信諾集團 (CI) 2025 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by for The Cigna Group's third 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，感謝各位耐心等待，我們將進行信諾集團2025年第三季業績回顧。（操作說明）提醒各位女士、先生，本次會議（含問答環節）正在錄製。

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

首先，我們將把會議交給拉爾夫·賈科貝。請繼續。

Great. Thanks. Good morning, everyone. Thank you 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.

偉大的。謝謝。各位早安。感謝您參加今天的電話會議。我是投資者關係高級副總裁拉爾夫·賈科貝。今天早上和我一起連線的是信諾集團董事長兼首席執行官大衛·科爾達尼；總裁兼首席營運官布萊恩·埃萬科；以及首席財務官安·丹尼森。

In our remarks today, David, Brian and Ann will cover a number of topics, including our third 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 將談到許多主題，包括我們 2025 年第三季的財務表現和我們對 2025 年的財務展望。在發表事先準備好的演講後，David、Brian 和 Ann 將接受問答環節。

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. 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.

正如我們在獲利報告中所述，在描述我們的財務表現時，我們使用了一些財務指標，包括調整後的營業收入和調整後的收入，這些指標並非按照美國公認會計原則（即 GAAP）確定。這些指標與最直接可比較的GAAP指標（股東淨利潤和總收入）的調節表已載於今日發布的盈利報告中，該報告已發佈在thecignagroup.com網站的投資者關係欄位中。我們使用「調整後營業收入」和「調整後每股盈餘」這兩個術語，其基礎與我們衡量主要財務表現的指標相同。

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，我們將發表一些前瞻性聲明，包括有關我們對 2025 年的展望和未來業績的聲明。這些聲明存在風險和不確定性，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發布的收益報告中的警示說明以及我們最近向美國證券交易委員會提交的報告中。

Regarding our results, in the third quarter, we recorded a net after-tax special item benefit of $61 million or $0.23 per share. Additional details of the special items are included in our quarterly financial supplement. 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.

關於我們的業績，第三季度，我們錄得稅後特殊項目淨收益 6,100 萬美元，即每股 0.23 美元。特別項目的更多詳情請參閱我們的季度財務增刊。此外，請注意，當我們對財務表現做出預期評論時，包括我們對 2025 年全年的展望，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。

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

接下來，我將把電話交給大衛。

Thanks, Ralph. Good morning, everyone, and thank you for joining our call. In a highly disruptive market, at The Cigna Group, we continue our track record of sustained growth in 2025, and I'm pleased to report that in the third quarter, The Cigna Group delivered strong results in a continued dynamic environment.

謝謝你，拉爾夫。各位早安，感謝各位參加我們的電話會議。在瞬息萬變的市場中，信諾集團在 2025 年繼續保持持續成長的良好記錄，我很高興地報告，在第三季度，信諾集團在持續動態的環境中取得了強勁的業績。

Today, I'll briefly walk through how we will sustain our growth by accelerating innovation to meet the needs of our customers, clients and partners. We're also introducing new solutions to create meaningful value and impact, including our announcement earlier this week of a new rebate-free model for pharmacy benefits.

今天，我將簡要介紹我們將如何透過加速創新來滿足客戶、合作夥伴的需求，從而保持成長。我們也在推出新的解決方案，以創造有意義的價值和影響，包括本週稍早宣布的新的無回扣藥房福利模式。

Then Brian will provide an update on our performance of our growth platforms as well as provide some perspective on 2026. Then Ann will share some more details on our financial results for the quarter. Then we'll open up for your questions.

然後，布萊恩將介紹我們成長平台的表現情況，並對 2026 年做出一些展望。接下來，安妮將分享更多關於本季財務表現的細節。接下來我們將開放提問環節。

Now let's get started. Third quarter, we delivered revenue of $69.7 billion and adjusted earnings of $7.83 per share, all while continuing to strategically invest in our business to drive growth and innovation. We've also taken further strategic actions to expand our addressable markets and position the company for future growth. One example is our recent investment in Shields Health Solutions completed earlier in September. Brian will share more details on this shortly.

現在我們開始吧。第三季度，我們實現了 697 億美元的收入和每股 7.83 美元的調整後收益，同時我們繼續對我們的業務進行策略性投資，以推動成長和創新。我們也採取了進一步的策略行動，以擴大我們的目標市場，並為公司的未來成長做好準備。例如，我們最近在 9 月初完成了對 Shields Health Solutions 的投資。布萊恩稍後會分享更多細節。

Our performance this quarter also underscores that we continue to deliver for those we serve, consistently navigating through dynamic and challenging environments. For example, this year alone, we publicly committed in February to a series of actions to further ease access to care in a coordinated way for patients and their physicians.

本季的業績也表明，我們繼續為服務對象提供優質服務，並持續應對動態和充滿挑戰的環境。例如，僅今年二月，我們就公開承諾採取一系列行動，以協調的方式進一步方便患者及其醫生獲得醫療服務。

Then we stepped forward to partner with HHS Secretary Kennedy and CMS Administrator Oz, along with others, on a broad set of initiatives that will create a more seamless access to care environment and care continuity for Americans, for example, when they switch health plans.

然後，我們挺身而出，與美國衛生與公眾服務部部長肯尼迪和醫療保險和醫療補助服務中心主任奧茲以及其他人士合作，開展了一系列廣泛的舉措，旨在為美國人創造更順暢的就醫環境和醫療連續性，例如，當他們更換醫療計劃時。

Additionally, earlier this month, Evernorth fertility pharmacies worked with the Trump administration and EMD Serono to make fertility treatments more accessible for Americans struggling to start or expand their families. And just this week, we announced our transformative new rebate-free delinked model. Our Pharmacy Benefit Services here are designed to improve health care affordability and the experience for tens of millions of Americans.

此外，本月初，Evernorth 生育藥房與川普政府和 EMD Serono 合作，使那些努力組建或擴大家庭的美國人更容易獲得生育治療。就在本週，我們宣布了具有變革意義的全新無返利脫鉤模式。我們提供的藥房福利服務旨在提高數千萬美國人的醫療保健可負擔性和就醫體驗。

Our durable business model is designed to evolve, flex and thrive through a variety of changes, whether economic, regulatory, legislative or evolving technologies. Today, the powerful forces of change across health care are accelerating and converging around long-standing challenges, particularly balancing access and affordability for consumers and patients. Drug pricing continues to create a significant affordability challenge and has become an even more intense part of the public dialogue in 2025.

我們可持續的商業模式旨在透過各種變化不斷發展、靈活調整並蓬勃發展，無論是經濟、監管、立法還是不斷發展的技術。如今，醫療保健領域的強大變革力量正在加速發展，並圍繞著長期存在的挑戰匯聚在一起，尤其是在平衡消費者和患者的就醫便利性和可負擔性方面。藥品定價問題持續造成民眾對藥品可負擔性的重大挑戰，並已成為2025年公眾討論的焦點。

One area where we've helped address affordability relates to generic drugs, with Americans today enjoying the lowest prices in the world for these medications. In fact, generic drugs now account for 90% of all prescriptions. And on average, they are one-third cheaper in the United States than in other countries. And pharmacy benefit managers and the industry as a whole have played a key role in contributing to these lower costs by leveraging a competitive environment for clinically equivalent drugs.

我們在解決藥品價格可承受性問題的一個領域是仿製藥，如今美國人享受著世界上最低的仿製藥價格。事實上，仿製藥目前佔所有處方藥的90%。而且平均而言，它們在美國的價格比在其他國家便宜三分之一。藥品福利管理機構和整個產業透過利用臨床等效藥物的競爭環境，在降低這些成本方面發揮了關鍵作用。

Now on the other hand, prices for brand-name medications continue to skyrocket, with those drugs that do not have a generic equivalent costing four times as much as the same drug in European markets. And in 2025, it's estimated that the median price set by drug companies for new FDA-approved drugs is projected to be approximately $390,000 per treatment course. As a result of these marketplace dynamics, even though brand name drug medications comprise only 10% of overall pharmaceutical volumes in the United States, they account for 88% of the spend.

另一方面，品牌藥的價格持續飛漲，那些沒有仿製藥的藥物在歐洲市場的價格是同類藥物的四倍。據估計，到 2025 年，製藥公司為獲得 FDA 批准的新藥設定的平均價格預計為每個療程約 39 萬美元。由於這些市場動態，儘管品牌藥在美國藥品總量中僅佔 10%，但卻佔藥品支出的 88%。

In recent weeks, President Trump announced a series of initiatives aimed at lowering the cost of brand name medications, bringing the US prices in line with those paid in other developed countries. We are aligned with these efforts and seek to expand access for all our clients, from employers to health plans and governmental plans so that even more Americans can benefit from fair pricing on their prescriptions.

最近幾週，川普總統宣布了一系列旨在降低品牌藥價格的舉措，使美國的藥品價格與其他已開發國家的價格保持一致。我們與這些努力保持一致，並致力於擴大所有客戶的獲取途徑，從雇主到健康計劃和政府計劃，以便讓更多美國人能夠享受到處方藥的合理價格。

Additionally, similar to our work to reduce pricing in generics, we continue to advocate for necessary changes to accelerate and broaden access to biosimilars, which boosts competition and lowers prices further. For example, the list price of HUMIRA is approximately $7,000 a month. That approaches $85,000 a year for this single medication. Thanks to our innovative offering, we provide customers with HUMIRA at a biosimilar level at no cost to the individual consumer.

此外，與我們降低仿製藥價格的工作類似，我們繼續倡導必要的變革，以加快和擴大生物相似藥的獲取途徑，從而促進競爭並進一步降低價格。例如，HUMIRA 的標價約為每月 7,000 美元。單單這種藥，每年就要花費近 85,000 美元。由於我們的創新產品，我們為客戶提供生物相似藥水平的 HUMIRA，而個人消費者無需支付任何費用。

From a consumer point of view, that's real value and that's innovation that matters. Even with these efforts, we continue to advance change for the benefit of our customers, clients and patients. We've deliberately shaped our well-balanced portfolio of businesses across two growth platforms at The Cigna Group, Cigna Healthcare and Evernorth Health Services. As a reminder, Cigna Healthcare is approximately 40% of our enterprise earnings. And in Evernorth, Specialty & Care and Pharmacy Benefit Services are approximately 30% each.

從消費者的角度來看，這才是真正的價值，這才是真正重要的創新。即便如此，我們仍將繼續推動變革，以造福我們的客戶、顧客和患者。我們精心打造了信諾集團旗下兩大成長平台－信諾醫療保健和永諾健康服務－的均衡業務組合。再次提醒，Cigna Healthcare 約占我們企業收益的 40%。在 Evernorth，專科護理和藥房福利服務各佔約 30%。

So 70% of our portfolio, Cigna Healthcare and Specialty & Care Services, remains well positioned for growth in 2026 and beyond. And to future-proof our company within our Pharmacy Benefit Services, we continue to take significant actions.

因此，我們投資組合中的 70%（信諾醫療保健和專科護理服務）在 2026 年及以後仍將保持良好的成長動能。為了確保公司在藥局福利服務領域能夠持續發展，我們將繼續採取重大措施。

First, we proactively secured a number of long-term large client renewals and extensions including the US Department of Defense, Prime Therapeutics, and Centene. We're pleased to be able to serve them and their customers and patients now and through the end of the decade and beyond.

