Skip to main content

The context you need, when you need it

When news breaks, you need to understand what actually matters — and what to do about it. At Vox, our mission to help you make sense of the world has never been more vital. But we can’t do it on our own.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

Join now

CVS has a plan to strong-arm other pharmacies out of selling cigarettes

Andrew Burton/Getty Images

Early last month, CVS became the first major pharmacy chain to halt the sales of tobacco products. At its 7,700 pharmacies across the country, cigarette sales are now a thing of the past.

You can think of that as phase one of the CVS war on tobacco. Today, the pharmacy chain announced phase two: making it unprofitable for competitors to sell tobacco either.

To understand how CVS can wield this kind of influence over other pharmacy chains, you have to understand how its business works. Most of us know CVS as the pharmacy chain with brick and mortar stores all across the country. And that is a big part of CVS’ business. But another big part of CVS’ business is Caremark, a pharmacy benefits manager.

Caremark is a company that insurance plans contract with to run the drug side of health coverage, doing things like setting up a pharmacy network and determining co-payments. Most health insurers use pharmacy benefit managers and, in that world, Caremark is one of the biggest players. And CVS announced today that it’s bringing Caremark into the fight against tobacco, too.

Caremark-managed health plans will now charge an additional $15 co-pay for any drugs picked up in a pharmacy that sells tobacco products, the Wall Street Journal’s Pharmalot blog reports Monday morning. More from Ed Silverman there:

A CVS Health spokeswoman tells us that "numerous" Caremark clients have asked about developing a "tobacco-free" network of pharmacies. And so, CVS "is in the process of identifying pharmacies that do not sell tobacco products," she writes us. She did not provide a specific start date.

CVS is using its force as a pharmacy benefit manager to create a huge disadvantage for competitors who sell tobacco. And if consumers in Caremark-managed plans want to avoid that extra $15 co-pay, they can go fill their drugs at the one national chain that doesn’t sell cigarettes: CVS.

This new decision helps explain why CVS was okay with giving up an estimated $2 billion in profits when they decided to end cigarette sales. This change to Caremark policies will likely have the effect of driving more prescriptions into CVS stores, as consumers seek to avoid the $15 surcharge. After all, who wants to pay more for antibiotics just because the store happens to be selling cigarettes in a totally separate aisle?

CVS told Pharmalot this isn’t about profits and that they’ve had insurers who use Caremark ask about setting up tobacco-free networks. And even if that is the sole motivation, the move will almost certainly help CVS financially — and get their competitors to think twice about their cigarette sales.

More in Health Care

Health
Hantavirus will test if the world learned anything from CovidHantavirus will test if the world learned anything from Covid
Health

The hantavirus outbreak is still small. But it’s a huge test for a battered public health sector.

By Dylan Scott
Health
How worried should I be about hantavirus?How worried should I be about hantavirus?
Health

5 questions about the hantavirus cruise ship outbreak, answered.

By Dylan Scott
Good Medicine
Do health influencers actually know what they’re talking about?Do health influencers actually know what they’re talking about?
Good Medicine

Most health influencers don’t have real credentials — but they are more influential than ever.

By Dylan Scott
Health
A major new study found AI outperformed doctors in ER diagnosis — but there’s a catchA major new study found AI outperformed doctors in ER diagnosis — but there’s a catch
Health

An Open AI model posted impressive results in emergency care. But we still need human doctors.

By Dylan Scott
Health
Please don’t inject yourself with bootleg peptidesPlease don’t inject yourself with bootleg peptides
Health

Why Americans have gone wild self-experimenting with the hottest thing in wellness: Peptides.

By Dylan Scott
Health
RFK Jr. is in his influencer eraRFK Jr. is in his influencer era
Health

The real reason Trump’s health secretary is launching a podcast.

By Dylan Scott