With the distribution of a COVID-19 vaccine looming, companies in the pharmaceutical supply chain are working overtime to plan for all contingencies.
At CVS Caremark, that means considering both the physical infrastructure needed to disseminate multiple, multi-dose vaccines with highly specific storage needs, as well as the data analytics necessary to track where they're going, Alan Lotvin, M.D., president of Caremark and executive vice president of CVS Health, told Fierce Healthcare.
As both Pfizer and Moderna's emerging vaccines require two doses, getting them out to every American will require substantial resource investment to deliver some-660 million doses, he said.
"That requires quite an army of vaccinators, of logistics to get the product around the country," Lotvin said.
In addition, it will be critical to effectively harness analytics to track which vaccines members received to ensure they get the appropriate boosters, Lotvin said. It's unclear what the side effects may be if there were a mix-up.
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"Someone's going to have to keep track of who got what vaccine," Lotvin said.
CVS is tackling the vaccine challenge from multiple angles, both as a large pharmacy benefit manager and as a huge national retail chain. CVS Pharmacy has, alongside its peers, signed on to assist the Trump administration in distributing a vaccine rapidly to nursing homes, and is pushing for pharmacy technicians to be able to administer COVID-19 vaccines.
In addition to building up the infrastructure needed for immediate distribution, Lotvin said plenty of questions still remain about what could happen long-term.
For example, it's not yet clear if a course of COVID-19 vaccinations will be enough for protection over a long period, or if it will become an annual inoculation like influenza. Plus, with multiple products on the market, consumer demand could be quite uneven, especially if one vaccine proves to be notably more effective than another over time, he said.
Wide distribution of a vaccine also doesn't mean the virus will vanish, Lotvin said.
"I still think that even once we get to a reasonable amount of vaccination we’re going to continue to maintain masks and social distancing for a while," he said. "The disease isn't going to go away."
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The work required to effectively disseminate the coming COVID-19 vaccine or therapies for the virus doesn't eliminate the traditional role of PBMs like Caremark in the market, so Lotvin said the team has put in a lot of effort to ensure drug distribution continues smoothly in a way that allows for social distancing, as well as to prevent gaps in care for specialty pharmacy patients.
Lotvin said Caremark had to "substantially change all of the workflows in the dispensing facilities" to enable social distancing, and that it was able to do so without hampering distribution to members.
It has also been active in working with employers on returning to work through its Return Ready platform, which has garnered interest from existing Caremark clients and from new customers. About 40% of those who signed on with the platform were not previously CVS Customers, CVS Health CEO Larry Merlo told investors earlier this month.
Lotvin said the program is admittedly not one for every single employer, as it's rigorous to administer and it's up to the firm whether to take on the costs. However, the response has been "outstanding" from the companies that have adopted it.
"The actual people who are experiencing it are feeling a lot safer," he said.