信諾集團 (CI) 2026 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by for The Cigna Group's second-quarter 2026 results review. (Operator Instructions)

各位女士、先生，感謝您撥冗參加 The Cigna Group 2026 年第二季業績回顧電話會議。(接線員指示)

As a reminder, ladies and gentlemen, this conference, including the Q&A session, is being recorded. We'll begin by turning the conference over to Ralph Giacobbe. Please go ahead.

提醒各位女士、先生，本次電話會議（包含問答環節）將被錄音。我們將把會議交給 Ralph Giacobbe。請開始。

Great. Thank you. 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 Brian Evanko, The Cigna Group's President and Chief Executive Officer; and Ann Dennison, Chief Financial Officer.

很好。謝謝。各位早安。感謝加入今天的電話會議。我是 Ralph Giacobbe，投資人關係資深副總裁。今天早上與我同線的有 The Cigna Group 總裁暨執行長 Brian Evanko，以及財務長 Ann Dennison。

In our remarks today, Brian and Ann will cover a number of topics, including our second quarter 2026 financial results and our financial outlook for 2026. Following their prepared remarks, Brian and Ann will be available for Q&A.

在今天的發言中，Brian 與 Ann 將涵蓋多項主題，包括我們 2026 年第二季財務結果，以及我們對 2026 年的財務展望。在他們的準備發言之後，Brian 與 Ann 將開放問答。

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.

如同我們的財報新聞稿所述，在描述財務結果時，我們使用若干財務衡量指標，包括調整後營運所得（adjusted income from operations）與調整後營收（adjusted revenues）；這些指標並非依據美國一般公認會計原則（GAAP）所決定。上述指標與最直接可比的 GAAP 指標（分別為股東淨利與總營收）之調節表，已收錄於今日的財報新聞稿中，並刊登於 thecignagroup.com 的投資人關係專區。

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. In our remarks today, we will be making some forward-looking statements, including statements regarding our outlook for 2026 and future performance. These statements are subject to risks and uncertainties that could cause actual results to differ materially from our current expectations.

我們以「調整後營運所得」與「調整後每股盈餘」作為我們主要的財務績效衡量指標，並以相同基礎呈列。在今天的發言中，我們將提出若干前瞻性陳述，包括關於 2026 年展望與未來表現的陳述。這些陳述受風險與不確定性影響，可能導致實際結果與我們目前預期出現重大差異。

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. Regarding our results in the second quarter, we recorded after-tax special item charges of $153 million or $0.58 per share. Details of the special items are included in our quarterly financial supplement.

相關風險與不確定性的說明載於今日財報新聞稿的警示性說明，以及我們最近向美國證券交易委員會（SEC）提交的報告中。就第二季結果而言，我們認列稅後特殊項目費用 1.53 億美元，或每股 0.58 美元。特殊項目的細節已納入我們的季度財務補充資料。

Additionally, please note that when we make prospective comments regarding financial performance, including our full year 2026 outlook, we will do so on a basis that includes the potential impact of future share repurchases and anticipated 2026 dividends.

此外請注意，當我們就財務表現發表前瞻性評論（包括 2026 全年展望）時，將以包含未來股票回購的潛在影響以及預期 2026 年股利的基礎來說明。

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

接下來，我把電話交給 Brian。

Thanks, Ralph. Good morning, everyone, and thank you for joining our call. I'm pleased to share we delivered strong performance in the second quarter as we continue to execute at a high level, drive results, and accelerate momentum across our enterprise.

謝謝你，Ralph。各位早安，感謝加入我們的電話會議。我很高興分享，我們在第二季交出強勁表現；我們持續以高水準執行、推動成果，並加速全公司動能。

Today, I'll discuss our performance for the quarter and key strategic drivers of our growth and demonstrate how the strength and durable nature of our model is fueling our success. I'll also share some examples of how we are leveraging data, AI, and technology to deliver more personalized health care experiences for our customers and patients. Then Ann will review additional details about our results and outlook for the rest of the year. Then we'll take your questions. So let's get started.

今天我將說明本季表現與推動成長的關鍵策略動因，並展示我們模式的強韌性與持久性如何驅動成功。我也會分享一些例子，說明我們如何運用資料、AI 與科技，為客戶與病患提供更個人化的醫療照護體驗。接著 Ann 將進一步說明我們的結果與今年剩餘期間的展望。然後我們將回答各位的問題。那我們開始吧。

As I've stepped into the CEO role, I'm energized by our strategic direction, our execution, and the impact we're having for those we serve, while leveraging the power of one of the most experienced leadership teams in the industry.

在我接任執行長職務後，我對我們的策略方向、執行力，以及我們在服務對象身上所帶來的影響感到振奮，同時也能借助業界最具經驗的領導團隊之一的力量。

Over the past few months, I've been spending even more time carefully listening to our partners across the health care system, including clients, customers, health care professionals, and brokers. Throughout these conversations, a few themes consistently emerge. First, an elevated focus on affordability as new expensive therapies continue to enter the market and demand for complex care grows. Second, growing expectations for more personalized experiences as people want health care to feel as easy as other areas of their lives. And third, the need for actionable insights and clinical programs to keep people healthy.

過去幾個月，我花了更多時間仔細傾聽醫療體系中各方夥伴的意見，包括客戶、消費者、醫療專業人員與保險經紀人。在這些對話中，有幾個主題一再出現。第一，隨著新的高價療法持續進入市場、複雜照護需求增加，對可負擔性的關注提升。第二，對更個人化體驗的期待日益提高，因為人們希望醫療照護能像生活中其他面向一樣便利。第三，需要可落地的洞察與臨床方案，以維持人們的健康。

These themes within health care are coupled with continued economic pressures, geopolitical uncertainty, and a rapid pace of change fueled by AI advances. While the current environment is certainly dynamic, I see the landscape as ripe with opportunity to innovate, drive change, and forge a new path in health care, all while continuing to execute on our commitments today.

這些醫療照護領域的主題，亦伴隨持續的經濟壓力、地緣政治不確定性，以及由 AI 進展所推動的快速變化步調。雖然當前環境確實多變，但我認為此一局勢充滿機會，可用以創新、推動變革並在醫療照護領域開創新路徑，同時持續履行我們當下的承諾。

This orientation has fueled our strong second quarter performance, where I'm pleased to report that both Evernorth and Cigna Healthcare results were ahead of expectations. In the second quarter, The Cigna Group delivered total revenues of $71.7 billion and adjusted earnings per share of $7.78, all while we continue to reinvest in our business to fund growth, expansion, and innovation for our customers. I'm proud of our team around the world for continuing to focus on those we serve. Our strategy is aligned with what customers and patients need most. And our portfolio is purpose-built for where health care is headed, and its relevance has never been greater.

這樣的定位推動了我們強勁的第二季表現；我很高興報告 Evernorth 與 Cigna Healthcare 的結果皆優於預期。第二季 The Cigna Group 總營收達 717 億美元，調整後每股盈餘為 7.78 美元；同時我們持續再投資於業務，以支持成長、擴張與為客戶帶來創新。我為全球團隊持續聚焦於我們所服務的對象而感到自豪。我們的策略與客戶與病患最需要的方向一致。我們的產品組合是為醫療照護的未來走向量身打造，其重要性從未如此之高。

Now looking at our performance across our businesses, we continue to drive impact and growth across both Evernorth Health Services and Cigna Healthcare. Overall, Evernorth's earnings were slightly ahead of expectations, with revenues increasing 6% year over year, reflecting the continued demand for our services while we invest in broadening our offerings and expanding our reach.

接著看我們各項業務的表現，我們持續在 Evernorth Health Services 與 Cigna Healthcare 兩大板塊推動影響力與成長。整體而言，Evernorth 的獲利略優於預期，營收年增 6%，反映市場對我們服務的持續需求；同時我們也投資以擴大產品供給並拓展觸及範圍。

Our Specialty and Care Services businesses delivered pre-tax adjusted earnings growth of 22% year over year, fueled by secular tailwinds as well as the differentiated strengths in Accredo and our expanded suite of specialty pharmacy services that support hospitals and health systems. This quarter, we also saw faster-than-expected adoption of specialty generics and biosimilars both of which improve affordability for patients and clients.

我們的 Specialty 與 Care Services 業務稅前調整後獲利年增 22%，受惠於長期結構性順風，以及 Accredo 的差異化優勢與我們擴充的專科藥局服務組合，該組合可支援醫院與醫療體系。本季我們也看到專科學名藥與生物相似藥的採用速度快於預期，兩者皆有助於提升病患與客戶的可負擔性。

Our growth in specialty continues to be fueled by our unique portfolio capabilities, which enables us to better serve patients with more complex clinically intensive needs. We're seeing continued growth in the number of patients relying on specialty medications, and we are uniquely positioned to serve them with our market-leading access to more than 330 limited distribution medicines. Our highly personalized capabilities, including our clinical care teams, tailored engagement, and deep understanding of complex health journeys distinguish us in our ability to serve these patients.

我們在專科領域的成長持續由獨特的產品組合能力所驅動，使我們能更好地服務臨床上更複雜、照護強度更高的病患需求。我們看到依賴專科藥物的病患人數持續增加，而我們憑藉市場領先、可取得超過 330 種限量配銷藥品的能力，具備獨特的服務優勢。我們高度個人化的能力，包括臨床照護團隊、量身打造的互動方式，以及對複雜健康旅程的深刻理解，使我們在服務這些病患方面更具差異化。

Turning to our Evernorth Pharmacy Benefit Services business. We delivered pre-tax adjusted earnings of $609 million, reflecting the impacts of the previously discussed renewals and extensions of large client contracts as well as investments to support the transition to our new rebate-free model, which we call Signature.

接著談 Evernorth Pharmacy Benefit Services 業務。我們實現稅前調整後獲利 6.09 億美元，反映先前所提及大型客戶合約續約與延展的影響，以及為支持轉型至我們新的「無回扣」模式（我們稱之為 Signature）所進行的投資。

The team is making strong progress in the build-out of our Signature pharmacy benefits model. We see significant early interest from health plans and employers as we prepare for our broader market launch in 2028. This will follow our important next step of introducing Signature to Cigna Healthcare's fully insured plans next year.

團隊在建置 Signature 藥品福利模式方面進展良好。在我們為 2028 年更廣泛的市場推出做準備之際，我們看到健康保險計畫與雇主端出現顯著的早期興趣。在此之前，我們明年將先完成一個重要的下一步：把 Signature 導入 Cigna Healthcare 的全保（fully insured）方案。

At the same time, we're adding value and winning business today with 2027 representing one of our strongest selling seasons in recent years. We've been able to achieve this performance in Pharmacy Benefit Services through our winning combination of superior unit costs, clinical programs designed to improve adherence to therapies, and market-leading innovations that help our clients anticipate what is around the corner in a rapidly changing environment, helping them build and tailor solutions to meet their needs today while planning for the future.

