Lucille Accetta, RPh, MPH, MBA

Lucille Accetta, RPh, MPH, MBA, chief pharmacy officer and head of CVS Specialty Operations, highlights how CVS Specialty combines digital innovation with clinical expertise to personalize care, streamline access, improve adherence, and support patients, prescribers, and pharmacists throughout the specialty medication journey.

Lucille Accetta, RPh, MPH, MBA: My name is Lucille Accetta. I'm chief pharmacy officer and head of CVS Specialty Operations. I've been a pharmacist for over 35 years. I have spent a good half of my career in specialty. I am so thrilled to be here. Thank you.

Your session emphasized the intersection of digital innovation and clinical expertise—what does that personalization look like in practice when all stakeholders are involved?

Accetta: Patients are at the center of everything that we do, and digital innovations are helping to bridge the gap that is sometimes there when you ask some specific clinical questions. We found that our digital assets are able to help support patients in being able to intersect a personalized experience and touchpoint with our technology.

For example, if you're a patient with a new diagnosis—let’s just say it's multiple sclerosis (MS)—we can leverage that technology to welcome a patient into specialty. It's a very difficult disease. We understand it. We can then engage them in how to onboard with their new medication, explain that medication, explain the opportunities for that patient to intersect with their prior authorizations, and give them an update on the technology that we have to be able to tell them where it is in the process. It's a cumbersome process. We try to make it extremely simple by following the patient through the journey with these interventions. But we're always [available to meet them] wherever they want to meet—whether through an interaction on the phone or through text or secure chat or even through a digital message.

It's bringing both the clinician and the technology together to help that patient get on their new journey, on their new medication, help them stay on it, be compliant, understand the side effects, any adverse events that they may be having, and then clicking into a clinician if they need to talk.

Sometimes we even find that patients tell us a little bit more when they're interacting with us digitally, because they feel a little bit more comfortable sharing the challenging effects that they may be having. What we have found, also, is by doing all this, we're interacting with them around their plan design, helping them with their out-of-pocket copays, and helping them understand their benefits. All of this is engaging through technology and digitization of the information that we're providing.

I'll give you an example. When biosimilars came out in 2024, we were able to onboard more than 85% of the patients on biosimilars with a zero out-of-pocket cost for them by using technology to engage in challenging them to understand the therapy, understand how it works as compared to the reference product, and we even interacted with the prescriber ahead of time and made it easy for the doctor to be able to write for the biosimilar. Technology is helping to reduce the administrative burden for patients—as well as for prescribers—but it's also engaging patients to become adherent and to stay on therapy.

How do you ensure that digital innovation enhances, rather than replaces, the personal connection patients have with their care teams?

Accetta: Everyone thought digital was going to take over and we were never going to talk to patients. It's not even true. We have found that the digital technology has enabled us to reduce a lot of the administrative burden that's happening in the doctor's office, and even with the pharmacist. All of this technology is enhancing the human connection and empowering our team.

We're finding that they have more time to interact with patients. It's providing better data and insights for our colleagues to interact with patients. It's providing a much higher patient satisfaction from the interactions that they're having with the pharmacy, as well as prescribers. They're finding the feedback [helpful] in having that intersection of technology and our human capabilities to be able to support patients exactly where they want to be.

What role do digital tools play in identifying when a patient might be struggling with adherence, affordability, or care navigation—and in prompting timely interventions?

Accetta: It's really interesting. Digital technology has allowed us to place some algorithms and some predictive analytics. It’s all behind the scenes, and we can pretty much identify if someone is struggling with adherence. We can proactively reach out if we see that they're not interacting with us or check in with them with what we call some nudges. We prompt them to intervene with us, to better understand how they are at being able to stay on therapy.

All of this technology helps us evaluate if someone is struggling with side effects or challenged with affordability. An example is sometimes our patients get challenged with the prior authorization process and providing them with a proactive update on the status and giving them access to the data—for more than 80% of the specialty patients that we service at CVS, we can actually see and review their electronic health record for intervention. I do feel that the technology that we have is enabling the capability of the patient to stay adherent, be able to have a cost-effective outcome of out-of-pocket fees, and allows us to also engage in care navigation with them and stay with them along their journey on the therapy.

I feel like that is probably where the tools help us support the patient in overcoming any challenges that they have during their therapy, starting on therapy, or even renewing therapy.

How can digital innovation help reduce friction points in the access journey—from prescription to payer approval to patient onboarding?

Accetta: There is a lot of technology today for how a prescription is written. If you start off in the doctor's office, in their electronic health record and their choices, we have the ability to tell prescribers where a prescription is on formulary, and some of the out-of-pocket costs—if it's a higher out-of-pocket cost or a lower out-of-pocket cost. These are all proprietary-type technologies that start the patient.

At the doctor's office, if you think about how it gets to the pharmacy, how we onboard a patient, the workflow, and the integration of that new therapy into the pharmacy—starting the prior authorization and taking the electronic health data that we have with the electronic medical records (EMR) to help fill out the prior authorization on behalf of the patient [is important].

We monitor that, see how the payer is approving it or denying it. Hopefully they approve it. Once that's approved, we get the patient started, we get them on therapy, we start talking to them about their side effects, what support they need from nursing, and we consolidate all of this information into our single CVS health application (app) that allows the management of that prescription all in one exact place.

More than 95% of the patients value their choice in how they get their medication. In the delivery process, right when it's about to be shipped, we even give them an option of whether they want to have it filled or sent to their local CVS pharmacy. We're consistently using this type of innovation to streamline the onboarding, their access, and reduce any of the challenges that they may have with becoming a new specialty patient.

What is the key message you aimed to convey to the Asembia audience during your session, and what takeaway do you hope they gained from it?

Accetta: At the Asembia session, I had 3 key leaders on the podium with me. One of them leads our centers of excellence, with more than 500 000 patients sitting in a very unique center of excellence. We had our technical leader who is engaging a lot of new enhancements into the workflow to support our colleagues and prescribers. We also had a nurse who discussed what it's like to have a patient start on a new therapy. That was one of the main components of showing the support that we provide by personalizing the patient's ability to choose CVS Specialty, to have the flexibility in how they want to engage with us, and obviously all the innovations in technology that we're using to help the patient, as well as the pharmacist and prescriber, with all of our clinical expertise.

We also had a lot of great video clips sharing what it's like to be a specialty patient, recognizing the challenges that they face in getting on therapy, staying on therapy, and affording the therapy. We had some unique videos of our patients.

In that session, we also shared visuals of how the workflow happens in prior authorization and what's happening on the digital app. We did a lot to showcase our clinical care as being best in class and prioritizing the trust that we build with our patients and our prescribers, as well as how we're investing in digital innovations and creating opportunities for these personal connections with our patients.

Is there anything else you’d like to share with the audience?

Accetta: I really enjoyed the opportunity to showcase what CVS Specialty can offer our patients today, as well as our prescribers. A lot of individuals came up afterwards intrigued by the amount of innovation that we've put into the workflow and into the process for our patients.

I took away a lot of great kudos, but also continuing opportunities for us to challenge ourselves to create even better experiences for our patients. At the end of the day, I felt like we at CVS Health have provided to our customers, our patients, our prescribers and our colleagues the commitment we have in showcasing the great work that we do at CVS Specialty for our patients.