CVS Health Corp (CVS) 2022 Q2 法說會逐字稿

Ladies and gentlemen, good morning, and welcome to the CVS Health Second Quarter 2022 Earnings Conference Call. (Operator Instructions) As a reminder, today's conference is being recorded.

女士們先生們，早上好，歡迎參加 CVS Health 2022 年第二季度收益電話會議。 （操作員說明）提醒一下，今天的會議正在錄製中。

I would now like to turn the call over to Larry McGrath, Senior Vice President of Business Development and Investor Relations for CVS Health. Please go ahead.

我現在想將電話轉給 CVS Health 業務發展和投資者關係高級副總裁 Larry McGrath。請繼續。

Good morning, and welcome to the CVS Health Second Quarter 2022 Earnings Call and Webcast. I'm Larry McGrath, Senior Vice President of Business Development and Investor Relations. I'm joined this morning by Karen Lynch, President and Chief Executive Officer; and Shawn Guertin, Executive Vice President and Chief Financial Officer.

早上好，歡迎來到 CVS Health 2022 年第二季度財報電話會議和網絡直播。我是拉里·麥格拉思，業務發展和投資者關係高級副總裁。今天上午，總裁兼首席執行官凱倫·林奇 (Karen Lynch) 加入了我的行列；和執行副總裁兼首席財務官 Shawn Guertin。

Following our prepared remarks, we'll host a question-and-answer session that will include Dr. Alan Lotvin, President of Pharmacy Services; Dan Finke, President Healthcare Benefits; Michelle Peluso, Chief Customer Officer and Co-President, Retail; and Prem Shah, Chief Pharmacy Officer and Co-President, Retail; as well as Tom Cowhey, Senior Vice President, Capital Markets.

在我們準備好的發言之後，我們將主持一個問答環節，其中包括藥房服務總裁 Alan Lotvin 博士； Dan Finke，醫療福利總裁； Michelle Peluso，首席客戶官兼零售業務聯席總裁； Prem Shah，首席藥房官兼零售業務聯席總裁；以及資本市場高級副總裁 Tom Cowhey。

Our press release and slide presentation has been posted to our website, along with our Form 10-Q that was filed this morning with the SEC. Today's call is also being broadcast on our website, where it will be archived for 1 year.

我們的新聞稿和幻燈片演示文稿連同我們今天早上提交給 SEC 的 10-Q 表格一起發佈到了我們的網站上。今天的電話會議也在我們的網站上播出，並將在網站上保存 1 年。

During this call, we'll make certain forward-looking statements reflecting current views related to our future financial performance, future events, including potential impacts related to COVID-19 and industry and market conditions, as well as the expected consumer benefits of our products and services and our financial projections. Our forward-looking statements are subject to significant risks and uncertainties that could cause actual results to differ materially from currently projected results. We strongly encourage you to review the reports we file with the SEC regarding these risks and uncertainties, including our most recent annual report on Form 10-K, our recent current reports on Form 8-K, this morning's earnings press release and our Form 10-Q.

在本次電話會議期間，我們將做出某些前瞻性陳述，反映與我們未來財務業績、未來事件相關的當前觀點，包括與 COVID-19 和行業和市場狀況相關的潛在影響，以及我們產品的預期消費者利益和服務以及我們的財務預測。我們的前瞻性陳述受到重大風險和不確定性的影響，可能導致實際結果與當前預測結果存在重大差異。我們強烈建議您查看我們向 SEC 提交的有關這些風險和不確定性的報告，包括我們最近的 10-K 表格年度報告、我們最近的 8-K 表格報告、今天上午的收益新聞稿和我們的 10 表格-Q。

During this call, we'll use non-GAAP measures when talking about the company's performance and financial conditions, and you'll find a reconciliation of these non-GAAP measures in this morning's press release and on the reconciliation documents posted to the Investor Relations portion of our website.

在本次電話會議中，我們將在談論公司業績和財務狀況時使用非 GAAP 指標，您將在今天上午的新聞稿和發佈到投資者關係的對賬文件中找到這些非公認會計原則指標的對賬我們網站的一部分。

With that, I'd like to turn the call over to Karen. Karen?

有了這個，我想把電話轉給凱倫。凱倫？

Thank you, Larry, and welcome to the team. Good morning, everyone, and thanks for joining our call today. CVS Health delivered another outstanding quarter. We grew revenue by 11% versus the prior year to over $80 billion with strong results across all business segments. We delivered adjusted operating income of $4.8 billion and generated adjusted earnings per share of $2.40.

謝謝你，拉里，歡迎加入團隊。大家早上好，感謝您今天加入我們的電話會議。 CVS Health 又交付了一個出色的季度。與去年相比，我們的收入增長了 11%，達到超過 800 億美元，所有業務部門都取得了強勁的業績。我們實現了 48 億美元的調整後營業收入和 2.40 美元的調整後每股收益。

This morning, we raised our full year 2022 adjusted earnings per share guidance range to $8.40 to $8.60, an increase of $0.20. We are also increasing our full year outlook for cash flow from operations to $12.5 billion to $13.5 billion. These guidance increases reflect the continued positive momentum across all of our businesses.

今天上午，我們將 2022 年全年調整後每股收益指導範圍提高到 8.40 美元至 8.60 美元，增加了 0.20 美元。我們還將運營現金流的全年預期提高到 125 億美元至 135 億美元。這些指導增加反映了我們所有業務的持續積極勢頭。

We remain well positioned and confident in our ability to achieve our near-term and longer-term growth goals. Our increasingly integrated foundational businesses delivered exceptional results for the quarter. The Health Care Benefits segment had a strong quarter with revenue growth of nearly 11% year-over-year. We achieved adjusted operating income of $1.8 billion.

我們仍然處於有利地位，對實現近期和長期增長目標的能力充滿信心。我們日益整合的基礎業務在本季度取得了非凡的業績。醫療保健福利部門的季度表現強勁，收入同比增長近 11%。我們實現了 18 億美元的調整後營業收入。

Our medical benefit ratio of 82.9% improved by 120 basis points versus the prior year as medical cost trends remained favorable. We generated membership growth across all product lines versus the prior year. These results reflect the end-to-end value of our assets, increasingly working together 1 customer at a time at national scale.

由於醫療成本趨勢仍然有利，我們的醫療福利比率為 82.9%，較上年提高 120 個基點。與上一年相比，我們在所有產品線都實現了會員增長。這些結果反映了我們資產的端到端價值，越來越多地在全國范圍內一次與 1 個客戶合作。

Our Medicare business remains one of our strongest growth segments, and we increased membership year-over-year across all Medicare products. Our individual Medicare Advantage membership continues to grow at a double-digit pace and faster than the overall market.

我們的醫療保險業務仍然是我們最強勁的增長領域之一，我們在所有醫療保險產品中的會員人數逐年增加。我們個人的 Medicare Advantage 會員繼續以兩位數的速度增長，並且比整個市場更快。

This quarter, we achieved a major milestone with more than 2 million individual Medicare Advantage members, including dual eligibles. Our PDP portfolio also maintains its momentum with healthy growth that is well ahead of industry trends, providing us future conversion and upsell opportunities.

本季度，我們實現了一個重要的里程碑，擁有超過 200 萬個人 Medicare Advantage 成員，包括雙重資格成員。我們的 PDP 產品組合也保持了健康增長的勢頭，遠遠領先於行業趨勢，為我們提供了未來的轉換和追加銷售機會。

Looking ahead to 2023, we're maintaining a nearly 98% client retention rate in national accounts. Additionally, we are having a successful group Medicare Advantage selling season and expect to show positive membership growth next year. As we continue to build our individual exchange business, we're on track to expand coverage where we currently have individual exchange offerings, and are obtaining final approval to add 4 new states to our portfolio, bringing our total to 12 states.

展望 2023 年，我們將在國民賬戶中保持近 98% 的客戶保留率。此外，我們正在經歷一個成功的團體 Medicare Advantage 銷售季，預計明年會出現積極的會員增長。隨著我們繼續建立我們的個人交易所業務，我們有望擴大我們目前擁有個人交易所產品的覆蓋範圍，並正在獲得最終批准，將 4 個新州添加到我們的投資組合中，使我們的總數達到 12 個州。

In Pharmacy Services, revenue grew nearly 12% compared to the prior year and delivered adjusted operating income of $1.9 billion. Specialty pharmacy revenue is up nearly 21% year-over-year. We are a leader in specialty pharmacy with programs that drive value in the marketplace, provide substantive savings to customers and differentiate us as we pair programs with digital assets.

在藥房服務方面，收入同比增長近 12%，調整後的營業收入為 19 億美元。專業藥房收入同比增長近 21%。我們是專業藥房的領導者，其計劃推動市場價值，為客戶節省大量成本，並在我們將計劃與數字資產配對時使我們與眾不同。

Looking ahead, we're maintaining a 98% client retention rate for the 2023 selling season with more than 75% of renewals complete. We drove $3.1 billion of growth new business, providing evidence of our market-leading trend management, transparency and integrated offerings.

展望未來，我們將在 2023 年銷售季節保持 98% 的客戶保留率，超過 75% 的續訂完成。我們推動了 31 億美元的增長新業務，證明了我們市場領先的趨勢管理、透明度和集成產品。

Turning to our Retail/Long-Term Care segment, we continued our momentum from the first quarter. Our deep customer relationships, high-quality patient interactions, resilient supply chain and agile operating model all contributed to the strong quarterly performance.

談到我們的零售/長期護理部門，我們延續了第一季度的勢頭。我們深厚的客戶關係、高質量的患者互動、有彈性的供應鍊和靈活的運營模式都促成了強勁的季度業績。

Nearly 4.8 million customers engage with us every day at CVS locations, making us a powerful community health destination. In the quarter, we delivered over 6% revenue growth versus the prior year and $1.9 billion in adjusted operating income. Our front store sales grew more than 9%, driven by strength in consumer health sales, including strong COVID over-the-counter tests and sales of cough, cold and flu products.

