Case Overview

Case: CVS Health Corp. & CaremarkPCS Health LLC Kickback Class Action

Filed: April 2026

Defendants: CVS Health Corp., CaremarkPCS Health LLC

Allegations: Selling formulary access in exchange for kickbacks from drug manufacturers

Status: Recently filed; litigation ongoing

CVS Health Faces Class Action Alleging Kickbacks Inflated Drug Costs for Patients

A new class action lawsuit is taking aim at one of the country's largest pharmacy benefit managers, alleging that CVS Health Corp. and its PBM subsidiary, CaremarkPCS Health LLC, accepted payments from drug manufacturers in exchange for preferential placement on drug formularies — a practice the complaint alleges ultimately drove up costs for patients.

According to recent class action reporting, the lawsuit alleges that CVS and Caremark treated drug formulary access as something that could be bought and sold, rather than determined by patient benefit or clinical need.

What Is a Drug Formulary — and Why Does It Matter?

For many readers, the term "formulary" may be unfamiliar. In short, a formulary is the list of prescription drugs that a health insurance plan or pharmacy benefit manager designates as preferred or covered. When a drug appears on a formulary — especially in a preferred tier — it is more likely to be prescribed, and patients typically pay less out of pocket for it.

Pharmacy benefit managers, or PBMs, serve as middlemen between drug manufacturers, insurers, and pharmacies. They negotiate drug pricing and determine which drugs make the formulary list. Because formulary placement can dramatically influence which drugs get prescribed and how often, it carries enormous financial weight.

What the Lawsuit Alleges

The complaint alleges that CVS Health and CaremarkPCS Health sold access to their formularies to drug manufacturers in exchange for kickbacks. Rather than placing drugs on formularies based on clinical effectiveness or patient outcomes, the lawsuit alleges, the defendants accepted payments — effectively allowing manufacturers to purchase preferred placement.

According to the complaint, this alleged arrangement harmed patients and plan members who paid more for drugs than they should have, or were steered toward more expensive medications that benefited drug manufacturers rather than their own health or wallets.

The filing states that the practice constitutes a breach of the defendants' duties to the patients and plan sponsors they serve.

Why This Case Is Drawing Attention

Pharmacy benefit managers have come under increasing scrutiny in recent years from lawmakers, regulators, and now plaintiffs' attorneys. Critics argue the PBM business model — which can involve complex rebate arrangements between manufacturers and benefit managers — lacks transparency and may not always serve the best interests of patients.

This lawsuit represents a direct legal challenge to those practices, framing what are often described as "rebates" as something closer to kickbacks that distort which drugs patients actually receive.

The case adds to a growing body of litigation targeting PBM practices across the country, as courts and regulators alike examine whether these arrangements comply with federal and state law.

Who May Be Affected

The lawsuit is framed as a class action, meaning it is intended to represent a broad group of individuals who may have been harmed by the alleged conduct. While the specific class definition will be determined as the litigation proceeds, the case could potentially affect:

• Patients who were prescribed drugs through CVS Caremark-managed benefit plans
• Employer-sponsored plan members whose formularies were managed by CaremarkPCS Health
• Health plan sponsors who contracted with Caremark for PBM services

Those who believe they may have been affected by the alleged conduct may wish to monitor the case as it develops. Eligibility for any potential class and any future recovery would be determined by the court.

Key Takeaways

• The lawsuit alleges CVS Health and its PBM subsidiary, Caremark, accepted payments from drug manufacturers in exchange for drug formulary placement — not based on clinical merit
• The complaint alleges this practice inflated drug costs and steered patients toward medications chosen for financial rather than medical reasons
• The case is part of broader national scrutiny of pharmacy benefit manager practices and transparency
• The litigation is in early stages; no settlement or judgment has been reached
• Those who received prescription drug coverage through CVS Caremark-managed plans may want to follow this case for updates

This article is for informational purposes only and does not constitute legal or medical advice. Consult a qualified attorney if you believe you have been harmed by the practices described in this lawsuit. Do not make changes to your prescriptions or coverage without consulting your physician or pharmacist.