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CVS Health's Caremark to Lead CalPERS' PBM Vision: What's at Stake?
ZACKSยท2025-07-18 13:36

Core Insights - Rising prescription drug costs are a significant concern in healthcare, with pharmacy benefit managers (PBMs) under scrutiny for their management of drug benefits [1] - CVS Health's Caremark has secured a five-year contract with CalPERS, replacing OptumRx, to provide outpatient prescription drug benefits to nearly 587,000 members starting January 1, 2026 [2][8] - CVS Caremark was chosen for its ability to offer more affordable drug benefits and strong contract terms, including a $250 million risk for failing to meet cost control and clinical quality targets [3][8] Company Developments - CVS Caremark will manage formulary changes for CalPERS, promoting affordability in drug coverage, including weight management medications, potentially saving clients 10-15% annually [4][8] - CVS shares have increased by 6.3% over the past year, contrasting with a 17.7% decline in the industry [7] - The stock is trading at a forward one-year price-to-earnings ratio of 9.60, below the industry average of 14.00, and has a Value Score of A [9] Industry Trends - The global PBM market is growing, with CVS Caremark, OptumRx, and Express Scripts leading the market [5] - Elevance Health reported a 33% year-over-year increase in CarelonRx operating gains, driven by higher prescription volumes and recent acquisitions [5] - Humana has partnered with Epic to integrate health plan information into MyChart, enhancing access for Medicare Advantage members [6] Financial Outlook - Analyst estimates for CVS Health's earnings in 2025 and 2026 show an upward trend, with current estimates for the next year at $7.00 per share [10][11] - CVS currently holds a Zacks Rank 1 (Strong Buy), indicating positive market sentiment [11]