每天有近 480 萬客戶在 CVS 地點與我們互動，使我們成為強大的社區健康目的地。在本季度，我們實現了與去年同期相比超過 6% 的收入增長和 19 億美元的調整後營業收入。在消費者健康銷售強勁的推動下，我們的前店銷售額增長了 9% 以上，包括強大的 COVID 非處方測試以及咳嗽、感冒和流感產品的銷售。

Our pharmacy grew prescriptions 1.6% or 4.6% excluding the impact of the COVID-19 vaccination, which declined versus the prior year. Our retail script growth trend is remarkable as we have consistently increased market share year-over-year since the first quarter of 2020. As COVID-19 continues to move towards an endemic phase, we will continue to play a critical role in communities across the country. Millions of Americans depend on us for COVID-19 testing, vaccine administration and dispensing antiviral medications for treatment.

不包括 COVID-19 疫苗接種的影響，我們的藥房增加了 1.6% 或 4.6% 的處方，與上一年相比有所下降。自 2020 年第一季度以來，我們的零售腳本增長趨勢顯著，因為我們的市場份額一直在逐年增加。隨著 COVID-19 繼續進入流行階段，我們將繼續在整個社區中發揮關鍵作用國家。數百萬美國人依靠我們進行 COVID-19 檢測、疫苗接種和分發抗病毒藥物進行治療。

We administered more than 4 million COVID-19 tests and approximately 6 million COVID-19 vaccinations nationwide in the second quarter. The demand for antiviral medications to treat COVID-19 continues to increase as the national positivity rate remains in the double digits.

我們在第二季度在全國范圍內進行了超過 400 萬次 COVID-19 測試和大約 600 萬次 COVID-19 疫苗接種。隨著全國陽性率保持在兩位數，對治療 COVID-19 的抗病毒藥物的需求繼續增加。

Overall, we continue to successfully navigate a challenging retail environment while expanding services and increasing share of wallet by bringing new customers to CVS Health. Of the approximately 43 million new customers who have chosen CVS Health for COVID-19 health services, nearly 15% have engaged us for additional services.

總體而言，我們繼續成功應對充滿挑戰的零售環境，同時通過為 CVS Health 帶來新客戶來擴大服務並增加錢包份額。在選擇 CVS Health 提供 COVID-19 健康服務的大約 4300 萬新客戶中，近 15% 的人聘請我們提供額外服務。

Our omnichannel approach connects consumer health experiences, driving high satisfaction levels and continuously enabling CVS Health to attract and retain customers. Our leadership on this omnichannel experience is a competitive advantage, and one we are committed to investing in enhancing over time.

我們的全渠道方法連接了消費者的健康體驗，提高了滿意度，並不斷使 CVS Health 能夠吸引和留住客戶。我們在這種全渠道體驗方面的領先地位是一種競爭優勢，我們致力於隨著時間的推移進行投資以增強這一優勢。

Turning to our strategic imperatives. Let me give you a few updates. We are a leading provider of retail health services nationally, and we continue to advance our care delivery capabilities. Our CVS Health care teams in our MinuteClinics have supported more than 2.8 million patient visits year-to-date, representing a 12% increase from the prior year. We are further enhancing our services and making them more relevant for our customers. We are working closely with the administration offering the test to treat program in our MinuteClinics and pharmacies and will be implementing pharmacists prescribing under certain conditions to even more seamlessly serve customers with COVID-19.

轉向我們的戰略要務。讓我給你一些更新。我們是全國領先的零售醫療服務提供商，我們將繼續提升我們的醫療服務能力。我們 MinuteClinics 的 CVS 醫療保健團隊今年迄今已支持超過 280 萬次患者就診，比上一年增加 12%。我們正在進一步增強我們的服務，使它們與我們的客戶更相關。我們正在與在我們的 MinuteClinics 和藥房提供治療計劃的管理部門密切合作，並將在某些條件下實施藥劑師的處方，以更加無縫地為 COVID-19 客戶提供服務。

This furthers our strategy to expand access to health services and helps consumers to navigate to the best site of care. As we evaluate complementary health services and care delivery capabilities to enhance our overall portfolio, we continue to take a disciplined approach. Inorganic growth is part of our strategy, and we look forward to updating you on our progress.

這進一步推進了我們擴大醫療服務可及性的戰略，並幫助消費者導航到最佳護理地點。在我們評估補充醫療服務和護理服務能力以增強我們的整體投資組合時，我們將繼續採取嚴格的方法。無機增長是我們戰略的一部分，我們期待向您通報我們的進展。

Relative to store optimization, we've closed 198 stores to date and remain on track to close 300 stores this year. We are successfully minimizing disruption to our customers and maintaining high levels of satisfaction as we maintain our store and pharmacy hours across our locations to meet consumer health needs. We are retaining over 70% of prescription volume within our network and have redeployed over 90% of impacted colleagues to our other CVS locations.

相對於門店優化，迄今為止我們已經關閉了 198 家門店，今年有望關閉 300 家門店。我們成功地最大限度地減少了對客戶的干擾並保持了高水平的滿意度，因為我們在我們的各個地點維持我們的商店和藥房營業時間以滿足消費者的健康需求。我們在我們的網絡中保留了超過 70% 的處方量，並將超過 90% 的受影響同事重新部署到我們的其他 CVS 地點。

Our technology forward digital-first approach is reducing complexity for our customers and creating new digital health solutions that are convenient. CVS Health now serves more than 45 million unique digital customers, up $1.5 million since last quarter. This increase is driven by our omnichannel pharmacy strategy focused on simplifying how consumers fill and receive prescriptions.

我們的技術向前數字優先方法正在為我們的客戶降低複雜性並創建方便的新數字健康解決方案。 CVS Health 現在為超過 4500 萬獨立數字客戶提供服務，比上一季度增加了 150 萬美元。這一增長是由我們專注於簡化消費者填寫和接收處方的全渠道藥房戰略推動的。

Over 60% of our newly acquired digital users are customers of our specialty, mail order and retail pharmacies. We are expanding our digital health services and deepening engagement through personalization to drive convenience for customers.

我們新獲得的數字用戶中有超過 60% 是我們的專業、郵購和零售藥店的客戶。我們正在通過個性化擴展我們的數字健康服務並加深參與度，從而為客戶帶來便利。

We launched our individualized health dashboard earlier this year and already have 6 million active users, up 20% from the prior quarter. As we successfully execute our strategy, our unified health model grows in relevance and importance every day for the consumers, customers and the communities we serve. And you can see this in our results.

今年早些時候，我們推出了個性化的健康儀表板，已經擁有 600 萬活躍用戶，比上一季度增長 20%。隨著我們成功執行我們的戰略，我們統一的健康模式對消費者、客戶和我們所服務的社區的相關性和重要性每天都在增長。您可以在我們的結果中看到這一點。

And finally, as part of our ongoing commitment to sustainability, we entered into an agreement to purchase renewable energy with one of the nation's largest producers of carbon-free energy. This is the latest step on our path to sourcing 50% renewable energy by 2040.

最後，作為我們對可持續發展的持續承諾的一部分，我們與美國最大的無碳能源生產商之一簽訂了購買可再生能源的協議。這是我們到 2040 年採購 50% 可再生能源的道路上的最新一步。

We are positioned to continue our momentum through the second half of this year. None of this would be possible without our talented colleagues who serve America's health needs every day. We recently added 2 proven leaders to the executive team. Tilak Mandadi has joined CVS Health as our first Chief Data, Digital and Technology Officer; and Violetta Ostafin has joined CVS Health as our Chief Strategy Officer. Both bring deep unique expertise to our diverse leadership team.

我們有能力在今年下半年繼續保持我們的勢頭。如果沒有我們每天為美國的健康需求服務的才華橫溢的同事，這一切都不可能實現。我們最近在執行團隊中增加了 2 位久經考驗的領導者。 Tilak Mandadi 已加入 CVS Health，擔任我們的首位首席數據、數字和技術官； Violetta Ostafin 已加入 CVS Health 擔任我們的首席戰略官。兩者都為我們多元化的領導團隊帶來了深厚的獨特專業知識。

I will now turn it over to Shawn for a deeper look into our operational and financial results and our outlook.

我現在將把它交給肖恩，以更深入地了解我們的運營和財務業績以及我們的前景。

Thank you, Karen, and good morning, everyone. Our second quarter results reflect the continuation of outstanding performance from each of our core business segments as we exceeded our expectations for revenue, cash flow generation and adjusted earnings per share. These results are driven by our steadfast focus on growth, operational execution and supporting the communities we serve. This momentum positions us to raise our 2022 adjusted EPS guidance to a range of $8.40 to $8.60 per share.

謝謝你，凱倫，大家早上好。我們的第二季度業績反映了我們每個核心業務部門的出色表現，因為我們超出了我們對收入、現金流量和調整後每股收益的預期。這些結果是由我們對增長、運營執行和支持我們所服務的社區的堅定關注推動的。這種勢頭使我們將 2022 年調整後的每股收益指引提高到每股 8.40 美元至 8.60 美元的範圍內。

A few highlights regarding total company performance. Second quarter revenues of $80.6 billion increased by 11% year-over-year, reflecting robust growth across each of our operating segments. We delivered adjusted operating income of $4.8 billion and adjusted EPS of $2.40.

關於公司整體業績的一些亮點。第二季度收入為 806 億美元，同比增長 11%，反映了我們每個運營部門的強勁增長。我們實現了 48 億美元的調整後營業收入和 2.40 美元的調整後每股收益。

Importantly, these superb results were produced despite the impact of about $100 million of net realized capital losses inside the quarter, which lowered adjusted EPS performance by $0.06. These net realized capital losses are reported primarily in the HCB segment, but also impact the Retail and Corporate segment results in the second quarter.

重要的是，儘管受到本季度約 1 億美元的淨已實現資本損失的影響，但仍產生了這些出色的業績，這使調整後的每股收益表現降低了 0.06 美元。這些已實現的淨資本損失主要在 HCB 部門報告，但也影響第二季度的零售和企業部門業績。

Looking at performance by business segment. In Health Care Benefits, we delivered strong revenue and adjusted operating income growth versus the prior year. Second quarter revenue of $22.8 billion increased by 10.9% year-over-year. Membership grew 4% year-over-year despite the loss of 266,000 lives from the completed divestiture of Aetna International's business in Thailand. Excluding the divested business, we delivered sequential membership growth of 176,000 members, reflecting growth across all product lines.

