CVS Health Corp (CVS) 2025 Q1 法說會逐字稿

Good morning and thank you all for attending the CVS Health Q1 2025 earnings conference call. My name is Brika, and I will be your moderator for today. (Operator Instructions)

早安，感謝大家參加 CVS Health 2025 年第一季財報電話會議。我叫布里卡 (Brika)，今天我將擔任你們的主持人。（操作員指示）

I would now like to pass the conference over to your host, Larry McGrath, Chief Strategy Officer. Thank you. You may proceed, Larry.

現在，我想將會議交給主持人、首席策略長拉里·麥格拉斯 (Larry McGrath)。謝謝。你可以繼續，拉里。

Good morning and welcome to the CVS Health first-quarter 2025 earnings call and webcast. I'm Larry McGrath, Chief Strategy Officer. I'm joined this morning by David Joyner, President and Chief Executive Officer; and Tom Cowhey, Chief Financial Officer.

早安，歡迎參加 CVS Health 2025 年第一季財報電話會議和網路廣播。我是首席策略長拉里·麥格拉斯。今天早上和我一起參加的是總裁兼執行長 David Joyner；以及財務長湯姆考希（Tom Cowhey）。

Following our prepared remarks, we'll host a question-and-answer session that will include additional members of the leadership team. Our press release and slide presentation are being posted to our website along with our Form 10-Q filed this morning with the SEC.

在我們準備好發言之後，我們將舉辦問答環節，其他領導團隊成員也將參加。我們的新聞稿和幻燈片簡報將連同我們今天早上向美國證券交易委員會提交的 10-Q 表格一起發佈到我們的網站上。

Today's call is also being broadcast on our website, where it will be archived for one year. During this call, we'll make certain forward-looking statements. 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, in particular, those that are described in the cautionary statement concerning forward-looking statements and risk factors in our most recent annual report on Form 10-K, our quarterly report on Form 10-Q filed this morning, and our recent filings in Form 8-K, including this morning's earnings press release.

今天的電話會議也將在我們的網站上播出，並將存檔一年。在本次電話會議中，我們將做出一些前瞻性的陳述。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目前預測的結果有重大差異。我們強烈建議您查看我們向美國證券交易委員會 (SEC) 提交的有關這些風險和不確定性的報告，特別是我們最近的 10-K 表年度報告、今天上午提交的 10-Q 表季度報告以及我們最近提交的 8-K 表（包括今天上午的收益新聞稿）中有關前瞻性陳述和風險因素的警示聲明中所述的報告。

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

在本次電話會議中，我們將使用非公認會計準則 (non-GAAP) 指標來談論本公司的財務表現和財務狀況，您可以在今天早上的新聞稿和發佈到我們網站投資者關係部分的對帳文件中找到這些非公認會計準則 (non-GAAP) 指標的對帳。

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

說完這些，我想把電話轉給大衛。大衛。

Thank you, Larry, and good morning, everyone. We continue to build momentum across CVS Health and are progressing on our aspiration to be America's most trusted healthcare company. This morning, we are pleased to report solid results and will continue to be a challenging and volatile environment. We delivered first quarter adjusted earnings per share of $2.25 and adjusted operating income of $4.6 billion. In addition, we increased our full year 2025 adjusted EPS guidance to a range of $6 to $6.20, up from our previous range of $5.75 to $6.

謝謝你，拉里，大家早安。我們繼續為 CVS Health 注入新的動力，並朝著成為美國最值得信賴的醫療保健公司的願望邁進。今天上午，我們很高興地報告取得了穩健的業績，並將繼續面臨充滿挑戰和動蕩的環境。我們第一季調整後每股收益為 2.25 美元，調整後營業收入為 46 億美元。此外，我們將 2025 年全年調整後每股盈餘預期從先前的 5.75 美元至 6 美元上調至 6 美元至 6.20 美元。

Our strong start to the year and our increased guidance reflects solid performance and execution across each of our businesses as we maintain a prudent outlook with opportunities for outperformance and deliver on our promise to you, our shareholders. One of my top and most urgent priorities coming into this role was ensuring I had of leadership team with diverse experiences that can help me execute against my strategic priorities.

我們今年的強勁開局和上調的預期反映了我們各項業務的穩健表現和執行力，因為我們保持審慎的展望，把握超越表現的機會並兌現對您（我們的股東）的承諾。擔任這個職位後，我最優先、最迫切的任務之一就是確保我擁有一支擁有豐富經驗的領導團隊，能夠幫助我實現策略重點。

Last month, we announced the appointments of Brian Newman as Chief Financial Officer, effective May 12, and Amy Compton-Phillips as a Chief Medical Officer effective May 19. I am confident that Brian and Amy will help us continue building upon the momentum we've created over the past several months as we execute on our strategy to deliver better health care to those we are privileged to serve. I believe I now have completed my management team and that Brian and Amy's collective and individual experience and expertise are well suited to position CVS Health for the future.

上個月，我們宣布任命 Brian Newman 為財務官，自 5 月 12 日起生效，任命 Amy Compton-Phillips 為首席醫療官，自 5 月 19 日起生效。我相信，布萊恩和艾米將幫助我們繼續鞏固過去幾個月來所創造的勢頭，執行我們的策略，為我們有幸服務的人們提供更好的醫療服務。我相信我現在已經完成了我的管理團隊，而 Brian 和 Amy 的集體和個人經驗和專業知識非常適合 CVS Health 的未來定位。

Brian is succeeding Tom Cowhey, who will continue to serve as a strategic adviser to me effective May 12 to help ensure a successful transition. I want to express my personal appreciation for all Tom has done in his 11 years at Aetna and three years at CVS Health. Tom has been instrumental in advancing our talent, advocating for the finance function and engaging with our shareholders. Tom has also played a critical role in our efforts to stabilize the Aetna business and position us on the path to improve results. I'm grateful for my time with Tom and wish him all the best in the future.

布萊恩將接替湯姆·考伊 (Tom Cowhey)，後者將從 5 月 12 日起繼續擔任我的策略顧問，以幫助確保成功過渡。我要對湯姆在 Aetna 工作 11 年以及在 CVS Health 工作 3 年期間所做的一切表示我個人的感謝。湯姆在提升我們的人才、倡導財務職能以及與股東互動方面發揮了重要作用。湯姆在我們穩定安泰業務和幫助我們改善績效的努力中也發揮了關鍵作用。我很感激與湯姆在一起的時光，並祝福他未來一切順利。

We are driving towards becoming America's most trusted healthcare company. Every day, we earn the trust of customers we serve by improving outcomes, expanding access and improving affordability to address one of the largest problems faced by our country, rising and unsustainable healthcare costs. We hold a unique position in healthcare with our scaled assets. Our 9,000 community health destinations, our more than 1,000 walk-in and primary care clinics and the deep connections we have with more than 185 million consumers we serve. It is this combination that differentiates CVS Health and provides us with a competitive advantage, allowing us to drive change and bring solutions to market at scale.

我們正在努力成為美國最值得信賴的醫療保健公司。每天，我們都透過改善治療效果、擴大醫療服務範圍和提高醫療可負擔性來解決我們國家面臨的最大問題之一——不斷上升且難以為繼的醫療成本，從而贏得客戶的信任。我們憑藉規模資產在醫療保健領域佔有獨特的地位。我們擁有 9,000 個社區健康目的地、1,000 多家無需預約的初級保健診所，與我們所服務的 1.85 億多消費者建立了深厚的聯繫。正是這種結合使 CVS Health 脫穎而出並為我們提供了競爭優勢，使我們能夠推動變革並大規模地將解決方案推向市場。

Addressing the fragmented and broken healthcare system of today is not easy, but we are facing this challenge head on. This is personal for me, my leadership team and the more than 300,000 CVS Health colleagues that work tirelessly every day to earn the trust of the customers we serve.

要解決當今支離破碎的醫療保健系統並不容易，但我們正面對這個挑戰。這對我個人、我的領導團隊以及超過 30 萬名 CVS Health 同事來說都具有重大意義，我們每天都在不知疲倦地工作以贏得我們所服務的客戶的信任。

Our solutions are driven by insights from the millions of consumer touch points we have across CVSL. We are purposely using these insights through our digital capabilities to improve transparency, empower our members and drive better outcomes. In our CVS Health app, customers now have greater visibility into their healthcare journey and how to address potential barriers to care.

我們的解決方案源自於 CVSL 數百萬消費者接觸點的洞察。我們有意透過我們的數位能力來利用這些見解來提高透明度、增強我們成員的能力並推動更好的結果。在我們的 CVS Health 應用程式中，客戶現在可以更清楚地了解他們的醫療保健歷程以及如何解決潛在的護理障礙。

This core digital asset is helping to drive a more trusted and integrated healthcare experience for our customers. We are also directly supporting our members with real-time AI-powered recommendations to help them better manage their health, and achieve better outcomes.

這項核心數位資產正在幫助我們的客戶獲得更值得信賴和全面的醫療保健體驗。我們也透過即時人工智慧建議直接支援我們的會員，幫助他們更好地管理健康並取得更好的結果。

Our capabilities allow us to precisely engage with members where we can have the most impact on their health and experience. We have the best run pharmacy businesses in the country. We have been investing in our colleagues strengthening our technology, and we continue to build on our market-leading cost of goods sold. Our focus in these areas has allowed us to deliver superior experiences to our customers while driving significant operational improvements across our nationwide footprint.

我們的能力使我們能夠準確地與會員互動，從而對他們的健康和體驗產生最大的影響。我們擁有全國經營最好的藥局業務。我們一直在投資我們的同事來加強我們的技術，並且我們將繼續鞏固我們市場領先的銷售成本。我們對這些領域的關注使我們能夠為客戶提供卓越的體驗，同時在全國範圍內推動顯著的營運改善。

Between our community, specialty and (inaudible) pharmacies, we process and dispense over 1.7 billion scripts each year, generating unique insights that create opportunities to improve processes and healthcare experiences at scale. We have been focused on simplifying and improving the prior authorization process for many years with the goal of getting patients their critical medications as quickly as possible. We eliminated requirements, accelerated decisions, created transparency as well as provide proactive support to improve their experience. We took what we know matters most to our customers and applied it to what we do every day across each of our businesses.

在我們的社區、專業和（聽不清楚）藥局之間，我們每年處理和分發超過 17 億張處方，產生獨特的見解，創造機會大規模改善流程和醫療保健體驗。多年來，我們一直致力於簡化和改進事先授權流程，目的是讓患者盡快獲得關鍵藥物。我們消除了要求，加快了決策，創造了透明度，並提供主動支援以改善他們的體驗。我們將對客戶最重要的資訊應用到我們每項業務的日常工作中。

In the last several months, our team is taking meaningful steps to address points of friction, including simplifying and streamlining the prior authorization process at Aetna. Today, Aetna maintains one of the shortest list of treatments and procedures that require prior authorization.

