CVS Health Corp (CVS) 2025 Q3 法說會逐字稿

Hello and welcome to CVS Health's third quarter 2025 earnings call. (Operator Instructions)As a reminder, this conference is being recorded today.(Operator Instructions)

大家好，歡迎參加 CVS Health 2025 年第三季財報電話會議。（操作員說明）提醒各位，本次會議正在進行錄音。 （操作員說明）

I would now like to pass the call to Larry McGrath, Chief Strategy Officer. Larry, please proceed.

現在我想把電話轉給首席策略長拉里·麥格拉斯。拉里，請繼續。

Good morning and welcome to the CVS Health third-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 Brian Newman, Chief Financial Officer.

早安，歡迎參加 CVS Health 2025 年第三季財報電話會議和網路直播。我是首席策略長拉里·麥格拉斯。今天早上和我一起接受採訪的是總裁兼執行長大衛·喬伊納和財務長布萊恩·紐曼。

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 have been posted to our website, along with our Form 10-Q filed this morning with the SEC. Today's call is also being broadcast on our website, where it'll be archived for one year.

在我們發表完準備好的演講後，我們將舉行問答環節，屆時領導團隊的其他成員也將參與其中。我們的新聞稿和幻燈片簡報已發佈到我們的網站上，同時，我們今天早上也向美國證券交易委員會提交了 10-Q 表格。今天的電話會議也會在我們的網站上進行直播，並將在網站上存檔一年。

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.

在本次電話會議中，我們將發表一些前瞻性聲明。我們的前瞻性聲明存在重大風險和不確定性，可能導致實際結果與目前預測的結果有重大差異。我們強烈建議您查閱我們向美國證券交易委員會提交的有關這些風險和不確定性的報告。

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 on Form 8-K, including this morning's earnings press release.

特別是那些在我們最新的 10-K 表格年度報告、今天早上提交的 10-Q 表格季度報告以及我們最近提交的 8-K 表格文件中關於前瞻性陳述和風險因素的警示性聲明中描述的內容，包括今天早上發布的收益新聞稿。

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GAAP指標來討論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我們網站投資者關係部分發布的調節文件中找到這些非GAAP指標的調節表。

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

接下來，我想把電話交給大衛。大衛？

Thank you, Larry, and good morning everyone. This morning we are pleased to report another quarter of solid results. Once again reflecting the power of our diversified business and progress on becoming the most trusted healthcare company in America.

謝謝你，拉里，大家早安。今天早上我們很高興地宣布，又一個季度業績穩健。這再次體現了我們多元化業務的實力，以及我們成為美國最值得信賴的醫療保健公司所取得的進展。

In the third quarter, we delivered adjusted operating income of $3.5 billion and adjusted earnings per share of $1.60. In addition, for the third consecutive quarter, we are increasing our full year 2025 adjusted earnings per share guidance to a range of $6.55 to $6.65, up from our previous range of $6.30 to $6.40.

第三季度，我們實現調整後營業收入35億美元，調整後每股收益1.60美元。此外，我們連續第三個季度調高2025年全年調整後每股盈餘預期，從先前的6.30美元至6.40美元上調至6.55美元至6.65美元。

Over the past 12 months, we have been intensely focused on executing against our commitments to our customers, partners, colleagues, and shareholders. We are building momentum across the enterprise and feel a growing excitement about the opportunities ahead for CVS Health.

過去 12 個月，我們一直全力以赴履行對客戶、合作夥伴、同事和股東的承諾。我們正在全公司範圍內積蓄力量，並對 CVS Health 未來的機會感到越來越興奮。

We are incredibly proud of what we have accomplished so far this year. While we are encouraged by our progress, we maintain a disciplined and cautious outlook as we position our business for another year of strong performance in 2026. This transformation is clearly visible within our Aetna business, or after a challenging 2024, there is renewed vigor and optimism about the future.

我們為今年迄今所取得的成就感到無比自豪。儘管我們對取得的進展感到鼓舞，但我們仍保持謹慎和自律的態度，為2026年業務的另一個強勁增長做好準備。這種轉變在我們安泰保險業務中顯而易見，或者說，在經歷了充滿挑戰的 2024 年後，人們對未來充滿了新的活力和樂觀。

Steve, Katrina, and the broader Aetna team are well on the path to ensuring this business is best in class. Yet the team continues to drive impactful and exceptional results. Aetna is once again the industry leader amongst national payers for 2026 Medicare Advantage Stars ratings. Even with CMS recently announcing that cut points for stars continue to become more challenging.

史蒂夫、卡特里娜以及整個安泰團隊正朝著確保這項業務成為業內最佳的目標穩步前進。然而，該團隊仍在不斷取得有影響力和卓越的成果。在 2026 年 Medicare Advantage 星級評定中，安泰保險公司再次成為全國支付者中的產業領導者。即使 CMS 最近宣布，明星球員的評選標準將變得越來越嚴格。

Based on the current membership, we expect over 81% of our Medicare Advantage members will be in plans rated 4 stars or higher, with over 63% of them in 4.5 star plans, nearly double the industry average. This result is not just a point of pride, but another proof point that our ability to effectively collaborate across the enterprise, allows us to deliver exceptional quality and service, drive down the cost of care, and remove friction from the healthcare system.

根據目前的會員情況，我們預計超過 81% 的 Medicare Advantage 會員將加入 4 星或更高評級的計劃，其中超過 63% 的會員將加入 4.5 星計劃，幾乎是行業平均水平的兩倍。這項成果不僅讓我們感到自豪，也再次證明了我們能夠有效地在整個企業範圍內進行協作，從而提供卓越的品質和服務，降低醫療成本，並消除醫療保健系統中的摩擦。

We are still in the early stages of the 2026 annual enrollment period, but we remain confident that our thoughtful approach to our geographic footprint, benefit design, and pricing, positions as well for another year of recovery.

2026 年年度註冊期仍處於早期階段，但我們仍然相信，我們對地理覆蓋範圍、福利設計和定價的周全考慮，將使我們為另一個復甦年做好準備。

In my first year as CEO, I have pushed our team to act with urgency and focus, as we execute on opportunities to improve our business. This means making thoughtful and difficult decisions, such as exiting our individual exchange business, or taking advantage of market opportunities like our acquisition of the Rite Aid assets. In a similar way, as we outlined last quarter, we are moving with urgency to address pressures in healthcare delivery.

在我擔任執行長的第一年，我敦促我們的團隊以緊迫感和專注力行動，抓住一切機會改善我們的業務。這意味著要做出深思熟慮且艱難的決定，例如退出我們的個人兌換業務，或抓住市場機遇，例如收購 Rite Aid 的資產。同樣，正如我們上個季度所概述的那樣，我們正在緊急採取行動，應對醫療保健服務方面的壓力。

During the quarter, we recorded a $5.7 billion goodwill impairment within healthcare delivery. I want to be clear that this business's performance in the quarter was in line with our most recent expectations. However, our decision during the quarter to temper Oak Street Health clinic growth over the next few years was the primary reason for recording this charge.

本季度，我們在醫療保健服務領域提列了 57 億美元的商譽減損。我想明確指出，該業務本季的業績符合我們最近的預期。然而，本季我們決定在未來幾年內放緩 Oak Street Health 診所的成長，這是記錄這筆費用的主要原因。

Despite this update, value-based care remains a critical component of our strategy. The reasons to believe in this business have not changed, but the marketplace is evolving, and we are adapting our strategy to get financial performance back in line with our expectations.

儘管進行了此次更新，但以價值為導向的醫療仍然是我們策略的關鍵組成部分。我們相信這項業務的理由沒有改變，但市場不斷變化，我們正在調整我們的策略，以使財務表現重新達到我們的預期。

We understand the challenges at Oak Street Health and have taken actions to improve performance in both the near and long-term. We continue to strengthen our healthcare delivery business through investments in technology, a new leadership team, and a fair and equitable contracts with our payer clients.

我們了解 Oak Street Health 面臨的挑戰，並已採取措施來改善其近期和長期的表現。我們透過投資技術、組建新的領導團隊以及與支付方客戶簽訂公平合理的合同，不斷加強我們的醫療保健服務業務。

Turning to pharmacy services, we're incredibly proud of the meaningful impact we've had on drug costs in this country. As you've seen with our recently announced IVF initiative with the administration, we are strong supporters of President Trump's focus on lowering brand prices in America. This is important for our patients, our customers, and for our business model.

談到藥房服務，我們為我們在這個國家對藥品成本的重大影響感到無比自豪。正如您從我們最近與政府共同宣布的試管嬰兒計劃中看到的那樣，我們強烈支持川普總統致力於降低美國品牌藥價格的舉措。這對我們的患者、客戶和我們的商業模式都至關重要。

By tackling branded pharma and equitable pricing strategies that have left Americans carrying the financial weight of global drug innovation, the government is helping to relieve a long-standing burden on US consumers and businesses.

透過解決品牌藥廠和公平定價策略問題（這些問題導緻美國人承擔了全球藥物創新帶來的經濟負擔），政府正在幫助減輕美國消費者和企業長期以來的負擔。

We believe that over time, the administration's actions can create a new, lower ceiling price in the US in which PBMs will continue to negotiate and further reduce costs for their customers and consumers. This has been our job for more than three decades, and we have been tremendously successful at achieving durable results.

我們相信，隨著時間的推移，政府的措施可以在美國創造一個新的、更低的藥品價格上限，藥品福利管理機構將繼續在此基礎上進行談判，進一步降低其客戶和消費者的成本。三十多年來，我們一直從事這項工作，並且在取得持久成果方面取得了巨大的成功。

We believe these actions are good for us, for our customers, and for consumers, and we are encouraged to see the impact they may create for the industry. As the leading healthcare consumer company, we've been working diligently for years to lead with greater transparency and savings for consumers at the pharmacy counter.

我們相信這些措施對我們、我們的客戶和消費者都有好處，我們也很高興看到這些措施可能對產業產生的影響。作為一家領先的醫療保健消費公司，我們多年來一直努力為藥房櫃檯的消費者提供更高的透明度和更優惠的價格。

We were at the forefront of this transition with more than 25 million members who benefit at the pharmacy counter from our lowest net cost through point of sale rebates. This includes our Aetna fully insured commercial members who we transitioned in 2019, and the benefit design we offer our own colleagues.

我們引領了這項變革，擁有超過 2500 萬會員，他們透過銷售點返利在藥局櫃檯享受最低淨成本。這包括我們在 2019 年過渡到安泰保險的全額商業會員，以及我們為自己的同事提供的福利方案。

Two years ago, we continued our innovation leadership when we introduced our new true cost model, which guarantees a net cost for each individual drug, delivering drug pricing transparency for our clients and consumers. We are encouraged by recent announcements that others are following us on this path. We know that this is the transition that consumers want, and it is also important for the future of our business.