按業務部門查看業績。在醫療保健福利方面，與去年相比，我們實現了強勁的收入和調整後的營業收入增長。第二季度收入為 228 億美元，同比增長 10.9%。儘管 Aetna International 在泰國業務的完全剝離導致 266,000 人喪生，但會員人數仍同比增長 4%。不包括剝離的業務，我們實現了 176,000 名會員的連續會員增長，反映了所有產品線的增長。

Our Medicare franchise remains a key growth opportunity for us, adding approximately 70,000 members sequentially across our portfolio of solutions for individuals and employers. Excluding the divestiture of our international business in Thailand, we continue to deliver sequential membership growth in our commercial business. We also continue to build out our individual exchange business, which will include 12 states as of January 1, 2023, pending regulatory approval.

我們的 Medicare 特許經營權對我們來說仍然是一個關鍵的增長機會，在我們為個人和雇主提供的解決方案組合中依次增加了大約 70,000 名成員。不包括剝離我們在泰國的國際業務，我們繼續在我們的商業業務中實現會員的連續增長。我們還將繼續發展我們的個人交易所業務，截至 2023 年 1 月 1 日，該業務將包括 12 個州，等待監管部門批准。

Sequential growth in Medicaid membership is largely driven by the ongoing suspension of redeterminations. Adjusted operating income of $1.8 billion grew 13.4% year-over-year, reflecting improved underlying performance and membership growth, partially offset by incremental investments to support growth in the business and net realized capital losses of $67 million. Our medical benefit ratio of 82.9% improved 120 basis points year-over-year, reflecting medical cost trends that remain modestly favorable to our pricing assumptions.

醫療補助成員的連續增長主要是由重新決定的持續暫停推動的。調整後的營業收入為 18 億美元，同比增長 13.4%，反映了基本業績和會員增長的改善，部分被支持業務增長的增量投資和 6,700 萬美元的已實現淨資本損失所抵消。我們 82.9% 的醫療福利比率同比提高 120 個基點，反映出醫療成本趨勢仍然適度有利於我們的定價假設。

Consistent with last quarter, medical cost trends in our commercial business remained generally in line with pre-pandemic trended baselines with government remaining slightly lower than pre-pandemic baselines. Consolidated days claims payable at the end of the quarter was 54.3, up 2.6 days sequentially as reserves grew at a modestly higher rate than premium growth displaying a pattern similar to what we experienced in the second quarter of 2021.

與上一季度一致，我們商業業務的醫療成本趨勢總體上與大流行前的趨勢基線保持一致，而政府仍略低於大流行前的基線。本季度末應付的綜合索賠天數為 54.3 天，環比增長 2.6 天，因為準備金的增長速度略高於保費增長，顯示出類似於我們在 2021 年第二季度所經歷的模式。

Overall, we remain confident in the adequacy of our reserves. In the Pharmacy Services business, our ability to deliver industry-leading drug trend for our clients, our specialty management capabilities and outstanding customer service levels continue to drive growth.

總體而言，我們對我們的儲備充足充滿信心。在藥房服務業務中，我們為客戶提供行業領先藥物趨勢的能力、我們的專業管理能力和出色的客戶服務水平繼續推動增長。

During the second quarter, revenue of $42.8 billion increased by 11.7% year-over-year, driven by pharmacy claims growth, growth in specialty pharmacy and brand inflation, partially offset by the impact of continued client price improvements.

第二季度，在藥房索賠增長、專科藥房增長和品牌通脹的推動下，收入 428 億美元，同比增長 11.7%，部分被客戶價格持續改善的影響所抵消。

Revenue in Specialty Pharmacy grew nearly 21% versus prior year, reflecting new business wins and pharmacy claims growth. Total pharmacy claims processed increased by 3.9% above prior year and 5.7% when excluding COVID-19 vaccinations, primarily attributable to new business in 2022, increased utilization and the impact of an extended cough cold and flu season.

專業藥房的收入與去年相比增長了近 21%，這反映了新業務的勝利和藥房索賠的增長。處理的藥房索賠總額比上年增長 3.9%，如果不包括 COVID-19 疫苗接種，則增長 5.7%，這主要歸因於 2022 年的新業務、利用率提高以及咳嗽感冒和流感季節延長的影響。

Total pharmacy membership grew sequentially, exceeding 110 million members as growth in commercial and government lives more than offset significant membership losses from the California Medicaid carve-out that started this year. Adjusted operating income of $1.9 billion grew 5.7% year-over-year, driven by improved purchasing economics reflecting increased contribution from the products and services of our group purchasing organization and membership growth. These favorable items were partially tempered by ongoing client price improvements as well as $55 million of restructuring and integration costs.

藥房會員總數環比增長，超過 1.1 億會員，因為商業和政府生活的增長抵消了今年開始的加州醫療補助計劃的重大會員損失。調整後的營業收入為 19 億美元，同比增長 5.7%，這得益於採購經濟的改善，這反映了我們團購組織的產品和服務的貢獻增加以及會員增長。這些有利的項目被持續的客戶價格改善以及 5500 萬美元的重組和整合成本所抵消。

Year-over-year contributions from our 340B product lines declined inside the quarter, as covered entities were slower to agree to manufacturer conditions than we had previously estimated. In our Retail/Long-Term Care segment, higher-than-projected COVID-related volume combined with strength in pharmacy and front store sales helped to drive strong results.

我們 340B 產品線的同比貢獻在本季度內有所下降，因為覆蓋實體同意製造商條件的速度比我們之前估計的要慢。在我們的零售/長期護理部門，高於預期的 COVID 相關銷量加上藥房和前店銷售的實力有助於推動強勁的業績。

Specifically, during the second quarter, revenue of $26.3 billion grew 6.3% year-over-year, reflecting increased prescription and front store volume, including increased sales of COVID over-the-counter test kits and cough, cold and flu products.

具體而言，在第二季度，收入為 263 億美元，同比增長 6.3%，這反映了處方藥和門店數量的增加，包括 COVID 非處方檢測試劑盒和咳嗽、感冒和流感產品的銷售增加。

Adjusted operating income of $1.9 billion declined 9.1% versus prior year, partially due to a $125 million gain from an antitrust legal settlement recognized in the second quarter of 2021, as well as lower COVID-19 vaccine volumes. Additional drivers include strength in pharmacy and front store sales, improved generic drug purchasing and the favorable impact of business initiatives during the quarter. These positive factors were offset by ongoing, but stable reimbursement pressure and business investments, including the minimum wage increase and store improvements.

調整後的營業收入為 19 億美元，較上年下降 9.1%，部分原因是 2021 年第二季度確認的反壟斷法律和解獲得了 1.25 億美元的收益，以及 COVID-19 疫苗數量減少。其他驅動因素包括藥房和前店銷售的強勁增長、仿製藥採購的改善以及本季度業務舉措的有利影響。這些積極因素被持續但穩定的報銷壓力和商業投資所抵消，包括提高最低工資和改善商店。

Pharmacy prescription volume grew 1.6% year-over-year, reflecting increased utilization in cough, cold and flu volume extending later into the spring. Excluding the impact of COVID, pharmacy prescription volume increased by 4.6% year-over-year.

藥房處方量同比增長 1.6%，反映出春季晚些時候咳嗽、感冒和流感量的使用增加。排除 COVID 的影響，藥房處方量同比增長 4.6%。

Turning to the balance sheet. Our liquidity and capital position remain excellent. Year-to-date, we generated cash flow from operations of $9 billion and ended the quarter with $5.8 billion of cash at the parent and unrestricted subsidiaries.

轉向資產負債表。我們的流動性和資本狀況仍然很好。年初至今，我們從運營中產生了 90 億美元的現金流，並在本季度結束時在母公司和不受限制的子公司獲得了 58 億美元的現金。

During the quarter, we repaid $1.5 billion of long-term debt. Further, in July, we announced that we will be executing a par call redemption on $1 billion of November 2022 notes. Yesterday, we also announced the par call on all of our notes due in December of 2022 for a combined total amount of $1.65 billion of debt, representing the last of our outstanding maturities for this calendar year.

本季度，我們償還了 15 億美元的長期債務。此外，在 7 月，我們宣布將對 10 億美元的 2022 年 11 月票據執行面值贖回。昨天，我們還宣布了對我們所有於 2022 年 12 月到期的票據的面值看漲期權，總債務總額為 16.5 億美元，這是我們本日曆年最後一次到期的未償債務。

Through our quarterly dividend, we returned $740 million to shareholders. We remain committed to maintaining our investment-grade ratings while also having the flexibility to deploy capital strategically for capability-focused M&A.

通過我們的季度股息，我們向股東返還了 7.4 億美元。我們仍然致力於維持我們的投資級評級，同時還可以靈活地戰略性地部署資本以進行以能力為中心的併購。

A few other items worth highlighting for investors. Adjusted EPS in the second quarter was impacted by reserve strengthening of $108 million in our legacy Long-Term Care insurance business. This adjustment, which represented the first time we have significantly adjusted this reserve since the Aetna acquisition, is included in adjusted operating income for our Corporate/Other segment and lowers total company adjusted EPS by $0.06 in the quarter.

其他一些值得投資者強調的項目。第二季度調整後的每股收益受到我們傳統長期護理保險業務儲備增加 1.08 億美元的影響。這一調整是我們自收購 Aetna 以來首次大幅調整該儲備金，包含在我們公司/其他部門的調整後營業收入中，並使本季度公司調整後的每股收益總額降低 0.06 美元。

From a GAAP reporting perspective, in June, we also completed the previously announced sale of PayFlex, which resulted in a pretax gain of $225 million in our second quarter financials. Consistent with past practice, this gain has been excluded from our adjusted operating metrics.

從 GAAP 報告的角度來看，6 月份，我們還完成了之前宣布的 PayFlex 出售，這導致我們第二季度財務的稅前收益為 2.25 億美元。與過去的做法一致，這一收益已被排除在我們調整後的運營指標之外。

Turning to our 2022 outlook. We are raising our adjusted earnings per share guidance by $0.20 to a range of $8.40 to $8.60. This increase reflects both the second quarter performance and an improved outlook for the retail LTC segment, as well as strong second quarter underwriting results in the HCB segment, tempered by $140 million to $180 million of lower net investment income contributions over the remainder of 2022, given the uncertainty and volatility of the current capital markets. As such, we are maintaining our full year adjusted operating income guidance in health care benefits of $5.94 billion to $6.04 billion. This reflects the aforementioned strong underlying fundamental performance, offset by $110 million to $145 million of lower net investment income contributions over the remainder of 2022 as the vast majority of our net investment income is generated in our Health Care Benefits segment.

