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CVS surgery would provide little if any relief



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The author is a Reuters Breakingviews columnist. The opinions expressed are his own.

By Robert Cyran

NEW YORK, Oct 1 (Reuters Breakingviews) -It’s easier to diagnose what ails CVS Health CVS.N than it is to prescribe a cure. Multiple profit warnings from the $78 billion healthcare conglomerate have raised doubts about its strategy. It may now be considering a breakup, but such radical surgery probably would bring little if any relief.

The company’s flagship drugstore chain is one painful problem. Insurance providers have been squeezing pharmacists as online marketplaces such as Amazon.com AMZN.O, mail-order rivals and big retailers including Walmart WMT.N muscle into the business. This competition is a big reason why CVS has generated a dismal 2% total shareholder return, including reinvested dividends, since 2015. It’s only slightly comforting that peer Rite Aid went bankrupt and Walgreen Boots Alliance WBA.O shareholders lost 80% of their investment over the same 10-year span.

CVS avoided an equally disastrous fate by diversifying. It paid $70 billion for insurer Aetna in 2018, following up with the $11 billion acquisition of primary care provider Oak Street and an $8 billion deal for Signify Health, which tends to patients at home. The M&A binge has been of dubious value, however. The combined purchase prices exceed the company’s current market capitalization, and it is now larded with $50 billion of net debt, twice as much as before the acquisitions, at nearly 5 times expected 2025 EBITDA, according to estimates gathered by LSEG.

Moreover, the latest struggles at CVS have centered around insurance. Boss Karen Lynch expanded the Medicare Advantage business, under which private insurers are paid by the U.S. government to manage healthcare benefits for retirees, at just the wrong time. Customers started using it more than expected while federal officials cracked down on reimbursements.

Carving up the company is now under consideration as part of a possible strategic shakeup, according to Reuters, amid pressure from at least one investor, per the Wall Street Journal. Its insurance business and ancillary services would generate $10 billion of adjusted operating profit this year, assuming second-half results match the first half. Rival Cigna CI.N trades at 10 times, implying Aetna-plus would be worth $100 billion.

Double the retail arm’s $2.4 billion of operating profit through June and put it on the same 9 times multiple commanded by Walgreens, and it would be worth nearly $45 billion. Together, the implied uplift for the enterprise would only be about 10%, including debt, which hardly justifies the risky operation. A better prescription for Lynch would be to stop doing overpriced deals and instead find ways to nurse the wounded units back to health.


Follow @rob_cyran on X

CONTEXT NEWS

CVS Health is exploring strategic options including breaking up the company by separating its pharmacy and insurance units, Reuters reported on Sept. 30, citing unnamed sources.

Hedge fund Glenview Capital has built a 1% stake in the company, according to an article published on the same day by the Wall Street Journal.


CVS shares have gone nowhere for a decade https://reut.rs/3Y54DNq


Editing by Jeffrey Goldfarb and Pranav Kiran

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