Cigna’s 2026 pharmacy profits could be dampened by transition to rebate-free model

Healthcare DIVE October 30, 2025
Rebecca Pifer

Overall, Cigna expects earnings to grow next year. But investments in a new PBM model and discounted contracts for some large clients could lower Express Scripts’ profitability.

Dive Brief:

• Cigna’s massive pharmacy benefit manager Express Scripts could have lower profits next year due to its transition to a new rebate-free model and discounted contracts for three major clients, the company said Thursday along with the release of its third quarter results.
• But “overall, we expect [earnings per share] growth in 2026,” COO Brian Evanko told investors. Earnings should climb due to growth in Cigna’s specialty pharmacy and higher margins in its health insurance business, executives said.
• Both Cigna’s health services business Evernorth and its insurance arm Cigna Healthcare beat...

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