首先，我們積極主動地爭取了多個長期大客戶的續約和延期，包括美國國防部、Prime Therapeutics 和 Centene。我們很高興能夠為他們、他們的客戶和患者提供服務，從現在到本世紀末乃至更遠的未來。

Second, we've stepped forward with our new simple and transparent model for Pharmacy Benefit Services, which will replace the complex post-purchase rebate process with a simple upfront discount, which will enable customers and patients to automatically pay the lowest price at the counter, whether through their benefit or on a cash pay basis and apply their payments to their deductible.

其次，我們推出了全新的、簡單透明的藥房福利服務模式，該模式將以簡單的預付折扣取代複雜的購買後返利流程，使顧客和患者能夠自動在櫃檯支付最低價格，無論是透過他們的福利還是現金支付，並將他們的付款用於他們的自付額。

And importantly, we continue to provide approximately 18,000 clinical safety checks as well as care coordination programs, which are essential for Americans who are taking multiple prescription medications that may have dangerous interactions.

更重要的是，我們繼續提供約 18,000 次臨床安全檢查以及護理協調計劃，這對於服用多種處方藥可能存在危險相互作用的美國人來說至關重要。

To make the benefits of this model even more evident, consider this, for Americans and health plans where they pay the full cost of medications, including, for example, high deductible plans, our new model will reduce the cost for a brand-name drug prescription on average 30%. This will be real savings for the consumers, and they'll see it right at the counter.

為了更清楚地說明這種模式的好處，請考慮以下情況：對於支付全部藥品費用的美國人和健康計劃（例如，高免賠額計劃），我們的新模式將使品牌藥處方的費用平均降低 30%。這將為消費者節省實實在在的費用，結帳時就能立刻看到這一點。

Cigna Healthcare will adopt this model 100% for fully insured lives beginning in 2027, and it will become our standard offering broadly for The Cigna Group to the marketplace starting in January 2028 and we expect to transition at least 50% of our book of business into this new model by the end of 2028.

信諾醫療保健將從 2027 年開始 100% 為全額投保人採用此模式，並將從 2028 年 1 月起成為信諾集團面向市場的標準產品，我們預計到 2028 年底，至少 50% 的業務將過渡到這種新模式。

Consistent with this direction, we are also creating a more sustainable economic model for independent pharmacists we contract with. We understand the critical role these clinicians play in health care, particularly in rural and at-risk communities and commit to continuing to support them with fair competitive pricing reimbursements for dispensing medications, as well as clinical services they provide for customers and patients.

與此方向一致，我們也在為我們簽約的獨立藥劑師創造一個更永續的經濟模式。我們了解這些臨床醫生在醫療保健中發揮的關鍵作用，尤其是在農村和高風險社區，並承諾繼續為他們提供公平、有競爭力的藥品價格報銷，以及他們為顧客和患者提供的臨床服務報銷。

Further, the combination of market forces and our capabilities position us to proactively drive these long-term strategic renewals, extensions, and program transformations to positively impact the marketplace for years to come.

此外，市場力量和我們自身能力的結合，使我們能夠積極推動這些長期策略續約、延期和專案轉型，從而在未來幾年對市場產生積極影響。

Now over the next two years, we will invest to support these renewals, extensions and innovations. These investments will support recontracting efforts across many clients and supply chain partners, technology improvements, process reengineering, as well as building and further enhancing data and analytical capabilities.

接下來兩年，我們將加大投資，支持這些更新、擴展和創新。這些投資將支持與眾多客戶和供應鏈合作夥伴的重新簽約工作、技術改進、流程重組，以及建構和進一步增強數據和分析能力。

Additionally, given the significant financial and affordability pressures for partners operating heavily in government programs, we have proactively improved the economic terms of the contracts for the benefit of these long-term strategic clients.

此外，考慮到在政府專案中大量營運的合作夥伴面臨著巨大的財務和負擔能力壓力，我們已主動改善合約的經濟條款，以使這些長期戰略客戶受益。

As a result of these factors, we expect margin pressure within our Pharmacy Benefit Services segment over the next two years. To be clear, we expect a sustained and durable growth trajectory over the long term for the business. I also want to be clear, even with these significant investments, we expect to grow EPS in 2026.

受上述因素影響，我們預計未來兩年內，我們的藥局福利服務部門的利潤率將面臨壓力。需要明確的是，我們預期該業務將在長期內保持持續穩定的成長動能。我還要明確一點，即使進行了這些重大投資，我們預計 2026 年每股盈餘仍將成長。

Brian will discuss this further in a few minutes when he addresses our tailwinds and headwinds. All these actions demonstrate the commitment and resolve from The Cigna Group to build a better future and sustain our growth and impact.

布萊恩將在幾分鐘後談到我們面臨的順風和逆風時，進一步討論這個問題。所有這些措施都體現了信諾集團致力於建立更美好未來、維持成長和影響力的決心和毅力。

Now to wrap up, against the backdrop of a dynamic and challenging environment, our third quarter results and our reaffirmed EPS outlook of at least $29.60 underscores the strength of our diverse portfolio of businesses and sustained disciplined execution and focus.

最後總結一下，在充滿活力和挑戰的環境下，我們第三季度的業績以及我們重申的每股收益至少為 29.60 美元的預期，凸顯了我們多元化業務組合的實力以及持續嚴謹的執行力和專注度。

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

接下來，我將把電話交給布萊恩。

Thank you, David. Good morning, everyone. I'll start by emphasizing our continued performance and delivery through a dynamic operating environment. Our strong fundamentals, disciplined focus on execution, and innovative mindset position us to continue demonstrating leadership for the benefit of those we serve and to build a more sustainable model for health care. Our continued success is rooted in the reasons our clients choose to partner with us, our breadth of capabilities, our clinical excellence and our benefit plan administration.

謝謝你，大衛。各位早安。首先，我要強調的是，在瞬息萬變的營運環境下，我們依然保持著良好的績效與交付能力。我們強大的基本面、嚴謹的執行力和創新的思維方式，使我們能夠繼續展現領導力，造福我們所服務的人群，並建立更永續的醫療保健模式。我們持續成功的根源在於客戶選擇與我們合作的原因、我們廣泛的能力、我們卓越的臨床水平以及我們完善的福利計劃管理。

Taken together, our expertise in these areas enables us to provide access to quality health services and prescription drugs at lower unit costs than clients could achieve on their own, helping them meet their affordability goals, programs and services that deliver personalized care and prioritize patient safety, and efficient and effective management of their complex benefit plans.

綜合來看，我們在這些領域的專業知識使我們能夠以比客戶自行獲取更低的單位成本提供優質的醫療服務和處方藥，幫助他們實現負擔能力目標，提供個性化護理並優先考慮患者安全的計劃和服務，以及高效、有效地管理其複雜的福利計劃。

Today, I'm going to cover two things. First, I will go through our third quarter performance across our businesses, and then I'll touch briefly on the tailwinds and headwinds we see for 2026.

今天，我要講兩件事。首先，我將介紹我們各業務部門第三季的業績，然後簡要談談我們認為 2026 年的利好因素和不利因素。

Let's begin with our performance in Evernorth and Cigna Healthcare. Evernorth Health Services delivered earnings in line with expectations in the third quarter. Our Specialty and Care Services businesses had another strong quarter where we delivered 11% adjusted earnings growth, reflecting our ability to deliver meaningful value to those we serve.

讓我們先來看看我們在 Evernorth 和 Cigna Healthcare 的表現。Evernorth Health Services 第三季獲利符合預期。我們的專業護理服務業務又迎來了一個強勁的季度，調整後收益成長了 11%，這反映了我們為服務對象創造有意義價值的能力。

Already this year, our specialty pharmacies have delivered approximately 7 million prescriptions, growing at a double-digit rate from last year. And we are continuing to see a strong shift to biosimilars for HUMIRA and STELARA, saving patients millions of dollars in out-of-pocket costs.

今年以來，我們的特藥藥房已交付約 700 萬份處方，比去年實現了兩位數的成長。我們持續看到 HUMIRA 和 STELARA 的生物相似藥的使用量大幅增加，為患者節省了數百萬美元的自付費用。

This quarter, we also completed a strategic investment in Shields Health Solutions, further expanding our existing specialty capabilities to serve health systems, hospitals, and other providers. We're excited about the multiple future opportunities in the over $400 billion specialty market.

本季度，我們也完成了對 Shields Health Solutions 的策略性投資，進一步擴展了我們現有的專業能力，以服務醫療系統、醫院和其他醫療服務提供者。我們對超過 4000 億美元的特種產品市場蘊藏的眾多未來機會感到興奮。

With our investment in Shields, we are enhancing our ability to serve the provider-administered portion of the specialty market, which today represents approximately 40% of the specialty space. This addressable market has strong secular growth and our investment in Shields will enable us to accelerate our strategy in the hospital and health systems segment that Shields serves. We're also pleased to be part of an effort by the Trump administration to make fertility treatments more affordable for Americans.

透過對 Shields 的投資，我們增強了服務於專科市場中由醫療服務提供者管理的細分市場的能力，該細分市場目前約佔專科市場的 40%。這個目標市場具有強勁的長期成長潛力，我們對 Shields 的投資將使我們能夠加速在 Shields 所服務的醫院和醫療系統領域的策略實施。我們也很高興能參與川普政府為降低美國人生育治療費用所做的努力。

As David noted, earlier this month, we announced that in conjunction with the launch of TrumpRx, we will expand our successful partnership with EMD Serono to deliver fertility treatments from our Evernorth fertility pharmacies in 2026, providing lower cost and differentiated clinical capabilities for the benefit of patients. All in, we see a number of growth opportunities in our Specialty &Care Services business. With our combined suite of capabilities across Accredo, CuraScript SD and CarepathRx, we have opportunities to enhance and expand the ways we support specialty for all stakeholders.

正如大衛在本月初指出的那樣，我們宣布，隨著 TrumpRx 的推出，我們將擴大與 EMD Serono 的成功合作，於 2026 年透過我們的 Evernorth 生育藥房提供生育治療，從而為患者提供更低成本和差異化的臨床能力。總而言之，我們看到了我們在專業護理服務業務方面的一些成長機會。憑藉 Accredo、CuraScript SD 和 CarepathRx 的全面能力，我們有機會加強和擴展我們為所有利害關係人提供專業支援的方式。

Now I'll turn to our second major platform within Evernorth, our Pharmacy Benefit Services business. We are proactively transforming our pharmacy benefits model to meet the demands of the market and improve affordability and experiences for our customers and patients. We're also seeing strong client retention and demand for our services. And as the 2026 selling season comes to a close, we expect approximately 97% retention in our Pharmacy Benefit Services business.

現在我將介紹 Evernorth 的第二個主要平台——我們的藥房福利服務業務。我們正在積極轉變我們的藥房福利模式，以滿足市場需求，並提高客戶和患者的負擔能力和體驗。我們也看到客戶留存率很高，對我們服務的需求也很旺盛。隨著 2026 年銷售季的結束，我們預期藥局福利服務業務的客戶留存率將達到約 97%。

During 2025, we proactively executed renewals and extensions with our largest clients, including Prime Therapeutics and Centene, building on our previous extension with the Department of Defense. We recognize there are significant financial and affordability pressures for partners operating heavily in the government programs market.

2025 年，我們積極主動地與包括 Prime Therapeutics 和 Centene 在內的最大客戶續簽和延期合同，並在此基礎上，進一步延長了我們之前與美國國防部的合同。我們認識到，在政府專案市場中大量營運的合作夥伴面臨著巨大的財務和支付能力壓力。

We have proactively improved the economic terms of the contracts for the benefit of these long-term strategic clients. We're pleased to have these partnerships secured through the end of the decade, given their attractive long-term economics. Separately, we're also continuing to see positive impact from our suite of GLP-1 offerings, EncircleRx, EnReachRx and the new EnGuide pharmacy.