轉向我們的 2022 年展望。我們將調整後的每股收益指引上調 0.20 美元，至 8.40 美元至 8.60 美元之間。這一增長反映了第二季度業績和零售 LTC 部門前景的改善，以及 HCB 部門第二季度強勁的承保業績，在 2022 年剩餘時間內，淨投資收入貢獻減少了 1.4 億美元至 1.8 億美元，鑑於當前資本市場的不確定性和波動性。因此，我們將全年調整後的醫療保健福利營業收入指引維持在 59.4 億美元至 60.4 億美元之間。這反映了上述強勁的基本面表現，但在 2022 年剩餘時間內被 1.1 億美元至 1.45 億美元的較低淨投資收入貢獻所抵消，因為我們的絕大多數淨投資收入來自我們的醫療保健福利部門。

Our updated outlook also contemplates the extension of the public health emergency through the end of 2022. We are raising full year retail LTC guidance as follows: revenue increases to a range of $101 billion to $102.7 billion, adjusted operating income guidance increases by $575 million at the midpoint to a range of $6.54 billion to $6.64 billion. We now forecast that we will administer nearly 20 million COVID-19 vaccinations in 2022, with approximately 75% already administered in the first half of 2022. We expect full year diagnostic testing volumes of approximately 19 million and sales of over-the-counter test kits to more than double compared to prior year, exceeding 50 million units.

我們更新後的展望還考慮將突發公共衛生事件延長至 2022 年底。我們將全年零售 LTC 指導提高如下：收入增加至 1010 億美元至 1027 億美元，調整後的營業收入指導增加 5.75 億美元中點在 65.4 億美元至 66.4 億美元之間。我們現在預測，我們將在 2022 年進行近 2000 萬次 COVID-19 疫苗接種，其中約 75% 已在 2022 年上半年進行。我們預計全年診斷檢測量約為 1900 萬次，非處方藥的銷售額約為套件比上一年增加一倍以上，超過 5000 萬套。

In aggregate, we expect these 3 categories of COVID-driven items to now produce nearly $3 billion of revenue in 2022, a decline of approximately 33% versus 2021, but indicative of the endemic tail of COVID on our retail business.

總的來說，我們預計這 3 類由 COVID 驅動的產品現在將在 2022 年產生近 30 億美元的收入，與 2021 年相比下降約 33%，但表明 COVID 對我們零售業務的地方性尾巴。

Our updated outlook also includes a provision for higher levels of investment spending in the back half of the year as we prepare for a potential late year increase in COVID cases and includes continued investments in our workforce and to enhance our customer experience.

我們更新後的展望還包括為下半年的更高水平的投資支出做準備，因為我們為年底可能增加的 COVID 病例做準備，並包括繼續投資於我們的員工隊伍並增強我們的客戶體驗。

In Pharmacy Services, we now expect to be at the low end of our full year adjusted operating income guidance range of $7.31 billion to $7.45 billion based on the following factors. The continued strength from our core capabilities, including purchasing economics and strong network volumes where we have increased the midpoint of our range by 50 million scripts; being pressured by the restructuring and integration costs I previously mentioned; and a reduced outlook for our 340B business, resulting in a contribution that will be down compared to prior year.

在藥房服務方面，基於以下因素，我們現在預計將處於全年調整後營業收入指導範圍 73.1 億美元至 74.5 億美元的低端。我們核心能力的持續優勢，包括採購經濟性和強大的網絡量，我們已將我們範圍的中點增加了 5000 萬個腳本；受到我之前提到的重組和整合成本的壓力；以及我們的 340B 業務前景下調，導致貢獻將低於上一年。

Looking at the enterprise as a whole, due to our sustained operating momentum, we anticipate continued strong cash from operations in 2022 and have raised our guidance to a range of $12.5 billion to $13.5 billion, with capital expenditures unchanged at a range of $2.8 billion to $3 billion. We are raising our full year adjusted effective tax rate guidance from 25.6% to 25.7%, primarily a result of the discussed changes to our investment income outlook.

縱觀整個企業，由於我們持續的經營勢頭，我們預計 2022 年的經營現金將持續強勁，並將我們的指導上調至 125 億美元至 135 億美元，資本支出保持在 28 億美元至30億美元。我們將全年調整後的有效稅率指引從 25.6% 提高到 25.7%，這主要是由於我們討論了對投資收入前景的變化。

And finally, as we evaluate the progression of earnings for the remainder of the year, we continue to remind investors that we project that earnings per share will be fairly evenly split between the third and the fourth quarters. All other guidance shared during our first quarter earnings call remains unchanged. You will find additional details regarding our updated guidance and the slide presentation we posted to our website this morning.

最後，在我們評估今年剩餘時間的收益進展時，我們繼續提醒投資者，我們預計每股收益將在第三季度和第四季度之間平均分配。我們在第一季度財報電話會議上分享的所有其他指導保持不變。您將找到有關我們更新的指南和我們今天早上在我們的網站上發布的幻燈片演示的更多詳細信息。

To conclude, our second quarter results reflect continued strength from all of our core business segments, and we are pleased to raise our full year 2022 adjusted EPS guidance. Our focus on growth and operational execution continues, and we continue to progress on our long-term strategy. We remain committed to the EPS targets implicit in our long-term model, including as we look to 2023.

總而言之，我們的第二季度業績反映了我們所有核心業務部門的持續實力，我們很高興上調 2022 年全年調整後每股收益指引。我們繼續關注增長和運營執行，並繼續推進我們的長期戰略。我們仍然致力於實現我們長期模型中隱含的每股收益目標，包括展望 2023 年。

We will now open the call to your questions. Operator?

我們現在將打開您的問題的電話。操作員？

(Operator Instructions) We'll take our first question from Ricky Goldwasser with Morgan Stanley.

（操作員說明）我們將回答摩根士丹利的 Ricky Goldwasser 提出的第一個問題。

And congrats on a great quarter. So my question, Karen and Shawn, is how are you thinking about your primary care strategy on the heels of the recent M&A news? And sort of really on that balance between organic and sort of the inorganic comments that you referred to, Karen, in your prepared remarks.

並祝賀一個偉大的季度。所以我的問題，Karen 和 Shawn，在最近的併購新聞之後，你們如何看待自己的初級保健戰略？凱倫，你在準備好的評論中提到了有機評論和無機評論之間的平衡。

Ricky, first of all, let me say congratulations, and it has been a pleasure working with you, and we want to, on behalf of the entire CVS leadership team, wish you all the best in your future endeavors.

Ricky，首先，讓我表示祝賀，很高興與您合作，我們希望代表整個 CVS 領導團隊，祝您在未來的工作中一切順利。

Relative to your question, first, let me remind you that we are the largest provider of retail health services in the nation. And having said that, we have a strategy that is -- we are expecting to enhance our health services in 3 categories, as you mentioned, primary care, provider enablement and home health.

關於您的問題，首先讓我提醒您，我們是全國最大的零售醫療服務提供商。話雖如此，我們的戰略是——我們期望在 3 個類別中加強我們的醫療服務，正如你所提到的，初級保健、提供者支持和家庭健康。

And as we've talked about in the past, there are multiple pathways for us to make a mark on our community health care and our ability to achieve our strategic goals. And as we've talked about before, Ricky, we have very specific criteria that we look at as we're evaluating our many options. We look to see if there's a strong management team, which we are looking to see if there's a very strong tech stack. Obviously, the ability to scale, given the size of the company that we are and a pathway to profitability.

正如我們過去所談到的，我們有多種途徑可以在我們的社區醫療保健和我們實現戰略目標的能力上留下印記。正如我們之前談到的，Ricky，我們在評估我們的許多選項時會考慮非常具體的標準。我們看是否有一個強大的管理團隊，我們正在尋找是否有一個非常強大的技術堆棧。顯然，考慮到我們公司的規模和盈利途徑，擴大規模的能力。

And as you know, Ricky, M&A can be very fluid. You don't necessarily design exactly how these deals and what gets announced. We are committed to extending our health services in categories. And we are very encouraged and confident that we'll take the next step on this journey by the end of this year.

如你所知，Ricky，併購可能非常靈活。您不一定要準確設計這些交易的方式以及宣布的內容。我們致力於在類別中擴展我們的衛生服務。我們非常鼓舞和相信我們將在今年年底前邁出這一旅程的下一步。

As you would expect, we are being very disciplined, both strategically and financially, as we pursue kind of our M&A strategy. We can't be in the primary care without M&A. We've been very clear about that. And let me ask Shawn to talk a little bit more about the specific market dynamics.

正如您所期望的那樣，在我們追求併購戰略時，我們在戰略和財務上都非常自律。沒有併購，我們就無法進入初級保健領域。這一點我們已經很清楚了。讓我請肖恩多談談具體的市場動態。

Yes. Thanks, Ricky, for the question. So we have been very active in evaluating a wide range of assets in and around the care delivery space. And what I would reiterate is that our priority areas remain primary care, provider enablement and home health. It's really of paramount importance and a capability-based play that we fully evaluate their defining characteristics, which would include their capabilities to drive real and lasting value, the financial dynamics of these different business models and the optionality and growth levers that they provide us with, including our own ability to deploy our existing assets and create value in these entities.

是的。謝謝，瑞奇，這個問題。因此，我們一直非常積極地評估護理服務領域內外的各種資產。我要重申的是，我們的優先領域仍然是初級保健、提供者支持和家庭健康。我們充分評估他們的定義特徵，這將包括他們推動真正和持久價值的能力、這些不同商業模式的財務動態以及他們為我們提供的可選性和增長槓桿，這真的是最重要的和基於能力的遊戲，包括我們自己部署現有資產並在這些實體中創造價值的能力。

And as Karen mentioned, we've consistently stated that there are multiple pathways to follow to achieve our vision. Our vision is something new and differentiated, as you know. And thus, there is no one-and-done asset there.