兩年前，我們繼續保持創新領先地位，推出了新的真實成本模型，保證了每種藥物的淨成本，為我們的客戶和消費者提供了藥品定價透明度。最近的消息讓我們感到鼓舞，因為其他人也正在追隨我們走這條路。我們知道這是消費者想要的轉型，這對我們業務的未來也至關重要。

We're incredibly encouraged by the path Caremark is on. However, we acknowledge there are near-term market dynamics from a few of our client contracts that have resulted in a revision to our guidance and will impact our near-term growth rate.

我們對 Caremark 的發展之路感到無比鼓舞。然而，我們承認，由於部分客戶合約的短期市場動態，我們不得不修改業績預期，這將影響我們近期的成長率。

While incorporating this, as Brian will discuss later, we continue to expect meaningful growth in enterprise earnings next year. We are working diligently to recontract over the next few years and resolve this issue. Importantly, clients, including the most sophisticated buyers of pharmacy benefit services, continue to see the tremendous value we provide, as evidenced by another strong selling season.

儘管布萊恩稍後會討論到這一點，但我們仍然預計明年企業獲利將實現顯著成長。我們將在未來幾年內努力重新簽訂合約並解決這個問題。重要的是，包括最精明的藥品福利服務買家在內的客戶，繼續看到我們提供的巨大價值，又一個強勁的銷售季證明了這一點。

We have achieved new client wins of nearly $6 billion and are closing out another selling season with retention in the high 90s. I am incredibly bullish about the road ahead and believe we will continue to lead this industry given our unique advantages and insights.

我們已成功贏得近 60 億美元的新客戶，並在另一個銷售季結束時保持了 90% 以上的客戶留存率。我對未來的發展道路充滿信心，並相信憑藉我們獨特的優勢和洞察力，我們將繼續引領這個產業。

Turning to PCW. Our leadership is clear in the retail pharmacy market as we work towards a more sustainable and transparent future. Our deliberate strategic decisions, intentional investments, best in class drug purchasing and superior customer service have meaningfully improved our differentiated position in the market.

轉向 PCW。在努力邁向更永續、更透明的未來的過程中，我們在零售藥局市場的領導地位顯而易見。我們深思熟慮的策略決策、有目的的投資、一流的藥品採購和卓越的客戶服務，顯著提升了我們在市場上的差異化地位。

Once again this quarter, CVS Pharmacy delivered solid performance, including pharmacy share gains. This is a testament to the strength and scalability of our model, as well as the commitment of our engaged colleagues. We play a critical role in improving the health of millions of Americans by providing convenient health services, including vaccinations.

本季度，CVS藥局再次取得穩健業績，包括藥局市場佔有率的成長。這證明了我們模式的強大性和可擴展性，以及我們敬業的同事們的奉獻精神。我們透過提供便利的醫療服務（包括疫苗接種）在改善數百萬美國人的健康方面發揮著至關重要的作用。

Our 9,000 pharmacies are the front door to our enterprise. They are a differentiator for our business and a force multiplier towards improving the health of the communities that we serve. For CVS Health, being the most trusted healthcare company in America means improving health, simplifying care, and delivering a quality experience every day.

我們的9000家藥局是我們企業的門面。它們是我們業務的差異化優勢，也是改善我們所服務社區健康狀況的倍增器。對 CVS Health 而言，成為美國最值得信賴的醫療保健公司意味著每天改善健康、簡化照護並提供優質體驗。

We do not take this responsibility lightly, and it is this team's firm belief that we must drive the evolution of healthcare forward in the US. We have unique capabilities to achieve all of those goals. The strength of our diversified businesses continued to set us apart, enabling us to deliver strong results even in this dynamic environment. The progress we've made this year is fielding momentum, and our disciplined execution position just for another year of strong performance in 2026.

我們絕不輕視這項責任，團隊堅信，我們必須推動美國醫療保健的進步。我們擁有實現所有這些目標的獨特能力。我們多元化業務的優勢使我們脫穎而出，即使在當前瞬息萬變的環境中，我們也能取得優異的業績。我們今年取得的進展正在積蓄力量，而我們嚴謹的執行力將確保我們在 2026 年再創佳績。

We are working to simplify healthcare and are bullish about the opportunities we see to lower the cost of care and drive innovation. Our future is bright because of the work of our more than 300,000 colleagues who take care of their friends, families, and neighbors in communities across our country. We look forward to sharing more on our longer-term plans at our Investor Day on December 9.

我們致力於簡化醫療保健，並對降低醫療成本和推動創新的機會充滿信心。我們擁有超過 30 萬名同事，他們在全國各地的社區中照顧著他們的朋友、家人和鄰居，正因他們的辛勤工作，我們的未來才如此光明。我們期待在12月9日的投資者日上與大家分享更多關於我們長期計劃的資訊。

With that, I'd like to hand the call over to Brian. Brian?

接下來，我想把電話交給布萊恩。布萊恩？

Thank you, David, and good morning. I will cover four key topics in my remarks. First, an update on our third quarter results, then I'll discuss cash flow and the balance sheet. After that, I will provide an update on a revised financial outlook for the remainder of 2025. And finally, I'll wrap up with a brief discussion on high-level headwinds and tailwinds as we look ahead to 2026.

謝謝你，大衛，早安。我的發言將涵蓋四個主要主題。首先，我將報告我們第三季的業績，然後討論現金流和資產負債表。之後，我將提供一份關於2025年剩餘時間修訂後的財務展望的最新資訊。最後，我將簡要討論展望 2026 年時所面臨的高空逆風和順風。

As David mentioned, we are pleased to report another quarter of solid performance, and to deliver a third quarter in a row where we beat and raised expectations as we continue to focus on building a track record of consistent success. We improved our full year outlook for revenue, adjusted EPS, and cash flow from operations, and our building positive momentum as we close out the year.

正如大衛所提到的，我們很高興地報告又一個季度業績穩健，並且連續第三個季度超出預期，我們將繼續專注於建立持續成功的良好記錄。我們提高了全年營收、調整後每股盈餘和經營活動現金流的預期，隨著年底臨近，我們正逐步建立積極的成長動能。

Let me start with highlights on our enterprise results in the quarter. Third quarter revenues achieved a new record of nearly $103 billion, an increase of approximately 8% over the prior year quarter, driven by revenue growth across all segments.

首先，讓我先重點介紹一下我們公司本季的業績。第三季營收創下近 1,030 億美元的新紀錄，比上年同期成長約 8%，這主要得益於所有業務部門的營收成長。

Adjusted operating income of approximately $3.5 billion increased approximately 36% from the prior year quarter, primarily driven by an improvement in our healthcare benefits segment. We delivered adjusted EPS of $1.60, an increase of nearly 47% from the prior year quarter. Finally, we generated year-to-date cash flow from operations of approximately $7.2 billion.

經調整後的營業收入約為 35 億美元，比去年同期成長約 36%，主要得益於醫療保健福利業務的改善。我們實現了調整後每股收益 1.60 美元，比上年同期增長近 47%。最後，我們今年迄今的營運活動現金流約為 72 億美元。

Turning now to each of our segments. In healthcare benefits, we generated nearly $36 billion of revenue in the quarter, an increase of over 9% from the prior year. This increase is primarily driven by our government business, largely related to the impact of the inflation Reduction Act on the Medicare Part D program.

現在我們分別來看各個部分。在醫療保健福利方面，我們本季創造了近 360 億美元的收入，比去年同期成長超過 9%。這一增長主要由我們的政府業務推動，這在很大程度上與通貨膨脹削減法案對醫療保險D部分計劃的影響有關。

We ended the quarter with medical membership of approximately 26.7 million, which was flat sequentially and decreased approximately 445,000 members from the prior year quarter. This year over year decrease is primarily driven by declines in our individual exchange and Medicare product lines, partially offset by growth in our commercial fee-based membership. Adjusted operating income in the quarter was approximately $314 million, a substantial increase from the adjusted operating loss recorded in the prior year quarter.

本季末，我們的醫療會員人數約為 2,670 萬，與上一季持平，比去年同期減少了約 44.5 萬會員。與前一年相比，此下降主要是由於個人保險交易和醫療保險產品線的下滑，部分被商業收費會員的成長所抵銷。本季調整後營業收入約 3.14 億美元，較上年同期調整後營業虧損大幅成長。

Our medical benefit ratio was 92.8%, a decrease of 240 basis points from the prior year quarter results of 95.2%. The change was driven by the favorable year over year impact of premium deficiency reserves, higher favorable prior period development, and improved underlying performance in our government business.

我們的醫療福利比率為 92.8%，比去年同期的 95.2% 下降了 240 個基點。這項變更是由保費不足準備金同比有利影響、前期發展更為有利以及政府業務基本面改善所驅動的。

These increases were partially offset by changes in the seasonality of the Medicare Part D program, due to the impact of the RRA and the impact of higher acuity in the individual exchange product line. Our medical benefit ratio this quarter was impacted by approximately 100 basis points, due to provider liabilities for matters dating as far back as 2018, and worsening individual exchange risk adjustment expectations based on the latest weekly data. Each of these two items were roughly equivalent.

由於 RRA 的影響以及個人交易產品線中更高嚴重程度的影響，Medicare Part D 計劃的季節性變化部分抵消了這些增長。本季度，由於供應商需承擔可追溯至 2018 年的責任，以及根據最新每週數據得出的個人交易所風險調整預期惡化，我們的醫療福利比率受到了約 100 個基點的影響。這兩件物品大致相當。

Medical cost trends in the quarter remained elevated across all products but were modestly favorable relative to our expectations, primarily driven by our individual MA book. Days claims payable at the end of the quarter was approximately 42.5 days, an increase of approximately 1.6 days sequentially, primarily driven by the partial release of premium deficiency reserves established in the first half of 2025, and as well as an additional day in the third quarter compared to the second quarter. We remain confident in the adequacy of our reserves.

本季所有產品的醫療成本趨勢仍然居高不下，但與我們的預期相比略有好轉，這主要得益於我們的個人醫療保險業務。截至本季末，應付賠款天數約為 42.5 天，比上一季增加約 1.6 天，主要原因是 2025 年上半年建立的保費不足準備金部分釋放，以及第三季度比第二季度多出一天。我們對儲備的充足性仍然充滿信心。

Shifting now to our Health Services segment. During the quarter, we generated revenues of over $49 billion, an increase of over 11% year-over-year. This increase was primarily driven by pharmacy drug mix and brand inflation, partially offset by continued pharmacy client price improvements. Adjusted operating income in the quarter of approximately $2.1 billion decreased 7% from the prior year quarter primarily driven by continued pharmacy client price improvements, partially offset by improved purchasing economics.