同時，我們也在當下創造價值並贏得業務，而 2027 年代表了我們近年來最強勁的銷售旺季之一。我們能在藥房福利服務（Pharmacy Benefit Services）中達成這樣的表現，得益於我們致勝的組合：更優異的單位成本、旨在提升治療依從性的臨床計畫，以及市場領先的創新，協助客戶在快速變動的環境中預判未來趨勢，並在規劃長期的同時，打造與調整解決方案以滿足其當前需求。

Turning to Cigna Healthcare. We delivered results ahead of expectations with pre-tax adjusted earnings growth of 17%. While the needs of every client are unique, several factors contribute to why we continue to win in this segment. Our deep focus on the employer-sponsored health care market, where we have differentiated expertise, generating continued customer growth in our US Employer business.

接著談到 Cigna Healthcare。我們交出優於預期的成果，稅前調整後盈餘成長 17%。儘管每位客戶的需求各不相同，但有幾項因素促成我們持續在此業務領域勝出。我們深耕雇主贊助的醫療保健市場，在此我們具備差異化專業能力，並帶動美國雇主業務持續的客戶成長。

Our disciplined pricing and execution, including in our stop loss business where we continue to make progress on margin recapture, our strategic portfolio shaping to drive focus, our ability to continuously find new ways to innovate by leveraging data and clinical programs that keep people healthy, and our integrated solutions that provide improved access and coordination across medical, pharmacy, and behavioral health services.

我們嚴謹的定價與執行力（包括在停損保險業務中持續推進利潤率回收）、我們為提升聚焦而進行的策略性投資組合調整、我們透過運用數據與臨床計畫以持續尋找創新方式來維持民眾健康的能力，以及我們整合式解決方案所帶來的跨醫療、藥局與行為健康服務之更佳可近性與協調性。

For example, given the growing demand for mental health services, our most recent solutions demonstrate our continued industry leadership and make us the partner of choice. Our provider matching capabilities for behavioral health patients are reducing costs by matching patients with high-quality providers. And offerings like Headspace are expanding access to lower acuity behavioral health options, improving affordability, encouraging earlier intervention, and complementing demand for outpatient services.

例如，鑑於心理健康服務需求日益增加，我們最新的解決方案展現了我們持續的產業領導地位，並使我們成為首選合作夥伴。我們針對行為健康患者的醫療提供者配對能力，透過將患者與高品質提供者媒合來降低成本。而像 Headspace 這類方案，正在擴大較低強度（lower acuity）的行為健康選項之可近性，提升可負擔性、鼓勵更早介入，並補足門診服務需求。

As you can see, a consistent reason why we win in both Evernorth and Cigna Healthcare is our ability to innovate to meet evolving customer and client demands.

如各位所見，我們在 Evernorth 與 Cigna Healthcare 兩大業務都能勝出的共同原因之一，是我們能夠持續創新以滿足不斷演變的客戶與委託方需求。

Now I want to spend a few minutes sharing more about how we are applying data, technology, and AI to improve customer outcomes and transform business models. Our AI approach is built on a simple principle: start with the customer and patient and identify where innovation can drive the most meaningful impact for them.

接下來我想花幾分鐘分享，我們如何運用數據、科技與 AI 來改善客戶成果並轉型商業模式。我們的 AI 方法建立在一個簡單原則之上：從客戶與病患出發，找出創新能為他們帶來最具意義影響的領域。

We are leveraging technology and AI to drive better health outcomes, simplify and personalize customer experiences and lower costs, and then execute that at scale. This has enabled us to use AI to change the trajectory of the most complex clinical journeys to improve the lives of our customers and patients.

我們正運用科技與 AI 來推動更佳的健康成果、簡化並個人化客戶體驗並降低成本，並將其規模化落地執行。這使我們得以運用 AI 改變最複雜臨床旅程的走向，進而改善客戶與病患的生活。

One example is Pharmacy Forward, our recently announced AI-powered program designed to improve how patients access and incorporate specialty medications into their treatment plans. We are unlocking new ways to coordinate care for patients by shortening the time between when a patient received their prescription and when they can begin treatment, while minimizing administrative friction along the way.

其中一個例子是 Pharmacy Forward，這是我們近期宣布的 AI 驅動計畫，旨在改善病患取得並將專科藥物納入其治療計畫的方式。我們正透過縮短病患取得處方到開始治療之間的時間，並在過程中將行政摩擦降到最低，開創協調病患照護的新方式。

With Pharmacy Forward, we're focused on personalizing support, streamlining processing, and helping patients start and stay on therapy with greater ease and confidence. Our targeted use of AI is expected to cut time to therapy in half on average. And for clinicians, it enables them to deliver more connected, informed support, reducing their documentation time by up to 50%, freeing capacity to spend more time on patient care.

透過 Pharmacy Forward，我們聚焦於個人化支援、簡化流程，並協助病患更輕鬆且更有信心地開始並持續治療。我們針對性運用 AI，預期可使平均開始治療所需時間縮短一半。對臨床人員而言，這也使其能提供更連結、更具資訊基礎的支援，將文件作業時間最多降低 50%，釋放量能以投入更多時間於病患照護。

We'll find the same philosophy within Cigna Healthcare. We know patients navigating complex conditions benefit from personalized clinical support to improve both outcomes and affordability. This month, we announced an expansion of our AI-enabled care coordination capabilities to help us identify customers with emerging complex or chronic health needs earlier such as cancer, heart disease, and high-risk pregnancies, and connect them more quickly to the personalized clinical support they need.

在 Cigna Healthcare 也能看到相同的理念。我們知道，面對複雜病況的病患，若能獲得個人化的臨床支援，將有助於同時改善治療結果與可負擔性。本月，我們宣布擴大 AI 賦能的照護協調能力，協助我們更早辨識出出現複雜或慢性健康需求的客戶（例如癌症、心臟病與高風險妊娠），並更快速地將他們連結到所需的個人化臨床支援。

Through predictive models and AI-enabled insights, we will be able to expand support to 20% more customers with emerging complex health needs. This is not about replacing clinicians with technology but helping clinicians spend more time where they can make the greatest difference.

透過預測模型與 AI 賦能洞察，我們將能把支援擴大到多 20% 的、正出現複雜健康需求的客戶。這並非要用科技取代臨床人員，而是協助臨床人員把更多時間投入在最能產生影響的地方。

And the results speak for themselves. Customers who engage in these programs reduce medical costs by approximately $2,000 per year on average. Early engagement has already yielded a 42% reduction in avoidable inpatient stays amongst those customers.

而成果不言自明。參與這些計畫的客戶，平均每年可降低約 2,000 美元的醫療成本。早期介入已使這些客戶中可避免的住院（inpatient）住院率降低 42%。

What makes these efforts unique is that they're not standalone technology initiatives. They are enabled by the combination of data, clinical expertise, and pharmacy capabilities that exist across our enterprise, all focused on better serving our customers. We believe this ability to connect insights with action and action with measurable outcomes is a significant competitive advantage for The Cigna Group.

這些努力之所以獨特，在於它們並非獨立的科技專案。它們是由我們全企業範圍內的數據、臨床專業與藥局能力之結合所驅動，且一切都聚焦於更好地服務客戶。我們相信，這種將洞察連結到行動、並將行動連結到可衡量成果的能力，是 The Cigna Group 的重要競爭優勢。

As we look ahead, we'll continue to focus our investments on meaningful applications of AI that improve affordability, enhance the customer experience, help clinicians work more effectively, and create long-term value.

展望未來，我們將持續把投資聚焦於 AI 的具意義應用，以提升可負擔性、強化客戶體驗、協助臨床人員更有效率地工作，並創造長期價值。

Now let me summarize our results. We have a proven track record of delivering differentiated value for those we serve by innovating new solutions like Signature, Clearity, Pharmacy Forward, and personalized care coordination, as well as through our flexible model and meaningful partnerships.

現在讓我總結我們的成果。我們在為服務對象提供差異化價值方面擁有經驗證的紀錄，這來自於我們創新推出如 Signature、Clearity、Pharmacy Forward 與個人化照護協調等新解決方案，以及我們的彈性模式與具意義的合作夥伴關係。

As a result, in the second quarter, we delivered on our financial commitments with adjusted EPS of $7.78, and are pleased to increase our guidance for full year adjusted earnings per share to at least $30.45. Further, our company has attractive, sustainable growth opportunities in the long term, building on our history and track record of results delivery.

因此，在第二季，我們以調整後 EPS 7.78 美元達成財務承諾，並很高興將全年調整後每股盈餘指引上調至至少 30.45 美元。此外，本公司在長期具備具吸引力且可持續的成長機會，並將在我們的歷史基礎與成果交付紀錄之上持續發展。

Overall, our strong performance and disciplined execution throughout the first half of the year reflects the intentional design of our company and the passion of our coworkers for serving our customers.

整體而言，我們在上半年展現的強勁表現與紀律執行，反映了公司有意為之的設計，以及同仁服務客戶的熱忱。

With that, I'd like to turn it over to Ann.

接下來，我想把時間交給 Ann。

Thanks, Brian. Good morning, everyone. As Brian mentioned, our second quarter results reflect another quarter of strong execution for the enterprise with both Evernorth and Cigna Healthcare delivering pre-tax adjusted earnings above expectations.

謝謝，Brian。各位早安。如 Brian 所提到，我們第二季的成果反映出企業再次展現強勁的執行力，Evernorth 與 Cigna Healthcare 的稅前調整後盈餘皆高於預期。

During the second quarter, we delivered total revenues of $71.7 billion, adjusted after-tax earnings of $2.1 billion, and adjusted earnings per share of $7.78. With our strong second quarter performance, we are raising our full year 2026 adjusted earnings per share outlook to at least $30.45. This outlook reflects the strong first half performance while maintaining a prudent view of the current environment.

第二季期間，我們實現總營收 717 億美元、調整後稅後盈餘 21 億美元，以及調整後每股盈餘 7.78 美元。憑藉第二季的強勁表現，我們將 2026 全年調整後每股盈餘展望上調至至少 30.45 美元。此展望反映上半年強勁表現，同時對當前環境維持審慎看法。

Now turning to our segment results. I'll start with Evernorth. Second quarter 2026 revenues grew 6% year-over-year to $61.5 billion and pre-tax adjusted earnings were $1.7 billion. Specialty and Care Services delivered strong performance with pre-tax adjusted earnings growing 22% year-over-year to $1.1 billion, ahead of expectations. The year-over-year growth reflects the strength of our Specialty businesses supported by continued specialty utilization growth and increased biosimilar adoption.