正如凱倫所提到的，我們一直表示有多種途徑可以實現我們的願景。如您所知，我們的願景是全新的和與眾不同的。因此，那裡沒有一勞永逸的資產。

And so while certainly no asset is perfect, there are differences, as Karen highlighted, when you look at the criteria amongst the available assets, particularly in terms of financial performance, the opportunities for future growth and our ability to drive value. I continue to believe that we can execute on our strategic vision via M&A and begin to execute on that vision in 2022.

因此，雖然沒有資產是完美的，但正如 Karen 強調的那樣，當您查看可用資產的標準時，尤其是在財務業績、未來增長機會和我們推動價值的能力方面，存在差異。我仍然相信，我們可以通過併購來執行我們的戰略願景，並在 2022 年開始執行該願景。

And the strength of our capital generation is part of what makes this possible, but also provides a powerful lever to supplement our core earnings via share repurchase. And I think we can still -- it still remains our goal to -- and commit to the targets that we talked about at Investor Day for '23 and '24.

我們資本產生的力量是實現這一目標的一部分，但也提供了一個強大的槓桿，通過股票回購來補充我們的核心收益。而且我認為我們仍然可以 - 它仍然是我們的目標 - 並致力於實現我們在 23 年和 24 年投資者日討論的目標。

Let me just ask a quick follow-up here. Thinking about your existing asset base and footprint and access point, as you sort of evaluate additional assets to add to your portfolio that will really sort of enable that kind of a long-term strategy. Maybe you can share with us sort of kind of how you're thinking about sort of...

讓我在這裡問一個快速的跟進。考慮您現有的資產基礎、足跡和訪問點，當您評估其他資產以添加到您的投資組合中時，這將真正實現這種長期戰略。也許您可以與我們分享您的想法...

Ricky, we're having a hard time hearing you.

瑞奇，我們很難聽到你的聲音。

Sorry, can you hear me now?

對不起，你現在能聽到我說話嗎？

Yes, a little bit better.

是的，稍微好一點。

Great. So if you think about your existing efforts driving the footprint in the access points, how are you thinking about kind of like -- what will really kind of like move, your long-term strategy? Is it sort of owning or acquiring a primary care provider versus that kind of like enabling technology that can connect it all together?

偉大的。因此，如果您考慮您現有的努力推動接入點的足跡，您如何考慮類似 - 真正的類似移動，您的長期戰略？是擁有或收購一家初級保健提供者，而不是那種可以將它們連接在一起的啟用技術？

Yes, Ricky, I think there's a number of ways for us to think about kind of our overall strategy, and I'll just go back to we're looking at capabilities, obviously, in the primary care space, in the home space and in the provider enablement space. So it's a combination of all those. And as Shawn said, it's not a kind of one-and-done activity. We'll continue to evaluate a number of these options.

是的，Ricky，我認為我們有很多方法可以考慮我們的整體戰略，我會回到我們正在研究的能力，很明顯，在初級保健領域，在家庭領域和在提供者支持空間中。所以它是所有這些的組合。正如肖恩所說，這不是一種一次性的活動。我們將繼續評估其中的一些選項。

Yes. And I think, Ricky, it is both, right? We do need both. And I think part of this is because it goes back to this sort of achieving sort of a new and differentiated vision, you need a platform to do that from, right?

是的。我認為，瑞奇，兩者都是，對吧？我們兩者都需要。我認為部分原因是因為它可以追溯到這種實現新的差異化願景，你需要一個平台來做到這一點，對吧？

So it is a set of extent businesses and assets that you can begin to work with, but it's also the platform and the technology and what that you can then use that the springboard to do new and better things. And I think that's why we really need to move on both fronts with equal importance, really.

因此，它是您可以開始使用的一系列範圍業務和資產，但它也是平台和技術，以及您可以使用哪些跳板來做新的更好的事情。我認為這就是為什麼我們真的需要在兩個方面都同等重要地前進，真的。

Yes. And I think, Ricky, the important point to make here is that we have a very strong foundation with the assets that we have, and that's evidenced by the strength that we're seeing in our retail health operation. We had a 12% increase in MinuteClinic visits just this quarter. So a lot of opportunity from the strong foundation that we already have.

是的。我認為，瑞奇，這裡要強調的重要一點是，我們擁有非常強大的資產基礎，我們在零售健康業務中看到的實力證明了這一點。僅在本季度，我們的 MinuteClinic 訪問量就增加了 12%。很多機會來自我們已經擁有的強大基礎。

Our next question will come from Lisa Gill with JPMorgan.

我們的下一個問題將來自摩根大通的 Lisa Gill。

Karen, I want to start with the current economic environment and how you're thinking about the overall 2023 selling season. So you talked about a strong selling season on the PBM side. But maybe if you or Alan could maybe talk a little bit about what are commercial employers looking for? How are you thinking about employee trends? You talked about the different assets that you have.

凱倫，我想從當前的經濟環境以及您對 2023 年整個銷售季節的看法開始。所以你談到了 PBM 方面的強勁銷售季節。但也許你或艾倫可以談談商業雇主在尋找什麼？您如何看待員工趨勢？您談到了您擁有的不同資產。

I know you have a new virtual primary care offering that you have in the marketplace. It's almost been 4 years since Aetna and CVS came together. So can you maybe just talk about where you see different plan design going in 2023 and what you're hearing from some employers in the marketplace today as we think about really bringing all of these assets together as a whole entity?

我知道您在市場上有一個新的虛擬初級保健產品。 Aetna 和 CVS 走到一起已經快 4 年了。那麼，當我們考慮將所有這些資產真正整合為一個整體時，您能否談談您在 2023 年看到的不同計劃設計以及您從當今市場上的一些雇主那裡聽到的內容？

Yes. So Lisa, I would say what we're seeing, and I said in the prepared remarks, we're having very strong retention results in all of our businesses through our national accounts and through Alan's businesses as well.

是的。所以麗莎，我會說我們所看到的，我在準備好的評論中說，我們通過我們的國民賬戶和艾倫的業務在我們所有的業務中都有非常強大的保留結果。

What we're seeing is continued focus on access, lower sites of care, continue to look at cost. Obviously, employers are still interested in making sure that there's low cost, flexibility and really strong service. And that's really consistent across kind of the entire portfolio.

我們看到的是繼續關注訪問、較低的護理地點、繼續關注成本。顯然，雇主仍然對確保低成本、靈活性和真正強大的服務感興趣。這在整個投資組合中都是一致的。

What we're seeing is we continue to see very strong results with our integrated offerings. We've had very good results. We've -- I think we've benefited from having an integrated sales team out in the market selling our products and capabilities. So we're pleased with kind of what we're seeing in the market.

我們看到的是，我們繼續通過我們的集成產品看到非常強勁的結果。我們取得了非常好的結果。我們已經 - 我認為我們已經受益於在市場上銷售我們的產品和能力的綜合銷售團隊。所以我們對我們在市場上看到的東西感到滿意。

Obviously, it's been a somewhat dampened pipeline across both businesses. So we've been, as I mentioned, having very strong retention. But let me ask Dan and Alan to give you a little more color on what they're seeing specifically as they're in the market and selling business, and I'll start with Dan.

顯然，這兩項業務的渠道都有些受挫。因此，正如我所提到的，我們一直擁有非常強大的保留率。但是讓我請丹和艾倫給你更多關於他們在市場和銷售業務中所看到的具體情況，我將從丹開始。

Yes. Thanks, Karen. I think you said it well. I mean, look, we're having really good conversations, and the top of the house is all about controlling cost access and consumer experience. As you think about how that value shows up in those conversations, it shows up in some of our integrated benefit designs and cross-sell opportunities. You can see that we're solving some of those access points with the no-cost, low-cost MinuteClinic benefit. We're also seeing it show up in new products and services, like our transformed diabetes and oncology program.

是的。謝謝，凱倫。我覺得你說得很好。我的意思是，看，我們的對話非常好，最重要的是控製成本獲取和消費者體驗。當您考慮該價值如何在這些對話中體現時，它會體現在我們的一些綜合福利設計和交叉銷售機會中。您可以看到，我們正在通過免費、低成本的 MinuteClinic 優勢解決其中一些接入點。我們還看到它出現在新產品和服務中，例如我們改造的糖尿病和腫瘤學項目。

And then, Lisa, you mentioned our virtual primary care. It's not just about virtual primary care. It's about total virtual care. And so offering solutions across the enterprise for virtual care. And then really, lastly, good conversations about how we're using our local resources like MinuteClinic, like the pharmacists for access points as well.

然後，麗莎，你提到了我們的虛擬初級保健。這不僅僅是關於虛擬初級保健。這是關於全面的虛擬護理。因此，為整個企業提供虛擬護理解決方案。最後，關於我們如何使用本地資源（如 MinuteClinic）以及藥劑師作為接入點的良好對話。

Yes. So Lisa, it's Alan. I'll just add 2 things. One, we've certainly seen at the larger end of the market the benefit manager is focusing on bringing people back into the office post-COVID. And so we have seen contracts that we thought might go out in '23 and pushing out to '24 and sometimes '25. So I think that's the first thing.

是的。所以麗莎，是艾倫。我只會添加兩件事。第一，我們肯定在更大的市場端看到福利經理正專注於讓人們在 COVID 後重返辦公室。因此，我們看到了我們認為可能會在 23 年到期的合同，並會推遲到 24 年，有時甚至是 25 年。所以我認為這是第一件事。

I think the second part would be, we see a continued desire for transparency, for cost controls, particularly in specialty. And for kind of digital connectivity and the ability to interact with members sort of in that really a critical moment when they're renewing a prescription and they're thinking about their health. So all of those things are resonating, particularly in those areas of the market that are still very active.

我認為第二部分是，我們看到對透明度和成本控制的持續渴望，特別是在專業領域。在他們更新處方並考慮自己的健康的關鍵時刻，對於某種數字連接和與成員互動的能力。所以所有這些事情都引起了共鳴，特別是在那些仍然非常活躍的市場領域。

Alan, you touched on specialty, and I mean, you guys are the biggest player. Obviously, Humira or (inaudible) or have biosimilars come to the market next year. Is that a conversation you're having with plan sponsors? And how do we think about that? Is that going to be a big driver, say, 2024 as we think about the PBM?

