Exclusive: CVS explores options including potential break-up, sources say

[BumRushDaShow]

Source: Reuters

October 1, 2024 9:26 AM EDT Updated a min ago


NEW YORK, Sept 30 (Reuters) - CVS Health (CVS.N) is exploring options that could include a break-up of the company to separate its retail and insurance units, as the struggling healthcare services company looks to turn around its fortunes amid pressure from investors, people familiar with the matter told Reuters. CVS has been discussing various options - including how such a split would work - with its financial advisers in recent weeks, the sources said, requesting anonymity as the discussions are confidential.

The plan to potentially split the company's pharmacy chain and the insurance business has been discussed with the board of directors, which is yet to decide on the best course of action for CVS to pursue, the sources said, cautioning that the plans have not been finalized and CVS may opt for a different strategy.

CVS is also discussing whether its pharmacy benefits manager unit, which manages drug benefits for health plans, should be housed within the retail unit or under insurance, if it were to proceed with a separation that could result in two publicly traded companies, the sources said.

Such a move would effectively unwind CVS's landmark $70 billion takeover of healthcare insurer Aetna in 2017 and come as CVS attempts to navigate one of the most challenging periods in its six-decade history. A CVS spokesperson declined to comment on whether it is holding talks to explore options.

Read more: https://www.reuters.com/business/healthcare-pharmaceuticals/cvs-explores-options-including-potential-break-up-sources-say-2024-09-30/

[LisaM]

1. Why are pharmacies having trouble?

I have to pick up a small eyedrop prescription about every six months. No matter which pharmacy I go to (usually Walgreens or Safeway, since I need to walk or use transit) there is a line. There seem to be hundreds or even thousands of prescriptions waiting to be picked up, and the pharmacists are working their keisters off. Yet Rite-Aid just closed all its Michigan stores, Walgreens is in trouble, and now CVS. Did private equity firms get involved? Are online prescription companies the issue (though Express Scripts just got into trouble).

Something seems really awry.

[BumRushDaShow]

4. There has been a lot of "consolidation" in this market over the decades

including the "buy or get bought" mentality, as well as diversifying the portfolio (like CVS apparently did taking over Aetna).

So for CVS, they envisioned themselves as a "one stop shop", being a "health insurer" that directed their preferred provider prescriptions to their own pharmacies, and even offered health services like "urgent care" at some locations.

Rite Aid (which I use), is a PA-based chain that expanded itself probably more than they should have, including buying a bunch of smaller chains in MI, as well as bigger ones like Eckerd (which itself had taken over Thrift Drug, a PA-based chain).

I do think the whole newer business model with mail order drug fulfillment, has been getting to them though. The pandemic really triggered the use of more and more interactions online versus in a retail outlet. And with supermarkets doing pharmacy duties too, that put more pressure on those pharmacy chains.

[thumper2547]

5. It's the PBMs

It's the Pharmacy Benefit Managers. From what I understand they usually get paid based on percentages (in complicated ways). They negotiate between the pharmacy, insurance companies, and the drug manufacturers. So the more the drugs cost the more money they make. Pharmacies all over the country are losing significant money on every name brand drug they dispense because it costs so much to buy and the reimbursement or coupons don't cover the loss. They only turn a profit off of generics. But if you lose 50 - 100 bucks (yes they are somtimes losing that much!) dispensing a bottle of name brand and only make a 5 dollar profit off a bottle of generics then you have to sell a crap ton of generics to make up for it. PBMs want the drugs to cost a lot so they cost a lot.

[modrepub]

6. Our Byzantine Healthcare System

You'd need a PHD just to try and understand it. It's so opaque. As my one colleague used to say; "names have been changed to protect the guilty".

I'm OK with a private based health care system BUT they system has to open and clear to the people using it. Prices should be clearly stated. There needs to be adequate competition. And there has to be some type of safe guard put in place that removes the bad players.

Our current system is far from adequate and its expensive. Don't expect help from politicians. They're heavily supported by the health care industry and they get access to a great health-care system.

[IronLionZion]

9. Lawsuits from the opioid crisis were a big factor with lots of publicity

and plenty of mergers/acquisitions that didn't work out the way they expected. So they are trying to divest now.

