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CVS breaking up its healthcare empire — splitting pharmacies from insurance business
CVS Health plans to split into two companies, separating its retail pharmacies from its insurance and pharmacy-benefit operations, according to a report citing the company. The move would reverse its strategy of combining healthcare businesses through acquisitions, including its roughly $78 billion purchase of Aetna in 2018.
One proposed structure would place about 9,000 pharmacies in a separately listed company, while Aetna and pharmacy-benefit manager Caremark would remain together; the final arrangement has not been confirmed. The potential split comes amid political and regulatory scrutiny of pharmacy benefit managers. CVS reported record revenue of $402.1 billion in 2025, up 7.8 per cent, and its market value has risen to about $117 billion since David Joyner became chief executive in October 2024.
In short
- CVS plans to divide its pharmacies from insurance and pharmacy-benefit operations.
- The plan would reverse its push to build an integrated healthcare business.
- CVS reported $402.1 billion in revenue in 2025.
Steelman: both sides, in good faith
The strongest fair case each way — we don't pick a winner.
The case for
Separating the retail pharmacies could make each business easier for investors and regulators to assess, while giving pharmacy operations more focus and flexibility. It may also address concerns that combining insurers, benefit managers and pharmacies can create conflicts of interest or obscure how decisions affect patients and customers.
The case against
The integrated structure may allow CVS to coordinate care, prescription benefits and pharmacy services, and splitting it could weaken those connections or add costs and complexity. A breakup would also reverse a strategy built through major acquisitions, with uncertain benefits for patients, employees and investors if the separate businesses lose advantages of scale.
Explained simply
CVS Health is a large US healthcare company that owns pharmacies, provides health insurance through Aetna and manages prescription drug benefits through Caremark. Pharmacy-benefit managers negotiate with drugmakers and help insurers decide which medicines are covered and how much patients pay.
CVS brought these businesses together through acquisitions, including its purchase of Aetna in 2018. The combination was intended to link insurance, prescription services and pharmacy care within one company.
Pharmacy-benefit managers have faced political and regulatory scrutiny over their role in drug prices and access to medicines. Separating parts of CVS could change how its businesses are organised and how investors assess them.