信諾集團 (CI) 2025 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by for The Cigna Group’s second-quarter 2025 results review. (Operator Instructions) As a reminder, ladies and gentlemen, this conference, including the Q&A session, is being recorded.

女士們、先生們，感謝您參加信諾集團 2025 年第二季業績評估。（操作員指示）女士們、先生們，提醒一下，本次會議（包括問答環節）正在錄製。

We'll begin by turning the conference over to Ralph Giacobbe. Please go ahead.

首先，我們把會議交給 Ralph Giacobbe。請繼續。

Thanks. Good morning, everyone. Thanks for joining today's call. I'm Ralph Giacobbe, Senior Vice President of Investor Relations. With me on the line this morning are David Cordani, The Cigna Group's Chairman and Chief Executive Officer; Brian Evanko, President and Chief Operating Officer; and Ann Dennison, Chief Financial Officer.

謝謝。大家早安。感謝您參加今天的電話會議。我是投資者關係資深副總裁 Ralph Giacobbe。今天早上與我一起接電話的還有 Cigna 集團董事長兼執行長 David Cordani、總裁兼營運長 Brian Evanko 和財務長 Ann Dennison。

In our remarks today, David, Brian, and Ann will cover a number of topics, including our second quarter 2025 financial results and our financial outlook for 2025. Following their prepared remarks, David, Brian, and Ann will be available for Q&A.

在今天的演講中，David、Brian 和 Ann 將討論許多主題，包括我們的 2025 年第二季財務表現和 2025 年財務展望。在準備好的演講之後，David、Brian 和 Ann 將參加問答環節。

As noted in our earnings release, when describing our financial results, we use certain financial measures, including adjusted income from operations and adjusted revenues, which are not determined in accordance with accounting principles generally accepted in the United States, otherwise known as GAAP.

正如我們的收益報告中所述，在描述我們的財務表現時，我們使用了某些財務指標，包括調整後的營業收入和調整後的收入，這些指標不是按照美國普遍接受的會計原則（也稱為 GAAP）確定的。

A reconciliation of these measures to the most directly comparable GAAP measures, shareholders' net income and total revenues, respectively, is contained in today's earnings release, which is posted in the Investor Relations section of thecignagroup.com. We use the term labeled adjusted income from operations and adjusted earnings per share on the same basis as our principal measures of financial performance.

今日的收益報告已將這些指標與最直接可比較的 GAAP 指標（股東淨利潤和總收入）進行了對賬，該報告發佈於 thecignagroup.com 的「投資者關係」版塊。我們使用「調整後營業收入」和「調整後每股盈餘」這兩個術語，其基準與我們衡量財務表現的主要指標相同。

In our remarks today, we will be making some forward-looking statements, including statements regarding our outlook for 2025 and future performance. These statements are subject to risks and uncertainties that could cause actual results to differ materially from our current expectations. A description of these risks and uncertainties is contained in the cautionary note to today's earnings release and in our most recent reports filed with the SEC.

在今天的演講中，我們將做出一些前瞻性的陳述，包括有關 2025 年和未來業績展望的陳述。這些聲明受風險和不確定性的影響，可能導致實際結果與我們目前的預期有重大差異。這些風險和不確定性的描述包含在今天的收益報告的警告說明中以及我們向美國證券交易委員會提交的最新報告中。

Regarding our results in the second quarter, we recorded net after-tax special item charges of $171 million or $0.64 per share. Additional details of the special items are included in our quarterly financial supplement.

關於我們第二季的業績，我們記錄的淨稅後特殊項目費用為 1.71 億美元，即每股 0.64 美元。有關特殊項目的更多詳細資訊包含在我們的季度財務補充中。

Additionally, please note that when we make prospective comments regarding financial performance, including our full year 2025 outlook, we will do so on a basis that includes the potential impact of future share repurchases and anticipated 2025 dividends.

此外，請注意，當我們對財務業績（包括 2025 年全年展望）做出前瞻性評論時，我們將以未來股票回購和預期 2025 年股息的潛在影響為基礎。

And with that, I'll turn the call over to David.

說完這些，我會把電話轉給大衛。

Thanks, Ralph. Good morning, everyone, and thank you for joining our call. We entered the second quarter with momentum, and I'm pleased to report that The Cigna Group delivered another quarter of differentiated financial results. And recognizing the meaningful disruption in the industry, we're also pleased to reaffirm our guidance for full year 2025.

謝謝，拉爾夫。大家早安，感謝你們參加我們的電話會議。我們以強勁的勢頭進入了第二季度，我很高興地報告，信諾集團又一個季度取得了差異化的財務業績。認識到產業發生的重大變革，我們也很高興重申對 2025 年全年的指導。

At The Cigna Group, we continue to meet our financial commitments by delivering innovative new solutions to improve access and affordability for customers and patients and working to build a better, more sustainable healthcare model. At the same time, we also remain laser-focused on delivering every day for the benefit of those we serve.

在信諾集團，我們繼續履行我們的財務承諾，提供創新的新解決方案，以提高客戶和患者的可及性和可負擔性，並努力建立更好、更永續的醫療保健模式。同時，我們也始終專注於每天為我們服務的人提供福祉。

Today, for our discussion, briefly, I'll discuss how the strength and durable nature of our model enables us to continue to grow. Then Brian will discuss the performance of our growth platforms and how we continue to expand our total addressable market. After that, Ann will provide details on our financial performance in the quarter, and we'll take your questions.

今天，在我們的討論中，我將簡要討論我們的模型的強度和持久性如何使我們能夠繼續成長。然後，布萊恩將討論我們的成長平台的表現以及我們如何繼續擴大我們的總目標市場。之後，安將提供有關我們本季度財務業績的詳細信息，我們將回答您的問題。

So let's get started. In the second quarter, we delivered $67.2 billion in total revenue and grew adjusted earnings per share to $7.20. This builds on our long track record of sustained attractive results, where over the average of each of the last three, five, and 10 years, we've achieved our growth algorithm of 10% to 14% compounded adjusted EPS growth.

那麼就讓我們開始吧。第二季度，我們的總營收達到672億美元，調整後每股盈餘增加至7.20美元。這得益於我們長期以來持續保持的良好業績記錄。在過去三年、五年和十年的平均水準上，我們實現了10%至14%的複合調整後每股盈餘成長。

Our results are a direct reflection of our clear and deliberate strategy to position The Cigna Group with differentiated services and integrated benefit capabilities, coupled with strong execution and led by the most tenured and capable leadership team in the industry.

我們的績效直接反映了我們清晰而深思熟慮的策略，即為信諾集團定位差異化的服務和綜合福利能力，加上強大的執行力，並由業內最資深、最有能力的領導團隊領導。

At a macro level, we continue to operate with the assumption that the environment will remain dynamic. We see eroding health status, affordability and access challenges as key forces of change in the healthcare system in the US and around the globe. In addition, we have operated in and will continue to operate in this space with elevated regulatory and legislative activity as well as significant technological, clinical and pharmacological advances.

在宏觀層面，我們繼續假設環境將保持動態。我們認為，健康狀況的下降、負擔能力和獲取醫療服務的挑戰是美國乃至全球醫療保健體系變革的主要力量。此外，我們已並將繼續在該領域開展業務，加強監管和立法活動，並取得重大技術、臨床和藥理學進展。

We have a number of differentiators, which enable us to lead through these dynamic markets. The first is our orientation toward anticipating, and in some instances, creating constructive disruption, which better positions us to identify opportunities. This is a foundational part of our strategy. For us, it means listening to our customers, patients and clients and leveraging their feedback to continue to evolve, innovate and deliver even more value.

我們擁有許多差異化優勢，使我們能夠在這些充滿活力的市場中保持領先地位。首先，我們傾向於預測，在某些情況下，創造建設性的破壞，這使我們能夠更好地發現機會。這是我們策略的基礎部分。對我們來說，這意味著傾聽我們的客戶、患者和客戶的意見，並利用他們的回饋來持續發展、創新並提供更多價值。

For example, as we stepped into 2025, the forces of change in healthcare further accelerated our efforts to help shape a more sustainable healthcare system, and in part, fueled our customer-focused commitments and actions we announced earlier this year. These commitments, which we refer to as our commitment to better, call on us to deliver easier access to care, better support to help customers and patients navigate the healthcare system, increase value, greater accountability and greater transparency.

例如，當我們步入2025年時，醫療保健領域的變革力量進一步加速了我們幫助塑造更永續的醫療保健體系的努力，並在一定程度上推動了我們今年早些時候宣布的以客戶為中心的承諾和行動。這些承諾，我們稱之為“更好的承諾”，要求我們提供更容易的醫療服務、更好的支持以幫助客戶和患者了解醫療保健系統、增加價值、提高責任感和透明度。

This quarter, we took another step forward with Cigna Healthcare introducing a new AI-powered virtual assistant to improve our customers' experience during common interactions such as checking benefits, estimating costs and finding care.

本季度，我們又向前邁進了一步，Cigna Healthcare 推出了一款新的人工智慧虛擬助手，以改善客戶在檢查福利、估算成本和尋求護理等常見互動中的體驗。

As it relates to regulatory and legislative activity, we continue to proactively lean in with a partnership orientation. We continue to believe in and embrace public-private partnerships, which are essential for the healthcare system to continue to be responsive to all stakeholder needs. And we are proactively working to bring forward new solutions with the current administration, Congress and within states.

由於它與監管和立法活動有關，我們將繼續積極地以合作夥伴的方式開展工作。我們繼續相信並支持公私合作夥伴關係，這對於醫療保健系統繼續回應所有利害關係人的需求至關重要。我們正在積極努力與現任政府、國會和各州共同提出新的解決方案。

The recent industry announcement to further streamline and simplify prior authorizations for the benefit of patients and physicians is a good example of this, and we partnered closely with HHS on this advancement. Each of these actions represent a commitment from The Cigna Group to build a better future, and I'm pleased that we continue to make good progress.

業界最近宣布將進一步簡化和簡化事先授權，以造福患者和醫生，就是一個很好的例子，我們與 HHS 就這一進展進行了密切合作。每一項行動都代表著信諾集團對建立更美好未來的承諾，我很高興看到我們繼續取得良好進展。

Our second differentiator is our diverse portfolio of businesses, which provides us with the strategic flexibility to pursue multiple avenues for delivering and capturing value. This is made possible by our service-based model, which provides us with significant amount of agility and nimbleness.

我們的第二個優勢是我們多元化的業務組合，這為我們提供了策略靈活性，可以透過多種途徑實現和獲取價值。這是透過我們基於服務的模式實現的，它為我們提供了相當大的靈活性和敏捷性。

We've deliberately shaped our services-based model over years, and today, they are configured in three strong platforms that together provide us with a diversified position and multiple pathways for growth, serving employers, health plans, governmental agencies and healthcare delivery systems. In Evernorth, that includes Specialty and Care Services and our Pharmacy Benefit Services business; and in our Cigna Healthcare portfolio, our integrated benefits offerings, both in the United States and globally.

多年來，我們精心塑造了基於服務的模式，如今，它們配置在三個強大的平台中，共同為我們提供多元化的地位和多種增長途徑，為雇主、健康計劃、政府機構和醫療保健提供系統提供服務。在 Evernorth，這包括專業和護理服務以及我們的藥房福利服務業務；在我們的 Cigna Healthcare 產品組合中，包括我們在美國和全球範圍內提供的全面福利產品。

Our proven approach leverages the combined strength and capabilities of these platforms to create even more value for the benefit of those we serve. Over the long term, the way we've architected our company, coupled with our strategic choices, including a capital-light model, has given us both the resilient model and the ability to pivot and evolve as the marketplace changes.