我們積極改善合約的經濟條款，以使這些長期策略客戶受益。鑑於這些合作關係具有良好的長期經濟效益，我們很高興能夠確保這些合作關係持續到本十年末。此外，我們的 GLP-1 產品系列 EncircleRx、EnReachRx 和新的 EnGuide 藥局也持續產生正面影響。

These offerings are anchored around affordability, access, clinical support, and patient safety. This includes access to FDA-approved medicines, prioritizing adherence, proper dosing, and a focus on diet and exercise to ensure durable lasting results for our patients.

這些服務以價格合理、方便取得、臨床支援和病人安全為核心。這包括 FDA 批准的藥物、優先考慮依從性、正確劑量，以及注重飲食和運動，以確保我們的患者獲得持久的效果。

Across Evernorth, we had a solid quarter as we continue to grow our Specialty & Care capabilities and invest in our Pharmacy Benefit Services model, strengthening our leadership position and delivering solutions for the future. In Cigna Healthcare, we delivered financial results that were in line with expectations, underscoring the resilience of our portfolio and business mix, even in an environment of persistently elevated medical costs.

在整個 Evernorth 集團，我們本季業績穩健，我們不斷提升專業護理能力，並投資於藥房福利服務模式，從而鞏固了我們的領導地位，並為未來提供解決方案。在 Cigna Healthcare，我們實現了符合預期的財務業績，凸顯了我們投資組合和業務組合的韌性，即使在醫療成本持續高企的環境下也是如此。

This performance reflects our ability to navigate dynamic market conditions while delivering on our commitments to those we serve, along with targeted customer growth, including an 8% increase in our Under 500 Select segment, and continued strong performance in International Health.

這項業績反映了我們能夠在動態的市場環境中游刃有餘，同時履行對客戶的承諾，並實現有針對性的客戶成長，包括500歲以下精選客戶群增長8%，以及國際健康業務的持續強勁表現。

As it relates to the medical care ratio, we were pleased with solid performance in the quarter from our US Employer business, including stop loss, which performed in line with expectations. Our overall Cigna Healthcare segment-wide medical care ratio was 84.8% for the quarter, driven by an updated view of risk adjustment in our Individual Exchange business. Across all of our Cigna Healthcare customers and clients, bending the cost curve and delivering affordability is more critical than ever.

就醫療保健比率而言，我們對美國雇主業務（包括止損業務）本季的穩健表現感到滿意，其表現符合預期。本季度，Cigna Healthcare 整體醫療保健比率為 84.8%，這主要得益於我們對個人交易所業務風險調整的最新看法。對於我們所有信諾醫療保健的客戶而言，控製成本成長和提供可負擔的醫療服務比以往任何時候都更重要。

As I noted, our clinical expertise and support programs are key reasons why our clients choose to partner with us. We're investing in predictive capabilities that allow us to engage our customers at the right time to support their care needs more effectively. We also enable clients and customers to access high-performing providers through value-based reimbursement models that align incentives and drive better outcomes. In Cigna Healthcare, we're proud to have delivered another solid quarter, fueled by the strength and diversity of our portfolio and our operational focus.

正如我所提到的，我們的臨床專業知識和支援計劃是客戶選擇與我們合作的關鍵原因。我們正在投資預測能力，以便能夠在適當的時間與客戶互動，從而更有效地滿足他們的護理需求。我們還透過基於價值的報銷模式，使客戶能夠獲得高績效的醫療服務提供者，從而協調激勵機制並推動更好的結果。信諾醫療保健公司很自豪地宣布，在強大的產品組合和多元化的經營理念的推動下，我們又取得了穩健的季度業績。

Next, I'll share a view of some of the tailwinds and headwinds we anticipate for 2026. Notable tailwinds include continued strong growth of our Specialty & Care businesses, including our investment in and partnership with Shields Health Solutions. In Cigna Healthcare, consistent with prior commentary, we took corrective action to reprice the stop loss business beginning early this year and expect to benefit from margin expansion within that business in 2026.

接下來，我將分享我們對 2026 年一些有利因素和不利因素的看法。顯著的利多因素包括我們專科護理業務的持續強勁成長，包括我們對 Shields Health Solutions 的投資和合作。與先前的評論一致，在 Cigna Healthcare，我們從今年年初開始採取糾正措施，重新定價止損業務，並預計將在 2026 年受益於該業務利潤率的擴張。

Turning to headwinds. In Evernorth, the aforementioned renewals and extensions will generate a modified margin profile going forward for these large clients. And our new rebate-free pharmacy benefits model will incur short-term investment and transition costs, including for technology and operational reconfiguration as we accelerate transformative change. And within Cigna Healthcare, the absence of nonrecurring benefits in 2025, specifically related to our divested Medicare businesses as well as our Individual Exchange business.

逆風而行。對 Evernorth 而言，上述續約和延期將為這些大客戶帶來未來利潤率的變化。我們新的無回扣藥房福利模式將產生短期投資和過渡成本，包括技術和營運重組成本，因為我們將加速變革。而對於 Cigna Healthcare 而言，到 2025 年將不再提供非經常性福利，特別是與我們剝離的 Medicare 業務以及我們的個人保險交易業務相關的福利。

Taking these factors all together, overall, we expect EPS growth in 2026. In Evernorth, we expect operating income to be slightly down in 2026. Our Specialty & Care Services business will grow income towards the higher end of its long-term growth target, offset by a decline in Pharmacy Benefit Services. In Cigna Healthcare, we expect operating income to grow towards the higher end of its long-term growth target.

綜合以上因素，我們預期 2026 年每股盈餘將成長。在 Evernorth，我們預計 2026 年的營業收入將略有下降。我們的專科護理服務業務收入將朝著長期成長目標的較高水平增長，但藥房福利服務收入的下降將抵消這一增長。我們預期信諾醫療保健的營業收入將成長至其長期成長目標的較高水準。

As I wrap up, I'd like to reiterate some bright spots for the quarter. We continue to deliver strong business performance and operational execution even in a dynamic environment. Evernorth continues to see strong growth in specialty, and we delivered 11% adjusted earnings growth within Specialty & Care services, reflecting the strength of our capabilities and clinical expertise.

最後，我想重申本季的一些亮點。即使在瞬息萬變的環境中，我們仍能維持強勁的業務表現和營運效率。Evernorth 在專業領域持續保持強勁成長，我們在專業護理服務領域實現了 11% 的調整後收益成長，這反映了我們強大的能力和臨床專業知識。

We're proactively bringing market-leading innovations such as our new rebate-free de-linked fee-based pharmacy benefits model that will deliver more value to customers and clients and simplify our economic model.

我們正在積極引入市場領先的創新，例如我們全新的無回扣、非關聯、基於費用的藥房福利模式，這將為客戶和顧客帶來更多價值，並簡化我們的經濟模式。

We've also extended our relationships with our three largest Evernorth clients through the end of the decade, providing further multi-year predictability. And Cigna Healthcare is successfully navigating a dynamic environment and delivering on our financial commitments, with notable strong medical customer growth in our Select segment.

我們也與 Evernorth 的三大最大客戶延長了合作關係，直至本十年末，從而提供了更多多年的可預測性。Cigna Healthcare 成功地應對了瞬息萬變的環境，並履行了我們的財務承諾，尤其是在 Select 細分市場，我們的醫療客戶實現了顯著強勁的成長。

Overall, we remain confident in the growth opportunities ahead, supported by strong fundamentals and secular tailwinds that position us to deliver even greater value for our customers, clients and shareholders.

整體而言，我們對未來的成長機會仍然充滿信心，強勁的基本面和長期利好因素將使我們能夠為客戶、合作夥伴和股東創造更大的價值。

Now I'll turn it over to Ann.

現在我把麥克風交給安。

Thank you, Brian, and good morning, everyone. Today, I will review Cigna's third quarter 2025 results and discuss our outlook for the full year, which we reaffirmed this morning. As David and Brian mentioned, our strong third quarter results demonstrate our ability to execute and deliver on our financial commitments in a dynamic environment.

謝謝你，布萊恩，大家早安。今天，我將回顧信諾保險 2025 年第三季的業績，並討論我們對全年的展望，我們今天早上已經重申了這一展望。正如大衛和布萊恩所提到的，我們強勁的第三季業績證明了我們有能力在動態的環境中執行並履行我們的財務承諾。

Key consolidated financial highlights for the third quarter include revenues of $69.7 billion and adjusted earnings per share of $7.83. Our performance through the first three quarters gives us the confidence to deliver on our full year 2025 adjusted earnings per share outlook of at least $29.60.

第三季主要合併財務亮點包括營收697億美元及調整後每股收益7.83美元。前三個季度的業績使我們有信心實現2025年全年調整後每股收益至少29.60美元的預期目標。

Now turning to our segment results. I will start with Evernorth. Third quarter 2025 revenues grew to $60.4 billion, while pre-tax adjusted earnings grew to $1.9 billion, in line with expectations. Specialty & Care Services continues to deliver strong growth with revenues up 10% to $26.3 billion and pre-tax adjusted earnings up 11% to $928 million, consistent with expectations. This performance reflects strong specialty volume growth and increased biosimilar adoption.

現在來看我們各細分市場的業績。我先從 Evernorth 開始。2025 年第三季營收成長至 604 億美元，稅前調整後收益成長至 19 億美元，符合預期。專業護理服務業務持續保持強勁成長，營收成長 10% 至 263 億美元，稅前調整後收益成長 11% 至 9.28 億美元，符合預期。這一業績反映了特藥銷售的強勁成長和生物相似藥採用率的提高。

We continue to see drugs used to treat inflammatory conditions, advanced pulmonary conditions, rare diseases and infertility as some of the drug classes that have seen the largest increases in utilization. As these trends continue, we remain well positioned to build on this momentum leveraging our expertise in specialty to drive affordability and strong clinical outcomes for our clients and patients.

我們持續看到，用於治療發炎性疾病、晚期肺部疾病、罕見疾病和不孕症的藥物，是使用量成長最快的藥物類別之一。隨著這些趨勢的持續，我們將繼續保持良好的發展勢頭，利用我們在專業領域的專業知識，為我們的客戶和患者帶來可負擔的價格和良好的臨床效果。

In our Pharmacy Benefit Services business, revenues were $34.1 billion and pre-tax adjusted earnings were $1 billion, in line with expectations. Pharmacy Benefit Services results in the third quarter reflect the rate and pace of investments including initiatives to improve the patient experience and accelerated biosimilar adoption, consistent with our prior commentary. Taken together, we are pleased with the performance of Evernorth in the third quarter.

在我們的藥房福利服務業務中，收入為 341 億美元，稅前調整後收益為 10 億美元，符合預期。第三季藥局福利服務績效反映了投資的速度和步伐，包括改善病患體驗和加速生物相似藥推廣的舉措，這與我們先前的評論一致。總的來說，我們對 Evernorth 在第三季的表現感到滿意。

Turning to Cigna Healthcare. Third quarter 2025 revenues were $10.9 billion, and pre-tax adjusted earnings were $1 billion. Cigna Healthcare pre-tax adjusted earnings were in line with expectations. Overall, results in our US Employer business, including stop loss and our International business were consistent with expectations, while our Individual business had an impact on our medical care ratio of 84.8%, reflecting an updated view of risk adjustment revenue. The higher medical care ratio in the quarter was offset by operating cost efficiencies.

