Of all the pharmacy businesses CVS owns, the one staying with its benefits manager after the breakup is not any of its 9,000 stores.
On Wednesday CVS said it will split in two by the first half of 2028. CVS Pharmacy gets the roughly 9,000 drugstores, the mail-order pharmacy and the MinuteClinics. CVS Health keeps Aetna, CVS Specialty, and the Caremark pharmacy-benefit manager — the middleman that stands between drug plans and pharmacies and sets what gets paid. The quarter had beaten forecasts, and chief executive David Joyner said the businesses are running really well. The stock fell 12.5 percent to $79.96, erasing nearly $15 billion of market value.
Analysts supplied the mood. UBS said the split was perceived as a defensive move against regulation rather than an offensive one. The regulation is not hard to find. Arkansas passed a law in 2025 barring benefit managers from owning pharmacies, and a federal judge put it on hold. Tennessee passed its own, and CVS sued in May after warning it could have to close all 134 of its stores there. A federal bill requiring companies that own insurers or benefit managers to divest their pharmacies was reintroduced the same month.
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What’s interesting is where the line falls. In January 2025 the Federal Trade Commission’s staff reported that the three biggest benefit managers, Caremark among them, marked up specialty generic drugs for cancer, HIV and other chronic conditions at their own affiliated pharmacies by hundreds and sometimes thousands of percent. Those pharmacies collected more than $7.3 billion above estimated acquisition costs from 2017 to 2022, and the benefit managers paid them more than outside pharmacies for nearly every drug studied. After the split, Caremark and CVS Specialty are still under one roof. The stores are what leave.
That reading has limits. The FTC figures cover all three companies, not CVS alone, end in 2022, and come from an interim staff report, and the agency has since published proposed settlement terms with Caremark. CVS Pharmacy, for its part, says that as a standalone company it will pursue partnerships with other insurers and benefit managers.
Most of the fight in statehouses and Congress has been over which pharmacies a benefits manager may own. After 2028, at CVS, the answer will be: not the ones on the corner.
After 2028, at CVS, the answer will be: not the ones on the corner.