現在轉到我們的醫療服務部門。本季度，我們創造了超過 490 億美元的收入，年增超過 11%。這一增長主要是由於藥房藥品組合和品牌價格上漲所致，但部分被藥房客戶價格的持續改善所抵消。本季調整後的營業收入約為 21 億美元，較上年同期下降 7%，主要原因是藥房客戶價格持續改善，但部分被採購經濟效益的改善所抵消。

Performance in our Health Care Delivery business during the quarter was broadly in line with our expectations. Total revenues grew approximately 25% compared to the same quarter last year, excluding the impact of our exit from our CVS Accountable Care business earlier this year. This increase was primarily driven by patient growth at Oak Street and increased volumes at Signify.

本季我們醫療保健服務業務的業績基本上符合預期。與去年同期相比，總營收成長了約 25%，不包括今年稍早退出 CVS Accountable Care 業務的影響。這一增長主要由 Oak Street 的患者數量增長和 Signify 的業務量增加所驅動。

During the quarter, we made certain strategic changes in our Health Care Delivery business, including the decision to reduce the number of new Oak Street clinics we expect to open over the next several years. These changes necessitated a quantitative assessment of the carrying value of goodwill in our Health Care Delivery reporting unit, which resulted in a goodwill impairment charge of approximately $5.7 billion during the quarter. We are focused on improving financial performance in our Health Care Delivery business. As discussed last quarter, we have and continue to take actions at Oak Street to enhance our operations.

本季度，我們對醫療保健服務業務進行了一些策略性調整，包括決定減少未來幾年內計劃開設的新 Oak Street 診所的數量。這些變更需要對我們的醫療保健服務報告部門的商譽帳面價值進行定量評估，導致本季產生了約 57 億美元的商譽減損費用。我們致力於提升醫療服務業務的財務表現。正如上個季度所討論的，我們已經並將繼續在橡樹街採取措施來提升我們的營運效率。

During the quarter, we completed a comprehensive review of our Oak Street clinic footprint. As David mentioned, this is core to our approach of evaluating each of our businesses, identifying strengths and making decisions to drive improved execution and performance.

本季度，我們對橡樹街診所的佈局進行了全面審查。正如大衛所提到的，這是我們評估每項業務、找出優勢並做出決策以推動改進執行和績效的核心方法。

Following our review, we made the difficult decision to close underperforming clinics where we do not see a reasonable path to sustainable margins. To be clear, we view value-based care as a critical component to our Medicare strategy and expect the actions we are taking to support improved financial performance beginning next year.

經過審查，我們做出了艱難的決定，關閉那些我們認為無法實現可持續利潤的業績不佳的診所。需要明確的是，我們認為以價值為基礎的醫療是我們醫療保險策略的關鍵組成部分，並期望我們採取的行動能夠從明年開始改善財務表現。

Our Pharmacy & Consumer Wellness segment delivered another strong quarter. We generated revenues of over $36 billion, an increase of nearly 12% versus the prior year quarter primarily driven by pharmacy drug mix and increased prescription volume, partially offset by continued pharmacy reimbursement pressure.

我們的藥局及消費者健康業務板塊又迎來了一個強勁的季度。我們創造了超過 360 億美元的收入，比去年同期增長了近 12%，這主要得益於藥房藥品組合和處方量增加，但部分被持續的藥房報銷壓力所抵消。

Revenues in the quarter increased over 14% on a same-store basis. Our retail pharmacy script share grew to approximately 28.9% as our emphasis on operational excellence and superior customer experiences enables us to benefit from pharmacy market disruption.

本季同店銷售額成長超過 14%。由於我們注重卓越營運和優質客戶體驗，能夠從藥房市場的變革中受益，我們的零售藥房處方份額增長至約 28.9%。

Same-store pharmacy sales in the quarter grew nearly 17% compared to the prior year, driven by pharmacy drug mix and a nearly 9% increase in same-store prescription volumes. Same-store front store sales increased 150 basis points versus the prior year quarter. Adjusted operating income decreased approximately 7% from the prior year to approximately $1.5 billion. This decrease was primarily driven by continued pharmacy reimbursement pressure and increased investments in colleagues and capabilities. These items were partially offset by increased prescription volume.

本季同店藥局銷售額較上年同期成長近 17%，主要得益於藥局藥品組合的變化以及同店處方量成長近 9%。同店銷售額較上年同期成長150個基點。調整後的營業收入比上年下降約 7%，約 15 億美元。這一下降主要是由於藥房報銷壓力持續增加以及對同事和能力的投入增加所致。這些因素的部分影響被處方量的增加所抵消。

Shifting now to cash flow and the balance sheet. We generated cash flows from operations of approximately $7.2 billion year-to-date through the third quarter. We have distributed approximately $2.6 billion in dividends to our shareholders year-to-date, and we ended the quarter with approximately $2.3 billion of cash at the parent and unrestricted subsidiaries. We continue to meaningfully improve our leverage ratio, supported by our strong year-to-date performance and expect to make further improvement next year as we grow enterprise earnings driven by margin recovery in our Aetna business.

接下來我們來看現金流和資產負債表。今年截至第三季末，我們的經營活動產生的現金流約為 72 億美元。今年迄今為止，我們已向股東派發了約 26 億美元的股息，截至本季末，母公司和非限制性子公司持有約 23 億美元的現金。由於今年迄今的強勁業績，我們的槓桿率持續顯著改善，預計明年隨著安泰保險業務利潤率的恢復，企業盈利將進一步增長，槓桿率也將進一步改善。

Shifting now to our revised outlook for 2025. We are increasing our full year 2025 guidance for adjusted EPS to a range of $6.55 to $6.65, an increase of $0.25. This update reflects our third quarter performance and our revised expectations for the remainder of the year, which continue to maintain a prudent outlook on medical cost trends and macro factors. We now expect full year total revenues of at least $397 billion, an increase of nearly $6 billion driven by increases across all segments.

現在轉向我們對 2025 年的修訂展望。我們將2025年全年調整後每股盈餘預期上調至6.55美元至6.65美元，調高0.25美元。這項調整反映了我們第三季的業績以及對今年剩餘時間的預期，我們繼續對醫療成本趨勢和宏觀因素保持審慎的展望。我們現在預計全年總收入至少​​為 3,970 億美元，比上年增加近 60 億美元，主要得益於所有業務部門的成長。

In our Health Care Benefits segment, we now expect full year adjusted operating income of approximately $2.72 billion at the low end of our guidance range, an increase of approximately $300 million reflecting our performance in the third quarter and improved expectations for the remainder of the year. We continue to 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%. This outlook continues to maintain a thoughtful and prudent view on medical cost trends through the remainder of the year.

在我們的醫療保健福利業務板塊，我們現在預計全年調整後營業收入約為 27.2 億美元，處於我們預期範圍的下限，比預期增加約 3 億美元，這反映了我們第三季度的業績以及對今年剩餘時間的預期有所提高。我們繼續預測，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導範圍的下限，約為 91%。這項展望將繼續對今年剩餘時間的醫療成本趨勢保持深思熟慮和謹慎的態度。

In our Health Services segment, we now expect full year adjusted operating income of at least $7.1 billion, a decrease of approximately $240 million from our prior guidance. This update reflects our latest expectations for performance that David highlighted in his remarks. Importantly, we continue to make progress evolving our contracting and pricing models to respond and adapt to market dynamics. We are confident we're on the path to lead the evolution with our new TrueCost model, which guarantees a net cost of each individual drug driving, drug pricing transparency for our clients and members. The outlook for our Health Care Delivery business remains largely unchanged.

在我們的醫療服務部門，我們現在預計全年調整後營業收入至少為 71 億美元，比我們先前的預期減少了約 2.4 億美元。這次更新反映了我們對業績的最新預期，正如大衛在演講中所強調的。重要的是，我們不斷改進合約和定價模式，以應對和適應市場動態，並取得持續進展。我們有信心憑藉我們全新的 TrueCost 模式引領變革，該模式保證了每位客戶和會員每次吸毒駕駛的淨成本，並提高了毒品定價的透明度。我們的醫療服務業務前景基本維持不變。

Lastly, in our Pharmacy & Consumer Wellness segment, we now expect full year adjusted operating income of at least $5.95 billion, an increase of approximately $270 million from our prior guidance. This increase reflects our performance in the third quarter and our revised expectations for the remainder of the year, while continuing to maintain a prudent outlook for the rest of the immunization season and potential impacts to the consumer environment.

最後，在我們的藥房和消費者健康業務板塊，我們現在預計全年調整後營業收入至少為 59.5 億美元，比我們先前的預期增加了約 2.7 億美元。這一增長反映了我們第三季度的業績以及我們對今年剩餘時間的預期調整，同時我們繼續對剩餘的免疫接種季以及對消費者環境的潛在影響保持謹慎的展望。

In aggregate, we now expect full year enterprise adjusted operating income to be in the range of $14.14 billion to $14.31 billion. We are also increasing our expectations for full year cash flow from operations to be in a range of $7.5 billion to $8 billion. Additionally, we now expect our full year adjusted effective tax rate to be 25.3%, an improvement of 40 basis points. You can find additional details on the components of our 2025 guidance on our Investor Relations website.

總體而言，我們現在預計全年企業調整後營業收入將在 141.4 億美元至 143.1 億美元之間。我們同時提高了對全年經營活動現金流的預期，預計達到 75 億至 80 億美元。此外，我們現在預計全年調整後實際稅率為 25.3%，比去年同期提高了 40 個基點。您可以在我們的投資者關係網站上找到有關我們 2025 年指導意見組成部分的更多詳細資訊。

Before we open the call up to Q&A, I also want to provide an update on some of the key headwinds and tailwinds for 2026. Consistent with past practice, we expect to provide formal 2026 guidance at our Investor Day in December.

在正式開始問答環節之前，我還想就 2026 年的一些主要不利因素和有利因素進行最新情況介紹。與以往做法一致，我們預計將在 12 月的投資者日上提供正式的 2026 年業績指引。

Beginning with our Health Care Benefits business, we expect another year of meaningful margin improvement at Aetna. This includes another year of progress in our Medicare Advantage business, supported by our disciplined approach to plan design and footprint in individual as well as repricing opportunities in our group business.

首先，就我們的醫療保健福利業務而言，我們預計安泰保險的利潤率將在未來一年內顯著成長。這包括我們在 Medicare Advantage 業務方面又一年取得的進展，這得益於我們在個人計劃設計和佈局方面採取的嚴謹方法，以及我們在團體業務中把握的重新定價機會。

We also expect a tailwind from our exit of the individual exchange business. Although our conversations with our Medicaid state partners continue to progress and this business has performed in line with our expectations this year, we are taking a cautious outlook in light of the broader pressures across the industry.

