As outlined in the agreement, CVS Caremark will implement a series of actions into its standard offering to commercial clients, including:

Aligning certain member cost sharing more closely with the net cost of medications after rebates to help push more savings to members at the point of sale.
Simplifying pricing structures by moving away from rebate guarantees and spread pricing.
Expanding transparency through enhanced reporting on drug pricing, rebates and member payments, along with disclosure of broker and consultant compensation.
Expanding affordability programs for medicines, including a new offering that will cap members' insulin costs at $25 per month.
Promoting point-of-sale rebate passthrough as a standard option to encourage plan sponsors to share drug cost savings more directly with members at the pharmacy counter.
Delinking manufacturer compensation from list prices.
Transitioning to acquisition-based reimbursement for independent retail pharmacies to ensure reimbursements are more closely aligned with their actual costs.
Counting TrumpRx purchases toward member deductibles and out-of-pocket maximums where allowed by law, subject to certain conditions in the settlement.

Many measures in the agreement align with CVS Caremark's existing affordability and transparency initiatives, the company said. These include point-of-sale rebate options, flat-dollar copays, copay caps, $0 preventive drug lists and the TrueCost pricing model each designed to reduce out-of-pocket costs and provide greater clarity at the drug level. These efforts also include ReducedRx,which offers insulin at $25 a month at more than 60,000 network pharmacies nationwide. In addition, Aetna has been providing fully insured commercial clients with point-of-sale rebates since 2019.

Instant Insights /

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