在過去的幾個月裡，我們的團隊正在採取有意義的措施來解決摩擦點，包括簡化和精簡安泰的事先授權流程。如今，安泰擁有最短的需要事先授權的治療和程序清單之一。

Of the eligible prior authorization requests we received, over 95% are approved within 24 hours, with some approved in as little as just a few hours. However, we know patients still feel friction in the system, and we are not satisfied with the status quo. We will continue leading the industry in driving change and improving member and provider experiences.

在我們收到的符合條件的事先授權請求中，超過 95％ 在 24 小時內獲得批准，有些甚至在短短幾個小時內就獲得批准。然而，我們知道患者仍然對系統感到不滿，我們對現狀並不滿意。我們將繼續引領業界推動變革並改善會員和供應商的體驗。

We recently announced a novel approach, which bundles multiple prior authorization requests into one. We have begun to deploy this solution in some common areas of cancer care, where we can have a meaningful impact supporting our members.

我們最近宣布了一種新方法，將多個事先授權請求捆綁為一個。我們已經開始在癌症護理的一些常見領域部署該解決方案，我們可以為我們的會員提供有意義的支援。

By bundling the prior authorization for multiple high-tech imaging scans like MRIs that are used for restaging cancer care, we are reducing the administrative load on providers, expediting treatment and reducing uncertainty for our members. Our goal is to launch additional bundles later this year and to expand the program more broadly to other conditions such as musculoskeletal and select cardiology services. We are excited about rolling out this new approach particularly after the positive response we've received from plan sponsors.

透過將用於重新進行癌症治療的 MRI 等多種高科技影像掃描的事先授權捆綁在一起，我們減少了醫療服務提供者的行政負擔，加快了治療速度並減少了會員的不確定性。我們的目標是在今年稍後推出更多套餐，並將該計劃更廣泛地擴展到其他病症，例如肌肉骨骼和精選心臟病學服務。我們很高興推出這種新方法，特別是在收到計劃發起人的積極回應之後。

Another critical component of earning the trust of our customers is enhancing access and making the cost of life-changing medications more affordable. We have a proven history of leading the market with the use of preferred formularies more than a decade ago. We led the market in driving the adoption of (inaudible) biosimilars delivering over $1 billion of savings for our clients. A year after we revitalized the biosimilar market, with the launch of Cordavis, our low-cost (inaudible) biosimilar and has the largest market share in the US.

贏得客戶信任的另一個關鍵因素是增強藥物的可近性，並降低改變生活的藥物成本。十多年前，我們就憑藉首選處方集引領市場，並已取得良好業績。我們引領市場推動（聽不清楚）生物相似藥的採用，為我們的客戶節省了超過 10 億美元的成本。一年後，我們推出了低成本（聽不清楚）生物相似藥 Cordavis，重振了生物相似藥市場，並在美國擁有最大的市場份額。

Today, we're leading the way forward on GLP-1s. These innovative drugs, which can have a meaningful impact on people's health, were launched at prices that pressured our clients' budgets.

今天，我們正在引領 GLP-1 的發展。這些創新藥物可以對人們的健康產生重大影響，但其推出的價格卻給我們客戶的預算帶來了壓力。

To address this, we are pleased to announce that we are partnering with Novo Nordisk to significantly increase access to Wegovy for our members at a more affordable price. We can increase the power of GLP-1s by combining them with additional lifestyle clinical support as part of our CVS weight management program offered to our clients through Caremark. This combination allows members to achieve better outcomes and even greater weight loss than the preprogram results. Additionally, we are the first retail pharmacy in the Novo Care Pharmacy network, this will enable us to provide convenient, safe and affordable access to Wegovy for eligible patients at our 9,000 community health locations across the country. Taken together, this demonstrates the value of our integrated model and what CVS helped us day in and day out.

為了解決這個問題，我們很高興地宣布，我們將與 Novo Nordisk 合作，以更實惠的價格大幅增加我們會員使用 Wegovy 的機會。我們可以透過將 GLP-1 與額外的生活方式臨床支援相結合來增強其功效，這是我們透過 Caremark 為客戶提供的 CVS 體重管理計劃的一部分。這種組合可以讓會員獲得更好的結果，甚至比計畫前的結果減輕更多的體重。此外，我們是 Novo Care Pharmacy 網路中的第一家零售藥局，這將使我們能夠為全國 9,000 個社區衛生點的符合條件的患者提供方便、安全且價格合理的 Wegovy 服務。總而言之，這證明了我們的綜合模式的價值以及 CVS 日復一日為我們提供的支援。

Our clients and the patients we serve continue to choose us because we innovate, create competition increase access and deliver savings while leveraging our leading clinical capabilities to improve health outcomes. Our industry-leading pharmacy capabilities built across our national footprint and powered by our efficient operations and our innovative and transparent pricing models have allowed us greater flexibility to focus on improving health outcomes. Patient experience and trust have a meaningful impact on medication adherence. Our success in this area has enabled us to be the top-ranked national retail chain for medication adherence. In our Aetna business, Medicare Advantage members who utilize CVS pharmacy are more adherent to the therapy.

我們的客戶和患者繼續選擇我們，因為我們創新、創造競爭、增加機會、節省開支，同時利用我們領先的臨床能力來改善健康結果。我們的行業領先的藥房能力建立在全國範圍內，並由我們高效的營運和創新透明的定價模式提供支持，使我們能夠更靈活地專注於改善健康結果。患者的經驗和信任對藥物依從性有重大影響。我們在這一領域的成功使我們成為全國排名第一的藥物依從性零售連鎖店。在我們的 Aetna 業務中，使用 CVS 藥局的 Medicare Advantage 會員更堅持治療。

This results in fewer acute medical events such as emergency room visits and on average, these members have 3% lower medical costs. Our unrivaled reach to consumer and our integrated business model allow us to establish deeper connections in the community and drive better outcomes. The combination of our capabilities across each of our businesses are what allow us to deliver on these promises. This is why the ongoing rhetoric and this guided actions by some aimed at integrated healthcare companies like CVS Health are (inaudible). In April, the Arkansas government took unjustified action that will leave hundreds of thousands of patients without their community pharmacy, severely limiting access to critical drugs and increasing cost for employers and consumers.

這使得急診室就診等急性醫療事件減少，平均而言，這些成員的醫療費用降低了 3%。我們無與倫比的消費者覆蓋範圍和全面的商業模式使我們能夠在社區中建立更深的聯繫並取得更好的成果。我們各個業務部門的能力結合使我們能夠兌現這些承諾。這就是為什麼一些針對 CVS Health 等綜合醫療保健公司的持續言論和指導行動（聽不清楚）。今年四月，阿肯色州政府採取了不合理行動，導致數十萬名患者無法去社區藥房，嚴重限制了他們獲得關鍵藥物的機會，並增加了雇主和消費者的成本。

The actions will also affect more than 10,000 people in Arkansas who have complex conditions like cancer and multiple sclerosis. These vulnerable patients require specialist care and close coordination with your specialty pharmacists. Independent pharmacies will not be able to fill the void this legislation creates in Arkansas as they often do not stock specialty medications and (inaudible) the capabilities to manage complex conditions. We saw an overwhelming response against this proposal from patients and customers who will now see a rise in the cost of medications and a decrease in their accessibility. We've also seen several direct letters from trade groups like the American Benefits Council and the (inaudible) Industry Committee.

這些行動也將影響阿肯色州 10,000 多名患有癌症和多發性硬化症等複雜疾病的人。這些脆弱的患者需要專業的護理以及與專業藥劑師的密切協調。獨立藥局將無法填補該法案在阿肯色州造成的空白，因為它們通常不儲備特種藥物，並且（聽不清楚）沒有處理複雜病症的能力。我們看到患者和顧客對這項提議的強烈反對，他們將看到藥品成本上漲，藥品可及性下降。我們也看到了幾封來自美國福利委員會和（聽不清楚）行業委員會等貿易團體的直接信件。

We are also concerned about the negative impact resulting from this bill. Our health plan partners have also raised issues as they will now have trouble satisfying network adequacy requirements, including for the Medicare program. We will continue to serve patients in the state for as long as we can and will work to educate stakeholders on all the ramifications of this flawed legislation. We are already seeing other states rejecting the Arkansas approach.

我們也擔心該法案帶來的負面影響。我們的健康計劃合作夥伴也提出了問題，因為他們現在難以滿足網路充分性要求，包括醫療保險計劃。我們將盡最大努力繼續為該州的患者提供服務，並將努力讓利益相關者了解這項有缺陷的立法的所有後果。我們已經看到其他州拒絕阿肯色州的做法。

Our position remains that we believe in common sense, meaningful actions that lower the cost of medications in the US, which is why we were pleased to see that the President's executive order on drug pricing focuses on the entire supply chain. We remain focused on building trust with you, our shareholders, by taking the right actions to strengthen our business and deliver on our commitments.

我們的立場仍然是，我們相信常識性、有意義的行動可以降低美國的藥品成本，這就是為什麼我們很高興看到總統關於藥品定價的行政命令關注整個供應鏈。我們將繼續致力於與您（我們的股東）建立信任，採取正確的行動來加強我們的業務並履行我們的承諾。

As you've seen over the last six months, we actively manage our portfolio of businesses to ensure a pathway to sustainable earnings and competitive viability. We took action at the end of last year with our infusion business at (inaudible) and we've announced earlier this year our exit from the ACO reach program and the sale of our MSSP business. We are disappointed by the continued underperformance from our individual exchange products, and have recently determined there is not a near- or long-term pathway for Aetna to materially improve its position in this product. As a result, we've decided that effective 2026 we will exit the states in which Aetna independently operates ACA plans.

正如您在過去六個月中所看到的，我們積極管理我們的業務組合，以確保實現可持續盈利和競爭優勢。我們在去年年底對我們的輸液業務採取了行動（聽不清楚），並且我們在今年早些時候宣布退出 ACO 覆蓋計劃並出售我們的 MSSP 業務。我們對個別交易所產品的持續表現不佳感到失望，最近確定安泰在短期或長期內都無法大幅提高其在該產品中的地位。因此，我們決定自 2026 年起退出 Aetna 獨立運營 ACA 計劃的州。

Despite our multiyear efforts, we must recognize what is and what is not working and we'll focus on the areas where we have a clear right to win. This is not a decision we made lightly, as we recognize the importance of this product to millions of members. This action will allow us to focus on areas where we will have the strongest capabilities, including Medicare, commercial and Medicaid where we continue to build on our ability to serve members and customers in a differentiated way. We are committed to supporting our individual exchange members for as long as we have the privilege to serve them, and we'll also work closely with our partners to ensure a smooth transition and that these members continue to have access to quality, affordable care. We are dedicated to transforming the healthcare experience in this country and believe we have the right set of assets the right strategy and the right team to deliver the most affordable and highest quality healthcare solutions to our customers.