我們經過驗證的方法利用這些平台的綜合優勢和能力，為我們服務的物件創造更多價值。從長遠來看，我們建立公司的方式，加上我們的策略選擇（包括輕資本模式），使我們既擁有彈性模式，又能夠隨著市場變化而調整和發展。

Now, a third key differentiator for us is our relentless execution fueled by our tenured and talented team. Ultimately, our results are made possible by our coworkers, including the most experienced enterprise leadership team in the industry. And along with the great depth and continuity of our leadership, we also continue to strategically infuse talent into our company in areas such as technology and clinical.

現在，我們的第三個關鍵區別在於我們由資深且才華橫溢的團隊推動的不懈執行力。最終，我們的成果歸功於我們的同事，其中包括業內最有經驗的企業領導團隊。隨著我們領導層的深度和連續性，我們也將繼續在技術和臨床等領域策略性地為公司注入人才。

The strength of our team continues to be a key differentiator in our ability to consistently execute on our strategy and deliver on our core fundamentals. Our team's deep expertise in the healthcare industry and strong understanding of the competitive landscape enables us to adapt quickly. This strategic agility helps us navigate challenging environments as well as to identify and seize new opportunities for growth.

我們團隊的實力仍然是我們能夠始終如一地執行我們的策略和實現我們的核心基本原則的關鍵因素。我們團隊在醫療保健行業的深厚專業知識和對競爭格局的深刻理解使我們能夠快速適應。這種策略敏捷性有助於我們應對充滿挑戰的環境以及發現和抓住新的成長機會。

We have drawn upon each of these differentiators time and time again to continue to grow in times of uncertainty, from the launch of the ACA to leading through the global pandemic. And during each of these events, we have sought to innovate through and deliver sustainable value for our customers, patients, clients and shareholders. As a result, we've delivered 13% compounded adjusted EPS CAGR over the last decade.

從推出《平價醫療法案》到引領全球疫情，我們一次又一次地利用這些差異化因素，在充滿不確定性的時期繼續成長。在每一次活動中，我們都力求透過創新為我們的客戶、患者、客戶和股東提供可持續的價值。因此，我們在過去十年中實現了 13% 的複合調整後每股收益複合年增長率。

Now, to wrap up my comments. Against the backdrop of a dynamic environment, we continue to deliver and are well positioned for the remainder of 2025. Our second quarter results underscore the strength of our diverse portfolio of businesses and our disciplined focus on innovation and partnership.

現在，總結一下我的評論。在充滿活力的環境背景下，我們將繼續努力，為 2025 年剩餘時間做好充分準備。我們第二季的業績凸顯了我們多元化業務組合的實力以及我們對創新和合作的嚴格關注。

We are confident in our ability to sustainably deliver 10% to 14% compounded adjusted EPS growth over the strategic horizon, along with an attractive dividend.

我們有信心在策略範圍內持續實現 10% 至 14% 的複合調整後每股收益成長，同時實現具有吸引力的股息。

And with that, I'll turn the call over to Brian.

說完這些，我將把電話轉給布萊恩。

Thank you, David. Good morning, everyone. To underscore David's comments, we continue to execute well and delivered against our customer and shareholder commitments through a dynamic operating environment.

謝謝你，大衛。大家早安。為了強調大衛的評論，我們繼續透過動態的營運環境表現良好並履行對客戶和股東的承諾。

Our capabilities across our three platforms, Cigna Healthcare, Evernorth Pharmacy Benefit Services and Evernorth Specialty and Care Services, uniquely positions us in the market with strong assets and expertise. Across our portfolio, we are leaders in serving employers, health plans and government entities. And we are increasingly entrusted to service health systems, hospitals and other providers with our Evernorth Specialty and Care Services capabilities.

我們的三大平台，即 Cigna Healthcare、Evernorth Pharmacy Benefit Services 和 Evernorth Specialty and Care Services，使我們憑藉強大的資產和專業知識在市場上佔據獨特地位。在我們的投資組合中，我們在服務雇主、健康計畫和政府實體方面處於領先地位。我們越來越多地被委託利用我們的 Evernorth 專業和護理服務能力為醫療系統、醫院和其他提供者提供服務。

Now, let me go a bit deeper on our second quarter business performance. Beginning with Cigna Healthcare, Cigna Healthcare delivered financial results that were in line with expectations even as we've seen persistently elevated medical costs throughout the year. Importantly, our flagship US employer business continues to grow, particularly in our Select segment through a consultative approach with clients.

現在，讓我更深入地介紹我們第二季的業務表現。從 Cigna Healthcare 開始，儘管我們看到全年醫療成本持續上漲，但 Cigna Healthcare 的財務表現仍符合預期。重要的是，我們的旗艦美國雇主業務繼續成長，特別是在我們透過與客戶協商的方式進行的精選業務中。

Overall, our performance reflects a medical care ratio of 83.2% in the second quarter. This is in line with expectations, driven by our sustained disciplined execution against our commitments.

總體而言，我們的業績反映出第二季醫療保健比例為 83.2%。這符合預期，因為我們持續嚴格地履行承諾。

And we have intentionally positioned our Cigna Healthcare portfolio with a product mix that has proven favorable in the current environment as we have no exposure to Medicaid or Medicare, instead choosing to serve these customers through our Evernorth services portfolio. Our planning assumption within Cigna Healthcare for 2025 is that we will continue to experience elevated medical costs throughout the year.

我們有意將 Cigna Healthcare 產品組合定位於在當前環境下已被證明有利的產品組合，因為我們沒有接觸過 Medicaid 或 Medicare，而是選擇透過我們的 Evernorth 服務組合為這些客戶提供服務。我們對 Cigna Healthcare 2025 年的規劃假設是，全年醫療成本將持續上漲。

Within the second quarter, we experienced pressures in our individual exchange business that we were able to overcome due to the strength of our broader Cigna Healthcare portfolio and the relatively small scale of our individual exchange business within that portfolio as a result of strategic choices we've made to reposition this product offering.

在第二季度，我們的個人交易業務面臨壓力，但由於我們更廣泛的 Cigna Healthcare 產品組合實力雄厚，並且由於我們對該產品組合進行了重新定位，因此我們的個人交易業務規模相對較小，因此我們能夠克服這一壓力。

Turning to Evernorth. Earnings were slightly ahead of expectations. This reflects our strong momentum within the Specialty and Care Services platform, coupled with continued good execution within Pharmacy Benefit Services.

轉向 Evernorth。獲利略高於預期。這反映了我們在專業和護理服務平台內的強勁勢頭，以及藥房福利服務內的持續良好表現。

In our Pharmacy Benefit Services business, we continue to see strong client retention with demand across diverse buyer groups, from employers to health plans and other PBMs. And today, we are proud to serve more than 120 million Americans. This includes long-standing client and partner relationships, many of them being the largest and most sophisticated purchasers in the US who come to us for solutions that help them best serve their needs.

在我們的藥房福利服務業務中，我們繼續看到強勁的客戶保留率，需求來自不同的購買者群體，從雇主到健康計劃和其他 PBM。今天，我們很自豪能夠為超過 1.2 億美國人提供服務。這包括長期的客戶和合作夥伴關係，其中許多是美國最大、最成熟的採購商，他們向我們尋求能夠最好地滿足其需求的解決方案。

This demand for our services has resulted in a number of multiyear renewals and other ongoing agreements with large clients. For example, we recently finalized a multiyear contract extension with Prime Therapeutics. Our clients also look to us for partnership around innovation. This quarter, Evernorth launched another first-of-its-kind benefit option that will save patients money on their GLP-1 weight loss prescriptions with greater choice and predictability.

對我們服務的需求導致我們與大客戶簽訂了多個多年期續約協議和其他持續協議。例如，我們最近與 Prime Therapeutics 達成了多年合約續約協議。我們的客戶也期待我們圍繞創新建立合作關係。本季度，Evernorth 推出了另一個首創的福利選項，該選項將為患者節省 GLP-1 減肥處方費用，並提供更多選擇和可預測性。

Building on our Encircle and EnReach offerings, this new benefit, negotiated directly with two drug manufacturers, limits the patient's out-of-pocket cost to no more than $200 per month and applies to their annual deductible. This benefit offers our clients flexibility to cover these medicines in multiple ways to best serve customers. As always, we continuously explore new approaches and models to drive greater access, affordability and transparency.

在我們的 Encircle 和 EnReach 產品的基礎上，這項新福利直接與兩家藥品製造商協商，將患者的自付費用限制在每月不超過 200 美元，並適用於他們的年度免賠額。此項福利為我們的客戶提供了靈活性，可以透過多種方式涵蓋這些藥物，從而為客戶提供最好的服務。像往常一樣，我們不斷探索新的方法和模式，以推動更大的可近性、可負擔性和透明度。

And in our Evernorth Specialty and Care Services businesses, we delivered another quarter of strong growth, led by Accredo, our industry-leading specialty pharmacy, which provides specialty medications for the treatment of complex and rare diseases.

在我們的 Evernorth 專業和護理服務業務中，我們又實現了一個季度的強勁增長，這主要得益於我們行業領先的專業藥房 Accredo，它提供用於治療複雜和罕見疾病的專科藥物。

Across the Specialty and Care Services portfolio, adjusted earnings increased 12% in the quarter when normalizing for the absence of the VillageMD dividend. This was driven by increased specialty prescription volume and ongoing biosimilar adoption, further powered by the strong secular tailwinds that we've discussed on prior calls.

在整個專業和護理服務組合中，由於沒有 VillageMD 股息，本季度調整後的收益增長了 12%。這是由特殊處方量的增加和生物仿製藥的持續採用所推動的，並受到我們在之前的電話會議上討論過的強勁長期順風的進一步推動。

Finally, our specialty distribution business serving health systems, hospitals and other providers delivered significant growth in the quarter. And our ability to serve these buyers with both distribution and our unique set of broader enablement capabilities drives future expansion opportunities.

最後，我們為醫療系統、醫院和其他供應商提供服務的專業分銷業務在本季實現了顯著成長。我們透過分銷和獨特的更廣泛的支援能力為這些買家提供服務的能力推動了未來的擴展機會。

I'm going to spend a few minutes unpacking this theme further. David talked earlier about our ability to find opportunities in a challenging environment to expand our addressable markets. Previously, we highlighted how our specialty pharmacy business uniquely supports patients through Accredo and our other pharmacies with our clinical expertise and services such as our in-home nurses.

我將花幾分鐘進一步闡述這個主題。David 之前談到了我們在充滿挑戰的環境中尋找機會以擴大目標市場的能力。在此之前，我們強調了我們的專業藥房業務如何透過 Accredo 和我們的其他藥房，利用我們的臨床專業知識和服務（例如我們的家庭護理師）為患者提供獨特的支援。

Today, I want to share a bit more about the important addressable market expansion opportunity we see serving health systems, hospitals and other providers with our specialty services across The Cigna Group. As a reminder, the specialty space is more than a $400 billion market today and is growing at high single digits annually. In 2024, approximately 70% of new drugs approved by the US Food and Drug Administration were specialty medications.

今天，我想進一步分享一些有關我們在信諾集團 (The Cigna Group) 中看到的為醫療系統、醫院和其他供應商提供專業服務的重要可尋址市場擴展機會的資訊。需要提醒的是，目前專業領域的市場規模已超過 4,000 億美元，並且每年以高個位數的速度成長。2024年，美國食品藥物管理局核准的新藥中約有70%是特殊藥物。

These medicines flow through both the pharmacy and medical benefit with the medical benefits segment representing about 40% of the specialty space. Specialty represents one of the highest growth areas in healthcare and within The Cigna Group, and we continue to expect long-term average annual income growth of 8% to 11% across our specialty portfolio.