我們也預計退出個人交易所業務將帶來利多。儘管我們與州醫療補助合作夥伴的對話仍在繼續，而且今年的業務表現也符合我們的預期，但鑑於整個行業面臨的更大壓力，我們仍持謹慎態度。

In our Health Services segment, we expect improvement in our Health Care Delivery business, primarily driven by Oak Street Health. In our Caremark business, we expect modestly lower growth as we continue our work to transition our contracts towards drug level pricing over the next few years. Altogether, we expect the segment to deliver low single-digit adjusted operating income growth next year.

在我們的醫療服務板塊，我們預計醫療服務業務將有所改善，這主要得益於 Oak Street Health 的推動。在我們的 Caremark 業務中，我們預計成長將略有放緩，因為我們將繼續努力在未來幾年內將合約過渡到藥品定價水平。整體而言，我們預計該業務板塊明年將實現個位數低段的調整後營業收入成長。

And in our Pharmacy & Consumer Wellness segment, we are encouraged by our strong performance this year and expect this momentum to continue into next year. While challenges, including reimbursement pressure and the impact of shifting consumer dynamics remain in this business, we currently expect the trajectory to improve relative to our long-term expectation of a 5% decline.

在藥局和消費者健康領域，我們對今年的強勁表現感到鼓舞，並預計這種勢頭將延續到明年。儘管該行業仍面臨諸多挑戰，包括報銷壓力和不斷變化的消費者動態的影響，但我們目前預計其發展軌跡將比我們長期預期的 5% 的下降幅度有所改善。

I would also remind everyone that consistent with past practice, the impact of prior year reserve development and other out-of-period items should be removed when considering an appropriate baseline for bridging to 2026. As of the end of the quarter, these items contributed approximately $0.45 to our year-to-date results.

我還要提醒大家，按照以往的做法，在考慮過渡到 2026 年的適當基準時，應剔除上一年準備金發展和其他期間外項目的影響。截至本季末，這些項目為我們年初至今的業績貢獻了約 0.45 美元。

Altogether and, after adjusting for these items, we currently expect a reasonable starting point for our 2026 adjusted EPS guidance to reflect mid-teens growth. We will provide formal guidance at our Investor Day on December 9.

綜上所述，在調整這些項目後，我們目前預計 2026 年調整後每股盈餘預期將以 15% 左右的成長為合理起點。我們將於12月9日的投資者日上提供正式指引。

Overall, we are encouraged by the year-to-date performance of our diversified enterprise and are confident we are taking the right steps to position us for both near- and long-term success. We recognize the importance of establishing credible commitments and expect to continue this philosophy as we establish future financial targets.

總體而言，我們對公司多元化業務今年迄今的業績感到鼓舞，並相信我們正在採取正確的措施，為公司近期和長期的成功做好準備。我們認識到建立可信承諾的重要性，並希望在製定未來財務目標時繼續秉持這一理念。

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

接下來，我們將開放提問環節。操作員？

(Operator Instructions)

（操作說明）

Lisa Gill, JPMorgan.

Lisa Gill，摩根大通。

And good morning and thanks for the question. I really want to start with some of the comments you made on the PBM side. So first, the $240 million that you talked about, as we shift more towards transparency, towards TrueCost, should we anticipate -- and again, this kind of goes to Brian's comments around '26 as well, should we anticipate as we see shifts in these contracts that we're going to continue to see headwinds as we make that initial shift? So that would be the first part of the question.

早安，謝謝你的提問。我想先談談您對藥品福利管理（PBM）的一些評論。首先，關於您提到的 2.4 億美元，隨著我們更加註重透明度，更加註重真實成本，我們是否應該預料到——這同樣與布萊恩關於 2026 年的評論有關——我們是否應該預料到，隨著這些合約的變化，在我們進行最初轉變的過程中，我們將繼續面臨阻力？所以，這就是問題的第一部分。

Secondly, how do we think about future PBM economics around a TrueCost model, not only for you as the PBM? But we also get questions around the plan sponsor. So as we know, many plan sponsors use rebates to offset premiums, et cetera. So how does that future look on the plan sponsor side as well as your economics on the PBM side?

其次，我們如何圍繞真實成本模型來思考未來的 PBM 經濟效益，這不僅對您作為 PBM 而言？但我們也經常收到關於計劃發起人的問題。眾所周知，許多計劃發起人利用回扣來抵消保費等費用。那麼，對於計劃發起人而言，未來前景如何？對於藥品福利管理機構 (PBM) 而言，經濟效益又如何呢？

Yeah. Lisa, great question and something that obviously we're prepared to address both today as well as where we see the marketplace evolving. But let me first start with, I think if you look at the headwinds that we're seeing specifically within the PBM, this does reinforce the strength of a diversified company. So this is the third consecutive quarter where we both exceeded and raised guidance. It highlights the focus and the commitment that we've made around building trust and credibility. So I think that is what I want to make sure is known, that there's performance again across the broader enterprise.

是的。麗莎，問得好，這顯然是我們今天以及未來市場發展趨勢都準備好要解答的問題。但首先我想說的是，如果你看看我們目前在藥品福利管理領域（PBM）所面臨的逆風，這確實強化了多元化公司的優勢。這是我們連續第三個季度既超出預期又上調了預期。它突顯了我們在建立信任和信譽方面所投入的重點和承諾。所以我認為，我想確保大家知道的是，整個企業的整體績效再次提升。

A couple of things as it relates to the PBM and specifically to your question about the future. Over the course of my 30-year career, Caremark has consistently driven innovation and been able to adapt to the changing market. The drive is not just changing the way in which our teams are working, but we're -- have talked over the last couple of years about changing the PBM model, and part of this is the TrueCost transition to what I believe will be the pricing model of the future.

關於藥品福利管理機構 (PBM) 以及您提出的關於未來的問題，有幾點需要說明。在我30年的職業生涯中，Caremark始終致力於創新，並且能夠適應不斷變化的市場。這項舉措不僅改變了我們團隊的工作方式，而且在過去的幾年裡，我們一直在討論改變 PBM 模式，其中一部分就是將 TrueCost 過渡到我認為是未來的定價模式。

So I remain confident that Caremark will deliver both on the strong earnings and cash flow for the foreseeable future. And I think it's going to be reinforced in what we've said about the selling season. Even in light of some of the challenges around the industry, we delivered $6 billion of new wins and had a high retention rate in the 90s. So I'm going to let Brian speak to some of the financials and some of the pressures, then I'll have Prem speak more broadly to the last question about where this is going from a PBM model. Brian?

因此，我仍然相信，在可預見的未來，Caremark 將繼續保持強勁的利潤和現金流。我認為，我們先前關於銷售旺季的論述也印證了這一點。即使考慮到業界面臨的一些挑戰，我們在 90 年代仍然贏得了 60 億美元的新訂單，而且客戶留存率很高。所以我將讓布萊恩談談一些財務方面的問題和一些壓力，然後我將讓普雷姆更廣泛地談論最後一個問題，即從 PBM 模式來看，這將走向何方。布萊恩？

Thanks, David. And Lisa, thanks for the question. I think if we take a step back, I think it's actually important to provide some context on the historical industry practices. Historically, the norm in the industry was to use an aggregate market basket-based approach to structure guarantees. And I think as we highlighted in our prepared remarks, throughout the year, we've observed a combination in mix of drugs, in utilization patterns that differed from our prior forecast. And given the market basket structure underlying the client guarantees, those dynamics are putting pressure on the contracts David actually mentioned in his prepared remarks.

謝謝你，大衛。麗莎，謝謝你的提問。我認為，如果我們退後一步，實際上有必要對歷史上的行業慣例進行一些背景介紹。從歷史上看，該行業的慣例是採用基於市場籃子的綜合方法來建立擔保。正如我們在準備好的演講稿中所強調的那樣，在過去一年中，我們觀察到藥物組合和使用模式與我們先前的預測有所不同。鑑於客戶擔保所依據的市場籃子結構，這些動態正在給戴維在準備好的發言稿中提到的合約帶來壓力。

So we've been closely monitoring the trends. And I think we realized -- while we realize the impact that the market basket had on guarantees on a subset of our contracts, we actually believe we had a credible and achievable pathway to mitigate the rapidly emerging challenges. So as we closed the quarter, we realized the mitigations that we had identified, they didn't materialize as quickly or have the impact we had initially anticipated.

因此，我們一直在密切關注這些趨勢。我認為我們已經意識到——雖然我們意識到市場籃子對我們部分合約的擔保產生了影響，但我們實際上相信我們有一條可信且可行的途徑來緩解迅速出現的挑戰。因此，在季度末，我們意識到我們所確定的緩解措施並沒有像我們最初預期的那樣迅速實現，也沒有產生預期的影響。

And that's really the driver as a result that drove us to modestly miss our expectations in the third quarter. So we've also revised our expectations for the full year. That's captured in the guide I gave. And as I mentioned in my prepared remarks, it will have an impact on the near-term growth outlook as we recontract over the next couple of years.

而這正是導致我們第三季業績略低於預期的主因。因此，我們也調整了對全年的預期。我提供的指南中已經包含了這些內容。正如我在準備好的演講稿中提到的，這將對近期成長前景產生影響，因為未來幾年我們將再次收縮經濟。

Prem, maybe you can talk more about the value Caremark delivers and the evolving model.

Prem，或許你可以多談談Caremark提供的價值以及不斷發展的商業模式。

Yeah. Lisa, thanks for the question. And just to answer directly on the future PBM economics. As you know, the PBM industry has been and will continue to be an extremely competitive space where we deliver tremendous value to our customers and deploy that value to them. If you think about our -- from my perspective, what Caremark has done over the course of the last many decades is we continue to focus on our clients' biggest problems, which is high cost of branded drugs. As we've said, 10% of drugs drive 88% of our pharmacy costs in this country. And we're going to continue to lead and be a leader in this space.

是的。麗莎，謝謝你的提問。最後，我想直接回答關於未來藥品福利管理（PBM）經濟效益的問題。如您所知，藥品福利管理 (PBM) 行業過去是、現在是、將來也仍將是一個競爭極其激烈的領域，我們為客戶創造巨大的價值，並將這些價值傳遞給他們。從我的角度來看，Caremark 在過去幾十年所做的，就是我們始終專注於客戶面臨的最大問題，即品牌藥價格高昂。正如我們所說，在這個國家，10% 的藥品佔藥局總成本的 88%。我們將繼續引領並保持這一領域的領先地位。

You saw this 18 months ago, we launched Cordavis. We went after the largest specialty drug in the country. We delivered our clients over $1 billion in savings and we've interchanged and moved all the product to a lower cost, 81% lower WACC price than the originator, and we delivered $1 billion of savings. You saw it earlier this year with our addressing GLP-1s. GLP-1s are approximately 15% of our clients' cost.

