The split still requires board approval and an SEC Form 10 registration, and neither has been completed. Public reports also differ on what CVS paid for Aetna, with Reuters citing about $78 billion and CNN citing $69 billion. CVS said the split should have little effect on customers, and it has announced no store closures. Details on how debt, shared services, and contracts will be divided between the two companies have not been released.
The split reverses the strategy CVS pursued for nearly two decades, beginning with the 2007 Caremark merger and the 2018 Aetna acquisition. It is one of the largest healthcare restructurings in recent years, and it lands as state and federal lawmakers target companies that own both PBMs and pharmacies. Tennessee's Fair Rx Act takes effect in 2028 and faces a legal challenge, a judge has blocked an Arkansas law, and a bipartisan Senate bill from Senators Elizabeth Warren and Josh Hawley would bar PBM-pharmacy co-ownership. Attorneys advising on PBM, pharmacy, or insurance matters should track the Form 10 filing, any board action, and how the Tennessee and Arkansas disputes develop, since they bear directly on whether the separated structure holds.