這些藥品在藥局和醫療福利部門流通，其中醫療福利部門約佔專科領域的 40%。專業領域是醫療保健和信諾集團內成長最快的領域之一，我們預計專業領域投資組合的長期平均年收入成長率將達到 8% 至 11%。

Increasingly, health systems and other providers are seeking to manage their in-house pharmacy capabilities and inventory, most specifically within specialty drugs as this provides an important source of revenue that can help to counterbalance pressures in other aspects of their business.

越來越多的醫療系統和其他供應商正在尋求管理其內部藥房能力和庫存，特別是特種藥物，因為這提供了一個重要的收入來源，可以幫助平衡其業務其他方面的壓力。

Let me outline a few of the unique capabilities within Evernorth that position us to provide innovative solutions and support health systems, hospitals and other providers as they seek to optimize their specialty pharmacy management.

讓我概述一下 Evernorth 的一些獨特功能，這些功能使我們能夠提供創新的解決方案並支援醫療系統、醫院和其他供應商優化其專業藥房管理。

First, across the supply chain, we can help health systems and providers procure specialty medicines, including highly complex and limited distribution therapies. Our specialty distribution serves more than 12,000 providers today, distributing some of the most complex and critical medications to physician offices, health systems and infusion centers. We do this through CuraScript SD, which has seen double-digit average revenue growth over the past three years and is now a $25 billion business.

首先，在整個供應鏈中，我們可以幫助醫療系統和供應商購買特殊藥品，包括高度複雜且分銷有限的療法。我們的專業分銷目前為超過 12,000 家供應商提供服務，向醫生辦公室、醫療系統和輸液中心分發一些最複雜和最關鍵的藥物。我們透過 CuraScript SD 實現這一目標，該公司在過去三年中實現了兩位數的平均收入成長，目前已成為價值 250 億美元的企業。

Second, our technology suite of services can support providers and hospitals as they navigate this complex specialty market.

其次，我們的技術服務套件可以支援供應商和醫院應對這個複雜的專業市場。

And finally, bringing our exceptional range of clinical services to these buyers provides them with peace of mind and the assurance that best practices are being drawn from across our client base. We offer specialty pharmacy and infusion services on behalf of more than 700 hospitals, health systems, and physician groups across the country, helping them expand their ability to offer coordinated access and continuity of care. Whether at home at the pharmacy or in a physician office or hospital, we are built to serve the needs of patients in any setting, delivering greater affordability and better clinical care. Overall, we see the opportunity to serve health systems and other providers holistically as a meaningful growth opportunity.

最後，我們為這些買家提供卓越的臨床服務，讓他們安心，並確保我們從整個客戶群中汲取最佳實踐。我們代表全國 700 多家醫院、衛生系統和醫生團體提供專業藥房和輸液服務，幫助他們擴大提供協調訪問和連續護理的能力。無論是在家中、藥房或醫生辦公室或醫院，我們都致力於滿足任何環境下患者的需求，提供更實惠的價格和更好的臨床護理。總體而言，我們認為為醫療系統和其他服務提供者提供全面服務是一個有意義的成長機會。

As I wrap up, I want to reiterate some notable bright spots for the quarter that underscore our strong business performance and operational execution. Cigna Healthcare earnings were solid and reflect the strength of our diverse portfolio and intentional choices around product offerings. We continued our strong track record of client retention with large strategic client renewals in our Evernorth Pharmacy Benefit Services segment.

最後，我想重申本季的一些值得注意的亮點，這些亮點凸顯了我們強勁的業務表現和營運執行力。Cigna Healthcare 的獲利穩健，體現了我們多元化投資組合的實力以及在產品供應方面的有意選擇。我們在 Evernorth 藥房福利服務部門透過大規模策略客戶續約延續了良好的客戶保留記錄。

We delivered 12% growth in normalized earnings within our Evernorth Specialty and Care Services operating segment, which has attractive growth exposure over the long term, particularly with health systems, hospitals and other providers.

我們的 Evernorth 專業和護理服務營運部門實現了 12% 的正常收益成長，從長遠來看，該部門具有有吸引力的成長前景，尤其是在醫療系統、醫院和其他提供者方面。

We continue to drive net growth in the US employer select segment within Cigna Healthcare. And our ongoing innovation for clients includes new enhancements in the quarter associated with GLP-1s in Evernorth and an AI-powered virtual assistant within Cigna Healthcare. Across our businesses, I'm excited about the ongoing growth opportunities we have.

我們持續推動 Cigna Healthcare 旗下美國雇主精選部門的淨成長。我們為客戶持續提供的創新包括本季與 Evernorth 的 GLP-1 相關的新改進以及 Cigna Healthcare 內部的人工智慧虛擬助理。在我們的業務中，我對我們擁有的持續成長機會感到非常興奮。

Now, I'll turn it over to Ann.

現在，我將把話題交給安。

Thank you, Brian, and good morning, everyone. Today, I will review Cigna's second quarter 2025 results and discuss our outlook for the full year, which we reaffirmed this morning.

謝謝你，布萊恩，大家早安。今天，我將回顧 Cigna 2025 年第二季的業績，並討論我們今天上午重申的全年展望。

As David and Brian mentioned, our second quarter results underscore the strength of our diversified portfolio of businesses in a dynamic environment and demonstrate continued execution against our operating and financial commitments.

正如戴維和布萊恩所提到的，我們的第二季業績凸顯了我們在動態環境中多元化業務組合的實力，並表明我們將繼續履行營運和財務承諾。

Key consolidated financial highlights for the second quarter include revenue of $67.2 billion and adjusted earnings per share of $7.20.

第二季的主要合併財務亮點包括 672 億美元的營收和 7.20 美元的調整後每股盈餘。

Our solid performance and disciplined execution in the first half of the year reinforce our confidence in delivering our full year 2025 adjusted earnings per share outlook of at least $29.60.

我們上半年的穩健表現和嚴謹執行增強了我們實現 2025 年全年調整後每股收益至少 29.60 美元的信心。

Now, turning to our segment results. I will start by commenting on Evernorth, our services chassis, which now contributes over 60% of our enterprise earnings. Evernorth's results reflect sustained strength across our Pharmacy Benefit Services business and Specialty and Care Services business.

現在，談談我們的分部業績。我首先要評論一下我們的服務底盤 Evernorth，它目前為我們的企業收益貢獻了 60% 以上。Evernorth 的業績反映了我們的藥房福利服務業務以及專業和護理服務業務的持續強勁表現。

Second quarter 2025 revenues grew to $57.8 billion, while pretax adjusted earnings grew to $1.7 billion, slightly ahead of expectations. Specialty and Care Services demonstrated strong growth with revenue up 13% to $25.9 billion. Normalizing for the impact of lower net investment income due to the absence of the VillageMD dividend, pretax adjusted earnings increased 12% year-over-year.

2025 年第二季營收成長至 578 億美元，稅前調整後收益成長至 17 億美元，略高於預期。專業和護理服務表現強勁，營收成長 13%，達到 259 億美元。由於沒有 VillageMD 股息導致淨投資收入較低，因此正常化後，稅前調整後收益年增 12%。

This performance showcases the power of our robust and unique specialty capabilities as we delivered broad-based growth across both Accredo and CuraScript.

這項業績展現了我們強大而獨特的專業能力，我們在 Accredo 和 CuraScript 方面實現了廣泛的成長。

Pharmacy Benefit Services delivered another quarter of solid growth. Pretax adjusted earnings increased to $833 million as we continued to drive affordability for our patients, customers and clients through innovative product offerings while continuing to invest to drive long-term growth.

藥房福利服務再度實現穩健成長。稅前調整後收益增至 8.33 億美元，因為我們繼續透過創新產品為患者、顧客和客戶提供負擔能力，同時繼續投資以推動長期成長。

Turning to Cigna Healthcare. Second quarter 2025 revenues were $10.8 billion. Pretax adjusted earnings were $1.1 billion. And the medical care ratio was 83.2%.

轉向 Cigna Healthcare。2025 年第二季營收為 108 億美元。稅前調整後收益為 11 億美元。醫療保健率為83.2%。

These results were broadly in line with expectations and reinforce the strength and stability of our portfolio of businesses, which, as David mentioned, was strategically constructed for sustainable long-term growth in a dynamic environment.

這些結果基本上符合預期，並增強了我們業務組合的實力和穩定性，正如大衛所提到的，我們的業務組合是在動態環境中實現可持續的長期成長的策略建構。

Cost trends for our commercial business, including stop-loss, remained elevated in the quarter, consistent with expectations.

本季度，我們商業業務的成本趨勢（包括停損）仍保持高位，與預期一致。

For our individual business, utilization was higher than expected, reflecting an increase in medical costs across the ACA marketplace. However, this pressure was manageable due to the smaller relative size of our ACA book, aided by our disciplined pricing actions over the past two years.

對於我們的個人業務而言，利用率高於預期，反映了整個 ACA 市場醫療成本的增加。然而，由於我們的 ACA 帳簿相對規模較小，並且得益於我們過去兩年採取的嚴格的定價行動，這種壓力是可以控制的。

Overall, Cigna Healthcare delivered consistent results, underscoring the strength of our execution in an environment that continues to present challenges across the industry.

總體而言，信諾健康保險取得了穩定的業績，凸顯了我們在整個產業持續面臨挑戰的環境中執行力的強勁。

Now, turning to our outlook for the full year 2025. Recognizing the overall disruption in the industry, we are pleased to reaffirm our full year 2025 expectation for consolidated adjusted income from operations of at least $29.60 per share.

現在，讓我們來展望一下 2025 年全年的展望。認識到行業的整體混亂，我們很高興重申我們對 2025 年全年合併調整後營業收入至少為每股 29.60 美元的預期。

Regarding the cadence of earnings, we expect the third quarter adjusted earnings per share to be slightly above 25% of the full year outlook.

關於獲利節奏，我們預計第三季調整後每股盈餘將略高於全年預期的 25%。

Now, turning to our 2025 outlook for each of our growth platforms. In Evernorth, we continue to expect full year 2025 pretax adjusted earnings of at least $7.2 billion, and we expect the third quarter adjusted earnings for Evernorth to be slightly above 25% of the full year outlook.

現在，讓我們來談談我們對每個成長平台的 2025 年展望。對於 Evernorth，我們繼續預計其 2025 年全年稅前調整後收益至少為 72 億美元，並且我們預計 Evernorth 第三季調整後收益將略高於全年預期的 25%。

For Cigna Healthcare, our outlook continues to assume elevated cost trends to persist throughout the year. We continue to expect full year 2025 pretax adjusted earnings of at least $4.125 billion, and we expect the third quarter adjusted earnings for Cigna Healthcare to be slightly below 25% of the full year outlook.

對於 Cigna Healthcare，我們繼續認為成本上升的趨勢將持續全年。我們繼續預期 2025 年全年稅前調整後盈餘至少為 41.25 億美元，我們預期 Cigna Healthcare 第三季調整後盈餘將略低於全年預期的 25%。

We continue to expect the full year medical care ratio within the range of 83.2% to 84.2%. Additionally, we expect the third quarter medical care ratio to be toward the upper end of the full year range, reflecting typical seasonality.

我們繼續預計全年醫療保健比率將在 83.2% 至 84.2% 之間。此外，我們預計第三季醫療保健比例將接近全年範圍的上限，反映出典型的季節性。

Turning to our 2025 capital management position. It's important to note that our operating cash flow can vary from quarter-to-quarter, influenced by timing-specific factors such as the payment of supply chain receivables and payables as well as changes in inventory levels, particularly within Accredo and CuraScript.