轉而選擇信諾醫療保健。2025 年第三季營收為 109 億美元，稅前調整後盈餘為 10 億美元。信諾醫療保健公司稅前調整後收益符合預期。總體而言，我們的美國雇主業務（包括停損業務）和國際業務的業績符合預期，而我們的個人業務對我們的醫療保健比率產生了 84.8% 的影響，反映了風險調整收入的最新看法。本季較高的醫療保健費用率被營運成本效率的提高所抵銷。

Now turning to our outlook for full year 2025. Given the strength of our results through the first three quarters, we have the confidence to reaffirm our full year 2025 expectation for consolidated adjusted earnings per share of at least $29.60.

現在讓我們展望一下2025年全年。鑑於前三個季度業績強勁，我們有信心重申我們對 2025 年全年綜合調整後每股收益至少為 29.60 美元的預期。

Our full year 2025 outlook for pre-tax adjusted earnings for each of our reporting segments remains unchanged. In Cigna Healthcare, we now expect our full year medical care ratio to be at the high end of our full year guidance range of 83.2% to 84.2%. This is driven by a higher expected MCR in our individual business.

我們對2025年全年各申報分部稅前調整後收益的預期維持不變。在 Cigna Healthcare，我們現在預計全年醫療保健比率將達到全年指引範圍 83.2% 至 84.2% 的高端。這是由於我們各業務部門的預期MCR較高所致。

Turning to our 2025 capital management position. Third quarter operating cash flow was $3.4 billion, and we continue to expect strong cash flow from operations in the fourth quarter, similar to the pattern we observed last year. Our debt-to-capitalization ratio was 44.9% as of September 30, 2025. The increase primarily reflects the impact of debt issuance associated with our investment in Shields Health Solutions. We continue to target a long-term debt to capitalization ratio of approximately 40%, and we expect to progress towards this target in the fourth quarter.

接下來談談我們對2025年的資本管理計畫。第三季經營現金流為 34 億美元，我們繼續預期第四季經營現金流將保持強勁，與我們去年觀察到的模式類似。截至 2025 年 9 月 30 日，我們的負債資本比率為 44.9%。此次成長主要反映了我們對與 Shields Health Solutions 的投資相關的債務發行的影響。我們繼續以長期債務資本比率約為 40% 為目標，並預計在第四季度將朝著這一目標邁進。

Looking ahead to 2026, we expect another year of strong growth in Cigna Healthcare and Specialty & Care Services, both at the higher end of our respective long-term growth target. And as David and Brian mentioned, we are proud to lead the industry with the proactive transformation of our new rebate-free pharmacy benefit model, which positions us for durable and sustainable long-term growth.

展望 2026 年，我們預計 Cigna Healthcare 和 Specialty & Care Services 將繼續保持強勁成長，兩項業務都將達到我們各自的長期成長目標的較高水平。正如大衛和布萊恩所提到的，我們很自豪能夠引領業界，積極轉型推出新的無回扣藥房福利模式，這將使我們實現持久和可持續的長期成長。

Due to the deliberate investments we anticipate making to implement this new model and the renewals and extensions of our largest clients, we expect adjusted operating income in Pharmacy Benefit Services to decline in 2026.

由於我們預計將進行有計劃的投資來實施這一新模式，以及我們最大客戶的續約和延期，我們預計 2026 年藥房福利服務的調整後營業收入將會下降。

Regarding our capital management position, we expect cash flow from operations in 2026 to be back-half weighted, consistent with the 2025 pattern. Taken together, we expect EPS to grow in 2026. We look forward to providing further details on our 2026 outlook on our fourth quarter earnings call.

關於我們的資本管理狀況，我們預期 2026 年的經營活動現金流將以下半年為主，與 2025 年的模式一致。綜合來看，我們預期 2026 年每股盈餘將會成長。我們期待在第四季財報電話會議上提供有關我們2026年展望的更多細節。

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

接下來，我們將把電話交給接線生進行問答環節。

(Operator Instructions)

（操作說明）

Lisa Gill, JPMorgan.

Lisa Gill，摩根大通。

Thanks very much and good morning. Obviously, a lot to unpack on the pharmacy side of the business. So first, I just want to make sure I understand a few things. One, we've heard from a competitor around rebate guarantees. From my memory, I don't recall Express Scripts ever having specific guarantees around rebates. So I want to clarify that that's the case.

非常感謝，早安。顯然，藥局業務方面有很多問題需要探討。首先，我想確認一下我是否理解了某些事情。第一，我們從競爭對手那裡聽說了有關退款保證的問題。就我記憶所及，我不記得 Express Scripts 曾經對返利做出任何具體保證。所以我想澄清一下，情況確實如此。

And then secondly, when we think about the renewal pricing going into next year, the shift over to the new rebate-free model, I really want to understand the economics. Is it that as we move into next year, there is an incremental element to the renewal pricing? And then longer term, how do we think about those economics? And then when we put this all together, I think your long-term growth rate for Evernorth was 5% to 8% EBIT growth. Are you saying we're going to take a step back from that in '26, but the plan is to get there in this new model longer term? I know that's a lot, but I'm just trying to unpack all this.

其次，當我們考慮明年的續約定價，以及轉向新的無回饋模式的轉變時，我真的很想了解其中的經濟原理。是不是到了明年，續費價格會有遞增的因素？那麼從長遠來看，我們該如何看待這些經濟問題呢？綜上所述，我認為 Evernorth 的長期成長率為 5% 至 8% 的息稅前利潤成長率。你是說我們在 2026 年會放棄這個目標，但從長遠來看，計畫是透過這種新模式實現目標嗎？我知道資訊量很大，但我只是想把這一切理清楚。

Lisa, good morning, it's David. It is a lot. And clearly, there's a lot going on in the space. Let me come to a couple of headlines for you first and foremost. The new model that we just walked through is a model that we're extremely excited about.

麗莎，早安，我是大衛。數量很多。顯然，這個領域有很多事情正在發生。首先，讓我先來跟大家介紹幾個重要新聞標題。我們剛才介紹的這個新模型，我們感到非常興奮。

I'm personally proud of our team's ability to step back and architect the new model of the future that is fee-based, de-linked, transparent and has the mechanism to have the lowest available price for the consumer at the counteron each transaction. And it's highly aligned with the regulatory priorities of the day. So that's frame one. To the core of your question, there's a few pieces in there. Our long-term algorithm for the Evernorth portfolio stays intact, number one.

我個人為我們團隊能夠退後一步，建立未來的新模式而感到自豪。這種模式以收費為基礎，與現有模式脫鉤，透明化，並且具有在每次交易中為消費者提供最低可用價格的機制。這與目前的監管重點高度契合。這是第一幀。你的問題的核心包含幾個面向。第一，我們針對 Evernorth 投資組合的長期演算法保持不變。

Two, for 2026, Evernorth will not be on that long-term growth algorithm. Specialty & Care will be, and it will be at the high end of its growth algorithm. The segment as a whole, Evernorth as a whole, will not be. Specifically focus on the PBS segment of our portfolio for the two reasons we talked about, significant investments in building these new sets of capabilities and the proactive actions we've taken around renewals and strategic extension of contracts, acknowledging the significant challenges of those that are serving the government-sponsored marketplace. We believe that the combination of those two actions materially future-proof that business for many years to come and are highly responsive to where the market needs to go.

第二，到 2026 年，Evernorth 將不會採用長期成長演算法。專科護理業務將會如此，並且會處於其成長演算法的高端。整個板塊，或者說整個 Evernorth 公司，都不會是。特別關注我們投資組合中的 PBS 部分，原因有二：一是我們在構建這些新能力方面進行了大量投資；二是我們在合約續約和策略性延期方面採取了積極主動的行動，同時我們也認識到服務於政府資助市場的公司所面臨的重大挑戰。我們相信，這兩項措施的結合，能實際保障企業在未來許多年的發展，並能對市場的發展方向做出快速反應。

To the last part of your question, and then I'll ask Brian to add any go-to-market comments specifically around value proposition to some of our stakeholders. The initial part of your question was around guarantees. Yes. There are instances where different dimensions of offerings have guarantees. We've not spent time with you all talking about guarantee volatility because, by and large, the aggregate relationships we have with our clients over many years and the value we've delivered for our clients has performed in a dynamic and volatile environment.

關於您問題的最後一部分，我會請 Brian 就價值主張方面，向我們的一些利害關係人補充一些行銷方面的評論。你問題的第一部分是關於擔保的。是的。有些情況下，不同維度的產品或服務都享有相應的保障。我們沒有花時間與大家討論擔保波動性，因為總的來說，多年來我們與客戶建立的整體關係以及我們為客戶創造的價值，在動態和波動的環境中都表現出色。

So -- but it's never been a headline that we've needed to bring to you on a regular basis. Importantly, ending where I started, the new model that we're building takes all that out of the equation. Rebates no longer exist. Reimbursements are no longer linked. They are transparent and fee-based, and they are highly aligned to the consumer low cost at the counter, which is why we're so passionate about it.

所以——但這從來都不是我們需要定期報道的新聞頭條。重要的是，回到我最初的出發點，我們正在建立的新模型消除了所有這些因素。已不再提供折扣。報銷不再與此掛鉤。它們透明且按費用收取，並且與消費者在櫃檯支付的低成本高度契合，這就是我們如此熱衷於此的原因。

Brian, maybe ask you to just highlight a few more of the benefits for our stakeholders on the new model.

Brian，或許可以請你再重點介紹一下新模式對我們的利害關係人有哪些好處。

Yeah. Sure, David. Lisa, maybe just -- before I get to that, I'll touch on your question about how to model the medium and longer term, because I think it's important as you step back and reflect on what David just went through.

是的。當然可以，大衛。麗莎，或許——在我談到這一點之前，我想先談談你關於如何對中長期進行建模的問題，因為我認為當你回顧和反思大衛剛剛經歷的事情時，這一點很重要。

So far in 2025, our Pharmacy Benefit Services business is tracking to expectations even in a challenging environment. So we're not seeing variability from expectations due to rebate guarantees or those sorts of drivers importantly.

截至目前，2025 年，即使在充滿挑戰的環境下，我們的藥房福利服務業務也符合預期。因此，我們沒有看到由於退款保證或類似因素導致的預期出現波動。

And for 2026, we do expect margin compression within our Pharmacy Benefit Services business driven by the two headwinds that we outlined earlier, specifically headwind one being the large client renewals and extensions that we secured through the end of the decade and headwind two being the transitional and investment spend associated with this transformative new rebate-free model, and that will result in meaningful costs across 2026 and 2027.

2026 年，我們預期藥局福利服務業務的利潤率將受到壓縮，這主要受我們先前概述的兩大不利因素的影響。具體而言，第一個不利因素是我們在本十年末之前獲得的大量客戶續約和延期合同，第二個不利因素是與這種變革性的全新無回扣模式相關的過渡和投資支出，這將導致 2026 年和 2027 年出現顯著的成本增加。

So when you think about modeling this business in the future, I would encourage you to think of it in three categories. Category 1 is represented by the three large clients that we referenced earlier. This represents roughly $90 billion of annual revenue and the 2026 margin profile should run rate through the end of the decade. We're thrilled to have these clients through the end of the decade.

所以，當你考慮未來如何建立這個業務模型時，我建議你從三個方面來考慮。第一類客戶以我們前面提到的三家大客戶為代表。這相當於每年約 900 億美元的收入，而 2026 年的利潤率水準應該會持續到本世紀末。我們很高興能與這些客戶合作到本世紀末。

Category 2 is the transitional and investment spend associated with our new rebate-free model. This will result in margin pressure across 2026 and 2027, but it will largely dissipate thereafter.

