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The CEO of CVS Health has stepped down as the company shares continue to struggle, falling 19% this year. 

Karen Lynch, will be replaced by CVS Health executive David Joyner, according to The Associated Press.

Leerink Partners analyst Michael Cherny said that he didn’t expect a change in leadership, but that it made sense in light of the company’s performance.

“It is hard, given the operational and stock underperformance, to say a change at the top is undeserved,” he said in a research note.

Earlier this month it was reported that CVS would lay off about 2,900 employees as part of an effort to reduce costs by $2 billion.

The Wall Street Journal reported that CVS is going to conduct a strategic review and potentially break up the healthcare company, citing anonymous sources.