轉向我們的 2025 年資本管理狀況。值得注意的是，我們的經營現金流量可能每季都有所不同，受到特定時間因素的影響，例如供應鏈應收帳款和應付帳款的支付以及庫存水準的變化，特別是 Accredo 和 CuraScript 內部的變化。

Second quarter operating cash flow was impacted by working capital timing within Evernorth. We expect the timing-related impact to reverse and continue to anticipate strong cash flow generation in the second half.

第二季的經營現金流受到 Evernorth 內部營運資本時機的影響。我們預計與時間相關的影響將會逆轉，並繼續預計下半年將產生強勁的現金流。

Now, to recap. Our first half 2025 results reflect disciplined execution across both Evernorth and Cigna Healthcare. Our 2025 outlook reflects the sustained momentum and strong fundamentals of our growth platforms, which gives us the confidence to reaffirm our full year 2025 adjusted earnings per share outlook of at least $29.60.

現在，回顧一下。我們的 2025 年上半年業績反映了 Evernorth 和 Cigna Healthcare 的嚴格執行。我們對 2025 年的展望反映了我們成長平台的持續發展勢頭和強勁基本面，這使我們有信心重申 2025 年全年調整後每股收益至少為 29.60 美元的預期。

And with that, we'll turn it over to the operator for the Q&A portion of the call.

接下來，我們將把電話會議的問答部分交給接線員。

(Operator Instructions) AJ Rice, UBS.

（操作員指示） AJ Rice，瑞銀。

I appreciate the comments about the innovative products that Evernorth brought to the market, particularly around GLP-1s. It makes me think even a little more broadly about your positioning in the commercial market, ASO insurance and how you use potentially Evernorth's PBM and pharmacy services business. You have insight on what's happening into those markets, and that's probably the biggest pressure point for commercial trends these days. And that insight is not something that, for example, your big Blue Cross competitors have.

我很欣賞對 Evernorth 推向市場的創新產品（尤其是 GLP-1 產品）的評價。這讓我更廣泛地思考您在商業市場、ASO 保險中的定位以及您如何潛在地利用 Evernorth 的 PBM 和藥房服務業務。您可以深入了解這些市場正在發生的事情，這可能是當今商業趨勢的最大壓力點。而這種洞察力並不是您的大型 Blue Cross 競爭對手所擁有的。

Just maybe try to flesh out a little bit more how you're using that? How much of an advantage do you think that is? Any thoughts on any of that?

也許可以嘗試更詳細地闡述您如何使用它？您認為這有多大的優勢？對此您有什麼想法嗎？

AJ, it's David. Maybe just a couple of macro comments and I'll hand it over to Brian. First, I appreciate your broad framing.

AJ，我是大衛。也許只是一些宏觀評論，然後我會把它交給布萊恩。首先，我很欣賞您的廣泛框架。

Two, contextually, as we step back, you go back a decade or so ago, aggregate pharmacy services was low double-digit percentage of the total medical cost equation. Fast-forward to today, the pie is both larger and aggregate pharmacy services, including specialty, is mid-20s growing, starting at potentially a 30% slice of the pie in short order.

二、從背景來看，回顧大約十年前，藥局服務總額在總醫療成本中只佔較低的兩位數百分比。快進到今天，這個蛋糕不僅更大，而且包括專業藥房在內的綜合藥房服務正在以 20% 左右的速度增長，並可能在短時間內佔據 30% 的份額。

So one, to reinforce your point, it's a more significant part of the overall care equation. Two is the interdependency between medical pharmacy, both traditional pharmacy and specialty pharmacy. And I would simply add mental health further consolidates in terms of a lot of our capabilities to be able to look at the whole person, both the predictive nature of more complex medical issues based on pharmaceutical consumption as well as the interdependency between the mental health aspect, which includes pharmacy as well as medical.

因此，首先，為了強調你的觀點，它是整體護理方程中更重要的一部分。二是醫療藥學、傳統藥學和專業藥學之間的相互依賴。我想補充的是，心理健康進一步鞏固了我們看待整個人的能力，既可以基於藥物消費預測更複雜的醫療問題，也可以理解心理健康方面（包括藥房和醫療）之間的相互依賴性。

So I'll turn it across to Brian, but I just wanted to amplify the interdependencies of those three areas, not just the 2. Secondly, the size of the overall healthcare equation of what pharmacy is today, 25-plus percent of the overall pie, on its way to 30% on a larger pie versus 10%, 12% just a decade ago or so. Brian?

因此我將把它交給 Brian，但我只是想擴大這三個領域的相互依賴性，而不僅僅是這兩個領域。其次，藥局在整體醫療保健中的佔比目前已超過 25%，而十年前僅為 10% 或 12%，預計未來將達到 30%。布賴恩？

So I certainly agree with the thesis underneath your question here that our three growth platforms, Cigna Healthcare, Pharmacy Benefit Services in Evernorth and our Specialty and Care Services platform in Evernorth, are mutually reinforcing and create value for one another. So that's indisputable.

因此，我完全同意您問題背後的論點，即我們的三個成長平台，即 Cigna Healthcare、Evernorth 的藥房福利服務以及 Evernorth 的專業和護理服務平台，是相互加強並相互創造價值的。這是無可爭議的。

And to your point, specialty pharmacy continues to be one of the highest trend categories across the healthcare system. That and mental health services, in particular, were large contributors to the overall cost trend environment that we've seen year-to-date.

正如您所說，專業藥局仍然是整個醫療保健系統中趨勢最高的類別之一。尤其是心理健康服務，是我們今年迄今為止看到的整體成本趨勢環境的巨大貢獻者。

As Ann mentioned in her comments, overall, though, cost trends have been elevated, but in line with our expectations. So having the Evernorth insight certainly has been helpful for our Cigna Healthcare team, and it's the way we're able to manage the health plan MCR to the levels that we've committed.

正如安在她的評論中提到的那樣，總體而言，成本趨勢有所上升，但符合我們的預期。因此，Evernorth 的洞察力無疑對我們的 Cigna Healthcare 團隊很有幫助，而且這也是我們能夠將健康計劃 MCR 管理到我們所承諾的水平的方式。

As David was just making reference to, 20% of an average employer's total cost of care is specialty drugs today. Now, that's not all in the drug benefit. A portion of that's in the medical benefit. So one of the things we really like about the way we've constructed the company is we can see a specific patient have their care journey start in the medical benefit and transition over into the pharmacy benefit.

正如大衛剛才提到的，目前，一般雇主的照護總成本中有 20% 來自特種藥物。現在，這還不是藥物的全部益處。其中一部分是醫療福利。因此，我們真正喜歡我們建立公司的方式之一是我們可以看到特定患者的護理旅程從醫療福利開始，然後過渡到藥房福利。

So a patient may have a specialty injectable that starts in the medical benefit that moves to a self-injectable under the drug benefit. We're able to manage that longitudinally given our suite of services across The Cigna Group.

因此，患者可能首先會獲得醫療福利中的特殊注射劑，然後根據藥物福利轉為自我注射。鑑於我們為信諾集團提供的一系列服務，我們能夠縱向管理這一點。

So all things considered, to the core of your question, we're really pleased with the way we've constructed the company and it's helped us to manage the Cigna Healthcare financial performance.

所以綜合考慮，對於您問題的核心，我們對我們建立公司的方式感到非常滿意，它幫助我們管理了 Cigna Healthcare 的財務表現。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

Can you maybe comment on the 2026 selling season? I heard you talk about specifically the renewal of Prime Therapeutics, but really a couple of components to this. One, what do you have up for renewal on the pharmacy benefit side? Two, what do you see as opportunities and what are people looking for?

您能評論一下 2026 年的銷售季節嗎？我聽到您具體談論了 Prime Therapeutics 的更新，但實際上它涉及幾個要素。一、在藥品福利方面，您有什麼續約計畫？二、您認為機會是什麼？人們在尋找什麼？

And then if I could just also add on to that, we saw the Arkansas ruling and the injunction. Can you maybe just comment as to how you're thinking about that and as to how you're thinking about legislation, generally speaking, on the PBM side?

然後，如果我還可以補充一點，我們看到了阿肯色州的裁決和禁令。您能否評論一下您對此的看法以及您對 PBM 方面的立法的總體看法？

It's Brian. I'll start with some of the selling season themes and then I'll turn it over to David, he could talk a little bit about what's happening with the legislative and regulatory dynamics.

我是布萊恩。我將從一些銷售季節主題開始，然後交給大衛，他可以稍微談談立法和監管動態的情況。

So maybe to kind of round out the first picture, I'll give you a sense for each of our growth platforms, some of the dynamics that we're seeing and then I'll get into some of the themes. So within our Express Scripts Pharmacy Benefit Services business, we're currently tracking toward mid-90s or better retention for 2026, which overall is a strong retention level consistent with prior years. And as I noted earlier, the largest and most sophisticated buyers of pharmacy benefit services continue to trust us and appreciate our value creation with an example of that being the multiyear renewal of Prime Therapeutics that was recently completed.

因此，為了完善第一幅圖，我可以讓您了解我們的每個成長平台，我們看到的一些動態，然後我將討論一些主題。因此，在我們的 Express Scripts Pharmacy Benefit Services 業務中，我們目前計劃在 2026 年實現 90 年代中期或更高的保留率，總體而言，這是一個與前幾年一致的強勁保留率水平。正如我之前提到的，藥品福利服務的最大和最成熟的買家繼續信任我們並欣賞我們創造的價值，例如最近完成的 Prime Therapeutics 多年期續約。

Within the Cigna Healthcare portfolio, it's still pretty early in the season for small employers, but we do have some good insights on the larger end of the market. And we continue to view the National Accounts space as one that will be a flat to shrinking market over time. And our strategy in the National Accounts space is to maintain our share in Cigna Healthcare. And at this point, we're not seeing anything unique for '26 that would cause us to deviate from that multiyear expectation.

在 Cigna Healthcare 投資組合中，對於小型雇主來說，現在還處於初期階段，但我們對較大的市場確實有一些很好的見解。我們仍然認為，隨著時間的推移，國民帳戶領域將逐漸持平甚至萎縮。我們在國家帳戶領域的策略是保持我們在 Cigna Healthcare 的份額。目前，我們還沒有看到 26 年出現任何特殊情況，導致我們偏離多年預期。

Within Cigna Healthcare, we do continue to be a net share winner in the under 500 Select segment, which is a function of our affordability improvements that we've driven, coupled with our consultative employer engagement model.

在 Cigna Healthcare 內部，我們繼續成為 500 以下 Select 細分市場的淨份額贏家，這得益於我們推動的可負擔性改進，以及我們的顧問式雇主參與模式。

And finally, in the Evernorth Specialty and Care Services platform, we do continue to benefit from secular tailwinds there, which leads to more patients utilizing specialty drugs, along with our Accredo specialty pharmacy being included as a network option in more unaffiliated PBM offerings.

最後，在 Evernorth 專業和護理服務平台，我們確實繼續受益於那裡的長期順風，這使得更多的患者使用專科藥物，同時我們的 Accredo 專業藥房也被納入更多非附屬 PBM 產品的網絡選項中。

In terms of some of the market dynamics or themes that apply more holistically across our businesses, first, I'd characterize this as a pretty active sales season, both as we compete for 2026 new business, both amongst our existing client base, but also new business opportunities for us.

就一些更全面地適用於我們業務的市場動態或主題而言，首先，我認為這是一個相當活躍的銷售季，因為我們既在現有客戶群中競爭 2026 年的新業務，也在為我們帶來新的業務機會。

Affordability continues to be the number one area of focus for employers, particularly with the persistently high cost trend environment that the industry has been experiencing. And part of that's driven by the question that AJ asked around specialty injectables as well as GLP-1s and the continued growth we're seeing in mental health spending.