儘管我們多年來一直努力，但我們必須認識到什麼是有效的，什麼是無效的，我們將集中精力於我們明顯有權獲勝的領域。我們並不是輕易做出這個決定的，因為我們認識到該產品對數百萬會員的重要性。這項措施將使我們能夠專注於我們能力最強的領域，包括醫療保險、商業和醫療補助，我們將在這些領域繼續增強以差異化方式為會員和客戶提供服務的能力。只要我們有幸為我們的個別交易所會員提供服務，我們就會致力於為他們提供支持，並且我們還將與我們的合作夥伴密切合作，以確保平穩過渡，並確保這些會員繼續獲得優質、負擔得起的醫療服務。我們致力於改變這個國家的醫療保健體驗，並相信我們擁有正確的資產、正確的策略和正確的團隊，可以為我們的客戶提供最實惠、最高品質的醫療保健解決方案。

We are focused on executing against the strategic priorities I laid out when I spoke to you last quarter and delivering strong results. We continue to lead the industry in driving innovation and better experiences for our members, patients and consumers and are working hard to ensure we deliver best-in-class performance from each of our businesses. As we continue to build trust and look to the future, we are setting expectations that are appropriate and achievable and continue to focus on areas where we can drive outperformance. With that, I'd like to hand the call over to Tom. Tom.

我們專注於執行我在上個季度與您交談時提出的策略重點並取得強勁成果。我們將繼續引領業界，為我們的會員、患者和消費者推動創新和更好的體驗，並努力確保我們的每項業務都提供一流的績效。隨著我們不斷建立信任並展望未來，我們正在設定適當且可實現的期望，並繼續專注於我們可以實現卓越表現的領域。說完這些，我想把電話交給湯姆。湯姆。

Thank you, David, and thanks to everyone for joining us this morning. I'll start with a few highlights on total company performance. First quarter revenues of nearly $95 billion increased 7% over the prior year quarter, driven by revenue growth across all segments. We delivered first quarter adjusted operating income of approximately $4.6 billion and adjusted EPS of $2.25, driven by strong performance across all segments including meaningful improvement in our Health Care Benefits segment. Finally, we generated cash flows from operations of approximately $4.6 billion during the quarter, an excellent start to the year that allowed us to increase our full year cash flow guidance this morning.

謝謝你，大衛，也謝謝大家今天早上加入我們。我首先要介紹一下公司整體表現的幾個亮點。第一季營收接近 950 億美元，較去年同期成長 7%，這得益於所有部門營收的成長。我們第一季的調整後營業收入約為 46 億美元，調整後每股收益為 2.25 美元，這得益於所有部門的強勁表現，包括醫療保健福利部門的顯著改善。最後，我們在本季度產生了約 46 億美元的經營現金流，這是今年的一個好開端，這使我們能夠在今天上午提高全年現金流預期。

Turning now to our segments, Health Care Benefits generated nearly $35 billion of revenue in the quarter, an increase of 8% over the prior year. driven by increases in our Medicare business, including the impact of improved Medicare Advantage Star Ratings for payment year 2025. Medical membership of approximately 27.1 million was flat sequentially as declines in our individual exchange and Medicare businesses were largely offset by growth in our commercial fee-based business. Shortly after quarter end, a premium grace period for individual exchange members expire.

現在談談我們的部門，醫療保健福利在本季度創造了近 350 億美元的收入，比上年增長了 8%。受醫療保險業務成長的推動，包括 2025 年支付年度醫療保險優勢星級評定提高的影響。醫療會員人數約為 2,710 萬，與上一季持平，因為我們的個人交易所和醫療保險業務的下滑在很大程度上被我們的商業收費業務的成長所抵消。季度結束後不久，個人交易所會員的保費寬限期將到期。

We obtained additional clarity on our effectuated membership. As a result of this subsequent attrition, our membership planned by approximately 300,000 members, which will be reflected in our second quarter membership. During the quarter, the segment generated adjusted operating income of approximately $2 billion, an increase of over $1.2 billion from the prior year quarter. Our medical benefit ratio of 87.3%, decreased 310 basis points from the prior year. These improvements were primarily driven by the favorable year-over-year impact of prior year reserve development across all line business, the majority of which was related to fourth quarter 2024 dates of service.

我們對我們的有效會員資格獲得了進一步的明確說明。由於隨後的人員流失，我們的會員數量計劃減少約 30 萬名，這將反映在我們第二季的會員數量中。本季度，該部門的調整後營業收入約為 20 億美元，較去年同期增加 12 億美元以上。我們的醫療福利率為 87.3%，比前一年下降了 310 個基點。這些改進主要得益於去年所有航線業務儲備量成長帶來的年比良好影響，其中大部分與 2024 年第四季的服務日期有關。

We also benefited from better underlying performance in Medicare, including the impact of improved Medicare Advantage Star Ratings for the 2025 payment year and seasonally strong performance in our Medicare Part D products. Partially offsetting this strong performance were a number of estimate changes related to prior period revenue. Altogether, prior year reserve development net of changes in revenue estimates, contributed approximately $400 million to adjusted operating income in the quarter. As David mentioned earlier, we plan to exit our individual exchange business in 2026. We are currently projecting that variable losses in this business will be between $350 million and $400 million for the full year 2025.

我們也受惠於醫療保險更好的基本表現，包括 2025 年支付年度醫療保險優勢星級評定提高的影響以及醫療保險 D 部分產品的季節性強勁表現。與前期收入相關的一些估計變化部分抵消了這一強勁表現。總體而言，扣除收入估計變動後，上年儲備金開發為本季調整後的營業收入貢獻了約 4 億美元。正如 David 之前提到的，我們計劃在 2026 年退出個人交易業務。我們目前預計，2025 年全年該業務的變動損失將在 3.5 億至 4 億美元之間。

As a result of these losses as well as updates to reflect the seasonality of this business. This quarter, we established a premium deficiency reserve of approximately $450 million related solely to the 2025 coverage. This PDR reflects updated seasonality projections based on our current membership mix as well as higher membership than previously anticipated. The premium deficiency reserve increased our first quarter medical benefit ratio by approximately 130 basis points. Medical cost trends during the quarter remained elevated but appeared to show early signs of stabilization, and we're broadly in line with our expectations for most of our businesses.

由於這些損失以及更新反映了該業務的季節性。本季度，我們設立了約 4.5 億美元的保費不足準備金，僅與 2025 年的保險範圍有關。此 PDR 反映了基於​​我們目前會員結構以及高於先前預期的會員數量的最新季節性預測。保費缺額準備金使我們第一季的醫療福利比率增加了約 130 個基點。本季的醫療成本趨勢仍然較高，但似乎顯示出穩定的早期跡象，並且與我們對大多數業務的預期基本一致。

While our group Commercial business delivered a strong quarter, our individual exchange business did experience higher-than-expected trends as reflected in our PDR. Trends in Medicare, while elevated, were modestly better than our expectations. In Medicare broadly, we continue to see higher trends in inpatient, outpatient and medical pharmacy, three categories which were elevated in '24, in which we will continue to monitor closely. That said, performance in Part D during the quarter was better than our projections but may simply reflect updated seasonality given program changes and our current mix of members. In particular, we are watching specialty utilization in this product.

雖然我們的集團商業業務本季表現強勁，但正如我們的 PDR 所反映的那樣，我們的個人交易所業務確實經歷了高於預期的趨勢。醫療保險的趨勢雖然有所上升，但仍略好於我們的預期。總體而言，在醫療保險領域，我們繼續看到住院、門診和醫藥藥房的上升趨勢，這三個類別在 24 年有所提升，我們將繼續密切關注。也就是說，本季 D 部分的表現優於我們的預期，但考慮到計劃變更和我們目前的會員組合，這可能只是反映了更新的季節性。特別是，我們正在關注該產品的專業利用率。

We also saw strong improvements in the performance of our supplemental benefit offerings. We remain cautious on the outlook for these products until we have more experience with the substantial changes we made for 2025. We are also closely watching trends in our group Medicare Advantage business, which remain pressured. In Medicaid, our overall rate (inaudible) remain on track as we continue to work with our state partners to align rates with changes in acuity. These claims payable at the end of the quarter was approximately 43 days, down about one day sequentially and from the prior year quarter, primarily driven by pharmacy costs, partially offset by the impact of the premium deficiency reserves.

我們也看到補充福利產品的績效有了顯著改善。在我們對 2025 年所做的重大改變有更多的經驗之前，我們對這些產品的前景仍持謹慎態度。我們也密切關注集團醫療保險優勢業務的趨勢，該業務仍面臨壓力。在醫療補助方面，我們的整體費率（聽不清楚）保持正常水平，因為我們將繼續與州合作夥伴合作，使費率與敏銳度的變化保持一致。本季末應付索賠的時間約為 43 天，比上一季和去年同期分別減少了約一天，這主要是由於藥房成本增加，但保費缺口準備金的影響部分抵消了這一影響。

When we compare sequential premium growth against reserve growth, those metrics were more consistent when normalized for the Part D premium changes. We remain confident in the adequacy of our reserves. Our Health Services segment generated revenues of over $43 billion during the quarter, an increase of nearly 8% year over year, primarily driven by pharmacy drug mix, growth in specialty and brand inflation partially offset by continued pharmacy client price improvements.

當我們將連續保費成長與儲備金成長進行比較時，這些指標在針對 D 部分保費變化進行標準化後更加一致。我們對我們的儲備充足性仍然充滿信心。我們的健康服務部門在本季度創造了超過 430 億美元的收入，同比增長近 8%，這主要得益於藥房藥品組合、專業藥品增長和品牌通膨，但藥房客戶價格的持續改善部分抵消了這一增長。

First-quarter adjusted operating income of over $1.6 billion increased nearly 18% from the prior year quarter, primarily driven by improved purchasing economics and pharmacy drug mix, partially offset by continued pharmacy client price improvements. Total pharmacy claims processed in the quarter were over $464 million and total pharmacy services membership as of the end of the quarter was approximately $88 million.

第一季調整後的營業收入超過 16 億美元，較去年同期成長近 18%，主要原因是採購經濟狀況和藥局藥品組合改善，但藥局客戶價格持續改善部分抵銷了這一影響。本季處理的藥房索賠總額超過 4.64 億美元，截至本季末的藥房服務會員總額約為 8,800 萬美元。

We started the year with another strong quarter of top line growth in our health care delivery business. Total revenues grew 27% compared to the same quarter last year, excluding the impact of our exit from the ACO reach program and the sale of our MSSP business. This increase was primarily driven by strong patient growth at Oak Street and increased volumes at (inaudible).

今年第一季度，我們的醫療保健業務再次實現了強勁的收入成長。不包括退出 ACO 覆蓋計劃和出售 MSSP 業務的影響，總收入與去年同期相比增長了 27%。這一增長主要得益於 Oak Street 的患者數量強勁增長以及（聽不清楚）。

Total at-risk members at Oak Street increased approximately 37% in the same period last year. While very immature, we have seen some signs of pressure in first quarter medical cost trends at Oak Street Health, which we will continue to monitor closely over the next several months as they continue to develop. Our pharmacy and consumer wellness segment also delivered another strong quarter. We generated revenues of nearly $32 billion, an increase of over 11% versus the prior year quarter and over 14% on a same-store basis. Adjusted operating income of over $1.3 billion increased over 11% from the prior year quarter, primarily driven by increased prescription volume and improved drug purchase.

