New York, Feb 4, 2026, 18:12 EST — After-hours
- Shares of UnitedHealth dropped roughly 3% Wednesday, slipping to $275.92 in after-hours trading.
- FTC’s insulin-case settlement with Cigna’s Express Scripts ramps up pressure on OptumRx and CVS Caremark
- Traders are focused on an FTC oral argument set for Feb. 5 and a House hearing on drug prices scheduled for Feb. 11
Shares of UnitedHealth Group Incorporated (UNH) dropped roughly 3% on Wednesday, slipping to a session low of $274.04. In after-hours trading, the stock was last down 2.9%, trading at $275.92.
This move carries weight since UnitedHealth’s Optum unit houses OptumRx, a top U.S. pharmacy benefit manager. PBMs act as middlemen between drugmakers, insurers, and pharmacies, determining which drugs are covered and at what price — frequently collecting fees, rebates, or payments linked to these choices from drugmakers.
On Wednesday, the Federal Trade Commission announced a 10-year settlement with Cigna’s Express Scripts over insulin pricing. The deal limits rebate practices linked to drug list prices and requires greater transparency for employers. The FTC is still targeting UnitedHealth’s Optum and CVS Health’s CVS Caremark. FTC chair Andrew Ferguson called the settlement a move to end “rebate games,” while CVS said it is “engaging in good-faith negotiations” with regulators. Express Scripts emphasized its “priority is simple: lowering drug costs for Americans.” UnitedHealth did not immediately reply to a request for comment. 1
The stock’s decline bucked the trend in healthcare, where the Health Care Select Sector SPDR Fund gained roughly 1.2% on the day. The S&P 500 dropped 0.5%, while the Dow closed in positive territory, per market data. 2
Shares of managed-care and pharmacy-benefit firms showed varied moves. CVS dropped roughly 2.1%, Cigna slid 1.3%, Humana edged down 0.5%, and Elevance Health rose 0.6%.
The FTC’s move adds fresh uncertainty to OptumRx’s financial outlook. Investors are weighing if UnitedHealth can negotiate terms that soften the blow to fees and margins, or if the regulator will demand structural changes like those forced on Express Scripts.
Capitol Hill is gearing up for increased scrutiny. On Feb. 11, a House Energy and Commerce health subcommittee will hold a hearing focused on the “root drivers” behind prescription drug costs. Executives from across the supply chain, including representatives from the PBM trade group, have been invited, according to The Washington Post. 3
Regulators are turning up the heat just as the insurer deals with fallout from last week’s Medicare Advantage rate shock. U.S. officials suggested a nearly flat hike in 2027 plan payments, sending UnitedHealth shares tumbling. Medicare Advantage, a government-backed private plan for seniors, remains a vital profit source for major insurers. 4
Still, the stock’s direction depends on details investors haven’t seen yet. A settlement might come with less severe terms than expected or drag out, fueling more headlines. Either scenario threatens a business model already strained by political pressure over rebates and pharmacy fees.
Traders are focused on the FTC oral argument set for Feb. 5 in the insulin case, which was pushed back by an earlier commission order. Any hint of negotiations with OptumRx—or a showdown—could influence UnitedHealth shares heading into Thursday. 5