可負擔性仍然是雇主關注的首要領域，尤其是在該行業持續經歷高成本趨勢的環境下。部分原因是 AJ 提出有關特種注射和 GLP-1 的問題，以及我們看到的心理健康支出的持續增長。

And amongst larger employers, we're seeing some elongated decision-making time frames, particularly as employers are seeking reassurance that their benefit decisions are appropriate given the continued pressures on affordability.

在規模較大的雇主中，我們看到一些決策時間框架被延長，特別是因為雇主正在尋求保證，考慮到持續的負擔能力壓力，他們的福利決定是合適的。

The second theme is personalization. This we're seeing across our buyer groups, which can take the form of network solutions, product offerings, clinical programs and service experiences. And during the quarter, we announced our new AI-powered virtual assistant for our Cigna Healthcare customers to help them navigate the complexity of the healthcare system with the most modern digital capabilities, and the feedback there has been very positive.

第二個主題是個性化。我們在買家群體中看到了這一點，他們可以採取網路解決方案、產品供應、臨床計劃和服務體驗的形式。在本季度，我們為 Cigna Healthcare 客戶推出了新的人工智慧虛擬助手，幫助他們利用最現代化的數位功能來應對複雜的醫療保健系統，並且獲得了非常積極的回饋。

And finally, we're hearing more of our larger employers seeking to reduce the number of point solutions, in some cases, finding that the ROI isn't there, or in other cases, finding that there are gaps in integrating these point solutions, which drives a level of fragmentation in the individual's healthcare journey.

最後，我們聽到越來越多的大型雇主尋求減少點解決方案的數量，在某些情況下，他們發現投資回報率不高，或者在其他情況下，他們發現在整合這些點解決方案方面存在差距，這導致個人醫療保健旅程的碎片化程度增加。

So a lot that I just covered there in a few minutes. But taken all together, we're well positioned to meet all these market needs and we expect 2026 to be a year of attractive results.

我只花了幾分鐘就講完了很多內容。但總的來說，我們已做好準備滿足所有這些市場需求，我們預計 2026 年將是取得可觀業績的一年。

David, maybe you can comment on Arkansas and the associated PBM dynamics.

大衛，也許您可以對阿肯色州和相關的 PBM 動態發表評論。

So yes, macro and specific to Arkansas. So at a more macro level, as I noted even in my prepared remarks, we believe that the industry will continue to operate in an active legislative and regulatory environment. And we believe the sustained environment requires a very strong and collaborative public-private partnership and relationship.

是的，這是宏觀的，並且具體到阿肯色州。因此，從更宏觀的層面來看，正如我在準備好的發言中指出的那樣，我們相信該行業將繼續在積極的立法和監管環境中運作。我們相信，永續的環境需要非常強大和協作的公私夥伴關係和關係。

And highlighting back to the industry leaning in on evolving prior authorization more broadly with the health plans coordinating a direction in the solution and collaborating with HHS, that's not a declaration of success. That's a positive indication of public-private partnership and collaborating to drive sustained improvement.

並強調該行業傾向於更廣泛地發展事先授權，健康計劃協調解決方案的方向並與 HHS 合作，這並不是成功的宣言。這是公私部門合作和合作推動持續改善的正面表現。

And I would say just broadly underlying mostly all the legislative and regulatory activity, there's an orientation around the affordability challenge that everybody is confronting, federal government, state government, employers and individuals, so desiring improvements in affordability while balancing access and quality. They have to actually get squared together. When you over-architect on one, you potentially push too hard on the other.

我想說的是，幾乎所有立法和監管活動都圍繞著可負擔性挑戰，聯邦政府、州政府、雇主和個人都希望在平衡可負擔性和品質的同時提高可負擔性。他們必須真正地團結起來。當你對其中一個進行過度設計時，你可能會對另一個施加過大的壓力。

Specific to Arkansas, to be very clear, we're quite pleased with the expeditious and clear decision of the courts thus far to put a TRO in place because the legislation, while potentially well intended, is contrary to what we believe society needs. And if you look at the legislation, the legislation essentially arbitrarily constrains access. The legislation would, as it's configured, break continuity of care. The legislation would restrict choice. And the legislation would have an undoubtable positive impact or upward impact in a negative way on affordability.

具體到阿肯色州，非常明確的是，我們對法院迄今為止迅速而明確的決定感到非常高興，決定實施臨時限制令，因為這項立法雖然可能出於好意，但卻與我們認為的社會需要相悖。如果你看一下立法，你會發現該立法基本上任意限制了存取權。依其規定，這項立法將會破壞照護的連續性。該法案將限制選擇。這項立法無疑會對負擔能力產生正面影響，或以負面的方式產生正面影響。

So we are pleased with the outcome and the temporary restraining order to look at the facts relative to that. We will continue to stay engaged both at the state level and federal level, and I come back to the imperative. The imperative is sustainable improvements to overall affordability that harness choice and innovation, that don't architect it away arbitrarily. They have to harness choice and innovation and then balance appropriate access and drive sustained quality.

因此，我們對結果和臨時限制令感到滿意，以便審查與此相關的事實。我們將繼續在州和聯邦層級保持參與，我回到當務之急。當務之急是持續改善整體負擔能力，利用選擇和創新，而不是任意設計。他們必須利用選擇和創新，然後平衡適當的訪問並推動持續的品質。

And we're confident, as Brian noted, our capabilities are well positioned to be able to drive that. Thanks for your questions.

正如布萊恩所說，我們有信心，我們有能力推動這一目標。感謝您的提問。

Josh Raskin, Nephron Research.

Josh Raskin，Nephron Research。

Could you provide an update related to the exchange business on your risk adjustment accruals? It just looked like revenue jumped in 2Q on a PMPM basis by a decent amount. And so I'm just curious if there was any specific adjustment for 2024 final settlement or as you're thinking about mortality for this year?

您能否提供有關交易所業務風險調整應計項目的最新資訊？看起來，第二季的營收按 PMPM 計算大幅成長。所以我只是好奇，對於 2024 年的最終結算是否有任何具體調整，或者您是否考慮過今年的死亡率？

And then could you provide maybe broader commentary on expectations for that book in 2026 and how you're pricing -- how you're approaching the pricing environment?

然後，您能否對 2026 年該書的預期以及您的定價方式（您如何處理定價環境）提供更廣泛的評論？

It's Brian. I'll start with maybe a little bit of context for the individual exchange market and then ask Ann to take the question you asked more specifically about risk adjustment accruals and such.

我是布萊恩。我首先會介紹個人外匯市場的背景，然後請安更具體地回答你提出的問題，即有關風險調整應計費用等。

I think it's important to step back and rewind the clock a couple of years to 2023. At that point in time, we served nearly 1 million customers in the individual exchanges, albeit with mixed financial performance.

我認為回顧一下並將時鐘撥回到幾年前到 2023 年是很重要的。當時，儘管財務表現好壞參半，但我們為各個交易所的近 100 萬客戶提供了服務。

Based upon our performance as well as our forward view of the market, we made the strategic choice to prioritize margin over growth, which included adjustments to product and network strategies, refinements to our geographic footprint and increased prices where necessary.

根據我們的業績以及對市場的前瞻性看法，我們做出了優先考慮利潤率而非成長的策略選擇，其中包括調整產品和網路策略、改進我們的地理覆蓋範圍以及在必要時提高價格。

And this decision to prioritize margin over growth in the individual exchanges has helped us to navigate some of the industry-wide pressures that have emerged here in 2025. And we now serve fewer than 400,000 customers in this business, down materially from the nearly 1 million we served in 2023.

這項優先考慮個別交易所利潤而非成長的決定幫助我們應對了 2025 年出現的一些產業壓力。目前，我們在該業務領域服務的客戶不到 40 萬，與 2023 年服務的近 100 萬客戶相比大幅下降。

Additionally, across both the 2024 and 2025 pricing cycles, our nationwide price increases were roughly double the industry average in each of those years. So as a result of those actions, some of our competitors showed meaningful growth in their individual exchange businesses while we chose to reposition our portfolio, which resulted in fewer individual exchange customers for Cigna Healthcare.

此外，在 2024 年和 2025 年的定價週期中，我們的全國價格漲幅約為業界平均值的兩倍。因此，由於採取了這些行動，我們的一些競爭對手在其個人交易所業務中表現出了有意義的成長，而我們選擇重新定位我們的投資組合，這導致 Cigna Healthcare 的個人交易所客戶減少。

So again, just to summarize what's transpired over the past two years in the individual exchanges. We made the choice to prioritize margin over growth, which resulted in a reduction of our customer base from nearly 1 million customers in 2023 to fewer than 400,000 customers today. Meanwhile, across the industry, individual exchange enrollment is up nearly 50% over that same time period.

因此，再次總結過去兩年中個人交流中所發生的事情。我們選擇優先考慮利潤而不是成長，這導致我們的客戶群從 2023 年的近 100 萬客戶減少到今天的不到 40 萬客戶。同時，在整個產業中，同一時期個人交易所的註冊人數增加了近 50%。

As it relates to 2026, we expect to take further price increases. We're in the process of working through the refiling of that as we speak. And again, we'll prioritize margin over growth for the 2026 year in the individual exchanges.

就 2026 年而言，我們預計價格將進一步上漲。我們正在處理此事的重新歸檔工作。再次強調，對於各個交易所而言，2026 年的利潤率將優先於成長。

Ann, maybe you can pick up on the risk adjustment component of this question?

安，也許你可以理解這個問題的風險調整部分？

Sure. So specifically on your question related to risk adjustments, there's a couple of things to note. Reflected in our results this quarter is a 2023 RADV adjustment, which we had visibility into coming into building our expectations for the year. So that was built -- already built into our expectations.

當然。因此，具體到您關於風險調整的問題，有幾點需要注意。本季度的業績反映了 2023 年 RADV 的調整，我們在製定年度預期時已經對此有所了解。所以這已經符合我們的預期。

Beyond that, we had a very modest positive adjustment to the 2024 risk adjustment that helped offset some of the pressure we saw related to utilization that I mentioned in my prepared remarks.

除此之外，我們對 2024 年風險調整進行了非常適度的積極調整，這有助於抵消我在準備好的發言中提到的與利用率相關的一些壓力。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

I wanted to ask about your views on the impact of more sophisticated hospital billing and coding to commercial trend, right? We're hearing about this all over. Curious what you're seeing here? And do you think this might have an above-average impact on stop-loss?

我想問一下您對更複雜的醫院計費和編碼對商業趨勢的影響的看法，對嗎？我們到處都在聽到這件事。好奇你在這裡看到了什麼？您認為這可能會對停損產生高於平均值的影響嗎？

And then lastly, just with rate increases running double digits for employers. David, I'd love to hear what you're hearing from employers on their ability to absorb it and what they're thinking here.

最後，雇主的薪資漲幅達到兩位數。大衛，我很想聽聽你從雇主那裡了解到的關於他們吸收它的能力以及他們的想法。

Let me take a portion of the question and ask Brian to give you some insights in terms of what we're experiencing specifically in terms of our stop-loss actions from a marketplace standpoint.

讓我回答問題的一部分，並請布萊恩從市場的角度就我們在停損行動方面的具體經驗給您一些見解。

So we have several questions here. First, are we seeing elevated billing sophistication harnessing AI or other capabilities? Broadly speaking, we think the answer to that is yes.

所以我們這裡有幾個問題。首先，我們是否看到利用人工智慧或其他功能來提高計費的複雜程度？從廣義上講，我們認為答案是肯定的。

I'm going to park on the side, there's a significant number of AI-related activities that we are driving as an organization in terms of driving efficiency and effectiveness and productivity, driving accelerated speed, precision and personalization and working to design new capabilities and there's a series of bright spots within that. Some of those capabilities help us to counteract, address and proactively engage very differently in terms of some of the forces we're seeing.

