
Health in Two Ways
41
1
Generics Remain an Opportunity
23.9
Abilify
16
16.5 Nexium 17 3
17.3
Copaxone Crestor
Celebrex
Namenda Gleevec
Diovan
Zetia
Lovaza 5.5
Seroquel XR 3.6
Viagra
Cialis
42
1
Incremental Break-open Benefit in 2016
Less Than 2015
14.4 15.5
11.1
8.7
5.0
Notes:
1. Break-open period for generic launches = 12 months from the point at which there are 3+ viable suppliers in the market (may span 2 calendar years), and
includes significant, “budgeted launch” products only. Brand market sales are at the time of first generic launch; break-open dates on the 15th or later were
rounded to next full month; dates before the 15th credited for that month
month.
2. 2014 includes all actual launches; 2015E forward includes all actual launches and only expected launches in total brand numbers whose annual sales exceed
$100M and assumes 6 months pediatric extension on all launches. Forward-looking analysis assumes no “at risk” launches.
Source: IMS Health; company estimates.
43
1
Biosimilars Represent an Additional
Opportunity
Total Market Sales
($, billions)
Notes:
1. Break-open period for generic launches = 12 months from the point at which there are 3+ viable suppliers in the market (may span 2 calendar years), and
includes significant, “budgeted launch” products only. Brand market sales are at the time of first generic launch; break-open dates on the 15th or later were
rounded to next full month; dates before the 15th credited for that month
month.
2. 2014 includes all actual launches; 2015E forward includes all actual launches and only expected launches in total brand numbers whose annual sales exceed
$100M and assumes 6 months pediatric extension on all launches. Forward-looking analysis assumes no “at risk” launches.
Source: IMS Health; company estimates.
44
1
With Incremental Generic Benefits Declining,
Biosimilars Will Become a Bigger Opportunity
Total Market Sales of
• Biosimilars are expected to act more like
Specialty Drugs
brands than generics
Losing Exclusivity
($, billions)
• Expected to increase competition in specialty
categories 19.5
45
2
Red Oak Sourcing to Add Smaller Incremental
Value in 2016 But Opportunity Remains
Venture withVenture
Cardinalwith Cardinal
Health Health
continues tocontinues to to CVS
provide value
provide
Health in three ways:value to CVS Health in three ways
46
2
Combined Procurement Has Grown 50%
Since Inception of Red Oak Sourcing
Relative Dollar Amount of Generics
• Red Oak is the largest generic
Procured Using Red Oak
sourcing entity in the U
U.S.
S
~50%
• Generic volumes sourced by Red
Oak continue to grow
A
Acquisitions
i iti
• Scale matters … incremental
Cardinal value continues to be derived
Health Red Oak from additional volume
CVS
Health • More sophisticated procurement
47
2016 Earnings Growth Significantly Back-half
Weighted
EARNINGS GROWTH
TIMING FACTORS EARNINGS GROWTH
TIMING FACTORS
Generic introductions / break-opens
L
Leap day
d
Medicare Part D
Easter Shift benefits Q1
Front store strategies’ benefits
to the detriment of Q2
Share repurchases
Tax rate
1st
Half 2nd
Half
48
2016 Q1 Guidance: Challenging EPS Growth Due to
Timing Factors
Q1 2016
Notes:
1. EPS estimates exclude acquisition-related transaction and integration costs.
2. Estimates assume that the acquisition of Target’s pharmacies and clinics closes at year-end 2015.
3. EPS estimates assume completion of approximately $4 billion in share repurchases during full-year 2016.
49
Agenda
Marketplace Misconceptions
50
Steady State Targets Affirmed
51
Capital Allocation Priorities Guide Use of Cash
Organic Growth
Operational
p Investments • Sto
Store
eggrowth
o t aand
d remodels
e ode s
• Continued technology improvements
Dividends
• 18% target CAGR 2014 through 2018
Capital Returned to • 35% target payout ratio by the end of 2018
Shareholders Repurchase stock
• Take advantage of share valuation, absent more attractive
alternatives
52
Many Initiatives You’ll Hear About Today to
Continue to Drive Enterprise Profit Growth
Health plans represent significant opportunity to drive value
and capture share, whether or not we’re the PBM
Our specialty business has unmatched assets
and continues to outpace the market
Target and Omnicare acquisitions enable pharmacy
share gains
Near-term opportunities to gain retail share from
market disruption
53
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Driving business decisions with enterprise mindset
Broadening the Base Acquisitions delivering growth into new channels
Full-year 2016
Intercompany Eliminations
(% off combined
bi d segmentt revenues))
~ 11.6%
Operating Expense
(% of consolidated revenue)
Moderate improvement
Notes:
1. Year-over-year growth based on midpoint of 2015 guidance.
2. Expectations exclude acquisition-related transaction and integration costs.
56
2016 Guidance: Consolidated Income Statement
Full-year 2016
Notes:
1. EPS estimates assume completion of approximately $4 billion in share repurchases in 2016. Timing of repurchases are expected to be weighted more in the
first half of the year rather than the second half.
2. Expectations exclude acquisition-related transaction and integration costs.
57
2016 Q1 Guidance: Segment Performance Reflects
Impact of Timing Factors
Q1 2016
58
Steady State Targets:
Key Assumptions to Keep in Mind
Anticipated Impact
F
Favorable
bl iindustry
d t demographics
d hi Utili ti
Utilization
Net-new
Net new PBM contracts Mix/volume/lives
High-return,
High return, bolt-on
bolt on acquisitions Operating profit
59
Driving Enterprise
Growth in an Evolving
Health Care Market
Larry Merlo
President &
Chi f Executive
Chief E ti Officer
Offi
Agenda
2
The Most Extensive Suite of Leading Assets …
Retail Mail
Long-term
Care
Retail Specialty
Clinics
Clinical
Infusion
Programs
g
3
Continue to Build One-of-a-kind Health Care
Company with Unmatched Integrated Assets
g provider
Leading p of p
pharmacy
y services in long-term
g care
4
Pharmacy Is Our Focus and We’ve Captured 39%
of Past 5
5-Year
Year Prescription Growth
Total U.S. Rx Industry
(Rx dispensed, billions)
~710M 5.5
new Rx
4.8
2010 2015E
Note:
1. All prescriptions dispensed on a 30-day equivalent basis. Does not include Omnicare.
Source: IMS data, CVS Health Internal Analysis.
5
Pharmacy Is Our Focus and We’ve Captured 39%
of Past 5
5-Year
Year Prescription Growth
Total U.S. Rx Industry
(Rx dispensed, billions)
~710M 5.5
new Rx CVS Health
share of
275M market growth
4.8
39%
2010 2015E
Gaining share in a growing Rx industry
Note:
1. All prescriptions dispensed on a 30-day equivalent basis. Does not include Omnicare.
Source: IMS data, CVS Health Internal Analysis.