接著看各業務分部的表現。我先從 Evernorth 開始。2026 年第二季營收年增 6% 至 615 億美元，稅前調整後盈餘為 17 億美元。專科與照護服務（Specialty and Care Services）表現強勁，稅前調整後盈餘年增 22% 至 11 億美元，優於預期。年增主要反映我們專科業務的強勁動能，並受惠於專科用量持續成長與生物相似藥採用率提升。

Additionally, we were successful in improving the penetration of specialty generics, including generic Revlimid. The higher penetration of biosimilars and specialty generics drives affordability and value to patients and clients and contributed favorably to earnings in the quarter.

此外，我們也成功提升專科學名藥的滲透率，包括 Revlimid 的學名藥。更高的生物相似藥與專科學名藥滲透率提升了病患與客戶的可負擔性與價值，並在本季對盈餘帶來正面貢獻。

Year-over-year earnings growth was further augmented by operating efficiencies and the income from our investment in Shields Health Solutions, which expands our reach into hospitals and health systems. The sustained growth in our Specialty and Care Services business reinforces our confidence in the long-term growth opportunity within Specialty and reflects the deliberate steps we've taken to position our company at the forefront of this attractive market.

年對年獲利成長進一步受惠於營運效率提升，以及我們對 Shields Health Solutions 的投資所帶來的收益；該投資擴大了我們在醫院與健康系統的觸及範圍。我們專科與照護服務（Specialty and Care Services）業務的持續成長，強化了我們對專科領域長期成長機會的信心，也反映出我們為使公司站上這個具吸引力市場前沿而採取的審慎步驟。

Within Pharmacy Benefit Services, pre-tax adjusted earnings were $609 million, down from the prior year, broadly as expected. Our performance reflects the previously discussed renewals and extensions of large client contracts and investments associated with the transition to our Signature rebate-free model.

在藥房福利服務（Pharmacy Benefit Services）方面，稅前調整後獲利為 6.09 億美元，較去年下降，整體而言符合預期。我們的表現反映了先前提及的大型客戶合約續約與延展，以及與轉換至我們 Signature 免回扣（rebate-free）模式相關的投資。

As we previously mentioned, we saw higher biosimilar and specialty generic adoption during the quarter, which benefited Evernorth's results, driving increased contribution in Specialty and Care Services while reducing contributions in Pharmacy Benefit Services.

如同我們先前提到的，本季我們看到生物相似藥與專科學名藥的採用率提高，這有利於 Evernorth 的業績表現，推動專科與照護服務的貢獻增加，同時降低藥房福利服務的貢獻。

Additionally, in the second quarter, we observed moderating GLP-1 growth as coverage levels slightly declined and utilization growth lowered from elevated levels experienced in prior periods. We expect this trend to continue throughout the remainder of the year, and it is contemplated in our full year outlook.

此外，在第二季，隨著給付覆蓋水準略為下降，且使用量成長自先前期間的高檔回落，我們觀察到 GLP-1 的成長趨勢趨於溫和。我們預期此趨勢將在今年剩餘期間持續，且已納入我們全年展望之中。

Overall, Evernorth's second quarter results reflect the continued strength of our Specialty and Care Services business, alongside progress in the evolution of our Pharmacy Benefit Services business.

整體而言，Evernorth 第二季的結果反映出我們專科與照護服務業務的持續強勁，同時也展現我們在推進藥房福利服務業務演進方面的進展。

Turning to Cigna Healthcare. Second quarter 2026 revenues grew 10% year-over-year to $11.8 billion, and pre-tax adjusted earnings were $1.3 billion. The Medical Care Ratio for the second quarter was 84.5%, slightly ahead of expectations. Cigna Healthcare delivered results ahead of expectations, driven by strong performance within the US Employer business. Broadly, overall cost trends remain elevated but stable.

接著談 Cigna Healthcare。2026 年第二季營收年增 10% 至 118 億美元，稅前調整後獲利為 13 億美元。第二季醫療照護比率（Medical Care Ratio）為 84.5%，略優於預期。Cigna Healthcare 的表現優於預期，主要由美國雇主（US Employer）業務的強勁表現所帶動。整體而言，總體成本趨勢仍處於高位，但維持穩定。

Against that backdrop, medical cost trends were slightly favorable to expectations during the quarter, reflecting lower outpatient trends, including lower surgical spend. Additionally, we continue to see good traction in the Employer market with medical membership growing year-to-date, reflecting the strength of our client relationships and the value of our offerings. Overall, we are pleased with Cigna Healthcare's performance, which reflects our disciplined pricing, effective care coordination, and focused execution.

在此背景下，本季醫療成本趨勢略優於預期，反映門診趨勢較低，包括手術支出下降。此外，我們在雇主市場持續看到良好動能，年初至今醫療會員數成長，反映我們客戶關係的強度以及我們產品與服務的價值。整體而言，我們對 Cigna Healthcare 的表現感到滿意，這反映出我們嚴謹的定價、有效的照護協調，以及聚焦的執行力。

Now turning to our outlook for the full year 2026. The strength of our second quarter performance gives us the confidence to increase our full year adjusted earnings per share outlook to at least $30.45, while maintaining a disciplined and prudent approach to the full year. Regarding the earnings cadence, we expect second half adjusted earnings per share to be split roughly evenly between the third and fourth quarter.

接著談我們對 2026 全年的展望。第二季表現的強勁讓我們有信心將全年調整後每股盈餘（adjusted EPS）展望上調至至少 30.45 美元，同時仍以嚴謹且審慎的方式看待全年。就獲利節奏而言，我們預期下半年調整後每股盈餘將在第三季與第四季之間大致平均分配。

Within Evernorth, we continue to expect full year pre-tax adjusted earnings of at least $6.9 billion and for the third quarter earnings seasonality to be consistent with prior years. Within Cigna Healthcare, we are raising our full year pre-tax adjusted earnings outlook to at least $4.55 billion and we expect the third quarter pre-tax adjusted earnings to be over 60% of the second half earnings.

在 Evernorth 方面，我們仍預期全年稅前調整後獲利至少 69 億美元，且第三季獲利季節性將與往年一致。在 Cigna Healthcare 方面，我們將全年稅前調整後獲利展望上調至至少 45.5 億美元，並預期第三季稅前調整後獲利將超過下半年獲利的 60%。

For the Medical Care Ratio, our full year MCR guidance remains unchanged, and we expect the third quarter MCR to be slightly above second quarter, consistent with historical seasonality.

就醫療照護比率（MCR）而言，我們全年 MCR 指引維持不變，且我們預期第三季 MCR 將略高於第二季，符合歷史季節性。

Turning to our 2026 capital management position. Second quarter operating cash flow was in line with expectations and consistent with historical patterns, which is influenced by calendarization impacts that shift a portion of receivables into early July. We continue to expect our cash flow to be back-half weighted, consistent with prior years. Our debt to capitalization ratio was 42.8% as of June 30, and we expect to end the year closer to our target of 40%.

接著談我們 2026 年的資本管理狀況。第二季營運現金流符合預期且與歷史型態一致；此結果受到日曆化（calendarization）影響，將部分應收款項移轉至 7 月初入帳。我們仍預期現金流將偏向下半年，與往年一致。截至 6 月 30 日，我們的負債對資本比率為 42.8%，並預期年底將更接近我們 40% 的目標。

In the second quarter, we repurchased approximately 900,000 shares of common stock for approximately $250 million. We continue to view share repurchases as an attractive use of capital, while maintaining a focus on debt paydown and disciplined capital management.

第二季我們以約 2.5 億美元回購約 90 萬股普通股。在維持聚焦於償還債務與嚴謹資本管理的同時，我們仍認為股票回購是具吸引力的資本運用方式。

Now to recap. Our second quarter results reflect focused execution with both Evernorth and Cigna Healthcare delivering pre-tax adjusted earnings above expectations, while we continue to make progress on initiatives to support our long-term growth strategy. We are pleased with our performance in the first half of the year and are confident in our increased full year 2026 adjusted earnings per share outlook of at least $30.45.

現在做個總結。我們第二季的結果反映出聚焦的執行力：Evernorth 與 Cigna Healthcare 的稅前調整後獲利皆高於預期；同時，我們也持續推進支持長期成長策略的各項計畫。我們對上半年表現感到滿意，並對上調後的 2026 全年調整後每股盈餘展望（至少 30.45 美元）充滿信心。

We look forward to our upcoming Investor Day in September, where we'll go deeper on our long-term strategy, growth opportunities, and the outlook for Evernorth and Cigna Healthcare.

我們期待 9 月即將舉行的投資人日（Investor Day），屆時我們將更深入說明長期策略、成長機會，以及 Evernorth 與 Cigna Healthcare 的展望。

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

接下來，我們把時間交給接線員，進入本次電話會議的問答環節。

(Operator Instructions) Stephen Baxter, Wells Fargo.

（接線員指示）Wells Fargo 的 Stephen Baxter。

I was wondering if you could maybe speak a little bit about how you'd expect the earnings growth progression within Evernorth to develop both for Specialty and Care and Pharmacy Benefits and how the pace of investments is impacting that.

我想請教您是否可以談談，您預期 Evernorth 內部的獲利成長軌跡將如何發展——包括專科與照護以及藥房福利兩個部分——以及投資步調如何影響這些表現。

Thanks, Steve. So we are really pleased with Specialty and Care's second quarter results, which exceeded our expectations. Now performance during the quarter was driven by continued strength in specialty utilization, faster-than-expected adoption of biosimilars and specialty generics, which improves operating efficiency. We saw improved operating efficiency and contributions from Shields.

謝謝你，Steve。我們對專科與照護第二季的結果非常滿意，表現超出我們的預期。本季的表現主要由專科用藥使用量持續強勁、以及生物相似藥與專科學名藥採用速度快於預期所帶動，進而提升營運效率。我們也看到營運效率改善，以及來自 Shields 的貢獻。

Notably, specialty generic penetration exceeded 80% for newer products during the quarter. These therapies improve affordability for patients and for clients, and contributed favorably to earnings performance.