我要停在一邊，作為一個組織，我們正在推動大量與人工智慧相關的活動，以提高效率、效力和生產力，推動加速速度、精確度和個性化，並致力於設計新功能，其中有一系列亮點。其中一些能力可以幫助我們以非常不同的方式抵消、處理和主動應對我們所看到的一些力量。

But to your first part of your question, we believe the answer to that is indisputably yes. We engage in that in terms of hospital contracting and provider contracting engagement modifications, our own AI and technology capabilities and seeking to get a balanced net outcome.

但對於您問題的第一部分，我們相信答案無疑是肯定的。我們致力於醫院承包和供應商承包參與修改、我們自己的人工智慧和技術能力，並尋求獲得平衡的淨結果。

On the back side of your question, before I hand it back to Brian to talk more specifically about the marketplace and stop-loss, there's no doubt that affordability is pressuring everybody. And before we come to the employers, it's important to articulate it's impacting the federal government as a payer. It's impacting state governments as a payer. It's impacting employers as payers and it's impacting individuals, which is why we always come back and articulate the impact of affordability as the number one issue to be able to drive forward.

關於你問題的背面，在我把它交還給布萊恩，讓他更具體地談論市場和止損之前，毫無疑問，負擔能力給每個人帶來了壓力。在談到雇主之前，我們必須明確指出這對作為付款人的聯邦政府的影響。它對作為付款人的州政府產生了影響。它影響著雇主作為付款人，也影響著個人，這就是為什麼我們總是回來並闡明負擔能力的影響是能夠推動的首要問題。

The precision, the personalization, new program designs, and in many cases, integration of point solutions are opportunities to mitigate some of that. And what I would say from an employer standpoint, what this is doing is it's raising the decision criteria in the C-suite even higher.

精確度、個人化、新程式設計以及在許多情況下的點解決方案的整合都是緩解其中某些問題的機會。從雇主的角度來看，我想說的是，此舉將進一步提高高階主管的決策標準。

It's potentially increasing openness to what may have been deemed to be more disruptive solutions, so more precise network solutions or more aggressive adoption of some of our new innovations like our Pathwell programs -- or Pathwell specialty program, which is an example to AJ's question of significantly more precision of network configuration around specialty infusions that deliver exponentially more volume and affordability.

這可能會增加對可能被視為更具顛覆性的解決方案的開放性，因此更精確的網絡解決方案或更積極地採用我們的一些新創新，例如我們的 Pathwell 計劃 - 或 Pathwell 專業計劃，這是 AJ 問題的一個例子，圍繞專業輸液的網絡配置更加精確，可提供成倍的容量和可負擔性。

So there is pressure there, no doubt. We see it as actually opening the door for more innovative conversations and bringing more precision to the solution.

因此毫無疑問那裡存在壓力。我們認為這實際上為更多創新對話打開了大門，並為解決方案帶來了更高的精確度。

Brian, can I ask you to talk about the stop-loss traction we're seeing in the marketplace and some of the progress there?

布萊恩，我可以請您談談我們在市場上看到的停損牽引力以及其中的一些進展嗎？

Sure, David. I know you asked a very specific question on stop-loss, I'm just going to zoom out for a bit and kind of remind of the big picture in terms of where we are with that product line. Our stop-loss offerings are a very important part of our US employer portfolio within Cigna Healthcare that work in complement with our other products and solutions for employers who choose to self-fund their health benefits.

當然，大衛。我知道您問了一個關於停損的非常具體的問題，我只是想稍微擴大一下範圍，並提醒大家我們在該產品線方面所處的總體情況。我們的停損產品是我們 Cigna Healthcare 旗下美國雇主產品組合中非常重要的一部分，它與我們為選擇自籌醫療福利資金的雇主提供的其他產品和解決方案相輔相成。

And importantly, they provide employers with budgetary protection against unexpected large claimant activity or aggregate cost levels being higher than projected.

重要的是，它們為雇主提供了預算保護，以防止意外的大型索賠活動或總成本水準高於預期。

And for us, all of the stop-loss business that we write is through an integrated offering with the employer where we also administer their overall medical benefits. And we continue to see very strong market demand for these solutions as evidenced by the 13% growth in stop-loss premiums in the second quarter.

對我們來說，我們所進行的所有停損業務都是透過與雇主的綜合服務進行的，我們也管理他們的整體醫療福利。我們持續看到市場對這些解決方案的強勁需求，第二季停損保費成長 13% 就是明證。

As we've talked about on prior calls, we're working to improve the margin profile on this business over the course of the next two renewal cycles and we're confident in our ability to deliver against this. And over the past few months, we have been able to make progress on this plan with the revised cost structure being reflected in our later 2025 client renewals, and we've been able to execute this while preserving typical client retention levels.

正如我們在先前的電話會議上所討論的那樣，我們正在努力在接下來的兩個更新周期內改善該業務的利潤率狀況，並且我們有信心實現這一目標。在過去的幾個月裡，我們已經能夠在該計劃上取得進展，修改後的成本結構反映在我們 2025 年後期的客戶續約中，並且我們能夠在保持典型客戶保留水平的同時執行該計劃。

And in fact, our sold rate increases for 2025 coverage effective dates after January are higher than our January 2025 sold increases, underscoring that our recovery plan is in motion. And it's important to keep in mind that about two-thirds of our stop-loss portfolio renews on January 1. So the pricing work for that cohort will be completed in the fall, and that will inform our 2026 outlook.

事實上，我們在 2025 年 1 月之後生效的保險的銷售費率增幅高於 2025 年 1 月的銷售費率增幅，這突顯了我們的復甦計劃正在實施中。重要的是要記住，我們的停損投資組合中約有三分之二將於 1 月 1 日更新。因此，該群體的定價工作將於秋季完成，這將為我們的 2026 年展望提供資訊。

But thus far, through the first six months of the year, the stop-loss portfolio is performing broadly in line with expectations and the more sophisticated or intensive billing that you made reference to, while it is impacting our US employer book, does not have an outsized impact on the stop-loss portfolio. So thanks for the question.

但到目前為止，在今年前六個月中，停損投資組合的表現基本上符合預期，而您提到的更複雜或更密集的計費雖然影響了我們的美國雇主帳簿，但對停損投資組合的影響並不大。感謝您的提問。

Charles Rhyee, TD Cowen.

查爾斯·瑞伊（Charles Rhyee），考恩（Cowen）TD。

Maybe I'd like to ask, Brian, if you could expand a little bit more. You talked about a lot on CuraScript and just curious sort of what does this market look like when you're selling into health systems, in particular? Do you have to go through the GPOs like Novation? Now, what does the contracting cycle there look like? And who are the incumbents? Are we talking about maybe some of the more traditional drug distributors like a McKesson or Cencora in this market?

也許我想問一下，布萊恩，你是否可以再詳細說。您談了很多關於 CuraScript 的內容，只是很好奇當您向醫療系統銷售產品時，這個市場是什麼樣的？您是否必須透過 Novation 等 GPO 來處理？現在，那裡的承包週期是什麼樣的呢？那麼現任者是誰？我們談論的可能是這個市場上一些更傳統的藥品分銷商，例如 McKesson 或 Cencora？

And then added to that, you talked about biosimilars in the press release. Just curious sort of what the experience you've had so far with maybe something like biosimilar STELARA through Quallent? And is this something you're also selling to health systems through Quallent?

另外，您在新聞稿中談到了生物相似藥。只是好奇您迄今為止透過 Quallent 使用類似生物相似藥 STELARA 的體驗如何？您是否也透過 Quallent 向醫療系統銷售該產品？

Charles, there's a lot in there, so I'll try to hit each of the components as best as I can. So I appreciate you asking about CuraScript and that part of our company because many people are not familiar with that. And we decided to spend a few minutes in my prepared comments on this opportunity that we see in further expanding the addressable market to serve more health systems, hospitals and provider groups with their specialty pharmacy capabilities. And this is one of the most exciting growth opportunities that we have across The Cigna Group going forward.

查爾斯，這裡面有很多內容，所以我會盡力講解每個部分。因此，我很感謝您詢問有關 CuraScript 和我們公司的那部分內容，因為很多人對此並不熟悉。我們決定在準備好的評論中花幾分鐘時間討論這個機會，我們認為可以進一步擴大目標市場，為更多的醫療系統、醫院和供應商團體提供專業藥房能力。這是信諾集團未來最令人興奮的成長機會之一。

And if you think about one of the core problem statements here for these providers is margin compression in their core business, it's often driven by some combination of payer mix, wage inflation, clinician burnout and other factors. So as a result, providers are increasingly looking to their in-house pharmacy capabilities, most notably specialty medication management as an alternative revenue source.

如果你考慮這些提供者面臨的核心問題之一，那就是其核心業務的利潤率壓縮，那麼這通常是由付款人組合、薪資上漲、臨床醫生倦怠和其他因素共同造成的。因此，供應商越來越多地將內部藥局能力（尤其是專科藥物管理）視為替代收入來源。

And we're able to support these providers both through distributing specialty medications to them, along with offering clinical coordination, inventory management and other enablement services to help providers manage their specialty pharmacy capabilities.

我們能夠透過向這些供應商分發特殊藥物來為他們提供支持，同時提供臨床協調、庫存管理和其他支援服務，幫助供應商管理他們的特殊藥房能力。

The specialty capability is fulfilled by our CuraScript business, which is already a $25 billion business and has been growing at a double-digit annualized rate in recent years. And the CuraScript business is primarily focused on the provider-oriented or medical benefit-oriented component of the specialty market, which represents about 40% of the over $400 billion specialty pharmacy addressable market.

我們的 CuraScript 業務滿足了專業能力，該業務現已達到 250 億美元，並且近年來一直以兩位數的年化率成長。CuraScript 業務主要集中於專業市場中以提供者為導向或以醫療福利為導向的部分，該部分佔超過 4000 億美元的專業藥房目標市場的 40% 左右。

And going forward, CuraScript has got multiple avenues for growth, both through serving these unaffiliated health systems and other providers, along with increasing its distribution reach through our Accredo specialty pharmacy.

展望未來，CuraScript 擁有多種成長途徑，既可以透過為這些非附屬醫療系統和其他提供者提供服務，也可以透過我們的 Accredo 專業藥房擴大其分銷範圍。

Now, the wholesalers that you made reference to, we don't compete with them directly in this space. They tend to be more focused on the prescription drug or the pharmacy benefits side of the specialty market, which is where our CuraScript business has very little volume today. So we're almost exclusively focused on serving providers through CuraScript. And so our value prop is a bit more holistic because we're able to offer those other enablement services that I made reference to as well to the health systems and other providers.

現在，您提到的批發商，我們不會在這個領域與他們直接競爭。他們往往更注重處方藥或專業市場的藥房福利方面，而目前我們的 CuraScript 業務在這些方面的業務量非常小。因此，我們幾乎只專注於透過 CuraScript 為供應商提供服務。因此，我們的價值主張更加全面，因為我們能夠向醫療系統和其他提供者提供我提到的其他支援服務。

As it relates to biosimilars, obviously, we're really pleased to see the building momentum of biosimilars across the US, particularly in the last 18 months as HUMIRA biosimilars have become more mainstream, and we see this as part of a multiyear wave for biosimilars more broadly. And beyond HUMIRA, we expect another $100 billion of specialty drug spend to be subject to competition from biosimilars and generics by 2030, representing a tremendous opportunity to reduce net cost for patients and clients.

