CVS Caremark’s Joshua Fredell on Simplifying Benefits and Leveraging Technology | PBMI Innovator

Joshua Fredell, Pharm.D., senior vice president at CVS Caremark, is one of six winners of Managed Healthcare Executive’s inaugural PBMI Innovator Award. The award highlights leaders advancing solutions in the evolving and often challenging pharmacy benefit management (PBM) industry.

When asked where the most innovation is happening in PBMs, Fredell first pointed to technology, but said improvements are needed in all areas. He explained that PBMs have to balance creating new tools with making benefit design and pricing simpler and stronger.

One area of focus, he said, is transparency. CVS Caremark’s TrueCost Pharmacy Pricing model is an example of how PBMs can simplify drug pricing for clients. By making prices more understandable at the drug level, employers and plan sponsors can more easily see the value of their pharmacy benefits.

“We appreciate that those customers have a lot on their plates,” Fredell said. “They’re trying to run their business and still provide a great healthcare benefit to their members.”

Another area of innovation lies in benefit design itself. Employers often face choices between different formularies, pharmacy networks, and tier structures. While these options have long been part of the PBM model, Fredell emphasized that refining and expanding these choices is essential. Tailoring plan design helps clients better align pharmacy benefits with their broader goals and philosophies, ensuring the needs of members are met while keeping costs in check.

Finally, Fredell said that once transparent pricing and flexible benefit design are in place, technology can take center stage. Digital tools and platforms can help members navigate their pharmacy benefits more seamlessly, creating a smoother experience that complements the structural improvements.

“When you’ve put in place a powerful pricing model like TrueCost and given clients the ability to tailor benefit design to their needs, technology can come in and make the entire experience seamless for members. That’s when innovation in PBMs becomes most impactful,” Fredell said.

For Fredell, innovation is not just about high-tech solutions but about building a stronger foundation that enables both clients and members to benefit from more transparent, flexible, and user-friendly pharmacy benefits.