值得注意的是，本季較新的產品中，專科學名藥滲透率超過 80%。這些療法提升了病患與客戶的可負擔性，並對獲利表現帶來正面貢獻。

So overall, we expect it to continue to perform well as we look through the back half of the year. We expect specialty generics and biosimilars to be a meaningful tailwind, and we expect strong -- we expected strong penetration throughout the year and built that into our original full year guide. We experienced it earlier than expected. So the magnitude of the benefit we saw in the second quarter is not expected to repeat at the same level in the third and fourth quarters, but we still expect strong results as we look to the back half of the year for Specialty and Care.

因此整體而言，展望下半年，我們預期其將持續維持良好表現。我們預期專科學名藥與生物相似藥將成為重要的順風因素；我們原先就預期全年將有強勁滲透率，並已納入原始全年指引。我們只是比預期更早看到這個趨勢。因此，我們在第二季看到的效益幅度，預期不會在第三季與第四季以同等水準重現，但就專科與照護而言，我們仍預期下半年將有強勁結果。

Lisa Gill, JPMorgan.

JPMorgan 的 Lisa Gill。

Brian, you made a comment that the PBM selling season was very strong. Can you maybe just do two things? One, can you talk about renewals and where your renewals are at? And two, can you size new business wins? And then thirdly, as we think about how important, how big your Specialty business is, can you talk about are there incremental opportunities within Specialty?

Brian，你提到 PBM 的銷售季非常強勁。能否請你做兩件事？第一，談談續約情況，以及你們的續約進度到哪裡了？第二，能否量化新業務得標的規模？第三，考量你們的專科業務有多重要、規模有多大，能否談談在專科領域是否還有額外的增量機會？

What did you see in this year's selling season specific to Specialty? Are you seeing carve-outs where you’re winning more business? Is it just incremental business through the PBM contracting? Just want to better understand how you're thinking about the selling season.

今年的銷售季在專科方面你們看到了什麼？你們是否看到 carve-outs（切割外包）而使你們贏得更多業務？還是只是透過 PBM 合約帶來的增量業務？我只是想更了解你們如何看待這個銷售季。

Lisa, I appreciate the multifaceted nature of that question. So maybe I'll talk about the '27 selling season just more generally across the company and get to some of the specifics of your question on our Pharmacy Benefit Services and Specialty businesses throughout that.

Lisa，我很感謝你這個問題所涵蓋的多面向性。所以我可能會先更概括地談談公司整體的 '27 銷售季，並在過程中再切入你對我們藥房福利服務（Pharmacy Benefit Services）與專科（Specialty）業務的一些具體問題。

As it relates to just common themes in the selling season, affordability continues to be the most pronounced problem across the health care space, and that's exacerbated certainly in the prescription drug space by the high unit prices for brand drugs. And then, of course, on the medical side, by the upward march of hospital prices, which has continued.

就銷售季的共同主題而言，可負擔性仍然是整個醫療保健領域最突出的問題；而在處方藥領域，品牌藥的高單價無疑加劇了這個問題。當然，在醫療端，醫院價格持續上升的趨勢也仍在延續。

And so those affordability pressures have led employers to consider alternate plan designs as well as financing solutions. Fortunately, we're well positioned to support employers and other buyers in those alternatives.

因此，這些可負擔性的壓力促使雇主考慮替代性的方案設計以及融資解決方案。所幸的是，我們具備良好條件，能夠在這些替代方案上支持雇主與其他買方。

A second common theme we're seeing is the focus on customer experience, what we call personalization, with employer and health plan clients increasingly looking for partners who will engage individuals with the right information at the right time in their preferred modality. And these themes are squarely where we're focused as an organization.

我們看到的第二個共同主題，是對客戶體驗的重視，也就是我們所稱的個人化（personalization）；雇主與健康計畫客戶愈來愈希望合作夥伴能以其偏好的方式，在正確的時間提供正確的資訊來與個人互動。而這些主題正是我們作為一個組織所聚焦的方向。

So as it relates to the specifics on the growth platforms, within our Evernorth Pharmacy Benefit Services business, we closed 2026 with over 97% retention. And the preliminary indicators for 2027 also suggest mid-90s or higher retention. So both of those 2026 and 2027 years are very consistent with historical norms. And to your point, as I shared earlier, our 2027 new business performance is quite strong. Total new business already secured is above the prior two selling seasons combined. So a very strong '27 new business performance.

至於成長平台的具體情況，在我們 Evernorth 藥房福利服務業務中，我們以超過 97% 的續約率結束 2026 年。而 2027 年的初步指標也顯示續約率在 90% 中段或更高。因此，2026 與 2027 這兩年的表現都非常符合歷史常態。而如你所提到、我先前也分享過的，我們 2027 年的新業務表現相當強勁。目前已取得的新業務總量已高於前兩個銷售季的合計。因此，'27 年的新業務表現非常強。

And looking forward, our new rebate-free signature model is generating considerable interest from both existing clients and prospects as we look to scale it in 2028 and beyond. So this is good evidence that our clients see us as a multi-year thought partner as they prepare for future changes in their pharmacy benefit programs.

展望未來，我們新的「無回扣」（rebate-free）旗艦模式正引發現有客戶與潛在客戶的高度興趣，我們也希望在 2028 年及之後擴大規模。這是很好的證據，顯示客戶將我們視為多年期的策略思考夥伴，協助他們為未來藥房福利計畫的變化做準備。

In the Specialty and Care services platform, we continue to benefit there from secular tailwinds, as Ann was just referencing, which leads to more patients utilizing specialty drugs along with our Accredo specialty pharmacy being included as a network option and even more unaffiliated PBM offerings.

在專科與照護服務（Specialty and Care services）平台方面，我們持續受惠於長期結構性順風（如 Ann 剛才提到的），這使得更多病患使用專科藥物；同時，我們的 Accredo 專科藥局也被納入網路選項，甚至在更多非關聯 PBM 的方案中提供。

We also continue to see strong growth in the hospital and health system space where our fee-based offerings from Verity, from Carepath, and some of the synergy we've been able to accomplish from our Shields Health Solutions investments are starting to pay off.

我們也持續看到在醫院與健康系統領域的強勁成長；我們來自 Verity、Carepath 的按費用計價（fee-based）產品，以及我們在 Shields Health Solutions 投資所帶來、已能實現的一些協同效益，正開始展現成果。

So putting all those pieces together, our solutions continue to adapt to market needs. We're confident in the long-term durability of The Cigna Group and pleased with the performance so far in the '27 selling season.

綜合以上各項因素，我們的解決方案持續因應市場需求而調整。我們對 The Cigna Group 的長期韌性充滿信心，也對目前 '27 銷售季的表現感到滿意。

AJ Rice, UBS.

AJ Rice，UBS。

I might pivot over to the benefits side. I appreciate the prepared remarks comment about the surgery volumes. I was wondering, is the overall cost trend you're seeing in the commercial business consistent with what you thought, high single digits I think is where it was pegged, or is it what you're seeing in surgical enough to move the needle?

我可能會把話題轉到福利端。我很感謝你在準備稿中提到手術量的評論。我想請問，你們在商業保險業務看到的整體成本趨勢，是否與你們原先的預期一致——我記得你們原本是以高個位數成長作為基準——還是你們在手術方面看到的情況足以對整體產生明顯影響？

And then, I guess, your comment on GLP-1, mainly on the Evernorth side. Is that helping you on the commercial cost trend? And you're also referencing a risk adjustment benefit. I wondered if you could size how meaningful that was for you in the quarter?

另外，我想問你對 GLP-1 的評論，主要是在 Evernorth 端。這是否有助於你們的商業保險成本趨勢？你們也提到了風險調整（risk adjustment）的效益。我想知道你能否量化一下，這在本季對你們而言有多重要？

AJ, I'll start on the first couple of components and Ann, maybe you can pick up on a risk adjustment and anything I missed from the first two pieces of AJ's question. So as it relates to Cigna Healthcare, obviously, we're pleased with the strong performance in the second quarter despite a challenging and dynamic operating environment, and the strong performance was driven by slightly favorable medical cost experience in the quarter, which resulted in the MCR being slightly favorable to expectations.

AJ，我先回答你問題的前兩個部分；Ann，風險調整以及我在前兩點可能遺漏的部分，或許你可以接著補充。就 Cigna Healthcare 而言，顯然我們對第二季在充滿挑戰且動態的營運環境下仍能有強勁表現感到滿意；這項強勁表現主要來自本季醫療成本經驗略為有利，因此 MCR（醫療成本率）也略優於預期。

Now to your point of absolute level, we continue to see high single digit type cost trends. So persistently elevated cost trend levels, not a significant deceleration and no acceleration fortunately as well. So that's how I would encourage you to think about what's happening with the cost trend environment.

至於你提到的絕對水準，我們仍然看到高個位數的成本趨勢。也就是說，成本趨勢水準持續偏高，並未出現明顯減速；所幸也沒有加速。因此，我會建議你用這樣的角度來理解目前的成本趨勢環境。

And to Ann's point, we're seeing -- we saw a little bit of favorability in the outpatient side, but again not enough to call it a break in cost trends at this juncture. And our forward-looking assumptions continue to assume an elevated cost trend environment through 2026 and 2027.

而呼應 Ann 的觀點，我們看到——我們在門診端看到些許有利因素，但仍不足以在此時就認定成本趨勢出現轉折。我們的前瞻性假設仍然認為，2026 與 2027 年將維持偏高的成本趨勢環境。

On the GLP-1 side, as we were talking about in respect to Evernorth, we saw some deceleration in the growth rate of GLP-1 prescriptions in the second quarter, which puts some very modest downward pressure on the PBS financial picture in the second quarter. That was more than offset by the strength in our Specialty business, which led to overall Evernorth results being above expectations.

在 GLP-1 方面，如同我們在談 Evernorth 時所提到的，我們在第二季看到 GLP-1 處方成長率有所放緩，這使得第二季 PBS 的財務表現承受非常輕微的下行壓力。但這一點被我們專科業務的強勁表現所抵銷，因此 Evernorth 整體結果仍高於預期。

To your point, on the Cigna Healthcare portfolio, the very modest benefit from the standpoint of GLP-1 prescriptions being a little bit lighter. But keep in mind, in the Cigna Healthcare portfolio, we serve many smaller employers who did not cover GLP-1s for weight management. So we continue to only see 15% to 20% of the book covering that for weight management. So the overall financial impact there was fairly immaterial as you think about the pull-through in the Cigna Healthcare portfolio.

就你提到的 Cigna Healthcare 組合而言，GLP-1 處方略少帶來的效益非常有限。但請記得，在 Cigna Healthcare 組合中，我們服務許多較小型的雇主，他們並未將 GLP-1 用於體重管理納入給付。因此，我們仍然只看到約 15% 到 20% 的保單組合涵蓋體重管理用途。所以，當你思考其在 Cigna Healthcare 組合中的連動影響時，整體財務影響相當不顯著。

Ann, can you address the risk adjustment question that AJ asked?

