It’s splitsville for Eli Lilly and CVS Caremark.

Beginning in the new year, pharma giant Eli Lilly will switch its pharmacy benefit manager (PBM) from CVS Caremark, one of the Big 3 PBMs that control about 80% of the pharmacy market, to Rightway, a much smaller alternative PBM founded in 2017, spokespeople for the three companies confirmed to Healthcare Brew.

The switch is “substantial,” according to Antonio Ciaccia, CEO of drug pricing nonprofit 46brooklyn Research and president of consulting firm 3 Axis Advisors. Drug manufacturers “spend a good deal of time blaming PBMs for problems in the marketplace…but then simultaneously, their companies contract with those same PBMs when it comes to their own employees,” he said.

“It begs the question: If these PBMs are so bad, why are you using them?” Ciaccia continued.

It’s also a noteworthy switch because Lilly is a large employer with around 23,000 US-based employees, making it one of the bigger contracts for a PBM to land.

Could Lilly’s move spark a trend?—MA

Welcome back to AI 411, a monthly roundup of AI announcements from across the healthcare industry.

This month, insurer Aetna, Minnesota-based health system Mayo Clinic, electronic health records (EHR) company Athenahealth, and New York-based health system Northwell Health made updates to their technology. There were also a couple of noteworthy fundraising rounds.

Here’s your breakdown of November AI updates from across the healthcare industry.

Abridge. Chicago-based UI Health finalized its expanded use of Abridge’s AI tools across its inpatient, outpatient, and emergency care offerings as of Nov. 24.

Aetna. Aetna, the insurance arm of CVS Health, announced Nov. 18 the launch of an AI assistant that can help members summarize benefits and ask questions about their plan.

Athenahealth. On Nov. 4, Athenahealth introduced an “AI-native clinical encounter” that aims to change the EHR from a simple documentation tool into an AI copilot by adding an AI scribe called athenaAmbient. User testing for the new product will start in the first half of 2026.

See the full list here.—CM

Healthcare leaders from Monument Health, Main Line Health, and Sentara join Regard cofounder Nate Wilson to share how AI-powered documentation is shifting care from reactive to proactive. Learn how smarter systems reduce burnout, improve metrics, and turn documentation into an advantage at this virtual event on Dec. 9.

The White House recently rolled out several policies that seek to deliver on President Donald Trump’s campaign promise to expand access to in-vitro fertilization (IVF).

EMD Serono, a fertility medication manufacturer, will offer certain drugs at a reduced cost exclusively through TrumpRx, the White House said in a fact sheet published on Oct. 16.

Additionally, the administration clarified that employers can offer fertility services as a standalone benefit, akin to how dental or vision insurance is often offered. The Department of Labor (DOL) issued guidance that details how businesses may go about this, but it’s unclear whether the policy will spur more companies to cover fertility treatment.

Keep reading on HR Brew.—CV

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