On November 5, 2026, Cigna Group raised its 2026 full-year adjusted operating income guidance to at least $30.60 per share after beating Wall Street's third-quarter earnings estimates. Growth in Cigna Healthcare and specialty pharmacy earnings helped offset margin pressure at Express Scripts, which faces heavy investment costs as it transitions to its transparent Signature pharmacy benefit model before 2028.
Full-year guidance and future outlook
- ▪Cigna Group reiterated its target of at least 10% adjusted earnings per share growth in 2027, despite expecting financial pressure from market exits and lower drug rebates
- ▪On November 5, 2026, Cigna Group raised its 2026 full-year adjusted operating income guidance to at least $30.60 per share from its previous forecast of at least $30.45 per share
Q3 2026 financial results and market reaction
- ▪For Q3 2026, Cigna Group reported adjusted revenue of $73.79 billion and adjusted earnings of $7.98 per share, topping Wall Street consensus estimates
- ▪Shares of Cigna Group increased by 3% on November 5, 2026 after the company posted its third-quarter financial results
Cigna Healthcare unit performance and coverage
- ▪Cigna Group reported a Q3 2026 medical loss ratio of 85%, rising from 84.8% in Q3 2025 due to shifts in its U.S. employer-sponsored health plans
- ▪Cigna Healthcare, Cigna Group's health insurance unit covering 18.5 million people, generated Q3 2026 adjusted operating income of $1.2 billion, up 15% year-over-year
Evernorth and specialty pharmacy performance
- ▪Cigna Group Chief Executive Officer Brian Evanko stated that the penetration rate for the blood cancer drug Revlimid reached approximately 90% in Q3 2026
- ▪Cigna Group's specialty pharmacy division earnings increased 15% year-over-year in Q3 2026, driven by stronger adoption of cheaper biosimilar and specialty generic drugs
- ▪Cigna Group's Evernorth Health Services division posted Q3 2026 adjusted revenue of $63.77 billion, an increase of about 6% year-over-year
Express Scripts operations and regulatory response
- ▪Cigna Group Chief Executive Officer Brian Evanko described a U.S. Department of Labor PBM transparency rule as redundant and unlikely to reduce drug spending
- ▪Cigna Group's Express Scripts pharmacy benefit manager reported a 22% year-over-year decline in Q3 2026 adjusted operating income amid transition costs
- ▪Express Scripts is implementing a transparent pharmacy benefit model called Signature ahead of its 2028 client availability to meet regulatory and client demands
Shift from government plans
- ▪Cigna Group confirmed it will exit Affordable Care Act individual exchanges at the end of 2026, following its prior exit from the Medicare Advantage market
- ▪Cigna Group reduced exposure to high-cost government-backed health plans as it shifted focus toward its traditional employer-sponsored healthcare business and pharmacy benefits management unit
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