去年同期，Oak Street 的高風險會員總數增加了約 37%。雖然還不成熟，但我們已經看到 Oak Street Health 第一季醫療成本趨勢中存在一些壓力跡象，我們將在接下來的幾個月中繼續密切關注其發展。我們的藥品和消費者保健部門也再次取得了強勁的業績。我們創造了近 320 億美元的收入，比去年同期成長超過 11%，同店成長超過 14%。調整後的營業收入超過 13 億美元，較去年同期成長超過 11%，主要得益於處方量的增加和藥品採購量的改善。

First-quarter results also benefited from stronger seasonal factors, including the impact of increased demand for certain vaccines and the extended flu season. Partially offsetting these items were continued pharmacy reimbursement pressure and the impact of softening consumer demand in the front store. Same-store pharmacy sales in the quarter grew nearly 18% versus the prior year and same-store prescription volumes increased nearly 7%.

第一季的業績也受惠於更強的季節性因素，包括某些疫苗需求增加和流感季節延長的影響。部分抵銷這些因素的是持續的藥局報銷壓力和前店消費需求疲軟的影響。本季同店藥局銷售額較上年同期成長近 18%，同店處方量成長近 7%。

Same-store front store sales were roughly flat versus the prior year quarter but were up nearly 1% after adjusting for the impact of leap day in the first quarter of 2024. Retail pharmacy script share in the quarter grew to approximately 27.6%, an increase of approximately 70 basis points from the same period last year, driven by continued strong execution, our ability to deliver superior customer experiences and our commitment to pharmacy access across the communities we serve.

同店銷售額與去年同期基本持平，但在調整 2024 年第一季閏日的影響後成長了近 1%。本季零售藥局處方份額成長至約 27.6%，比去年同期成長約 70 個基點，這得益於持續強勁的執行力、我們提供卓越客戶體驗的能力以及我們對所服務社區藥局可及性的承諾。

Shifting now to cash flow and the balance sheet. We generated cash flows from operations of approximately $4.6 billion in the first quarter. During the quarter, we returned $840 million to our shareholders through our quarterly dividend. We ended the quarter with approximately $1.5 billion of cash of the parent and unrestricted subsidiaries. Our leverage ratio at the end of the quarter improved meaningfully from year-end.

現在轉向現金流和資產負債表。我們第一季的經營現金流約為 46 億美元。本季度，我們透過季度股息向股東返還了 8.4 億美元。本季結束時，母公司和不受限制的子公司的現金約為 15 億美元。我們本季末的槓桿率較年底有顯著改善。

While our ratio remains above our long-term targets, we are pleased by the progress we made in lowering our leverage this quarter. We continue to expect our leverage ratio to return to more normalized levels as we maintain our disciplined financial policies and make progress on margin recovery in the Aetna business. Shifting now to our outlook for 2025. As David mentioned, we are increasing our full year 2025 guidance for adjusted EPS to a range of $6 to $6.20. This update incorporates our first quarter performance while maintaining a respectful view on medical cost trend and a prudent outlook on various macro factors for the remainder of the year.

雖然我們的比率仍高於長期目標，但我們對本季在降低槓桿率方面取得的進展感到高興。隨著我們保持嚴格的財務政策並在安泰業務的利潤率恢復方面取得進展，我們繼續預計我們的槓桿率將恢復到更正常的水平。現在我們來展望一下 2025 年。正如大衛所提到的，我們將 2025 年全年調整後每股收益預期上調至 6 美元至 6.20 美元的範圍。此次更新綜合了我們第一季的業績，同時對醫療成本趨勢保持尊重的看法，並對今年剩餘時間的各種宏觀因素保持審慎的展望。

We now expect total revenue of $382.6 billion, down approximately $3.3 billion, largely due to our exit from the ACO REACH program and the sale of our MSSP business. In our Health Care Benefits segment, we now expect adjusted operating income of approximately $1.91 billion at the low end of our guidance range. This reflects an increase of approximately $400 million primarily driven by the previously mentioned prior year reserve development, net of changes in estimates related to prior period revenue that we experienced in the first quarter.

我們現在預計總收入為 3826 億美元，下降約 33 億美元，這主要是因為我們退出 ACO REACH 計劃以及出售我們的 MSSP 業務。在我們的醫療保健福利部門，我們現在預計調整後的營業收入約為 19.1 億美元，處於我們指導範圍的低端。這反映了約 4 億美元的成長，主要原因是前面提到的去年儲備金發展扣除了我們在第一季經歷的與上期收入相關的估計變化。

We project our full-year 2025 medical benefit ratio at the low end of our Health Care Benefits adjusted operating income guidance range to be approximately 91.3%. Our guidance maintains a respectful view of medical cost trends for the remainder of the year.

我們預計，2025 年全年醫療福利比率將處於醫療保健福利調整後營業收入指引範圍的低端，約為 91.3%。我們對今年剩餘時間的醫療成本趨勢保持樂觀看法。

In particular, we continue to keep a close eye on performance of our group Medicare Advantage business. As we discussed last quarter, contracts in this book are typically multiyear and thus take longer to reprice. While we are encouraged by the favorable development of our 2024 medical cost estimates, our claims experience for 2025 remains immature, particularly in light of changing membership mix in our Medicare Advantage and individual exchange products. That said, outperformance on the medical benefit ratio remains one of the largest potential factors that could drive us higher in our adjusted EPS guidance range.

特別是，我們持續密切關注集團醫療保險優勢業務的表現。正如我們上個季度所討論的，本書中的合約通常是多年期的，因此需要更長的時間來重新定價。雖然我們對 2024 年醫療費用估算的良好發展感到鼓舞，但我們 2025 年的索賠經驗仍不成熟，特別是考慮到我們的醫療保險優勢計劃和個人交易所產品的會員結構發生變化。儘管如此，醫療福利比率的優異表現仍然是推動我們調整後每股盈餘指引範圍走高的最大潛在因素之一。

We expect to end the year with approximately 26.4 million members of approximately 600,000 members from our previous guidance, primarily driven by higher membership in our individual exchange and Medicare businesses. We continue to expect our Medicare Advantage membership to end the year consistent with our previously guided range of down 5% to 10% year over year.

我們預計今年底會員人數將達到約 2,640 萬，比先前的預測高出約 60 萬，這主要得益於個人交易所和醫療保險業務的會員人數增加。我們繼續預計，今年年底我們的醫療保險優勢會員人數將與我們先前預測的同比下降 5% 至 10% 的範圍一致。

Adjusted operating income guidance for our health services and pharmacy and consumer wellness segment is unchanged from our previous expectations. We are encouraged by the performance of each of these segments in the first quarter and are maintaining a cautious outlook for the remainder of the year. In PCW, we are closely monitoring the potential for a softening consumer environment and the implications of tariffs, as well as potential changes in consumer sentiment towards vaccines that may impact market demand.

我們醫療服務、藥局和消費者健康部門的調整後營業收入指引與我們先前的預期相同。我們對第一季各部門的表現感到鼓舞，並對今年剩餘時間的表現保持謹慎的展望。在 PCW，我們正在密切關註消費環境疲軟的可能性和關稅的影響，以及可能影響市場需求的消費者對疫苗的情緒的潛在變化。

We are also closely watching the persistently elevated trends in Medicare Advantage and the potential impact they could have on our health care delivery business, particularly at Oak Street Health. In aggregate, we expect our consolidated adjusted operating income to be in a range of $13.31 billion to $13.65 million. We continue to believe these expectations represent an appropriately achievable baseline with opportunities for outperformance.

我們也密切關注醫療保險優勢計劃 (Medicare Advantage) 持續上升的趨勢及其對我們的醫療保健業務（尤其是 Oak Street Health）可能產生的潛在影響。整體而言，我們預計合併調整後的營業收入將在 133.1 億美元至 1,365 萬美元之間。我們仍然相信，這些預期代表著一個可以適當實現的基準，並且具有超越的機會。

Based on these changes, we are also updating our expectation for full year cash flow from operations to approximately $7 billion. Additionally, we now expect our interest expense to be approximately $3.15 billion, and our adjusted effective tax rate to be approximately 25.9%.

根據這些變化，我們還將全年經營現金流預期更新為約 70 億美元。此外，我們現在預計我們的利息支出約為 31.5 億美元，調整後的有效稅率約為 25.9%。

As you think about the cadence of earnings for the remainder of the year, we now expect approximately 60% of full year consolidated earnings to occur in the first half of the year. This reflects a change from our previous estimate, largely driven by strong first quarter performance.

當您考慮今年剩餘時間的獲利節奏時，我們現在預計全年綜合獲利的約 60% 將出現在上半年。這反映了我們先前估計的變化，主要是由於第一季表現強勁。

For Health Services, while we were pleased with the strength of the quarter and our reiteration of full year guidance, we will remind you that results in the pharmacy services business can see material fluctuations by quarter. Specifically, as we sit here today, consensus expectations for the second quarter are notably higher than our own expectations. You can find additional details on the components of our 2025 guidance on our Investor Relations website.

對於健康服務，雖然我們對本季的強勁表現和對全年指引的重申感到滿意，但我們要提醒您，藥局服務業務的業績可能會按季度出現重大波動。具體來說，今天我們坐在這裡，對第二季度的普遍預期明顯高於我們自己的預期。您可以在我們的投資者關係網站上找到有關我們 2025 年指導組成部分的更多詳細資訊。

We are encouraged by our performance in the first quarter as our results demonstrate execution of initial steps to restore (inaudible) target margins. While we still have a significant amount of work to do, this quarter was an important first step in our multiyear journey to unlock the embedded earnings power of CVS Health.

我們對第一季的表現感到鼓舞，因為我們的結果顯示我們已經執行了恢復（聽不清楚）目標利潤率的初步措施。雖然我們仍有大量工作要做，但本季是我們多年釋放 CVS Health 內在獲利能力的旅程中重要的第一步。

With that, we'll now open the call to your questions. Operator.

現在，我們就可以開始回答你們的問題了。操作員。

(Operator Instructions) Justin Lake, Wolfe Research.

（操作員指示）賈斯汀·萊克（Justin Lake），沃爾夫研究公司。

I wanted to focus on your comments around Medicare Advantage, specifically -- it sounds like you're seeing early trends better in individual and Part D, maybe some pressure incrementally in (inaudible). So hoping you can give us some more color there across those 3 segments. And also maybe give us your early impression of trend versus that high single-digit medical trend you put in guidance for MA?

我想重點談談你對醫療保險優勢計劃的評論，特別是——聽起來你看到個人和 D 部分的早期趨勢有所好轉，也許在（聽不清楚）。所以希望您能為我們提供更多關於這三個部分的詳細資訊。另外，也許您可以向我們介紹一下您對趨勢的初步印象，以及您在 MA 指導中提出的高個位數醫療趨勢？

Yes, Justin, this is David. Thanks for the question. We expect that there will be questions around the trend. And let me -- before I hand it off to the team to talk more specifically about the drivers and how we're thinking about the end of -- or the rest of this year. I want to just take a moment talking about what we've done in the last six months, and we've talked a lot about creating operating stability, improving the way in which we're forecasting and pricing our products. And then we had to have a good open enrollment.

