New York, February 5, 2026, 11:03 EST — Regular session
- CI edges higher as investors digest quarterly earnings and a revised 2026 outlook
- Biggest swings keep coming from medical-cost trends and pharmacy-benefit reform
- Express Scripts’ insulin agreement with the FTC intensifies focus on PBM practices
The Cigna Group’s shares (CI) jumped about 3.2% to $280.46 in late morning trading Thursday after it unveiled quarterly results and its 2026 outlook. UnitedHealth slipped nearly 1.6%, CVS Health rose close to 2.2%, and Elevance slipped around 0.7%. CI stock traded in a range from $270.00 up to $283.59.
This matters now because even small shifts in medical expenses can quickly hit profits for managed-care companies. Investors are losing patience with any hints of cost increases ahead of 2026.
Cigna is also caught up in the drug-pricing fight through its subsidiaries Express Scripts and Evernorth. Pharmacy benefit managers, or PBMs, act as middlemen, negotiating drug prices and coverage terms for employers and health plans.
Cigna posted adjusted Q4 earnings of $8.08 per share, beating the $7.88 analysts anticipated. Revenue in Evernorth’s pharmacy benefit business surged 20% to $36.3 billion. Yet, the 2026 guidance—adjusted EPS of at least $30.25 and revenue around $280 billion—came in below LSEG’s estimates. The medical loss ratio rose to 88%. CFO Ann Dennison called the outlook “appropriate prudence” in an “elevated cost environment.” Oppenheimer’s Michael Wiederhorn said the Evernorth segment “appears to be on-track.” 1
Regulatory pressure landed squarely on Express Scripts. The company agreed to a 10-year settlement with the U.S. Federal Trade Commission over insulin pricing claims. The FTC estimates the deal could slash costs for patients by as much as $7 billion over the decade. Meanwhile, the agency continues legal actions against UnitedHealth’s Optum and CVS Caremark. As part of the pact, Express Scripts will curb rebate tactics tied to drug list prices and move its Switzerland-based rebate handler, Ascent Health Services, stateside, under the watch of an independent monitor for three years. FTC Chair Andrew Ferguson described the move as ending “convoluted rebate games,” while Express Scripts stressed its “priority is simple: lowering drug costs for Americans.” 2
That upside carries risks. Should medical usage stay high, insurers might face bigger-than-expected claims payouts. Typically, those losses don’t weigh on current earnings but show up later in higher premiums.
Traders are zeroing in on signs about cost trends and how quickly Cigna’s pharmacy model changes appear in renewals. Just as important is whether regulators step in to curb the biggest PBMs, which could restrict the sector’s maneuvering room.
A filing showed Cigna’s board raised the quarterly dividend to $1.56 per share, up from $1.51. CEO David Cordani said, “In 2025, we expanded access and support, lowered costs, and improved transparency.” The new dividend will be paid March 19 to shareholders of record as of March 5’s close of trading.