你們在18個月前就看到了，我們推出了Cordavis。我們瞄準了全國最大的特藥市場。我們為客戶節省了超過 10 億美元，並將所有產品轉移到成本更低的管道，WACC 價格比原供應商低 81%，我們實現了 10 億美元的節省。今年早些時候，我們已經就 GLP-1 問題進行了探討，大家已經看到了。GLP-1 類藥物約占我們客戶成本的 15%。

We were able to narrow our formulary in the weight loss category and our clients benefited from lower cost. And I would argue, the market benefited from the fact that we moved against one of the products. And we saw the list -- or sorry, we saw the net prices of the entire category come down.

我們縮小了減肥類藥物的配方範圍，客戶也因此受益，降低了成本。我認為，我們針對其中一款產品所採取的行動，對市場是有利的。我們看到了整個類別的淨價下降了。

This is what PBMs do every single day. They create this competition. This is what they've done for the last three decades and will continue to do that. As it relates to the value and how the economics kind of pass through from us and our clients and how that plays out in the marketplace. At the end of the day, the problem in this country still is health care is unaffordable.

這就是藥品福利管理機構每天都在做的事情。他們製造了這場競爭。過去三十年來，他們一直這樣做，將來也會繼續這樣做。因為它關係到價值，以及經濟效益如何從我們和我們的客戶傳遞出去，並在市場中如何體現。歸根結底，這個國家的問題仍然是醫療保健費用過高。

And what you're describing is really kind of the spread of which is a member out of pocket or a planned premium. And from our perspective, what we're doing with TrueCost which we launched two years ago was very deliberate, and it was driving greater transparency and making sure that consumers and clients had the benefit of that transparency while, again, maintaining our ability to create the competition and lower the net cost of drugs.

你所描述的其實就是會員自掏腰包支付保費還是計畫保費支付保費的分佈。從我們的角度來看，我們兩年前推出的 TrueCost 計劃是經過深思熟慮的，旨在提高透明度，確保消費者和客戶能夠從中受益，同時，也保持我們創造競爭和降低藥品淨成本的能力。

As David said in his prepared remarks, we have over 25 million customers and consumers that are in our point-of-sale rebate program. Aetna has launched point-of-sale rebates as far back as 2019. So this is something that we have been really focused on where we get the consumers the lowest possible price at the counter because we know medicines in this country help lower the cost of overall health care expenditures and it's critically important.

正如大衛在事先準備好的演講稿中所說，我們有超過 2500 萬客戶和消費者參與了我們的銷售點回饋計畫。安泰保險早在 2019 年就推出了銷售點返利活動。因此，我們一直非常關注如何讓消費者在櫃檯上獲得盡可能低的價格，因為我們知道，在這個國家，藥品有助於降低整體醫療保健支出成本，這至關重要。

And lastly, I'll say, as all the things have been happening with the administration, we're excited to play an active role in making medicine more affordable in this country. We think we will continue to play that role. And we love the fact that they are going after the inequity across countries that you've seen and the price disparities that exist.

最後，我想說，鑑於本屆政府所做的一切，我們很高興能夠積極參與，讓這個國家的藥品價格更加親民。我們認為我們將繼續扮演這個角色。我們非常讚賞他們致力於消除各國之間的不平等現象和價格差異。

So more to come. But I would say the PBM business continues to be a very competitive space, continues to have durable margins and continue to be a very necessary component of how we deliver care and lower cost in this country.

敬請期待更多內容。但我認為，藥品福利管理 (PBM) 業務仍然是一個競爭非常激烈的領域，利潤率仍然穩定，並且仍然是我們國家提供醫療服務和降低成本的一個非常必要的組成部分。

And maybe just one final comment. I think it's important to note that we saw this trend several years back, which is part of what we're trying to do within retail moving to CostVantage and where the PBM was driving towards TrueCost. So we saw where the marketplace is going. We led the market. We're in the middle of that transition to the model of the future. And again, I think the near-term headwinds is not an implication on the long-term viability of the PBM model. Thanks, Lisa. Next question.

最後，或許還有一點要補充。我認為值得注意的是，我們幾年前就看到了這種趨勢，這也是我們在零售業向 CostVantage 轉型以及 PBM 向 TrueCost 轉型過程中努力的方向之一。所以我們看到了市場的發展方向。我們引領了市場。我們正處於向未來模式過渡的過程中。而且，我認為近期的不利因素並不會對 PBM 模式的長期可行性產生影響。謝謝你，麗莎。下一個問題。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Thanks. Good morning. I wanted to ask about the PCW business. It looks like 3Q was ahead of your expectations and you have about 3% growth assumed for the fourth quarter. I was hoping you could share some of the drivers around your confidence in that fourth quarter growth, particularly the headwind from lower vaccine volumes to OI and then the benefit of the 600 store file buy you got from Rite Aid for the fourth quarter and how that EBIT impacts into 2026. Thanks.

謝謝。早安.我想詢問一下PCW的業務狀況。看來第三季業績超出預期，第四季將成長約 3%。我希望您能分享您對第四季度成長充滿信心的驅動因素，特別是疫苗銷售下降對 OI 帶來的不利影響，以及您從 Rite Aid 獲得的 600 家門市第四季度採購計劃帶來的好處，以及該 EBIT 對 2026 年的影響。謝謝。

All right. Thanks, Justin. I appreciate the question on PCW. So Prem, do you want to talk specifically about the growth rate?

好的。謝謝你，賈斯汀。感謝您提出關於PCW的問題。Prem，你想具體談談成長率嗎？

Yeah. Justin, thanks for the question. And as you recall from a few analyst days ago, we were very deliberate with our strategy and purposeful with how we were going to kind of get this business back to something better than minus 5%. So a couple of things.

是的。賈斯汀，謝謝你的提問。正如您幾天前從分析師那裡了解到的那樣，我們制定策略時非常謹慎，並且有目的地考慮如何讓這項業務的業績回升到低於 -5% 的水平。有兩件事。

One, I'm incredibly proud of the leadership team and the strong execution that we've delivered. We have the right strategy and we're focused on it, and it's a foundation of just health care engagement. It's one of the things we really believe. So we have over 9,000 community pharmacy destinations where we know we can service patients and members in a much better way to create differentiated services. At this point, I'm proud to say we are the best running pharmacy in the country.

首先，我為領導團隊和我們所取得的出色執行力感到無比自豪。我們擁有正確的策略，並且我們專注於此，這是醫療保健參與的基礎。這是我們真心相信的事情之一。因此，我們擁有超過 9,000 個社區藥房，我們知道在這些藥房我們可以更好地為患者和會員提供服務，從而創造差異化的服務。此時此刻，我很自豪地說，我們是全國經營最好的藥局。

And it's operating nationally at scale. It has extremely strong consumer engagement and really good clinical expertise that we're delivering into the marketplace. And it's a very, very strong deliverer of trust for our consumers, and we can then continue to create value in other parts of our enterprise.

而且它正在全國範圍內大規模運營。它擁有極強的消費者參與度和非常優秀的臨床專業知識，我們正在將這些優勢帶入市場。而且，它能非常有效地贏得消費者的信任，這樣我們才能繼續在企業的其他領域創造價值。

When you think about what's driving that, first, from a business perspective, we were very deliberate in our investments in technology and taking care of our colleagues. We have over 200,000 colleagues in 9,000 of these stores that continue to deliver best-in-class service.

當你思考是什麼驅動了這一切時，首先從商業角度來看，我們非常謹慎地投資於技術並照顧我們的同事。我們在9000家門市擁有超過20萬名員工，他們持續提供一流的服務。

And then secondly, we were focused on how we can engage and better engage consumers in a differentiated way. So all in all, is going really well. As it relates to the quarter, we delivered a strong quarter despite some of the persistent reimbursement pressures that we faced.

其次，我們專注於如何以差異化的方式更好地吸引和維繫消費者。總而言之，一切進展順利。就本季而言，儘管我們面臨一些持續的報銷壓力，但我們仍然取得了強勁的季度業績。

If you look at the script growth, we had top line growth, about 11.7%. And our pharmacy market share is now at 28.9%. Rite Aid was one of the drivers that was in that as we kind of moved that business into our operating model. But just remember, the strong foundation, the strong service enabled us to really be able to do that in a much more effective way.

如果從劇本成長來看，我們的總收入成長了約 11.7%。目前，我們的藥房市佔率為 28.9%。Rite Aid 是推動我們把這項業務融入我們的營運模式中的因素之一。但請記住，強大的基礎和優質的服務使我們能夠以更有效的方式做到這一點。

And then if you think about the immunization piece, we continue to be a trusted choice and a convenient option for those choosing to get vaccinated. The market demand is down year-over-year, but we've been able to offset that with a market share growth in our channel. We've seen approximately 400 basis points of market share growth inside of CVS.

此外，就免疫接種方面而言，我們仍然是值得信賴的選擇，也是選擇接種疫苗者的便利之選。市場需求年減，但我們透過通路市場佔有率的成長抵消了這一影響。我們看到 CVS 的市佔率成長了約 400 個基點。

Secondly, if you think about our front store, we still have strong momentum. We're posting another positive comp for the second quarter in a row and improved from last year. We grew our customer base 2.6% versus last year. We increased trips 2.7% versus last year. And our retail market share on the front store has gained by 2 basis points versus last year. So we're continuing to focus on delivering the value being where consumers want us to be in the front store by driving loyalty and improving our value proposition.

其次，如果你看看我們的前店，我們仍然保持著強勁的發展勢頭。我們連續第二季實現了正成長，並且比去年同期有所改善。與去年相比，我們的客戶群成長了2.6%。與去年相比，我們的出遊次數增加了 2.7%。我們的零售市佔率（前店）比去年增長了 2 個基點。因此，我們將繼續專注於在消費者希望我們出現的門市前線提供價值，透過提高客戶忠誠度和改善我們的價值主張來實現這一目標。

And I'd just say, all in all, we're incredibly proud of the results, incredibly proud of the leadership team and the focus that you have here. But we still have work to do to stabilize this business over time.

總而言之，我們對所取得的成果感到無比自豪，對領導團隊以及你們在這裡所展現的專注精神感到無比自豪。但我們仍需努力使這項業務長期穩定下來。

And Brian, I'll hand it over you for a couple more comments.

布萊恩，我把麥克風交給你，請你再說幾句。

Yeah. No, just, Justin, in terms of the outlook, the strong performance Prem talked about in the quarter. We lifted our guide for the segment and it's now sitting at growth of 3% for the year. And I'd remind you, that's an 8% swing from our initial expectations of down 5%. So we're seeing that business improve, and we'll talk more about it come December 9 at Investor Day.