6
Prescription Growth Through Enterprise Channels
Demonstrates Power of Unique, Integrated Model …
CVS/caremark Claims
(Rx, millions)
~1,165
1,080
905
Channel agnostic
740 offerings allow us to
capture growth in
CVS/caremark claims
while helping to drive
445 470 client savings
275 365
Notes:
1. CVS Health dispensed prescriptions include CVS/pharmacy, mail, CVS/specialty and Omnicare prescriptions across all years.
2. CVS retail and mail prescriptions on a 30-day equivalent basis.
3. 2015E is midpoint of guidance range.
7
… and Has Allowed Us to Capture 700 bps of
Revenue Share, Equating to $7 Billion
CVS/caremark Revenue
($, billions)
~100
88
59 700 bps
increase
44
=
$7 Billion
48% 50% 53% 55%
2008 2011 2014 2015E
CVS Health share All other
8
Agenda
9
Evolving Health Care Market Creates Opportunities
10
Health Reform and Demographics Expanding 1
Insured Population
Growth in U.S. Insured Lives
(lives, millions)
306
286 Individuals/Exchanges
35
264 19
14
63 65 Medicaid
53
49 53 62 Medicare
11
Aging U.S. Population Will Drive Prescription 1
Utilization …
U.S. Population Aged 65+ Retail Prescription Utilization
(lives, millions) by
y Age
g Group p
(Rx per member per year)
+18M
lives 65.9
65+ 36.6
56.4
47.8
19-64 16.2
0-18 4.1
12
… and Fuel Growth in Prescription Expenditures 1
6.2% 564
CAGR
464
385
328
Source: CMS, Office of the Actuary, Prescription Drug Expenditures (figures as of July 30, 2015).
13
Pharmacy Is One of the Most Cost-efficient 1
Ways to Manage Overall Health Care Costs
Healthcare Savings from Improved Adherence
(PMPY)
Hyperlipidemia Diabetes Hypertension
ROI $5,883 ROI $5,676
9X 9X
ROI $3,311
5.5X
Source: Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication adherence leads to lower health care use and costs despite increased drug
spending. Health Affairs. 2011;30(1):91-99. Carls GS, Roebuck MC, Brennan TA, Slezak JA, Matlin OS, Gibson TB. Impact of medication adherence on worker
productivity: an instrumental variables analysis in five chronic diseases. JOEM, 2012. Cholesterol savings from generic medications only.
14
CVS Health Can More Broadly Reach Patients 1
Across the Continuum of Care
Standalone Standalone
CVS Health
Retailer PBM
Retail pharmacy
Mail Order
Specialty/Infusion
LTC pharmacy
Retail clinics
Clinical programs
Channel connectivity
15
Growth in U.S. Population Over 85 Underscores 1
Need for Long-term
Long term Care
U.S. Population Aged 85+ Omnicare is a leading pharmacy
(lives, millions) services provider to LTC facilities
16
Evolving Health Care Market Creates Opportunities
17
Specialty Growth Will Be Primary Driver of 2
Pharmacy Trend
Addressable Specialty Industry
($, billions)
14% 220
CAGR
130
65
Note:
1. Addressable specialty industry currently excludes infused oncology.
Source: NHE, Artemetrx, CVS Health Internal Analysis, 2015.
18
We Are Well-positioned as the Largest and 2
Fastest-growing
Fastest growing Specialty Pharmacy in the U.S. …
CVS Health Specialty Revenue
($, billions)
49
27%
CAGR
40
30
22
19
.
Source: CVS Health Internal Analysis. Does not include specialty revenue from Target pharmacies.
19
… with the Broadest Capabilities to Manage 2
Trend and Improve Care
Site-of-care
Sit f • H
Home or alternate-site
lt t it iinfusion
f i services
i can
Management dramatically lower costs
Medical
• Novologix platform enables editing and re-pricing for
Claims
Editing medical pharmacy claims
Care
Coordination • Certified nurse case managers provide clinical support
20
Evolving Health Care Market Creates Opportunities
21
Retailization of Health Care Continues with 3
Growth in Consumer
Consumer-directed
directed Health Plans
CDHP Enrollment
Drivers of Trend
(lives, millions)
• Employers looking to CDHPs
37.5 to help control mounting health
25% care costs
CAGR 30 5
30.5 − Employees have accountability in
their health care decision-making
22.0
• Growth in CDHPs also driven by
health insurance choosers on the
12.5 exchanges
6.1
22
Promoting Healthy Behavior Is Critical in 3
Avoiding Unintended Consequences with CDHPs
As Patient Cost Share Rises…
CVS Health Advantages
23
Example: Reduced Co-pay for Key Maintenance 3
Medications Improves Adherence in CDHPs
80% 82%
+560
bps
63%
57%
24
Evolving Health Care Market Creates Opportunities
25
Payment Models Continue to Evolve Away from 4
Fee-for-service
Fee for service and Towards Value
Value-based
based Payments
33%
52%
34%
18% Two-thirds in
alternative
30% 33% models
2015E 2018E
Medicare Advantage Value-based FFS Volume-based FFS
Source: Burwell S. Setting Value-Based Payment Goals – HHS Efforts to Improve U.S. Health Care. The New England Journal of Medicine. 2015; 372:897-899.
26
Public and Private Payors Taking Steps to 4
Managing Outcomes and Total Cost of Care
Medicare Part D
Enhanced MTM model
Sources:
1. HHS, CMS finalizes bundled payment initiative for hip and knee replacements, November 2015.
2. CMS, CMS announces Part D Enhanced Medication Therapy Management Model, September 2015.
3. Health Care Transformation Task Force, Major Health Care Players Unite to Accelerate Transformation of US Health Care System, January 2015.
27
CVS Health Can Support Health Systems Across 4
the Payment Continuum
Sacramento,
Birmingham,
AL
Evolving Contracting Arrangements CA
28
Full Range of Tools and Services to Support 4
Differentiated Needs of Providers
Health
Hospital
CVS/minuteclinic Epic EMR Engagement
Transitions
Engine
29
CVS Health Best-in-class Tools to Drive Adherence 4
30
Largest
CVS Health
MedCan
D PDP
Directly
to Achieve
Impactaa4-Star
Significant
Rating 4
Portion
for the 2016
of Star
Plan
Metrics,
Year Driving Outperformance
Largest PDPs by Enrollment
(lives, millions)
Star
Rating
OptumRx 5.4 3.0
CVS Health 45
4.5 40
4.0
Humana 4.4 3.5
Express Scripts 28
2.8 40
4.0
CIGNA 1.5 3.0
Aetna 1.5 3.0
WellCare 1.0 2.6
Note:
1. Star Rating based on weighted average enrollment by parent organization. Only plans that were CVS/caremark managed for the 2016 measurement period
and received a Star rating were included.
Source: CMS (membership figures as of October 9, 2015), CVS Health Internal Analysis.