Alan，你談到了專業，我的意思是，你們是最大的球員。顯然，修美樂或（聽不清）或有生物仿製藥明年上市。這是您與計劃贊助商的對話嗎？我們如何看待這一點？當我們考慮 PBM 時，這是否會成為一個重要的驅動因素，比如 2024 年？

Yes. So 2 things, Lisa. One, as you look out, it's more than just -- everyone's focused on 2023 and Humira. But if you look out over the next 7 or 8 years, there's about $100 billion of product that's going to lose marketing exclusivity. We've started talking with our clients about biosimilars back in the BASAGLAR Day. So 3, 4 years ago. So we've both prepared the market for it. We've articulated the strategies around lowest net cost and are continuing to work with our clients.

是的。所以兩件事，麗莎。一，正如你所看到的，它不僅僅是——每個人都關注 2023 年和 Humira。但如果你展望未來 7 或 8 年，大約有 1000 億美元的產品將失去營銷專有權。早在 BASAGLAR 日，我們就開始與客戶討論生物仿製藥。所以三四年前。所以我們都為它做好了市場準備。我們已經圍繞最低淨成本製定了策略，並繼續與我們的客戶合作。

So I do think that as we create -- as more competition comes into the market, historically, that's always been very, very good for our customers. And generally, when -- as I've said many times before, when we create value for our customers, they generally are happy to pay us for it. So I do think this is going to be a substantial impact in the PBM industry over the next 7, 8 years.

所以我確實認為，隨著我們的創造——隨著更多的競爭進入市場，從歷史上看，這對我們的客戶來說總是非常非常好的。通常，正如我之前多次說過的，當我們為客戶創造價值時，他們通常很樂意為此付錢給我們。因此，我確實認為這將在未來 7、8 年內對 PBM 行業產生重大影響。

Yes, Lisa. The one thing I would add, you did ask specifically about some of the componentry on 2023, and I think it makes sense just to offer some high-level comments on sort of the broader context, I think, that we see for '23.

是的，麗莎。我要補充的一件事是，您確實特別詢問了 2023 年的一些組件，我認為僅就我們在 23 年看到的更廣泛的背景提供一些高級評論是有道理的。

And obviously, I'm not providing specific 2023 guidance here. But I'd expect the construct of 2023 to be one of higher adjusted operating income in PSS and HCB given some of the things that Dan and Alan were just talking about.

顯然，我在這裡沒有提供具體的 2023 年指導。但鑑於 Dan 和 Alan 剛剛談到的一些事情，我預計 2023 年的結構將是 PSS 和 HCB 調整後營業收入較高的情況之一。

And then given a 2020 retail COVID outlook that's nearly double our initial expectations, I'd expect that we'd see lower earnings year-over-year in retail. Below operating income, given the activity, we'd expect lower interest expense and a flat share count. But I would say that overall, at this stage, again, I'd reiterate that we remain committed to delivering on the adjusted EPS targets for '23 and '24 that are implied by our December Investor Day guidance and as reflected in current consensus estimates.

然後考慮到 2020 年零售 COVID 前景幾乎是我們最初預期的兩倍，我預計零售業的收入將同比下降。低於營業收入，鑑於活動，我們預計利息費用較低且股票數量持平。但我想說，總的來說，在這個階段，我再次重申，我們仍然致力於實現 23 年和 24 年調整後的每股收益目標，這些目標在我們 12 月的投資者日指導中暗示，並反映在當前的共識估計中.

Our next question will come from A.J. Rice with Credit Suisse.

我們的下一個問題將來自 A.J.瑞信的賴斯。

Maybe first, just ask about your experience with the front end store in the retail side. That continues to be quite strong even though I think there have been an expectation it would moderate this year. And I assume at-home tests is a part of that. Can you parse that out? And then also just say anything you will about sort of the underlying growth and where you're seeing the strength?

也許首先，只需詢問您在零售方面的前端商店的經驗。儘管我認為今年它會放緩，但這種情況仍然非常強勁。我認為家庭測試是其中的一部分。你能把它解析出來嗎？然後也只是說任何你會說的潛在增長以及你在哪裡看到的力量？

Yes, A.J., I'll -- let me just offer some kind of a frame for the quarter's performance, which you are absolutely right. We've continued to see underlying strength in both the front and the back of the store beyond COVID.

是的，A.J.，我會——讓我為該季度的表現提供某種框架，你是絕對正確的。除了 COVID 之外，我們繼續看到商店正面和背面的潛在實力。

In the quarter itself, I would say about 60% of our outperformance in retail was really driven by those kind of COVID categories that we talk about. But the remainder, which is still a substantial amount, is actually sort of the core strength in sort of the front store and the retail pharmacy operations. And obviously, OTC kits are a big part of the story, as I mentioned in my remarks. But I'll turn it to Michelle to add some more detail on what's going on in the retail operation.

在本季度，我想說，我們在零售方面的出色表現中約有 60% 是由我們談論的那些 COVID 類別驅動的。但剩下的，仍然是一筆可觀的數額，實際上是某種前店和零售藥店業務的核心力量。顯然，正如我在講話中提到的，OTC 試劑盒是故事的重要組成部分。但我將把它交給 Michelle，以添加更多關於零售業務中發生的事情的細節。

Yes. We're really proud of the strength we've seen in the front store. That's come from a mid-single-digit increase in trips and also a mid-single-digit increase in average basket size. And as Shawn said, while sort of cough, cold, COVID was part of that and a strong part of that, we did see strength across all categories.

是的。我們真的為我們在前店看到的實力感到自豪。這來自於旅行的中個位數增長以及平均購物籃大小的中個位數增長。正如肖恩所說，雖然咳嗽、感冒、COVID 是其中的一部分，而且是其中的重要部分，但我們確實看到了所有類別的實力。

I would just say 2 things. We think the momentum is a result of our continual pivot to fulfill the strategy we laid out at Investor Day to serve as local community health and wellness destinations. And secondly, that our investments are paying off. We're uniquely positioned in an omnichannel world. And so our strong digital assets plus our community presence and our investments in things like buy online, pick up in store, omnipharmacy, they're accelerating. They're helping to fuel our growth.

我只想說兩件事。我們認為這種勢頭是我們不斷轉向實現我們在投資者日制定的戰略的結果，以作為當地社區健康和保健目的地。其次，我們的投資正在獲得回報。我們在全渠道世界中處於獨特的位置。因此，我們強大的數字資產加上我們的社區存在以及我們對在線購買、店內提貨、全藥房等方面的投資，它們正在加速發展。他們正在幫助推動我們的發展。

We've also redesigned cvs.com, which is driving much stronger engagement. We're modernizing our fleet and investing in smart supply chain infrastructure. So smart automation is helping us fuel our in-stock position, which we feel good about. And then finally, really doubling down on service to ensure we're most trusted in the community. That trust is a core part of our enterprise strategy, as you know.

我們還重新設計了 cvs.com，它正在推動更強大的參與度。我們正在對我們的車隊進行現代化改造，並投資於智能供應鏈基礎設施。因此，智能自動化正在幫助我們提升庫存狀況，我們對此感覺良好。最後，真正加倍投入服務以確保我們在社區中最受信任。如您所知，這種信任是我們企業戰略的核心部分。

And just a small note, we were happy to see Morning Consult's recognition of CVS Pharmacy is the most trusted brand in retail and actually one of the most trusted brands across every industry. So solid performance, and we think we're well positioned as we head into next year.

只是一個小小的說明，我們很高興看到 Morning Consult 認可 CVS Pharmacy 是零售業最受信任的品牌，實際上是每個行業中最受信任的品牌之一。如此穩健的表現，我們認為我們在進入明年時處於有利地位。

Great. Great. And on the -- maybe just quickly on Medicaid reverifications. Updated thoughts there about timing on when that may go into effect, what your exposure might be? And have you done any analysis about your ability to recapture either through the marketplace or the commercial market, some of those members that may lose coverage via Medicaid?

偉大的。偉大的。並且在 - 可能只是很快就醫療補助重新驗證。更新了關於何時生效的時間的想法，你的曝光可能是什麼？您是否對您通過市場或商業市場重新奪回的能力進行了任何分析，其中一些可能會通過 Medicaid 失去承保範圍？

Yes, A.J., so now we're assuming, obviously, that the redeterminations really won't happen until next year of any kind of magnitude, obviously, with the extension of the PAG assumption in our guidance.

是的，A.J.，所以現在我們顯然假設，隨著 PAG 假設在我們的指導中的擴展，重新確定要到明年才會真正發生。

We estimate we've added about 400,000 to 500,000 members as a result of that. And this is a -- I put a caveat. It's a difficult thing to estimate on the retention side, but we might retain 25% plus or minus of that membership.

我們估計我們因此增加了大約 400,000 到 500,000 名成員。這是一個——我提出警告。在保留方面進行估計是一件困難的事情，但我們可能會保留該會員的 25% 上下。

Obviously, our individual exchange footprint is expanding, but still limited in the scope of our overall Medicaid block. So some of that will help, but still obviously a lot to play out. And then obviously, so this activity, obviously, will be more of a '23 activity now than '22, which we had talked about a quarter ago.

顯然，我們的個人交易所足跡正在擴大，但仍局限於我們整個 Medicaid 區塊的範圍。所以其中一些會有所幫助，但顯然還有很多工作要做。然後很明顯，所以這個活動，很明顯，現在將比 22 年更像是 23 年的活動，我們在四分之一之前討論過。

Our next question will come from Michael Cherny with Bank of America.

我們的下一個問題將來自美國銀行的 Michael Cherny。

Congratulations on a nice quarter. Shawn, I appreciate the early color that you provided on '23. I just want to maybe take a step back real quick. Any changes to think about relative to the baseline in terms of what you've reported and how to think through the dynamics of where you sit right now? And I guess, along those lines, as you think about the implied guidance into the end of the year, how do the moving pieces on COVID potential for increased costs in health care benefits versus potential upside as boosters and vaccines and testing continue in the store, how do those factor into where we should be considering the jumping off points next year?