第二類支出是與我們新的無退稅模式相關的過渡和投資支出。這將導致 2026 年和 2027 年利潤率承壓，但此後這種壓力將基本消散。

Category 3 is the fundamental earnings profile on the balance of the Pharmacy Benefit Services book. You should think of this as not meaningfully changing from today in terms of client level earnings contributions, meaning that we would expect comparable earnings contributions from our rebate-free model as we have today in our existing solutions. So you put that all together, all these actions strengthen the long-term durability of our Pharmacy Benefit Services business.

第 3 類是藥局福利服務帳簿餘額的基本收益概況。你應該認為，就客戶層面的收入貢獻而言，這與今天相比並沒有實質的變化，這意味著我們預計，我們的無返利模式將帶來與我們現有解決方案中類似的收入貢獻。綜上所述，所有這些措施都增強了我們藥局福利服務業務的長期永續性。

David asked me to touch briefly on what's in it for some of the stakeholders in terms of our new rebate-free model. So let me just do a very brief run through some of the key stakeholders. So for patients, this model will insulate them from the high list prices set by drug manufacturers, even if they're in a high deductible health plan. Our Price Assure technology will ensure that they always pay the lowest possible out-of-pocket price. Even in those rare instances where an alternative cash pay option is less expensive than our negotiated price. And if the patient does pay out of pocket, we will ensure that it applies to their deductible.

David 請我簡單談談，對於我們新的無返利模式，一些利害關係人能從中獲得什麼好處。那麼，讓我簡要介紹一下一些主要利害關係人。因此，對於患者而言，即使他們參加了高免賠額的健康計劃，這種模式也能讓他們免受藥品製造商設定的高昂標價的影響。我們的價格保證技術將確保他們始終支付盡可能低的自付費用。即使在極少數情況下，現金支付方式比我們協商的價格便宜。如果患者需要自費支付，我們會確保這筆費用計入他們的自付額。

Our breakthrough new model also supports independent pharmacists by reimbursing them based upon their drug procurement cost plus a dynamic dispensing fee that varies based upon the clinical intensity of the prescriptions they're filling. Critical access, rural pharmacies will receive a higher dispensing fee and acknowledgment of the crucial role these pharmacies play in our communities.

我們突破性的新模式也為獨立藥劑師提供支持，根據他們的藥品採購成本加上動態配藥費（根據他們配發的處方的臨床強度而變化）向他們支付報酬。關鍵准入機制將使農村藥房獲得更高的配藥費，並認可這些藥房在我們社區中發揮的關鍵作用。

And for our clients, I'll just use an employer to illustrate this quickly. It's a simple fee-based, de-linked payment structure that covers all administration and clinical programs. This offers the employer more budget certainty versus today's model, which is a post-utilization reimbursement approach.

對於我們的客戶，我將以一位雇主為例來快速說明這一點。它採用簡單的按服務收費、不掛鉤的支付結構，涵蓋所有行政和臨床項目。與目前的後使用報銷模式相比，這種模式能為雇主提供更大的預算確定性。

It also should result in greater employee satisfaction with their benefits. Today, often, there’s sticker shock when a patient is faced with the out-of-pocket cost for expensive brand drugs. This is a solution to that problem for employers. And we would expect stronger adherence to treatment protocols, resulting in improved employee productivity and presenteeism over time.

這也有助於提高員工對福利的滿意度。如今，當患者面臨昂貴品牌藥的自費費用時，常常會感到震驚。這是解決雇主面臨的這個問題的一種方案。我們預計員工將更嚴格地遵守治療方案，從而隨著時間的推移提高員工生產力和出席率。

And from a shareholder perspective, we expect that this model will simplify the analysis of our company and provide you with more visibility, transparency and predictability of our performance. So long question, long answer. Hopefully, that helps.

從股東的角度來看，我們期望模型能夠簡化對我們公司的分析，並為您提供更清晰、透明且可預測的績效資訊。問題很長，答案也很長。希望這能有所幫助。

Thank you.

謝謝。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Thanks. Good morning. I'll stay on the PBM here. First, just any color you can share with us in terms of the magnitude of that 2026 decline, is it low single digits, mid-single digits, not to pin you down on a number, but just maybe a range you could help us with, so we could think about the magnitude of the pharmacy benefit pressure there next year?

謝謝。早安.我將繼續使用PBM。首先，您能否就 2026 年的下降幅度給我們一些估計，例如個位數的低位、個位數的中位，我們並不是要您給出一個具體的數字，只是希望您能提供一個範圍，以便我們思考明年藥品福利面臨的壓力有多大？

And then you -- so it sounds like you're saying the renewals will play themselves out next year, and it's really that transition and investment spend that will be the pressure in 2027. So maybe you could give us some color on how much of that -- how big that investment spend bucket is maybe relative to the overall pressure and how much of that we should see in '27, just so we can understand how much of a -- do we get back to typical earnings in '27 growth minus whatever this investment spend is. Is that the right framework? And maybe give us some numbers on that. Thanks.

然後你——所以聽起來你的意思是說續約問題明年就會自行解決，而真正的壓力將在 2027 年到來，那就是過渡和投資支出。所以，您能否給我們詳細說明一下，這筆投資支出在整體壓力下佔多大比例，以及我們在 2027 年應該看到多少，這樣我們才能了解，在扣除這筆投資支出後，我們能在 2027 年恢復到正常的盈利增長水平。這個框架合適嗎？或許還可以提供我們一些相關數據。謝謝。

Good morning, Justin, it's Brian. So in terms of the second part of your question, your framework is right in terms of the large client extensions and proactive renewals that will become a new run rate starting in '26 through the end of the decade plus. And the investment spending is the component that will continue into '27. So you've got the right frame of reference there.

早安，賈斯汀，我是布萊恩。所以，關於你問題的第二部分，你的框架是正確的，從 2026 年開始到未來十年末，大客戶的延期和主動續約將成為新的運行速度。而投資支出這一部分將持續到 2027 年。所以你的參考係是正確的。

As it relates to sizing the impact on the Pharmacy Benefit Services operating segment for '26, just maybe I'll walk through a few of the components within Evernorth to help give you some color here. I just -- we're not giving explicit guidance today. This is meant to be more of a directional outline to help you understand what we see for '26.

至於評估 2026 年藥房福利服務營運部門受到的影響，或許我可以介紹一下 Evernorth 的一些組成部分，以幫助您更好地了解情況。我只是──我們今天不給予明確的指導。這更像是一個方向性的概述，旨在幫助您了解我們對 2026 年的展望。

If we start with our 2025 Evernorth income guidance of at least $7.2 billion, you can think of this as round numbers split approximately equally between Specialty & Care Services and Pharmacy Benefit Services. So that would be about $3.6 billion of income in each.

如果我們以 Evernorth 2025 年至少 72 億美元的收入預期為起點，你可以把這個數字看作是大致平均分配給專科護理服務和藥房福利服務兩大業務板塊的整數。這樣一來，兩國將分別獲得約36億美元的收入。

And as I noted earlier, we expect the Specialty & Care Services business to grow towards the higher end of its long-term income growth algorithm, inclusive of the contribution from our investment in Shields. And we expect the aggregate 2026 Evernorth segment income to decline slightly from the 2025 level. So the delta between those two items represents the expected decline in Pharmacy Benefit Services in 2026.

正如我之前提到的，我們預計專業護理服務業務將朝著其長期收入成長演算法的高端成長，其中包括我們對 Shields 的投資所做出的貢獻。我們預計 2026 年 Evernorth 各業務部門的總收入將比 2025 年略有下降。因此，這兩個項目之間的差異代表了 2026 年藥品福利服務的預期下降幅度。

Now the expected decline in Pharmacy Benefit Services income is attributable to the two headwinds that I made reference to earlier, one being the proactive extensions and renewals of our three largest clients, including both Prime Therapeutics and Centene during 2025. All of that results in a new margin profile on these clients going forward. You can think of that as that headwind being more than half of the overall Pharmacy Benefit Services decline in income that we expect for '26.

現在，預計藥房福利服務收入的下降是由於我之前提到的兩個不利因素造成的，其中一個是我們的三大客戶（包括 Prime Therapeutics 和 Centene）在 2025 年積極地延長和續約合約。所有這些都將導致這些客戶未來的利潤率結構改變。你可以把這看作是2026年我們預期藥局福利服務收入整體下降的一半以上的不利因素。

And then the second headwind for the 2026 Pharmacy Benefit Services income is the investment in transitional costs associated with our transformative new rebate-free model. So this is less than half of the 2026 headwind for the PBS business.

2026 年藥局福利服務收入面臨的第二個不利因素是與我們變革性的全新無回扣模式相關的過渡成本投資。所以這還不到 2026 年 PBS 業務面臨的不利因素的一半。

And again, while these are 2026 headwinds, both of them serve to extend the long-term value and the durability of our Pharmacy Benefit Services platform for the future. So hopefully, that helps with some of the components.

再次強調，雖然這些是 2026 年的不利因素，但它們都有助於延長我們藥房福利服務平台的長期價值和持久性。希望這能對某些組成部分有所幫助。

AJ Rice, UBS.

AJ Rice，瑞銀集團。

Thanks. Hi everybody. Just to maybe keep on trying to drill down that point. If you're looking at the Pharmacy Services business sort of at the higher end, the Healthcare business at the higher end of long-term targets. And then the PBM pretty much offsetting the growth in Pharmacy Services to the point where Evernorth is slightly negative, a couple of percentage points. I'm getting back of the envelope that that probably generates EPS growth of roughly mid-single digits, 5% to 6%. I would just so people get off this call understanding in some framework, what you're describing. Is that generally in the ballpark? And are you making any assumptions about capital deployment, share repurchase, et cetera? And how they may contribute to growth in the next two years in this model?

謝謝。大家好。或許只是想繼續深入探究這一點。如果你關注的是藥局服務業務的高端領域，或者說是醫療保健業務的高端長期目標，那麼你就會明白這一點。然後，藥品福利管理機構 (PBM) 幾乎完全抵消了藥房服務的成長，以至於 Evernorth 略微虧損了幾個百分點。我粗略估計，這可能會帶來大約 5% 到 6% 的中等個位數的每股盈餘成長。我希望大家結束這通通話後，能夠對你所描述的內容有一個大致的了解。這個數字大致合適嗎？您是否對資本部署、股票回購等方面做出了任何假設？那麼，在這種模式下，它們將如何在未來兩年內促進成長？

And then I'm finally going to just ask a fundamental question on the new program. A lot of employers have had the opportunity to do pass-through rebates and so forth. You're going a step further in eliminating rebates. But a lot of employers push back and say, hey, they like that pool of rebates. Have you got any early indications of how likely they are to want to adopt this model as you go out with it?

最後，我要問一個關於這個新專案的基本問題。很多雇主都有機會進行轉嫁返利等操作。你們在取消回扣方面又邁進了一步。但很多雇主對此表示反對，並說，嘿，他們喜歡這種回饋池。在推廣過程中，你有沒有初步跡象顯示他們有多大可能接受這種模式？

AJ, good morning. It's David. Two different questions. Let me give you some color on the first. First as you walk through the big box cars, I would ask you to think about it in terms of the earnings profile, and my comments will separate the EPS profile here in a moment. You have the big box cars Cigna Healthcare, 40% of the company on algorithm toward the higher end of the range, Specialty & Care on algorithm toward the higher end of the range, offset by the PBS downturn in 2026 driven by the two items that we drove ourselves relative to the strategic positioning of the franchise on a go-forward basis. We're not guiding to EPS for 2026. I appreciate the desire relative to that.

