Express Scripts pioneered a transparent model with ClearCareRx in April, 2023. OptumRx soon followed with its Cost Made Clear initiative, launching Cost Clarity and Cost Advantage models the same month, and then introduced the value-based Trend Guarantee Model in May 2024. Express Scripts added ClearNetwork in late 2023, while CVS Caremark introduced CostVantage and TrueCost in early 2024, mirroring the strategies of ESI and OptumRx. These moves mark a strategic shift towards greater transparency and predictability, driven by regulatory pressures and rising competition from market disruptors.