CVS Caremark, however, will continue to manage specialty drug benefits for Tyson Foods.
Tyson Foods has replaced CVS Caremark with Rightway, a PBM that has a pass-through model with a single administration fee, effective Jan 1, 2024. CVS Caremark will, however, continue to provide specialty benefits. Tyson Foods is a Fortune 100 company headquartered in Springdale, Arkansas, and has about 140,000 employees.
“Their current PBM relationship was not generating the economics that they were looking for, and the feedback from their key members and associates was suboptimal in terms of experience access and affordability,” Jordan Feldman, co-founder and CEO of Rightway, said in an interview. Rightway has a pass-through pricing model and does not retain any rebates or use spread pricing.
A spokesperson for CVS Caremark said the company is pleased to continue serving Tyson as their specialty pharmacy provider through Rightway. “Our specialty pharmacy services support members managing high cost, complex conditions and typically represent over 50% of pharmacy benefit spend in the marketplace. Historically, we have provided Tyson Foods with significant transparency, including point of sale rebates for its members, a custom retail pharmacy network and unique utilization management strategies that resulted in flat trend over the last several years.”
Last year, Blue Shield of California also made the decision to drop CVS Caremark as its PBM in January 2025. This is part of the plan’s decision to remake its pharmacy benefit model. The new model breaks apart the traditional services of a pharmacy benefit manager (PBM) into five different areas. One of the biggest changes is the replacement of CVS Caremark with Prime Therapeutics as the company that will negotiate savings with drug manufacturers to move toward a value-based model that focuses on health outcomes.
As with Rightway, CVS Caremark will continue to provide specialty pharmacy services for Blue Shield of California members with complex conditions, including education and high-touch patient support.
Blue Shield of California has said the new model save up to $500 million in annual drug costs.
The CVS Caremark spokesperson cautioned about fragmentation in the healthcare industry, which he said is one of the primary reasons healthcare remains too complex and expensive. “We remain confident in the value we provide our customers and that our integrated solutions will continue to resonate in the marketplace.”
Feldman, however, said the PBM industry at an inflection point. “For decades, three PBMs have used this classic middleman positioning to only their advantage, accruing profits that are outsized relative to the benefits downstream for employers and their employee,” he said.
Employers, Feldman say, are driving a change. “They are frustrated by the double-digit compounded increases in pharmacy spend. They've noticed the trend of pharmacy benefits growing from 5% of total healthcare spend to 30% of total healthcare spend. This is unsustainable, and they are no longer satisfied or willing to accept the status quo.”
PBMs, Feldman said, serve a critically important role within the healthcare and pharmacy benefit ecosystem, connecting drug manufacturers and their innovation to employers. But the incentives have been misaligned.
“Big PBMs have used their size to their advantage to skim profits, and essentially steal money from employers and their employees. We need to fundamentally rearchitect and reengineer what it meant to be a PBM.”
Rightway, he said, was founded in 2017 with the objective to financially realign the model, focusing on technology and customer service. “We've obsessed about unit cost of pharmacy benefits for decades. The reality is member experience and member management is far more critical to the overall cost of pharmacy benefits than that underlying unit pricing.”
Rightway pharmacists are available to help guide members toward effective medications at the lowest price. The company says they are able to save 15% in pharmacy costs. Within diabetes, the PBM is able to achieve a 94% compliance rate and members saving about 10% in out-of-pocket costs. Additionally, Rightway was the first PBM to be added to the Mark Cuban Cost Plus Drug network.