AJ，早安。是大衛。兩個不同的問題。讓我先給你詳細介紹一下第一點。首先，當您瀏覽大型貨車時，我想請您從盈利情況的角度思考一下，我稍後會詳細分析這裡的每股收益情況。你們有大型汽車保險，Cigna Healthcare，公司 40% 的股份通過算法交易，達到較高水平；Specialty & Care 也通過算法交易，達到較高水平；但 2026 年 PBS 的下滑抵消了這些影響，而 PBS 的下滑是由我們自己推動的兩項舉措造成的，這兩項舉措與該特許經營權的未來戰略定位有關。我們不提供 2026 年每股盈餘預測。我理解您在這方面的願望。

So we gave you the components of how to think about the earnings. The last piece I would encourage you to think about in Ann’s prepared comments, she profiled our cash flow profile for 2025 as largely being back-half weighted.

所以我們向你介紹了思考收益的各個組成部分。最後，我想鼓勵大家思考Annâ準備的評論，她將我們2025年的現金流狀況描述為主要集中在下半年。

The capital profile for 2026 will follow a similar pattern to be back-end loaded. So you may want to think about that in the context of how you're considering your own buildup and projections. Additionally, we've noted that we will balance share repurchase and deleveraging priorities over the near term. So I just will give you those components.

2026 年的資本結構將遵循類似的模式，即後期資本集中。所以，在考慮自己的發展規劃和預測時，你可能需要考慮到這一點。此外，我們注意到，在短期內，我們將平衡股票回購和去槓桿化的優先事項。所以我把這些零件都給你。

So the last part of your question, which is a very important part of the question, in terms of framing -- in terms of go-to-market. Yes, pass-through has been available for a long period of time. By the way, as have point-of-service rebates in the marketplace and we offer both. This goes beyond it. And just to reiterate your points, no rebates, delinked economics and importantly, a capability that validates for the consumer, lowest available price at the counter regardless of the mechanism that generates that and in 95%+ of the situation, it's the benefits program that yields it, but in low single-digit percentage, which is meaningful given the number of scripts in America. It could be an alternative mechanism, we have the ability to facilitate it.

所以，你問題的最後一部分，也是問題中非常重要的一部分，它關乎框架──關乎市場推廣。是的，過帳功能已經存在很久了。順便一提，市場上也有服務點回饋，我們兩者都提供。這遠不止於此。再次重申你的觀點，沒有回扣，經濟脫鉤，更重要的是，要能夠為消費者驗證，無論產生該價格的機制是什麼，都能在櫃檯獲得最低價格。在 95% 以上的情況下，是福利計畫產生了最低價格，但比例很低，考慮到美國處方藥的數量，這意義重大。這或許是一種替代機制，我們有能力促成此事。

We indicated this will be our standard offering as we look to the future. We will carry Cigna Healthcare's guaranteed cost portfolio across to it on January 1, 2027. It will be our standard offering out of Evernorth for the 2028 cycle, and employers, let's say, for example, as you infer, maybe a collective bargaining union employer or state employer, if they still want a different program or they want to transition over a multi-year period of time, we have the broad suite of capabilities. We have a broad suite of capabilities.

我們已表明，展望未來，這將是我們的標準產品。我們將於 2027 年 1 月 1 日將 Cigna Healthcare 的保證成本組合轉移到該公司。這將是 Evernorth 在 2028 年周期內的標準產品，例如，正如您所推斷的，可能是集體談判工會雇主或州政府雇主，如果他們仍然想要不同的方案，或者他們想要在多年內進行過渡，我們擁有廣泛的能力。我們擁有廣泛的能力。

And lastly and importantly, we have the consultative approach to work one employer, one buyer at a time to come up with the transitional strategies that work best for them based on how they design the program, ending with, we believe this is the future of where the market is going. We're proud to lead it. And we need to have the capabilities to be able to serve the consumer, the employer, and the independent pharmacists with the model. AJ, thanks for the question.

最後，也是非常重要的一點，我們採用諮詢式方法，一次與一位雇主、一位買家合作，根據他們設計方案的方式，制定最適合他們的過渡策略。我們相信，這就是市場未來的發展方向。我們很榮幸能夠領導這項工作。我們需要具備這樣的能力，才能利用這種模式為消費者、雇主和獨立藥劑師提供服務。AJ，謝謝你的提問。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

Hi, good morning. I wanted to follow up on the Evernorth comments. My understanding was that some of those large contracts were only modestly profitable, and now you're talking about lower profitability on those contracts. So is it fair to think that some of them might be operating at a loss near term? And how should we think about the progression of profitability over a multi-year period? Thanks.

您好，早安。我想就 Evernorth 的相關評論做個後續說明。我的理解是，其中一些大額合約的獲利能力並不高，而您現在又提到這些合約的獲利能力較低。那麼，認為其中一些公司短期內可能會出現虧損是否合理呢？那麼，我們該如何看待多年期間獲利能力的演變呢？謝謝。

Andrew, I'll start. We don't comment on individual contract profitability, number one. Two, I think if you take the bigger picture, typically in business of all shapes and sizes, very large relationships have lower earnings profiles than a portfolio as a whole. So a directional comment going with you. I'd ask you to consider, we proactively extended. We proactively worked to restructure, and we engaged in energized renewals for these contracts.

安德魯，我先來。第一，我們不對個別合約的獲利情況發表評論。第二，我認為從更宏觀的角度來看，通常在各種規模的企業中，規模非常大的關係的收益水準都低於整體投資組合的收益水準。所以，給你一個提醒。我想請您考慮一下，我們主動延長了期限。我們積極主動地進行重組，並積極推動這些合約的續約。

Said otherwise, we're pleased to have these relationships, and we're proud to be able to support and service the DoD, be a differentiated partner for Prime, and be a strategic partner for Centene. So we proactively collaborated to generate this. I'm not answering your numbers. I'm coming back to lower margin profile, yes, on $90 billion, as you would expect. You should assume we would not have proactively engaged in these relationships if we didn't deem them be strategically important.

換句話說，我們很高興擁有這些合作關係，我們很自豪能夠支持和服務美國國防部，成為 Prime 的差異化合作夥伴，以及成為 Centene 的戰略合作夥伴。因此，我們積極合作，共同完成了這項工作。我不會接你的電話。是的，正如你所預料的那樣，900億美元的規模意味著較低的利潤率。你應該明白，如果我們不認為這些關係具有戰略重要性，我們就不會主動建立和維繫這些關係。

And maybe Brian comment a little bit relative to the relationship and the evolved relationship we have with the parties as well.

或許布萊恩也可以就我們與各方之間的關係以及不斷發展的關係發表一些評論。

Yeah, good morning, Andrew, just a couple of comments I'd pile on to David's start there. One, we don't write business at a loss constantly, so you should not expect that these contracts are running at a loss on a sustained basis. But to David's point, they do run at a lower margin profile on balance compared to the overall portfolio.

是的，早安，安德魯，我只想補充幾句大衛剛才說的話。第一，我們不會一直虧本做生意，所以你不應該期望這些合約會持續虧損。但正如大衛所說，與整體投資組合相比，它們的利潤率總體上確實較低。

It's also important to note that across the Pharmacy Benefit Services client relationships that we have, many of them deepen over time. So sometimes that's our strong specialty capabilities or home delivery pharmacies or some of our care services capabilities such as our virtual care platform, MDLIVE. So oftentimes, the relationships deepen and expand over time. We're not banking on that happening with any of our three large clients here, but it is an opportunity for further value creation in the future.

值得注意的是，在我們與藥局福利服務客戶建立的許多關係中，隨著時間的推移，這些關係都在不斷加深。所以有時候，這體現在我們強大的專業能力、送貨上門藥局服務，或是我們的一些護理服務能力，例如我們的虛擬護理平台 MDLIVE。因此，隨著時間的推移，人際關係往往會加深和擴展。我們並不指望這種情況會發生在我們這三家大客戶中的任何一家身上，但這卻是未來創造更多價值的機會。

Thank you.

謝謝。

Charles Rhyee, TD Cowen.

Charles Rhyee，TD Cowen。

Yeah, thanks for taking the question. Maybe, David, obviously, you're making this choice to strategically move the business model going forward. And I appreciate all the comments that you had here. You're kind of going it alone at the moment. You talked about sort of the examples with prior auths earlier this year. Can you maybe give us a sense here on what the dialogue might be like in Washington between yourselves and other, some of your peers? It does seem like the work that you're doing with administration IVF and some of the other things seems to suggest that the environment is better in terms of coming to some type of bigger resolution and trying to see -- do you see room to find more common ground either with regulators or the administration to maybe come to some more broader resolution that could perhaps lift this regulatory overhang that's kind of been on the industry for years.

好的，謝謝你回答這個問題。大衛，很顯然，你做出這個選擇是為了從策略上推動業務模式向前發展。感謝大家在這裡提出的所有意見。你目前基本上是單打獨鬥。今年早些時候，您曾談到一些關於事先授權的例子。您能否向我們介紹一下，在華盛頓，您與一些同行之間的對話可能會是什麼樣的？看來您在體外受精管理以及其他一些方面所做的工作表明，環境正在好轉，預計將達成某種更大的解決方案，並嘗試看看——您是否認為有空間與監管機構或政府部門找到更多共同點，以達成更廣泛的解決方案，從而消除多年來一直困擾該行業的監管負擔。

Charles, thank you for the question. I guess I'll come at it through a few frames as you paint the picture. One, we've long, as a company, believed that sustained public-private partnership and collaboration is critical in the United States.

查爾斯，謝謝你的提問。我想我會透過幾個片段來慢慢理解，就像你描繪這幅畫面一樣。第一，我們公司一直認為，在美國，持續的公私合作至關重要。

If you step back and look at the way in which programs are designed in the United States, having good alignment of public-private partnership is quite important in the interdependencies of the programs, be they employer, Medicaid, Medicare, exchange or otherwise, there are interdependencies between the way the programs function.

如果你退後一步，看看美國各種項目的設計方式，你會發現，良好的公私合作關係對於各個項目的相互依存性至關重要，無論是雇主提供的、醫療補助、醫療保險、交易所提供的還是其他類型的項目，這些項目在運作方式上都存在相互依存的關係。

Point two is, if you paint the last year and you referenced some of the components, you can think about actions we've driven in a few categories. One, further extending public-private partnership. Example of that I cited in my prepared remarks and pleased to see the industry more broadly stepping forward with Secretary Kennedy and CMS Administrator Oz relative to changing and transforming the way prior authorizations work, and changing and transforming continuity of care between health plans for an individual that no action of their own results in a preapproved event in December. Their health plan changes over in January. They today have to go through a new event. We took that off the table. That's a good example.

第二點是，如果你回顧過去一年，並參考其中的一些組成部分，你就可以思考我們在幾個類別中採取的行動。第一，進一步拓展公私合作。我在準備好的發言稿中舉了一個例子，很高興看到整個行業與肯尼迪部長和 CMS 局長奧茲一道，更廣泛地推進了事先授權的工作方式的改變和轉型，以及改變和轉型個人健康計劃之間的護理連續性，因為個人在 12 月份沒有採取任何行動，導致發生預先批准的事件。他們的醫療保險計劃將於一月變更。他們今天必須經歷一件新的事情。我們已經否決了這個方案。這是一個很好的例子。

Or as you referenced, the fertility outcome on an expedited basis, taking our capabilities, understanding the need statement and through public-private partnership evolving a capability with EMD Serono, ourselves, the administration going forward. That falls into public-private partnership.

