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      CVS Caremark TrueCost® set a new standard for pharmacy pricing models. We’re raising the bar again.

      Briefing

      Three years ago, we redefined pharmacy pricing by bringing TrueCost to the market, the industry’s first transparent, drug-level net-cost pricing model. At a time when pharmacy benefit managers (PBMs) relied on market basket pricing and cross-subsidization, plan sponsors were looking for something different: greater visibility into net drug costs, more predictable pricing and a clearer path forward.

      Pharmacy pricing models, reimagined

      >1.23M members on the full TrueCost model*

      1.9M members benefit from Drug Level Rebate Guarantees*

      TrueCost:

      • Removed cross-subsidization
      • Increased transparency into rebate value
      • Introduced drug-level net-cost guarantees
      • Created a more sustainable pharmacy reimbursement approach

      Today, many of the principles that shaped TrueCost are now industry standards. For us, that’s not the finish line. It’s the starting point for what’s next.

      Transparency isn't the direction we're moving toward because regulators demanded it. It's foundational to our relationships with our clients.

      ~Edward Devaney, EVP & President, CVS Caremark 

      We didn’t build TrueCost to win a moment. We built it to create a fundamentally different approach to pharmacy pricing models.

      And we’re continuing to move the market with pricing that delivers greater predictability, simpler validation and fewer surprises. 

      Price stability

      >98% of claims are adjudicated within 125% of the guarantee*

      44% decrease in large price changes (>5%)*

      Why trust matters in pharmacy pricing

      Let's be honest. Pharmacy pricing models are often viewed with skepticism. Many plan sponsors and consultants wonder whether the system works the way it should and whether they're seeing the full picture. That’s exactly why we’ve spent years making pricing easier to understand.

      TrueCost pricing is 2X more likely to be less than or equal to NADAC.*

      We believe clients should have the visibility to understand the pricing dynamics at play.

      • What drives drug costs
      • Where savings come from
      • What’s driving performance

      Because the best innovations don’t add layers. They remove guesswork.

      Advancing simplicity and visibility through continuous innovation

      Three years after introducing a pricing model that challenged industry norms, we’re continuing to evolve TrueCost. Our goal? Give plan sponsors an even clearer understanding of individual drug costs. Not because regulators told us to. Because it’s what plan sponsors need to make more informed decisions and better manage costs.

      Here’s what’s next.

      Making rebate value easier to see

      Each step brings pricing closer to true market alignment.

      ~ CVS Caremark client, Client Forum 2026

      Historically, we grouped drugs into tiers of similar rebate value, delivering drug-level visibility to which drugs earn no rebates, high rebates and everything in between. Now, we’re moving the market again with visibility at the GPI-14 drug level, disclosing our best estimates of the manufacturer rebates we expect to receive over the contract year.* The result is a more direct connection between a drug, its rebate value and its estimated net cost, making pricing easier to understand and validate.

      A simpler path to net-cost guarantees

      And we’re just getting started. Because we see that as proof plan sponsors want something different: • Greater clarity • Fewer surprises • A PBM willing to challenge the status quo That’s what continues to guide the TrueCost evolution – making pharmacy pricing models easier to understand, validate and trust.

      Less aggregation. More precision. A clearer picture of what you’re paying for. The payoff is simple:

      • More accurate net costs
      • Better alignment between projected and actual spend
      • Simpler financial reconciliation, easier validation
      • Reduced administrative burden
      • Clearer insight into what drives costs

      The future of pharmacy pricing models is easier to understand

      For many plan sponsors, pharmacy spend is one of the largest and fastest-growing areas of health care costs. That’s why pharmacy pricing models aren’t just about contracts and guarantees. They’re about budgeting with confidence. Planning for what’s ahead. Making informed decisions for the business you’re running and the people who depend on your benefits.

      >95% of our commercial book of business benefit from TrueCost*

      And we’re just getting started. Because we see that as proof plan sponsors want something different:

      • Greater clarity
      • Fewer surprises
      • A PBM willing to challenge the status quo

      That’s what continues to guide the TrueCost evolution — making pharmacy pricing models easier to understand, validate and trust. 

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      Discover additional insights

      • *FOR MORE THAN 1.23M MEMBERS SOURCE: CVS Health Analytics, 2026

      • *FOR 1.9M MEMBERS BENEFIT SOURCE: CVS Health Analytics, 2026

      • *FOR >98% OF CLAIMS SOURCE: Data Science Dashboard. Pertains to 2025 and 2026 TrueCost clients. P1019770826
        *FOR 44% DECREASE IN LARGE PRICE CHANGES SOURCE: P1019340626

      • *FOR TRUECOST PRICING IS 2X MORE LIKELY CLAIM: NADAC (National Average Drug Acquisition Cost) is a national benchmark used to represent pharmacy acquisition cost. Applies to commercial generics only; excludes Aetna, Carelon and AAC clients. P1019330626.

      • *FOR INDIVIDUAL GPI-14 DRUG LEVEL DEFINITION: A GPI-14 (Generic Product Identifier) is a drug classification that allows rebate value to be tied directly to a specific medication.

      • *FOR 95% OF OUR COMMERCIAL BOOK OF BUSINESS BENEFITS FROM TRUECOST FEATURES CLAIM: The features include rebalancing in retail, mail and/or specialty or the full TrueCost pricing model with drug-level rebates. CVS Health Analytics, 2026. S1019310626