就生物相似藥而言，顯然，我們很高興看到美國各地生物相似藥的發展勢頭強勁，特別是在過去 18 個月中，HUMIRA 生物仿製藥已成為主流，我們認為這是生物仿製藥多年浪潮的一部分。除了 HUMIRA 之外，我們預計到 2030 年，另外 1000 億美元的特種藥物支出將面臨來自生物相似藥和仿製藥的競爭，這為降低患者和客戶的淨成本提供了巨大的機會。

Importantly, each biosimilar will have different rates of adoption based upon factors such as interchangeability, dosage levels, branded alternatives and other dimensions. And so far, we launched our $0 patient out-of-pocket biosimilar for STELARA in May, leveraging the learnings we had from HUMIRA biosimilars. The returns are very early, but we're seeing encouraging signs already of biosimilar adoption here. And we do expect to see gradual growth in STELARA biosimilars over the balance of the year, all of which is contemplated in the Evernorth outlook.

重要的是，每種生物相似藥的採用率都會有所不同，這取決於可互換性、劑量水平、品牌替代品和其他方面等因素。到目前為止，我們利用從 HUMIRA 生物相似藥中汲取的經驗，於 5 月推出了患者自付費用為 0 美元的 STELARA 生物仿製藥。雖然回報還很早，但我們已經看到了生物相似藥採用的令人鼓舞的跡象。我們確實預計 STELARA 生物相似藥在今年餘下時間將逐步增長，所有這些都已在 Evernorth 的展望中考慮到。

And to your point, importantly, CuraScript is a distribution vehicle for our Quallent biosimilars to many of the health systems and other providers that I made reference to. So appreciate the question. Hopefully, that captures the essence of what you were hoping to hear.

正如您所說，重要的是，CuraScript 是我們向許多我提到的醫療系統和其他供應商銷售 Quallent 生物相似藥的工具。非常感謝你的提問。希望這能抓住您希望聽到的內容的本質。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great. I guess one of your larger competitors talked about how at least they're under-earning on the commercial side of the business and need to reprice over the next couple of years. I was wondering if you could just give us a little bit of color on what you're seeing within the competitive pricing environment within commercial broadly? And then if you can give any color what's the difference between the subsegments that you focus on versus maybe the segments that you deemphasized a little bit.

偉大的。我猜你們的一個較大的競爭對手談到至少他們在商業業務方面的收益不足，需要在未來幾年重新定價。我想知道您是否可以向我們稍微介紹一下您所看到的廣泛的商業競爭定價環境？然後，如果您可以給出任何顏色，那麼您關注的子段與您稍微弱化的段落之間有什麼區別。

Kevin, it's Brian. I'll start and then Ann can pick up some of the questions around margin and such. So overall, I'd characterize the market as pretty firm right now from a pricing standpoint, meaning there doesn't appear to be a lot of appetite for competitors to go out and underprice business to try to pick up volume.

凱文，我是布萊恩。我先開始，然後安可以回答一些關於保證金等的問題。因此，總體而言，從定價的角度來看，我認為目前的市場相當堅挺，這意味著競爭對手似乎沒有太大的興趣透過低價出售來增加銷售量。

And as we talked about earlier, our planning assumptions for the balance of 2025, they do assume a continued elevated cost trend environment. And for 2026, our pricing assumptions assume another year of elevated cost trends. And at the current point in time, our expectation is that we will secure price increases for 2026 that exceed what we achieved in 2025, which were already at high levels compared to historical norms.

正如我們之前所討論的，我們對 2025 年餘額的規劃假設確實假設成本趨勢環境持續上升。對於 2026 年，我們的定價假設是成本趨勢將再上升一年。目前，我們預計 2026 年的價格漲幅將超過 2025 年的水平，而 2025 年的價格漲幅已經高於歷史水平。

Now, of course, this is prior to clients making adjustments to their benefit designs or network strategies, which could serve to mitigate some of the price increase without impacting our margins.

當然，這是在客戶調整其福利設計或網路策略之前，這可以減輕部分價格上漲而不會影響我們的利潤率。

As a reminder, the vast majority of our US employer business is self-funded or it's priced using client-specific experience as opposed to being block rated, which is one of the differences potentially from some competitive comments that you made reference to.

提醒一下，我們在美國絕大多數的雇主業務都是自籌資金的，或者根據客戶特定的經驗來定價，而不是按整體評級，這可能是與您提到的一些競爭性評論的區別之一。

But again, the market overall is firm and rational at the current point in time as it relates to the pricing environment.

但就定價環境而言，當前市場整體上是堅挺且理性的。

Do you want to talk, Ann, a little bit about the margin dynamics?

安，你想談談利潤動態嗎？

Sure. Thanks, Brian. So as Brian mentioned earlier, we continue to see elevated cost trends, but those are in line with our expectations. Most notably, we see it in specialty injectables and behavioral health services trends that have remained high and continue to be the primary contributors to the trend.

當然。謝謝，布萊恩。正如 Brian 之前提到的，我們繼續看到成本上升的趨勢，但這符合我們的預期。最值得注意的是，我們看到專業注射劑和行為健康服務趨勢保持高位，並繼續成為這一趨勢的主要貢獻者。

Last quarter, we saw some favorability on surgery trends. This quarter, we saw a more normalized trend in line with our expectations. So when you think about the impact across the Cigna Healthcare portfolio, the businesses are generally performing as expected and in the target margin range.

上個季度，我們看到了手術趨勢的一些有利因素。本季度，我們看到了更正常化的趨勢，符合我們的預期。因此，當您考慮對 Cigna Healthcare 產品組合的影響時，您會發現這些業務的表現總體上符合預期，並且處於目標利潤範圍內。

I'd note two exceptions to that. So the exchange business, given some of the pressure we're seeing there around utilization, we would expect to run below target margins for 2025.

我要指出的是兩個例外。因此，考慮到我們在利用率方面看到的一些壓力，我們預計交換業務的利潤率將低於 2025 年的目標。

And then Brian talked earlier about the stop loss business and our journey to recover to run rate margins through 2026 and into 2027. But overall, performance across the healthcare businesses was in line with our expectations, and we are really pleased to reaffirm our full year guidance.

然後，布萊恩早些時候談到了止損業務以及我們在 2026 年和 2027 年恢復運行率利潤率的歷程。但總體而言，醫療保健業務的表現符合我們的預期，我們很高興重申我們的全年指導。

Jason Cassorla, Guggenheim.

傑森·卡索拉，古根漢。

Great. I wanted to ask about Evernorth margins in the quarter. You talked about the investment income headwind. But if we completely back out the investment income across both of your subsegments within Evernorth, it looks like Specialty and Care margins were relatively consistent year-over-year, but the PBM margins were down a little bit.

偉大的。我想詢問本季 Evernorth 的利潤率。您談到了投資收益逆風。但如果我們完全放棄 Evernorth 內兩個子部門的投資收入，看起來專業和護理利潤率比去年同期相對穩定，但 PBM 利潤率略有下降。

I know you've discussed investment spend across Evernorth, but maybe can you just walk us through the margin paradigm and the drivers in the quarter, just given the revenue strength?

我知道您已經討論過 Evernorth 的投資支出，但考慮到收入實力，您能否向我們介紹本季的利潤率模式和驅動因素？

And then you spent some time talking about the medical side of the specialty business in your prepared remarks. Can you give us a sense on how to think about margins as you go after that TAM opportunity? That would be very helpful.

然後，您在準備好的演講中花了一些時間談論專業業務的醫療方面。您能否告訴我們，在追求 TAM 機會時，如何考慮利潤率？那將會非常有幫助。

So I'll start on the margin question as it relates to Evernorth Pharmacy Benefit Services and I'll pass it over to Brian for the second part of the question. So just to set the stage, so our performance in Evernorth continues to reflect strength across both Pharmacy Benefit Services and Specialty and Care. Considering the breadth of the business, there are a few dynamics to consider with respect to margin and I'd point to two things that are contributing to some of those dynamics that you see.

因此，我將從與 Evernorth Pharmacy Benefit Services 相關的利潤問題開始，然後我將它交給 Brian 回答問題的第二部分。因此，只是為了奠定基礎，我們在 Evernorth 的表現繼續反映出藥房福利服務以及專業和護理方面的實力。考慮到業務的廣度，在利潤率方面需要考慮一些動態因素，我想指出兩件對您看到的一些動態因素有所貢獻的事情。

So one is client mix. So we've had some -- bringing on some large clients, some large client renewals and our largest clients are growing the fastest and they generally come with lower margin profiles. So that is a contributor to what you're seeing.

一是客戶組合。因此，我們引入了一些大客戶，一些大客戶進行了續約，我們最大的客戶成長最快，而且他們的利潤率通常較低。所以這就是你所看到的情況的一個原因。

The second thing that I'd point to is drug mix. So we're seeing higher-priced drug sales, and higher-priced drug sales create a larger impact on revenues than on margins. So you put those two things together and that's really what's creating the dynamic that is coming through the numbers.

我要指出的第二件事是藥物混合。因此，我們看到藥品銷售價格較高，藥品銷售價格較高對收入的影響大於對利潤的影響。所以，把這兩件事放在一起，這就是真正創造出透過數位呈現的動態的東西。

Taking into account those two things, we feel really good about the strength of the business and the ability to drive sustained growth across both of those businesses. But I'll turn it over to Brian for the second part of the question on healthcare.

考慮到這兩點，我們對業務實力以及推動這兩項業務持續成長的能力感到非常滿意。但關於醫療保健問題的第二部分，我將交給布萊恩回答。

Yes. Thanks, Ann. So as it relates to the medical side of specialty and the Evernorth services that we provide there, I'd encourage you to think of it in two buckets. So category one is our distribution business, CuraScript. So I made reference to that's a $25 billion business today, been growing at double digits in recent years, has a lot of runway ahead of it.

是的。謝謝，安。因此，由於它與專業醫療方面以及我們在那裡提供的 Evernorth 服務相關，我鼓勵您從兩個角度來考慮它。第一類是我們的分銷業務 CuraScript。所以我提到，這是一項目前價值 250 億美元的業務，近年來一直以兩位數的速度成長，未來還有很長的路要走。

You can think of that as a low-margin business, call it, low single-digit type margins. Not that different than what the wholesaler margin profile is, although we provide a little bit more complexity alongside the distribution that we do, so we're able to earn a slightly higher margin. But think of that as a relatively low-margin business.

你可以把它看作是一個低利潤業務，或稱為低個位數利潤。與批發商的利潤狀況並沒有什麼不同，儘管我們在分銷的同時提供了更多的複雜性，所以我們能夠獲得略高的利潤。但請將其視為利潤相對較低的業務。

The second category of enablement services, you can think of that as a fee-based oriented business. So relatively low revenue contributions, but high margins on those fees. So you can think of that as not yet as noticeable in the P&L from a revenue standpoint, but we have quite a bit of long-term opportunity there as that addressable market continues to grow and we continue to build out our capabilities in that space.

第二類支援服務，您可以將其視為收費業務。因此，收入貢獻相對較低，但費用利潤率較高。因此，從收入的角度來看，你可以認為這在損益表中還不那麼明顯，但隨著潛在市場的持續成長以及我們繼續在該領域建立我們的能力，我們在那裡擁有相當多的長期機會。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Could you give us an update on some of the changes that you're seeing in the retail reimbursement model and landscape with more of the cost-plus models?

您能否向我們介紹一下您在零售報銷模式和成本加成模式方面看到的一些變化？

Do you expect a large portion of the government business to start moving in that direction as well on top of the commercial that started kind of to move in that direction in 2025? And if so, kind of how do you embrace that on the PBM side? And just talk about how you're navigating that now.