Ann，你可以回應一下 AJ 問到的風險調整問題嗎？

Yes, sure. So AJ, the release of the 2025 final risk adjustment data and also the June Wakely update for 2026 confirmed our risk adjustment position, so results were consistent with our expectations, and it wasn't a driver for the quarter.

好的，當然。AJ，2025 年最終風險調整資料的發布，以及 Wakely 在 2026 年 6 月的更新，都確認了我們的風險調整部位；結果與我們的預期一致，並不是本季表現的驅動因素。

Charles Rhyee, TD Cowen.

Charles Rhyee，TD Cowen。

Ann, I think you mentioned in Pharmacy Benefits or about biosimilars that it kind of benefits Specialty and it was -- it sounds like there was a little bit of a headwind for Pharmacy Benefits. Is that a function of -- maybe you can talk about sort of the mechanics is that you get better margins as on the SP side, but maybe the impacts in terms of rebate dollars and GPO fees on the Pharmacy Benefit side. And then just real quickly, if you could comment on in Cigna Healthcare, I know there's been a lot of concerns about IDR and maybe sort of talk about your exposure related to that and stop loss.

Ann，我想你在藥房福利（Pharmacy Benefits）或談到生物相似藥（biosimilars）時提到，它對專科業務有利，但對藥房福利端似乎有一點逆風。這是否是因為——也許你可以談談其中的運作機制：在 SP 端你們的利潤率更好，但在藥房福利端可能會受到回扣金額與 GPO 費用的影響。另外很快地，如果你能評論一下 Cigna Healthcare 方面，我知道市場對 IDR 有很多疑慮；也請談談你們在這方面以及停損（stop loss）的曝險。

Charles, let me just provide a few opening thoughts here and Ann can get some of the details on both of those important questions that you raised. So first off, on the specialty generics and biosimilars. We're really pleased with the strong second quarter performance as we saw more rapid adoption of both biosimilars and specialty generics in the quarter.

Charles，我先提供幾點開場想法，Ann 之後可以就你提出的兩個重要問題補充一些細節。首先，關於專科學名藥與生物相似藥。我們對第二季的強勁表現感到非常滿意，因為我們在本季看到生物相似藥與專科學名藥的採用速度更快。

And importantly, we're seeing this building momentum across America of biosimilars and specialty generics, powered forward particularly in the past couple of years as Humira biosimilars become more mainstream. And really, we're still in the starting point of a multi-year wave with respect to more biosimilars, especially generics coming to market.

而且很重要的是，我們看到生物相似藥與專科學名藥在全美正累積動能，特別是在過去幾年，隨著 Humira 生物相似藥逐漸成為主流而加速推進。而且實際上，就更多生物相似藥、尤其是學名藥上市而言，我們仍處於一波為期多年的浪潮起點。

And importantly, these cost-effective prescription drug alternatives are all examples of putting our patients first in our strategy because they result in lower out-of-pocket costs as well as a better net price for the employer, the health plan, or the government entity that's funding the drug underneath. So we're really pleased to see that.

同樣重要的是，這些具成本效益的處方藥替代方案，都是我們策略中「以病患為先」的例子，因為它們能降低自付費用，同時也為雇主、健康保險計畫或為藥品買單的政府機構帶來更好的淨價格。因此我們很高興看到這樣的發展。

On the Cigna Healthcare side, as I mentioned earlier in AJ's question, we're pleased with the favorability we saw in the second quarter in aggregate for Cigna Healthcare. Relative to the IDR aspect of your question, we do support the overall strategic intent of consumer protection from surprise billing. However, we're seeing some clear abuses of the IDR vehicle in practice. So we're seeing right now the IDR mechanism has seen unsustainable volume levels, much of which is concentrated amongst a small number of providers.

在 Cigna Healthcare 方面，如我先前在回應 AJ 的問題時提到的，我們對第二季 Cigna Healthcare 整體呈現的有利表現感到滿意。就你問題中提到的 IDR 部分而言，我們支持其整體策略意圖，也就是保護消費者免於突襲式帳單。然而，我們看到 IDR 機制在實務上存在一些明顯的濫用情形。因此我們目前看到 IDR 機制的案件量已達到不可持續的水準，其中很大一部分集中在少數幾家醫療提供者。

The vast majority of the settlements are favoring providers both in terms of the frequency of wins and losses as well as the result in payment amounts. And all of this just further exacerbates the affordability challenges for employers and health plans who are ultimately required to pay these outsized settlement amounts.

絕大多數的和解結果都偏向醫療提供者，無論是在勝負頻率上，或是在支付金額的結果上皆然。而這一切只會進一步加劇雇主與健康保險計畫的可負擔性挑戰，因為最終他們必須支付這些過高的和解金額。

In fact, 2025 alone, the research that was published showed $15 billion in health care spending across the industry was processed through the IDR mechanism. And we view much of that spending as wasteful or abusive. Now for us, specifically, the impact has been manageable within our Cigna Healthcare planning and pricing assumptions. So a little bit of color on each of those parts of your question.

事實上，僅 2025 年，已發布的研究顯示，全產業有 150 億美元的醫療支出是透過 IDR 機制處理的。而我們認為其中相當一部分支出屬於浪費或濫用。就我們而言，具體影響在 Cigna Healthcare 的規劃與定價假設內仍屬可控。以上就你問題的各個部分補充一些說明。

Ann, maybe you can talk a little bit about the P&L geography, if you will, on the generics and biosimilars, is there anything further you want to add on the Cigna Healthcare side?

Ann，也許你可以談談學名藥與生物相似藥在損益表（P&L）上的「地理分布」（如果可以這麼說）的情況；另外在 Cigna Healthcare 這邊，你還有沒有想補充的？

Sure. So on the specialty generics and the adoption of that and how it sort of lands geography wise within the P&L -- as we see stronger adoption of biosimilars and specialty generics, it’s a benefit for us overall in Evernorth from a margin perspective. It benefits the patients and our clients as well. But the economics shift from Pharmacy Benefit Services to the Specialty and Care line. And there's also -- because drug costs are lower, you'll see a sort of not a proportional increase in the revenue line. So overall, I'd say, overall net benefit to Evernorth as a whole. Lower results in Pharmacy Benefit Services and higher results in Specialty and Care are sort of how it all comes together.

當然。關於專科學名藥及其採用情況，以及它在損益表中按「地理」來看會落在哪裡——隨著我們看到生物相似藥與專科學名藥的採用更為強勁，從利潤率角度來看，這對 Evernorth 整體是有利的。這也同樣有利於病患與我們的客戶。但經濟效益會從 Pharmacy Benefit Services 轉移到 Specialty and Care 這條線。此外——因為藥品成本更低，你會看到營收端不會出現等比例的增加。所以整體而言，我會說對 Evernorth 整體是淨受益。Pharmacy Benefit Services 的結果較低、Specialty and Care 的結果較高，這大致就是整體如何匯總呈現。

I think your last -- so I was just shifting over to the stop loss. I think your last question was there on stop loss, I’d just say that we're tracking in line with expectations. So it was not a variance driver in the second quarter. We've done a lot of work to enhance our analytics and clinical data to monitor early performance and these indicators are tracking well.

我想你最後一個——所以我剛才轉到停損（stop loss）。我想你最後一個問題是關於停損；我只想說我們的追蹤結果符合預期。因此第二季它並不是造成差異的驅動因素。我們已做了大量工作來強化分析能力與臨床資料，以監測早期表現，而這些指標目前追蹤良好。

I'll just give one example. We've seen stable frequency trends in high cost claimants across multiple attachment point levels. So these trends have developed consistent with both our expectations and in line with the levels that we observed last year. So all in all, we -- all of these indicators support our confidence in the stop loss book and our expectations for the full year.

我舉一個例子。我們看到在多個自負額門檻（attachment point）水準下，高成本理賠人（high cost claimants）的發生頻率趨勢保持穩定。因此這些趨勢的發展既符合我們的預期，也與我們去年觀察到的水準一致。總體而言，我們——所有這些指標都支持我們對停損業務組合的信心，以及我們對全年表現的預期。

Justin Lake, Wolfe Research.

Justin Lake，Wolfe Research。

Just want to follow up on something you just talked about here. Your Specialty growth has been phenomenal in the first half of the year. Your guidance is intact for Evernorth overall. So it does feel like the PBM services side is maybe a little weaker. And -- so that was kind of the core of my question.

我想追問一下你剛才提到的內容。你們的 Specialty 在上半年成長非常亮眼。你們對 Evernorth 整體的指引維持不變。所以感覺 PBM 服務這一端可能稍微弱一些。——所以這大概就是我問題的核心。

It sounded like in your last answer, you were talking about the fact that there might be some geography of earnings shift because of biosimilars. So I was hoping maybe you can double-click on that a little bit. Is there any way to give us some proportionality or put some numbers around how that -- how much Specialty earnings are being benefited by that and how much PBM earnings are being kind of offset?

聽起來在你上一個回答中，你提到因為生物相似藥，獲利可能會出現某種「地理」上的移轉。所以我希望你能再深入一點說明。有沒有辦法給我們一些比例概念，或用數字量化一下——Specialty 的獲利因此受益多少，而 PBM 的獲利又被抵銷了多少？

Sure. Thanks for the question, Justin. Maybe I'll just start just by saying we're really pleased with overall Evernorth's second quarter performance, which came in slightly ahead of expectations. So there were pockets of outperformance in the quarter. We saw faster penetration, like you said, for specialty generics and biosimilars in Specialty and Care and also some modestly lower-than-expected GLP-1 volume growth. So when you couple those together, it supports maintaining our current guidance rather than raising at the time.

好的。謝謝你的問題，Justin。也許我先說，我們對 Evernorth 第二季整體表現非常滿意，實際結果略高於預期。因此本季有一些領域表現超出預期。我們看到 Specialty and Care 端的專科學名藥與生物相似藥滲透率提升速度更快（如你所說），同時 GLP-1 用量成長也略低於預期。把這兩者合在一起看，支持我們維持目前指引，而不是在當時上調。

As we look ahead at the back half of the year, we continue to expect specialty generics and biosimilars to be a meaningful tailwind. However, we came into the year, we expected strong penetration throughout the year, and we've built that into our original full year guide. So we experienced it earlier than expected. So the magnitude of the benefit that we saw in the second quarter is sort of not expected to repeat at the same level in the third and fourth quarters.

