The California Public Workers Retirement System (CalPERS) has inked a five-year contract with CVS Caremark as its pharmacy advantages supervisor, the group introduced Tuesday. CVS is changing OptumRxwhich served CalPERS for 9 years.
CalPERS is a public pension fund, providing retirement and well being advantages for state, college and public company members. Via the brand new contract, CVS will present outpatient prescription drug advantages for about 587,000 members enrolled in fundamental or Medicare HMO or PPO plans, accounting for about 40% of the 1.5 million members who obtain well being advantages by way of CalPERS, in response to the announcement.
The brand new contract goes into impact on January 1, 2026. As a part of the contract, CVS should meet sure price and high quality targets. The corporate is liable to $250 million if they don’t meet these objectives, notably associated to bettering take care of hypertension and diabetes.
“By holding the PBM accountable for delivering outcomes, we’re aligning their pursuits with these of our members and their public sector employers,” mentioned Don Moulds, CalPERS chief well being director, in a press release. “This contract is designed to make sure that each greenback spent on pharmaceuticals delivers worth for our members and ensures the sustainability of our program.”
CalPERS mentioned in its announcement that it chosen CVS Caremark over different distributors due to its “demonstrated capacity to ship extra inexpensive drug advantages and its dedication to efficiency ensures in key areas equivalent to managing pharmacy price developments and guaranteeing scientific high quality.”
CVS mentioned it’s “honored” to be working with CalPERS.
“Day by day we work to barter the bottom internet price for medicines, establish protected and clinically efficient therapies, and help the distinctive wants of our clients,” mentioned Ed DeVaney, president of CVS Caremark, in an electronic mail. “Via innovation and a relentless give attention to bettering the member expertise, we’re driving higher well being outcomes and decreasing out-of-pocket prices for customers. We’re dedicated to constructing a powerful, collaborative relationship with CalPERS to ship inexpensive protection and broaden entry to high-quality well being care for his or her plan members.”
The contract with CVS comes at a time when PBMs (notably the Massive Three: CVS Caremark, OptumRx and Categorical Scripts) are dealing with lots of scrutiny for his or her vertical integration with insurers and are sometimes blamed for rising prescription drug prices. These three PBMs management 80% of the prescription drug market.
Simply final week, a gaggle of bipartisan legislators launched a invoice that might crack down on PBMs. Quite a few different payments have additionally been launched tackling PBMs, and the state of Arkansas not too long ago created a legislation banning PBMs from proudly owning pharmacies within the state.
Photograph: megaflopp, Getty Photos