您是否預計，除了 2025 年開始朝這個方向發展的商業業務之外，政府業務也有很大一部分開始朝這個方向發展？如果是這樣，您如何在 PBM 方面接受這一點？並談談您現在如何處理這個問題。

It's Brian. So as it relates to retail reimbursement and more of the cost-plus and other alternative style models that are being advanced, there's certainly market curiosity around these topics. I would note, though, these types of solutions really aren't for everyone.

我是布萊恩。因此，由於它與零售報銷以及更多正在推進的成本加成和其他替代模式有關，市場肯定會對這些主題感到好奇。但我要指出的是，這些類型的解決方案實際上並不適合所有人。

And as David mentioned earlier, we continue to prioritize choice as it relates to how clients choose to pay us. We've got a variety of formularies that clients can choose from, some of which are customized to a client. And we have a variety of network configurations available.

正如大衛之前提到的，我們繼續優先考慮選擇，因為它與客戶選擇如何向我們付款有關。我們有多種處方可供客戶選擇，其中一些是根據客戶量身定制的。我們有多種網路配置可供選擇。

Specifically on cost-plus style offerings, as we hear from our Pharmacy Benefit Services clients, there's been relatively limited appetite for this thus far because many of them see this as paying more for the same thing in comparison to the more aligned incentive models that we've been able to drive historically and concerns around will I still have incentive for generic replacement continue to come up. So these are challenges with some of the cost-plus style models that have been advanced. That said, we do have certain network arrangements that are contracted on that basis.

特別是對於成本加成式產品，正如我們從藥房福利服務客戶那裡聽到的那樣，到目前為止，對此的興趣相對有限，因為其中許多人認為，與我們過去能夠推動的更一致的激勵模式相比，這需要為同樣的東西支付更多的費用，而且圍繞我是否仍有動力進行仿製藥替代的擔憂不斷出現。因此，這些都是一些已經推進的成本加成式模型所面臨的挑戰。話雖如此，我們確實有一些以此為基礎簽訂的網路安排。

To your point on government business, we have not seen a wholesale shift from one line to another as we think about commercial versus government versus other payer types within the Evernorth platform. David, do you want to get on this question?

關於您提到的政府業務，當我們考慮 Evernorth 平台內的商業、政府和其他付款人類型時，我們並沒有看到從一條線路到另一條線路的全面轉變。大衛，你想繼續討論這個問題嗎？

Sure. Just to amplify a point here, and Erin, I appreciate your question. I think when you think about the cost-plus terminology, sometimes it's used as a broader moniker for the industry. But to Brian's point, there is pressure on paying more for the same.

當然。我只是想強調這裡的觀點，艾琳，我很感謝你的提問。我認為，當您考慮成本加成術語時，有時它被用作該行業的更廣泛的名稱。但正如布萊恩所說，為同樣的東西付出更多錢是有壓力的。

Conversely, evolution to more fee-based models, evolution to more enhanced performance-based models, evolution to enhanced transparency that are in support of fee-based models, those are all part of the bigger ecosystem. And our team continues to lean into that heavily and offer increased choice and opportunities for clients.

相反，向更多基於費用的模式的演變、向更多基於績效的模式的演變、向支持基於費用的模式的增強透明度的演變，這些都是更大生態系統的一部分。我們的團隊將繼續大力支持這一點，為客戶提供更多的選擇和機會。

So I'd ask you to maybe step back and think about the theme. The theme is another push toward increased affordability while managing choice, and cost-plus is maybe used as a broader moniker of heading down that path of fees, but they need to be performance-based. There needs to be a performance-based dimension here to drive additional efficiency, effectiveness and value on a go-forward basis. And our team continues to be putting up some significant innovations in the marketplace that are responsive to this. Appreciate your question.

所以我請你退一步思考這個主題。主題是在管理選擇的同時進一步提高可負擔性，而成本加成也許可以作為沿著這條收費道路發展的更廣泛的名稱，但它們需要以績效為基礎。這裡需要有一個基於績效的維度來推動未來的額外效率、效力和價值。我們的團隊將繼續在市場上推出一些應對此問題的重大創新。感謝您的提問。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

There's been a lot of developments in the GLP-1 market, including your announced partnerships with Lilly and Novo this quarter. And one of your peers called out a headwind from GLP-1 pharmacy services this year. So can you give us an update on your GLP-1 products and how we should be thinking about the dispensing economics for those drugs given the recent deals?

GLP-1 市場取得了許多發展，包括本季宣布與 Lilly 和 Novo 建立合作夥伴關係。您的一位同行指出，今年 GLP-1 藥局服務面臨阻力。那麼，您能否向我們介紹一下您的 GLP-1 產品的最新情況，以及根據最近的交易，我們應該如何考慮這些藥物的配藥經濟性？

It's Brian. So maybe I'll talk for a minute about the most recent innovations that we've introduced and then get to the core of your question on dispensing economics and such.

我是布萊恩。因此，也許我會花一點時間談論我們引入的最新創新，然後深入探討您關於分配經濟學等問題的核心。

The headline I'd ask you to take away, though, is, broadly speaking, the GLP-1 contributions to Evernorth in 2025 are in the range of what we expected coming into the year, and our guidance does contemplate that, which reflects some decelerating growth in overall scripts, but still strong growth year-over-year compared to what the 2024 volumes would have been.

不過，我想請大家記住的是，從廣義上講，2025 年 GLP-1 對 Evernorth 的貢獻在我們預期的範圍內，我們的指導確實考慮到了這一點，這反映了整體腳本的增長有所減速，但與 2024 年的銷量相比，同比增長仍然強勁。

But when you step back from the GLP-1 space broadly, at The Cigna Group, we're proud to introduce new solutions for some of healthcare's biggest challenges and GLP-1s are clearly an example of that. And during our first quarter call, you heard us talk about a series of programs that we introduced earlier to create new value in the GLP-1 space, namely, EnCircle, EnReach and EnGuide. These combine access, affordability, clinical safety as well as longer-term lifestyle changes all for the benefit of our clients and patients.

但是，當你廣泛地退出 GLP-1 領域時，在 Cigna 集團，我們很自豪能夠為醫療保健領域的一些最大挑戰推出新的解決方案，而 GLP-1 顯然就是其中的一個例子。在我們的第一季電話會議上，您聽到我們談論了我們之前推出的一系列旨在在 GLP-1 領域創造新價值的計劃，即 EnCircle、EnReach 和 EnGuide。這些結合了可近性、可負擔性、臨床安全性以及長期生活方式的改變，所有這些都是為了我們的客戶和患者的利益。

And to your point on economics, we earn fees for those programs as part of our client relationships in helping them manage GLP-1 clinical safety and cost levels. Subsequent to introducing these programs, we noted that many employers remain reluctant to provide access to GLP-1 drugs for weight management due to the price. So the net cost of a GLP-1 weight management prescription after reflecting the discounts we had negotiated from drug manufacturers and the patient cost sharing was still high and would incrementally pressure employer budgets.

關於您提到的經濟學問題，作為我們客戶關係的一部分，我們會透過這些項目賺取費用，幫助他們管理 GLP-1 臨床安全性和成本水準。在推出這些計劃之後，我們注意到許多雇主由於價格原因仍然不願意提供 GLP-1 藥物來管理體重。因此，在反映了我們與藥品製造商協商的折扣和患者分攤的費用後，GLP-1 體重管理處方的淨成本仍然很高，並且會逐漸給雇主預算帶來壓力。

So we challenged ourselves to develop a solution that would further reduce net cost for employers while ensuring that patient out-of-pocket costs will be lower than if they purchased the GLP-1 drugs directly. So in May, we announced a new program that targeted employers who are not yet offering GLP-1 coverage for weight management. And the new solution is coupled with a maximum out-of-pocket cost of no more than $200 per month for the patient while allowing for patient and physician choice.

因此，我們挑戰自己，開發解決方案，進一步降低雇主的淨成本，同時確保患者自付費用低於直接購買 GLP-1 藥物的費用。因此，我們在五月宣布了一項新計劃，針對尚未提供 GLP-1 體重管理保險的雇主。新解決方案還規定患者每月自付費用最高不超過 200 美元，同時允許患者和醫生自行選擇。

And that generated some win-win dynamics. The net cost to the employer is reduced by our negotiated rates and by the cost share from the patient. The patient's cost sharing being capped at $200 per month offered a more affordable option than other pathways for FDA-approved treatments. And the drug manufacturers would benefit from higher volumes.

這產生了一些雙贏的局面。雇主的淨成本透過我們協商的費率和患者分擔的費用來減少。患者每月分攤的費用上限為 200 美元，與其他 FDA 批准的治療途徑相比，這是更實惠的選擇。而藥品製造商將從產量增加中獲益。

So we introduced this program in late May, again the most recent in our series of innovations. We only have a couple of months of market feedback. The feedback has been very positive thus far, although I would note changes to benefit offerings associated with this new program are more likely to be incorporated at client renewals as opposed to us seeing midyear benefit changes. But again, this is another example of the innovation we brought to the GLP-1 space.

因此，我們在五月下旬推出了這個項目，這也是我們一系列創新中的最新一項。我們只有幾個月的市場回饋。到目前為止，回饋都非常積極，但我注意到與該新計劃相關的福利產品的變化更有可能在客戶續約時納入，而不是我們看到的年中福利變化。但同樣，也是我們為 GLP-1 領域帶來的另一個創新例子。

Again, we continue to see growth in this market. The client adoption rates continue to be flattish in our book of business between 2024 and 2025, but the economic contribution is broadly in line with what we had anticipated coming into the year for Evernorth.

我們再次看到這個市場持續成長。2024 年至 2025 年期間，我們業務中的客戶採用率將繼續保持平穩，但經濟貢獻與我們對 Evernorth 今年的預期大致一致。

Thank you. I'll now turn the call back over to David Cordani for closing remarks.

謝謝。現在我將電話轉回給 David Cordani 做最後發言。

Thanks. Just briefly wrap us up. First, we want to thank you again for joining our call. To highlight a couple of headlines. We continue to build on our momentum, and we have confidence in our ability to deliver on our commitments, which include our attractive adjusted EPS outlook of at least $29.60 for full year 2025.

謝謝。請簡單總結一下。首先，我們再次感謝您參加我們的電話會議。重點突出幾個標題。我們將繼續保持良好的發展勢頭，並且有信心能夠兌現我們的承諾，其中包括我們對 2025 年全年至少 29.60 美元的調整後每股收益的預期。

I also want to say how proud I am of our coworkers across the globe and their dedication and commitment to making sure we serve all our diverse stakeholders who we have the privilege to support.

我還想說，我為我們遍布全球的同事感到多麼自豪，他們奉獻並致力於確保我們為我們有幸支持的所有不同利益相關者提供服務。

As an enterprise, we remain focused on executing on our growth strategy by leveraging the strength of our diverse businesses, continue to foster partnerships and drive innovation and systematically work to expand our addressable markets. Thank you again, and have a good day.

作為一家企業，我們將繼續專注於利用多元化業務的優勢來執行我們的成長策略，繼續建立合作夥伴關係，推動創新，並有系統地努力擴大我們的潛在市場。再次感謝您，祝您有美好的一天。

Ladies and gentlemen, this concludes The Cigna Group's second-quarter 2025 results review. Cigna Investor Relations will be available to respond to additional questions shortly. A recording of this conference will be available for 10 business days following this call. You may access the recorded conference by dialing (800) 835-8067 or (203) 369-3354. There is no passcode required for this replay.

女士們、先生們，信諾集團 2025 年第二季業績回顧到此結束。Cigna 投資者關係部將很快回答您的其他問題。本次會議的錄音將在會議結束後 10 個工作天內提供。您可以撥打 (800) 835-8067 或 (203) 369-3354 存取錄製的會議。這次重播不需要密碼。

Thank you for participating. We will now disconnect.

感謝您的參與。我們現在將斷開連接。