是的，賈斯汀，這是大衛。謝謝你的提問。我們預計圍繞這一趨勢會出現一些疑問。在我將會議交給團隊之前，請允許我更具體地談談車手以及我們對今年年底或剩餘時間的看法。我想花點時間談談我們在過去六個月中所做的工作，我們談了很多關於創造營運穩定性、改進我們預測和定價產品的方式。然後我們必須有一個良好的開放招生。

So I think we've executed against all three of those priorities. And I feel really good about the team, the focus and the execution that that's in front of us. And so I think that has allowed us, again, to, I think, drive the kind of performance that we've seen in this first quarter. I will also say that we will continue to hold a respect for trend. And I think that will be the theme you'll hear today as we look at both the performance in Q1 and also the elevated trends as we expect for the rest of this year.

所以我認為我們已經實現了所有這三個優先事項。我對我們面前的團隊、焦點和執行力感到非常滿意。因此，我認為這再次使我們能夠取得第一季所看到的那種業績。我還要說的是，我們將繼續尊重趨勢。我認為這將是今天大家聽到的主題，因為我們既要回顧第一季的表現，也要回顧我們預期的今年剩餘時間的上升趨勢。

So with that, I'll let Steve Nelson give a broader framework on Medicare and in that with the other businesses within that, and I'll let Tom speak to the specific trends.

因此，我將讓史蒂夫·尼爾森 (Steve Nelson) 給出關於醫療保險及其內部其他業務的更廣泛的框架，然後讓湯姆談談具體的趨勢。

Great. Well, thanks, David. Justin, David used the word this morning momentum. And I think that's the right word, as you think about Aetna specifically. The objectives that we've laid out are clear.

偉大的。好吧，謝謝，大衛。賈斯汀，大衛今天早上用了「勢頭」這個詞。我覺得這個字很正確，特別是當你想到 Aetna 的時候。我們所訂定的目標是明確的。

We have a multiyear path to return Aetna to its target margins. And while it's very early in that journey, the progress is very encouraging. So maybe I'll just highlight 4 or 5 points that I think point to some of the drivers of that progress. I'll start with Medicare Advantage in the individual business. Through the AEP process, we, I think, did a really good job of rationalizing both geographies and product mix, combined with really strong execution around the total cost of care and just the overall operational rigor and management process focus, discipline, it's really producing results.

我們有一個多年的途徑來讓安泰恢復其目標利潤率。儘管這趟旅程才剛開始，但進展卻令人鼓舞。因此，也許我只想強調我認為可以推動這一進步的 4 到 5 點。我將從個人業務中的醫療保險優勢計劃開始。透過 AEP 流程，我認為我們在合理化地域和產品組合方面做得非常好，再加上在總護理成本方面的強大執行力以及整體運營嚴謹性、管理流程重點和紀律性，它確實產生了成果。

And as Dave and Tom both said, early innings here, but the elevated trends that we've seen, we are starting to see early signs of stabilization. So it's really producing results and very pleased with the progress in that business overall. I'll just touch on the other businesses quickly to kind of round out just the overall perspective on Aetna. Our Medicaid business is continuing to perform well, and we really like the progress we're making around rate advocacy very much tracking in line with our full year expectations. And we're very competitive in this space.

正如戴夫和湯姆所說，這只是一個早期階段，但我們已經看到了上升趨勢，我們開始看到穩定的早期跡象。因此，它確實產生了成果，並且對整個業務的進展感到非常滿意。我將快速談一談其他業務，以完善對安泰的整體看法。我們的醫療補助業務持續表現良好，我們非常喜歡我們在費率倡議方面取得的進展，這與我們的全年預期非常一致。我們在這個領域非常有競爭力。

We had a couple of really good wins with Texas and Georgia. They're obviously pending protests. We're confident that we'll prevail there and hopeful but really strong performance in the early innings at Medicaid as well. And then our commercial business has been performing slightly ahead of our expectations, mainly driven by a return to more competitiveness in our fully insured book. That's due to a really nice disciplined pricing and great work on our trend as well as better-than-expected retention.

我們在德克薩斯州和喬治亞州取得了幾次非常不錯的勝利。顯然，他們正在等待抗議。我們有信心在那裡取得勝利，並且希望在醫療補助計劃的早期階段也能有非常強勁的表現。我們的商業業務表現略高於我們的預期，主要原因是我們的全保業務恢復了更強的競爭力。這是因為我們制定了非常嚴格的定價，對趨勢做出了出色的貢獻，而且保留率比預期好。

And then when you think about our self-insured our (inaudible) business, international public and labor accounts business, we've seen some really nice wins there in incredibly competitive markets. The Pennsylvania Employee Benefits Trust Fund, the Advocate Health System, these are examples of full replacement opportunities that we were able to achieve incredibly proud to be able to serve those customers. We -- David mentioned in his prepared remarks that we'll be exiting the IFP business the -- our exchange business. And we've now met with all of our independent market in states, including CMS and they're appreciative of the transparency and the thoughtful approach that we're taking here, and we are committed to serving these members through the rest of the year, and that's our focus. So we will continue to update you on that process.

然後，當您想到我們的自保（聽不清楚）業務、國際公共和勞工帳戶業務時，我們在競爭異常激烈的市場中看到了一些非常好的勝利。賓州員工福利信託基金、倡導健康系統，這些都是完全替代機會的例子，我們能夠實現這些目標，我們非常自豪能夠為這些客戶提供服務。我們——大衛在他的準備好的演講中提到，我們將退出 IFP 業務——我們的交易所業務。現在我們已經與包括 CMS 在內的所有州獨立市場進行了會面，他們對我們的透明度和周到的態度表示讚賞，我們致力於在今年剩餘時間裡為這些成員提供服務，這是我們的重點。因此我們將繼續向您通報這項進程。

And then the last point, we're continuing to make progress in our culture and the way that folks think, our colleagues and moving to an advocacy mindset, focusing on innovation around member experience and our provider experience. David made an announcement about how we're going to streamline the prior authorization process for certain conditions, and we're just going to build on this. This is going to be a focus of our company. A watch item, just to finish up here, is the Medicare Group. Medicare Advantage Group business, Justin, you asked about that specifically.

最後一點，我們將繼續在我們的文化和人們的思維方式、我們的同事方面取得進步，並轉向倡導思維，專注於圍繞會員體驗和我們的提供者體驗的創新。大衛宣布了我們將如何簡化某些情況下的事先授權流程，我們將在此基礎上繼續前進。這將成為我們公司的重點。最後要關注的是醫療保險集團 (Medicare Group)。賈斯汀，您具體詢問了醫療保險優勢集團業務。

And that business will be -- we have a strong market position there, and we've had success. It has not been immune from the elevated trends. So we've seen that definitely in the group business due to the multiyear contract nature of the business, there's not as many levers to pull there, but we are getting after the clinical opportunities aggressively, and we're also going to be introducing some rate actions as well. So we think that will mitigate some of the pressure. But overall, again, a multiyear journey, it's early, but incredibly encouraged about the progress and proud of the team for what they've done.

而且這項業務將是——我們在那裡擁有強大的市場地位，並且取得了成功。它未能免受這種上升趨勢的影響。因此，我們已經看到，在集團業務中，由於業務的多年合約性質，可以利用的槓桿並不多，但我們正在積極爭取臨床機會，我們也將採取一些利率行動。因此我們認為這將減輕一些壓力。但總的來說，這是一段多年的旅程，現在還為時過早，但我們對所取得的進展感到非常鼓舞，並為團隊所做的一切感到自豪。

So Tom, I'll turn it over to you for more detail on the trend part.

所以湯姆，我會把更多關於趨勢部分的細節交給你。

Great. Justin, so as you look at the quarter, if you strip out the premium deficiency reserve, the underlying Aetna business beat by about $1 billion. So we had strong prior period reserve development of the 12/31 reserves, which, as I noted in the prepared remarks, was partially offset by some out-of-period revenue changes. And so net those two are worth about $400 million, which was the driver of the increased guidance this morning. As you look at the current period, the upside is almost entirely driven by Medicare.

偉大的。賈斯汀，當你看這個季度時，如果你去掉保費不足準備金，安泰的基礎業務就會超出約 10 億美元。因此，我們在 12/31 儲備方面的前期儲備發展強勁，但正如我在準備好的評論中指出的那樣，這被一些期外收入變化所部分抵消。因此，這兩家公司的淨價值約為 4 億美元，這也是今天上午提高指導價的推動因素。從當前時期來看，上漲幾乎完全是由醫療保險推動的。

So the other businesses are largely going to offset. And inside Medicare, there's a few things going on. First, there was about $100 million of expense favorability, which is primarily timing will come back over the remainder of the year. As you look at the core Medicare trends, they're running consistent with to slightly better than our outlook. And as Steve said, they're showing early signs of stabilization.

因此其他業務將在很大程度上得到抵消。在醫療保險內部，發生了一些事情。首先，大約有 1 億美元的費用優惠，這主要是時間因素，將在今年剩餘時間內恢復。當您查看核心醫療保險趨勢時，您會發現它們的運作與我們的展望一致，甚至略好於我們的展望。正如史蒂夫所說，他們正顯示出穩定的早期跡象。

First quarter inpatient trends are generally consistent with the full year '24. We've also seen some modest favorability in outpatient, but medical pharmacy trends remain stubbornly high.

第一季的住院趨勢與 24 年全年基本一致。我們也看到門診病人出現了一些溫和的青睞，但醫藥藥局的趨勢仍然居高不下。

Outside of the core trends, as I noted, we saw a strong seasonal performance out of Part D and we also saw a strong year-over-year improvement in our supplemental benefit trends. But we haven't pulled through this favorability until we've seen more data. And then turning last -- just to close out your specific question on group. That is a place where we continue to watch, specifically inpatient trends on that block have remained quite high. And we've also seen a little bit of acceleration in outpatient.

除了核心趨勢之外，正如我所指出的，我們看到 D 部分的季節性表現強勁，我們的補充福利趨勢也出現了強勁的同比改善。但直到我們看到更多數據，我們才能夠擺脫這種有利因素。最後，我們來結束關於小組的具體問題。我們會持續關注這個地方，特別是該街區的住院趨勢一直保持相當高水準。我們也看到門診病人數量略有增加。

And so we're watching that very closely. But net-net, very pleased with the performance in the quarter. Obviously, pleased enough that we were able to raise the guidance this morning. And we think that the outlook that we've taken here is quite prudent and respectful of how trends may emerge over the remainder of the year.

因此我們正在密切關注此事。但總體而言，我對本季的表現非常滿意。顯然，我們很高興今天早上能夠提高指導。我們認為，我們在此採取的展望是相當謹慎的，並且尊重今年剩餘時間內可能出現的趨勢。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

I'm going to shift over to the relationship that you announced today with Novo for Wegovy. David, can you help me understand a few things. One, when we think about your preferred formulary, can you talk about the number of lives that are on there? Two, when we think about coverage, I know we've been talking in the last few years around how expensive this is for employers to cover, where are we on coverage today for weight loss? And will this increase the number of potential lives that could be covered with this program?