展望下半年，我們仍預期專科學名藥與生物相似藥將是重要的順風因素。不過，我們在年初就預期全年會有強勁的滲透率，並已將其納入原先的全年指引。因此我們只是比預期更早看到這個效益。所以第二季所看到的受益幅度，預期不會在第三、第四季以同樣水準重複出現。

And so -- at the same time, within Pharmacy Benefit Services, we saw the moderation of GLP-1 growth rates that had a slight impact on the actual quarter, but we expect that dynamic to continue through the balance of the year.

同時，在 Pharmacy Benefit Services 方面，我們看到 GLP-1 成長率放緩，對本季實際結果造成些微影響，但我們預期這個動態會在今年剩餘期間持續。

So when we look across Evernorth, we've got a couple of offsetting dynamics. PBS tracking modestly below our earlier assumptions due to the shift in economics and the faster adoption of specialty generics and slightly lower GLP-1 volume growth, while Specialty and Care is performing above our expectations, driven by the continued strength in the specialty generics and biosimilars. So when we put that all together, we remain confident in the overall strength of the Evernorth business and in our prudent full year outlook.

因此，從 Evernorth 整體來看，我們有幾個彼此抵銷的動態。由於經濟效益的移轉、專科學名藥採用更快，以及 GLP-1 用量成長略低，PBS 的表現較我們先前假設略為偏低；而 Specialty and Care 的表現則高於預期，主要由專科學名藥與生物相似藥的持續強勁所帶動。綜合以上，我們仍對 Evernorth 業務的整體實力，以及我們審慎的全年展望充滿信心。

Just to simplify this down a bit as you think about what happened in the second quarter versus the full year, we had strength in the second quarter above expectations for Evernorth. We're anticipating a little bit of modest downward pressure on the GLP-1 volumes for the back half of the year.

為了把這件事簡化一些，當你比較第二季發生的情況與全年時，我們第二季的確有高於預期的強勁表現。我們預期下半年 GLP-1 用量會面臨一些溫和的下行壓力。

So essentially, the outperformance in the second quarter is given back in the form of slightly lower GLP-1 volumes in the back half of the year. So that's how I encourage you to think about the overall segment. But importantly, the overall strength of our enterprise allowed us to raise adjusted EPS for the full year to at least $30.45, which we feel very good about heading into the third quarter here.

所以本質上，第二季的超預期表現，會以下半年 GLP-1 用量略低的形式被「回吐」。這就是我建議你用來理解整體分部表現的方式。但重要的是，我們企業整體的實力使我們能把全年調整後 EPS 上調至至少 30.45 美元，對於即將進入第三季，我們對此感到非常有信心。

Erin Wright, Morgan Stanley.

Erin Wright，摩根士丹利。

Great, thanks. And might be getting ahead of the Investor Day, but you're obviously taking a step back in the PBM with a -- or PBS with the transition that you're making this year, but do you remain relatively flat in that business in 2027 and then grow 2% to 4% PBS long term? Is that the right kind of growth algorithm with durable margins in that 3% to 4%? And net-net, does that mean that you hit the low end of the 10% to 14% EPS growth in 2027?

很好，謝謝。可能有點超前投資人日的討論，但你們今年在PBM（或PBS）隨著正在進行的轉型，顯然是在該業務上退一步；不過你們是否預期該業務在2027年大致持平，然後長期PBS成長2%到4%？這是否是正確的成長算法，同時能維持在3%到4%的可持續利潤率？整體而言，這是否意味著你們在2027年能達到10%到14% EPS成長的低端？

And just as it relates to that PBS model transition, you spoke to the selling season, which, yes, is important, but it's also early. But there's other levels of recontracting here that are important, right, like in terms of the renegotiation process with pharma companies and pharmacy as well. I guess how is that part of the transition progressing relative to plan?

另外，關於PBS模式轉型，你提到銷售季，這當然重要，但也還早。不過這裡還有其他層面的重新簽約也很重要，對吧？例如與藥廠以及藥局端的重新談判流程。我想問的是，這部分的轉型進度相較於計畫如何？

Good morning, Erin. There's a few different aspects to your question. So let me talk first about the financial side, and then I'll pivot over into the status of our Signature model build-out. So relative to where we are on '27 and the multiyear trajectory of PBS, obviously, we're only halfway through '26. So it's a bit early to provide formal guidance for '27.

早安，Erin。你的問題有幾個不同面向。我先談財務面，接著再轉到我們Signature模式建置的進展狀況。就我們對2027年以及PBS多年期走勢的看法而言，顯然我們目前才走到2026年的一半。因此現在要對2027年提供正式指引還稍早。

That said, at the enterprise level, our view for '27 continues to be consistent with our prior commentary to deliver against our 10% to 14% EPS algorithm. And we'll provide more detailed guidance as we typically do on our segments during our fourth quarter call.

不過，在企業整體層面，我們對2027年的看法仍與先前的評論一致，也就是將依照我們10%到14%的EPS算法來交付成果。我們會如同以往在第四季電話會議中，提供各事業部更詳細的指引。

As it relates to Signature and the status of where we are right now, first off, we're proud to lead the industry with our new Signature pharmacy benefits offering. As I mentioned earlier, affordability continues to be the number one challenge facing patients, and that's particularly acute for high-cost branded prescriptions, which represents just 10% of all prescriptions in America, but some 90% of the drug spending.

至於Signature以及我們目前的進展，首先，我們很自豪能以全新的Signature藥房福利方案引領產業。如我先前提到的，可負擔性仍是病患面臨的第一大挑戰，而這在高成本品牌處方藥上尤其嚴峻；這類處方僅占美國所有處方的10%，卻約占藥品支出的90%。

And as we engage with all key stakeholders across the pharmacy benefits ecosystem, whether that's an individual employer or broker or drug manufacturers themselves, everyone acknowledges that the status quo is unsustainable.

當我們與藥房福利生態系中的所有關鍵利害關係人互動時，無論是個別雇主、經紀人，或是藥品製造商本身，大家都認同現狀不可持續。

So the market feedback so far on our work there has been positive as these stakeholders learn more about the model. When you think about the Signature model, it's fully aligned with the requirements of the Consolidated Appropriations Act provisions, which will be effective in mid-2028. And with our Signature model, we took it even multiple steps further beyond that regulatory minimum in order to simplify pharmacy benefits for our stakeholders.

因此，隨著這些利害關係人對該模式了解加深，市場對我們這項工作的回饋目前為止是正面的。談到Signature模式，它完全符合《綜合撥款法案》（Consolidated Appropriations Act）相關條款的要求，該條款將於2028年年中生效。而在Signature模式中，我們更在法規最低要求之上再往前推進了好幾步，以便為利害關係人簡化藥房福利。

So for patients the Price Assure capability guarantees customers the lowest possible out-of-pocket cost. So whether that's through our negotiated price, their co-pay, or a cash pay alternative for employers and other clients. We're seeing a lot of interest and appetite here because there are increasing fiduciary obligations, and they see the Signature model as a direct way of meeting those obligations, and the model offers greater budget predictability through simple fee-based arrangements.

對病患而言，Price Assure功能可保證客戶自付費用為可能的最低水準。無論是透過我們協商的價格、他們的共付額，或是提供給雇主及其他客戶的現金支付替代方案。我們看到很高的興趣與需求，因為受託責任（fiduciary obligations）正在增加，而他們將Signature模式視為直接履行這些責任的方法；同時，該模式透過簡單的按費用計價安排，提供更高的預算可預測性。

You also asked about drug manufacturers. We've been actively engaged in conversations there for months, starting with the larger ones. The conversation so far, positive and productive. Manufacturers know that lower prices for patients at the counter will ultimately result in greater satisfaction, better adherence, less need for copay assistance. You also asked about the network pharmacies. Our new reimbursement model of cost plus a dynamic dispensing fee will ensure that clinical complexity is properly reflected in what the pharmacies are ultimately paid.

你也問到藥品製造商。我們已經積極進行相關對話好幾個月，先從大型製造商開始。目前為止的對話是正面且具建設性的。製造商知道，讓病患在櫃檯端支付更低價格，最終會帶來更高的滿意度、更好的用藥依從性，也更不需要共付額補助。你也問到合作藥局（network pharmacies）。我們新的給付模式——成本加上動態調劑費（cost plus a dynamic dispensing fee）——將確保臨床複雜度能適當反映在藥局最終獲得的報酬中。

So put all those pieces together, we're tracking well to scale our Signature offerings in 2028, and we'll have the Cigna Healthcare insured book as early adopters in 2027. And I shared the strong 2027 selling season as an early data point that our clients are seeing us as a multi-year thought partner that they prepare for all those future changes in their pharmacy benefit programs. And we're confident that ultimately, our Signature product will yield margins in that 4% range as you asked about, similar to what our legacy pharmacy benefit solutions products were able to deliver.

把這些要素綜合起來看，我們正按計畫推進，將在2028年擴大Signature方案的規模，而Cigna Healthcare的承保業務（insured book）將在2027年成為早期採用者。我也分享了2027年強勁的銷售季，作為一個早期數據點，顯示客戶將我們視為多年期的思考夥伴，協助他們為藥房福利計畫中未來的各項變革做準備。我們也有信心，最終Signature產品將如你所問，帶來約4%的利潤率，與我們既有的藥房福利解決方案產品過去所能達成的水準相近。

So apologies for all the detail there, but hopefully, that hits the core of your question.

抱歉講得有點細，但希望有切中你問題的核心。

Kevin Fischbeck, Bank of America.

Kevin Fischbeck，美國銀行。

Great. Maybe if I sneak in two just real quick. What kind of free cash flow are you expecting in the back half of the year? I think you've talked about that accelerating? Just trying to figure out what's available for capital deployment.

很好。我想快速插問兩個問題。你們預期下半年自由現金流會是多少？我記得你們提過會加速？我只是想了解可用於資本配置的資金規模。

But then also kind of maybe building on the Signature commentary. Any update on just how the transition expenses are coming in, you still feel good about those numbers and then those numbers going away starting in '28 and then by '29?

另外也延伸一下Signature的評論。轉型費用的最新情況如何？你們仍對那些數字有信心嗎？以及那些費用是否會從2028年開始消失，並在2029年完全結束？

And I wasn't sure -- I mean, I think most of your comments about Signature and reception to Signature have been on the PBM side of things. And I understand that the rebate aspect, it might be the biggest component of Signature so it doesn't really apply to the risk customers, but there are other aspects to it as far as you mentioned the point-of-sale rebates and things like that. How are those things being received by your risk customers as you head into 2027? Any feedback there?