31
CVS Health Can Directly Impact a Significant 4
Portion of Star Metrics, Driving Outperformance
Largest PDPs by Enrollment SilverScript is excelling…
(lives, millions)
Star • O
Only
l PDP with
ith >50%
50% llow-
Rating
income-subsidy lives to
OptumRx 5.4 3.0 achieve 4 Star rating
CVS Health 45
4.5 40
4.0 And we’re helping clients
Humana 4.4 3.5 achieve their goals…
Express Scripts 28
2.8 40
4.0 • Ability
y to directlyy impact
p more
than 80% of Med D and 55% of
CIGNA 1.5 3.0 MAPD Star metrics
Note:
1. Star Rating based on weighted average enrollment by parent organization. Only plans that were CVS/caremark managed for the 2016 measurement period
and received a Star rating were included.
Source: CMS (membership figures as of October 9, 2015), CVS Health Internal Analysis.
32
Evolving Health Care Market Creates Opportunities
33
We Can Partner with Health Plans in a Multitude 5
of Ways to Drive Value
Strong
Broad service Pharmacy y is Unique
q abilityy
procurement
portfolio to our focus and a to leverage
capabilities and
support plan key lever for consumer
claims scale
needs whether managing insights
makes
or not we are overall health to improve
us a low-cost
the PBM costs care
provider
34
After Consolidation, Regional and Blues Plans 5
Will Still Manage More Than Half of Total Lives
Humana
Aetna Aetna
Cigna
Anthem
Anthem Nationals 46%
United United
Regionals
54%
Blues
35
We Dispense 8X to 11X the Prescription 5
Volume of the Proposed Combinations …
2015 Estimated Rx Volume
(Rx dispensed, millions) CVS Health Advantages
170 120
Notes:
1. Estimated dispensed Rx include prescriptions filled at CVS/pharmacy and mail order and specialty prescriptions filled at CVS/caremark.
2. Estimated dispensed Rx also displayed on a pro forma basis to include full year 2015 Dispensed Rx volume from Omnicare and Target.
Source: CVS Health Internal Analysis, Company disclosures. All prescriptions dispensed on a 30-day equivalent basis.
36
… and We Manage 2X to 3X the Claims 5
Volume of the Proposed Combinations
2015 Estimated Claims Volume
CVS Health Advantages (Rx managed, millions)
• Substantial managed claims
volume supports negotiations for 1,165
rebates / formulary placement
~2X
2X ~3X
• Creates value as majority of
rebates are passed to clients 600
480
Note:
1. Estimated managed claims include all CVS/caremark network claims plus specialty and adjusted mail claims.
Source: CVS Health Internal Analysis, Company disclosures. CVS/caremark claims represent midpoint of guidance range.
37
We Dispense 8X to 11X and Manage 2X to 3X the 5
Volumes of the Proposed Combinations
2015 Estimated Rx Volume 2015 Estimated Claims Volume
(Rx dispensed, millions) (Rx managed, millions)
1,350 1,165
~2X
2X ~3X
~8X ~11X 600
480
170 120
38
Agenda
39
Our Strategic Business Imperatives
40
Our Strategy for Long-term Enterprise Growth
5
4
Opportunistic bolt-on acquisitions
2
Enhance patient engagement
Add capabilities
p to enhance core business
41
Today’s Key Takeaways
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Expanding
p g core p
pharmacyy business while broadening
g
Broadening the Base reach into new health care channels
43
Delivering Value Today,
Ensuring Growth
for Tomorrow
Jon Roberts
Executive Vice President &
President CVS/caremark
President,
Agenda
Demonstrating
Demonstrating Value:
Value:
PBM
PBM Performance
P f
Performance Highlights
Hi hli ht
Highlights
Addressing Clients
Clients’ Top Concern: Cost
2
Continued Strong PBM Performance
58.9 2.2
3
Another Successful Selling Season:
Gross New Business Wins of $13.5 Billion for 2016
$1.8B13 5B
13.5B $11.2B
IN NEW
BUSINESS WINS
State of Oklahoma
State
St t off
Illinois Health Plan
Government & Union
Employer
Notes:
1. As of 12/04/2015.
2. Gross wins exclude Medicare Part D SilverScript individual products.
4
Net New Client Business of $11.5 Billion for 2016
with 98% Retention
Revenues
($, billions) 60% of client
non-renewalsl
13.5 0.8 due to acquisition
and retirees
0.4
0.8
11.5
5
Gross New Business Creates Share Gain Opportunity
54%
$0.6B
Mail Choice
28%
$1.8B data
Specialty 22%
$11.1B
$
Retail New Existing Existing
Networks Business Health Plan Employer
Notes:
1. Enterprise share represents the percent of Rx volume dispensed through a CVS Health enterprise channel (Mail, Specialty, Retail).
2. All claims on a 30-day equivalent basis.
6
Client Priorities: Prescription Drug Cost
Top Concern Across Segments
UTILIZATION
AVOIDING MEDICARE MEMBER CLIENT PRESCRIPTION
& CLINICAL
DISRUPTION EXPERTISE SERVICE SERVICE DRUG COST
PROGRAMS
LEVEL OF IMPORTANCE
7
Our Model Provides Flexibility to
Address
dd ess C
Client
e t Priorities
o t es
Employers
UTILIZATION
AVOIDING MEDICARE MEMBER CLIENT PRESCRIPTION
& CLINICAL
DISRUPTION EXPERTISE SERVICE SERVICE DRUG COST
PROGRAMS
LEVEL OF IMPORTANCE
8
Our Model Provides Flexibility to
Address
dd ess C
Client
e t Priorities
o t es
Health Plans
UTILIZATION
AVOIDING MEDICARE MEMBER CLIENT PRESCRIPTION
& CLINICAL
DISRUPTION EXPERTISE SERVICE SERVICE DRUG COST
PROGRAMS
LEVEL OF IMPORTANCE
9
Our Model Provides Flexibility to
Address Client Priorities
Medicare
UTILIZATION
AVOIDING MEDICARE MEMBER CLIENT PRESCRIPTION
& CLINICAL
DISRUPTION EXPERTISE SERVICE SERVICE DRUG COST
PROGRAMS
LEVEL OF IMPORTANCE
10
Multi-segment PBM Market Demands Flexibility
Employers
p y Government Health
and Unions Plans
11
Delivering on Client Priorities:
Clients and Members Highly Satisfied with Service
2015 Client Satisfaction 2015 Member Satisfaction
96% 95%
12
Delivering on Client Priorities: Medicare
Actuarial
A t i l / bid,
bid formulary
f l Progressive and
and plan integrated strategies to
design support help manage trend
MEDICARE
HEALTH
PLAN
Star Ratings
g Compliance
p
Note:
1. Star ratings for 2016 based on internal analysis of CMS data released October 2015. Star rating based on weighted average enrollment by parent
organization. Only plans that were CVS/caremark managed for the 2016 measurement period and received a Star rating were included.