祝賀你度過了一個美好的季度。肖恩，我很欣賞你在 23 年提供的早期顏色。我只是想快點退後一步。就您所報告的內容以及如何思考您現在所處位置的動態而言，是否需要考慮相對於基線的任何變化？而且我猜，沿著這些思路，當您考慮到年底的隱含指導時，隨著助推器、疫苗和測試在商店中繼續進行，COVID 潛在的醫療福利成本增加與潛在的上行空間有何不同，這些因素如何影響我們明年應該考慮的起點？

Yes. So there's a lot in there in terms of moving parts, right, the classic sort of baseline adjustments that we would make the prior year's development. That's probably in the neighborhood of, I think, about $0.12 right now on a year-to-date basis.

是的。所以在移動部件方面有很多，對，我們將在前一年的開發中進行的經典基線調整。我認為，從年初至今，這可能在大約 0.12 美元附近。

The big driver here, right, is the thing that last year was realized capital gains. This year is realized capital losses. And we have about $175 million recognized losses year-to-date and obviously, year-over-year investment income. So that's a story that will play out through the second half of the year. And one that we're going to need to refine expectations on the net investment income for 2023, just with all of the moving parts.

沒錯，這裡的主要驅動力是去年實現了資本收益。今年是實現資本虧損。年初至今，我們確認的損失約為 1.75 億美元，顯然是同比投資收入。所以這是一個將在今年下半年上演的故事。我們需要改進對 2023 年淨投資收入的預期，包括所有活動部分。

Obviously, there were -- we did talk about sort of the onetime adjustment that we had related to the long-term care insurance business. That's worth about $0.06. So those are some of the big baseline pieces. And then you sort of now pivot to, I think, sort of the COVID moving parts between retail and HCB.

顯然，我們確實談到了與長期護理保險業務相關的一次性調整。這大約值 0.06 美元。所以這些是一些重要的基線部分。然後你現在有點轉向，我認為，零售和 HCB 之間的 COVID 移動部分。

I think for HCB, as I mentioned, we're at a point where we've priced this. We're 3 years away from sort of the last time we had a baseline without COVID. And this really I think has to kind of come down to the way we've always talked about this business traditionally, right? This is about kind of matching our prudent price increases across all of our products with our expected cost trends and kind of managing the revenue growth and operating margin dynamics. And I think we're in a very good place right now for 2022 on that front and then -- and as we position for 2023.

正如我所提到的，我認為對於 HCB，我們已經到了定價的地步。我們距離上一次沒有 COVID 的基線還有 3 年的時間。我認為這真的必須歸結為我們一直以來談論這項業務的傳統方式，對吧？這是為了將我們所有產品的謹慎價格上漲與我們預期的成本趨勢相匹配，以及管理收入增長和營業利潤率動態。我認為我們現在在 2022 年在這方面處於一個非常好的位置，然後 - 以及我們對 2023 年的定位。

I think on retail, while again, it's logical to think that given the level we're at this year, that will go backwards. I think our thinking is we still have sort of an endemic tail and a contribution in 2023. And I think we still anticipate that, that business can perform at a baseline level. That's consistent with what we talked about on Investor Day from sort of the jump-off point of around $6 billion. That's still something that we can operate around in that business.

我認為在零售方面，考慮到我們今年的水平，這將倒退是合乎邏輯的。我認為我們的想法是，我們在 2023 年仍然有某種地方性的尾巴和貢獻。而且我認為我們仍然預計，該業務可以在基線水平上表現。這與我們在投資者日從大約 60 億美元的起點談起的內容是一致的。這仍然是我們可以在該業務中運營的東西。

So there's still a lot to be played out, obviously, here in terms of where we go with future recommendations, obviously, around booster. But I do feel good that we've got our -- we are in a positive pricing position, I think, right now in HCB as we think about sort of pricing for COVID. And obviously, I think we're in a good position in terms of serving the communities and continuing to serve the communities on the COVID front.

因此，顯然還有很多事情要做，就我們未來的建議而言，顯然是圍繞助推器。但我確實感覺很好，我們得到了我們的 - 我認為，當我們考慮 COVID 的某種定價時，我們現在在 HCB 處於積極的定價位置。顯然，我認為我們在為社區服務和繼續為 COVID 前線社區服務方面處於有利地位。

Our next question will come from Justin Lake with Wolfe Research.

我們的下一個問題將來自 Justin Lake 和 Wolfe Research。

First off, let me congrats on hiring Larry McGrath. He's the best. Congrats. And then second, just on -- I wanted to ask a couple of questions on PBM. Specifically, there's a lot of questions in terms of how the drug pricing provisions on the Inflation Reduction Act might impact PBM. Was hoping to get some color there.

首先，讓我祝賀你聘用了 Larry McGrath。他是最好的。恭喜。其次，我想問幾個關於 PBM 的問題。具體來說，關於《通貨膨脹減少法》中的藥品定價規定如何影響 PBM，存在很多問題。希望那裡能有一些顏色。

And then, Shawn, you mentioned the headwind from 340B. Any way to size that for us? And then your thinking about how that might roll into next year? Is it fully annualized this year? Or could that be a further headwind to 2023?

然後，肖恩，你提到了 340B 的逆風。有什麼方法可以為我們調整大小嗎？然後你對這可能會如何進入明年的想法？今年是否完全年化？或者這可能是對 2023 年的進一步不利影響？

So Justin, it's Alan. So first on the drug pricing provisions. They're sort of limited, if you look at the details, it's 10 drugs in '26 and 20 by '29. And if you look at the way the language is structured, it would articulate that these are all products that are unlikely to have material competition.

賈斯汀，是艾倫。所以首先是關於藥品定價的規定。它們是有限的，如果你看一下細節，26 年有 10 種藥物，到 29 年有 20 種藥物。如果你看一下語言的結構方式，就會清楚地表明這些都是不太可能有實質性競爭的產品。

So I think the overall impact is going to be -- it will be positive in the sense that pricing will come down for those products in advance of competition, but I don't think the impact on the overall model is going to be substantial, just given the nature of the way the definition of which drugs fall in work. That's the first part.

所以我認為整體影響將會是積極的，因為這些產品的價格會在競爭之前下降，但我認為對整體模型的影響不會很大，剛剛給出的性質方式定義了哪些藥物在起作用。這是第一部分。

The second part, with respect to 340B, as you know, there have been a lot of changes to the way that program has operated. And essentially, if you boil it down, it's -- there are 2 critical decisions/actions on behalf of the covered entities.

第二部分，關於 340B，如您所知，程序的運行方式發生了很多變化。從本質上講，如果您將其歸結為 - 代表涵蓋實體有 2 個關鍵決策/行動。

In order to reaccess the financial value, which, as I know you know is critically important to many of those critical access hospitals to maintain their financial viability, they need to start providing a certain level of data on contract pharmacies to the pharmaceutical industry. Their decision-making process is somewhat slower than I think people expected, and then the ability to turn that data on is a little bit slower. But we're seeing steady decision-making and steady expansion of the number of hospitals that are doing it. And we expect that, that will continue through this year and into next year.

為了重新獲得財務價值，據我所知，您知道這對於許多關鍵的醫院維持其財務可行性至關重要，他們需要開始向製藥行業提供一定水平的合同藥房數據。他們的決策過程比我認為人們預期的要慢一些，然後打開這些數據的能力也有點慢。但是我們看到了穩定的決策和正在做這件事的醫院數量的穩步擴大。我們預計，這將持續到今年和明年。

Yes. And Justin, just specifically to give you sort of a sense. I mean, as I mentioned in my remarks, we still think we'll be within the range, but probably in the lower half of that range for PSS. And the width of the midpoint to the bottom is a little more than $100 million. And so it's in that sort of ballpark sort of is the year-over-year sort of decrement. Some of which, by the way, we experienced already a little bit in Q2.

是的。還有賈斯汀，只是為了給你一種感覺。我的意思是，正如我在評論中提到的，我們仍然認為我們會在這個範圍內，但可能在 PSS 範圍的下半部分。而中點到底部的寬度，也就一億多一點。因此，在這種情況下，這種情況是逐年遞減的。順便說一句，我們在第二季度已經經歷了一些。

But last -- about a quarter ago, we thought this could come in flat year-over-year, and now we think it will be down a little bit year-over-year.

但是最後 - 大約一個季度前，我們認為這可能會與去年同期持平，現在我們認為它會同比下降一點。

Our next question will come from Eric Percher with Nephron Research.

我們的下一個問題將來自 Nephron Research 的 Eric Percher。

I'll shift back to the retail side. And a question really around COVID and the profitability of the vax scripts that you're seeing. I know you held some G&A cost early in the year given some of the increases in demand. Did you see a change in the level of G&A of staffing you're able or have to hold in Q2? Do you find that the profitability on COVID scripts is moving up as you can staff for it? And then how does that flip as we think about the second half of the year? And I know you mentioned investments.

我會回到零售方面。還有一個真正圍繞 COVID 和您所看到的 vax 腳本的盈利能力的問題。我知道你在年初持有一些 G&A 成本，因為需求有所增加。您是否看到第二季度您能夠或必須持有的 G&A 人員水平發生了變化？您是否發現 COVID 腳本的盈利能力正在上升，因為您可以為其配備人員？那麼當我們考慮下半年的情況時，情況會如何轉變？我知道你提到了投資。

Yes. So Eric, I would say, I mean, like sort of like anything that you do for a while, right, you get more and more efficient at how to do it. So I think on the margin, directionally, that's sort of gotten better, but we've kind of taken the opportunity, obviously, with the results to think about how we continue to sort of invest in this business and invest in the customer experience. And make sure that we can provide sort of the staffing and all of the services and capabilities that we need on the retail side. And so we've made some provision for that in our thinking for the second half of the year, and that's sort of incorporated in our outlook.

是的。所以埃里克，我想說，我的意思是，就像你在一段時間內做的任何事情一樣，對，你會越來越有效率地去做。所以我認為在邊際上，方向上，這有點好轉，但顯然我們已經抓住了這個機會，結果考慮了我們如何繼續投資這項業務並投資於客戶體驗。並確保我們能夠提供我們在零售方面所需的某種人員配備以及所有服務和能力。因此，我們在下半年的思考中為此做出了一些準備，這在某種程度上納入了我們的展望。

As you look at endemic, if we think about 10 million flu shots a year with relatively minimal change to the P&L during that season, do you get to a point where you're able to staff for this in the pharmacy by moving around what you already have? Or is there always an incremental? Do you think it becomes even more efficient?

