FTC settlement forces Caremark to curb drug rebates and cut costs

CVS Health’s Caremark agreed to count qualifying TrumpRx purchases toward deductibles once the program has the needed regulations, letting patients use discount-site savings without losing progress toward insurance coverage. The settlement also forces Caremark to curb rebate-driven pricing and gives clients an option to opt out of rebate payment models, two changes that can push down what patients pay at the pharmacy counter.

The FTC says the agreement locks in up to $8.5 billion in consumer savings over 10 years and could unlock as much as $4.5 billion more through point-of-sale rebates. It also sets up a reimbursement option for small pharmacies based on actual drug cost plus a fee, addressing complaints that pharmacy benefit managers squeeze independent drugstores while obscuring how much of each prescription dollar goes to rebates, fees and spread pricing.

The FTC brought its insulin antitrust case on September 20, 2024, targeting Caremark Rx LLC, Express Scripts and OptumRx, along with affiliated group purchasing organizations, over alleged anticompetitive rebating practices that artificially lifted insulin list prices. The Caremark deal resolves that lawsuit, and it follows a February 2026 settlement with Cigna’s Express Scripts that also required direct purchases through TrumpRx to count toward copays and deductibles in standard employer plans.

TrumpRx.gov launched in February 2026 as the White House opened a direct-to-consumer path for discounted prescription drugs, including medicines that many patients buy outside insurance. A House Judiciary Committee interim staff report released on January 21, 2026, accused the company of protecting itself from competition and innovation.

CVS said the July 14 agreement resolves all outstanding FTC litigation and investigations involving rebate practices, pharmacy network contracting and vertical integration. The company negotiated nearly $80 billion in prescription-drug savings for clients and members last year, delivered nearly $900 million in point-of-sale rebate savings to 25 million Americans, and expects broader client adoption of those rebates to produce about $450 million a year in savings over the next decade.