The Drug Trend Report

Report Section

Drug Trend Report - Overall Trend

We’ve delivered single-digit trend for five years running – fueled by constant innovation on behalf of our clients. We use every tool possible to achieve the lowest net cost in every category, create the best savings and guarantee the highest clinical integrity. In 2021, we continued this work, delivering low trend amid another extraordinary year in health care, while building a foundation for savings sustainability.

Overall Drug Trend
in 2021

Trend Methodology

of Clients Had Negative Trend in 2021

We Partner with Clients to Consistently Lower Trend
in 2021

80.5% of Clients Had Less Than 10% Trend


63.1% of Clients Had Less Than 10% Trend 2 Years Running


Clinical Integrity and Best Practices Drive Our Approach

Our approach begins with the latest clinical research, guidelines and best practices – and our formulary decisions are managed by a committee of independent, unaffiliated clinical pharmacists and physicians. Across every therapeutic category, we strive to achieve the lowest net cost for our clients and their plan members. Getting there means managing the two fundamental forces behind drug spending: price and utilization.

Lowest Price

Negotiating to Lower Prices

We bring our size, scale and expertise as the largest purchaser of prescription drugs in the United States to the negotiating table – working to reach the lowest prices possible with drug manufacturers.

Getting The Mix Right

We apply our innovation to ensure the most effective, lowest-cost medications are used. Whether it’s taking the lead in adding biosimilars or ensuring that less costly, clinically equivalent generics get preference, we use our formularies to manage costs.

Appropriate Utilization

Ensuring Appropriate Treatment Use

We guide coverage toward the treatments most likely to deliver the best outcomes – avoiding wasted time and money on less effective medications.

Minimizing Waste

We monitor the market for unjustifiably high-priced drugs with less costly clinical equivalents, removing them from our formularies. And we work with members to support optimal adherence, prevent stockpiling and minimize wasted spend.

Lowest Net Cost

Trend Methodology

Unless noted, all cost savings data in this report was updated in March 2023 to reflect full-year 2021 data.

This report provides an overview of performance for CVS Health commercial PBM clients – employers and health plans. Data were calculated on a cohort of 1,029 clients, covering approximately 22 million lives. The cohort is built only on clients under our management throughout all of 2020 and Q1 through Q4 2021, excluding commercial clients with eligibility shifts exceeding 20 percent, as well as clients contractually prohibiting use of plan data. Prescription drug trend is the measure of growth in prescription spending per member per month. Unless otherwise noted, reported data are net of negotiated pricing, rebates and manufacturer discounts.