當你看流行病時，如果我們考慮一下每年有 1000 萬次流感疫苗注射，而那個季節損益表的變化相對較小，你是否達到了能夠通過移動你的東西來為藥房配備人員的地步？已經有？還是總是有增量？你認為它變得更有效率嗎？

Yes. No, I'll turn it to Prem, but I think...

是的。不，我會把它交給 Prem，但我認為...

Yes, we definitely can plan for it and it's part of our modeling. We do that with flu season every year. I would say, as we've gotten smarter with COVID, we continue to be very nimble with our models. And being able to leverage our staff, whether they're doing prescription-related work or vaccination-related work. So we're continuing to do that really well. And we're also preparing for some of the tests to treat that's come out from HHS for the back half of this year in a pilot and then going to scale throughout the year. So we feel really good about it.

是的，我們絕對可以計劃它，它是我們建模的一部分。我們每年都會在流感季節這樣做。我想說，隨著我們對 COVID 變得更加聰明，我們繼續對我們的模型非常靈活。並且能夠利用我們的員工，無論他們是從事與處方相關的工作還是與疫苗接種相關的工作。所以我們繼續做得很好。我們還準備在今年下半年進行一些測試，以治療 HHS 在試點中進行的治療，然後在全年進行擴展。所以我們對此感覺非常好。

Just let me go back because I want to make sure I didn't -- Eric usually ask about PBM, I'll use you to go back to Justin's question on the PBM. I want to make sure that I was clear and not confusing on something. My commentary about directional contribution on 340B was specific to 2022 in terms of like what was in our guidance. Obviously, as that volume comes back online, we'd expect a different result for 2023 going forward.

讓我回去吧，因為我想確保我沒有—— Eric 通常會問 PBM，我會利用你回到 Justin 關於 PBM 的問題。我想確保我清楚並且不會對某些事情感到困惑。我對 340B 的定向貢獻的評論是針對 2022 年的，就像我們的指導一樣。顯然，隨著該卷重新上線，我們預計 2023 年的結果會有所不同。

Our next question will come from Brian Tanquilut with Jefferies.

我們的下一個問題將來自 Jefferies 的 Brian Tanquilut。

Congrats on the quarter. I guess my question, as we think about the store, the front store, front out the store, I mean, obviously, high inflation rates for product categories across the board. So how are you thinking about -- first, what you're seeing in terms of product inflation right now, where that's trending? And how are you thinking about that as it relates to the guidance? What assumptions have you embedded for the revenue guidance going forward?

祝賀本季度。我想我的問題，當我們考慮商店、前店、前店時，我的意思是，很明顯，產品類別的高通脹率。那麼您如何考慮 - 首先，您現在看到的產品通脹情況，趨勢在哪裡？您如何看待與指導相關的問題？您為未來的收入指導嵌入了哪些假設？

Yes. Let me start with what we're seeing and then turn it to Shawn on guidance. So for the most part, we're able to pass inflation through to our customers. Having said that, we're super mindful to the environment where we want to make sure there's value on the shelf at all times for our customers.

是的。讓我從我們所看到的開始，然後將其交給肖恩指導。因此，在大多數情況下，我們能夠將通貨膨脹傳遞給我們的客戶。話雖如此，我們非常注意環境，我們希望確保貨架上始終為我們的客戶提供價值。

And we think about that in -- of course, we think about that in terms of how we price. But it's a great time for our store brands. Our store brands on average are 20% to 40% below our national brand. So it's a great time for consumers to find value in our store brands. We do have a lot of substitutability across categories.

我們會考慮這一點——當然，我們會根據我們的定價方式來考慮這一點。但對於我們的商店品牌來說，這是一個好時機。我們的商店品牌平均比我們的民族品牌低 20% 到 40%。因此，現在是消費者在我們的商店品牌中尋找價值的好時機。我們確實有很多跨類別的可替代性。

And last but not least, we have a very large lever with extra care and care pass. I know care pass is up another 26% year-over-year. We have a great lever with extra care and care pass to make sure we're providing personalized coupons and deals so that our consumers see value on the shelf. So while it's a good guy in terms of being able to price in, we're mindful of value in thinking about that really carefully across categories.

最後但並非最不重要的一點是，我們有一個非常大的槓桿，帶有額外的護理和護理通行證。我知道護理通行證同比增長了 26%。我們有一個很好的槓桿，提供額外的護理和護理通行證，以確保我們提供個性化的優惠券和交易，以便我們的消費者看到貨架上的價值。因此，雖然它在定價方面是一個好人，但我們在跨類別仔細考慮這一點時會注意價值。

And keep in mind that the significant majority of our revenue in the retail segment is pharmacy driven, and we're not really seeing sort of the inflationary impacts that you kind of hear about in the headlines ripping through that segment. So that's still more the typical levels of pharmacy inflation that would be embedded in our outlook.

請記住，我們在零售領域的大部分收入都是藥房驅動的，我們並沒有真正看到你在該領域的頭條新聞中聽到的那種通貨膨脹影響。因此，這仍然是我們展望中的典型藥房通脹水平。

And even within our front store product mix, sort of the inherent inflation rates in that kind of product mix is different and lower than sort of the big kind of gaudy headline numbers that you hear about in kind of when they talk about inflation headlines. But again, really, it's really going to be the pharmacy sort of inflation assumptions that drive our revenue outlook.

即使在我們的前店產品組合中，這種產品組合中固有的通脹率也有所不同，並且低於你在談論通脹頭條時聽到的那種華麗的頭條數字。但是，實際上，真正推動我們收入前景的將是藥房那種通脹假設。

Our next question will come from Nathan Rich with Goldman Sachs.

我們的下一個問題將來自高盛的 Nathan Rich。

Shawn, you mentioned the favorable cost trend versus expectations in the second quarter. Could you just give a little bit more detail on what drove that? And you didn't change the guidance for MBR for the full year. Is there any change to your thinking for how cost trend plays out in the back half of the year?

肖恩，你提到了第二季度有利的成本趨勢與預期。您能否詳細說明是什麼推動了這一點？而且您全年沒有更改 MBR 的指導。您對下半年成本趨勢的看法有什麼變化嗎？

And then if I could ask a follow-up just upfront. I just wanted to clarify the new COVID assumptions. I was trying to follow the numbers, and it seems like maybe $500 million of incremental revenue and $200 million of incremental earnings. But if you could just clarify that, that would be great.

然後，如果我可以提前詢問後續情況。我只是想澄清新的 COVID 假設。我試圖追踪這些數字，似乎可能增加了 5 億美元的收入和 2 億美元的增加收益。但如果你能澄清這一點，那就太好了。

Yes. Let me do that one first. It's significantly more than that. We're talking about $3 billion -- we've raised retail revenue about $2 billion. Well more than half of that is related to these COVID categories. So it's a significantly bigger contribution for the full year on that totaling about $3 billion of revenue for the year.

是的。讓我先做那個。遠不止於此。我們談論的是 30 億美元——我們已經提高了大約 20 億美元的零售收入。其中一半以上與這些 COVID 類別有關。因此，與全年約 30 億美元的總收入相比，它對全年的貢獻要大得多。

And as I mentioned, that's nearly double where we sort of started the expectations for the year. On the MBR front, no, that's definitely positive. I still think our range is indicative of our performance in there. But obviously, just on Q2, we are on the favorable side of that. And so that outlook remains, I think, very positive from an underlying standpoint. As I mentioned, the product -- sort of the way this is rolling out by product has been very similar. Commercial really consistent with our baselines and probably a little favorability on Medicare and Medicaid. But I'll ask Dan to comment a little bit on what we're seeing below that.

正如我所提到的，這幾乎是我們開始對這一年的期望的兩倍。在 MBR 方面，不，這絕對是積極的。我仍然認為我們的範圍表明了我們在那裡的表現。但顯然，就在第二季度，我們處於有利的一面。因此，我認為，從潛在的角度來看，這種前景仍然非常積極。正如我所提到的，產品——按產品推出的方式非常相似。商業與我們的基線非常一致，並且可能對醫療保險和醫療補助有點好感。但我會請丹對我們在下面看到的內容髮表一些評論。

Yes. Let me give you just a little flavor of what we're seeing in some of the service categories. First of all, across all of the lines of business, we are seeing the inpatient volume favorable. We are watching preventative care, PCP visits and specialists. And generally, those have returned to normal levels.

是的。讓我稍微介紹一下我們在某些服務類別中看到的情況。首先，在所有業務領域，我們都看到住院人數有利。我們正在關注預防保健、PCP 就診和專家。一般來說，這些已經恢復到正常水平。

We've been really focused on making sure our members have access to preventative care throughout the pandemic. ER is still slightly lower than expected. And then when you think about the COVID costs overall as well, we did see a steady volume of COVID costs but that had lower severity, lower length of stand lower costs overall. So just to give you a little flavor of the service categories.

我們一直非常專注於確保我們的會員在整個大流行期間都能獲得預防性護理。 ER 仍略低於預期。然後，當您還考慮 COVID 的總體成本時，我們確實看到了 COVID 成本的穩定數量，但嚴重程度較低，支架長度較短，總體成本較低。所以只是給你一點服務類別的味道。

This does conclude the Q&A portion of today's conference. I would now like to turn the call back over to Ms. Karen Lynch for her closing remarks.

這確實結束了今天會議的問答部分。我現在想將電話轉回給 Karen Lynch 女士，以完成她的閉幕詞。

Before we conclude today, I just want to leave you with a couple of thoughts. Our team is delivering meaningful progress on our strategy as we're striving to become the nation's leading health solutions company. We are confident that we'll continue to build on this powerful momentum through 2022 and 2023, and we look forward to continuing to update you on our progress. Thanks for joining the call today.

在我們今天結束之前，我只想給你一些想法。隨著我們努力成為美國領先的健康解決方案公司，我們的團隊正在為我們的戰略取得有意義的進展。我們相信，到 2022 年和 2023 年，我們將繼續在這一強勁勢頭的基礎上再接再厲，我們期待繼續向您通報我們的進展。感謝您今天加入電話會議。

This concludes today's CVS Health Second Quarter 2022 Earnings Call and Webcast. You may disconnect your lines. Have a wonderful day.

今天的 CVS Health 2022 年第二季度財報電話會議和網絡直播到此結束。你可以斷開你的線路。有一個美好的一天。