我不太確定——我的意思是，我想你們對Signature以及市場對Signature的反應，多半是從PBM端來談。我理解回扣（rebate）面向可能是Signature最大的組成部分，因此對承擔風險的客戶（risk customers）可能不太適用，但你也提到一些其他面向，例如銷售點回扣（point-of-sale rebates）之類。在邁向2027年的過程中，這些做法在你們的風險型客戶那邊的接受度如何？有任何回饋嗎？

So thanks for the question, Kevin. I'll start on the first two parts of the question related to cash flow and transition expenses. So as you know, our cash flow can move around from quarter to quarter, largely because of the timing of supply chain receivables and payables. Second quarter is typically lighter than other quarters, primarily because of calendarization shifts -- shifts a portion of receivable payments into early July. So that timing, if you're looking at our second quarter or first half cash flows, that timing affected the numbers that you see, but our full year outlook remains unchanged. We continue to expect operating free cash flow of approximately $9 billion and that to be mostly back half weighted.

謝謝你的問題，Kevin。我先回答前兩個部分，關於現金流與轉型費用。如你所知，我們的現金流會在各季度之間波動，主要是因為供應鏈應收款與應付款的時間差。第二季通常比其他季度輕，主要是因為日曆化（calendarization）的變動——會把一部分應收款的收款時間移到7月初。因此，如果你看我們第二季或上半年的現金流，那個時間因素會影響你看到的數字，但我們對全年展望維持不變。我們仍預期營運自由現金流約為90億美元，而且大部分會集中在下半年。

Specifically with respect to your question on the transition expenses, we came into the year with an expectation of continued investment in Signature. We are tracking exactly to what we expected to spend this year. We expect to spend similar levels in '27. And then we'll continue -- obviously, continue to invest in the business over time at the right level. But the levels of investments should ramp down over time.

就你問到的轉型費用而言，我們在年初就預期會持續投資Signature。我們目前的支出進度完全符合今年原先預期。我們預期在2027年也會維持相近的支出水準。然後我們會持續——當然，會在適當的水準下長期投資這項業務。但投資水準應會隨時間逐步下降。

And the final piece of your question in terms of market receptivity from our employer clients. It's -- obviously, the impact of moving into Signature model will vary client to client. So those that have high deductible plans tend to see the most amount of change relative to where they are today. Those that are in co-pay plans today tend to have minimal impact relative to what it does to their financials, what it does to patient by patient cost sharing dynamics. So the impact varies by client.

而你問題的最後一部分，是關於我們雇主客戶端對市場的接受度。很明顯，轉向 Signature 模式的影響會因客戶而異。因此，採用高自付額方案的客戶，相較於他們目前的狀況，通常會看到最大的變化幅度。而目前採用定額自付（co-pay）方案的客戶，對其財務面、以及逐一病患的成本分攤機制而言，影響通常相對有限。所以影響會因客戶而不同。

For our risk book thus far, Kevin, it's actually very smooth because if you think about the way risk business is priced, everything is in there from the standpoint of there's one price and as a result of that, we consult client by client with any plan design changes that they may want to consider. But so far so good on the risk book of business.

就我們目前的風險業務組合而言，Kevin，其實非常順利，因為如果你想想風險業務的定價方式，從某種角度來看都已經包含在內——就是一個價格；因此，我們會逐一與客戶諮詢他們可能想考慮的任何方案設計變更。但到目前為止，風險業務組合的進展都很好。

In 2028, we'll scale the model more broadly and we'll have a lot more self-funded business in this model. And as I was making reference to earlier, that's where we see particularly the increase in demands on fiduciary obligations being important and a lot of our clients interested to move to this simple fee-based transparent model that we've introduced.

到 2028 年，我們會更廣泛地擴大這個模式，並且會有更多自籌資金（self-funded）的業務採用此模式。如同我先前提到的，這也是我們特別看到受託責任（fiduciary obligations）要求提高的重要性之處，且許多客戶有興趣轉向我們推出的這種簡單、按費用計價且透明的模式。

Scott Fidel, Goldman Sachs.

Scott Fidel，高盛。

Interested if -- just with the planned exit from the exchange business and how that's going to free up some capital and also just some of the resources -- just looking at the looking at the Cigna Healthcare business, are there other end markets or existing lines of business that you’re sort of thinking about emphasizing more or looking to potentially sort of roll out additional offerings? And clearly, Middle Market and Select have been sort of the long-term historical focus, I'm sure that you're going to continue to do that. But maybe National Accounts or large group? Curious around how you're thinking about maybe redeploying resources of capital into them as you as you remove the exchange capital and resources off of the portfolio.

我想了解的是——隨著計畫退出交易所（exchange）業務，這將釋放一些資本以及部分資源——從 Cigna Healthcare 業務來看，是否還有其他終端市場或既有業務線，是你們正在考慮加大投入、或可能推出更多產品/服務的？而且很明顯，中型市場（Middle Market）與 Select 一直是長期的歷史重點，我相信你們會持續聚焦。但例如 National Accounts 或大型團體（large group）呢？我想知道，當你們把交易所業務的資本與資源從投資組合中移除後，你們如何思考把資本與資源重新部署到這些領域。

Scott, I'll start and then Ann can pick up on the implications of the Individual exchange sunsetting that will happen at the end of this calendar year. Overall, we really like our positioning in the Cigna Healthcare business and do not feel any compelling need to enter different end markets at this juncture.

Scott，我先回答，然後 Ann 可以補充個人交易所（Individual exchange）業務在本曆年年底落日（sunsetting）所帶來的影響。整體而言，我們非常喜歡 Cigna Healthcare 業務的定位，現階段並不覺得有任何迫切需要去進入不同的終端市場。

And a lot of that comes back to the discipline we've had around portfolio shaping and being really focused as to where we feel we have the differential right to win and not trying to be all things to all people in terms of serving all different end markets where we maybe don't have the specialization or the expertise.

這很大一部分回到我們在投資組合塑形（portfolio shaping）上的紀律：我們非常聚焦於我們認為具備差異化「致勝權」（right to win）的領域，而不是試圖在服務各種不同終端市場上面面俱到——尤其是在那些我們可能缺乏專業化或專長的領域。

So we'll continue to invest in our US Employer business in the way that we have for many years, and we continue to see more headroom for growth, particularly in the under 500 Select segment, where we've continued to grow even in a very complex dynamic operating environment. You’ll see, customers are up 5% year-over-year, and we couple that with our expertise in risk transfer with our stop loss offerings where we're tracking for over $8 billion of premiums this year. So we continue to really like the US Employer space.

因此，我們會一如既往、延續多年來的做法，持續投資於美國雇主（US Employer）業務；我們也仍然看到更大的成長空間，特別是在 500 人以下的 Select 分群，即使在非常複雜且多變的營運環境中，我們仍持續成長。你會看到，客戶數年增 5%；同時我們也結合我們在風險移轉方面的專業，透過停損（stop loss）產品，今年保費規模預計超過 80 億美元。因此，我們仍然非常看好美國雇主市場。

Now along with that, there are a variety of additional products that can attach. So things like more and more supplemental health benefits or voluntary benefits as employers look for opportunities for affordability improvement. So we see more and more benefits potentially going to a voluntary chassis over time. So we're excited about that opportunity.

此外，還有各式各樣可附加的產品。例如，隨著雇主尋求提升可負擔性的機會，補充性健康福利或自願性福利（voluntary benefits）會越來越多。因此，我們看到隨著時間推移，越來越多福利可能會轉向以自願性福利架構（voluntary chassis）來承載。我們對這個機會感到非常興奮。

We continue to look to scale our International Health business, which has been, while a small part of the overall company, a very strong source of performance over a multi-year period. So do not feel compelled to get into other elements of the health plan space at this point. We're quite pleased with what we have in terms of the current franchise. Ann, do you want to pick up on the Individual exchange exit implications?

我們也持續尋求擴大國際健康（International Health）業務規模；雖然它在整體公司中占比不大，但在多年期間一直是非常強勁的績效來源。因此，目前我們並不覺得需要進入健康保險計畫領域的其他環節。就現有的業務版圖而言，我們對目前的特許經營（franchise）相當滿意。Ann，你要不要補充一下退出個人交易所的影響？

Yes, sure. So there are two key factors to consider regarding the impact of the ACA exchange exit when you're thinking about our 2027 results. So as a reminder, for this year, we're coming into the year, we expected margins in the business to be positive, but below target levels. Year-to-date, we're tracking consistently with that expectation, sort of right on point. So that's a consideration as you look into '27.

好的，當然。因此，當你在思考我們 2027 年的結果時，關於退出 ACA 交易所的影響，有兩個關鍵因素需要考量。提醒一下，今年年初我們預期該業務的利潤率會是正的，但低於目標水準。截至目前，我們的追蹤結果與該預期一致，基本上正好符合。因此，這是你展望 2027 年時的一項考量。

Second, we do expect some stranded overhead as we exit the business. We're continuing to evaluate, manage through this impact. We'll provide further details on that as we close out the year. And then lastly, to your point on capital release, there'll be a modest capital release, but nothing of significance to note with respect to that.

第二，隨著我們退出該業務，我們確實預期會有一些「擱置」的間接費用（stranded overhead）。我們正在持續評估並管理這項影響。我們會在年底結束時提供更多細節。最後，關於你提到的資本釋放，會有小幅的資本釋放，但沒有任何值得特別指出的重大事項。

Jason Cassorla, Guggenheim.

Jason Cassorla，Guggenheim。

Great, thanks. Maybe just on the medical side of Specialty and Care. You've had the investment in Shields for almost a year now. You flagged opportunities to partner with hospitals and health systems. I was just hoping maybe you could delve into that a little bit more.

很好，謝謝。也許先談 Specialty and Care 的醫療端。你們對 Shields 的投資到現在差不多快一年了。你們提到與醫院及健康系統合作的機會。我希望你們能再深入談談這一點。

It sounds like you're seeing strong growth there. But I guess where are you seeing in terms of your solutions resonating, if the momentum that you're seeing kind of gives you greater confidence in penetrating that market? I guess, just a bit more on the trends and expectations within the hospital and health system opportunity would be very helpful.

聽起來你們在那裡看到強勁成長。但我想問的是，你們看到你們的解決方案在哪些方面最能引起共鳴？你們目前看到的動能，是否讓你們對滲透該市場更有信心？我想，多談一些醫院與健康系統機會中的趨勢與預期，會非常有幫助。

Jason. So I'll take that question as it relates to the, we call it our Health System Services business within Specialty and Care Services, and we call it Health System Services because it's both hospitals and health systems, and really builds on the expertise that we've amassed over a multi-year period in the specialty pharmacy space.

