Few American companies touch as many patients as CVS Health, which fills prescriptions at the corner drugstore, administers drug benefits for employers and sells coverage through Aetna. On Wednesday it said it would pull those pieces apart. One business, keeping the CVS Health name under Chairman and Chief Executive David Joyner, will house Aetna, the Caremark pharmacy benefit manager, specialty pharmacy, Oak Street Health and Signify Health, while a new CVS Pharmacy led by Prem Shah takes about 9,000 stores, mail pharmacy, MinuteClinic (including virtual care), and the Health100 technology services business, in a separation targeted for the first half of 2028 that is meant to be tax-free and leave shareholders holding stock in both, the company said in a release.
CVS bought Aetna in 2018 for $78 billion to build a vertically integrated health conglomerate, and had already weighed a breakup during a strategic review in October 2024 before setting the idea aside, CNBC reported. The integrated model was the core of its pitch to investors and clients: a company that insures a patient, manages the drug benefit and fills the prescription could squeeze costs across the whole chain. Scale came with it. As of June 30, 2026, the benefits manager had about 87 million plan members and the insurance products covered an estimated 37 million people, its quarterly report said.
That same structure has become a political liability. Arkansas and Tennessee have passed laws over the past two years intended to stop one company from doing both, Quartz reported, citing The New York Times. A standalone CVS Pharmacy would be free to court rival insurers and benefit managers as customers rather than competitors, a shift the company framed as opening a wider set of partnerships.
The breakup arrives with the company's turnaround showing in its results. That forecast has been raised repeatedly this year as Aetna's margins recovered. Until the split closes, CVS Health will run as one company, and completion still depends on final board approval, an effective registration statement with securities regulators and confirmation of the tax treatment.