13
Delivering on Client Priorities: Clinical Programs
SPECIALTY CARE
PHARMACY ADVISOR MANAGEMENT NURSE
Note:
1. Savings quoted may vary based on various factors including things such as plan design, programs adopted and demographics.
Sources:
Pharmacy Advisor : CVS/caremark internal data
data, 2013
2013. Medication Reconciliation: CVS/caremark sample study
study, 2014
2014. Robust UM (integrated PA)
CVS/caremark Specialty Client Solutions and Trend Management, 2013, internal analyses for estimated program savings. Specialty engagement source:
Accordant® - Comprehensive Data Warehouse; SQL Server 2008. Greensboro, NC: care management Health Services, a CVS/caremark Company; 2013
www.hpminstitute.org/content/wellness-and-disease-management-podcast-industry-specialist-judy-mueller.
14
Agenda
Demonstrating Value:
PBM Performance
P f Highlights
Hi hli ht
15
Size and Scale Ensures Competitive Cost
Note:
1. 2016E based on midpoint of 2016 guidance.
16
Comprehensive Program Addresses 3 Possible
Areas of Fraud, Waste and Abuse
MEMBER
• Medication abuse / misuse CVS/caremark provides:
• Doctor shopping
• Pharmacy shopping • Active and retrospective
claims monitoring
PRESCRIBER • Review of high-risk
high risk
prescribing patterns
• Illegal or irresponsible prescribing • Robust network pharmacy
credentialing program
PHARMACY • Pharmacy
Ph audits
di
• Fraudulent billing • High- and low-touch
interventions
• Inaccurate dispensing
• Drug diversion
For 2015, CVS/caremark pharmacy audits will lead to more than $240M in
savings and recovery of incorrect
incorrect, improper or fraudulently-billed claims
Source: CVS/caremark internal data.
17
2014 Double-digit Pharmacy Trend: A Call to Action
IMPACT TO TREND
1 0%
1.0%
2.0%
3.4% (5.9)%
11.8% 1.5%
2.1%
7.7%
2014 Book Non- Specialty Utilization Hep C Compounds Generic Drug Mix
of Business specialty Brand Inflation
Brand Inflation
Trend
Inflation
Note:
1. Trend is net of rebates.
Source: CVS Health Enterprise Analytics, Book of Business Trend Cohort.
18
RxInsights: Client-Specific Reporting on Trend
Performance and Key y Metrics
EXECUTIVE SUMMARY
Note:
1. Sample data, actual results may vary.
19
CVS HEALTH - COMPREHENSIVE SOLUTIONS TO MANAGE TREND
IDENTIFY EXPLORE MANAGE OPTIMIZE
EMERGING ROOT CAUSES THROUGH CHANNEL
TREND FORMULARY
Interactive RxInsights
Individual classes are p
plotted below. The g
graph
p is showing
g the relationship
p between Cost and Contribution to Trend. Size represents
p the Cost/Days
y Supply
pp y for a g
given class.
3%
2%
RxInsights
1%
0% Demo
-1%
-2%
-3%
$0 $1 $2 $3 $4 $5 $6 $7 $8
GROSS COST PMPM TREND
$
$120
$100
$80
©2015 CVS Health and/or one of its
J
January 2014 M 2014
May S t b 2014
September J
January 2015 M 2015
May S t b 2015
September affiliates: Confidential and Proprietary
Strong Adoption of Key Cost Management Solutions
… Meaningful Opportunity Remains
Total Lives
Current Lives Savings
Opportunity
MAINTENANCE
CHOICE 23M 44M Up to 4%
TOTAL NETWORK
STRATEGIES 37M 75M Up to 4%
FORMULARY
STRATEGIES 25M 53M Up to 12%
EXCLUSIVE
SPECIALTY 35M 50M Up to 7%
SPECIALTY MEDICAL
MANAGEMENT 10M 41M Up to 13%
Notes:
1 Current Lives includes 2016 known enrollments
1. enrollments.
2. Exclusive Specialty savings apply to specialty spend under the pharmacy benefit.
3. Specialty Medical Management opportunity based on Health Plan lives in PBM book of business; savings apply to specialty spend under the medical benefit.
4. Savings results will vary based on a variety of factors including demographics, plan design and other programs implemented by the client.
21
Adoption of Our Plan Designs Helps Reduce Plan
Costs While Growing Enterprise Share
Enterprise Share Growth in a Multi-state Health Plan
11.4 pp
increase
31.3%
26.7%
19.9%
Plan has implemented programs that reduce plan and member cost
and grow enterprise share
22
2014 Year-to-date
2015 Double-digit Trend
Pharmacy
Summary
Trend: A Call to Action
2015
2014
YTDBook
Book Non- Specialty Utilization Hep C Compounds Generic Drug Mix
of Business specialty Brand Inflation
Brand Inflation
Trend
Inflation
Note:
1. Trend is net of rebates.
Source: CVS Health Enterprise Analytics, Book of Business Trend Cohort.
23
Agenda
Demonstrating Value:
PBM Performance
P f Highlights
Hi hli ht
Addressing Clients
Clients’ Top Concern: Cost
24
Driving Market Evolution: Government Programs
Linking
g Payments
ay e ts to Qua
Quality
ty
50% of traditional
1 in 3 Medicare spending
Americans are currently will be linked to quality incentives by 2018
covered by government- % OF MEDICARE 50%
SPENDING TIED TO
sponsored
p health QUALITY INCENTIVES
insurance programs
20%
$1off every $2
spent on health care goes
through Medicare and
M di id
Medicaid 2014 2018
To succeed, payors and providers must align with CMS focus on quality
Notes:
1. Health Affairs – National Health Expenditure Projections 2014-2024, July 2015.
2. Modern Healthcare, January 26, 2015.
25
Our Model Uniquely Meets Evolving Needs
Integrated Assets
and Ability to Improve Outcomes
Position Us for Growth
1 2 3 4
26
We Make Data Actionable and Deliver It When and
Where Interventions Can Do the Most Good
Optimal Interventions
P
Powered d by
b the
th
Health Engagement Engine
CVS/omnicare ™
Adherence Medication
counseling reviews for high Omnicare
Omnicare
risk patients Wellness support support
Supportfor for
Support for
self-management Specialty condition Transitions
transitions inincare
Care
of chronic conditions management
Note:
1. CVS Health uses and shares data as allowed by applicable law, our agreements and our information firewall.
Adh
Adherence opportunities
t iti
Intervention
results
Medication
M di ti and d
allergy info
MinuteClinic
Provider
visit summaries
Affiliated with 60+ health systems to share data and support patient
interventions and better outcomes
Note:
1. CVS Health uses and shares data as allowed by applicable law, our agreements and our information firewall.
30 3 Provider Connectivity
Supporting Patients After Discharge from Hospital:
Care Transitions Challenge the System
Sources:
1. Health Affairs Health Policy Brief, November 12, 2013, Medicare Hospital Readmission Reduction Program.
2. Annals of Internal Medicine; The Incidence and Severity of Adverse Events Affecting Patients after Discharge from the Hospital, 2003.
