More CVS Chicanery
CVS Health has a subsidiary called Zinc Health Services. You have never heard of it. That is by design. They are not the only ones.
The Hidden Flow of Drug Money
Zinc is a group purchasing organization. A GPO. It sits between CVS Caremark and every pharmaceutical manufacturer that wants its drugs on the Caremark formulary. When a manufacturer wants preferred placement, the negotiation goes through Zinc. When a rebate check gets cut, it flows through Zinc. When the formulary decides which version of a drug your patient gets, Zinc’s contracts are part of why.
You have never seen Zinc’s name on a remittance. You have never seen it on an EOB. You have never seen it on a formulary notice. But it touches every rebate dollar that flows through Caremark’s system.
In September 2024, the FTC sued all three major PBMs and their GPOs. Caremark and Zinc Health Services. Express Scripts and Ascent Health Services. OptumRx and Emisar Pharma Services. The allegation was that these six entities rigged the pharmaceutical supply chain and artificially inflated insulin list prices for over a decade.
The FTC said PBMs used their GPOs to create a rebate structure that rewarded manufacturers for raising list prices. The higher the list price, the bigger the rebate, the bigger the GPO’s cut. Patients paid more. Pharmacies absorbed the cost. The PBM and its GPO split the spoils.
CVS reached a proposed settlement with the FTC in March 2026 for Caremark and Zinc to withdraw from the case. The FTC projected consumer savings of $7 billion over 10 years from the settlement changes. Seven billion dollars. That is the FTC’s own estimate of how much patients were overcharged.
$7 billion in projected savings means $7 billion was being taken.
Every pharmacy owner reading this has watched insulin prices make no sense for years. You know your acquisition cost. You know what the PBM reimburses. You know the patient is paying a copay based on a list price that has nothing to do with the actual cost of the drug. Now you know why. Zinc.
The big three PBMs each have one of these GPO subsidiaries. They all do the same thing. They all sit in the shadows. And they all exist to extract rebate revenue that flows up to the parent company instead of down to the patient.
This is one subsidiary. CVS Health has over 200.