Cigna reported adjusted operating earnings of $8.08 per share for the fourth quarter, outpacing consensus estimates of $7.88 and up from $6.64 a year earlier. Revenue climbed 10% year-over-year to $72.50 billion, above analyst forecasts of $69.53 billion. The specialty pharmacy unit within Evernorth drove much of this growth, with pharmacy benefit services revenue rising 20% to $36.3 billion, supported by new client wins and increased demand for higher-cost therapies. Total customer relationships grew 3% to 188.4 million, while medical care spending trends lifted the medical care ratio to 88.0%, slightly above the prior year’s 87.9%.

The Federal Trade Commission finalized a settlement requiring Cigna’s Express Scripts to eliminate spread pricing, decouple rebates from list prices and relocate its group purchasing organization to the U.S. over the next decade. The agreement is projected to save patients up to $7 billion in out-of-pocket insulin costs and aims to increase annual revenues for community pharmacies. Cigna must also adopt a cost-plus reimbursement model for independent pharmacies starting in 2027 and will undergo 10 years of FTC monitoring to ensure compliance with the new pricing framework.

For fiscal 2026, Cigna expects adjusted operating earnings per share of at least $30.25 and revenues of approximately $280 billion, compared with consensus estimates of $30.36 per share and $283.9 billion in revenue. The company projects a full-year medical care ratio between 83.0% and 84.7%, and anticipates maintaining roughly 18.1 million medical plan members. Reflecting confidence in cash flow generation, Cigna raised its quarterly dividend by 3.3% to $1.56 per share, marking the 16th consecutive annual increase and sustaining a dividend yield above 2%.