我將轉到您今天宣布的與 Novo 就 Wegovy 建立的合作關係。大衛，你能幫我理解一些事情嗎？首先，當我們考慮您喜歡的處方集時，您能談談其中涉及的生命數量嗎？第二，當我們考慮保險範圍時，我知道過去幾年我們一直在討論雇主承擔的費用有多高，我們現在對減肥的保險範圍在哪裡？這是否會增加該計劃可能涵蓋的潛在生命數量？

And then just wrapping that around, you talked about clinical services, and this will come through Caremark, can you maybe just talk about the economic value of this for both care markets as well as the member? And then just lastly, when I think about the pricing, should I assume that you've been able to negotiate through Caremark is going to be better than the 499 that you also announced at retail?

然後總結一下，您談到了臨床服務，這將透過 Caremark 實現，您能否談談這項服務對於護理市場和會員的財務價值？最後，當我考慮定價時，我是否應該假設您透過 Caremark 協商的價格會比您在零售時宣布的 499 更優惠？

Yes. Lisa, thank you and really good thoughtful questions on the new relationship. And I'm going to turn it over to Prem. But before I do, I just want to say we continue to be a leader and innovate in the areas that our customers care most about. And we've known that we've had cost pressures in this category.

是的。麗莎，謝謝你，關於新的關係的問題確實很深刻。我要把它交給 Prem。但在此之前，我只想說，我們將繼續在客戶最關心的領域中保持領先地位並不斷創新。我們知道我們在這個類別中面臨成本壓力。

They've been asking for solutions. And I couldn't be happier about what we announced today. So I'll have Prem walk through the relationship and then answer specifically the questions that you asked. Prem?

他們一直在尋求解決方案。我對我們今天宣布的消息感到非常高興。因此，我將讓 Prem 介紹這種關係，然後具體回答你提出的問題。普雷姆？

Yes. Thanks, David. And Lisa, thanks for the question. As you know, our company and Caremark has a long proven history of creating competition and driving affordability and increasing access for all patients with this relationship, we'll do that for our insured and covered lives as well as for uninsured lives that choose to use our 9,000 community health destinations. Our announcement today also demonstrates the value of our integrated model and what we can do every single day.

是的。謝謝，大衛。麗莎，謝謝你的提問。如您所知，我們公司和 Caremark 長期以來一直致力於創造競爭、提高醫療可負擔性並增加所有患者的就醫機會，我們將透過這種關係為我們的投保人和受保人以及選擇使用我們 9,000 個社區健康目的地的未投保人做到這一點。我們今天的公告也證明了我們的綜合模式的價值以及我們每天可以做的事情。

And we're really excited about this example on how we're going to continue to create competition and affordability for the clients and members that we serve. Just as a little bit of a history lesson. If you look back over the last couple of decades, the main pain point for our customers and clients was the rising cost of specialty drugs. You saw our organization take action last year with the launch of Cordavis, it generated over $1 billion of net savings for our clients, and we led the market in terms of conversion to biosimilars and are continuing to create a competitive marketplace over there. If you kind of fast forward to today and over the course of last year, exactly as you mentioned, our clients' biggest pain point today has kind of moved from these specialty drugs that were rising and the utilization increasing to GLP-1s.

我們對這個例子感到非常興奮，我們將如何繼續為我們服務的客戶和會員創造競爭力和可負擔性。就像一堂小小的歷史課。如果回顧過去幾十年，我們客戶和客戶的主要痛點是特種藥品成本的上漲。您看到我們公司去年採取了行動，推出了 Cordavis，它為我們的客戶帶來了超過 10 億美元的淨節省，我們在生物仿製藥轉化方面處於市場領先地位，並將繼續在那裡創造一個有競爭力的市場。如果您快轉到今天和去年，正如您所提到的，我們客戶今天最大的痛點已經從這些不斷增長且利用率不斷提高的特種藥物轉移到 GLP-1。

And the trend on these are now rising faster than those specialty drugs. And so -- as you think about GLP-1s, they're our biggest pharmacy trend driver for our clients. And we continue to -- what I would say is leverage all of the PBM cost management strategies to enable and deliver maximize savings for our customers. And the facts are, to your question, because of the high cost of these medications, about 1/3 of our clients have elected not to cover GLP-1s as part of their benefits and due to affordability concerns. And so today, we're pleased to announce this partnership with Novo Nordisk to significantly increase the access to Wegovy for our members at a more affordable price by taking a formulary action on (inaudible) to prefer Wegovy.

現在這些藥物的銷售量成長速度比那些特種藥物還要快。因此 — — 當您想到 GLP-1 時，它們是我們為客戶提供的最大藥房趨勢驅動力。我們將繼續——我想說的是利用所有的 PBM 成本管理策略來實現並為我們的客戶帶來最大化的節省。事實是，對於您的問題，由於這些藥物的成本高昂，大約有 1/3 的客戶選擇不將 GLP-1 作為其福利的一部分，並且出於負擔能力方面的考慮。因此，今天，我們很高興地宣布與 Novo Nordisk 建立合作夥伴關係，透過採取處方行動（聽不清楚）選擇 Wegovy，以更實惠的價格顯著增加我們會員使用 Wegovy 的機會。

And it's for our largest commercial template that has tens of millions of lives on it. And later today, we're going to be providing this detail to our clients and the benefit consultant community around this important formulary change and how we're continuing to what I would say is drive the market to make medications more affordable and drive long-term value for our clients and create competition with pharma. And so as you think about that and then you wrap that into what I would say is the enhanced value bring as part of Caremark in our CVS weight management program, this results in better outcomes and even greater weight loss than their preprogram results.

這是我們最大的商業模板，上面有數千萬條生命。今天晚些時候，我們將向我們的客戶和福利顧問社區提供有關這一重要處方變化的詳細信息，以及我們將如何繼續推動市場使藥品更加實惠，為我們的客戶創造長期價值並與製藥公司展開競爭。因此，當您考慮到這一點，然後將其融入我所說的 Caremark 在我們的 CVS 體重管理計劃中所帶來的增強價值時，這將帶來比計劃前更好的結果，甚至更大的減肥效果。

So it's the medication plus the wraparound support that we give to members in our channel that really delivers the results for our customers. And as you know, our pharmacy benefit manager customers rely on us and depend on us in our expertise to deliver these types of solutions to make medications more affordable, which allow our clients to expand access to their members.

因此，我們為通路中的會員提供的藥物加上全方位支援才真正為我們的客戶帶來了成果。如您所知，我們的藥品福利管理客戶信賴我們並依靠我們的專業知識來提供這些類型的解決方案，以使藥品更加實惠，從而使我們的客戶能夠擴大其會員的藥品獲取管道。

And then lastly, the news on the -- what we're launching in our 9,000 community health pharmacy locations are excited to be part of the Nova Care Pharmacy network. This will enable us to provide convenient, safe and affordable access to Wegovy for eligible patients. And again, we reiterate our excitement of this partnership and the value we're going to deliver for our clients and customers as you go forward.

最後，關於這個消息——我們將在 9,000 個社區健康藥房推出這項服務，我們很高興成為 Nova Care 藥房網路的一部分。這將使我們能夠為符合條件的患者提供便利、安全且價格合理的 Wegovy 服務。我們再次重申我們對這項合作關係的興奮之情，以及我們將在未來為我們的客戶和顧客提供的價值。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Just a follow-up on the Health Care Benefits guidance. It looks like you had close to $1.6 billion worth of prior year development and understanding it, it seems like the individual losses are also increasing inside the P&L. But just trying to understand better what are these prior period sort of revenue adjustments that you're talking about, I guess what businesses actually relate to? And how do we think about there's an impact to the prior year? Is there an impact to 2025 to consider?

這只是對健康保健福利指導的後續。看起來您前一年的開發案價值接近 16 億美元，並且在了解這一點後，似乎損益表中的個人損失也在增加。但是只是想更好地理解您談論的這些前期收入調整是什麼，我猜這實際上與哪些業務相關？我們如何看待它對前一年的影響？是否需要考慮對 2025 年的影響？

And then as we just think about your expectations around the kind of earnings that you can generate from exiting the individual business, I know you gave us the variable loss figure for the year. Is that the right way to think about the potential for year-over-year earnings contribution from (inaudible) the exchanges? Or are there other considerations we should be keeping in mind?

然後，當我們思考您對退出個人業務所能產生的收益的期望時，我知道您給了我們今年的變動損失數字。這是思考（聽不清楚）交易所對年度獲利貢獻的潛力的正確方法嗎？或者我們還應該考慮其他因素嗎？

Stephen, so as you think about the development, here's what I can say. The development occurred across all business lines. The majority of the development was off the fourth quarter dates of service. And the largest single source of favorability was Medicare, which is also our largest block of business. As you look at Medicare, in particular, the largest driver of favorability in the fourth quarter was inpatient, but we also saw some favorability in our specialist categories.

史蒂芬，當你考慮發展時，我可以說的是。這一發展涉及所有業務線。大部分開發工作均在第四季的服務日期之外。其中，最大的單一支援來源是醫療保險，這也是我們最大的業務部門。特別是當你看醫療保險時，第四季最大的有利因素是住院病人，但我們也看到了專科類別的一些有利因素。

As you think about the offsets there, and your $1.6 billion that you're getting out of the (inaudible) forward, that's gross. That does not incorporate all the earnings that we took into -- all the impact that we took into earnings. And so a lot of that is put back into the reserve.

當你考慮那裡的抵銷額度，以及你從（聽不清楚）遠期獲得的 16 億美元時，這太龐大了。這並沒有包括我們計入收益的所有收益──也沒有包括我們計入收益的所有影響。因此，其中許多都被放回了儲備金中。

So you can't translate the $1.6 billion into the bottom line impact. So the bottom line impact, net of the revenue items, is specifically the $400 million that we called out, which is the increase in the guidance this morning. And most of those changes are out of period and they relate specifically to both Medicare and to the individual business -- the individual exchange business.

因此，您無法將 16 億美元轉化為底線影響。因此，扣除收入項目後的底線影響具體來說是我們所說的 4 億美元，這是今天上午的指導增加。大多數變化都是過時的，並且具體涉及醫療保險和個人業務——個人交易業務。

As you think about the losses then on the individual business, that's why we gave you the $350 million to $400 million. This is a $7.5 billion block of business at this point. And so it carries with it a fair amount of fixed costs. It's unclear whether or not we'll be able to reallocate those fixed costs or whether we'll be able to take them out for the 2026 calendar year. So you should think about the year-over-year improvement as being the elimination of the variable loss, which will be in that $350 million to $400 million range.

當你考慮到個別業務的損失時，這就是我們給你 3.5 億至 4 億美元的原因。目前，這是一筆價值 75 億美元的業務。因此它會產生相當多的固定成本。目前尚不清楚我們是否能夠重新分配這些固定成本，或者是否能夠在 2026 日曆年將其取出。因此，您應該將同比成長視為消除變動損失，變動損失將在 3.5 億至 4 億美元的範圍內。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

I was wondering if -- two questions about your sort of guidance expectations. One, are you having any change in your guidance expectation on the back of the Wegovy announcement? It doesn't look like it, but I just wanted to check on that.