Jason。我來回答這個問題，這與我們在 Specialty and Care Services 之下、我們稱之為 Health System Services 的業務有關；我們之所以稱為 Health System Services，是因為它同時涵蓋醫院與健康系統，並且真正建立在我們多年來在專科藥局（specialty pharmacy）領域累積的專業之上。

So if you think about specialty pharmacy space more broadly, it's approaching a $500 billion total addressable market with high single-digit secular growth moving forward. So one of the few subsegments of the US health care system with such strong secular growth, which is why we're so excited about our existing position as well as the expanding capabilities we're developing in the hospital and health system space.

如果你從更廣的角度看專科藥局領域，它正接近 5,000 億美元的總可服務市場（TAM），未來仍有高個位數的長期結構性成長。因此，它是美國醫療體系中少數具有如此強勁長期結構性成長的子領域之一；這也是為什麼我們對既有的市場地位，以及我們在醫院與健康系統領域正在打造的擴展能力感到非常振奮。

Now within that $500 billion -- nearly $500 billion addressable market, approximately 60% of that is what we describe as direct-to-patient, where we've already achieved an industry leadership role in this clinically intensive business. So here, you can think of primarily through our Accredo specialty pharmacy. And then the remaining 40% of that $500 billion addressable market is provider administered drugs where we've historically had a relatively small position.

在這個 5,000 億美元——接近 5,000 億美元的可服務市場中，約 60% 是我們所稱的「直接到病患」（direct-to-patient），在這個臨床密集型業務中，我們已經取得產業領導地位。在這裡，你主要可以想到我們的 Accredo 專科藥局。而剩下約 40% 的 5,000 億美元可服務市場，則是由醫療提供者施用（provider administered）的藥物，而我們在歷史上在這一塊的布局相對較小。

So this is where we've been making investments with our acquisition of Carepath, with our Verity capabilities, and where Shields Health Solutions is focused. So Shields is specifically focused on providing management services to health systems to operate their own specialty pharmacies, and Shields is the clear leader in the management services space. They serve over 80 sizable health systems, representing more than 1,000 hospitals across 50 states.

因此，這正是我們透過收購 Carepath、透過我們的 Verity 能力，以及 Shields Health Solutions 所聚焦的方向來進行投資的領域。Shields 特別專注於為健康系統提供管理服務，以營運其自有的專科藥局；而 Shields 在管理服務領域是明確的領導者。他們服務超過 80 個大型健康系統，涵蓋全美 50 州、超過 1,000 家醫院。

You can think of our future growth opportunities in this space really in three different categories. One is the natural secular growth of the market as specialty drugs continue to grow. Two, the percentage of health systems who hire a management company today is relatively small, which offers a natural growth opportunity for us as this market matures. And three, there are some mutual value creation opportunities between Shields and Evernorth, through our respective client relationships and the broader suite of combined capabilities that we have, which could result in expanded solutions for those clients.

您可以將我們在此領域未來的成長機會，概括為三個不同的類別。第一，是隨著專科藥品持續成長，市場本身的長期結構性成長。第二，目前聘用管理公司之醫療體系的比例仍相對偏低，隨著市場成熟，這為我們帶來自然的成長機會。第三，Shields 與 Evernorth 可透過各自的客戶關係，以及我們所具備更廣泛的整合能力組合，創造一些相互的價值創造機會，進而可能為這些客戶帶來擴展的解決方案。

So this is an area we're going to continue to invest in. We're excited about the opportunities. As margins continue to compress for hospitals and health systems they’re looking increasingly at their own in-house pharmacies and their specialty drug capabilities, and we are there to help them and to support them on that journey. So I appreciate the question.

因此，這是我們將持續投入的領域。我們對這些機會感到振奮。隨著醫院與醫療體系的利潤率持續受到擠壓，他們愈來愈著眼於自有院內藥局以及其專科藥品能力，而我們會在那裡協助他們並在這段旅程中支持他們。所以感謝您的提問。

Sarah James, Cantor Fitzgerald.

Sarah James，Cantor Fitzgerald。

Cigna ended employee coverage of GLP-1s for Wegovy and Zepbound on July 1, citing rising availability and new options. Are you seeing that same sort of driver being reflected in your mid-year updates or your early 2027 renewal conversations? Or has there been more pushback just on direct cost rather than the new oral entrants? And then how does that mix of drivers interact with how you see growth trends for EnCircle going forward?

Cigna 於 7 月 1 日終止員工對 Wegovy 與 Zepbound 的 GLP-1 用藥給付，理由是供應可得性提升以及出現新的選擇。您是否也在年中更新或 2027 年初的續約洽談中看到同樣的驅動因素反映出來？或者，是否更多的反彈是針對直接成本，而非新的口服競品？另外，這些驅動因素的組合，會如何影響您對 EnCircle 未來成長趨勢的看法？

Sarah, I'll attempt to hit the different components there. If I miss anything, please let me know. So starting with the GLP-1 coverage within our employee health plan. Just like other large employers in the U.S., we’re faced with constant trade-off decisions related to the comprehensiveness of our employee benefit programs versus the competitiveness of our products and solutions in the market and the associated profitability of those.

Sarah，我會嘗試涵蓋您提到的不同面向。如果我漏掉任何部分，請告訴我。先從我們員工健康計畫中的 GLP-1 給付談起。和美國其他大型雇主一樣，我們持續面臨取捨：員工福利方案的完整性，與我們在市場上產品與解決方案的競爭力，以及其相關獲利能力之間的平衡。

So we did make the difficult decision during 2026 to discontinue financial support for GLP-1 drugs for weight management within our own employee health plan. And that coincides with broader availability of GLP-1 options that are now available in the market for individuals using the drugs for weight management, inclusive of the orals and tablets that you made reference to.

因此，我們確實在 2026 年做出艱難決定：在我們自有的員工健康計畫中，停止對用於體重管理的 GLP-1 藥物提供財務支持。而這也與市場上用於體重管理的 GLP-1 選項更廣泛可得相吻合，包括您提到的口服與錠劑形式。

We are offering a supplemental discount program to those employees who wish to pay out of pocket, and our clinical programs are available to support them. We'll continue to cover GLP-1s for diabetes within our own plan. Now the decision that we made in our employee benefit plan is driven by the exact same set of challenges that many of our clients are facing, specifically where the net cost of the drug is straining the overall affordability of the plan.

我們為希望自費的員工提供補充性的折扣方案，並提供臨床計畫以支持他們。在我們自有計畫中，我們仍將為糖尿病用途的 GLP-1 提供給付。我們在員工福利計畫所做的決策，正是由許多客戶面臨的同一組挑戰所驅動，特別是藥品的淨成本正在拉扯整體計畫的可負擔性。

Now of course, we'll continue to monitor the situation carefully and should drug manufacturers decide to meaningfully discount the net prices they offer, we may revisit this in the future. Across our broader client base, we're seeing some of those same decisions being made and made reference to earlier, a slight downtick in the percentage of our employers in Evernorth that are covering GLP-1s for weight management, and that produces a modest headwind to our 2026 results, which fortunately, it was overwhelmed or was more than offset by the strength in Specialty in the second quarter. And so overall, Evernorth results continue to deliver.

當然，我們會持續密切監測情勢；若藥廠決定對其提供的淨價格進行有意義的折扣，我們未來可能會重新檢視。在更廣泛的客戶群中，我們也看到一些類似的決策；如先前提到的，Evernorth 旗下雇主中，為體重管理提供 GLP-1 給付的比例略有下滑，這對我們 2026 年的結果帶來溫和的逆風；所幸第二季專科業務的強勁表現已將其壓過或完全抵銷。因此整體而言，Evernorth 的業績仍持續交出成果。

As it relates to the GLP-1 coverage decision and the implications for our support programs, we continue to offer a variety of financing solutions for employers that range from fully covering the cost of the GLP-1 drugs to covering a portion of the cost to offering it on more of a sponsored or voluntary basis.

就 GLP-1 給付決策及其對我們支持方案的影響而言，我們仍持續為雇主提供多元的資金安排解決方案，範圍從全額負擔 GLP-1 藥物成本、負擔部分成本，到以較偏向贊助或自願參與的方式提供。

So this space will certainly continue to evolve in the future. Our EnCircle program continues to be very effective for those employers who do cover it for weight management. But we expect that this is going to continue to be an area of debate and tension for employers in terms of funding for these drugs going forward.

因此，這個領域未來勢必會持續演變。對於那些確實為體重管理提供給付的雇主而言，我們的 EnCircle 計畫仍然非常有效。但我們預期，對雇主來說，未來在這些藥物的資金負擔上，仍將是一個持續存在的爭論與拉扯焦點。

So I appreciate the question. Let me know if there's any elements in there that I didn't cover.

所以感謝您的提問。如果其中有任何我沒有涵蓋到的要素，請告訴我。

I will now turn the call back over to Brian Evanko for closing remarks.

我現在把電話交回給 Brian Evanko 作結語。

Thanks for your questions and for your time today. With our momentum, we're confident that we'll deliver on our increased adjusted EPS outlook of at least $30.45 for 2026. We look forward to hosting our Investor Day this fall, where we'll discuss advancements in our growth strategy and in each of our businesses. But before we close, I do want to recognize and express appreciation for our coworkers around the world. It's their continued focus and dedication that supports our ability to deliver on our commitments for those we serve and for our shareholders.

感謝各位今天的提問與撥冗參與。憑藉我們的動能，我們有信心達成 2026 年至少 30.45 美元的上調後調整後每股盈餘（adjusted EPS）展望。我們期待在今年秋季舉辦投資人日，屆時將討論我們成長策略以及各項業務的進展。但在結束之前，我確實想要表揚並向全球同仁表達感謝。正是他們持續的專注與投入，支持我們有能力兌現對服務對象與股東的承諾。

We're proud of what we've achieved and are excited about the opportunities ahead. Thanks for joining. Hope you have a great day.

我們為已取得的成果感到自豪，也對前方的機會感到振奮。感謝各位加入。祝各位有美好的一天。

Ladies and gentlemen, this concludes The Cigna Group's Second Quarter 2026 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 (866) 405-7290 and or (203) 369-0603. There is no passcode required for this replay.

各位女士、先生，以上為 The Cigna Group 2026 年第二季業績回顧會議的全部內容。Cigna 投資人關係部門將在稍後可回覆其他問題。本次會議的錄音將於會後提供 10 個工作天。您可撥打 (866) 405-7290 或 (203) 369-0603 收聽錄音。本次重播不需要輸入密碼。

Thank you for participating. We will now disconnect.

感謝您的參與。我們現在將中斷連線。