CI · 10-Q · 2026Q3 · Full report

Pharmacy Claims and Client Trends

Cigna Group · 2026-11-05 · Importance 25 · Surprise 32

Evernorth Health Services’ Pharmacy Benefit Services and Specialty and Care Services experienced different claims trends: Pharmacy Benefit Services pharmacy claim volume declined 2% in the nine months ended September 30, 2026, while Specialty and Care Services had higher customer claims volume. Evernorth adjusted revenues increased 7% for the nine-month period, primarily reflecting claims composition in Pharmacy Benefit Services and higher customer claims volume in Specialty and Care Services, partially offset by lower Pharmacy Benefit Services claims volume. The company said changes in drug mix, distribution methods, manufacturer prices and alternative uses of drugs in formularies remain significant drivers of segment results.

Key facts

• Evernorth Health Services adjusted revenues increased 6% in the third quarter and 7% in the first nine months of 2026, driven primarily by Pharmacy Benefit Services claims composition (+6% and +7%) and Specialty and Care Services customer claims volume (+1% in both periods), partly offset by lower Pharmacy Benefit Services claims volume (-1% in both periods). source
• Evernorth Health Services pre-tax adjusted income from operations decreased 4% in the third quarter and 1% in the first nine months of 2026, primarily reflecting client- and customer-focused initiatives in Pharmacy Benefit Services (-13% and -14%) and Specialty and Care Services (-3% and -1%), partly offset by Specialty and Care Services growth (+6% and +8%) and operating efficiencies. source
• Changes in drug types, distribution methods, manufacturer prices (including government programs), and alternative uses of drugs within formularies are significant drivers of Cigna's revenues and operating income. source
• Cigna's pharmacy revenues were affected by claims composition, while pharmacy and other service costs also rose with claims composition in Pharmacy Benefit Services. source