Skip to main content

Smart savings for you. Real support for members.

Protecting your people, budget and strategy

We help employers do all three. Whether you’re a CHRO minimizing disruption or a CFO managing spend, we’re here to help.

Supporting your employees when it matters most

  • 93%

    member satisfaction1

  • up to $115

    savings per member, per month2

  • up to 48%

    savings on overall pharmacy benefit spend2

Your employees are at the heart of 
your business

They’re also at the heart of ours. We support them during key moments — while helping you manage costs and deliver results.

A vertical flowchart with three gray boxes connected by downward arrows. The top box says “Better adherence,” the middle says “Healthier outcomes,” and the bottom says “Lower costs,” all in bold red text. The diagram shows a progression from better adherence to healthier outcomes to lower costs.

Driving better health and lower costs

Your workforce expects a pharmacy experience that’s simple, supportive and stress-free — from onboarding to refills. With access to the largest network of covered pharmacies and personalized support, we make it easy for members to get the medications they need.

We don’t just manage pharmacy benefits —
 we move them forward.

  • The 1st PBM

    to use formulary exclusions

  • The 1st PBM

    to remove Humira and replace it with a biosimilar for a $0 copay

Integration that reshapes health care

We’re not just a PBM 

We’re part of a larger, integrated enterprise that’s reshaping health care. We’re trusted and local, and we work together to manage spend, improve outcomes and deliver a positive member experience.

  • 46 of the Fortune 100 companies trust CVS Caremark to manage their employees’ pharmacy benefits3
  • Backed by CVS Health, which was voted one of the country’s most trusted brands4

From virtual visits to mental health support, we’re connecting members to the care they need — when and where they need it. And we’re reimagining how therapies are sourced, so members can get reliable, affordable access at scale.

By connecting medical, pharmacy claims and care data, we deliver personalized support, close care gaps and keep your employees healthier.

When it comes to pharmacy benefit management, there's a lot of buzz around disaggregation. Disaggregation sounds great on paper. More vendors, more control –– right? But the truth is that breaking PBM services into separate parts often leads to more work and responsibility for you, and it leads to more confusion, gaps in care and frustration for your members.

Let's bust four big myths about disaggregation and show why integration is a better solution for your team and your members. Myth One: Integration isn't aligned to the customer's needs. Actually, integration is all about alignment. We connect the dots using data from pharmacy and medical claims to lab results to demographics and biometrics.

This is how we personalize care, close gaps and improve outcomes. The results? A 12% reduction in unnecessary emergency room visits. Up to 1.28% annual drug spend savings.

For example, if an employer has a drug spend of 1 million annually, integrating their medical and pharmacy benefits would save them $12,800. Disaggregated vendors may specialize in one area, but they don't see the whole picture. We combine data and clinical expertise to make it easy for members to get what they need. This leads to fewer ER visits, better adherence and lower drug spend.

With over 64,000 pharmacies in our network, the largest in the industry, clients choose the network and members choose where and how they get their meds. Through interventions and counseling, every pharmacist in every pharmacy in our network plays an important role in helping members close gaps in care. Disaggregated plans leave members wondering who to call when they have questions. We keep it simple, connected, and focused on better outcomes.

Myth two: Vertically integrated PBMs are more incentivized to push pricey drugs than to find the safest, most affordable options. Not true. Our goal is better health, not more profits or fills. Clinical experts guide our utilization management and formulary decisions, not pharmacy sales.

We build clinical checks into every claim and formulary, asking: Is it safe? Is it right for the condition? Is it cost effective without compromising care? And because we see the full picture, we catch things that could fall through the cracks, like adding supplies a member needs to stay on track.

Disaggregated vendors only see their piece of the puzzle. Myth three: Disaggregation gives you best of breed in all areas. Disaggregated vendors may be good at one thing, but they can't see the whole picture. We can.

CVS Caremark already brings together best-in-class services, and integration makes them even stronger. By connecting medical, pharmacy claims, and care data across our organization, we deliver tailored support that helps members better manage their conditions and keeps symptoms in check. Our data connectivity powers smarter care and lower costs for you and your members. Programs like Transform Diabetes Care and CVS Weight Management help members manage conditions, reduce meds when appropriate and avoid complications.

We create customized interventions across five clinical impact areas to help improve outcomes. Programs like these really work, increasing adherence by 6.1% and reducing clients' GLP-1 spend by 42%. Disaggregated vendors only specialize in one area, but our in-house expertise is as wide and broad as our network. And our businesses are connected, so however a member chooses to interact with us–– online, at a retail store or on the phone––we can help them.

Myth four: Integrated PBMs are working for pharma, not for you, making money off rebates instead of prioritizing clients. That's a common misconception. We pass back over 99% of rebates to clients. This helps lower overall costs.

Plus, 90% of the drugs we dispense are generics, which typically don't have rebates, and PBMs operate on slim margins––around three to five percent–– which is far lower than pharmaceutical companies and other healthcare industries. Clients can choose how they want to handle rebates and pricing, giving them more transparency and control over their costs. They may choose a spread pricing model where PBMs bill payors a higher price than it reimburses the pharmacy. Many think we profit off spread pricing, but the truth is the average spread is just 1.5%–– far, far lower than the average EBIT margins of the top six US pharmaceutical companies, which is 37%.

We advocate for our clients and their members by negotiating directly with manufacturers, using our scale to secure the lowest possible prices. We've also created CVS Caremark True Cost, the Industry's first acquisition based pricing model. True Cost is more transparent for clients, more predictable for members, and more reliable for pharmacies. Our goal isn't to profit on rebates.

Instead, we're focused on driving real value through transparency, affordability, and better outcomes. Visit business.caremark.com to learn how integration drives savings and connects care.

Myths vs. facts

Watch this video to see how integration supports your members and your bottom line.

 

Built for employers. Backed by experience.

We’re a partner, not just a vendor. We work with your consultants, align with your strategy and deliver results.   

“CVS Caremark’s network and clinical resources are robust, programs are innovative, and the account team is proactive and collaborative. They’ve helped us meet our objectives.”

 

— National technology and consulting firm

You choose the cost strategies that fit your goals — we provide the tools, data and analytics, and clinical support to make them work. From onboarding to continuous account support, you have access to dashboards and real-time reports with open data and auditability, giving you a clear view into pricing, rebates and member benefit usage. We partner with you to identify trends and cost-savings opportunities and advocate for state and federal policies to preserve your ability to offer quality, affordable prescription drug benefits.

 

Wondering if your plan 
could be doing more? 

Stay updated with the latest news and articles

This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.

 

  • 1 ​2025 Overall Member Satisfaction with Prescription Benefit Services for total book of business. This represents the percent of members who indicated a rating of satisfied or better on a 5-point scale. P1009480721

  • 2 CVS Health Analytics, 2024. CVS Health Q4 2024 commercial cohort that have implemented Advanced Control Specialty Formulary (ACSF) (>95% of plan lives), Exclusive Specialty (>95% of plan lives) and Standard Specialty Guideline Management (SGM) (>95% of activity in standard criteria), January-December 2024. Savings consider prior authorization, formulary and quantity limit outcomes with 0.5% pricing discount for Exclusive Specialty and full rebate yield attributed to ACSF. PrudentRx savings are actual outcomes for clients with adoption on or prior to Jan. 1, 2024, and >70% members eligible and used as a proxy for clients that currently do not have adoption. Total program savings represents commercial clients with adoption. All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Savings projections are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client-specific modeling available upon request.

  • 3 CVS Caremark Analysis of 2023 Fortune 100 rankings as of May 2024. P1013930223