31 4 Transitions in Care
Supporting Patients After Discharge from Hospital:
Reducing Risk, Improving Outcomes
32 4 Transitions in Care
One-of-a-kind: Assets and Capabilities to Connect
and Coordinate with All Stakeholders
Integrated
Model Helps
RETAIL PHARMACY Lower Costs LARGEST HOME
FOOTPRINT and INFUSION
Improve
Outcomes
33
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Flexibility to meet evolving market needs
Broadening the Base Adding value with new capabilities
35
Capitalizing on Growth
Opportunities in Specialty
Performance Highlights
2
CVS/specialty Has Grown Faster Than the Industry
40
30
22
19
.
Source: CVS Health Internal Analysis, does not include specialty revenue from Target pharmacies.
3
CVS/specialty Has Grown Faster Than the Industry
35
32.3%
CVS/specialty
27 CAGR
20
14 19.3%
11 Industry
CAGR
.
Source: CVS Health Internal Analysis, does not include specialty revenue from Target pharmacies.
4
CVS/specialty Is Growing Faster Than Nearest
Competitor to Become the Largest Specialty Pharmacy
25% 26%
33% 35%
300 bps 700 bps
point lead for
point lead for
CVS/specialty
p y
competitor
2% 19%
2% 28% 3%
10% 6%
11%
$63B Market $78B Market
Competitor A Competitor B Competitor C Competitor D All other
Source: 2013 Share: Pembroke Consulting estimates. This chart appears as Exhibit 14 in the 2013-14 Economic report on Retail, Mail, and Specialty
Pharmacies, Drug Channels Institute, January 2014; Proforma for UHC and Catamaran Combination. 2014 Share: Drug Channels, The Top 10 Specialty
Pharmacies of 2014.
5
Agenda
Performance Highlights
6
The Traditional Specialty Pharmacy Model Now
Represents ‘Table
Table Stakes
Stakes’ in the Industry
CLINICAL CLINICAL
LOGISTICS
MANAGEMENT MONITORING
7
CVS Health’s Enterprise Assets ‘Raise the Bar’ in
Specialty Pharmacy
Coram, Infusion Services
Novologix, Medical Specialty Cost
M
Management t M
Management
t
Narrowest Exclusion Formulary
ONLY
Accordant, Care Management Quality
Q y
Specialty Connect
Best-in-class Mobile App
pp Access
Access to 99% of Specialty Drugs
8
CVS/specialty Model Starts with National Footprint
CVS/specialty:
CVS/specialt
CVS/
CVS/pharmacy:
T
Target:
Total th12
t hmoreh than
more
t l CVS/pharmacy:
CVS/ th 7,900
than
1 660
1,660
more 7than
th9009,500
9 500
9 Access
CVS/specialty Model Starts with National Footprint
CVS/specialty:
CVS/specialt
T
Target:
Total th12 1,660
t moreh than
t l CVS/pharmacy:
CVS/ 1 660
more than
th 9,500
9 500
10 Access
CVS/specialty Model Starts with National Footprint
CVS/specialty:
CVS/specialt
Total CVS/ h 12
T t l CVS/pharmacy: more than
th 9,500
9 500
11 Access
CVS/specialty Model Starts with National Footprint
CVS/specialt 12
CVS/specialty:
12 Access
Our Specialty Connect Model Improves the Patient
Experience with Convenience
HIGHLY-UTILIZED
HIGHLY UTILIZED DELIVERY
DELIVERYOF CLINICAL
CHANNEL CHOICE SUPPORT
~500
specialty patients a day
13 Access
Our Specialty Connect Model Improves Patient
Experience
p with Flexibility
y
HIGHLY-UTILIZED
HIGHLY UTILIZED DELIVERY
DELIVERYOF CLINICAL
CHANNEL CHOICE SUPPORT
54%
prefer to pick up at
CVS/pharmacy
Note:
1. In-store pick up currently is not available in Arkansas, Oklahoma and West Virginia. Some states require first fill prescriptions to be transmitted directly to the
di
dispensing
i specialty
i l pharmacy.
h O
Other
h restrictions
i i may apply.
l PProducts
d available
il bl through
h h the
h SSpecialty
i l C Connect program are di dispensed db
by CVS/
CVS/specialty
i l iin
compliance with all applicable state laws.
Source: "The Adherence Impact of a Program Offering Specialty Pharmacy Services to Patients Using Retail Pharmacies.”, Journal of the American Pharmacists
Association. In press.
14 Access
Our Specialty Connect Model Improves Patient
Experience with Better Outcomes
HIGHLY-UTILIZED
HIGHLY UTILIZED DELIVERY
DELIVERYOF CLINICAL
CHANNEL CHOICE
C OC SUPPORT
S O
11.4% adherence
improvement
Note:
1. In-store pick up currently is not available in Arkansas, Oklahoma and West Virginia. Some states require first fill prescriptions to be transmitted directly to the
di
dispensing
i specialty
i l pharmacy.
h O
Other
h restrictions
i i may apply.
l PProducts
d available
il bl through
h h the
h SSpecialty
i l C Connect program are di dispensed db
by CVS/
CVS/specialty
i l iin
compliance with all applicable state laws.
Source: "The Adherence Impact of a Program Offering Specialty Pharmacy Services to Patients Using Retail Pharmacies.”, Journal of the American Pharmacists
Association. In press.
15 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
ONE-STEP REFILL
16 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
ONE-STEP REFILL
17 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
Fingerprint Touch ID
Facial Recognition
ONE-STEP REFILL
18 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
Fingerprint Touch ID
Facial Recognition
ONE-STEP REFILL
19 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
Fingerprint Touch ID
Facial Recognition
ONE-STEP REFILL
Scan to Refill
Refill Reminder
20 Access
Our Best-in-class Mobile App Further Improves
Experience for Specialty Patients
SIMPLE COMMUNICATIONS
Choice of Delivery
Text Messaging
EASY TO LOGIN
Fingerprint Touch ID
Facial Recognition
ONE-STEP REFILL
Scan to Refill
Refill Reminder
21 Access
Enterprise Assets Make CVS/specialty the
Pharmacy of Choice When Patients Have Options
22 Access
Our Assets Also Make CVS/specialty a Pharmacy of
Choice in Limited Manufacturer Networks
Blincyto
y Uptravi
p
Infused anti-cancer Oral pulmonary arterial
therapy hypertension (PAH) therapy
23 Access
Effective Quality and Cost Management Solutions
Are
e Resonating
eso at g witht Payors
ayo s
Nearly 1,000
clients in the
past 2 years
have selected
CVS/specialty
as their
Exclusive
Specialty
P
Provider
id
Lives, millions
Enrolled lives in 2014 182
Enrolled lives in 2016
Eligible lives
42
41
37
22
11
8
1.3 0.2
Accordant Specialty Formulary Specialty Medical
Management
Illustrative
Ill t ti IIntegrated
t t d
Trend PA
Site
20% 6% of
Claims
Care
Editing &
3% Pricing Specialty
Formulary Generic
2% Pricing
2% Programs Models Exclusive Remaining
1% Network
1% Trend
1%
4%
Source: CVS/caremark Specialty Client Solutions and Trend Management, 2014, internal analyses for estimated program savings.