我想知道——關於您的指導期望有兩個問題。首先，在 Wegovy 公告發布後，您的指導預期有任何變化嗎？看起來不像，但我只是想檢查一下。

And two, could you comment on how you see the potential tariff impact? I know some of the pieces are still very much moving, but maybe you could at least sort of comment on the front end of the store? And then maybe some of your broader thoughts on potential other impact to the business?

第二，您能否評論一下您如何看待潛在的關稅影響？我知道有些作品仍然很受歡迎，但也許您至少可以對商店的前端發表一些評論？然後，您是否對業務可能受到的其他影響有更廣泛的看法？

Yes. Thanks, Elizabeth. So the first answer on the Wegovy announcement, it is not impacting our guidance, and it's not factored in. So this will be obviously savings that we will deliver for our customers, the customers will get the benefit of our negotiated savings. And I think as we look at -- its unknown at this point how the migration from the compound pharmacies into other pharmacy settings are going to occur, but we do expect that there will be obviously some benefit by opening up 9,000 stores.

是的。謝謝，伊麗莎白。因此，關於 Wegovy 公告的第一個答案是，它不會影響我們的指導，也沒有被考慮。因此，這顯然是我們為客戶帶來的節省，客戶將從我們協商的節省中受益。我認為，就我們目前的情況來看，我們還不清楚從複合藥局向其他藥局環境的遷移將如何進行，但我們確實預計，開設 9,000 家門市顯然會帶來一些好處。

9,000 opportunities for patients to be able to get the medication. As it relates to tariffs, it's obviously a very fluid environment. We -- and there's many variables in play at the moment, and we look at it really in 3 different ways. The first is the front store, in which we currently source the vast majority of our front store items in American-based companies today. So we do not see a significant impact as it relates to the tariffs and where we are looking at impacts, we're looking at alternative sourcing and/or diversifying the suppliers.

為患者提供 9,000 次獲得藥物的機會。就關稅而言，這顯然是一個非常不穩定的環境。我們 — — 目前有很多變數在起作用，我們實際上從 3 個不同的角度來看待它。第一個是前店，目前我們的前店商品絕大多數都是從美國公司購買的。因此，我們認為關稅不會產生重大影響，而我們正在尋找替代採購和/或多樣化供應商。

As it relates to the pharma supply chain, there's a lot of what I would say, a lot of variables that will go into how this will be impacted depending on how we're dealing with both the country of origin as well as how we're looking at brands versus generics. And if I look at even the Novo announcement for GLP-1s, they manufacture that product here in the US. So that will obviously get the benefit of a US-based manufacturing and be able to not be impacted by the tariffs.

因為它與製藥供應鏈有關，我想說有很多變數會影響它如何受到影響，這取決於我們如何處理原產國以及我們如何看待品牌藥和仿製藥。如果我看 Novo 關於 GLP-1 的公告，就會發現他們在美國生產該產品。因此，這顯然將受益於美國製造業，並且不會受到關稅的影響。

So we're obviously watching closely the announcements that will be made over the course of the next week or so as it relates to how we're going to be dealing with tariffs with the pharmaceutical supply chain. And as it relates to Aetna, because we're in the midst of preparing for our '26 Medicare bid for both Part D and the MA, we are obviously watching closely the impact both of the pharmaceutical supply chain as well as the other medical devices and supplies that will impact the broader healthcaresystem.

因此，我們顯然正在密切關注未來一周左右發布的有關如何處理醫藥供應鏈關稅的公告。就 Aetna 而言，由於我們正在為 26 年醫療保險 D 部分和 MA 的競標做準備，我們顯然正在密切關注醫藥供應鏈以及其他醫療設備和用品對更廣泛醫療保健系統的影響。

So -- and we are currently monitoring it and really more planning today for our 26 beds as Aetna is contemplating the impact for tariffs.

因此 — — 我們目前正在監控它，並且今天正在為我們的 26 張床位做更多的規劃，因為 Aetna 正在考慮對關稅的影響。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

I wanted to follow up on your comments at Oak Street, where you noted some early signs of pressure. Can you elaborate on the nature and timing of what you're seeing there? And relatedly, is there anything that changed from year one to year two of B-28 that was either unanticipated or more challenging from an operational perspective?

我想跟進您在 Oak Street 的評論，您在那裡提到了一些早期的壓力跡象。您能詳細說明一下您在那裡看到的情況的性質和時間嗎？與此相關的是，從營運角度來看，B-28 從第一年到第二年是否發生了一些意料之外或更具挑戰性的變化？

Prem, I'll let you take this question.

Prem，我讓你來回答這個問題。

Thanks. And Andrew, thanks for the question. The health care delivery business has performed in line with our expectations. As we said, some signs of pressure in the first quarter as it relates to medical cost trends at Oak Street. That is offset by some of the favorability we're seeing in other parts of health care delivery. Oak Street, it's still very immature or early in the year. We see that pressure (inaudible) how claims will develop over the course of the next several months and we'll report back on that piece.

謝謝。安德魯，謝謝你的提問。醫療保健業務的表現符合我們的預期。正如我們所說，第一季出現了一些與 Oak Street 醫療成本趨勢相關的壓力跡象。但這被我們在醫療保健服務的其他領域看到的一些有利因素所抵消。橡樹街 (Oak Street)，目前還非常不成熟，或者說還處於早期階段。我們看到了壓力（聽不清楚）索賠在未來幾個月將如何發展，我們將對此進行報告。

On the (inaudible) business, it's a strong start to the year with our IHG volume. Our customers are really valuing the service that we provide and the operational excellence that we have there as well. So more to come as we go. But right now, we feel good overall about health care delivery with a little bit of pressure in Oak Street.

就（聽不清楚）業務而言，憑藉洲際酒店集團 (IHG) 的業務量，今年開局強勁。我們的客戶非常重視我們提供的服務以及我們卓越的營運。隨著我們的前進，還會有更多內容。但目前，我們對醫療保健服務整體感覺良好，只是橡樹街有一點壓力。

Michael Cherny, Leerink Partners.

Michael Cherny，Leerink Partners。

Maybe just a follow-up on PCW. Obviously, this is the first quarter that you've had the cost vantage impact. Anything you can say about the market impact, how it's trended based to your expectations? And then going forward, you've talked about the potential to roll this into government. Any updated thoughts there?

也許只是 PCW 的後續。顯然，這是您第一次感受到成本優勢的影響。能談談市場影響嗎？根據您的預期，其趨勢如何？然後展望未來，您談到了將其納入政府的可能性。有任何更新的想法嗎？

So maybe before I turn it over to Prem, I think this is another example where you've heard consistently today, the innovation that we're driving in the business, whether it be the prior authorization work that Steve Nelson is working on at Aetna or the biosimilars that we announced last year or now the Novo. I think this is another example where Prem and the PCW team has led on the front in terms of reshaping how pharmacy pricing is delivered in this country. So, Prem, why don't you speak more broadly to Michael's question?

因此，在我將其交給 Prem 之前，我想這是另一個例子，今天您一直聽到的，我們在業務中推動的創新，無論是 Steve Nelson 在 Aetna 開展的事先授權工作，還是我們去年宣布的生物仿製藥或現在的 Novo。我認為這是 Prem 和 PCW 團隊在重塑這個國家藥品定價方式方面發揮領導作用的另一個例子。那麼，Prem，你為什麼不更廣泛地回答 Michael 的問題呢？

Yes. So, Mike, thanks for the question. And from my perspective, the PCW business continues to perform really strong. In the simple statement, we're the best run national pharmacy period. If you think about how we're achieving our results.

是的。所以，麥克，謝謝你的提問。從我的角度來看，PCW 業務持續表現強勁。簡單來說，我們是全國經營最好的藥局。如果你思考一下我們是如何取得成果的。

One, it's extremely strong execution in our 9,000 local community, health destinations that are powered by our 200,000-plus colleagues every single day that we're enabling, and we continue to make labor investments and technology investments to continue to improve the workforce environment. We continue to see our NPS of our colleagues improve in our stores, and we've transformed the technology and the operating model in our stores to better serve our customers.

首先，我們在 9,000 個當地社區、健康目的地的執行力非常強，每天都有超過 20 萬名同事為我們提供支持，我們將繼續進行勞動力和技術投資，以繼續改善勞動力環境。我們不斷看到我們商店同事的 NPS 不斷提高，並且我們已經改變了商店的技術和營運模式，以更好地服務我們的客戶。

And lastly, we've really focused on our omnichannel capabilities inside of our stores to really connect care and make those experiences better and more convenient for our customers. If you look at the quarter, there's probably three things that impacted PCW first front store. If you think about this challenging macro environment, we're pleased with our performance.

最後，我們真正專注於商店內部的全通路功能，以真正連接服務並為客戶提供更好、更便捷的體驗。如果你看一下本季，可能會有三件事影響了 PCW 第一家門市。如果你考慮到這個充滿挑戰的宏觀環境，我們對自己的表現感到滿意。

We saw a shift in seasonal illness into Q1, and we had a double peak from that seasonal -- double peak of that seasonal illness that contributed to our outperformance. We also grew our customer base in the front store and grew -- increased our frequency of trips. So those are both two really promising signs as we go into the back half.

我們看到季節性疾病轉向第一季度，並且我們經歷了季節性的雙峰 - 季節性疾病的雙峰有助於我們取得優異的業績。我們也擴大了前店的客戶群，並增加了我們的購物頻率。因此，當我們進入後半段時，這兩者都是非常有希望的跡象。

The second piece is in our pharmacy business, our script comp growth was approximately 7%. Our share is now at 27.6%. So we're really excited about what we're delivering there. As it relates to cost manage, we're still early. We're obviously in Q1 of the transformation into a much more transparent model that allows our payer customers to get the value that we receive from our industry-leading cost of goods in a much more transparent way.

第二部分是我們的藥局業務，我們的處方藥銷售額成長約為 7%。我們的份額現在為27.6%。因此，我們對在那裡交付的產品感到非常興奮。就成本管理而言，我們還處於早期階段。顯然，我們在第一季正向更透明的模式轉型，使我們的付款客戶能夠以更透明的方式獲得我們從行業領先的商品成本中獲得的價值。

And as you -- as you recall from November '23, when we first announced this, the goal of this is to address one, the cross subsidization that exists in the marketplace across brands and generics and to create stable, more predictable margins and pass the value back to payers in a much more predictable way when we receive that. And so where we are today, we've moved 100% of our commercial scripts as we said on [1125] into cost manage. We moved the cash discount card space into cost manage as well. We're working very hard for [1126] to move the rest of our scripts into this model, and we'll provide more updates on the outcomes of this, but we're really pleased with where we are with this, and we're really pleased with the results of PCW and the strong performance powered by the 200,000 colleagues you have in retail.

