CVS Caremark (PBM)
institution
A single company can be your insurer, your prescription middleman, and your pharmacy all at once, shaping what your medicine costs.
Who they are
CVS Caremark, a Pharmacy Benefit Manager owned by CVS Health/Aetna.
What they do
It's a middleman that sits between drugmakers, insurers, and pharmacies deciding how prescription claims get processed and paid.
How it works
It holds roughly 26-27% market share and covers about 100 million people, and is one of just three such middlemen that handle around 80% of US prescription claims. It's stacked into one company alongside an insurer, retail pharmacies, and doctor practices.
Why it matters
So much of the prescription system runs through one vertically combined company that it has enormous power over drug access and pricing.
The engine's record — word for word
Pharmacy Benefit Manager. CVS Health / Aetna parent. ~26-27% market share. ~100M covered lives. One of three PBMs processing roughly 80% of US equivalent prescription claims by 2024-2025. Vertically integrated: insurer + PBM + retail pharmacies + physician practices + care delivery platforms in single corporate structure.
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