Cigna reported adjusted operating earnings of $8.08 per share for the fourth quarter, surpassing analysts’ consensus of $7.88. Adjusted revenue climbed 10% year-over-year to $72.5 billion, well above the $69.5 billion forecast. Evernorth Health Services, which includes the company’s pharmacy benefit management operations, delivered $36.3 billion in revenue (up 20% year-on-year), supported by new client wins and strong specialty pharmacy volume. Cigna Healthcare’s segment saw sales decrease 16% to $11.2 billion, while the company’s consolidated medical care ratio rose slightly to 88.0% from 87.9%, signaling elevated clinical spend but in line with management expectations.

The Federal Trade Commission finalized a settlement with Cigna’s PBM unit, Express Scripts, requiring the elimination of spread pricing, decoupling rebates from list prices and relocation of its GPO to the U.S. Under the terms, Cigna will adopt a cost-plus reimbursement model for independent pharmacies and is projected to save U.S. patients up to $7 billion in out-of-pocket insulin costs over the next decade. The agreement also includes a 10-year FTC monitoring provision and is expected to generate new annual revenue streams for local pharmacies.

Cigna forecasts adjusted operating earnings per share of at least $30.25 and adjusted revenue of approximately $280 billion for fiscal 2026, compared with Street estimates of $30.36 and $283.9 billion, respectively. The company projects a full-year health care medical care ratio between 83.0% and 84.7% and anticipates maintaining a medical customer base of roughly 18.1 million. In addition, Cigna raised its quarterly dividend to $1.56 per share (up from $1.51), reflecting confidence in cash flow generation and supporting a dividend yield of approximately 2.2%.