正如您所記得的，2023 年 11 月我們首次宣布這一消息時，我們的目標是解決市場上跨品牌和仿製藥的交叉補貼問題，創造穩定、更可預測的利潤率，並在我們收到這些利潤時以更可預測的方式將價值返還給付款人。所以我們現在的情況是，正如我們在 [1125] 中所說的那樣，我們已經將 100% 的商業腳本轉移到成本管理中。我們也將現金折扣卡空間移入成本管理。我們正在努力將[1126]其餘的腳本轉移到這個模型中，我們將提供更多關於其結果的更新，但我們對目前的情況感到非常滿意，我們對 PCW 的結果以及由你們在零售業擁有的 20 萬名同事推動的強勁表現感到非常滿意。

And Michael, maybe just one thing to add. As we look in the back half of the year, obviously, PCW is running as well as we would expect. With the one caution to watch out is the vaccines and immunizations as we anticipate volume impacts depending on the government action for the end of this year.

邁克爾，我只想補充一點。展望下半年，顯然 PCW 的運作情況正如我們預期的那樣好。需要注意的是疫苗和免疫接種，因為我們預計今年年底政府採取的行動將對疫苗和免疫接種數量產生影響。

Charles Rhyee, TD Cowen.

查爾斯·瑞伊（Charles Rhyee），考恩（Cowen）TD。

David, I wanted to circle back to your comments earlier about the (inaudible) pass in Arkansas. And obviously, I think it's been reported that you could end up potentially closing sort of your retail locations in the state. Obviously, some other states are considering kind of similar legislation and certainly, maybe Arkansas is an easy state to exit from if you had to -- if we think this gets adopted more broadly. And I think back to the (inaudible) California contract where you -- they kind of split that contract up and you guys ended up retaining the specialty pharmacy part of the business. And I think at the time, you guys had said that was obviously the most profitable part of the business.

大衛，我想回到你之前關於阿肯色州（聽不清楚）通行證的評論。顯然，我認為有報導稱，你們最終可能會關閉該州的一些零售店。顯然，其他一些州也在考慮類似的立法，當然，如果我們認為這項立法能夠得到更廣泛的採用，那麼阿肯色州可能是一個很容易退出的州。我回想起（聽不清楚）加州合同，他們把合同分割開來，你們最終保留了專業藥房業務部分。我認為當時你們就說過這顯然是業務中最賺錢的部分。

If that's the case, and we see a future where sort of splitting these business, and I understand the argument why having a vertically integrated business makes more sense, but if you have to divest or the other, is it fair to think that you would look to divest maybe the PBM part of the business and retain specialty pharmacy? And if that's the case, is that a difficult kind of process to enact if you had to?

如果情況確實如此，並且我們看到未來會拆分這些業務，而且我理解為什麼垂直整合業務更有意義，但如果您必須剝離其他業務，您是否會考慮剝離 PBM 部分業務並保留專業藥房？如果事實確實如此，那麼如果必須實施的話，這個過程是否很困難？

And just a quick follow-up to Lisa's question earlier, Wegovy being on the national formulary, I assume that comes with a better rebate structure?

再簡單回答一下 Lisa 之前提出的問題，Wegovy 被納入國家藥典，我猜想它有更好的回扣結構吧？

All right. Charles, thanks for the question. Let me first talk about Arkansas because I think it's important in terms of just stating how we see at least laying out the facts as we see them. One is we believe this is really bad policy. And it's putting a lot of patients at risk is taking the most competitive pharmacies out of the marketplace.

好的。查爾斯，謝謝你的提問。讓我先談談阿肯色州，因為我認為就陳述我們的看法而言，至少陳述我們所看到的事實是很重要的。一是我們認為這是一項非常糟糕的政策。這讓許多患者面臨風險，讓最具競爭力的藥局退出市場。

And so it will essentially increase the cost on the backs of the consumer. So I think when you take a step back and look at this, this is going to be impactful, both in terms of cost and disruption and access. There's over 300,000 people that we currently serve with more than 4 million prescriptions. So it's going to create what we know will be the headline of the day, which is pharmacy deserts and access problems. So when you look at the most vulnerable population, which is the specialty population.

因此，這實際上會增加消費者的成本。所以我認為，當你退一步來看這個問題時，這將會產生影響，無論是在成本、中斷或存取方面。目前，我們為超過 30 萬人提供服務，開出了超過 400 萬張處方。因此，它將成為我們所知的當天的頭條新聞，即藥房荒廢和獲取問題。因此，當您觀察最脆弱的人群，即特殊人群時。

As I mentioned in the opening comments, there's 10,000 patients that will be disrupted and/or potentially have access to care issues. And not to mention the savings that we've delivered for biosimilars and other things that we've taken cost out of our plan sponsors pockets and actually save the consumers' money. So this is what I believe that most other states are looking at and saying whether or not this is going to be picked up across the country. I recognize that there are other states that are looking at this. We've had some really positive developments over the last couple of weeks with states that have rejected this notion.

正如我在開場白中提到的那樣，有 10,000 名患者將受到干擾和/或可能需要解決護理問題。更不用說我們在生物相似藥和其他產品上節省的費用，這些費用都從我們的計劃發起人口袋中扣除，實際上節省了消費者的錢。所以我相信大多數其他州都在關注這個問題，並正在考慮是否要在全國範圍內推行這項政策。我知道其他州也在關注此事。在過去幾週，我們與一些拒絕這個想法的州取得了一些非常積極的進展。

And I think they've done this in large part because the plan sponsors and the payers are going to see their costs go up, and they're going to see the complexity of being able to meet the access needs of the patients. So as we look and presenting the facts, I do believe that common sense will prevail and that we won't have to make the decisions that you're asking us -- what businesses we are or not going to be in because I do believe in the power of and the ability for us to be able to serve customers through the integrated assets that we currently operate.

我認為他們這樣做很大程度上是因為計劃發起人和付款人將看到他們的成本上升，並且他們將看到滿足患者獲取醫療服務需求的複雜性。因此，當我們審視和呈現事實時，我確實相信常識將佔上風，我們不必做出您問我們的決定——我們將從事或不從事哪些業務，因為我確實相信我們能夠透過我們目前運營的綜合資產為客戶提供服務的力量和能力。

So as it relates to with Wegovy, the obvious answer is, this is what a PBM does. When there's enough supply in the marketplace, we create competition and we ultimately lower cost for the customers in which we serve. And that is also now going to be delivered to the pharmacies that we run and operate. So if you go back to the Arkansas example, we are now opening up the Wegovy access to 9,000 pharmacies and potentially not being -- they will not be an affordable retail access in their state if this continues.

因此，就 Wegovy 而言，顯而易見的答案是，這就是 PBM 所做的。當市場上有足夠的供應時，我們就會創造競爭，最終降低我們服務的客戶的成本。這些藥品現在也將運送到我們經營的藥局。因此，如果你回到阿肯色州的例子，我們現在向 9,000 家藥局開放了 Wegovy 通道，如果這種情況繼續下去，這些藥局可能不會成為該州負擔得起的零售通道。

So I think when you just look more broadly at the role that we play, I think that we clearly have, I think, the fact base and I think the proof point is to be able to demonstrate the value that we're bringing. But thanks for the question, Charles. All right. One more question, operator?

因此，我認為，當你更廣泛地看待我們所扮演的角色時，我認為我們顯然有事實基礎，而且我認為證明點就是能夠證明我們所帶來的價值。但謝謝你的提問，查爾斯。好的。還有一個問題，接線生？

Ann Hynes, Mizuho.

安‧海因斯 (Ann Hynes)，瑞穗。

Yes. Can you just provide a little bit more commentary on your -- commentary on the flu in your prepared remarks. I guess what makes you a little bit more concerned? Is it just less support from the CDC? And can you remind us how much of your -- how many flu vaccines you do a year and what you have embedded in guidance for a potential change in behavior?

是的。您能否在您準備好的發言中就流感問題再多發表一點評論？我猜是什麼讓你更擔心呢？這是否只是 CDC 的支持減少？您能否提醒我們您每年接種了多少流感疫苗，以及您在指導中提出了哪些可能的行為改變？

And then additionally, is it -- are you just worried about the flu? Are you just -- or is it your entire vaccine portfolio that you might be a little bit more worried about given the Washington environment?

另外，您只是擔心流感嗎？考慮到華盛頓的環境，您是否只是——或者說，您可能會對您的整個疫苗組合感到有點擔心？

Yes. Thank you, Ann. And I'll let Prem answer this, but this is more broadly the immunization and vaccination program that we're talking about. So, Prem, do you want to address the question?

是的。謝謝你，安。我讓 Prem 來回答這個問題，但更廣泛的是，我們討論的是免疫和疫苗接種計劃。那麼，Prem，你想回答這個問題嗎？

Yes. So as Tom and David said in prepared remarks, we're monitoring a few things. One is consumer sentiment. And what I would say is around vaccines and potential changes in the protocols required to deliver these.

是的。正如湯姆和大衛在準備好的演講中所說，我們正在監控一些事情。一是消費者情緒。我想說的是有關疫苗以及接種疫苗所需協議的潛在變化。

The pressure that we're contemplating is primarily on COVID vaccines and if there's some changes in terms of those requirements. And so there's a committee called (inaudible) that meets in the middle of the year that will kind of help drive and make sure that we understand what the national standards are for delivery of this.

我們正在考慮的壓力主要在於 COVID 疫苗，以及這些要求是否會改變。因此，有一個名為（聽不清楚）的委員會在年中召開會議，以幫助推動並確保我們了解實現這一目標的國家標準。

What I'll say is our stores are prepared and ready to deliver vaccinations. We continue to create a really good consumer experience to deliver that. We continue to see really good progress in terms of our ability to gain share of the total addressable market of patients (inaudible) need vaccine. So it's really around the size of the entire market as it relates to COVID.

我想說的是，我們的商店已經做好準備，隨時可以提供疫苗。為了實現這一目標，我們將繼續創造真正良好的消費者體驗。我們在獲得需要疫苗的患者（聽不清楚）總目標市場份額的能力方面繼續取得了非常好的進展。因此，這實際上與與 COVID 相關的整個市場的規模有關。

All right. Thank you, Prem. So before I end the call, I want to thank over 300,000 dedicated colleagues for the work you do every day. Your commitment to serving our consumers, patients and members are important drivers of the strong results we delivered this quarter and key contributors in our journey to become America's most trusted healthcare company. Thank you for joining our call today, and we look forward to providing updates as our progress -- as we progress throughout the year.

好的。謝謝你，Prem。因此，在結束通話之前，我想感謝 30 多萬名敬業的同事，感謝你們每天所做的工作。您致力於服務我們的消費者、患者和會員，這是我們本季取得強勁業績的重要驅動力，也是我們成為美國最值得信賴的醫療保健公司的關鍵貢獻者。感謝您今天參加我們的電話會議，我們期待隨著我們全年的進展提供最新進展。

Thank you all for joining today's conference call with CVS Health. I can confirm today's call has now concluded. You may now disconnect. Thank you for your participation, and please enjoy the rest of your day.

感謝大家參加今天與 CVS Health 的電話會議。我可以確認今天的電話會議已經結束。您現在可以斷開連線。感謝您的參與，祝您今天過得愉快。