是的。不，賈斯汀，就前景而言，Prem 談到了本季強勁的業績。我們上調了對該細分市場的預期，目前預計全年增長率為 3%。我還要提醒各位，這與我們最初預期的下降 5% 相比，出現了 8% 的波動。所以我們看到這項業務正在改善，我們將在 12 月 9 日的投資者日上對此進行更詳細的討論。

Maybe just closing out on the PCW conversation. This is a business that we've been investing in over the last several years. I think some of this has come to fruition in terms of the investments we've made in becoming best-in-class. So we've talked about this in the opening comments that the 9,000 stores is our front door to the enterprise. And when this business runs well, it does become the force multiplier to improving health and our focus on serving the community. So really excited about the performance, and we'll share obviously more, as Brian said, on Investor Day about the future direction of this business.

或許就此結束關於PCW的討論吧。這是我們在過去幾年一直投資的一項業務。我認為，我們在成為行業領導者方面所做的投資，已經取得了一些成果。我們在開場白中提到過，這 9000 家門市是我們企業的大門。當這項業務運作良好時，它確實會成為改善健康狀況和我們服務社區的倍增器。我對業績感到非常興奮，正如布萊恩所說，我們將在投資者日上分享更多關於公司未來發展方向的資訊。

Stephen Baxter, Wells Fargo.

史蒂芬‧巴克斯特，富國銀行。

Stephen Baxter, you may now unmute your audio and ask your question.

Stephen Baxter，你現在可以解除靜音並提問了。

Elizabeth Anderson, Evercore.

伊麗莎白·安德森，Evercore。

Good morning, guys. Thanks so much for the question. I believe you can hear me. I had a question in terms of the 100 basis points provider liabilities that you called out. Can you give us a little bit more detail on exactly what those are? And is this a onetime item? Do we expect this to continue for a couple of quarters? Just any additional color there would be helpful because, obviously, with that, it shows that your MBR was much more in line than maybe it looked like from the first glance. Thanks.

各位早安。非常感謝你的提問。我相信你聽得到我說話。關於您提到的 100 個基點的供應商責任，我有一個問題。能更詳細地說明一下這些具體是什麼嗎？這是一次性事件嗎？我們預計這種情況會持續幾個季度嗎？如果能添加一些其他顏色就更好了，因為很明顯，這樣就能表明你的主臥比乍一看要整潔得多。謝謝。

Yeah. Elizabeth, thanks for the question. And you're correct in that assumption. So Brian, do you want to speak to the.

是的。伊麗莎白，謝謝你的提問。你的假設是正確的。所以布萊恩，你想和…談談嗎？

Yeah. I guess I'd lift it up from an HCB perspective, Elizabeth. We're really pleased with the performance in the third quarter. As you think specifically about the third quarter MBR, some of the noise I called out in my prepared remarks, we had about 100 basis points of impact. Two things, provider liabilities.

是的。伊莉莎白，我想我會從 HCB 的角度來看這個問題。我們對第三季的表現非常滿意。具體來說，就第三季MBR而言，我在準備好的發言稿中提到的一些幹擾因素，對我們產生了大約100個基點的影響。兩件事，供應商的責任。

Those are dating as far back as 2018 for kind of a three-, four-year period. And then a combination of that, that was roughly 50 basis points of the 100, and then worsening expectations for the individual exchange risk adjustment. We got the latest [wakely] data that informed that.

這些事件最早可以追溯到 2018 年，持續了三到四年。再加上上述因素的綜合影響，約佔 100 個基點中的 50 個基點，以及個人匯率風險調整預期的惡化。我們獲得了最新的[wakely]數據，這些數據證實了這一點。

So those two factors really took a 92.8% as we printed. And if you back that up to get to a 91.8% roughly, it would say that the core outperformance on the MBR in the quarter was driven on an adjusted basis by individual MA. So that's how we think about the two drivers specifically to your question.

因此，這兩個因素在我們印刷時實際佔比高達 92.8%。如果按比例推算，大約達到 91.8%，則表示該季度 MBR 的核心超額收益經調整後是由個別 MA 驅動的。所以，針對您的問題，這就是我們對這兩個驅動因素的看法。

Stephen Baxter, Wells Fargo.

史蒂芬‧巴克斯特，富國銀行。

Hi, I hope. Hi, thanks. Sorry for the difficulties there. Just to kind of come back to that point a little bit. I think with the first couple of quarters of the year, you size in each quarter that, I guess, on a continuing basis there was around $500 million core upside that you weren't taking through into the guidance. Wondering if there's an equivalent amount, if you think about kind of excluding the items that you called out around the exchanges and around the out-of-period settlements that you'd cite for Q3? And I guess how do we reconcile that versus the raise that you made?

你好，希望如此。您好，謝謝。很抱歉造成不便。再稍微回到這一點上來。我認為，在今年前兩個季度，每個季度你都會估算出，持續存在大約 5 億美元的核心成長空間，而你並沒有將其納入業績指引中。我想知道，如果排除您提到的與交易所相關的項目以及您在第三季度引用的非正常結算項目，是否存在一個等值的金額？那麼，我們該如何調和這一點與你所獲得的加薪之間的關係呢？

And I guess just one clarification as we're getting a lot of questions on it. This mid-teens EPS growth that you're framing for 2026, is that after taking the $0.45 out of the baseline? Or is that off of this year's guidance as you currently revised it? Thank you.

我想澄清一點，因為我們收到了很多關於這個問題的問題。您預測 2026 年每股收益將達到 15% 左右，這是在扣除基準值 0.45 美元之後得出的嗎？或者這是根據你們目前修訂後的今年的指導方針制定的？謝謝。

Yeah. To take your last question first, Stephen, you take the midpoint of the guide, which is $6.60, back off the $0.45 and then you can grow mid-teens off of that. And the way we got to the $0.45, I think going into the quarter, we had about a combination of net both positives and negatives. If you take some of the out-of-period risk adjustments and revenue adjustments net of the upside, we'd be about $900 million coming out of the first half of the year. You take the $150 million of the provider settlements, that's how we get to $750 million roughly or the $0.45 as we adjusted and which I just walked you through.

是的。先回答你的最後一個問題，Stephen，你取指南的中點，也就是 6.60 美元，減去 0.45 美元，然後你就可以以此為基礎增長到十幾歲。而我們最終達到 0.45 美元這個目標的過程，我認為在本季開始時，我們既有積極的因素，也有消極的因素。如果扣除一些非當期風險調整和淨收入調整（扣除上行收益），我們上半年的利潤約為 9 億美元。加上供應商和解金 1.5 億美元，我們就得到了大約 7.5 億美元，或者像我們剛才調整的那樣，0.45 美元。

Michael Charney, Leerink Partners.

Michael Charney，Leerink Partners。

Great. Thank you so much for taking the question. I know Lisa had asked about the PBM headwinds that you had been discussing. I want to talk a little bit more about the PBM tailwinds. Beyond Cordavis, what are you seeing broadly from a specialty growth perspective? And can you talk about some of the strategic advancements you're making to continue to benefit from what has obviously been an extremely strong overall market growth? Thank you.

偉大的。非常感謝您回答這個問題。我知道麗莎問過你一直在討論的PBM逆風問題。我想再多談談PBM順風。除了 Cordavis 之外，從專業成長的角度來看，您看到了哪些更廣泛的趨勢？能否談談貴公司為了繼續從目前強勁的整體市場成長中獲益而採取的一些策略舉措？謝謝。

Prem, do you want to take that?

普雷姆，你想拿嗎？

Sure. Thanks for the question, Michael. Just a couple of things. So from a tailwind perspective, as you've said, we see a tremendous opportunity to continue to lower cost for our customers. And as you know, when we can lower cost for our customers, the PBM industry typically benefits from that as well.

當然。謝謝你的提問，麥可。就兩件事。所以從順風的角度來看，正如你所說，我們看到了繼續降低客戶成本的巨大機會。如您所知，當我們能夠降低客戶的成本時，藥品福利管理產業通常也會從中受益。

So a couple of things. One is, if you think about the biosimilar pipeline, it still remains. There's $100 billion of biosimilars by the end of this decade or early 2030, 2031 time frame. So we continue to look at ways in which we can enable and drive down costs for our customers as it relates to biosimilars. We believe that there still is our ability to benefit from other specialty drugs as well in the generic pipeline that are going generic that will be an opportunity for us to deliver value for our customers.

有兩件事。其一是，如果你考慮生物相似藥的研發管線，它仍然存在。到本世紀末或 2030 年初、2031 年，生物相似藥的市場規模將達到 1,000 億美元。因此，我們將繼續尋找各種方法，幫助我們的客戶降低生物相似藥的成本。我們相信，我們仍然能夠從其他正在進入仿製藥研發階段的專科藥物中受益，這將為我們為客戶創造價值提供機會。

And let me just take a couple of seconds to talk about our CVS Specialty Pharmacy business. It continues to be a leading asset in the specialty pharmacy arena. It's a leader and a key overall performance driver of Caremark, and we expect it will continue to be helping to support the members that they serve. Remember, these 1% or 2% of the population that utilize specialty pharmacy benefits typically drive 50%, 60% of all of health care expenditure. And so our business continues to perform really well.

請容許我花幾秒鐘時間談談我們的 CVS 特藥藥局業務。它仍然是專科藥房領域的領先資產。它是 Caremark 的領導者和關鍵整體績效驅動因素，我們期望它能繼續幫助支持其服務的會員。請記住，這 1% 或 2% 使用專科藥房福利的人口通常會消耗 50% 或 60% 的醫療保健支出。因此，我們的業務持續表現良好。

And we have a strong track record of continuing to gain access of new limited distribution drugs in that space. We continue to build technology that makes it seamless to transition patients from branded products to biosimilars.

我們在該領域擁有持續獲得新型限量發行藥物的良好記錄。我們持續研發相關技術，使患者能夠無縫地從品牌藥過渡到生物相似藥。

And lastly, our operating platforms, tremendous amount of credit goes to our leadership in this business, that's driving to a much more tech-driven AI native platform, that's driving and really taking a lot of the work out a lot of operations and something that was one of the most complex parts of health care, which is effectively trying to drive these medications into the patients' home. And so we continue really proud of those points as it relates to that. We also see opportunities in the PBM for what I would say is efficiencies and optimization over time, where we see the opportunity to leverage technology and other things to also play a role.

最後，我們的營運平台要歸功於我們在該行業的領導地位，正是這種領導地位推動我們向更技術驅動的 AI 原生平台轉型，從而大大減輕了許多營運工作量，並有效地解決了醫療保健領域最複雜的部分之一——將這些藥物送到患者家中。因此，我們對與此相關的這些觀點仍然感到非常自豪。我們還看到了藥品福利管理 (PBM) 領域的機會，我認為隨著時間的推移，這可以提高效率和優化，我們可以利用技術和其他因素來發揮作用。

And lastly, I think the PBM sales season is great evidence that we continue to focus on our customers. We're winning net new customers and delivering the value that they're asking for us. So we had over $6 billion of net new sales for 2026. So continue to be excited about this industry.

