The Cigna Group reported sharply different second-quarter 2026 earnings trends across its Evernorth Health Services businesses, as strong specialty-drug growth and operating efficiencies lifted Specialty and Care Services profit while Pharmacy Benefit Services earnings declined.
Specialty and Care Services generated $26.97 billion in adjusted revenue, increasing 4% from $25.87 billion in the prior-year quarter. Adjusted pre-tax operating income jumped 22% to $1.05 billion from $863 million.
The business generated nearly twice as much adjusted pre-tax operating income as Pharmacy Benefit Services despite producing approximately $7.5 billion less revenue.
Cigna attributed the Specialty and Care Services improvement to organic growth across its specialty businesses, including higher volumes, greater adoption of generic and biosimilar medicines, and operating efficiencies.
The company said increased use of generics and biosimilars lowers costs for clients and patients while improving the profitability of the specialty business.
Pharmacy Benefit Services reported adjusted revenue of $34.5 billion, increasing 8% from approximately $31.95 billion. The revenue increase primarily reflected changes in drug mix.
However, adjusted pre-tax operating income declined 27% to $609 million from $833 million.
Cigna attributed the decline primarily to client-focused initiatives, including large client contract renewals, and other customer-focused actions that were consistent with its previous commentary.
The contrasting results demonstrate that revenue growth did not translate evenly into earnings across Evernorth. Pharmacy Benefit Services handled a larger revenue base, but Specialty and Care Services produced substantially more operating profit.
Specialty and Care Services accounted for approximately 63% of Evernorth’s second-quarter adjusted pre-tax operating income, compared with roughly 37% from Pharmacy Benefit Services.
Total Evernorth adjusted revenue increased 6% to $61.47 billion from $57.83 billion. However, adjusted pre-tax operating income declined 2% to $1.66 billion from $1.7 billion as the specialty-care increase did not fully offset lower pharmacy benefit earnings.
Evernorth’s adjusted pre-tax operating margin declined to 2.7% from 2.9%. The results indicate that contract economics and customer investments within the pharmacy benefit business placed pressure on profitability despite higher revenue.
The number of pharmacy customers also declined. Cigna reported 118.2 million pharmacy customers at the end of June, representing a 4% decrease from 123.6 million at the end of 2025.
The company attributed the reduction to expected client transitions and lower membership among health plan customers. Total customer relationships declined 3% from year-end to 182.8 million.
Cigna nevertheless increased companywide second-quarter revenue by 7% to $71.67 billion from $67.18 billion. Adjusted revenue reached $71.56 billion.
Shareholders’ net income increased to $1.66 billion, or $6.29 per share, from $1.53 billion, or $5.71 per share.
Adjusted income from operations increased 6% to approximately $2.05 billion. Adjusted earnings per share rose to $7.78 from $7.20.
The earnings improvement was primarily driven by Cigna Healthcare rather than Evernorth.
Cigna Healthcare adjusted revenue increased 9% to $11.73 billion, primarily reflecting premium increases intended to cover expected medical-cost inflation.
Adjusted pre-tax operating income for Cigna Healthcare increased 17% to approximately $1.28 billion from $1.09 billion, primarily because of improved margins in the U.S. Employer business. Its adjusted pre-tax operating margin expanded to 10.9% from 10.2%.
Cigna Healthcare’s medical care ratio increased to 84.5% from 83.2%. The company attributed the comparison primarily to higher Affordable Care Act risk-adjustment benefits recorded in the prior-year quarter within its Individual and Family Plans business.
Medical membership increased 2% from the end of 2025 to approximately 18.4 million, reflecting growth in the Middle and Select markets, partly offset by lower National Accounts membership.
Cigna previously announced plans to exit the Individual and Family Plans medical business as of January 1, 2027.
The company also improved its operating efficiency. Its adjusted selling, general, and administrative expense ratio declined to 4.6% from 4.9%.
Based on its second-quarter performance, Cigna raised its full-year 2026 adjusted earnings outlook by $0.10 to at least $30.45 per share.
The company maintained its Evernorth adjusted pre-tax operating income forecast of at least $6.9 billion. It increased the Cigna Healthcare forecast by $25 million to at least $4.55 billion.
The limited change to Evernorth’s outlook suggests that management remains cautious about the extent to which continued specialty growth can offset pressure within Pharmacy Benefit Services during the remainder of the year.
The quarter highlights the increasingly important role of specialty pharmaceuticals, generic medicines, biosimilars, and care services within Cigna’s earnings mix. Specialty and Care Services now generates the majority of Evernorth’s operating income despite remaining smaller than Pharmacy Benefit Services by revenue.
KEY QUOTES:
“By harnessing technology, data and AI to deliver more personalized experiences, improve access and lower costs, we are creating greater value every day. Our strong second quarter results reflect continued progress against these priorities and demonstrate the effectiveness of our strategy and execution.”
Brian C. Evanko, President And Chief Executive Officer Of The Cigna Group