Specialty
Site
Formulary
of
Care 4% Generic
Programs
Claims Exclusive
Editing 3% N t k Remaining
Network
Trend
& Pricing 1%
12%
Pricing
Models
Source: CVS/caremark Specialty Client Solutions and Trend Management, 2014, internal analyses for estimated program savings.
Performance Highlights
28
Our Strategic Business Imperatives
29
Aggregating Lives Requires Innovative Cost
Management Programs: Value
Value-based
based Contracting
A il bl 2016
Available P
Psoriasis:
i i
Exclusion
Formulary
for CVS/caremark
clients
4
30 Aggregate Lives
Growing Share in Growing Segments:
Outperform Upon Launch with Proactive Strategies
Indexed Growth:
Key Tactics
CVS/specialty Share
1.7 1.7
• Establish Centers of Excellence
• Incorporate into
Specialty Connect
1.5 1.5
• Engage physicians with
differentiated service model
Note:
1. CVS/specialty share is based on internal analysis and IMS data.
31 Grow Share
Strong Pipeline Creates Growth Opportunity for
CVS/specialty in Newly Launched Products
ROBUST PIPELINE: ANTICIPATED SPECIALTY AGENTS IN 2016-2018
New Drugs
238
ANTICIPATED BLOCKBUSTER DRUGS:
NSC Lung Cancer Breast Cancer Liver Disease (NASH) Alzheimer’s Disease
rociletinib ribociclib obeticholic acid aducanumab
(2016) (2017) (2018) (2018)
Note:
1. NSC (Non-small Cell) NASH (Nonalcoholic Steatohepatitis)
32 Grow Share
Oncology Remains Key Pain Point for Payors:
CVS/specialty Developing Innovative Approach
AVERAGE EPISODE SPEND
BY PROVIDER: BREAST CANCER FIVE MODIFIABLE COST FACTORS
Duration of Therapy
Use of Generics
75th percentile: $60K
33 Drive Innovation
Oncology Remains Key Pain Point for Payors:
CVS/specialty Developing Innovative Approach
AVERAGE EPISODE SPEND CVS/SPECIALTY VALUE-BASED
BY PROVIDER: BREAST CANCER APPROACH
Reduced
R d d
Reduce variability in expense with
variability capitated risk program for plans
34 Drive Innovation
Adding New Capabilities to the Enterprise
Augments Organic Growth Strategies
35 Enterprise Focus
New Relationship with Leading Social Network for
Patients with Chronic Disease
MyHealthTeams
36 Enterprise Focus
New Relationship with Leading Social Network for
Patients with Chronic Disease
300K 48%
Registered Users Active Users
Creating
Increasing
Awareness
and Engagement Script Growth
37 Enterprise Focus
The Right Strategy for an Evolving Health Care Market
39
Changing the Face of
Retail Pharmacy Through
Innovation
Helena Foulkes
Executive Vice President &
President CVS/pharmacy
President,
Agenda
Evolution of CVS/minuteclinic
2
Retail Pharmacy at a Glance
72%
Pharmacy
y
3
Strong Record of Share Growth in Both
Pharmacy and Front Store
CVS/pharmacy Share of Total U.S.
Health & Beauty Share
Retail Prescriptions
+240 +50
bps bps
21.6% 11.5% 12.0%
19.2%
Note: Note:
1. Compares 2015 90 day adjusted scripts from January through August to 1. Market = remainder of Food/Drug/Mass;compares 2015 YTD through
2010 January through August August to 2010 Jan through August
Source: IMS Source: IRI
4
Continued Strength in Core Retail
Pharmacy Business
Growth in Prescriptions
(2010 – 2015)
38%
Notes:
1 Compares total CVS/pharmacy prescriptions for 90 day adjusted scripts January through August for 2010 compared with January through August for 2015
1.
2. Compares total market (excluding CVS/pharmacy) for 90 day adjusted scripts January through August for 2010 compared with January through August for 2015
3. Reduction in labor cost to fill excludes wage inflation.
Source: IMS
5
Continued Strength in Core Retail
Pharmacy Business
Growth in Prescriptions
(2010 – 2015)
38%
~2X
19%
Faster ~13%
reduction in labor
cost to fill each
Rx since 2010
Notes:
1 Compares total CVS/pharmacy prescriptions for 90 day adjusted scripts January through August for 2010 compared with January through August for 2015
1.
2. Compares total market (excluding CVS/pharmacy) for 90 day adjusted scripts January through August for 2010 compared with January through August for 2015
3. Reduction in labor cost to fill excludes wage inflation.
Source: IMS
6
We Are Continuing to Use Various Channels to Drive
Growth in Pharmacy Volume
Omnicare Acquisition
7
Success in High Margin Health & Beauty Businesses
2010 2015E
Note:
1. 2015 YTD through August with estimate through end of year. Sources: CVS Health Internal Analysis, IRI, Mintel market reports, Global-
Source: CVS Health Internal Analysis. Markets reports, ITE Beauty, CVS Health Internal Analysis.
8
Continued Success in Store Brands
9
Agenda
Evolution of CVS/minuteclinic
10
Growing Our Business Through Acquisition of
Target Pharmacies and Clinics
• ~4,000
~4 000 pharmacists • ~380
380 clinical
li i l
providers and
• ~10,000 technicians
staff members
• ~80
80 field
fi ld lleaders
d
• 430,000 annual
• ~100 million prescriptions visits
filled annually
11
Target Pharmacies Complement and Expand Our
Existing Footprint, Increasing Patient Access
OR
ID SD
CO
New regions
AK include …
• Seattle
• Denver
• Portland
• Salt Lake City
12
Transitioning New Assets to Our Brand and Network
• Rebrand as CVS/pharmacy
y and MinuteClinic
• Introduce unique CVS clinical programs and capabilities
• Focus on driving script growth and profitability
13
Acquisition Will Benefit New and Existing Patients
Target CVS/pharmacy
Note:
1. FY 2014 data, prescriptions on a 30-day equivalent basis.
Source: Target.