最後，我認為 PBM 銷售季很好地證明了我們始終以客戶為中心。我們正在贏得新的客戶，並提供他們所要求的價值。因此，我們預計 2026 年的淨新增銷售額將超過 60 億美元。所以，請繼續保持對這個行業的熱情。

It remains to be highly competitive, as it always has been. And we continue to remain to be a leader in driving that competition and driving affordability for our customers and creating innovative solutions that they can deliver into the marketplace.

它仍然像以往一樣，競爭非常激烈。我們將繼續保持領先地位，推動市場競爭，降低客戶的成本，並創造他們可以推向市場的創新解決方案。

Thanks, Prem. Maybe just one additional comment on the PBM because there's obviously emerging models that we're seeing around the DTC. So two things I would point out. One is we were the first large provider to join the Novo Care program for GLP-1s. So that's again our push into lowering the cost of these obesity products in the direct-to-consumer market.

謝謝，Prem。關於藥品福利管理（PBM），我可能還有一點補充說明，因為很明顯，我們在直接面向消費者（DTC）領域看到了一些新興模式。所以我想指出兩點。其一是我們是第一個加入 Novo Care GLP-1 計畫的大型醫療機構。所以，這也是我們努力降低面向消費者的肥胖症產品價格的另一個舉措。

And then the most recent announcement we made with the administration with respect to the IVF therapy, again, our specialty pharmacy playing essential or critical role in the rollout of that program as we serve consumers and our customers.

然後，我們最近與政府就試管嬰兒療法發布了公告，我們的特藥藥房在為消費者和客戶提供服務的過程中，在該計劃的推廣中發揮了至關重要的作用。

Eric Percher, Nephron Research.

Eric Percher，腎單位研究。

Thank you. I'd like to return to Caremark and ask you to clarify the extent to which you're seeing pressure from adoption of TrueCost versus change in mix, if it's TrueCost, how much of that was CVS? I'd expect you were ahead of that versus others or independents that you're enabling. And then if more change in mix, are you seeing that changes to GLP-1 formulary or biosimilar private label is having an impact on rebate guarantees?

謝謝。我想回到 Caremark，請您澄清一下，您認為 TrueCost 的採用所帶來的壓力與產品組合變化所帶來的壓力有多大？如果是 TrueCost，其中有多少是 CVS 帶來的？我原本以為你會比你所扶持的其他人或獨立人士更有遠見。如果藥品組合發生更多變化，您是否發現 GLP-1 處方集或生物相似藥自有品牌的變化對回扣保證產生了影響？

Yeah, Eric. Thanks for the question. First off, let me be clear. This is not from TrueCost. The TrueCost model is not what's driving this. As you know, in the legacy PBM models in the PBM marketplace, we predict and try to drive rebate guarantees, which is a way in which we derive the value for our customers. In that case, we had probably three primary drivers of some of the pressure.

是的，埃里克。謝謝你的提問。首先，讓我把話說清楚。這並非來自 TrueCost。驅動這現象的並非 TrueCost 模型。如您所知，在 PBM 市場的傳統 PBM 模型中，我們會預測並努力推動回扣保證，這是我們為客戶創造價值的一種方式。在這種情況下，我們可能有三個主要因素導致了部分壓力。

One, the slower growth of GLP-1s that we're seeing in the back half, primarily driven from we expected a little bit more of the compounding volumes to come back into the benefit, which we're not seeing. Secondly, we had a couple of products on the autoimmune category not related to Cordavis, but drivers of a couple of products that we're driving that. So one is in the autoimmune category and one is in the HIV category. So this is not from TrueCost. It is something we're working with our clients actively adjusting our guarantees appropriately as we move forward, but create a little bit of pressure in the short term.

第一，我們看到下半年 GLP-1 的成長速度放緩，這主要是因為我們原本預期複合銷量會回升，但我們並沒有看到這種情況。其次，我們在自體免疫類別中有幾個產品與 Cordavis 無關，但卻是我們正在推動的幾個產品的驅動因素。所以，一個屬於自體免疫疾病，一個屬於愛滋病毒感染。所以這不是來自 TrueCost 的數據。我們正在與客戶積極合作，隨著事態發展適當調整我們的擔保，但這會在短期內造成一些壓力。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

Hi, good morning. I wanted to ask about the re-contracting efforts at Oak Street and understand the room for improvement there. So first, can you share the pretax operating losses of that business today? And to the extent you had problematic external membership this year, did you see the needed changes made to benefits for the 2026 plan year? And if not, can you help us understand what contracting changes you're making, including how much risk is shifting back to your Medicare Advantage partners? Thanks.

您好，早安。我想了解一下橡樹街的重新承包工作情況，以及那裡還有哪些改進空間。首先，能否分享一下該企業目前的稅前營運虧損？如果今年你們的外部會員資格有問題，你們是否看到 2026 年計畫年度的福利方面做出了必要的改變？如果不行，能否請您幫助我們了解您正在進行的合約變更，包括有多少風險轉移回了您的 Medicare Advantage 合作夥伴？謝謝。

Thanks very much. I'll let Prem talk to the business and the evolution. We don't share the pretax loss, but I think we, we've been very focused on the Oak Street business. Once again, the impairment we took was at the HCD level. But we took a look at clinic growth and really by slowing the clinic growth, the terminal values, what drove the impairment charge. And we believe we're getting the Oak Street business in particular on the path to profitability.

非常感謝。我會讓普雷姆來談談業務和發展趨勢。我們不分享稅前虧損，但我認為我們一直非常專注於橡樹街的業務。再次，我們所受到的損害程度達到了 HCD 水準。但我們仔細研究了診所的成長情況，發現診所成長放緩確實會影響最終價值，導致減損支出。我們相信，我們正在讓橡樹街的業務走上獲利之路。

Prem, do you want to give a little color on the business?

Prem，你想稍微介紹一下公司的運作嗎？

Yeah, sure. And thanks for the question. First off, just to be really clear, the performance in this quarter was in line with our expectations that would be kind of -- as we adjusted the guidance prior. So performance is in line. If you think about value-based care, and David mentioned this in the prepared remarks, it's still a critical component of our strategy. We recognize the significant impact it can have on the health care system, the importance to patients on experience and outcomes and costs.

當然可以。謝謝你的提問。首先，為了明確起見，本季的業績符合我們的預期，正如我們先前調整預期時所說的。所以性能符合預期。如果你考慮以價值為基礎的醫療保健，正如大衛在準備好的演講稿中提到的那樣，它仍然是我們策略的關鍵組成部分。我們認識到這會對醫療保健系統產生重大影響，對患者的就醫體驗、治療效果和治療成本都至關重要。

So there's three or four things that we're really focused on in Oak Street Health. Let me just talk specifically to the payer contracts. One, we won't comment on any specific contracts, but we're focused on ensuring that we have alignment with our payers on ensuring the sustainability of these agreements and having fair and equitable terms for the value that we provide.

所以，在 Oak Street Health，我們真正關注的是三、四件事。我只談談付款方合約。第一，我們不會評論任何具體合同，但我們專注於確保與付款方保持一致，以確保這些協議的可持續性，並為我們提供的價值制定公平合理的條款。

So we're continuing to work on that with our payers and continue to drive that forward. But the two other areas I think that are really critical is we are really proud of our clinical model that we have. We continue to enhance our technology and our operations to drive an enhanced model in which will ultimately lower cost and improve quality of our members.

因此，我們正在繼續與支付方合作，並繼續進行這項工作。但我認為另外兩個方面也至關重要，我們為我們擁有的臨床模式感到非常自豪。我們將繼續改進技術和運營，以推動更完善的模式，最終降低成本並提高會員的服務品質。

And lastly, on the center footprint, listen, at the end of the day, the world has changed in value-based care. So we're being very prudent and we've slowed the number of clinic growth that we had. And we're focused on growing membership inside of our clinics. And so from our perspective, those things are all the components that are driving. And we expect the Oak Street business to improve year-over-year.

最後，關於中心佈局，聽著，歸根結底，世界已經發生了基於價值的醫療保健的變化。所以我們採取了非常謹慎的態度，放慢了診所數量的成長速度。我們正致力於發展診所會員。因此，從我們的角度來看，這些都是驅動因素。我們預計橡樹街的業務將逐年改善。

And lastly, as it relates to B-28, it's in line with our expectations of the impact of that as we think about that business.

最後，就 B-28 而言，這符合我們對這項業務影響的預期。

George Hill, Deutsche Bank.

喬治·希爾，德意志銀行。

Yeah, good morning guys, and thanks for taking the question. And David and Brian, my question is kind of focused on the retail pharmacy business. And you talked about how 2026 is going to show an improvement from the long-term guide.

好的，各位早安，感謝你們回答這個問題。大衛和布萊恩，我的問題主要集中在零售藥局業務。您也提到，2026 年的情況將比長期指導方針有所改善。

I guess I would ask if you can comment, how far are we away from like the long-term guidance down 5% not being the case anymore? And given the PBMs are paying pharmacies more money and CostVantage gas taken root across different payer segments, does earnings growth starts to look more like script growth in that segment? I'll stop there.

我想請您談談，目前距離長期業績指引下調 5% 的情況不再成立還有多遠？鑑於藥品福利管理機構 (PBM) 向藥房支付更多費用，並且 CostVantage 已在不同的支付方領域紮根，該領域的盈利增長是否開始看起來更像是處方增長？我就說到這裡吧。

Yeah. When we -- thanks, George, for the question. Maybe high level, when we announced CostVantage, that was a long-term goal, which we are the largest purchaser in the country today. We believe we have the best cost of goods in the market.

是的。當我們——謝謝喬治的提問。或許從宏觀層面來說，當我們宣布推出 CostVantage 時，那是一個長期目標，而如今我們已成為全國最大的 CostVantage 採購商。我們相信我們擁有市場上最具競爭力的商品價格。

And as we perform better, the payers will get the benefit of that. And so that is, we are now going into year two of that in '26. So as we get to Investor Day, we'll have more clarity about how that business will be performing. But ultimately, we do see better alignment with the payers in terms of how the actual cost of goods align with the actual reimbursement for the services we're providing.

隨著我們表現的提升，支付方也將從中受益。所以，我們現在進入了2026年的第二年。因此，隨著投資者日的到來，我們將更清楚地了解該業務的業績表現。但最終，我們看到，在商品的實際成本與我們所提供服務的實際報銷金額的匹配度方面，與付款方的一致性得到了提高。

And so, Prem, do you want to give any other color?