或者正如您所提到的，加快生育結果的實現，利用我們的能力，了解需求聲明，並透過公私合作，與 EMD Serono、我們自己以及政府共同發展能力，朝著這個方向前進。這屬於公私合作模式。

Bucket two is sustained relentless innovation. And you use the go it alone phraseology. I won't put it uniquely in the go it alone. If you just look back at the GLP-1 space over the recent past, we led the industry with our Encircle program that acknowledges and recognizes the need to have broader programs wrapped around GLP-1s for employers around lifestyle management, behavior modification, titration of medication programs on an individual-by-individual basis.

第二類挑戰是持續不斷的創新。你也常使用「單幹」的說法。我不會把它單獨歸類為「單打獨鬥」。回顧 GLP-1 領域最近的發展，我們憑藉 Encircle 計畫引領了業界，該計畫承認並認識到需要為 GLP-1 患者制定更廣泛的計劃，包括生活方式管理、行為矯正、根據個人情況調整藥物治療方案等。

We're pleased to have over 10 million individuals benefiting from that program today or an expansion of a program that didn't have one drug, had both leading drugs, with a different program for employers that capped the out of pocket up to $200. So those are examples of continued innovation like our Pathwell programs or otherwise.

我們很高興今天有超過 1000 萬人受益於該計劃，或者說，該計劃的擴展不僅涵蓋了一種藥物，而是涵蓋了兩種主要藥物，還為雇主制定了不同的計劃，將自付費用上限設定為 200 美元。這些都是我們持續創新的例子，例如我們的 Pathwell 專案或其他專案。

And the third category are our step function transformations. This is the step function transformation. We should be very blunt about it. It is a reframing of the marketplace to where the marketplace needs to go, whether you look at it through the consumers' lens, the consumer even on 5% of the pharmaceuticals in America, if there's 6 billion prescriptions, if 5% or 3% of them have some dislocation at the counter, that's too many. That's too many for Americans.

第三類是階躍函數變換。這是階躍函數變換。我們應該直截了當地說。這是對市場進行重新定義，使其朝著市場應有的方向發展。無論你從消費者的角度來看，即使美國祇有 5% 的藥品需要消費者，如果 60 億張處方中只有 5% 或 3% 的藥品在櫃檯出現問題，那也太多了。對美國人來說，這太多了。

And while benefit programs have been designed comprehensively and responsibly by employers, by health plans, by governmental agencies, there is increasing friction for the consumer. This takes that out of the equation. There is increasing complexity for the employer. As Brian referenced, this takes that out to the equation, and there is more support for the independent pharmacists. All of that is to say that we're driving public-private partnership.

雖然雇主、醫療計劃和政府機構都已全面負責地設計了福利計劃，但消費者卻面臨越來越多的摩擦。這樣就排除了這種可能性。對雇主而言，情況變得越來越複雜。正如布萊恩所提到的，這消除了這種因素的影響，也為獨立藥劑師提供了更多支持。這一切都表明，我們正在推動公私合作。

We're driving innovation, and we're driving step function growth. And there is good collaborative engagement in Washington, relative to the direction, the importance and the need, and we will continue to lean into a nonpartisan fact based patient customer-centric engagement in Washington going forward. So this is an important moment for us, and I appreciate your question. Good progress through all fronts of the three categories I referenced. Thanks for your question.

我們正在推動創新，我們正在推動階躍式成長。在華盛頓，各方就方向、重要性和必要性進行了良好的合作，我們將繼續在華盛頓推行以病人為中心、不偏不倚、基於事實的合作。所以這對我們來說是一個重要的時刻，感謝你的提問。在我提到的這三個方面都取得了良好進展。謝謝你的提問。

Thank you.

謝謝。

Scott Fidel, Goldman Sachs.

Scott Fidel，高盛集團。

Oh hi, thanks and good morning. Well, I guess one of us should probably ask about Cigna Healthcare, so I'll do that. Appreciate the framing that you gave around 2026 and the growth in Cigna Healthcare expected to be towards the higher end of the long-term algorithm.

哦，你好，謝謝，早安。我想我們當中應該有人問關於信諾醫療保健（Cigna Healthcare）的事情，所以我來問吧。感謝您對 2026 年左右的展望，以及對 Cigna Healthcare 預計成長將達到長期演算法高端的預測。

Can you walk us through maybe some of the key building blocks that are the inputs into that? And just thinking about some of the most impactful dynamics that have been driving sort of fundamentals there. One, stop loss. It sounds like that was in line with expectations in the quarter.

您能否為我們介紹一下構成這一過程的一些關鍵組成部分？想想那些對基本面產生影響最大的因素。第一，停損。聽起來這符合本季的預期。

How does that sort of feed into the expectations at next year? And then that the Exchange business as well. And just within the Exchange business, if you have any sort of framing around sort of the pricing and enrollment expectations that you're sort of building to get to that? Thanks.

這又將如何影響人們對明年的預期呢？還有交易所業務。僅就交易所業務而言，您是否對定價和註冊預期有任何框架，以達到目標？謝謝。

Good morning. It's David. Good to hear from you. It sounds like you may have a little bit of a cold. So hopefully you're doing okay. I'm going to ask Brian to provide some color relative to the comment you articulated because there are several pieces here in your question.

早安.是大衛。很高興收到你的來信。聽起來你可能有點感冒了。希望你一切都好。我打算請布萊恩就你提出的觀點補充一些細節，因為你的問題包含了幾個面向。

One is building blocks that support the outlook for 2026, and there's a couple of important ones you called out. And as he talks, for example, through the stop loss component, maybe I'll invite Ann to talk a little bit about what we've seen on a year-to-date basis and the results, and Brian will talk a little bit about what we're seeing in terms of the go-to-market component and then I'll punctuate on the back end the Individual or the Exchange-based programs.

一是支撐 2026 年前景的基石，你提到的其中有幾個重要的基石。例如，當他講解止損部分時，我可能會邀請安談談我們今年迄今為止的觀察結果，布萊恩會談談我們在市場推廣方面看到的情況，然後我會重點介紹個人或交易所項目。

Before I hand it over to Brian, in a nutshell, we're on track in 2026 for our growth outlook and algorithm. And by and large, our 2025 performance is in line with our expectations with the exception of, as called out in advance, some of the pressure we saw in the Individual Exchange business.

在把發言權交給布萊恩之前，我簡單概括一下，到 2026 年，我們的成長前景和演算法都將按計劃進行。總的來說，我們 2025 年的業績符合預期，但如同先前所提到的，我們在個人交易業務方面遇到了一些壓力。

Brian, could I ask you to talk a little bit about the Cigna Healthcare tailwinds and headwinds for 2026?

Brian，能否請你談談Cigna Healthcare在2026年面臨的利多與不利因素？

Sure, David. Good morning, Scott. So for Cigna Healthcare, which represents again about 40% of the company's earnings, we expect tailwind from the repricing of our stop loss business within the US Employer portfolio. Now this is partially offset by the absence of some nonrecurring benefits that we had in 2025, specifically the contributions from our divested Medicare business as well as some prior year true-ups in the Individual Exchange business. So when you net that all together, we expect that 2026 Cigna Healthcare income will grow toward the higher end of our long-term income growth algorithm.

當然可以，大衛。早安，史考特。因此，對於占公司收益約 40% 的 Cigna Healthcare 而言，我們預期美國雇主投資組合中止損業務的重新定價將帶來利多。現在，由於我們在 2025 年失去了一些非經常性收益，部分抵消了上述損失，特別是我們剝離的醫療保險業務的貢獻以及個人交易所業務的一些前幾年的調整。因此，綜合所有因素來看，我們預期 2026 年 Cigna Healthcare 的營收將朝著我們長期收入成長演算法的較高水準成長。

As it relates to stop loss, we're tracking well as it relates to the two-year margin recovery plan that we outlined in our fourth quarter call. So we've been able to execute against the higher rate actions that we required with typical levels of retention. So we're quite pleased with the performance of that year-to-date. 2026 will be a step forward toward the ultimate margin recovery that we expect to be completed by the end of 2027.

就停損而言，我們按照在第四季度電話會議上概述的兩年保證金恢復計劃，進展順利。因此，我們能夠在維持正常客戶留存率的情況下，執行我們所需的高頻率行動。因此，我們對今年迄今的業績相當滿意。 2026年將是朝著最終利潤率恢復目標邁出的重要一步，我們預計利潤率恢復目標將在2027年底完成。

And so far, the claims experience on that business has been running in line with expectations in 2025. As it relates to the '25 performance, Ann, do you want to talk about what we're seeing in stop loss and Individual Exchange a bit?

到目前為止，該業務的理賠情況與 2025 年的預期相符。關於2025年的表現，安，你想談談我們在停損和個別交易所方面看到的情況嗎？

Yeah, sure. Thanks, Brian. So as Brian said, our stop loss business continues to track in line with expectations. So just as a reminder, we had assumed a higher MCR for this year compared to last year, which was in the low 90s. So a few things I'd note on what we're seeing sort of as we're sitting here now in the fourth quarter. Our rate and execution -- rate execution, excuse me, and persistency, as Brian said, are tracking in line with expectations.

當然可以。謝謝你，布萊恩。正如布萊恩所說，我們的停損業務繼續按照預期發展。再次提醒大家，我們假設今年的 MCR 比去年高，去年的 MCR 在 90% 左右。所以，關於我們目前在第四季所看到的情況，我想提幾點。正如布萊恩所說，我們的速度和執行力——抱歉，是速度執行力和堅持性——都符合預期。

I'd also point to the paid MCR, which measures claims as a percentage of premium collected. That is tracking where we would expect it to be at this point in the year. In addition to those stats, we are analyzing how the results are tracking against expectations. We've developed enhanced analytics, in addition this year, that include those that leverage both claims and clinical data to predict individual claims experience. So using these analytics, we've constructed a range of stop loss outcomes based on where members currently sit against their pooling points and predictions of their future claims, those analytics reinforce our expectations for the full year. So taken together, we feel good about expectations for the stop loss book this year.

我還要指出付費 MCR，它是以收取的保費的百分比來衡量索賠的。這與我們預期它在今年這個時候的發展趨勢一致。除了這些統計數據之外，我們還在分析結果與預期之間的差距。今年，我們還開發了增強型分析功能，其中包括利用理賠數據和臨床數據來預測個人理賠經驗的功能。因此，利用這些分析，我們根據成員目前相對於其資金池積分的位置以及對其未來索賠的預測，構建了一系列止損結果，這些分析強化了我們對全年的預期。綜上所述，我們對今年的停損單市場前景感到樂觀。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great, thanks. I just want to make sure that I'm clear about what you guys are communicating around the investment spending component of the pressure on the PBM business. When you say that the investment spending will continue into 2027. Are you saying that it's going to be a similar year-over-year drag in '27 or that it's stable in '27 before margin recovery in '28 as you start to overcome those investments and recapture them?

太好了，謝謝。我只是想確認一下，你們在談到藥品福利管理 (PBM) 業務面臨的投資支出壓力時，究竟表達了什麼意思。您說投資支出將持續到 2027 年。你是說 2027 年的業績會像 2028 年一樣同比下滑，還是說 2027 年業績會保持穩定，然後在 2028 年隨著你開始彌補這些投資並收回成本，利潤率才會回升？

Good morning, Kevin. It's Brian. So it's more of the latter, if you were to think about the choices that you outlined there. You can think of the investment spending continuing from '26 into '27. So at this juncture, we don't anticipate that being a year-over-year headwind '27 over '26. Maybe let me elaborate a little bit on the nature of it, just to give you a little more texture here.