14
Expanded Network Increases Options for
Payor Partners – Example: Minnesota
Number of Locations
132
72
51%
increase in
57 CVS/caremark
26 members with
60 access to
t
31 CVS/pharmacy
Pharmacies Clinics
CVS Target
15
Agenda
Evolution of CVS/minuteclinic
16
Unique Model Enables Deep Understanding of Both
B2B and B2C Capabilities
I
Integrated
d B2B and
d B2C C
Capabilities
bili i
B2B
17
Five Key Innovations Are Delivering Value to
Customers and Strategic Partners
2 ScriptSync
Value to
Customers
3 Specialty Connect and
Partners
4 Strategic Partnerships
5 Digital Integration
18
Next Generation Patient Care: New Patient- 1
centric Approach to Drive Retail Pharmacy Growth
Traditional
Next Generation Patient Care
Pharmacyy Model
Customer insights enable patient-centric, targeted approach
Demographics
Broad-
based
service
to all
Geography Clinical inputs
Customer
preferences
19
Example: Proactive Weather Campaign – Partnering 1
with the U.S. Department of Health & Human Services
20
ScriptSync: Making It Easier for Our Patients to 2
Manage Multiple Medications
Pre-ScriptSync Post-ScriptSync
Post-ScriptSync
JANUARY FEBRUARY
~70% of patients accept the program when offered; >500k have enrolled
21
Specialty Connect: Seamless Customer Experience 3
for All Specialty Care Needs at CVS/pharmacy
22
Strategic Partnerships: We Partner with BCBSA 4
Federal Employee Program to Provide Customer Care
23
Strategic Partnerships: A Resource for Health Plans 4
as They Respond to the Retailization of Health Care
Value to Consumers
Convenient access to
health insurance resources
for customers
24
Digital Drives Adherence, Pharmacy Growth and 5
Loyalty
Prescriptions Filled
1 in 3 patients enrolled in
2.4X text messaging
Added medication
reminder and mobile Rx
Non-Digital
g Patients Digital
g pick-up tools
Patients
25
Agenda
Evolution of CVS/minuteclinic
26
2010: 454 MinuteClinic Locations
454
Full-time clinics
in 2010
27
2015: 1,055 MinuteClinic Locations in 32 States and
Washington, D.C.
1,055+
Full-time clinics
in 2015
28
2016: 1,055 MinuteClinic Locations in 32 States (and
D.C.) and Integrating ~80
80 Target Clinics
1,135
Full-time clinics
in 2016
29
CVS/minuteclinic Expanding Scope of Care on Epic
Electronic Health Record Platform
Primary Care Services:
Epic Implementation
50 Most Common Diagnoses
• National MinuteClinic
roll-out of Epic EHR
completed in 2015
• Epic EHR has extended
connectivity to about ~56%
250 provider organizations of most
Expanded
p 11 common
• Enables accelerated CVS/minuteclinic Diagnoses
diagnoses
Scope (22%)
roll-out of new services
Historical 17
C S/
CVS/minuteclinic Diagnoses
Scope (34%)
Notes:
1 Diagnoses not weighted by individual volume.
2 Examples of expanded scope include gastrointestinal illnesses, musculoskeletal pain.
Source: Top 50 Codes: 2015 Family Practice. www.aapc.com/icd-10.
30
Looking Ahead: Expanding Digital Services and
Partnering to Expand TeleHealth
Online
wait times
Remote
queuing
Future
scheduling
31
Agenda
Evolution of CVS/minuteclinic
32
Continue to Expand Our Basket Despite
Industry Headwinds
U.S. Store Trips Growth in Sales per CVS Basket
(trips per person per year) (2015 over 2014)
-2%
4.0%
150 148 143
2.0%
Focus on driving profitable front store growth, attracting new pharmacy patients
Note: Note:
1. U.S. shopper for Food/Drug/Mass retail. 1. All transactions are for TY vs. LY YTD August and adjusted to exclude tobacco.
Source: IRI. Source: CVS Health Internal Analysis.
33
We Launched Front Store Strategy in 2015 with
Five Key Themes to Drive Growth
Be a L
B Leading
di Health
H lth and
d
Beauty Destination
1 2 3 4 5
Better Health Elevate MyCVS Customer- Digital
Made Easy Beauty Store Driven Innovation
Personalization
34
We Launched Front Store Strategy in 2015 with
Five Key Themes to Drive Growth
Be a L
B Leading
di Health
H lth and
d
Beauty Destination
1 2 3 4 5
Better Health Elevate MyCVS Customer- Digital
Made Easy Beauty Store Driven Innovation
Personalization
35
We Executed Key Elements of Our Better Health Made
Easy and Elevate Beauty Strategy in 3 Different Ways
In-store enhancements
Store Remodel
1 2
Better Health Elevate
Made Easy Beauty
Assortment
Expansion
36
These Changes Have Enhanced Thousands of Stores
and Improved Customer Experience
In-store enhancements
Light Touch
• Focus on elevating beauty
Store fixtures
fi t att a minimal
i i l costt
Enhancement
Note:
1. Store reset doors (n=85) at steady state (24+ weeks post-construction, through 9/26).
37
Better Health Made Easy: Revolutionizing Healthy 1
Food Industry
“
I love the fact CVS
added so much
healthy food – CVS
• Edibles up +8.5% overall in remodel stores is really putting
their money where
• 75% of shoppers indicate an intention of their mouth is!
shopping more for on-the-go snacking at CVS ”
Note:
1. Store reset doors (n=85) at steady state (24+ weeks post-construction, through 9/26).
38
Better Health Made Easy: Leading Change from 1
Sick Care to Self Care
39
Elevate Beauty: Multi-step Process to Re-imagine 2
Beauty Segment
Before
(2014)
40
Elevate Beauty: Multi-step Process to Re-imagine 2
Beauty Segment
4,500
stores
41
Elevate Beauty: Multi-step Process to Re-imagine 2
Beauty Segment
After
1 600
1,600
stores
42
Elevate Beauty: Multi-step Process to Re-imagine 2
Beauty Segment
3. Elevated Facial
After
2,000
,
stores
43
Elevate Beauty: Multi-step Process to Re-imagine 2
Beauty Segment
After
44
MyCVS Store: Poised to Capture the High-growth 3
Hispanic Cluster
• Sales up
p +10% in 11 test stores
• Strong results: Edibles +11% and Beauty +20%
• 700 stores in chain with matching demographics
Note:
1. Results are at steady state program to date thru 9/15 – excluding construction period.
45
Customer-driven Personalization: The Future Is 4
Personalization by Leveraging ExtraCare
More Efficient Promo Spending Accretive to Margin
• De-emphasizing
promotion that loses
margin
• Prioritizing promotion
Certain Circular Promotion (e.g.