那麼，Prem，你還想添加其他顏色嗎？

Yeah. So George, remember, those three primary headwinds in the retail business, if you go back when we started CostVantage -- sorry, three tailwinds that were offsetting one big headwind, which was reimbursement pressure. So the three tailwinds were we would always drive incremental volume into our stores, right, script growth. We would have productivity initiatives that drove and lowered the cost of our cost basis of delivering those scripts. And lastly, there was cost of goods improvement. And all that netted out to a somewhat tailwind -- or a headwind that we're trying to cover.

是的。所以喬治，記住，零售業的三大主要不利因素，如果你回顧一下我們創辦 CostVantage 的時候——抱歉，是三大有利因素抵消了一大不利因素，那就是報銷壓力。因此，三大有利因素是：我們將持續推動門市銷售成長，對吧？處方量增長。我們將推行提高生產力的舉措，從而降低我們交付這些劇本的成本基礎。最後，商品成本也有所改善。所有這些最終都變成了順風——或者說是我們正在努力克服的逆風。

If you think about what CostVantage was doing and, as we mentioned, it was going to take a multiyear journey to get us to a place in which reimbursement erosion equaled our cost of goods improvement. We're making good progress towards that, but we still have reimbursement pressure in the underlying business that we continue to focus on.

想想 CostVantage 正在做的事情，正如我們所提到的，要使報銷減少與商品成本改善達到平衡，需要多年的時間。我們在這方面取得了良好進展，但我們仍然面臨著基礎業務的報銷壓力，我們將繼續關注這個問題。

So just from a CostVantage perspective, as we said at the beginning, 2025 was a transitional year. We're proud that we moved all of our commercial and third-party discount card programs into our CostVantage program. We're making good progress in Medicare on transitioning to cost-based pricing models across our full look at business. We're more than 60% complete and targeting 100% of our eligible book by the start of 2026.

所以，從 CostVantage 的角度來看，正如我們一開始所說，2025 年是一個過渡年。我們很自豪地宣布，我們將所有商業和第三方折扣卡項目整合到了 CostVantage 項目中。在全面審視業務的過程中，我們在 Medicare 向基於成本的定價模式過渡方面取得了良好進展。我們已經完成了 60% 以上的工作，目標是在 2026 年初之前完成 100% 的符合條件的書籍。

If you compare our Medicare negotiations to our commercial negotiations, we're ahead of where we were last year. So we feel pretty good about where we are. And lastly, if you think about the impact of CostVantage, at this point, it's performing in line with our expectations. As I said, it's going to be a multiyear journey to get that back. And we're addressing one of the major pain points that existed in retail pharmacy, which was cross-optimization of branded and generic drugs.

如果將我們與聯邦醫療保險的談判與我們與商業保險公司的談判進行比較，我們比去年取得了進展。所以我們對目前的狀況感覺相當不錯。最後，如果你考慮 CostVantage 的影響，目前來看，它的表現符合我們的預期。正如我所說，要恢復這種狀態，需要數年時間。我們正在解決零售藥房存在的一個主要痛點，即品牌藥和仿製藥的交叉優化。

Yeah. And George, maybe one final comment. Your thesis is right, which is our growth should be tied to script growth. And as we get CostVantage rollout across our payers, that will become part of the growth.

是的。喬治，或許還有最後要補充一點。你的論點是正確的，那就是我們的成長應該與劇本的成長掛鉤。隨著 CostVantage 在我們所有支付方的推廣，這將成為成長的一部分。

The second part is the services we're going to provide inside the pharmacy. So if you look at the stars performance within Aetna, a lot of this was driven because of the collective enterprise effort and the services and the specific programs that have been delivered and launched within retail to engage and drive better performance around adherence and the other quality measures. So that is the next frontier, and this is how we're going to collectively drive the value across the enterprise

第二部分是我們將在藥局內提供的服務。因此，如果你觀察安泰保險公司 (Aetna) 的明星員工表現，你會發現這很大程度上得益於整個企業的共同努力，以及在零售領域推出的服務和具體項目，旨在提高員工的依從性和其他品質指標，從而提升業績。這就是下一個前沿領域，也是我們將如何共同推動整個企業價值成長的方式。

Kevin Caliendo, UBS.

瑞銀集團的凱文·卡利恩多。

Thanks for taking my question. II want to ask a little bit about what's embedded in your '26 comments for the Health Care Benefits around MA margin expansion. Can you get to be profitable next year? And also enrollment, I know enrollment is not over yet, but your sense of where your enrollment goes in individual MA next year.

謝謝您回答我的問題。我想問您在 2026 年關於 MA 利潤率擴張的醫療保健福利評論中具體包含哪些內容。明年你能獲利嗎？還有招生方面，我知道招生還沒結束，但你對明年個人碩士招生情況的看法如何？

Thanks for the question. As we think about the guide, which we'll really get into in December at Investor Day, but in HCB, which you asked about, I would say we expect another year of meaningful margin improvement. It will include progress in MA. I think that reflects our disciplined approach to the plan design and footprint. We have repricing opportunities in group with, I think, about half the book repricing as of January.

謝謝你的提問。當我們思考業績指引時（我們將在 12 月的投資者日上詳細討論），但在你提到的 HCB 方面，我認為我們預計未來一年利潤率將有顯著提高。它將包括碩士階段的進展。我認為這體現了我們對規劃設計和佈局的嚴謹態度。我們集團內有重新定價的機會，我認為從一月開始，大約有一半的書籍將重新定價。

As you think more broadly about HCB, we'd expect a tailwind from our exit of the IFP business next year. And while we're seeing good progress in Medicaid in terms of rate advocacy discussions, we are taking a cost outlook in light of the broader pressures that are across the industry.

從更廣泛的角度來看待 HCB，我們預計明年退出 IFP 業務將帶來利好。雖然我們在醫療補助費率倡導討論方面看到了良好的進展，但考慮到整個行業面臨的更廣泛壓力，我們正在對成本前景進行評估。

Steve, do you want to provide a little bit more color?

史蒂夫，你想再添加一些色彩嗎？

Sure. Thanks. Good morning. Look, when we entered this year from the Aetna perspective and all of CVS together, we're focused on a couple of objectives. One is to return the business to target margins, second, to regain leadership position overall industry. And within those objectives, we rallied around three very specific priorities, to be exceptional to fundamentals, make sure that we are distinctive and we could offer distinctive capabilities to our customers and build a really strong culture with top talent. And so we've been executing with discipline and rigor and urgency around those three priorities.

當然。謝謝。早安.你看，從安泰保險和整個CVS集團的角度來看，今年我們專注於幾個目標。一是使企業恢復到目標利潤率，二是重新奪回整個產業的領導地位。在這些目標的框架下，我們圍繞著三個非常具體的優先事項團結起來：在基本方面做到卓越，確保我們與眾不同，能夠為客戶提供獨特的能力，並建立擁有頂尖人才的強大文化。因此，我們一直以嚴謹、認真和緊迫的態度圍繞著這三個優先事項開展工作。

And as you can see by the performance, and as Brian highlighted and David in his opening remarks, the plan is working. And so we are really encouraged by the progress across all of our businesses at Aetna. And we believe this momentum will carry into not only the fourth quarter but 2026. So we're going to lean into that momentum.

正如你從表演中看到的那樣，也正如布萊恩和戴維在開場白中所強調的那樣，這個計劃正在奏效。因此，我們對安泰保險旗下所有業務的進展感到非常鼓舞。我們相信這種勢頭不僅會延續到第四季度，還會延續到2026年。所以我們要順勢而為。

Having said that, we're obviously respectful of the high trend environment and it's a first year of a multiyear recovery. So really encouraged by the progress.

話雖如此，我們顯然尊重當前的高趨勢環境，而這只是多年復甦的第一年。這樣的進展真的令人鼓舞。

And maybe I'll just -- a couple of comments on Medicare and open enrollment as you asked. Look, obviously, early days, but it's going according to our expectations in line with those objectives of returning and continuing on the path to returning to target margins on this business. We made really great progress.

或許我還會——正如你所問的，就醫療保險和開放註冊發表幾點看法。當然，現在還處於早期階段，但一切都在按我們的預期進行，符合我們實現恢復並繼續朝著該業務目標利潤率邁進的目標。我們取得了非常大的進展。

It actually is a little bit ahead in terms of favorability, in terms of trends and the individual Medicare Advantage business in the third quarter. And so we're going to take that momentum. And the early signs in AEP is that we're on track to continue that momentum and keep the business on track to returning to target margin.

實際上，就第三季的市場前景、發展趨勢以及個人醫療保險優勢計劃業務而言，它略微領先一些。所以我們要乘勢而上。AEP 的早期跡象表明，我們正朝著保持這一勢頭並保持業務朝著目標利潤率恢復的方向發展。

With respect to just sort of overall competitive positioning, we like our position. Again, early days. We do have the ability and we've developed capabilities as we did last year during the AEP to continue to make adjustments and be nimble as we need to dial up and down products, geographies, other kinds of mechanisms that we have to make sure that we continue on track in a really disciplined and rational approach.

就整體競爭地位而言，我們對自己的地位感到滿意。現在還只是初期階段。我們確實有能力，而且正如去年在AEP期間一樣，我們已經培養了相應的能力，可以繼續進行調整，並根據需要靈活地調整產品、地域和其他機制，以確保我們以真正自律和理性的方式繼續朝著正確的方向前進。

So so far, so good. And I would just say, we expect to exit AEP roughly flat in our individual Medicare Advantage membership. So very encouraged so far, early signs. Look forward to providing more color at our Investor Day.

目前為止，一切順利。我只想說，我們預計在 AEP 結束後，我們的個人醫療保險優勢計劃會員人數將基本持平。目前來看，這是一個很好的早期跡象，令人鼓舞。期待在我們的投資者日上為大家帶來更多精彩內容。

Yeah. Steve, great quarter, and congrats to you and your team. So this will conclude the earnings call for this quarter. So before I end the call, I just want to thank our dedicated colleagues across CVS Health for the work you do every day. The trust we earn an comes directly from the commitment to caring for our customers. I'm very encouraged about the progress we continue to make and look forward to providing you additional updates at our Investor Day on December 9. Thank you for joining the call.

是的。史蒂夫，這個季度表現出色，恭喜你和你的團隊。本次季度財報電話會議到此結束。在結束通話之前，我只想感謝 CVS Health 所有敬業的同事們每天所做的工作。我們贏得的信任直接來自我們對客戶的關懷。我對我們持續取得的進展感到非常鼓舞，並期待在 12 月 9 日的投資者日上向您提供更多最新資訊。感謝您參加通話。

Thank you for joining CVS Health's third-quarter 2025 earnings call. This concludes today's conference call. You may now disconnect.

感謝您參加 CVS Health 2025 年第三季財報電話會議。今天的電話會議到此結束。您現在可以斷開連線了。