[slightlv]

11. I think this is ironic,

since CVS bought up all the Mom and Pop pharmacies in town. I hated that... you actually get a relationship going with a drugstore, a pharmacist and then these big corporations come in, buy them out, and shut them down. And to your point, not only is there a line, but the time they tell you to come in and pick up your med is never right... they tell you 3pm, and you still wait there until they put it together. It's like only if you're standing there is there any pressure to actually fill the script.

I recently quit CVS; moved all my scripts over to the pharmacy in Dillon's. CVS never had my hydrocodone in stock. And, even if I called a day early, and they had it at that time, they wouldn't put it together and hold it until the next day when I was "allowed" to pick it up. Not only that, but I was continually getting "attitude" from CVS pharmacists when I'd fill a couple of scripts, the hydro included. One time I really did tell the guy... "look, live a day in my body and THEN talk smack to me."

[mercuryblues]

13. I take 2 medications

One is about $17,000 the other is almost $14,000 a month. That is not a typo.

I have CVS prescription coverage, therefore I have to get them filled at CVS.

Between my ins and pharma assistance plans, I pay out of pocket $75.00

There is no reason the Rx should cost that much.

Can you see the scam? All they are doing is circulating money back and forth. That business model is not sustainable.

[FakeNoose]

14. Have you looked into Cost Plus Drugs?

This is Mark Cuban's prescription service that provides some drugs (they don't have everything) at wholesale prices. It's a safe, reliable service and they're trying to help the "little guys" who are getting slammed by the crazy high prices from Big Pharma.

Here's their website, you can check to see if they carry what you need:
https://costplusdrugs.com/

Mark Cuban is a good guy (originally from Pittsburgh) but he lives in Texas now. He's made a lot of money and he's part-owner of the Dallas Mavericks. Even though he's wealthy now, he still relates to regular middle-class folks where he came from, and that's why he started this company.

If they don't carry your prescription drugs, you can request it and maybe they will be able to get it for you.

[mercuryblues]

15. I have to get it through CVS

I only pay $75 a month, despite the listed price.

Who pays the difference? IMO it is a scam.

[FakeNoose]

16. Of course it is - Americans are paying through the nose

Insurance companies should be screaming holy hell. Why aren't they?
Medicare will be bankrupt if this doesn't get fixed.

[bucolic_frolic]

2. So the guys that dispense medications own the guys that pay for medications

I did not know that. Sounds like a conflict of interest. But TEVA makes half the generics in the US. Everytime the meds change hands the price increases, even if just for the handling.

[lanlady]

3. I have Cigna and they force us to go to CVS

for prescriptions. So does Aetna. Yet CVS is in financial trouble? How is that possible? They have a nice medical monopoly going on.

[BumRushDaShow]

7. Way back in the late '70s

my first experience with a CVS was in college in Massachusetts when I was at UMASS. I had never heard of them because we had our own chains here in PA (and in Philly, where there were still some indie pharmacies, a/k/a "drug stores", around).

IOW, CVS was primarily a New England chain.

Of course with Raygunomics, whole industries got into the expansion madness and that included CVS. I remember when they eventually began to open stores here in Philly, when the acquisition and expansion schemes were underway.

It's just like when Sears all of a sudden decided to get into the "financial services" business (and that included the insurance industry with Allstate, and even real estate with Coldwell Banker). Of course we know what eventually happened to Sears.

I think they are now paying for those types of business decisions and trying to unwind.

[slightlv]

12. How this is not a monopoly, I don't understand.

Or a huge conflict of interest! I'm with Aetna, and I know one of them owns the other one - after killing all the Mom and Pop's in town. Using SingleCare and GoodRX, a good portion of the time I don't even use insurance to pay for my scripts. One of these days, whatever mechanism these private companies use will come back to bite us, no doubt. Until then, it's easier and less stressful to just quit CVS and go elsewhere.

[eggplant]

8. But for-profit healthcare is the best thing ever.

Uh huh.

[turbinetree]

10. We really need a nationalized healthcare system...............