Certain Circular Promotion (e.g. Soda) Drive Sales with lower salesBut
butLose
Soda) Drive Sales
But Lose Margin significantly
g y positive
p
Margin
margin
• Aspiring to deliver
Divestment Investment Investment in promotions that drive
from negative in high margin Personalization higher sales and
margin promo promo margin
(e.g., soda) (e.g., vitamins)
46
Customer-driven Personalization: Using Shopping 4
Behavior to Segment and Value Our Customers
20%
Lower FS
Front
Value
Store
Customers
Value Customers
70%
80%
Higher FS
Front
Value
Store
Value Customers
Customers 30%
FS Shoppers FS Revenue
47
Customer-driven Personalization: Leverage Data to 4
Produce Relevant and Personalized Communications
• Establish routine
Our Strategy
• Create a reason to visit weekly
• Personalized resupply
1:1 reminder email monthlyy
Higher
Hi h value
l C
Communication
• Personalized sale items
customer
Average
g weekly
y spend
p up
p 38% and average
g redemption
p rate up
p almost 2X
48
Digital Drives Front Store Sales and Loyalty 5
Enhanced customer
Non-digital Digital convenience
Customers Customers
49
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Continuing Rx innovation to serve customer needs
Broadening the Base Strengthening leadership in overall health & beauty
51
Serving Patients Across
the Continuum of Care
Rocky Kraft
Executive Vice President &
President Omnicare
President,
Agenda
2
Aging Population Shaping U.S. Health Care System
285 65 9
274 278
50
41 7
6
10,000 baby boomers projected to turn 65 every day for next 15 years
3
Increase in Older Population Driving the Need for
Long-term
Long term Care Services and Support
By 2050, 27 million people will need long-term care services and support
Note:
1. Long-Term Services & Support (LTSS) based on limitations regardless of age, cause, etc.
Source: Long Term Care Services in the U.S.: 2013 Overview: U.S. Department of HHS.
4
Navigating Through the Senior Care Continuum
Social activities,
SERVICES Cooking, cleaning,
Cooking cleaning Dining, social,
Dining social and 24-hour
24 hour
assistance with
PROVIDED transportation, etc. recreational services nursing care
ADLs
Retail, mail order, Institutional
PHARMACY Institutional
Retail, mail order institutional pharmacy, retail,
CHOICE pharmacy
pharmacy mail order
ANNUAL RX
Not Available $3 Billion $5 Billion $8 Billion
SPEND
TOTAL COST
1.0% Not Available 2.5% 3.7%
5-YR CAGR
5
Agenda
6
An Industry Leader in Long-term Care Pharmacy
Notes:
1. Publicly disclosed 2014 revenue.
2. Revenue is estimated for Skilled Nursing, Assisted Living and Independent Living communities.
3. For the year ended December 31, 2014. Long-Term Care Pharmacy Revenue only:; does not include manufacturing services.
7
Omnicare Value Proposition Gives Us a Competitive
Advantage in the Long
Long-term
term Care Market
N ti
Nationwide
id footprint
f t i t
Efficient operations
Innovative technology
8
A D VA N TA G E # 1
9
A D VA N TA G E # 1
10
A D VA N TA G E # 2
Infrastructure
Automation
On-site Dispensing
• On-site first fill / emergency dose
− Key component to emergency dose strategy and delivery
cost management
11
A D VA N TA G E # 3
12
A D VA N TA G E # 4
Omniview MyOmniview
13
A D VA N TA G E # 4
• Designed
g for residents
of communities and
their caregivers
• Access financial
information and health
records
• Talk
T lk with
ith a pharmacist
h i t
MyOmniview
14
A D VA N TA G E # 4
• Secure customer
facing technology
• Optimize cost
effectiveness
• Enhance medication
management
Omniview
15
Agenda
CVS/omnicare
CVS/Omnicare Positioned
Positioned to
to Drive
Drive Value
Value in
in an
an
Evolving Health Care Market
16
Multiple Opportunities for Driving Enterprise Value
from CVS/omnicare Both Near
Near- and Long
Long-term
term
Deliver Future
Drive Revenue
Leverage Operational Synergies
Shared Efficiencies
Phase-in • Focused on
Services transitions of
Integrating Systems • Combined
operational care, market
Procurement • Leveraging adjacencies
best practices infrastructure
• Technology and
focused on across the • Improved differentiated
• Significant business workflow
high quality offerings
purchasing
synergies customer • P d i t l
Predominately • More efficient
service and complete by delivery
• Integrated 1H visibility YE 2016 service
2016
• Predominately
complete by
YE 2016
17
CVS/omnicare Value Proposition Provides New
Channels to More Effectively Serve Broader Population
Skilled Assisted
Independent
p Home
Nursing Living
Living Care
Facilities Facilities
18
Enhanced Offering for Skilled Nursing Driven by
Improved Coordination During Care Transitions
Completeness
Skilled Assisted
of Service Offerings
Independent Home
Nursing Living
Living Care
Facilities Facilities
Omnicare CVS/omnicare
Source: Study by NIA (National Institute on Aging) and Robert Wood Johnson Foundation based on Medicare inpatient & SNF claims 2000 – 2006.
19
Segmented Assisted Living Offering in Development
to Better Align with Varying Resident Needs
Completeness
Skilled Assisted
of Service Offerings
Independent Home
Nursing Living
Living Care
Facilities Facilities
Omnicare CVS/omnicare
20
Consumer-driven Effort to Better Target Rapidly
Growing Independent Living Market
Completeness
Skilled Assisted
of Service Offerings
Independent Home
Nursing Living
Living Care
Facilities Facilities
Omnicare CVS/omnicare
21
Care Coordination Offering to Better Serve Seniors
Requiring More Acute Services in Home Setting
Completeness
Skilled Assisted
of Service Offerings
Independent Home
Nursing Living
Living Care
Facilities Facilities
Omnicare CVS/omnicare
22
The Right Strategy for an Evolving Health Care Market
Driving Sustainable
Significant opportunities for driving long-term growth
Enterprise Growth
Retail Institutional
Access Open to the public Closed door pharmacies
Deliveries
Deli eries to facility
facilit average
a erage
Dispensing Primarily at pharmacy counter
3 times per day
Standard compliant
Packaging Primarily bottles/vials
specialized unit dose
Federally mandated quick
Adjudication Prior to dispensing turnaround may require dispensing
prior to adjudication
Required consultant pharmacists
Primarily
P i il ffocused
d on
Services provide extensive patient facing
patient/caregiver
services within facility
Extensive regulation significantly
Costs Generally lower cost to dispense
increases cost to dispense
25
The Right Strategy for an
Evolving
g Health Care Market
Larry
y Merlo
President & Chief Executive Officer
Analyst Day
December 16, 2015
The Most Extensive Suite of Leading Assets…
Retail Mail
Long-term
Care
Retail Specialty
Clinics
Clinical
Infusion
Programs
g
2
Today’s Key Takeaways
The Right Strategy for an Evolving Health Care Market
Growing
g the Core,, Expanding
p g core p
pharmacyy business while broadening
g
Broadening the Base reach into new health care channels