早安，凱文。是布萊恩。所以，如果你仔細想想你列出的那些選擇，答案就更接近後者。你可以把投資支出看成是從 2026 年延續到 2027 年。因此，目前我們預期 2027 年不會比 2026 年出現年比逆風。或許我可以稍微詳細闡述它的性質，以便讓你對它有更深入的了解。

So as I noted earlier, this is one of the two headwinds that are impacting our Pharmacy Benefit Services business as we head into 2026 with the other being the large client renewals and extension. And the investment in transitional spending represents less than half of the Pharmacy Benefit Services headwind.

正如我之前提到的，這是我們藥局福利服務業務在邁向 2026 年之際面臨的兩大不利因素之一，另一個不利因素是大客戶的續約和延期。過渡性支出的投資還不到藥品福利服務所面臨的不利因素的一半。

Now importantly, as we've said multiple times here, this is a fundamental business model pivot much more than just simply a new product launch. So as a result of that, there's some substantial technology investments required, some that are market facing as well as others that are more back office in nature. So just keep in mind, our existing infrastructure really has been built around a pharmacy rebate oriented ecosystem.

重要的是，正如我們多次提到的，這不僅僅是推出新產品，而是一次根本性的商業模式轉型。因此，需要進行大量的技術投資，其中一些是面向市場的，而另一些則更偏向後台性質。所以請記住，我們現有的基礎設施實際上是圍繞著以藥品回扣為導向的生態系統建立起來的。

Secondly, we do have a series of re-contracting work that needs to be completed in order to deliver the model. So think of this as manufacturer contracts, network pharmacy contracts, as well as client contracts. So overall, these are fairly substantial changes that represent, again, one of the drivers of 2026 being a transitional year for our PBS business. But you should think of the spend levels as being broadly consistent between the two years.

其次，為了交付該模型，我們還需要完成一系列重新簽訂合約的工作。所以，你可以把這些合約看作是製造商合約、連鎖藥局合約以及客戶合約。總的來說，這些都是相當大的變化，再次表明 2026 年是我們 PBS 業務轉型之年的原因之一。但你應該認為這兩年的支出水準大致相當。

David, anything you’d like to add?

大衛，你還有什麼要補充的嗎？

Kevin, just maybe to give you a summary, I think where you’re going with your question. And I'm going to give you a directional comment as opposed to a financial comment. As you think about the building blocks of the capabilities, our Cigna Healthcare we’re on algorithm in '26, Specialty and Care on algorithm in '26, PBS off algorithm in '26.

凱文，或許我可以給你總結一下，我想你這個問題想表達的意思大概是這樣的。我將給予一些方向性的意見，而不是財務方面的意見。當你思考各項能力的建構模組時，我們的 Cigna Healthcare 在 '26 年採用了演算法，Specialty and Care 在 '26 年採用了演算法，PBS 在 '26 年退出了演算法。

As you play that forward another year where you're going in terms of the moving points, Brian indicated the greater than 50% in the PBS part of our capabilities that is large client related will run rate going forward. So you have a different basis but new run rate going forward.

展望未來一年的發展趨勢，布萊恩指出，我們與大型客戶相關的 PBS 能力中超過 50% 的成長率將持續下去。所以，你們的基礎不同了，但未來的運行速度會有所不同。

And when you wrap it together, while there's investments that will carry into 2027, at this point, it would be reasonable to assume we would expect to be back on at the enterprise level on algorithm for 2027 with the strength of the franchise.

綜上所述，雖然有些投資將持續到 2027 年，但就目前而言，憑藉該品牌的實力，我們有理由認為，到 2027 年，我們將在企業層面重新開始使用演算法。

Perfect. Thanks.

完美的。謝謝。

Jason Cassorla, Guggenheim Securities.

Jason Cassorla，古根漢證券。

Great, thanks. Good morning. Maybe just for health care first, could you clarify, are you saying health care AOI growth at the high end of your long-term target next year off of the AOI baseline that does not include some of the nonrecurring benefits like Medicare attribution and those true-ups?

太好了，謝謝。早安.或許先就醫療保健而言，您能否澄清一下，您是指明年醫療保健 AOI 增長達到長期目標的高端，而 AOI 基線不包括一些非經常性收益，例如 Medicare 歸屬和那些調整？

And then my real question for 2026. Are you expecting further membership growth there? Just any pockets or areas you want to highlight, you're looking for strong growth and any other puts and takes around membership to consider for next year would be helpful. Thanks.

那麼，我對2026年的真正疑問是什麼呢？您預計該地區的會員人數會進一步成長嗎？你想重點指出哪些領域或方向，你正在尋找強勁的成長點，以及明年會員方面的任何其他注意事項，都將對我們有所幫助。謝謝。

Good morning, Jason, it's Brian. So on the first point, the again, directional commentary we're giving you today, we expect Cigna Healthcare income growth at the higher end of our long-term growth algorithm off of our full year guide. So no adjustments to that. So our guide is at least $4.125 billion. We expect to grow at the higher end of our income growth algorithm off of that. So just to clarify that.

早安，傑森，我是布萊恩。所以關於第一點，也就是我們今天給出的方向性評論，我們預計 Cigna Healthcare 的收入成長將達到我們全年指導長期成長演算法的較高水準。所以這方面不需要調整。因此，我們的參考值至少為 41.25 億美元。我們預計，基於此，我們的收入成長演算法將達到較高水準。所以，我來澄清一下。

As it relates to customer growth going forward within Cigna Healthcare, the portfolio is obviously quite diverse in terms of the different types of buyer groups within that. Our national accounts business, which is largely done for 2026 at this stage as it relates to January 1, we expect a flat to slightly declining customer outlook for '26, which is in line with our expectations over the long run given that our strategy is to maintain share in that part of the portfolio.

就 Cigna Healthcare 未來的客戶成長而言，其產品組合顯然非常多樣化，涵蓋了不同類型的買家群體。就目前而言，我們的全國客戶業務在 2026 年 1 月 1 日之前基本上已經完成，我們預計 2026 年的客戶前景將持平或略有下降，這與我們長期的預期一致，因為我們的策略是保持在該部分投資組合中的份額。

Our Select segment continues to grow, as I indicated in my earlier comments, also within the US Employer portfolio. And despite the higher rate increases that are in the market across all competitors, we're tracking for another good year of performance in the Select segment.

正如我先前的評論中所提到的，我們的精選客戶群在美國雇主投資組合中也持續成長。儘管市場上所有競爭對手的費率漲幅都更高，但我們預計在精選客戶領域，今年的業績仍將保持良好勢頭。

Our Individual Exchange business, we expect to see a decline in membership next year, roughly commensurate with what the overall industry-wide enrollment is expected to look like. So those are the bigger building blocks as you think about the overall customer picture for 2026. So different rates of growth or decline business to business. But overall, we like the way we're positioned in Cigna Healthcare, again, confident in growing the income at the higher end of our long-term growth rate range

我們預計明年個人會員數量將有所下降，與整個行業的預期註冊人數大致相當。所以，這些是你在思考 2026 年整體客戶圖景時需要考慮的幾個重要部分。因此，不同企業的成長或衰退速度各不相同。但總的來說，我們對目前在信諾醫療保健集團的定位感到滿意，並且有信心實現長期成長率目標範圍內的較高收入成長。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

Right, thanks so much. Back in September, I think you mentioned that roughly in the range of 4% PBM margin would be durable or sustainable even with some of the potential permutations of outcomes from a PBM reform perspective, at least those that are out there today. And -- and is that still the right way to think about it, particularly also in light of the rebate-free model transition over the -- obviously, this is over the longer term, excluding some of those nuances in 2026, '27. If you could comment on that longer-term margin profile? Thanks.

好的，非常感謝。我記得您在九月提到過，即使從 PBM 改革的角度來看存在一些潛在的結果組合，4% 左右的 PBM 利潤率也是持久或可持續的，至少就目前的情況而言是如此。而且——而且這種思考方式是否仍然正確，尤其是在考慮到無退稅模式過渡到——顯然，這是從長遠來看的，不包括 2026 年、2027 年的一些細微差別。您能否就該長期利潤率狀況發表一下看法？謝謝。

Good morning, Erin, it's Brian. So as it relates to the 4% margin benchmark we've provided in the past for Pharmacy Benefit Services. We do believe that that's a reasonable way to look at the business when you think about the long term. So as I made reference to in an earlier question, we would expect the earnings contribution for our new rebate-free delinked model to be comparable to what the existing solutions are across the portfolio.

早安，艾琳，我是布萊恩。所以，這與我們過去為藥局福利服務提供的 4% 利潤率基準有關。我們認為，從長遠角度來看，這是一種合理的看待企業的方式。正如我在先前的問題中提到的那樣，我們預計我們新的無回扣脫鉤模式的收益貢獻將與現有解決方案在整個投資組合中的收益貢獻相當。

Now when you do the overall calculation at the portfolio level, depending on the mix of large clients, small clients, mid-market clients, the overall portfolio level margin may be higher or lower than that at any given point in time, but we would expect strong levels of contribution from our new rebate-free model comparable to what we see on a similar client level today with the existing solutions.

現在，當您在投資組合層面進行整體計算時，根據大客戶、小型客戶、中端市場客戶的組合，投資組合層面的整體利潤率在任何特定時間點都可能高於或低於此值，但我們預計，我們新的無返利模式將帶來強勁的貢獻，與我們今天在類似客戶層面使用現有解決方案所看到的貢獻相當。

Thank you. At this time, I'll turn the call back over to the speakers.

謝謝。此時，我將把通話轉回給發言人。

I just want to briefly wrap up our call today. First and foremost, thank you for joining, and thank you for your questions during our call. As I wrap up, I want to say how much I appreciate and how proud I am of our co-workers across the globe. It's their continued focus and dedication that support our ability to deliver on our commitments for those we serve, and generate the net benefits for our shareholders.

我只想簡單地總結一下我們今天的通話。首先，感謝各位的參與，也感謝各位在通話期間提出的問題。最後，我想表達我對全球各地同事的感激之情和自豪之情。正是他們持續的專注和奉獻，才使我們能夠履行對服務對象的承諾，並為股東創造淨收益。

And this is all in an environment that is dynamic as we both deliver on our existing promises and enable ourselves to design and deliver these new solutions and these transformative solutions for the benefit of our customers for years to come.

這一切都發生在一個充滿活力的環境中，我們既要履行現有的承諾，又要不斷設計和交付這些新的、變革性的解決方案，以造福我們的客戶，並使他們在未來幾年受益。

We're proud of what we've achieved. We're jumping off a strong base in 2025, and 2026 will mark another strong year for the organization in our Cigna Healthcare portfolio and in our Specialty & Care portfolio as we invest significantly in our PBS portfolio to future proof it for years to come. Thanks, again, and have a good day.

我們為所取得的成就感到自豪。2025 年，我們將以強勁的基礎起步；2026 年，隨著我們對 PBS 組合進行大量投資，以確保其在未來幾年內保持強勁增長，公司在 Cigna Healthcare 組合和 Specialty & Care 組合方面也將迎來又一個強勁的年份。再次感謝，祝您今天過得愉快。

Ladies and gentlemen, this concludes the Cigna Group's third quarter 2025 results review. Cigna Investor Relations will be available to respond to 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 866-405-7290 or 203-369-0603. There is no passcode required for this replay. Thank you for participating. We will now disconnect.

女士們、先生們，信諾集團2025年第三季業績回顧到此結束。信諾投資者關係部門將盡快回覆您的問題。本次會議的錄音將在會議結束後10個工作天內提供聆聽。您可以撥打 866-405-7290 或 203-369-0603 收聽錄音會議。本次回放無需密碼。感謝您的參與。我們現在將斷開連接。