There’s a lot of conversation right now about transparency in pharmacy benefit management. While transparency has always been an important topic, new regulations and mandates have increased the focus for all stakeholders.
I understand the urgency. The affordability pressures on employers, health plans, and their members are real. But I want to be direct: at CVS Caremark, transparency isn’t the direction we’re moving toward because regulators demanded it. It’s foundational to our relationships with our clients.
Driving transparency
CVS Caremark introduced TrueCost in 2023, building on a commitment to deliver lower net costs through drug-level pricing regardless of whether value is driven by rebates or discounts. That wasn’t a reaction to external pressure. It was a response to what our clients requested so we could better serve them: improved visibility into the actual cost of individual drugs, and plan design decisions grounded in more granular data — not high-level estimates or blended averages.
As of January 1, 2026, 85% of our commercial book of business benefits from TrueCost features. We are moving away from spread pricing in our standard offering and continuing to expand reporting capabilities so clients have greater visibility into how their benefits are performing. That’s not a compliance-driven rollout. That’s a market signal.
Clients have always been in the driver’s seat
This is the part of the PBM conversation that gets lost.
Our clients choose how their plan is designed, including how the value we create gets passed to members. They decide whether rebates flow to the point of sale or to lower premiums, how to structure formularies, and how to balance cost-sharing. Clients have long had control over these decisions.
What transparent pricing does is sharpen those decisions. TrueCost helps clients see the actual cost of individual drugs and understand where drug costs come from, formulary impacts, and the effects of their decisions. When plan sponsors have that visibility, they design better benefits, make smarter trade-offs, and can clearly explain costs to their members.
The standard has been set
Our continued development of TrueCost and other offerings reflects our commitments—including pass-through of manufacturer rebates and discounts to members at the point of sale, elimination of retail spread pricing, shifting more contracts to cost-based pharmacy reimbursement, and enhanced reporting to help clients track their savings more directly.
The industry is changing. New entrants are making promises about transparency that remain to be proven at scale. We welcome the competition — it validates what we’ve been building. CVS Caremark will continue to lead with transparency, innovation, and client-centricity to earn the trust of our customers every day.
That’s the PBM of the future. And we’ve been building it for a while.
