Here’s how CVS’ breakup of its pharmacy and insurance coverage empire might have an effect on shoppers
CVS’ latest choice to divide its retail pharmacies from its insurance and pharmacy-benefit businesses has raised hopes of shopper financial savings as Americans continue to reel from high prices of residing.
The breakup of one of the largest health-care conglomerates in the US has the potential to deliver about decrease prices on some providers, though that stays to be seen, consultants told The Post.
A CVS Pharmacy in Los Angeles in May 2024. Getty Images
“It is potentially a good thing, however, it will depend on how the regulators enforce the separation,” said Doug Hoey, CEO of the National Community Pharmacists Association.
About 25% of the nation has their prescriptions managed by CVS, with about 10% receiving direct insurance coverage providers from the company.
The breakup of one of the largest health-care conglomerates in the US might deliver decrease prices on some providers. Getty Images
CVS Health will hold its insurance coverage company, Aetna, and its pharmacy advantages supervisor, Caremark under one roof. Meanwhile, CVS Pharmacy will embrace the company’s retail division, with 9,000 storefronts and mail-to-order infrastructures in another company, with the split-up going into impact by early 2028.
Will drug costs at CVS pharmacies go down?
The change in the company’s provide chain might permit some wiggle room for competitors and would possibly disincentivize the pharmacy advantages supervisor, Caremark, from attempting to maximise earnings from CVS pharmacy — translating to some financial savings on drug prices.
“Caremark pays its affiliated CVS retail pharmacies, which results in higher premiums in cost sharing for patients,” Emma Freer, a senior healthcare fellow at the American Economic Liberties, told The Post.
“So because they’re spinning off their retail pharmacies under this proposal, it would foreclose that particular avenue for that type of gaming.”
In a assertion, CVS maintained there has always been a firewall between the two entities and that they don’t affect each other.
Dr. Mariana Socal, a Johns Hopkins professor who research the pharmaceutical market, told The Post she doesn’t see costs going down because she doesn’t imagine this break up is definitely separating Caremark and CVS.
A pharmacist talks to a buyer as a technician organizes drugs cabinets at a CVS Pharmacy in Miami Beach, Fla., in October 2025. Jeff Greenberg/Universal Images Group by way of Getty Images
“There is no change,” she predicted.
Will sure sorts of medication be affected more than others?
CVS Health is holding its specialty pharmacy providers in-house. CVS sometimes doles out prescriptions for cancer medication, a number of sclerosis treatment, hormonal therapy and weight-loss drugs at the specialty websites, carrying a increased price tag.
Freer, Hoey, and Socal imagine the company’s break up might really deliver increased specialty drug costs.
“The specialty pharmacy may use this new well to help replace some of those profits and revenue that might be dried up with these new regulations,”Hoey said.
Will Aetna insurance coverage prices go down?
Socal doesn’t see premiums going down, saying what might need introduced prices down would have been separating Caremark from Aetna.
CVS agreed to buy Aetna in 2017 for $69 billion, and at the time there was already rising scrutiny over the relationships between insurers and pharmaceutical benefit managers.
Two males stand in a queue inside a CVS Pharmacy in Miami Beach, Fla., in August 2025. Jeffrey Greenberg/Universal Images Group by way of Getty Images
Nearly 10 years later, that scrutiny has only grown. The Department of Labor finalized a rule last week that would require pharmacy advantages managers to share price data and funds with drugmakers.
Could issues change between now and 2028?
CVS Health CEO David Joyner said on CNBC that got here about partly because of rising lawmaker scrutiny of healthcare conglomerates and how they revenue off proudly owning large parts of the provide chain.
“Companies need to navigate the regulatory environment, and we are setting ourselves up for success,” he said.
Hoey told The Post it’s finally up to regulators to see if the split-up yields advantages for shoppers.
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