CVS Health (CVS) plans to accelerate enterprise growth, simplify a consumer health system that is confusing and inconvenient, and position the company for long-term growth and increased shareholder value.
CVS’s objective is to place consumers at the center of its strategy and help them achieve their best health by strengthening health care locally and making it simpler to use and understand.
One of CVS’s priorities is to deliver transformational products and services. A key initiative is its Chronic Kidney Care Program, which includes the early identification of chronic kidney disease, targeted patient engagement and education to help slow disease progression and increasing access to transplants in home dialysis to optimize care.
CVS’ priority is in line with the recent Executive Order signed by the President to launch Advancing American Kidney Health, a new initiative to improve the lives of Americans suffering from kidney disease, expand options for American patients, and reduce healthcare costs.
Across America, 37 million patients suffer from chronic kidney disease and more than 726,000 have end-stage renal disease (ESRD). There are nearly 100,000 Americans waiting on the list to receive a kidney transplant, and kidney disease ranks as the ninth leading cause of death in America.
Approximately twenty percent of dollars in traditional Medicare—$114 billion a year—are spent on Americans with kidney disease. Yet of the more than 100,000 American who begin dialysis to treat end-stage renal disease each year, one in five will die within a year.
CVS received FDA approval to initiate the clinical trial of its hemodialysis system. This system is designed to make home hemodialysis safer and simpler, while allowing patients to receive longer, more frequent dialysis treatments, where the research has shown leads to better health outcomes.
Up to 70 patients will participate in the clinical trial with the first patients already enrolled. The clinical trial is expected to take approximately 18 months and if successful the product launch is projected to occur in 2021. The trial assessing safety and efficacy will be held at as many as 10 kidney centers in the U.S. The Rogosin Institute, a kidney-treatment center in New York, is the initial trial site.
Home dialysis is seen as not just less expensive but potentially more effective, facilitating longer treatments. Dialysis patients typically visit clinics three times a week to remove toxins from their blood.
Approximately one-third of Medicare spending on kidney disease goes to dialysis treatments. A new payment model is intended to improve incentives for disease prevention, home dialysis and transplants. The market size is estimated to be $35 billion.
DaVita Inc. and Fresenius Medical Care North America dominate the U.S. dialysis market. Both companies offer home-dialysis options and have historical relationships with renal disease doctors.
DaVita is the largest provider of home dialysis in the country, continuing to deliver innovative technologies like home remote monitoring and a telehealth platform to make it easier for patients to treat at home. As of March 31, 2019, DaVita served 203,000 patients at 2,664 outpatient dialysis centers in the United States. The company also operated 241 outpatient dialysis centers in nine countries across the world.
Fresenius Medical Care is the world’s largest provider of products and services for individuals with renal diseases of which around 3.4 million patients worldwide regularly undergo dialysis treatment. Through its network of 3,971 dialysis clinics, Fresenius Medical Care provides dialysis treatments for 336,716 patients around the globe. Fresenius Medical Care is also the leading provider of dialysis products such as dialysis machines or dialyzers.
CVS began working on a home-dialysis machine designed by entrepreneur Dean Kamen’s Deka Research & Development Corporation in 2017, which uses a distillation system, avoiding the need for using large amounts of purified water. This system also is designed to limit the amount of supplies needed for dialysis.
CVS plans to utilize medical and pharmacy claims data and predictive analytics algorithms, in accordance with HIPAA, to identify people most at risk for kidney disease and progression to kidney failure. AccordantCare nurses will engage these individuals to educate them on their risk, important tests and the need to see a nephrologist. This team will continue to work with individuals that progress toward ESRD.
CVS plans to utilize the predictive analytics platform it has built for adherence programs as well as its AccordantCare programs for other conditions to inform and build this new initiative.
The company is entering a new market as CVS’ plan will make it a medical-device firm and a provider of dialysis, the complex blood-cleansing procedure vital to patients suffering from kidney failure.
CVS plans to offer home dialysis services, both using the new device and a different method known as peritoneal dialysis, but the chain doesn’t expect to perform dialysis in its own facilities or stores, instead leasing or selling the new device to other providers.
This initiative is another piece of CVS’ overall strategy to become a health-care provider for people with chronic conditions. CVS is counting on the new device technology, absence of the cost of owning and operating kidney centers, and relationships with health-care payers to help it compete successfully in the market.