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Cuyahoga County panel advances $123.7 million pharmacy benefit contract with Caremark
Summary
The Human Resources Appointment & Equity Committee voted to move a $123,742,902.8 pharmacy benefit management contract with Caremark PCS Health LLC forward under second-reading suspension after staff explained scoring, a 10% contingency buffer and network coverage.
Cuyahoga County’s Human Resources Appointment and Equity Committee on March 18 advanced a nearly $123.8 million contract for pharmacy benefit management with Caremark PCS Health LLC (CVS Caremark), approving a second-reading suspension so the award can proceed to the full council.
County Human Resources Director Sarah Namasol introduced the request as a three-year agreement covering prescription benefits for employees and eligible dependents from Jan. 1, 2025, through Dec. 31, 2027. "This request is for our employee group health plans associated prescription drug benefit service agreement with Caremark PCS Health," she said.
The department’s benefits director, Gloria Langford, told the committee the county is self-insured for prescription benefits and that the procurement included participation in a group purchasing consortium called Employers Health, which negotiates drug pricing and returns rebates to the county. Langford said Caremark prevailed in the RFP scoring: "Caremark PCS LLC did prevail over all other proposals scoring the highest in all categories and overall." She said it is projected that only about "1.4% of the contract costs will be paid to CVS Caremark... and the other 98.6 of the contract costs will be reimbursing CVS Caremark for the cost of prescription drugs and related services."
Business Service Manager Steven Witt told the committee the county’s prior contract and final payments for 2024 totaled about $85,000,000 and that the new agreement includes a 10% contingency "on top of the projected medical inflation year to year" to allow for unexpected spikes in prescription spending. Langford and staff cited recent large-cost drugs as examples of unpredictable drivers of spending and said utilization management and prior authorization processes are in place to limit overuse.
Committee members pressed staff on details they said they would need during upcoming budget hearings: how self-insurance fund reserves are handled, whether unused buffers revert to the fund, and whether county code or other legal authority limits transfers to the general fund. Witt and Langford said the reserves are generally dedicated to the self-insured medical plan and that legal counsel would be asked to provide a definitive answer.
Members also asked about retail access after recent CVS and Rite Aid store closings. Langford said she had seen "not many complaints about the CVS closings" so far and that Metro Health Pharmacy also participates in the network; staff agreed to provide additional location-impact information if available.
The committee voted by voice to approve suspension of the second reading and move Resolution 20250112 forward; the resolution was described in the meeting as an award on requisition 14,216 to Caremark PCS Health LLC "in the amount not to exceed $123,742,902.8."
