Press Release

Results reflect impact of pediatric obesity epidemic and evolving approach to treatment of co-morbidities

WOONSOCKET, R.I., April 6 /PRNewswire-FirstCall/ -- A study by CVS Caremark (NYSE: CVS) published today in the April 2009 issue of Archives of Pediatrics and Adolescent Medicine, found that over a two-and-a-half year period ending in June 2007, the use of medications to treat high blood pressure, high cholesterol and diabetes among children increased 15.2%. Observed changes in medication use differed by therapeutic class and patient age with oral antidiabetics, insulin, and antihypertensives showing increased use, while statin therapy decreased over the same time period. In addition, while the oldest age group (16- to 18-year olds) had the highest prescription drug usage overall, the greatest rate of increase was found among 6- to 11-year olds (18.7% among females and 17.3% among males).

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"The increasing use of antidiabetic and antihypertensive medications in this younger population likely reflects the rise of pediatric obesity and a failure of lifestyle changes to control cardiovascular risk factors typically associated with adults," said Josh Liberman, Ph.D., Vice President, Strategic Research CVS Caremark and lead author of the study. "These results also suggest heightened awareness among health care providers of the potential benefits of pharmaceutical treatments in certain cases."

The study was designed to document trends in the use of prescription medications indicated for the treatment of type 1 and type 2 diabetes, high blood pressure and high cholesterol among children and adolescents over a time period that spanned close to three years. Results found that the one-month prevalence of use of these medications increased 15.2%, from 3.3 per 1,000 youths in November 2004 to 3.8 per 1,000 youths in June 2007. In addition, the results indicated that 16- to 18-year olds had the highest rate of use overall, with treatment rates of 5.9 per 1,000 per month for females and 5.1 per 1,000 per month for males.

Overall, antidiabetic therapy was most common (1.9 per 1,000 per month), followed closely by antihypertensive therapy (1.5 per 1,000 per month). Dyslipidemia pharmacotherapy was least common (0.2 per 1,000 per month) and use of statins, the most common dyslipidemia class, actually declined by 22.9% during the study period. Among the antihypertensive drug classes reviewed in the study, beta-blockers and ACE inhibitors were the most commonly used, with ACE inhibitor use increasing 27.7% among 6- to 11-year old females and 25.2% among males in the same age group. In addition, during the study period, insulin use alone increased by 14.8% and insulin use in conjunction with oral antidiabetic use increased by 23.3%.

"There is growing recognition that childhood obesity is nearing an epidemic and, as a result, consensus treatment guidelines for the associated cardiovascular conditions and risk factors recommend the introduction of pharmaceutical treatments if life style and behavioral modifications fail to achieve desired results," said Dr. Liberman. "Given CVS Caremark's focus on patient engagement through Proactive Pharmacy Care we believe it is important to continue efforts to provide primary care pediatricians and consumers with up-to-date information on optimal patient screening, lifestyle and behavioral management techniques and the full range of pharmaceutical options available for the treatment of these conditions in children."

The study evaluated de-identified data for up to 6 million commercially insured US children and adolescents aged 6 to 18 years from the CVS Caremark PBM pharmacy insurance claims records. The prevalence rates were measured monthly from November 1, 2004, through June 30, 2007 to determine the proportion of the population filling prescriptions for selected medications, which included antidiabetics, antihypertensives and dyslipidemics. All treatment prevalence rates were calculated per 1,000 patients per month and were calculated overall and by age group (6-11, 12-15 and 16-18 years) for selected therapeutic classes.

About CVS Caremark

CVS Caremark is the largest provider of prescriptions in the nation. The Company fills or manages more than 1 billion prescriptions annually. Through its unmatched breadth of service offerings, CVS Caremark is transforming the delivery of health care services in the U.S. The Company is uniquely positioned to effectively manage costs and improve health care outcomes through its more than 6,900 CVS/pharmacy and Longs Drugs stores; its Caremark Pharmacy Services division (pharmacy benefit management, mail order and specialty pharmacy); its retail-based health clinic subsidiary, MinuteClinic; and its online pharmacy, CVS.com. General information about CVS Caremark is available through the Investor Relations section of the Company's Web site, at cvscaremark.com/investors, as well as through the press room section of the Company's Web site, at cvscaremark.com/newsroom.

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